Factors contributing to anxious driving behavior: the role of stress history and accident severity

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.

Feature selection for driving style and skill clustering using naturalistic driving data and driving behavior questionnaire

Driver's driving style and driving skill have an essential influence on traffic safety, capacity, and efficiency. Through clustering algorithms, extensive studies explore the risk assessment, classification, and recognition of driving style and driving skill. This paper proposes a feature selection method for driving style and skill clustering. We create a supervised machine learning model of driver identification for driving behavior data with no ground truth labels on driving style and driving skill. The key features are selected based on permutation importance with the underlying assumption that the key features for clustering should also play an important role in characterizing individual drivers. The proposed method is tested on naturalistic driving data. We introduce 18 feature extraction methods and generate 72 feature candidates. We find five key features: longitudinal acceleration, frequency centroid of longitudinal acceleration, shape factor of lateral acceleration, root mean square of lateral acceleration, and standard deviation of speed. With the key features, drivers are clustered into three groups: novice, experienced cautious, and experienced reckless drivers. The ability of each feature to describe individuals' driving style and skill is evaluated using the Driving Behavior Questionnaire (DBQ). For each group, the driver's response to DBQ key questions and their distribution of key features are analyzed to prove the validity of the feature selection result. The feature selection method has the potential to understand driver's characteristics better and improve the accuracy of driving behavior modeling.

Association of Driving Fitness and Driving Efficacy in the Elderly with Generalized Anxiety Disorder

Purpose

The purpose of this study was to investigate the relationship between driving fitness and driving efficacy in elderly patients with generalized anxiety disorder and identify factors influencing anxiety.

Methods

The anxiety level, driving efficacy, and driving performance were assessed for 45 elderly drivers who had been diagnosed with or were suspected of having an anxiety disorder in the past. The Korean-Self-rating Anxiety Scale (K-SAS), Korean-Adelaide Driving Self-Efficacy Scale (K-ADSES), and Korean-Drivers 65 Plus (K-D65+) were used as test tools. Factors affecting anxiety and the differences between the groups with high anxiety symptoms and anxiety in the normal range were analyzed.

Results

There were differences in driving efficiency and driving performance between elderly drivers with anxiety scores in the normal range and those with mild-to-moderate anxiety (p < 0.05). Significant factors (p < 0.001) influencing driving anxiety in the high anxiety group were GAD duration (β = 0.170), driving difficulty (β = 10.648), drug use (β = 0.656), traffic sign/signal awareness (β = −0.870).

Conclusion

Our results suggest that a combination of a driving rehabilitation approach and interventions that can provide emotional support and reduce mental health anxiety, as well as exposure treatment for driving performance training, may be necessary for driving rehabilitation of the elderly with generalized anxiety disorder.

Implementation and evaluation of a fuzzy-based system for determining stress feeling level in VANETs: Effect of driving experience and history on driver stress

Drivers are held responsible for the vast majority of traffic accidents. While most of the errors that cause these accidents are involuntary, a significant number of them are caused by irresponsible driving behaviors, which must be utterly preventable. Irresponsible driving, in addition, is often associated with the stress drivers experience while driving. We have previously implemented an intelligent system based on fuzzy logic for determining driver’s stress in Vehicular Ad hoc Networks (VANETs), called Fuzzy-based System for Determining the Stress Feeling Level (FSDSFL), considering the driver’s impatience, the behavior of other drivers, and the traffic condition as input parameters. In this work, we present an Improved FSDSFL (IFSDSFL) system, which considers the driving experience and history as an additional input. We show through simulations the effect that driving experience and history and the other parameters have on the determination of the stress feeling level and demonstrate some actions that can be performed when the stress exceeds certain levels.

A Fuzzy Logic Approach for Determining Driver Impatience and Stress Leveraging Internet of Vehicles Infrastructure

Drivers are held responsible for the vast majority of traffic crashes. Although most of the errors causing these accidents are involuntary, a significant number of them are caused by irresponsible driving behaviors, which must be utterly preventable. Irresponsible driving, on the other hand, is often associated with driver stress and the impatience they show while driving. In this paper, we consider the factors that cause drivers to become impatient and experience stress and propose an integrated fuzzy logic system that determines the stress level in real time. Based on the stress level, the proposed system can take the appropriate action that improves the driving situation and consequently road safety. By using inputs, such as the unnecessary maneuvers that drivers make, the time pressure, and the number of times they are forced to stop, a fuzzy logic controller determines the driver’s impatience, which is then considered alongside other factors, such as the driving experience and history, the behavior of other drivers, and the traffic condition to determine the stress level. We show, through simulations, the feasibility of the proposed approach to accurately determine driver stress and demonstrate some actions that can be performed when stress exceeds certain levels.

The influence of experienced severe road traffic accidents on take-over reactions and non-driving-related tasks in an automated driving simulator study

Road traffic accidents (RTAs) are an ever-existing threat to all road users. Automated vehicles (AVs; SAE Level 3-5) are developed in many countries. They are promoted with numerous benefits such as increased safety yielding less RTAs, less congestion, less greenhouse gas emissions, and the possibility of enabling non-driving related tasks (NDRTs). However, there has been no study which has investigated different NDRT conditions, while comparing participants who experienced a severe RTA in the past with those who experienced no RTA. Therefore, we conducted a driving simulator study (N = 53) and compared two NDRT conditions (i.e., auditory-speech (ASD) vs. heads-up display (HUD)) and an accident (26 participants) with a non-accident group (27; between-subjects design). Although our results did not reveal any interaction effect, and no group difference between the accident and the non-accident group on NDRT, take-over request (TOR), and driving performance, we uncovered for both groups better performances for the HUD condition, whereas a lower cognitive workload was reported for the ASD condition. Nevertheless, there was no difference for technology trust between the two conditions. Albeit we observed higher self-ratings of PTSD symptoms for the accident than for the non-accident group, there were no group differences on depression and psychological resilience self-ratings. We conclude that severe RTA experiences do not undermine NDRT, TOR, and driving performance in a SAE Level 3 driving simulator study, although PTSD symptoms after an RTA may affect the psychological wellbeing.

Global impact of COVID-19 pandemic on road traffic collisions

BACKGROUND

Various strategies to reduce the spread of COVID-19 including lockdown and stay-at-home order are expected to reduce road traffic characteristics and consequently road traffic collisions (RTCs). We aimed to review the effects of the COVID-19 pandemic on the incidence, patterns, and severity of the injury, management, and outcomes of RTCs and give recommendations on improving road safety during this pandemic.

METHODS

We conducted a narrative review on the effects of COVID-19 pandemic on RTCs published in English language using PubMed, Scopus, and Google Scholar with no date restriction. Google search engine and websites were also used to retrieve relevant published literature, including discussion papers, reports, and media news. Papers were critically read and data were summarized and combined.

RESULTS

Traffic volume dropped sharply during the COVID-19 pandemic which was associated with significant drop in RTCs globally and a reduction of road deaths in 32 out of 36 countries in April 2020 compared with April 2019, with a decrease of 50% or more in 12 countries, 25 to 49% in 14 countries, and by less than 25% in six countries. Similarly, there was a decrease in annual road death in 33 out of 42 countries in 2020 compared with 2019, with a reduction of 25% or more in 5 countries, 15-24% in 13 countries, and by less than 15% in 15 countries. In contrast, the opposite occurred in four and nine countries during the periods, respectively. There was also a drop in the number of admitted patients in trauma centers related to RTCs during both periods. This has been attributed to an increase in speeding, emptier traffic lanes, reduced law enforcement, not wearing seat belts, and alcohol and drug abuse.

CONCLUSIONS

The COVID-19 pandemic has generally reduced the overall absolute numbers of RTCs, and their deaths and injuries despite the relative increase of severity of injury and death. The most important factors that affected the RTCs are decreased mobility with empty lines, reduced crowding, and increased speeding. Our findings serve as a baseline for injury prevention in the current and future pandemics.

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.

Predicting the Coping Skills of Older Drivers in the Face of Unexpected Situation

In recent years, when an older driver who cannot immediately recognize, judge, and operate properly faces an unexpected situation, they often panic, which may cause a traffic accident. However, there has not yet been enough discussion about the coping skills of older drivers in the face of this unexpected situation. Therefore, this study discusses the coping skills of older drivers in the face of unexpected situations. Moreover, we propose a coping skills prediction system (CP system). The CP system predicts coping skills from the tilt angle and angular velocity of the left foot when an older driver is driving or preparing to start a car. The experiment carried out two phases, a phase of driving a car and a phase of preparing to start the car. In the driving phase, the young and older driver drive the car in a driving simulator. The average age of the young driver group was ± standard deviation = 20.6 ± 0.7 years, and the age of the older driver group was 78.5 ± 5.1 years. The driving route included 15 cases in which collision accidents are likely to occur. We analyzed the experimental results of the driving phase and clarified the predictors of coping skills. Moreover, we analyzed the correlation between the left foot movement in driving and the left foot movement during preparing to start the car. As a result of the experiment, there was a 0.84 correlation between the tilt angle of the left foot of the older driver in driving and the tilt angle of the left foot of the older driver in preparing to start the car. The result shows that the coping skills can be predicted from the tilt angle of the left foot of the older driver during preparing to start the car. We showed that the coping skill can be predicted with an accuracy of 92% or 94% on average from the tilt angle and the angular velocity of the left foot while driving or preparing to start the car. Moreover, we clarified that the tilt angle of the left foot of a driver without coping skills is perpendicular to the ground compared to a driver with coping skills. This study is expected to contribute to the prevention of traffic accidents that occur in the face of an unexpected situation.

Differences in Driving Intention Transitions Caused by Driver's Emotion Evolutions

Joining worldwide efforts to understand the relationship between driving emotion and behavior, the current study aimed at examining the influence of emotions on driving intention transition. In Study 1, taking a car-following scene as an example, we designed the driving experiments to obtain the driving data in drivers’ natural states, and a driving intention prediction model was constructed based on the HMM. Then, we analyzed the probability distribution and transition probability of driving intentions. In Study 2, we designed a series of emotion-induction experiments for eight typical driving emotions, and the drivers with induced emotion participated in the driving experiments similar to Study 1. Then, we obtained the driving data of the drivers in eight typical emotional states, and the driving intention prediction models adapted to the driver’s different emotional states were constructed based on the HMM severally. Finally, we analyzed the probabilistic differences of driving intention in divers’ natural states and different emotional states, and the findings showed the changing law of driving intention probability distribution and transfer probability caused by emotion evolution. The findings of this study can promote the development of driving behavior prediction technology and an active safety early warning system.

Assessment of the Risks of Occupational Diseases of the Passenger Bus Drivers

Background

The working conditions of bus drivers are difficult; they lead to occupational diseases and require careful study, particularly in Ukraine. The objective of the article is the description of occupational health risks of passenger bus drivers that lead to deteriorating health.

Methods

The risk assessment was performed using a modified Risk Score method, which allowed determining the generalized level of danger to the driver's health. The hygienic hazards level was assessed as based on Stevenson's law, which was generalized later.

Results

Based on the modification of the Risk Score method, it was possible to depart from expert assessments method of the risk level and calculate the general indicator based on the degree of dependence of the impact on the human body on its intensity, proposed by V. Minko. This allows objective determining of the impact of hygiene hazards on the health of the driver and to predict the occurrence of occupational diseases associated with the cardiovascular system, musculoskeletal system, and partial or complete disability due to the accumulation of emotional fatigue. The hazard assessment was carried out for three brands of passenger buses common in Ukraine, in which the driver is exposed to the dangers of fever, vibration, noise, harmful impurities in the bus cabin, and emotional load.

Conclusion

The health of drivers in the cabins of passenger buses is most affected by hygiene hazards: fever, vibration, and emotional stress. The generalized level of risk is calculated by the modified method of Risk Score is 0.83; -0.99, -0.92 respectively.

Fuzzy support vector machine-based personalizing method to address the inter-subject variance problem of physiological signals in a driver monitoring system

Physiological signals can be utilized to monitor conditions of a driver, but the inter-subject variance of physiological signals can degrade the classification accuracy of the monitoring system. Personalization of the system using the data of a tested subject, called local data, can be a solution, but the acquisition of sufficient local data may not be possible in real situations. Therefore, this paper proposes an effective personalizing method using small-sized local data. The proposed method utilizes a fuzzy support vector machine to allocate higher weight to the local data than to others, and a fuzzy membership is assigned to the training data by analyzing the importance of each datum. Three classification problems for a physiological signal-based driver monitoring system are introduced and utilized to validate the proposed method. The classification accuracy is compared with that of other personalizing methods, and the results show that the proposed method achieves a better accuracy on average, which is 3.46% higher than that of the simple approach using a basic support vector machine, thereby proving its effectiveness. The proposed method can train a personalized classifier with improved accuracy for a tested subject. The advantages of the proposed method can be utilized to develop a practical driver monitoring system.

Influence of Adaptive Human–Machine Interface on Electric-Vehicle Range-Anxiety Mitigation

The electrification of vehicles is without a doubt one of the milestones of today’s automotive technology. Even though industry actors perceive it as a future standard, acceptance, and adoption of this kind of vehicles by the end user remain a huge challenge. One of the main issues is the range anxiety related to the electric vehicle’s remaining battery level. In the scope of the H2020 ADAS&ME project, we designed and developed an intelligent Human Machine Interface (HMI) to ease acceptance of Electric Vehicle (EV) technology. This HMI is mounted on a fake autonomous vehicle piloted by a hidden joystick (called Wizard of Oz (WoZ) driving). We examined 22 inexperienced EV drivers during a one-hour driving task tailored to generate range anxiety. According to our protocol, once the remaining battery level started to become critical after manual driving, the HMI proposed accurate coping techniques to inform the drivers how to reduce the power consumption of the vehicle. In the following steps of the protocol, the vehicle was totally out of battery, and the drivers had to experience an emergency stop. The first result of this paper was that an intelligent HMI could reduce the range anxiety of the driver by proposing adapted coping strategies (i.e., transmitting how to save energy when the vehicle approaches a traffic light). The second result was that such an HMI and automated driving to a safe spot could reduce the stress of the driver when an emergency stop is necessary.

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.

Associations between emotional symptoms and self-reported aberrant driving behaviors in older adults

OBJECTIVE

To examine associations between internalizing symptoms and self-reported aberrant driving behaviors in a large sample (n = 341) of older adults (mean age = 62.6 years, SD = 4.8).

DESIGN

Cross-sectional survey.

RESULTS

Multiple regression analyses revealed that greater symptoms of emotional distress (i.e., higher scores on the Expanded Version of the Inventory of Depression and Anxiety Symptoms (IDAS-II) emotional distress composite) were associated with greater aberrant driving behaviors (i.e., higher scores on the Driving Behavior Questionnaire). In contrast, neither obsessions/fears nor emotional well-being were associated with greater aberrant driving behaviors. Follow-up regression analyses examining specific IDAS-II subscales revealed that greater suicidality, appetite gain, appetite loss, panic, and ill temper were associated with greater aberrant driving behaviors. Individuals reporting greater suicidality and appetite loss reported greater tendencies to unintentionally commit errors behind the wheel, while individuals reporting greater ill temper and appetite loss reported greater tendencies to intentionally engage in unsafe driving behaviors that may put other drivers in harm's way.

CONCLUSION

Older adults reporting emotional distress may be at risk for engaging in aberrant driving behaviors. In particular, certain symptoms of emotional distress (e.g., suicidality, ill temper) are tied to higher rates of aberrant driving behaviors within this population.

Adverse effects of anxiety on attentional control differ as a function of experience: A simulated driving study

This study tested whether adverse effects of state anxiety on attention and performance may be modulated by experience. Sixteen experienced and eleven inexperienced drivers drove in a simulator under low- and high-stress conditions. Anxiety was manipulated by competition, the presence of an evaluator, external video camera, and traffic noise. Most drivers showed greater anxiety scores and higher mean heart rates following manipulation. In both groups increased state anxiety decreased car speed control and caused more collisions, accompanied by fewer fixations of longer duration towards the driving lane across a horizontally narrower region. Inexperienced drivers increased the number of short fixations towards cars, while experienced drivers increased the number of short fixations on the speedometer. Although anxiety impairs processing efficiency and performance effectiveness for both groups, attentional changes differ as a function of experience. Inexperienced drivers tended to shift attention to threatening stimuli, while experienced drives were more likely to consciously monitor task goal.

Work stress and health problems of professional drivers: a hazardous formula for their safety outcomes

Background

Several empirical studies have shown that professional drivers are a vulnerable occupational group, usually exposed to environmental stressors and adverse work conditions. Furthermore, recent studies have associated work-related stress with negative job performances and adverse health outcomes within this occupational group, including cardiovascular diseases and unsafe vehicle operation.

Objective

The aim of this study was to describe the working conditions and the health status of this occupational group, and to evaluate the association between the Demand-Control model of job stress and their self-reported health and safety outcomes.

Methods

A pooled sample of 3,665 Colombian professional drivers was drawn from five different studies. The Job Content Questionnaire and the General Health Questionnaire were used to measure work stress and self-reported mental health, respectively. Additionally, professional drivers self-reported health problems (hypertension, dyslipidemia, diabetes and overweight) and health-related risky behaviors (smoking and sedentary behavior).

Results

Regarding the Job Demands-Control (JDC) model, it was found that approximately a third part of Colombian professional drivers suffer from high job strain (29.1%). Correlational and multivariate analyses suggest that de JDC model of stress is associated with the professional drivers' mental health, traffic accidents and fines, but not with other physical and behavioral health-related outcomes, which are highly prevalent among this occupational group, such as hypertension, dyslipidemia, diabetes, overweight, smoking and sedentary behavior.

Conclusion

The results of this study suggest that (a) stressful working conditions are associated with health and lifestyle-related outcomes among professional drivers, and (b) that evidence-based interventions are needed in order to reduce hazardous working conditions, job stress rates and their negative impact on the health of this occupational group.

Does gender really matter? A structural equation model to explain risky and positive cycling behaviors

INTRODUCTION

While the use of bicycles as mean of transport is growing worldwide, the increasing rates of traffic crashes involving cyclists have turned into a relevant scientific, public health, and road safety concern. According to several studies, and despite the fact that some countries are taking part in preventive actions, the data indicate that the problem of cycling injuries implies high costs for the community welfare, for the economy, and for healthcare systems, thus proving a clear need for solutions. In this regard, and considering the available empirical evidence, risky and positive riding behaviors have gained significant weight in terms of explaining, intervening in, and preventing traffic crashes of cyclists, and some evidence suggests that gender may influence the road behavior of users.

OBJECTIVE

The objective of this study was to examine the effect of gender on cyclists' risky and positive riding behavior, considering a set of demographic, psychosocial and bike-use-related variables as potential predictors.

METHOD

For this cross-sectional study, data from 1064 cyclists (61.2% males and 38.8% females, aged between 17 and 80) from 20 countries, responding an electronic survey, were analyzed through a multi-group structural equation modeling approach.

RESULTS

Although hourly intensity, psychological distress and level of knowledge of traffic rules similarly predict the risky road behaviors of both genders, age and risk perception are significant behavioral predictors only in the case of male cyclists. On the other hand, positive behaviors of men are predicted by cycling intensity, knowledge of traffic rules and risk perception, while in the case of women psychological distress predicts -to a significant extent- positive behaviors. Age had no significant effect on the explanation of positive behaviors.

CONCLUSION

The findings of this study support the influence of gender in the statistical explanation of risky and protective behaviors, and they also reveal differentiating variables predicting the riding behavior of male and female cyclists.

Are anxiety and fear separable emotions in driving? A laboratory study of behavioural and physiological responses to different driving environments

Research into anxiety and driving has indicated that those higher in anxiety are potentially more dangerous on the roads. However, simulator findings suggest that conclusions are mixed at best. It is possible that anxiety is becoming confused with fear, which has a focus on more clearly defined sources of threat from the environment, as opposed to the internal, thought-related process associated with anxiety. This research aimed to measure feelings of fear, as well as physiological and attentional reactions to increasing levels of accident risk. Trait anxiety was also measured to see if it interacted with levels of risk or its associated reactions. Participants watched videos of driving scenarios with varying levels of accident risk and had to rate how much fear they would feel if they were the driver of the car, whilst skin conductance, heart rate, and eye movements were recorded. Analysis of the data suggested that perceptions of fear increased with increasing levels of accident risk, and skin conductance reflected this pattern. Eye movements, when considered alongside reaction times, indicated different patterns of performance according to different dangerous situations. These effects were independent of trait anxiety, which was only associated with higher rates of disliking driving and use of maladaptive coping mechanisms on questionnaires. It is concluded that these results could provide useful evidence in support for training-based programmes; it may also be beneficial to study trait anxiety within a more immersive driving environment and on a larger scale.

The driving behavior survey as a measure of behavioral stress responses to MVA-related PTSD

Numerous treatments are available that address the core symptoms of posttraumatic stress disorder (PTSD). However, there are a number of related behavioral stress responses that are not assessed with PTSD measures, yet these behavioral stress responses affect quality of life. The goal of the current study was to investigate whether a recently developed measure of behavioral stress response, the Driving Behavior Survey (DBS), was sensitive to change associated with treatment among a group of participants diagnosed with PTSD. The DBS indexes anxious driving behavior, which is frequently observed among individuals with motor vehicle accident-related PTSD. Participants (n = 40) were racially diverse adults (M age = 40.78, 63% women) who met diagnostic criteria for motor vehicle accident-related PTSD. Hierarchical linear modeling analyses indicated that participants who were assigned to a brief, exposure-based intervention displayed significant reductions on the DBS subscales relative to participants assigned to the wait-list control condition (r = .41–.43). Moreover, mediational analyses indicated that the observed reductions on the DBS subscales were not better accounted for by reductions in PTSD. Taken together, these findings suggest that the DBS subscales are sensitive to changes associated with PTSD treatment and can be used to augment outcome assessment in PTSD treatment trials.

The Driving Behavior Survey as a measure of behavioral stress responses to MVA-related PTSD

Numerous treatments are available that address the core symptoms of posttraumatic stress disorder (PTSD). However, there are a number of related behavioral stress responses that are not assessed with PTSD measures, yet these behavioral stress responses affect quality of life. The goal of the current study was to investigate whether a recently developed measure of behavioral stress response, the Driving Behavior Survey (DBS), was sensitive to change associated with treatment among a group of participants diagnosed with PTSD. The DBS indexes anxious driving behavior, which is frequently observed among individuals with motor vehicle accident-related PTSD. Participants (n=40) were racially diverse adults (M age=40.78, 63% women) who met diagnostic criteria for motor vehicle accident-related PTSD. Hierarchical linear modeling analyses indicated that participants who were assigned to a brief, exposure-based intervention displayed significant reductions on the DBS subscales relative to participants assigned to the wait-list control condition (r=.41-.43). Moreover, mediational analyses indicated that the observed reductions on the DBS subscales were not better accounted for by reductions in PTSD. Taken together, these findings suggest that the DBS subscales are sensitive to changes associated with PTSD treatment and can be used to augment outcome assessment in PTSD treatment trials.

Properties of the Driving Behavior Survey among individuals with motor vehicle accident-related posttraumatic stress disorder

Data suggest anxious drivers may engage in problematic behaviors that place themselves and others at increased risk of negative traffic events. Three domains of problematic behavior--exaggerated safety/caution, performance deficits, and hostile/aggressive behaviors--previously were identified during development of the Driving Behavior Survey (DBS), a novel measure of anxiety-related behavior. Extending this research, the current study examined the psychometric properties of DBS scores among individuals with posttraumatic stress disorder (PTSD) subsequent to motor vehicle trauma (N=40). Internal consistencies and 12-week test-retest reliabilities for DBS scales ranged from good to excellent. Comparison of scores to normative student data indicated dose-response relationships for safety/caution and performance deficit subscales, with increased frequency of anxious behavior occurring within the PTSD sample. Associations with standard clinical measures provide additional evidence for anxiety-related driving behavior as a unique marker of functional impairment, distinct from both avoidance and disorder-specific symptoms.

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.

I-95 phobia treated with hypnotic systematic desensitization: a case report

Systematic desensitization and hypnosis mediated therapy share empirical evidence of efficacy in the treatment of specific phobias. However, a review of the literature indicated there is limited documentation in the employment of these modalities for treating driving related phobias (DRP). This article reports on the use of hypnosis aided systematic desensitization (HASD) in the successful treatment of a case of non-accident related driving phobia, specifically manifested on Interstate 95 (I-95). The treatment consisted of 6 office sessions of HASD along with 14 in-vivo sessions where the patient performed multiple exposures/rehearsals of the behaviors that had been successfully mastered at the office visits. The results indicated that this patient with case of (DRP) was able to resume travel on I-95 at conclusion of treatment. The patient was symptom free at follow up 6 months later.