The Driving Cognitions Questionnaire: development and preliminary psychometric properties

Assessing the determinants of crash propensity using structural equation modeling: Role of distractions caused by fellow drivers

INTRODUCTION

Aggressive behavior of drivers is a source of crashes and high injury severity. Aggressive drivers are part of the driving environment, however, excessive aggressive driving by fellow drivers may take the attention of the recipient drivers away from the road resulting in distracted driving. Such external distractions caused by the aggressive and discourteous behavior of other road users have received limited attention. These distractions caused by fellow drivers (DFDs) may agitate recipient drivers and ultimately increase crash propensity. Aggressive driving behaviors are quite common in South Asia and, thus, it is necessary to determine their contribution to distractions and crash propensity.

METHOD

Our study aimed to evaluate the effects of DFDs using primary data collected through a survey conducted in Lahore, Pakistan. A total of 801 complete responses were obtained. Various hypotheses were defined to explore the associations between the latent factors such as DFDs, anxiety/stress (AS), anxiety-based performance deficits (APD), hostile behavior (HB), acceptability of vehicle-related distractions (AVRD), and crash propensity (CP). Structural Equation Modeling (SEM) was employed as a multivariate statistical technique to test these hypotheses.

RESULTS

The results supported the hypothesis that DFDs lead to AS among recipient drivers. DFDs and AS were further found to have positive associations with APDs. Whereas, there was a significant negative association between DFD, AS, and AVRD. As hypothesized, DFD and AS had positive associations with CP, indicating that distractions caused by aggressive behaviors leads to stress and consequently enhances crash propensity.

PRACTICAL APPLICATIONS

The results of this study provide a statistically sound foundation for further exploration of the distractions caused by the aggressive behaviors of fellow drivers. Further, the results of this study can be utilized by the relevant authorities to alter aggressive driving behaviors and reduce DFDs.

Psychological therapy using virtual reality for treatment of driving phobia: a systematic review

PURPOSE

Driving phobia is prevalent in injured individuals following motor vehicle crashes (MVCs). The evidence for virtual reality (VR) based psychological treatments for driving phobia is unknown. This systematic review synthesized the available evidence on the effectiveness, feasibility, and user experience of psychological treatments for driving phobia using VR.

METHODS

Three databases (PsycINFO, SCOPUS, and PubMed) were searched. Eligibility criteria included adults with clinical or sub-clinical levels of driving phobia manifesting as part of an anxiety disorder or post-traumatic stress disorder (PTSD). Primary outcomes were driving-related anxiety/fear or avoidance, PTSD symptoms and driving frequency/intensity, as well as treatment feasibility including recruitment, treatment completion and retention rates, user experience and immersion/presence in the VR program. Secondary outcomes were other health outcomes (e.g., depression) and VR technological features.

RESULTS

The 14 included studies were of low methodological quality. Clinical and methodological heterogeneity prevented quantitative pooling of data. The evidence provided in this review is limited by trials with small sample sizes, and lack of diagnostic clarity, controlled designs, and long-term assessment. The evidence did suggest that VR-based psychological interventions could be feasible and acceptable in this population.

CONCLUSIONS

For VR-based psychological interventions to be recommended for driving phobia, more high-quality trials are needed. Implications for rehabilitationVirtual reality (VR) based psychological treatments may be feasible and acceptable to patients with driving phobia.There is potential to increase accessibility to psychological therapies in patients with driving phobia following motor vehicle crashes through the use of digital psychiatry such as VR.

Measuring Driving Fear

Abstract. Presently, there is no instrument to support the diagnosis of driving fear and its severity. To enable a reliable and valid diagnosis, the 5-item German-language Instrument for Fear of Driving (IFD) was developed. The items, by DSM-5 criteria for a specific phobia, measure the emotional, cognitive, and physiological components of driving fear as well as the degree of avoidance and impairment. The present paper comprises two studies that describe the development of the IFD and its psychometric properties. In Study 1, the IFD was administered to 810 non-clinical participants in an online survey and demonstrated good reliability and construct validity. In Study 2, fifty-four people with a clinical diagnosis, including clinically relevant driving fear, completed the IFD and a clinical interview. The IFD demonstrated good sensitivity and specificity, and a cut-off score resulted in 95% sensitivity and 97% specificity. While the findings are preliminary and further studies with larger samples are needed, the IFD is a promising screening instrument for driving fear and its severity.

An evaluation of eye movement desensitization and reprocessing therapy delivered remotely during the Covid-19 pandemic

BACKGROUND

In addition to having a negative impact on the physical and emotional health of the population, the global Covid-19 pandemic has necessitated psychotherapists moving their practice to online environments. This service evaluation examines the efficacy of Eye Movement Desensitization and Reprocessing (EMDR) Therapy delivered via the internet.

METHODS

A real-world service evaluation was conducted from a self-selecting group of EMDR therapists that subscribe to either a JISCMail discussion list or either the UK or All Ireland National EMDR Associations. Author designed questionnaires were used to gather information on the efficacy of EMDR delivered online as well as client and therapist characteristics.

RESULTS

Thirty-three therapists provided efficacy data on a total of 93 patients. Statistically significant and clinically meaningful reductions were found in all four-psychometrics used both in adult and children and young people populations. Client outcome was not related to therapist experience.

CONCLUSIONS

EMDR delivered via the internet can be an effective treatment for clients experiencing mental health issues.

A Cognitive Behavioral Intervention for Driving for Autistic Teens and Adults: A Pilot Study

Background

For many autistic individuals approaching adulthood, interventions to promote skills toward independence are lacking. Driving is an important ability to cultivate as it may be a critical step to attaining independence, securing and maintaining work, and fostering relationships. Only about one third of able autistic individuals drive independently, and fear to drive is a common reason for not driving.

Methods

This initial pilot study was a 3-month open trial to investigate the feasibility, acceptability, and initial estimates of outcomes for the newly developed Cognitive Behavioral Intervention for Driving (CBID) intervention, a manualized curriculum to enhance executive functioning (EF) and emotional regulation (ER) skill development for driving, combined with individualized commentary-based driving simulator practice, in autistic teens and adults within a community research environment. Nineteen participants received the CBID intervention in 1.5-hour group sessions for 10 weeks, across two cohorts, with approximately five individualized driving simulator sessions. Data were collected on anxiety symptoms, driving cognitions, driving attitudes, and simulated driving performance at pre- and post-intervention assessments.

Results

Program completion rate was 81%. Participants and parents rated both the intervention and simulator practice sessions with high satisfaction. All the participants (100%) reported both a positive attitude change (interest toward driving) and a desire to drive in the future at the post-intervention assessment. Significant changes occurred for driving cognitions, attitudes, and behaviors, and 47% of participants obtained a driver's permit or license by 2 months post-intervention.

Conclusions

For autistic individuals, the CBID intervention appeared to directly impact the pursuit toward driving goals by both increasing driving attitudes and behaviors and reducing anxiety/apprehension. This highlights the need for driving intervention programs designed specific to autistic teens/adults that focus on EF and ER skills coupled with individualized simulator practice. CBID could be provided in community services to increase the number of autistic individuals driving.

Lay summary

Why was this study done?: Driving contributes greatly to independence in many teens and adults. Anxiety can act as a barrier to that independence by affecting driving attitudes, ability and performance. Autistic individuals are often affected by anxiety, executive functioning, and emotion regulation challenges. Previous studies show that virtual reality training and Cognitive Behavioral Therapy (CBT), separately, can reduce driving anxiety in autistic individuals and support driving skills. However, to date, no studies have developed and tested a manualized intervention specific to driving that combines such methods.What was the purpose of this study?: The goal of this study was to develop and test a group intervention, called Cognitive Behavioral Intervention for Driving (CBID), combined with individualized, coached driving simulator practice to help reduce fears and increase cognitions, attitudes and performance towards driving. The study examined the following questions: 1) Do autistic individuals actively participate in CBID? 2) Do autistic participants like CBID? and 3) Are autistic participants more prepared to drive after taking part in CBID than they were before they participated in the program?What did the researchers do?: After developing the CBID intervention with community member involvement, the researchers ran 2 intervention groups and individualized driving simulator sessions to a total of 19 enrolled participants. The group intervention focused on strengthening executive functioning and emotion regulation skills in 1.5 hour sessions over 10 weeks and 5, 1 hour driving simulator sessions. Researchers compared data on participant anxiety levels, driving cognitions, attitudes, and performance before and after the intervention.What were the results of the study?: Most of the participants completed the program (81%) and all (100%) rated satisfaction with the group and simulator practice. All (100%) of the participants changed attitudes towards driving. Participants had higher levels of positive thoughts about driving, better attitudes towards wanting to drive and less driving errors (like speeding, collisions, crossing lanes) on the driving simulator after completing CBID. Almost half (47%) of participants obtained a driver's permit or license by 2 months after the intervention.What do these findings add to what was already known?: This study adds a new option of an integrated approach, CBID, for addressing driving anxiety or apprehension. It provides initial findings of the value of incorporating executive functioning skills with traditional cognitive behavior therapy for enhancing driving readiness.What are the potential weaknesses in the study?: This study contained a small sample size that was mostly white male participants. This limits generalizing the results to a representative diverse population. It also did not have a control group or use randomization which means that results can't be interpreted as causal at this time. There was no information about participants obtaining permit/licensure later than 2 months after CBID so it is unclear if some participants require more time to pursue a license. There was no follow up to understand if participants continued to feel comfortable driving overtime.How will these findings help autistic adults now or in the future?: This study showed that it's possible to combine virtual reality training and Cognitive Behavioral Therapy into one driving readiness program. The new CBID program may help autistic adults by addressing multiple aspects of what they need to be ready to drive. Since the study used previously tested strategies, enrolled a community sample, manualized the program, and used a services approach, it was designed for broad distribution to other community settings.

Cognitive and body manifestations of driving anxiety according to different onsets

BACKGROUND

Driving anxiety can have deleterious effects not only on driving behavior, but also on life quality. The interaction between motor vehicle collision (MVC) experiences and driving anxiety has been studied from different standpoints. However, the comparison with other events triggering it has been scarcely considered. Objectives: To analyze the body manifestations and the driving cognitions related to the accident, social and panic concerns in people suffering from different levels of driving anxiety. Method: A total of 260 participants suffering from driving anxiety were included in a survey, including Driving Cognition Questionnaire and Body Sensation Questionnaire. Results: Panic attacks and criticisms are the most relevant onsets of driving anxiety, more than MVC. Only 11.4% of MVC victims considered it as the onset. People with MVC history showed lower scores in social concerns than people without MVC experience and neither the responsibility of the MVC nor the role (driver/passenger) seemed to have an impact on the anxiety level. Conclusions: Although the most relevant body sensations, heart palpitations and sweating, were the same in people with panic attack experiences and MVC victims, a discrimination of the emotions behind the concept of "driving anxiety" is desirable to clarify the psychological effects of different onsets.

Changes in beliefs during driver training and their association with risky driving

OBJECTIVE

Researchers continue to seek reasons for novice drivers' over-representation in crashes. Evidence on how early interventions might mitigate this global phenomenon remains inconclusive. This study explores changes in novice drivers' beliefs during pre-licensure training and within their first one-year independent provisional license period, and how these changes might help to predict subsequent risky driving.

METHOD

A sample of novice drivers (N = 175) from Lithuania participated in a three-wave longitudinal study. They completed questionnaires when beginning driver training (T1), at the end of their training (T2), and after one year of independent driving (T3). The Attitudes towards Risky Driving Questionnaire, the Adelaide Driving Self Efficacy Scale, the Driving Cognitions Questionnaire, the Driver Behaviour Questionnaire, and the Social Desirability Scale were used.

RESULTS

Reported driving self-efficacy increased and fear of driving decreased from the beginning to the end of driver training and after one-year follow-up in both men and women. Road safety attitudes changed in the risk-unfavourable direction from T1 to T2. However, at T3 these attitudes returned to the initial level for men. Female novice drivers reported the same level of safety attitudes at T2 and T3. Risky attitudes, driving self-efficacy, and fear of driving predicted reported driving errors and violations.

CONCLUSIONS

Reported psychological changes occurred during the driver training period and in the first year of independent driving. It is recommended that special attention should be paid to a group of novices who experienced safety compromising changes in attitudes, driving self-efficacy, and fear of driving during training and in the first year of their driving career.

Measuring Anxiety-Related Avoidance With the Driving and Riding Avoidance Scale (DRAS)

Abstract. Driving anxiety is a common experience that, for those with high levels of driving anxiety, can markedly interfere with functioning, particularly because of avoidance behavior. The Driving and Riding Avoidance Scale (DRAS; Stewart & St. Peter, 2004 ) is a promising measure of self-reported avoidance, but its psychometric properties have been questioned as the instructions do not specifically ask respondents to report avoidance that is due to driving anxiety. The present study investigated the psychometric properties of the DRAS using revised instructions in 437 participants from the general population of New Zealand. Internal consistency for the DRAS was 0.94 and ranged from 0.79 to 0.90 for the four subscales. A two-factor solution was supported, in line with previous research using the revised instructions, supporting the distinction between general and traffic avoidance compared with weather and riding avoidance. Further work on the psychometric properties of this measure with clinical samples is needed to clarify the subscale structure.

Anger while driving in Mexico City

This study aims to analyze the level of anger developed by drivers in Mexico City and also understand the behavior that those drivers use to express that anger, using four different survey methods. The first focuses on personal information, the second Driving Anger Expression Inventory (DAX), the third refers to a shorten version of Driving Anger Scale (DAS) and the fourth being the Dula Dangerous Driving Index (DDDI). These have previously been applied and validated in several different countries. The questionnaires were filled out online by 626 drivers. Using the data collected through the online platform, it was possible to identify the kind of reactions volunteers displayed while driving. Also, it was possible to identify that people in Mexico City developed anger depending on their driving area. Our analyses shows that in the Adaptive/Constructive Expression subscale, males and females show a significant difference in their mean score, with women express their anger in a more constructive way than males.

Understanding driving anxiety in older adults

BACKGROUND/OBJECTIVES

Driving anxiety is a heterogeneous experience that can impact on everyday activities. Little is known about whether older adults experience driving anxiety and, if so, what impact it has on their health, functioning, and quality of life. This is particularly important given the ageing population and driving patterns of older drivers. The present study examines the extent of self-reported driving anxiety in older adult drivers.

DESIGN

Population survey of community-dwelling older drivers.

SETTING

New Zealand.

PARTICIPANTS

1170 adults aged 65 and over.

MEASUREMENTS

Self-reported ratings of driving anxiety.

RESULTS

62.3% of participants reported no driving anxiety, 27.0% reported mild driving anxiety and 10.7% endorsed more moderate to extreme levels of driving anxiety, which is higher than has been identified with adults aged 55-72. Women were significantly more often (p <  .01) represented in the groups of mildly and moderately anxious drivers, and those who were moderately to extremely anxious were more likely to be aged 70+ (p <  .04). Those with moderate to severe driving anxiety tended to drive less often, for shorter distances, and to use alternative modes of transport more often than those with mild or no driving anxiety.

CONCLUSION

Driving anxiety is experienced by many older adults, with quite a large proportion reporting high levels of driving anxiety and associated differences in driving patterns. Further research is needed to better understand why older drivers experience driving anxiety, and how it impacts health and wellbeing as well as driving self-regulation and cessation.

Driving cognitions, rumination, and posttraumatic stress disorder in road traffic accidents survivors

This study evaluated the relationships between driving cognitions (i.e., panic-related cognitions, accident-related cognitions, and social-related cognitions), rumination, and posttraumatic stress disorder (PTSD) symptoms in a sample of road traffic accidents (RTAs) survivors. We also investigated the indirect effect of driving cognitions on PTSD symptoms through rumination. The sample included 633 drivers (62% were men; Mage = 36.09; standard deviation [SD] = 11.42 years). The participants completed scales measuring driving cognitions, rumination, and PTSD symptoms, as well as providing their demographic information. The results showed that all three types of driving cognitions assessed in the present study and rumination were significantly positively associated with PTSD symptoms. Furthermore, rumination mediated the relation between social-related cognitions and PTSD symptoms. The implications for PTSD treatment and future research are discussed.

Virtual reality exposure therapy for fear of driving: analysis of clinical characteristics, physiological response, and sense of presence

OBJECTIVE

To investigate the reactions of women with driving phobia to a therapeutic program of scheduled virtual reality exposure treatment (VRET) sessions.

METHODS

The study intervention consisted of a computer game with car-driving scenarios that included several traffic situations. We investigated the participants' sense of presence, subjective distress, and physiological responses during eight virtual-reality exposures. We also evaluated clinical characteristics, driving cognitions, and quality of life in the participants.

RESULTS

Thirteen women were selected. Eight were able to complete the protocol. After VRET, there was a decrease in the frequency of distorted thoughts and state anxiety scores, as well as a slight improvement in quality of life. Subjective discomfort scores, heart rate variation, and sense of presence scores confirmed that there was sense of presence in the virtual reality environment.

CONCLUSION

All patients showed some degree of improvement and demonstrated different levels of anxiety in subsequent in vivo driving experiences. Our findings suggest that VRET could be used to facilitate in vivo exposure, because it can induce presence/immersion and reduce anxiety in patients with specific phobia. Furthermore, VRET is not associated with any type of risk.

Die deutsche Version des „Driving Cognitions Questionnaire“ (DCQ)

Zusammenfassung. Theoretischer Hintergrund: Die Kenntnis spezifischer Kognitionen autofahrphobischer Patient_innen kann zum Verständnis der Ätiologie der Autofahrphobie sowie deren differentialdiagnostischer Abgrenzung beitragen. Die Modifikation dysfunktionaler Kognitionen bei Autofahrphobie ist zudem Ziel kognitiv-behavioraler Therapien. Bisher liegt jedoch kein deutschsprachiges Messinstrument vor, um spezifische Kognitionen bei Autofahrphobie zu erfassen, sodass die Skala „Driving Cognitions Questionnaire“ (DCQ) von Ehlers et al. (2007) ins Deutsche übersetzt wurde. Erfasst werden panikbezogene Sorgen, unfallbezogene Sorgen und Sorgen über die Bewertung durch Andere. Ziel ist eine psychometrische Validierung der deutschen Übersetzung des DCQ. Methode: Der DCQ wurde 98 ambulanten Psychotherapiepatient_innen sowie 843 Personen im Rahmen einer Online-Erhebung vorgelegt. Zur Validierung des deutschsprachigen Messinstruments wurde eine gekürzte Adaptation des „Driving Situations Questionnaire“ (DSQ) von Ehlers, Hofmann, Herda & Roth (1994) sowie das „Brief Symptom Inventory 18“ (BSI-18) von Franke et al. (2011) herangezogen. Dargestellt werden sowohl item- und skalentheoretische Befunde als auch faktorenanalytische Ergebnisse. Ergebnis: Die exploratorische Faktorenanalyse bestätigt die dreifaktorielle Struktur der Originalversion und konfirmatorisch führt ein bifaktorielles Modell zu einem guten Fit. Es liegen Belege für eine gute Reliabilität (.86 ≤ α ≤ .89) und Validität vor. Schlussfolgerung: Die deutsche Version des DCQ ist sowohl für Forschung als auch für die klinische Praxis einsetzbar und kann als Grundlage für weitere Untersuchungen in Bereichen der Klassifikation, Ätiologie und der Entwicklung von Behandlungsansätzen genutzt werden.

Psychometric evidence of the Brazilian version of Driving Cognitions Questionnaire (DCQ)

This paper examined the psychometric data obtained by the Brazilian version DCQ (Driving Cognitions Questionnaire) and its convergence with DBS (Driving Behavior Survey). The research included 187 participants of both genders, aged between 19 and 79years (mean 34years), with driving license in category 'B' (cars). The internal consistency obtained by research (Cronbach's alpha) was α=0.96 for full DCQ; α=0.89 for the subscale panic in the direction, α=0.91 for the subscale of concern in causing accidents and α=0.92 for the subscale of social concern. Psychometrically the results are positive and confirm the relevance of using the instrument. The survey also found positive convergence (although less pronounced) with the DBS, which is another instrument that comes to difficulties when driving or dealing with traffic or driving a car. Thus, this article demonstrates psychometric results that point to the profitable use of the Brazilian version of DCQ as an adjunct in the diagnosis of difficulty in driving.

Assessment of trypophobia and an analysis of its visual precipitation

We developed and validated a symptom scale that can be used to identify "trypophobia", in which individuals experience aversion induced by images of clusters of circular objects. The trypophobia questionnaire (TQ) was based on reports of various symptom types, but it nevertheless demonstrated a single construct, with high internal consistency and test-retest reliability. The TQ scores predicted discomfort from trypophobic images, but not neutral or unpleasant images, and did not correlate with anxiety. Using image filtering, we also reduced the excess energy at midrange spatial frequencies associated with both trypophobic and uncomfortable images. Relative to unfiltered trypophobic images, the discomfort from filtered images experienced by observers with high TQ scores was less than that experienced with control images and by observers with low TQ scores. Furthermore, we found that clusters of concave objects (holes) did not induce significantly more discomfort than clusters of convex objects (bumps), suggesting that trypophobia involves images with particular spectral profile rather than clusters of holes per se.

Visuo-vestibular contributions to anxiety and fear

The interactive roles of the visual and vestibular systems allow for postural control within boundaries of perceived safety. In specific circumstances, visual vestibular and postural interactions act as a cue that trigger fear, similarly to what occurs in motion sickness. Unusual patterns of visuo-vestibular interaction that emerge without warning can elicit fear, which can then become associated to a certain stimuli or situation, creating a CS-US association, (i.e., phobia), or can emerge without warning but also without becoming associated to a particular concomitant event (i.e., panic). Depending on the individual sensitivity to visuo-vestibular unusual patterns and its impact in postural control, individuals will be more or less vulnerable to develop these disorders. As such, the mechanism we here propose is also sufficient to explain the lack of certain fears albeit exposure. Following this rationale, a new subcategory of anxiety disorders, named visuo-vestibular fears can be considered. This model brings important implications for developmental and evolutionary psychological science, and invites to place visuo-vestibular fears in a particular subtype or specification within the DSM-5 diagnostic criteria.

Translation and cross-cultural adaptation of the Brazilian Portuguese version of the Driving Behavior Survey (DBS)

BACKGROUND

Fear of driving has been recognized as a complex diagnostic entity. For this reason, the use of psychometric instruments is fundamental to advancing research in this area. Psychometric instruments are also necessary for clinical care, as they can help conceptualize the disorder and plan adequate treatment.

OBJECTIVE

To describe the cross-cultural adaptation of a Brazilian version of the Driving Behavior Survey (DBS).

METHODS

The process consisted of: 1) two translations and back-translations carried out by independent evaluators; 2) development of a brief version by four bilingual experts in mental health; 3) experimental application; and 4) investigation of operational equivalence.

RESULTS

The adaptation process is described and a final Brazilian version of the DBS is presented.

CONCLUSION

A new instrument is now available to assess the driving behaviors of the Brazilian population, facilitating research in this field.

The Driving Behavior Survey: scale construction and validation

Although long recognized in the clinical literature, problematic behavior characteristic of anxious drivers has received little empirical attention. The current research details development of a measure of anxious driving behavior conducted across three studies. Factor analytic techniques identified three dimensions of maladaptive behaviors across three college samples: anxiety-based performance deficits, exaggerated safety/caution behavior, and anxiety-related hostile/aggressive behavior. Performance deficits evidenced convergent associations with perceived driving skill and were broadly related to driving fear. Safety/caution behaviors demonstrated convergence with overt travel avoidance, although this relationship was inconsistent across studies. Safety/caution scores were associated specifically with accident- and social-related driving fears. Hostile/aggressive behaviors evidenced convergent relationships with driving anger and were associated specifically with accident-related fear. Internal consistencies were adequate, although some test-retest reliabilities were marginal in the unselected college sample. These data provide preliminary evidence for utility of the measure for both research and clinical practice.

Virtual reality exposure therapy in the treatment of driving phobia

A growing number of researches has appeared on virtual reality exposure therapy (VRET) to treat anxiety disorders. The purpose of this article was to review some evidences that support the VRET efficacy to treat driving phobia. The studies were identified through computerized search (PubMed/Medline, Web of Science, and Scielo databases) from 1984 to 2007. Some findings are promising. Anxiety/avoidance ratings declined from pre to post-treatment. VRET may be used as a first step in the treatment of driving phobia, as long as it may facilitate the in vivo exposure, thus reducing risks and high costs of such exposure. Notwithstanding, more randomized/controlled clinical trials are required to prove its efficacy.

Do cognitive models help in predicting the severity of posttraumatic stress disorder, phobia, and depression after motor vehicle accidents? A prospective longitudinal study

The study investigated the power of theoretically derived cognitive variables to predict posttraumatic stress disorder (PTSD), travel phobia, and depression following injury in a motor vehicle accident (MVA). MVA survivors (N = 147) were assessed at the emergency department on the day of their accident and 2 weeks, 1 month, 3 months, and 6 months later. Diagnoses were established with the Structured Clinical Interview for DSM-IV. Predictors included initial symptom severities; variables established as predictors of PTSD in E. J. Ozer, S. R. Best, T. L. Lipsey, and D. S. Weiss's (2003) meta-analysis; and variables derived from cognitive models of PTSD, phobia, and depression. Results of nonparametric multiple regression analyses showed that the cognitive variables predicted subsequent PTSD and depression severities over and above what could be predicted from initial symptom levels. They also showed greater predictive power than the established predictors, although the latter showed similar effect sizes as in the meta-analysis. In addition, the predictors derived from cognitive models of PTSD and depression were disorder-specific. The results support the role of cognitive factors in the maintenance of emotional disorders following trauma.

Driving fear and driving skills: Comparison between fearful and control samples using standardised on-road assessment

The present study explores driving skills in a group of 50 media-recruited driving-fearful and 50 control drivers, all of whom were women. Participants completed an on-road practical driving assessment with a professional driving instructor. Diagnostic as well as pre-post self-report and instructor driving assessments were conducted. Fearful drivers made more errors on the driving assessment than controls. However, the pattern of errors was identical for both groups, indicating that fear and anxiety may be associated with the number rather than the type of driving errors made. These differences remained when factors such as driving history, current driving frequency, and diagnosis were controlled using case selection. More research is needed to replicate the findings in more diverse samples. Additional work should also aim to clarify the specific role of driving skills in driving fear, which will facilitate treatment planning for exposure-based treatments and help identify cases where driving skills assessment may be appropriate.