Examining the effects of fatal vision goggles on changing attitudes and behaviors related to drinking and driving

Assessing the effectiveness of psychoeducational interventions on driving behavior: A systematic review and meta-analysis

This review aimed to quantitatively summarize the evidence concerning the effectiveness of psychoeducational interventions on driving behavior. A final pool of 138 studies, totaling approximately 97,000 participants, was included in the analyses and covered all types of driving behavior targeted by the interventions. Using a random effects model, significant results were found for almost all driving outcomes, both post-intervention and long-term. The strongest effect was for reducing distracted driving at post-intervention (d = 1.87 [1.12, 2.60], Z = 4.94, p < 0.001). The only non-significant effects were for reducing errors in the long term (d = 0.50 [-0.87, 1.86], Z = 0.71, p = 0.48) and driving under the influence at post-intervention (d = 0.35 [0.00, 0.71], Z = 1.96, p = 0.05). Concerning which type of intervention was more effective, feedback, training and motivational ones appear to work best. Educational interventions show only weak effects, while awareness interventions seem mostly ineffective. Overall, our results show that most interventions can reduce different types of driving behaviors, but there are specific aspects to be considered based on the targeted behavior.

Predicting drunk driving using a variant of the implicit association test

INTRODUCTION

Drunk driving is one of the primary causes of road traffic injuries and fatalities. A possible approach to reduce drunk driving rates is to identify which individuals are at risk of such behavior and establish targeted prevention. Simply asking individuals about drunk driving in real-world contexts would be problematic because of potential deception. The use of implicit measures such as the Implicit Association Test (IAT) could overcome this problem because they are less controllable than self-reports and thus less susceptible to deception. However, previous studies have shown poor predictive utility of implicit measures for drunk driving behavior. The current studies aimed to test the predictive utility of a variant of the IAT designed to assess beliefs about past driving under the influence (the P-DUI-IAT).

METHOD

Study 1 (N = 216) tested whether the P-DUI-IAT could predict self-reported prior drunk driving and future likelihood of drunk driving. We also examined incremental predictive validity of the P-DUI-IAT for these outcomes. Study 2 (N = 159) examined whether results from Study 1 were reproducible.

RESULTS

In both studies, results showed that the P-DUI-IAT discriminated well between participants who had engaged in drunk driving and participants who had not. The P-DUI-IAT also showed independent and incremental predictive validity for past drunk driving and future likelihood of drunk driving.

CONCLUSIONS

These studies provided initial evidence for the predictive utility of the P-DUI-IAT for drunk driving.

PRACTICAL APPLICATIONS

The P-DUI-IAT is a promising tool for identifying which individuals are at risk of drunk driving. The application of this measure could especially be valuable for identifying young novice drivers at risk for drunk driving-related accidents.

A systematic review of alcohol education programs for young people: do these programs change behavior?

Numerous education programs have addressed young peoples' alcohol use. To date, no peer-reviewed publication has evaluated the effectiveness of such programs delivered across a range of contexts to change alcohol-related behaviors, attitudes and/or knowledge. This systematic review aimed to identify alcohol education programs addressing young people, and determine whether they changed alcohol-related behavior, knowledge and attitudes; and, ascertain components of successful programs. Studies were identified, guided by the PRISMA review process, from the earliest records until June 2020. Included studies (N = 70) comprised an alcohol education program which focused on young people (15-24 years). Forty programs reported behavior changes, and these programs were the highest quality. Others impacted attitudes and/or knowledge only (n = 12); or reported no impacts (n = 17). Recent programs were more likely than older programs to feature online delivery and report behavior changes. To enhance alcohol education, future programs should include the identified quality criteria, alongside process and long-term outcome evaluations, to better monitor effectiveness. Findings indicated some education programs have capacity to positively change alcohol-related behavior; however, outcome consistency varied even in high-quality programs. Alcohol education programs should be designed alongside health education/promotion models and best-practice recommendations, to improve the likelihood of desirable behavior-related outcomes.

Effects of alcohol intoxication goggles (fatal vision goggles) with a concurrent cognitive task on simulated driving performance

Objective: Fatal vision goggles (FVGs) are image-distorting equipment used to simulate alcohol impairment in driver education programs. Unlike alcohol, which disrupts cognitive processes, FVG only induces visual impairment. Performing concurrent cognitive tasks while wearing FVG may reduce the wearer's attentional resources and provide a better simulation of alcohol intoxication. This study examined the impact of wearing FVG with/without administration of a concurrent cognitive task on simulated driving.Methods: Twenty-one males (23 ± 3 y, mean ± SD) participated in this randomized, repeated-measures study involving two experimental trials. In each trial, participants completed a baseline drive then an experimental drive under one of two conditions: (1) FVG and (2) FVG with additional cognitive demand (FVG + CD). The driving test included 3 separate scenarios (Task 1, 2, 3) lasting ∼5min each. Lateral (standard deviation of lane position [SDLP]; number of lane crossings [LCs]) and longitudinal control parameters (average speed; standard deviation of speed [SDSP]; distance headway; minimum distance headway) were monitored in Tasks 1 and 2. Latency to two different stimuli (choice reaction time [CRT]) was examined in Task 3.Results: In Task 1, SDLP and LC were unaffected by either condition. However, SDSP increased significantly from baseline with FVG, irrespective of cognitive demand. In Task 2, distance headway decreased significantly from baseline with FVG, but increased significantly with FVG + CD. Minimum distance headway was significantly decreased, while SDLP increased significantly and LC increased (although not statistically significant) in both conditions relative to baseline. In Task 3, a significant increase in CRT occurred with FVG + CD, but not with FVG alone.Conclusions: Wearing FVG negatively impacted simulated driving performance. However, effects were isolated to specific performance outcomes and were dependent on complexity of the driving task. Addition of a secondary cognitive task exacerbates the effects of FVG on select driving outcomes (i.e. lane position, SDSP), influences the effect direction on other measures (i.e. distance headway), and has a detrimental effect on reaction time to stimuli embedded in the scenario, that is not observed with FVG alone. Future studies using FVG as a surrogate means to alcohol intoxication should consider these results, informing methodological decisions to reduce potential for confounding effects.

Randomized Clinical Trial Examining Cognitive Behavioral Therapy for Individuals With a First-Time DUI Offense

BACKGROUND

Driving under the influence (DUI) programs are a unique setting to reduce disparities in treatment access to those who may not otherwise access treatment. Providing evidence-based therapy in these programs may help prevent DUI recidivism.

METHODS

We conducted a randomized clinical trial of 312 participants enrolled in 1 of 3 DUI programs in California. Participants were 21 and older with a first-time DUI offense who screened positive for at-risk drinking in the past year. Participants were randomly assigned to a 12-session manualized cognitive behavioral therapy (CBT) or usual care (UC) group and then surveyed 4 and 10 months later. We conducted intent-to-treat analyses to test the hypothesis that participants receiving CBT would report reduced impaired driving, alcohol consumption (drinks per week, abstinence, and binge drinking), and alcohol-related negative consequences. We also explored whether race/ethnicity and gender moderated CBT findings.

RESULTS

Participants were 72.3% male and 51.7% Hispanic, with an average age of 33.2 (SD = 12.4). Relative to UC, participants receiving CBT had lower odds of driving after drinking at the 4- and 10-month follow-ups compared to participants receiving UC (odds ratio [OR] = 0.37, p = 0.032, and OR = 0.29, p = 0.065, respectively). This intervention effect was more pronounced for females at 10-month follow-up. The remaining 4 outcomes did not significantly differ between UC versus CBT at 4- and 10-month follow-ups. Participants in both UC and CBT reported significant within-group reductions in 2 of 5 outcomes, binge drinking and alcohol-related consequences, at 10-month follow-up (p < 0.001).

CONCLUSIONS

In the short-term, individuals receiving CBT reported significantly lower rates of repeated DUI than individuals receiving UC, which may suggest that learning cognitive behavioral strategies to prevent impaired driving may be useful in achieving short-term reductions in impaired driving.

Group Cohesion and Climate in Cognitive Behavioral Therapy for Individuals with a First-Time DUI

Few studies have examined group cohesion and climate in the substance use disorder treatment literature. We examined whether group cohesion and climate are associated with increased self-efficacy outcomes and reduced drinks per week, binge drinking and DUI behaviors, in a sample of individuals with a first-time DUI receiving either cognitive behavioral therapy (CBT) or usual care. Additionally, we examined whether CBT moderates these relationships. Group measures and drinking outcomes were not significantly associated. This study is the first to provide an in-depth analysis on group processes in DUI settings, and as such, provides important insights into how group processes may differ in a mandated DUI context.

Efficacy of interventions targeting alcohol, drug and smoking behaviors in university and college students: A review of randomized controlled trials

OBJECTIVE

To evaluate the effectiveness of interventions targeting alcohol consumption, drug use and smoking for college/university students.

PARTICIPANTS

College/University students.

METHODS

Studies were eligible if: (1)included students attending universities/colleges; (2)implemented in a university/college setting; (3)aimed to improve at least one of the following behaviors: alcohol and/or drug use and/or smoking; (4)were RCTs. The effect of the interventions on behaviors was determined by the percentage of studies that reported an effect. Due to the heterogeneity of outcomes meta-analysis was not conducted.

RESULTS

88 studies met criteria. University-based interventions were effective for reducing alcohol-related outcomes (drinking patterns, BAC, consequences, problem drinking). Inconsistent findings for drug and smoking were observed.

CONCLUSIONS

University-based interventions have the potential to improve health for students. While there is a breadth of research examining the efficacy of interventions to reduce alcohol consumption, further research is needed to determine the best approach for addressing smoking and drug use among students.

Differences in alcohol cognitions, consumption, and consequences among first-time DUI offenders who co-use alcohol and marijuana

BACKGROUND

A significant portion of alcohol-related DUI offenders engage in co-use of alcohol and marijuana (AM). Given expanding marijuana legalization and the impaired driving risks associated with co-use, it is of increased importance to understand how characteristics of AM co-users compare to those who use alcohol only (AO) in order to inform DUI interventions and prevent recidivism.

METHODS

Participants were 277 first-time DUI offenders enrolled in a first-time DUI offender program across three locations. Using well-established measures, we evaluated differences in alcohol-related cognitions (positive expectancies and self-efficacy), frequency and quantity of alcohol consumption, and alcohol-related consequences between AO users and AM co-users by running a series of multivariate generalized linear models.

RESULTS

Compared to AO users, AM co-users reported lower self-efficacy to achieve abstinence and avoid DUI. Differences in abstinence self-efficacy largely explain higher relative rates of average and peak drinking quantity and higher odds of binge drinking among AM co-user. Despite lower self-efficacy and higher drinking quantity, there were no significant differences between AM and AO-users on alcohol-related consequences and past month reports of drinking and driving.

CONCLUSIONS

Our results provide preliminary evidence that DUI offenders who co-use alcohol and marijuana have higher alcohol use and lower self-efficacy than AO-users, and long-term consequences for this group should be monitored in future research. DUI programs may screen and identify co-users and consider tailoring their interventions to build self-efficacy to address the risks associated with AM co-use uniquely.

Using alcohol intoxication goggles (Fatal Vision® goggles) to detect alcohol related impairment in simulated driving

OBJECTIVE

Fatal vision goggles (FVGs) are image-distorting equipment used within driver education programs to simulate alcohol-related impairment. However, there is no empirical evidence comparing the behavioral effects associated with wearing FVGs to alcohol intoxication. The purpose of this study was to determine the validity of FVGs in producing alcohol-related impairment in simulated driving.

METHODS

Twenty-two healthy males (age: 23 ± 3 years, mean ± SD) participated in a placebo-controlled crossover design study involving 4 experimental trials. In each trial, participants completed a baseline level simulated driving task followed by an experimental driving task, involving one of 4 treatments: (1) a dose of alcohol designed to elicit 0.080% breath alcohol concentration (BrAC; AB), (2) an alcohol placebo beverage (PB), (3) FVG (estimated % blood alcohol concentration [BAC] 0.070-0.100+), and (4) placebo goggles (PGs). The driving tasks included 3 separate scenarios lasting ∼5 min each; these were a simple driving scenario, a complex driving scenario, and a hazard perception driving scenario. Selected lateral control parameters (standard deviation of lane position [SDLP]; total number of lane crossings [LCs]) and longitudinal control parameters (average speed; standard deviation of speed [SDSP]; distance headway; minimum distance headway) were monitored during the simple and complex driving scenarios. Latency to 2 different stimuli (choice reaction time [CRT]) was tested in the hazard perception driving scenario. Subjective ratings of mood and attitudes toward driving were also provided during each of the trials.

RESULTS

Neither placebo treatment influenced simulated driving performance. Mean BrAC was 0.060 ± 0.010% at the time of driving on the AB trial. Lateral control: In the simple driving scenario, SDLP and LC were not affected under any of the experimental treatments. However, in the complex driving scenario, significantly greater SDLP was observed on both the FVG and AB trials compared to their respective baseline drives. LC increased significantly from baseline on the AB trial only. Longitudinal control: Speed was not affected by any of the experimental treatments; however, SDSP increased significantly from baseline on the FVG trial. A significant reduction in distance headway and minimum distance headway was detected on the FVG trial compared to baseline. Hazard perception: Neither AB nor FVG trials were influential on CRT. Subjective mood ratings were significantly altered on the AB and FVG trials compared to baseline and placebo conditions. Participants reported reduced willingness and ability to drive under the active treatments (AB and FVG) than the placebo treatments (PB and PG).

CONCLUSIONS

FVGs may have some utility in replicating alcohol-related impairment on specific driving performance measurements. Hence, the equipment may offer an alternative approach to researching the impact of alcohol intoxication on simulated driving performance among populations where the provision of alcohol would otherwise be unethical (e.g., prelicensed drivers).

Brief alcohol interventions for adolescents and young adults: a systematic review and meta-analysis

This study reports findings from a meta-analysis summarizing the effectiveness of brief alcohol interventions for adolescents (age 11-18) and young adults (age 19-30). We identified 185 eligible study samples using a comprehensive literature search and synthesized findings using random-effects meta-analyses with robust standard errors. Overall, brief alcohol interventions led to significant reductions in alcohol consumption and alcohol-related problems among adolescents (g = 0.27 and g = 0.19) and young adults (g = 0.17 and g = 0.11). These effects persisted for up to 1 year after intervention and did not vary across participant demographics, intervention length, or intervention format. However, certain intervention modalities (e.g., motivational interviewing) and components (e.g., decisional balance, goal-setting exercises) were associated with larger effects. We conclude that brief alcohol interventions yield beneficial effects on alcohol-related outcomes for adolescents and young adults that are modest but potentially worthwhile given their brevity and low cost.

Longitudinal associations between attitudes towards binge drinking and alcohol-free drinks, and binge drinking behavior in adolescence

Alcohol attitudes are often considered an important predecessor of drinking behavior, although the literature is equivocal. Lately, attention has turned to enhancing positive cognitions on alcoholic-free drinks to discourage heavy drinking. The current study was the first to longitudinally examine associations between attitudes towards binge drinking and alcohol-free drinks and binge drinking behavior in a cross-lagged path model in Mplus. Participants were 293 adolescents (131 boys, M(age)=16.1 years) who filled in two online questionnaires with a six-month interval. Binge drinking behavior and attitudes towards binge drinking and alcohol-free drinks were all significantly correlated at both waves. The multivariate model, however, showed that only higher levels of binge drinking at T1 were prospectively related to more positive binge drinking attitudes at T2, and not vice versa. Analyses were controlled for sex, educational level, and age. Findings discard the Theory of Planned Behavior, but rather seem consistent with the Theory of Cognitive Dissonance, i.e., adolescents may adapt their cognitions to their behavior. More longitudinal research with several time points and over a longer period of time is needed to further examine the development of attitudes and drinking behavior.

Alcohol Interventions for College Students Improves Antecedents of Behavioral Change: Results from a Meta-Analysis of 34 Randomized Controlled Trials

The current meta-analysis examined the effects of individual-level alcohol interventions on college students' knowledge and psychological outcomes at first post-intervention assessment. Data from 34 randomized controlled trials published between 1980 and June 2007 (N = 8,569) were included. Independent raters coded participant characteristics, design and methodological features, and intervention content. Weighted mean effect sizes, using both fixed- and random-effects models, were calculated; positive effect sizes indicated greater improvement in alcohol-related knowledge or psychological outcomes. Compared to controls, alcohol interventions improved participants' alcohol-related knowledge, attitudes toward drinking, and descriptive norms (vis-à-vis national college students), and intentions to consume alcohol but did not improve alcohol expectancies or self-efficacy. Several sample, study and intervention characteristics moderated the knowledge and psychological outcomes. Implications of these findings are discussed.

Assessing DUI risk: examination of the Behaviors & Attitudes Drinking & Driving Scale (BADDS)

Despite research findings indicating attitudinal differences among drivers with and without a history of driving under the influence (DUI) offenses, there are no well-established instruments specifically designed to clinically assess drinking and driving attitudes and behaviors among adults. The purpose of this current series of three studies was to investigate the psychometric properties of the Behaviors & Attitudes Drinking & Driving Scale (BADDS). The BADDS was developed in previous studies by the authors and assesses respondents' rationalizations for drinking and driving, likelihood of future drinking and driving, drinking and driving behaviors, and riding with a drinking driver behavior in the previous month. Study 1 (N=179) and Study 2 (N=338) assessed college participants, while Study 3 gathered data from adult DUI offenders (N=160) and non-DUI offenders (N=166). Results indicate good to excellent test-retest reliability and internal consistency estimates for BADDS scale scores. Support for the construct validity as well as concurrent and predictive criterion validity of BADDS scores was also demonstrated. Potential applications for the measure, as well as need for future research are described.