Capturing attention to brake lamps

Rear-end collisions and distraction are major concerns and basic research in cognitive psychology concerning attention in visual search is applicable to these problems. It is proposed that using yellow tail lamps will result in faster reaction times and fewer errors than current tail lamp coloring (red) in detecting brake lamps (red) in a "worst case" scenario where brake lamp onset, lamp intensity and temporal and contextual cues are not available. Participants engaged in a visual search for brake lamps in two conditions, one using red tail lamps with red brake lamps and one with the proposed combination of yellow tail lamps with red brake lamps in which they indicated by keyboard response the presence or absence of braking cars. The hypothesis that separating brake and tail lamps by color alone would produce faster RTs, reduce errors, and provide greater conspicuity was supported. Drivers and non-drivers detect absence and presence of red brake lamps faster and with greater accuracy with the proposed yellow tail lamps than red tail lamps without the aid of any of the aforementioned cues. Vehicle conspicuity will be improved and reductions in rear-end collisions and other accidents will be reduced by implementing the proposed yellow tail lamp coloring.

Visual attention and self-regulation of driving among older adults

BACKGROUND

With the number of older drivers increasing, self-regulation of driving has been proposed as a viable means of balancing the autonomy of older adults against the sometimes competing demand of public safety. In this study, we investigate self-regulation of driving among a group of older adults with varying functional abilities.

METHOD

Participants in the study comprised 1,543 drivers aged 75 years or older. They completed an objective measure of visual attention from which crash risk was estimated, and self-report measures of driving avoidance, driving exposure, physical functioning, general health status, and vision. Crash records were obtained from the State Department of Public Safety.

RESULTS

Overall, participants were most likely to avoid driving in bad weather followed by driving at night, driving on high traffic roads, driving in unfamiliar areas, and making left-hand turns across oncoming traffic. With the exception of driving at night, drivers at higher risk of crashes generally reported greater avoidance of these driving situations than lower risk drivers. However, across all driving situations a significant proportion of higher risk drivers did not restrict their driving. In general, self-regulation of driving did not result in reduced social engagement.

CONCLUSION

Some older drivers with visual attention impairments do not restrict their driving in difficult situations. There is a need for physicians and family members to discuss driving behaviors with older adults routinely to ensure their safety. The association between visual attention and driving restriction also has implications for interventions aimed at preserving mobility in the elderly.

Psychobiology of posttraumatic stress disorder in pediatric injury patients: A review of the literature

Research suggests that about a quarter to a third of children with traffic-related injuries develop posttraumatic stress disorder (PTSD). Early symptoms of PTSD have been found to predict poor mental and physical outcome in studies of medically injured children. However, these symptoms are rarely recognized by physicians who provide emergency care for these children. In addition, there is insufficient knowledge about predictors of posttraumatic stress symptoms in this specific pediatric population. Early identification of those children at particular risk is needed to target preventive interventions appropriately. After some introducing remarks on the classification and the nature of posttraumatic stress reactions, current research findings on psychological and biological correlates of PTSD in pediatric injury patients are presented. The particular focus in this paper is on the neurobiological mechanisms that influence psychological responses to extreme stress and the development of PTSD. Continued study of the psychobiology of trauma and PTSD in pediatric injury patients, both in terms of neurobiology and treatment is needed.

Decision making and personality in traffic offenders: a study of Israeli drivers

Traffic offences present danger to the offender, and to others. This study examines differences in decision making and personality between traffic offenders and non-offenders. Fifty-one traffic offenders participating in penalty courses were compared to a control group of 36 drivers who were not penalized for traffic offences in the 5 years prior to the study. All participants performed the Iowa Gambling Task (IGT), a popular decision task employed for assessing cognitive impulsivity, and completed the "big five" personality questionnaire. The results showed that traffic offenders made fewer advantageous choices on the IGT; and an analysis with a formal cognitive model, the Expectancy Valance model, suggests that this results from offenders' high weighting of gains compared to losses. An examination of personality factors reveals that traffic offenders were more extraverted. The predictive power of IGT performance was comparable to that of the personality factor. These results demonstrate that the IGT can be useful for studying individual differences in risk taking in a real-world task, and combined with the EV model, identify the sources of these differences.

The impact of event scale-revised: psychometric properties in a sample of motor vehicle accident survivors

This study examined the factor structure, internal consistency, concurrent validity, and discriminative validity of the Impact of Event Scale-Revised (IES-R, [Weiss, D. S. & Marmar, C. R. (1997). The Impact of Event Scale-Revised. In: J. P. Wilson & T. M. Keane (Eds.). Assessing psychological trauma and PTSD (pp. 399-411). New York: Guilford Press]) in a sample of 182 individuals who had experienced a serious motor vehicle accident. Results supported the three-factor structure of the IES-R, Intrusion, Avoidance, and Hyperarousal, with adequate internal consistency noted for each subscale. Support was obtained for the concurrent and discriminative validity, as well as the absence of social desirability effects. Although some differences were noted between the IES-R Avoidance subscale and diagnostically based measures of this cluster of symptoms, these differences do not necessarily signify measurement problems with the IES-R. The IES-R seems to be a solid measure of post-trauma phenomena that can augment related assessment approaches in clinical and research settings.

Factors associated with agreement between experts in evidence about psychiatric injury

Psychiatrists and psychologists acting as expert witnesses in court cases are often accused of bias or error. We examined the level of agreement and factors influencing agreement between expert reports admitted into evidence during adversarial civil proceedings. The inter-rater reliability of the psychiatric diagnosis was examined in 51 pairs of civil medicolegal reports written by experts engaged by the same side and 97 pairs of experts engaged by opposite sides. Reports written by experts engaged by the same adversarial side had good agreement about the presence of a mental disorder (kappa = .74) but had only fair agreement about the specific psychiatric diagnosis (average kappa = .31). Reports written by experts engaged by opposing adversarial sides had poor agreement about the presence of any mental disorder and also the specific psychiatric diagnosis. Experts were more likely to agree about the presence of a mental disorder if the plaintiff was involved in a fatal accident. The agreement of treating doctors and experts was similar to that of pairs of experts.

Application of the theory of planned behaviour to the prediction of objectively assessed breaking of posted speed limits

In two studies the Theory of Planned Behaviour (TPB) including moral norms, anticipated regret and past behaviour was applied to predicting intention to exceed the posted speed limit across different roads and objectively assessed speeding behaviour. All measures except behaviour were taken by self-report questionnaires referring to different driving scenarios. The behaviour measures were based on performance in a simulator (Study 1) or unobtrusive on-road speed camera assessment taken without driver awareness (Study 2) across roads with varying posted speed limits. Results are reported averaged across road types in both studies. In Study 1 (N=83), 82% of the variance in intentions to speed was explained, with attitudes, subjective norms, perceived behavioural control (PBC), moral norms, anticipated regret and past behaviour being significant predictors. A total of 35% of the variance in speed as assessed on a driving simulator was accounted for with intentions, PBC, moral norms and previous accidents being significant predictors. In Study 2 (N=303), 76% of the variance in intentions to speed was explained with attitudes, moral norms, anticipated regret and past behaviour being significant predictors. A total of 17% of the variance in speed as assessed on-road was accounted for with intentions and moral norms being significant. Practical implications of the findings for road safety are discussed.

Residents' evaluation of urban environments: attraction of urban life and anxiety associated with traffic accidents and urban crimes

The results of questionnaire and interview surveys conducted in Mitaka and Musashino cities are presented for investigating of residents' evaluation of their urban environment, particularly regarding its attractiveness. A special attention was paid to residents' evaluation with regard to anxiety associated with traffic accidents and urban crimes. The urban infrastructure and residents' responses were examined using a Geographic Information System (GIS). Attractiveness associated with the urban environment was classified into two categories: "attractiveness in daily life" and "attractiveness in non-daily life." The residents valued opportunities for relaxing and living in comfort. In non-daily life, the residents specifically valued improved living conditions and harmony between the natural environment and commercial facilities. They attributed crime anxiety to trees, narrow streets, obstructed views, dark areas and a gloomy atmosphere. Residents regarded violent crimes as being prevalent, but considered trespassing and property crimes infrequent. The residents' anxiety about traffic accidents was caused by reckless driving habits, narrow streets, lack of separation between roadway and pedestrians' ways, heavy traffic, and obstructed views. Residents cited main roads and intersections as locations of anxiety, which concurred with frequent accidents.

Drivers involved in road traffic accidents in Piedmont Region: psychoactive substances consumption

INTRODUCTION

The role played by psychoactive substances in road safety has become object of increasing interest: these substances can reduce driving performance and increase accidents risk. Aims of the study are to establish the dimension of the problem and to describe the characteristics of people involved in accidents under psychoactive substance effects.

METHODS

Target population consists of people from 18 to 60-years-old involved in accidents afferent in Emergency Rooms. Subjects were interviewed by surveyors and a urines was collected for psychoactive substances screening.

RESULTS

In 18.5% of people we found substance consumption. Cocaine was the most frequently detected substance (9.5%), then benzodiazepines (7.5%), methadone, morphine and marijuana (THC) (3.5%). In 5.5% of subjects more than one substance was found. Considering only illegal substances detected, female have a higher risk to be consumers (OR = 1.36) and the young age (18-35 years) seems to be at higher prevalence and risk for substance use (OR = 1.86).

DISCUSSION

Considering all psychoactive substances detected, clearly the problem about substances consumption and driving is not restricted to youngest but involves all age groups.

CONCLUSIONS

In order to decrease the number of accidents due to substance use, new prevention programmes able to involve also middle age groups should be planned.

Cell phone users, reported crash risk, unsafe driving behaviors and dispositions: a survey of motorists in Maryland

INTRODUCTION

The purpose of this investigation was to identify risky driving behaviors and dispositions that distinguish drivers who use a cell phone while operating a motor vehicle from non-cell phone using drivers.

METHOD

Annual telephone surveys were used to identify drivers who reported using a cell phone while driving in the last month (n=1803) and were compared to those who said they did not use cell phones while driving (n=1578).

RESULTS

Cell phone using drivers were more likely to report driving while drowsy, going 20 mph over the speed limit, driving aggressively, running a stop sign or red light, and driving after having had several drinks. They were also more likely to have had a prior history of citation and crash involvement than non-cell phone using drivers. Cell phone using drivers also reported they were less careful and more in a hurry when they drive than non-cell phone using drivers.

CONCLUSION

Cell phone using drivers report engaging in many behaviors that place them at risk for a traffic crash, independent of the specific driving impairments that cell phone usage may produce. Strategies that combine coordinated and sustained enforcement activities along with widespread public awareness campaigns hold promise as effective countermeasures for these drivers, who resemble aggressive drivers in many respects.

Predictors of fitness to drive in people with Parkinson disease

OBJECTIVE

To develop an efficient clinical screening battery to accurately predict the fitness to drive in people with Parkinson disease (PD).

METHODS

This prospective study included 80 participants: 40 patients with PD and 40 healthy age- and sex-matched control subjects. All participants were assessed using a driving simulator, a driving history survey, and the Clinical Dementia Rating. The patients with PD also underwent a clinical test battery and an evaluation of fitness to drive performed by an official center, which included visual, cognitive, and on-road tests. A two-class decision from this driving assessment center was the main outcome measure.

RESULTS

A screening battery assessing four clinical variables (disease duration, contrast sensitivity, Clinical Dementia Rating, and motor part of the Unified Parkinson's Disease Rating Scale) provided the best model (R(2) = 0.52) to predict the fitness to drive and correctly classified 36 (90%) of the patients with PD as pass or fail (sensitivity = 91%, specificity = 90%). The Test Ride for Investigating Practical fitness to drive (TRIP) driving simulator score discriminated significantly between drivers with PD and their healthy peers (p = 0.0008). When the TRIP driving simulator score was added to the clinical model, the total explained variance increased (R(2) = 0.60) and correctly classified 39 (97.5%) of drivers with PD into the pass/fail category (sensitivity = 91%, specificity = 100%).

CONCLUSIONS

A short clinical screening battery that measures disease duration, contrast sensitivity, cognitive and motor functions can predict fitness to drive in people with Parkinson disease with a high degree of accuracy.

Road rage and collision involvement

OBJECTIVES

To assess the contribution of road rage victimization and perpetration to collision involvement.

METHODS

The relationship between self-reported collision involvement and road rage victimization and perpetration was examined, based on telephone interviews with a representative sample of 4897 Ontario adult drivers interviewed between 2002 and 2004.

RESULTS

Perpetrators and victims of both any road rage and serious road rage had a significantly higher risk of collision involvement than did those without road rage experience.

CONCLUSIONS

This study provides epidemiological evidence that both victims and perpetrators of road rage experience increased collision risk. More detailed studies of the contribution of road rage to traffic crashes are needed.

Age-related differences in street-crossing decisions: the effects of vehicle speed and time constraints on gap selection in an estimation task

Two experiments were conducted to study how age affects street-crossing decisions in an estimation task, with particular emphasis on how oncoming vehicle speed and a time constraint influence the time gap deemed acceptable for crossing. Experiment 1 showed that when there was a time constraint, all age groups selected a shorter time gap for the higher speed. This was associated with a large number of missed opportunities for the low speed and many unsafe decisions for the high speed. In the second experiment, which had no time constraint, young pedestrians operated in a constant-time mode regardless of speed, whereas older pedestrians accepted shorter and shorter time gaps as speed increased. The results seem to indicate that the effect of speed is due to a mixed operating mode of participants, whose decisions may be based on either time or vehicle distance, depending on the task requirements and on the participant's own ability to meet those requirements.

The social accident: a theoretical model and a research agenda for studying the influence of social and cultural characteristics on motor vehicle accidents

The paper develops a sociological model to explain collisions between two drivers or more. The "Social Accident" model presented here integrates empirical findings from prior studies and extant sociological theories. Sociological theory posits that social groups have unique cultural characteristics, which include a distinctive world view and ways of operating that influence its members. These cultural characteristics may cause drivers in different groups to interpret a given situation differently; therefore, they will make conflicting decisions that may possibly lead to road accidents. The proposed model may contribute to an understanding of the social mechanism related to interactions and communication among drivers by presenting new directions for understanding accidents and collisions. The paper concludes with suggestions for future research that will employ the model to assess its predictive and practical utility.

Task-induced fatigue and collisions in adult drivers with attention deficit hyperactivity disorder

OBJECTIVE

This study compares collision involvement between adult drivers with attention deficit hyperactivity disorder (ADHD) and control participants in a simulation experiment designed to enhance the effects of fatigue. Because the effects of ADHD include difficulties in maintaining attention, drivers with ADHD were hypothesized to be more susceptible to the effects of fatigue while driving.

METHODS

Data are drawn from a validated driving simulation study, portions of which were focused on enhancing the effects of fatigue. The simulator data are supplemented with written questionnaire data. Drivers with ADHD were compared with controls.

RESULTS

The self-report data indicated that drivers with ADHD were more likely to report having been involved in an accident within the previous five years. Simulation data showed that time of day of participation in the experiment were significantly related to likelihood of collision, and that these effects were further exacerbated by ADHD status. Participants with ADHD were more likely than controls to be involved in a crash in the simulator regardless of time of day, but the effects were particularly pronounced in the morning, and the rate of increase in accident involvement from the late afternoon into the evening was greater among participants with ADHD. No differences in self-reported sleep patterns or caffeine use were found between participants with ADHD and controls.

CONCLUSIONS

The results suggest that drivers with ADHD became fatigued more quickly than controls. Such drivers thus face greater risk of involvement in accidents on highways or open roadways where the visual and task monotony of the environment contribute to greater driver fatigue.

Minimal hepatic encephalopathy: a vehicle for accidents and traffic violations

OBJECTIVES

MHE patients have impairment on driving tests. However, it is unclear whether this impairment is restricted to the testing environment or is associated with increased traffic violations and/or motor vehicle accidents.

METHODS

An anonymous driving history and driving behavior questionnaire (DBQ: self-scored, best score 104), coded according to MHE status, was sent to 200 cirrhotics without overt hepatic encephalopathy and 100 age/education-matched controls. The questionnaire inquired about demographics, alcohol/illegal drug use, and violations/accidents within 1 and 5 yr. The cirrhotics had been divided into those with MHE (MHE+), without MHE (MHE-), and those not tested for MHE because of psychoactive drug use, on a previous study.

RESULTS

Cirrhotics versus controls had similar driving duration, alcohol/illegal drug use but significantly higher percentage with violations within both 1 and 5 yr (25%vs 4%[5 yr]), 13%vs 2%[(1 yr]), accidents (17%vs 4%[5 yr]), 9%vs 1%[1 yr]), and both (34%vs 7%[5 yr], 18%vs 3%[1 yr]). MHE+ cirrhotics had significantly higher percentage with violations (36%[5 yr], 21%[1 yr]), accidents (33%[5 yr]), 17%[1 yr]), and both (53%[5 yr], 33%[1 yr]) versus other cirrhotics. DBQ score was significantly lower in cirrhotics than controls (92 vs 99). Within cirrhotics, DBQ score was highest in MHE-versus other groups. MHE+ status was the only risk factor (odds ratios: 4.2-7.6) for violations and for accidents on multivariate logistic regression.

CONCLUSIONS

Cirrhotics have a higher self-reported occurrence of violations and accidents compared to controls. MHE+ a is strong predictor for violations and accidents. Prospective studies investigating the effect of MHE treatment on violations and accidents are warranted.

Elevated morning serum interleukin (IL)-6 or evening salivary cortisol concentrations predict posttraumatic stress disorder in children and adolescents six months after a motor vehicle accident

BACKGROUND

This study examined prospectively the activity of the hypothalamic-pituitary-adrenal axis, the sympathetic nervous system and inflammatory factors in children shortly after a motor vehicle accident (MVA) in relation to later posttraumatic stress disorder (PTSD) development.

PATIENTS AND METHODS

Fifty six children, aged 7-18, were studied after an MVA and 1 and 6 months later; 40 subjects served as controls. Morning serum cortisol and interleukin (IL)-6 and plasma catecholamine concentrations were measured within 24h after the event. Salivary cortisol was measured 5 times at defined time points during the same day. PTSD diagnoses 1 and 6 months later were based on K-SADS interview.

RESULTS

Morning serum IL-6 concentrations, measured within the first 24h after the accident, were higher in children that developed PTSD 6 months later than those who did not and those of the control group. Longitudinal IL-6 measurements revealed normalization of IL-6 in the PTSD group, while no differences between the three groups were detected 1 and 6 months later. Evening salivary cortisol and morning serum IL-6 after the accident were positively inter-related (r=0.54, p<0.001) and in separate regression analyses both predicted PTSD development 6 months later. In contrast, morning serum IL-6 did nor correlate with morning serum or salivary cortisol concentrations.

CONCLUSIONS

Immediate posttraumatic alterations in neuroendocrine or inflammatory factors-increased evening salivary cortisol and/or increased morning serum IL-6 concentrations-are involved in subsequent PTSD development in children and adolescents.

Suicidal behavior by motor vehicle collision

BACKGROUND

The ability for suicides of drivers to be disguised as traffic accidents raises the possibility that suicidal behaviors of this nature are far more prevalent than previously thought, potentially impacting health, road safety, and insurance companies.

METHOD

Persons residing at the Gold Coast, Australia, identified as having a history of suicidal ideation and behaviors (n = 1,196), were sent a mail-out survey after their consent was obtained in initial telephone contact (CATI random digit-dialing). Among those responding, 412 had made suicide plans or arrangements and 228 suicide attempts.

RESULTS

Of those who reported planning a suicide, 14.8% (19.1% of male planners and 11.8% of female planners) had conceived to have a motor vehicle "accident" (n = 61). Of all attempters, 8.3% (13.3% of male attempters) had previously attempted via motor vehicle collision (n = 19). All attempters reported having emotional or mental problems at the time of the event. Suicide planners were significantly more likely to be in full-time employment and have a partner and children compared with other planners.

CONCLUSION

The study gives a rare insight into driver suicide plans and attempts, via a large-scale community survey, to provide the best opportunity of collecting unbiased data on the driver suicide behavior. Results suggest the use of this method, particularly in attempts made by males, may be underreported leading to inaccuracy of statistics. The motives behind choosing this method are somewhat different to those behind other methods, including financial benefits and eliminating stigma in the aftermath of a suicide.

Driving after use of alcohol and marijuana in college students

Driving after use of marijuana is almost as common as driving after use of alcohol in youth (P. M. O'Malley & L. D. Johnston, 2003). The authors compared college students' attitudes, normative beliefs and perceived negative consequences of driving after use of either alcohol or marijuana and tested these cognitive factors as risk factors for substance-related driving. Results indicated that youth perceived driving after marijuana use as more acceptable to peers and the negative consequences as less likely than driving after alcohol use, even after controlling for substance use. Results of zero-inflated Poisson regression analyses indicated that lower perceived dangerousness and greater perceived peer acceptance were associated with increased engagement in, and frequency of, driving after use of either substance. Lower perceived likelihood of negative consequences was associated with increased frequency for those who engage in substance-related driving. These results provide a basis for comparing how youth perceive driving after use of alcohol and marijuana, as well as similarities in the risk factors for driving after use of these substances.

Driving with minimal hepatic encephalopathy: real world consequences?

Mounting evidence suggests that minimal hepatic encephalopathy of cirrhosis may compromise driving performance. A study now reveals that patients with minimal hepatic encephalopathy had a greater self-reported frequency of motor vehicle accidents and traffic violations. There are still numerous issues to be resolved before this increasingly recognized variant of hepatic encephalopathy can be firmly linked to hazardous driving. Minimal hepatic encephalopathy affects a substantial proportion of patients with otherwise well-compensated cirrhosis, and because therapies are effective in reversing this type of encephalopathy, its role in motor vehicle accidents deserves further attention.

Demographic and clinical characteristics of motor vehicle accident victims in the community general health outpatient clinic: a comparison of PTSD and non-PTSD subjects

Motor vehicle accidents (MVAs) are the leading cause of posttraumatic stress disorder (PTSD) in the general population, often with enduring symptomatology. This study details epidemiological and clinical features that characterize PTSD among MVA victims living in a nonhospitalized community setting long after the MVA event, and includes exploration of premorbid and peritraumatic factors. MVA victims (n=60; 23 males, 37 females) identified from the registry of a community general health outpatient clinic during a 7-year period were administered an extensive structured battery of epidemiological, diagnostic and clinical ratings. Results indicated that 30 subjects (50%; 12 males, 18 females) had MVA-related PTSD (MVAR-PTSD). Among those with PTSD, 16 individuals exhibited PTSD in partial remission, and six, in full remission. There were no significant demographic or occupational function differences between PTSD and non-PTSD groups. The most common comorbid conditions with MVAR-PTSD were social phobia (20%), generalized anxiety disorder (7.8%) and obsessive-compulsive disorder (0.5%). Previous MVA's were not predictive of PTSD. Subjects with MVAR-PTSD scored worse on the Clinician-Administered Posttraumatic Stress Disorder Scale, Part 2 (CAPS-2), Impact of Event Scale, Hamilton Depression Rating Scale, Hamilton Anxiety Rating Scale, Impulsivity Scale, and Toronto Alexithymia Rating Scale. Study observations indicate a relatively high rate of PTSD following an MVA in a community-based sample. The relatively high rate of partially remitted MVAR-PTSD (N=16) underscores the importance of subsyndromal forms of illness. Alexithymia may be an adaptive method of coping with event stress. The development of PTSD appears not to be associated with the severity of MVA-related physical injury.

Emergency department screening for risk for post-traumatic stress disorder among injured children

OBJECTIVE

To discuss the successes and challenges associated with the implementation of a post-traumatic stress disorder (PTSD) screening tool in two pediatric emergency departments (ED).

METHODS

The STEPP screening tool has been developed previously on an inpatient population of motor vehicle trauma patients. It was applied here to the general ED population at two different pediatric trauma centers. Nurse screeners were trained and a convenience sample of patients with unintentional injuries who met study criteria were screened in the ED. Feedback from nurse screeners was obtained.

RESULTS

The process of implementing a screening tool to identify patients and their families significantly at risk for PTSD symptomatology presented some barriers, but overall acceptability of the process was high for both the emergency department staff and the patient. Recommendations for others considering implementation of screening programs in the ED are offered.

CONCLUSIONS

Future research using screening protocols in the ED should, in their design, attempt to capitalize on the successes identified in the current protocol and circumvent barriers also encountered.

Feasibility and effectiveness of cognitive-behavioral therapy for posttraumatic stress disorder in preschool children: two case reports

New evidence raises concerns that posttraumatic stress disorder (PTSD) in preschool children is unremitting over years even with unstructured community treatment. This report presents proof of concept of the feasibility and effectiveness of a structured therapy, cognitive-behavioral therapy (CBT), for preschool PTSD that follows a range of different traumatic events. Two cases are presented, including transcribed dialogue, from a motor vehicle accident and Hurricane Katrina, respectively. Three key CBT feasibility questions were examined; it was concluded that (a) young children can cooperate meaningfully in structured, trauma-related exposure exercises; (b) they can utilize relaxation techniques successfully; and (c) highly anxious parents do not inhibit their children's improvement per se as long as they can facilitate the manual techniques. Clinicians need to be aware of emerging evidence-based treatment for preschool children.

Level of neurotic disorders among drivers causing traffic accidents

Different aspects of driver personality may affect traffic safety. Extended driver reaction time causes deceleration of the reflexes, which is a major cause of traffic accidents. Cornell index was used in 30 drivers responsible for traffic accidents, with the aim to measure their level of neurotic disorder and compare them with results of controls (drivers not responsible for traffic accidents). Reaction time was maesured and compared among subjects with normal results of Cornell test and those with pathological findings. Drivers causing traffic accidents showed significantly higher Cornell index scores than drivers not responsible for traffic accidents. Drivers with pathological results of Cornell index showed a significantly longer reaction time.

Misunderstanding of right-of-way rules at various pedestrian crossing types: observational study and survey

Misunderstanding of right-of-way rules may contribute to pedestrian trauma, especially at crossings where pedestrian and traffic signals appear to give contradictory messages. Two thousand eight hundred and fifty-four pedestrians were observed crossing at signal-controlled intersections to compare attention to traffic for different combinations of pedestrian and traffic signals. In addition, a survey was conducted at signal-controlled intersections and nearby car parks in metropolitan and rural areas. Five hundred and seventy-four participants took the role of pedestrian or driver when responding to questions regarding beliefs about pedestrian right-of-way for a range of situations at signal-controlled crossings, zebra crossings, and unmarked sections of road (specifically: alone, with pedestrian refuge, or paved). Results suggest that at signal-controlled crossings pedestrian right-of-way is erroneously thought to be influenced by the pedestrian signal. Many respondents thought that a pedestrian refuge or paving gave a pedestrian right-of-way at an otherwise unmarked section of road. In many situations more than 20% of both drivers and pedestrians reported that they would take right-of-way. Pedestrian crossing types should be rationalised, and education should be provided regarding rules and responsibilities at available crossings.