Neurocognitive characteristics of DUI recidivists

DUI offenders display reduced perception of intoxication and heightened impulsive choice in response to alcohol

Driving under the influence (DUI) of alcohol continues to be a major contributor in traffic fatalities. There is growing evidence for heightened trait impulsivity in DUI offenders, but little is known about how impulsivity could interact with alcohol intoxication in a manner that would increase the likelihood of driving while intoxicated. This placebo-controlled study examined the acute effects of 0.65g/kg alcohol on 2 facets of impulsivity (impulsive choice and response inhibition), simulated risky driving behavior, and subjective intoxication in a group of 20 DUI offenders and 20 control drivers with no history of DUI. It was predicted that compared with controls, DUI offenders would self-report greater impulsivity, and display greater impulsive choice and driver risk taking, particularly in response to alcohol. Results showed that alcohol impaired drivers' inhibitory control and increased their impulsive choice behavior and risky driving behavior. Alcohol selectively increased impulsive choice of DUI offenders, as control drivers showed no alcohol-induced increase in their impulsive choices. Results also showed that, compared with controls, offenders reported feeling less intoxicated and were more willing to drive after drinking. Laboratory studies are beginning to show that DUI offenders differ from nonoffenders in their acute responses to alcohol. This study identified two alcohol response characteristics of DUI offenders that indicate their lack of risk awareness during intoxication: heightened impulsivity and reduced subjective intoxication. Strategies and treatments to alter these response characteristics in DUI offenders could enhance their risk awareness during the intoxicated state and possibly reduce risk of DUI recidivism. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Estimating factors of individual and regional characteristics affecting the drink driving recidivism

Traffic violations, particularly drink driving, are a menace to the drivers themselves, and to other road users. Drink driving crashes often cause death or serious injury to the driver. Understanding the recidivism effect factor of drink driving is essential for designing effective countermeasures. This study is based on register-based data from the National Police Agency, Ministry of the Interior of Taiwan and monthly administrative area information from 2012 to 2015 for the entire population. Hence, this study not only focuses on the effect factor and violation differences between recidivists and non-recidivists, but discusses the entire regional characteristics effect for recidivism. The purpose of this study is to offer a comprehensive econometrical framework, using a multilevel random effect logistic model, which highlights important contributors to drink driving recidivism from regional attributes. As the study findings from our empirical results indicate, there are statistically significant differences with drink driving in administrative areas, depending on the number of report on drink driving by police, divorce rate of the population, alcohol consumption, number of community security patrol teams, number of bus trips, and level of education. The results of this study provide suggestions to the government for enhancing community security and developing public transportation, both of which can effectively decrease drink driving recidivism and improve public road safety.

Explicit Attitudes, Working Memory Capacity, and Driving After Drinking

BACKGROUND

Attitudes toward driving after drinking are strongly predictive of drinking and driving behavior. This study tested working memory capacity (WMC) as a moderator of the association between attitudes and drinking and driving behavior. Consistent with dual process models of cognition, we hypothesized that the association between perceived danger and drinking and driving would be stronger for individuals with higher WMC.

METHODS

Participants (N = 161) enrolled in larger alcohol administration study were randomly assigned to an alcohol (n = 57), placebol (n = 52), or control (n = 52, not included) beverage condition. Past-year frequency of driving after drinking and WMC were assessed at baseline. Attitudes were assessed by asking participants to rate the perceived danger of driving at their current level of intoxication twice on the ascending limb (AL1, AL2), at peak breath alcohol concentration (BrAC), and twice on the descending limb (DL1, DL2).

RESULTS

Analyses across the BrAC curve indicated that the hypothesized interaction was observed for the alcohol but not placebo condition. Analyses for each assessment point indicated that the interaction was significant for the ascending limb and peak BrAC. In the alcohol condition, for those higher in WMC, lower perceived dangerousness was strongly associated with increased driving after drinking (AL1: incident rate ratios [IRR] = 5.87, Wald's χ²  = 12.39, p = 0.006, 95% CI [2.19, 15.75]; AL2: IRR = 8.17, Wald's χ²  = 11.39, p = 0.001, 95% CI [2.41, 27.66]; Peak: IRR = 5.11, Wald's χ²  = 9.84, p = 0.002, 95% CI [1.84, 14.16]). Associations were not significant at low WMC.

CONCLUSIONS

Results suggest that individuals higher in WMC are more likely to act consistently with their explicit attitudes toward drinking and driving. Findings may have implications for existing drinking and driving interventions and suggest the potential for novel interventions targeting implicit associations or WMC.

Examination of personality traits and social problem-solving skills of individuals whose driving licenses have been confiscated due to drunk driving

OBJECTIVE

Drunk driving is one of the major behavioral issues connected with problematic alcohol consumption. The objective of this study was to evaluate the relationship between personality traits and social problem-solving skills of individuals who drive while intoxicated.

METHOD

One hundred forty-four individuals apprehended twice while driving drunk and sent to a driver behavior training program (9 females and 135 males) participated in our study. The Eysenck Personality Questionnaire Revised-Abbreviated (EPQ-RA) composed of 4 subscales (Extroversion, Neuroticism, Psychoticism, and Lying) and the Social Problem Solving Inventory (SPSI) composed of 7 subscales (Cognitive, Emotion, Behavior, Problem Definition and Formulation, Creating Solution Options, Solution Implementation and Verification, and Decision Making) were used to evaluate the participants.

RESULTS

A positive relationship was found between the Extroversion subscale of the EPQ-RA and the Cognition subscale (P <.01), Emotion subscale (P <.01), Behavior subscale (P <.01), Generation of Alternatives subscale (P <.01), Decision Making subscale (P <.05), and Solution Implementation and Verification subscale (P <.01). For individuals who repeated intoxicated driving, all subscales of the EPQ-RA (Extroversion, Lying, Neuroticism, and Psychoticism subscales) explained 12% of the scores of the Cognition subscale and 16.2% (P <.001) of the Emotion subscale of the SPSI. There was no significant relationship between the first and second incident alcohol blood levels (P >.05).

CONCLUSION

Drinking and driving behaviors appear to be negative or maladaptive behaviors closely related to personality traits and may represent an effort to avoid negative emotions. Evaluation of negative emotions may have an important place in training programs intended to change drunk driving behavior.

Personality, Executive Control, and Neurobiological Characteristics Associated with Different Forms of Risky Driving

Background

Road crashes represent a huge burden on global health. Some drivers are prone to repeated episodes of risky driving (RD) and are over-represented in crashes and related morbidity. However, their characteristics are heterogeneous, hampering development of targeted intervention strategies. This study hypothesized that distinct personality, cognitive, and neurobiological processes are associated with the type of RD behaviours these drivers predominantly engage in.

Methods

Four age-matched groups of adult (19–39 years) males were recruited: 1) driving while impaired recidivists (DWI, n = 36); 2) non-alcohol reckless drivers (SPEED, n = 28); 3) drivers with a mixed RD profile (MIXED, n = 27); and 4) low-risk control drivers (CTL, n = 47). Their sociodemographic, criminal history, driving behaviour (by questionnaire and simulation performance), personality (Big Five traits, impulsivity, reward sensitivity), cognitive (disinhibition, decision making, behavioural risk taking), and neurobiological (cortisol stress response) characteristics were gathered and contrasted.

Results

Compared to controls, group SPEED showed greater sensation seeking, disinhibition, disadvantageous decision making, and risk taking. Group MIXED exhibited more substance misuse, and antisocial, sensation seeking and reward sensitive personality features. Group DWI showed greater disinhibition and more severe alcohol misuse, and compared to the other RD groups, the lowest level of risk taking when sober. All RD groups exhibited less cortisol increase in response to stress compared to controls.

Discussion

Each RD group exhibited a distinct personality and cognitive profile, which was consistent with stimulation seeking in group SPEED, fearlessness in group MIXED, and poor behavioural regulation associated with alcohol in group DWI. As these group differences were uniformly accompanied by blunted cortisol stress responses, they may reflect the disparate behavioural consequences of dysregulation of the stress system. In sum, RD preference appears to be a useful marker for clarifying explanatory pathways to risky driving, and for research into developing more personalized prevention efforts.

Profiling drunk driving recidivists in Denmark

Drunk drivers are a menace to themselves and to other road users, as drunk driving significantly increases the risk of involvement in road accidents and the probability of severe or fatal injuries. Although injuries and fatalities related to road accidents have decreased in recent decades, the prevalence of drunk driving among drivers killed in road accidents has remained stable, at around 25% or more during the past 10 years. Understanding drunk driving, and in particular, recidivism, is essential for designing effective countermeasures, and accordingly, the present study aims at identifying the differences between non-drunk drivers, drunk driving non-recidivists and drunk driving recidivists with respect to their demographic and socio-economic characteristics, road accident involvement and other traffic and non-traffic-related law violations. This study is based on register-data from Statistics Denmark and includes information from 2008 to 2012 for the entire population, aged 18 or older, of Denmark. The results from univariate and multivariate statistical analyses reveal a five year prevalence of 17% for drunk driving recidivism, and a significant relation between recidivism and the drunk drivers' gender, age, income, education, receipt of an early retirement pension, household type, and residential area. Moreover, recidivists are found to have a higher involvement in alcohol-related road accidents, as well as other traffic and, in particular, non-traffic-related offences. These findings indicate that drunk driving recidivism is more likely to occur among persons who are in situations of socio-economic disadvantage and marginalisation. Thus, to increase their effectiveness, preventive measures aiming to reduce drunk driving should also address issues related to the general life situations of the drunk driving recidivists that contribute to an increased risk of drunk driving recidivism.

Alcohol effects on simulated driving performance and self-perceptions of impairment in DUI offenders

Drivers with a history of driving under the influence (DUI) of alcohol self-report heightened impulsivity and display reckless driving behaviors as indicated by increased rates of vehicle crashes, moving violations, and traffic tickets. Such poor behavioral self-regulation could also increase sensitivity to the disruptive effects of alcohol on driving performance. The present study examined the degree to which DUI drivers display an increased sensitivity to the acute impairing effects of alcohol on simulated driving performance and overestimate their driving fitness following alcohol consumption. Adult drivers with a history of DUI and a demographically matched group of drivers with no history of DUI (controls) were tested following a 0.65 g/kg alcohol and a placebo. Results indicated that alcohol impaired several measures of driving performance, and there was no difference between DUI offenders and controls in these impairments. However, following alcohol, DUI drivers self-reported a greater ability and willingness to drive compared with controls. These findings indicate that drivers with a history of DUI might perceive themselves as more fit to drive after drinking, which could play an important role in their decisions to drink and drive.

Acute effects of alcohol on inhibitory control and simulated driving in DUI offenders

INTRODUCTION

The public health costs associated with alcohol-related traffic accidents have prompted considerable research aimed at identifying characteristics of individuals who drive under the influence (DUI) in order to improve treatment and prevention strategies. Survey studies consistently show that DUI offenders self-report higher levels of impulsivity compared to their nonoffending counterparts. However, little is known about how individuals with a DUI history respond under alcohol. Inhibitory control is a behavioral component of impulsivity thought to underlie risky drinking and driving behaviors.

METHOD

The present study examined the degree to which DUI drivers display deficits of inhibitory control in response to alcohol and the degree to which alcohol impaired their simulated driving performance. It was hypothesized that DUI offenders would display an increased sensitivity to the acute impairing effects of alcohol on simulated driving performance. Young adult drivers with a history of DUI and a demographically-comparable group of drivers with no history of DUI (controls) were tested following a 0.65 g/kg dose of alcohol and a placebo. Inhibitory control was measured by using a cued go/no-go task. Drivers then completed a driving simulation task that yielded multiple indicators of driving performance, such as within-lane deviation, steering rate, centerline crossings and road edge excursions, and drive speed.

RESULTS

Results showed that although DUI offenders self-reported greater levels of impulsivity than did controls, no group differences were observed in the degree to which alcohol impaired inhibitory control and driving performance. The findings point to the need to identify other aspects of behavioral dysfunction underlying the self-reported impulsivity among DUI offenders, and to better understand the specific driving situations that might pose greater risk to DUI offenders.

PRACTICAL APPLICATIONS

The systematic study of candidate cognitive deficits in DUI offenders will provide important information on their role in risky driving behavior and decisions to drink and drive. Such information is critical for guiding new interventions for DUI offenders that will move treatment beyond general addiction counseling.

Heritability of DUI convictions: a twin study of driving under the influence of alcohol

BACKGROUND

The study was undertaken to assess the relative contributions of genetic and environmental influences on drunk-driving.

METHODS

Driving records of a cohort of male and female twins (N = 17,360) from the Mid-Atlantic Twin Registry were examined. Structural equation models were used to estimate the magnitude of genetic and environmental effects on male and female phenotypes, and test for gender differences.

RESULTS

There were significant gender and age effects. Compared with females, males were five times more likely to engage in driving under the influence. Among persons aged 21-49 years, the risk for drunk-driving was eight times that for those aged 50+ years and five times greater than those ≤20 years. In both males and females, aged 21-49 years, a large proportion (57%) of the variance in drunk-driving was due to genetic factors and the remaining 43% due to individual specific environmental influences.

CONCLUSIONS

Drunk-driving is under significant genetic influence in both males and females. Our findings suggest that a different set of genes influence DUIs in men and women.

Decision-making capacities and affective reward anticipation in DWI recidivists compared to non-offenders: a preliminary study

OBJECTIVES

Impaired decision making is seen in several problem behaviours including alcoholism and problem gambling. Decision-making style may contribute to driving while impaired with alcohol (DWI) in some offenders as well. The Somatic Marker Framework theorizes that decision making is the product of two interacting affective neural systems, an impulsive, rapid, amygdala-dependent process for emotionally signalling the immediate negative or positive consequences of an option, and a reflective, longer-lasting, ventral medial prefrontal cortex dependent system for emotionally signalling the future negative or positive prospects of an option. This study tested the hypothesis that offenders who showed disadvantageous decision-making would be at higher risk for recidivism than those who showed more advantageous decision-making. In addition, in line with the Somatic Marker Hypothesis, offenders who showed disadvantageous decision-making would exhibit a distinct pattern of somatic activation compared to offenders who showed more advantageous decision-making.

METHODS

A sample of 21 DWI offenders with from 2 to 7 past DWI convictions and a reference group consisting of 19 non-offender (N-O) drivers were recruited and administered the Iowa Gambling Task (IGT), as well as evaluated on sociodemographic, driving and alcohol use dimensions. In addition, anticipatory skin conductance response (aSCR) was measured in the 5s prior to each of a 100 card draws on the IGT.

RESULTS

Median split of the DWI offender sample based upon overall performance on the IGT yielded two subgroups (IGT-R Hi and IGT-R Lo). Hypothesis 1 was supported, as the IGT-R Lo group possessed significantly greater frequency of past DWI convictions and severity of past drinking. Descriptive analyses revealed that on the IGT, IGT-R Hi group performed similarly to the N-O reference group while the IGT-R Lo group performed significantly worse. Hypothesis 2 was not supported.

CONCLUSIONS

Decision making is a plausible explanatory neurocognitive pathway to severer forms of DWI. The role of emotional processing in DWI risk is uncertain. Subtyping DWI offenders using neurocognitive criteria seems a promising avenue for improving clinically meaningful methods of DWI risk assessment and intervention.

Reducing impaired driving through the identification of Repeat Target Vehicles: A case study

INTRODUCTION

One of the most persistent groups of impaired drivers that are seemingly unaffected by social pressure, moral appeals, and the fear of arrest is that of the repeat impaired driver. This smaller group accounts for a disproportionate number of all impaired driving trips, often with high blood alcohol contents. New approaches are needed to identify and deal with the repeat impaired driver.

METHOD

We propose a method based on the discovery that almost 10% of all impaired driving calls for service involve repeat vehicles. Using the number of times a vehicle appears in our data, the average time to repeat, and the personality characteristics of the repeat impaired driver, we are able to create a comprehensive and predictive description of a Repeat Target Vehicle (RTV).

CONCLUSIONS

Our method provides an opportunity to explore new and innovative crime reduction strategies that were never before possible.

Decision-making in people who relapsed to driving under the influence of alcohol

BACKGROUND

Alcohol use has been previously associated with neurocognitive impairments, especially in decision-making cognition. However, some studies have shown little to no decision-making deficits in relation to different characteristics of people with drinking problems. Relapsing to driving under the influence (DUI) of alcohol is an important issue with legal and psychosocial aspects. We evaluated decision-making performance in second-time DUI offenders by using the Iowa Gambling Task (IGT).

METHOD

Thirty-four male second-time DUI offenders who had been selected for an official psychoeducational rehabilitation program and 31 healthy controls that were matched for age, education, and alcohol use were included. Along with psychiatric assessment, we applied conventional neuropsychological testing comprising cognitive set-shifting, response inhibition, attention, and visuospatial abilities. Also, we used the Temperament and Character Inventory (TCI) to assess personality patterns. A computerized version of IGT was used.

RESULTS

No significant differences were found between the groups in regard to sociodemographics and conventional neuropsychological testing. DUI participants had significantly higher scores only in "self-transcendence" subdomain of TCI. On the fifth block of the IGT, DUI participants had significantly lower net scores than controls (U = 380.0, p < 0.05). Also, DUI participants chose significantly more risky decks compared to controls.

CONCLUSIONS

Our results suggest that there may be subtle decision-making deficits in DUI participants, which goes undetected on conventional neuropsychological testing and which is not correlated with TCI subdomains related with impulsivity patterns.

Are biomarkers of chronic alcohol misuse useful in the assessment of DWI recidivism status?

A first driving while impaired by alcohol (DWI) conviction is a key opportunity to identify offenders who are at high risk for recidivism. Detection of alcohol use disorder (AUD) is a major target of current DWI assessments. However, offenders frequently underreport their alcohol consumption, and use of biomarkers has been proposed as a more objective indicator. Among the best established are aspartate aminotranferase (AST), alanine aminotransferase (ALT), gamma-glutamyl transferase (GGT), mean corpuscular red blood cell volume (MCV), carbohydrate-deficient transferrin (CDT), and thiamine. To our knowledge, no research has directly verified whether AUD biomarkers predict DWI recidivism status. Using a cross-sectional design, this study tested three hypotheses related to the utility of biomarkers in DWI assessment.

HYPOTHESES

(1) DWI recidivists possess biomarkers indicative of greater prevalence of AUD compared to first-time offenders; (2) multiple biomarkers better differentiate first-time offenders from recidivists compared to individual biomarkers; and (3) biomarkers add significantly to the prediction of recidivism over and above psychosocial questionnaires.

METHODS

First-time offenders (n = 49) and recidivists (n = 95) participated in the study. In addition to self-reported information on sociodemographic and driving characteristics, data from several AUD questionnaires were gathered: Michigan Alcoholism Screening Test, Alcohol Use Disorders Identification Test, Composite International Diagnostic Interview, and Timeline Follow-Back. Blood samples were collected to measure AST, ALT, GGT, MCV, CDT, and thiamine.

RESULTS

AUD biomarkers, taken individually or in combination, did not indicate that recidivists had more frequent AUD compared to first-time offenders. Also, they failed to significantly differentiate first-time offenders from recidivists or predict recidivism status. Finally, the superiority of biomarkers over psychosocial AUD questionnaires was not supported in the laboratory setting.

CONCLUSION

The present findings suggest that biomarkers of chronic patterns of heavy drinking may not be adequate to capture the multiple processes that appear to promote recidivism (e.g., binge drinking, other risky behavioural and personality features). Despite their objectivity, caution is warranted in the interpretation of a positive score on these biomarkers in DWI assessment. Longitudinal research is needed to more comprehensively explore the relationship between positive biomarkers in first-time offenders and their risk of becoming recidivists.

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.

DUI offenders who delay relicensing: a quantitative and qualitative investigation

OBJECTIVES

As in many jurisdictions, individuals convicted of driving under the influence (DUI) in the province of Quebec are mandated to relicensing programs, which include obligatory participation in intervention programs. However, prolonged delay in relicensing is widespread, potentially contributing to unlicensed driving, untreated substance misuse problems, and drink-driving risk. Information about the characteristics of DUI offenders who delay relicensing (DR) is sparse. This investigation compares the characteristics of DR offenders with those offenders who do not delay (NoDR). In addition, the rationales of DR offenders for delaying relicensing are explored qualitatively.

METHODS

Two studies were conducted to explore the characteristics of DR offenders. In Study 1, DR offenders (n = 46) were compared to NoDR offenders (n = 74) on multidimensional measures of psychosocial functioning, driving behavior, substance use, and psychological and neurocognitive characteristics. In Study 2, a qualitative examination of 20 DR offenders' reasons underlying delayed relicensing was undertaken, with verbatims content analyzed to identify major themes. A questionnaire, based upon this preliminary analysis, was then administered to another sample of DR participants (N = 37) to appraise and confirm thematic comprehensiveness.

RESULTS

The main findings of Study 1 were that, compared to NoDR offenders, DR offenders had more past DUI convictions, were at greater risk for drink driving per kilometer (km) driven, were more likely to have received substance abuse treatment, and exhibited indices of poorer neurocognitive performance in visual memory and behavioral inhibition domains. No group differences were uncovered on substance use measures. The findings of Study 2 revealed that the expense of participation, availability of alternate transportation, lack of interest, and no access to a vehicle were the most frequent explanations for delayed relicensing.

CONCLUSIONS

Overall, these findings suggest that both individual and contextual factors influence timely fulfillment of relicensing requirements. While the cost of relicensing may succeed in removing some offenders from the road, it may also be a barrier for others at risk for drink driving, preventing exposure to needed intervention programs. Reducing this barrier may need to be weighted against the risks of relicensing more DUI offenders. Neurocognitive factors may need to be taken into account to not only decrease delay in relicensing but also increase the benefits from participation in interventions that are part of current relicensing programs.

Hypothalamic-pituitary-adrenal axis response to stress in male DUI recidivists

Cortisol is a stress hormone mediated by the hypothalamic-pituitary-adrenal (HPA) axis and a psychobiological marker of genetic risk for alcoholism and other high-risk behavioural characteristics. In previous work with driving under the influence of alcohol (DUI) recidivists, we uncovered a significant inverse relationship between the frequency of past DUI convictions and salivary cortisol, whose strength surpassed those observed between DUI frequency and measures of alcohol abuse and other DUI-related characteristics. This finding emerged using a methodology not specifically contrived to test this relationship. The goals of this follow-up study were to (a) examine if a standardized stress-induction protocol would produce a significant inverse relationship between cortisol response and number of DUI offences; and (b) clarify whether HPA axis dysregulation could be linked to particular DUI-related behavioural correlates, such as alcohol use severity, sensation seeking, and antisocial features. Thirty male DUI recidivists were recruited as well as 11 male non-DUI drivers as a comparison group. Results indicated an inverse relationship between DUI frequency and cortisol response (r(39)=-0.36, p=0.021), as well as a lower cortisol response in DUI offenders than the comparison group (F(1,39)=5.71, p=0.022). Finally, for recidivists, hierarchical regression analyses indicated that experience seeking (R(2)=0.23, p=0.008), followed by number of cigarettes smoked daily ((Delta)R(2)=0.12, p=0.031), combined to explain 35% of the variance in cortisol (F(2,29)=7.26, p=0.003). These findings indicate that severe recidivism may have psychobiological underpinnings, and that HPA axis dysregulation appears to be a mechanism common to high-risk behaviours including DUI recidivism, sensation seeking, and cigarette smoking.