What surviving drivers learn from a fatal road accident

AUTHOR: Rajalin S & Summala H
JOURNAL: Accident Analysis and Prevention 1997; 29: 277-283.

ABSTRACT: "The effects of involvement in a fatal accident on surviving drivers' subsequent driving behavior were studied. The quantity (mileage) and quality of driving (offences in driver records) of 245 surviving drivers were compared in three-year periods before and after the accident. A random sample of 253 drivers from the driver register were additionally used as controls. The data showed that about half of the car drivers decreased their driving, with greater reductions being associated with more serious injuries. However, the total number of convictions did not reduce but even showed a tendency to increase in proportion to the amount of driving. The proportion of car drivers with post-crash offences was approximately constant (27-32%) independent of any change in mileage. The data suggest that professional heavy-vehicle drivers incurred fewer convictions during the post-crash period in comparison to car drivers. Thirty-seven surviving drivers were further interviewed on the duration and specificity of the effects. With the exception of three drivers, all said that the fatal accident had affected their driving behavior, but only for a relatively short time. Most commonly, the drivers reported that the effect was limited to those circumstances and situations which led to the accident and did not generalize to safer driving practices. This study suggests that car drivers, if not seriously injured, typically return to their 'normal' driving within a few months, while heavy-vehicle drivers show a tendency towards more cautious behavior after a fatal crash in terms of violations, presumably due to the continuous reinforcement which the latter receive in their work community." [abstract]

SUMMARY/TAKE HOME MESSAGE: About 20% of driving involved in an accident where there was a fatalities permanently reduce or cease their driving behavior. Drivers who believed their own error caused the accident were more severely affected.

Psychiatric consequences of motor vehicle accidents

AUTHOR: Mayou RA
JOURNAL: Psychiatry in the Medically Ill 2002; 25: 27-41.

ABSTRACT: "Psychiatric complaints are frequent following motor vehicle accidents and may be major predictors of persistent pain and other complaints. Outcomes are not related closely to the nature or severity of any medical injury. Psychiatric problems often are unrecognized and untreated. There is a need for more behaviorally inferred routine care, early recognition of complications, and the use of psychological and pharmacological interventions."

SUMMARY/TAKE HOME MESSAGE: Motor vehicle accidents are relatively common and frequently have serious mental health consequences including driving-related phobia.

EXPERIMENTAL REPORT: Virtual Reality for the Psychophysiological Assessment of Phobic Fear: Responses During Virtual Tunnel Driving

PEER-REVIEWED

AUTHORS: Mühlberger, A., Bülthoff, H.H., Wiedemann, G., Pauli, P.
JOURNAL: Psychological Assessment 2007; 19: 340-346.

ABSTRACT: "An overall assessment of phobic fear requires not only a verbal self-report of fear but also an assessment of behavioral and physiological responses. Virtual reality can be used to simulate realistic (phobic) situations and therefore should be useful for inducing emotions in a controlled, standardized way. Verbal and physiological fear reactions were examined in 15 highly tunnel-fearful and 15 matched control participants in 3 virtual driving scenarios: an open environment, a partially open tunnel (gallery), and a closed tunnel. Highly tunnel-fearful participants were characterized by elevated fear responses specifically during tunnel drives as reflected in verbal fear ratings, heart rate reactions, and startle responses. Heart rate and fear ratings differentiated highly tunnel-fearful from control participants with an accuracy of 88% and 93%, respectively. Results indicate that virtual environments are valuable tools for the assessment of fear reactions and should be used in future experimental research."

SUMMARY: Most treatments for phobia involve some kind of counter conditioning. That is being placed in the feared situation, usually starting with low intensity, and replacing feelings of fear with feelings of relaxation. As the authors note, placing driving in a feared situation such as driving in a tunnel, is neither easy nor particularly safe.

This study further developed a virtual reality system as a fully controlled and safe substitute for real driving. The study shows that those with a specific fear of driving in tunnels did become more fearful during periods of simulation of tunnel driving, but not during open driving (there was also a control group that did not become afraid at all). this suggests that virtual reality systems may, in the future, have a useful role in treating driving phobias.

Fearfulness was measured from self-report, but also heart rate, and skin conductivity. Self report was the most useful measure, followed by heart rate with which it was moderately correlated. Skin conductivity was, well a bit rubbish all round.

MY THOUGHTS: This is all very nice... but can we move along with using it for actual treatments?

Mühlberger, A., Bülthoff, H., Wiedemann, G., & Pauli, P. (2007). Virtual reality for the psychophysiological assessment of phobic fear: Responses during virtual tunnel driving. Psychological Assessment, 19 (3), 340-346 DOI: 10.1037/1040-3590.19.3.340

See also:
Efficacy of virtual reality exposure therapy to treat driving phobia: a case report

New Url

Please update your bookmarks to http://www.drivinganxiety.info

I apologise for the downtime; it took a little while to get the domain, host and blog host to all play well together.

It will take just a little longer to settle fully into this new theme and get everything linked up and looking pretty....

But I hope that once that is done this site will be a lot more functional, and I have a lot more great information to add to it.

Discomfort, affects and coping strategies in driving activity

AUTHORS: Cahour, B
JOURNAL: Proceedings of the 15th European conference on Cognitive ergonomics: the ergonomics of cool interaction, 2008

ABSTRACT: "Psychological comfort/discomfort is a global feeling constructed from the affective states which are lived by the users during the activity. This empirical study is about discomfort and emotions lived during all sorts of driving situations, and it is based on "explicitation interviews" and questionnaires. The analysis allowed us to specify the categories of uncomfortable situations during driving and their level of discomfort, to develop the underlying cognitive and social sources of discomfort (need of multiple attention; impossible anticipation; loss of control and feeling of un-ability; social image and relation), and to look at how people cope with the disagreeable situations, specifying the different types of coping modes (internal coping, external coping, avoidance)." [Full text available here (pdf)]

SUMMARY: This study is based on hour long interviews with 18 participants from a range of age groups. It is a general examination of experiences that cause negative emotions during driving. It was found that the most commonly experienced emotions were "tension and fear", followed by anger and then all other feelings. The sources of these feelings seem to be the need to attend to multiple aspects of a situation, of failures to see or anticipate events, feelings of being out of control or unskilled and the interference and opinions of other people. Coping strategies fall into three main groups: trying to change ones own thoughts or behavior, trying to change the situation, and avoidance of situations such as driving in certain areas. "It seems that older people are more often avoiding uncomfortable situations of driving..."

MY THOUGHTS: While not specifically about driving anxiety this paper gives a good background to the causes and outcomes of negative feelings whilst driving.

Béatrice Cahour (2008). Discomfort, affects and coping strategies in driving activity ACM International Conference Proceeding Series, 369

Why am I so afraid of driving?

POPULAR PRESS
AUTHORS: Fox, S.
PUBLICATION: The Times (London), 1999.

SUMMARY: A journalist account of suffering from spontaneous driving anxiety and seeking help for it.

"...I was horrified at how out of proportion my fears had become."

"It was a relief to sit with Professor Ehlers who, without be judgmental, was able to explain what happened to me."

"Professor Ehler divides driving phobics into three categories. Post-traumic stress disorder follows an accident ... another group .. suffer from panic disorder ... someone with a driving phobia."

"Professor Ehlers ... "I would hope that your anxiety could be dealt with in 12 to 15 sessions...."
MY THOUGHTS: So this article neither explains what causes the anxiety, nor goes even as far as beginning to treat it.

TAKE HOME MESSAGE: Why call an article "why am I so scared of driving?" and then not provide any kind of answer? A phobia diagnosis describes that you are afraid--it does not explain why.

Psychosocial sequelae of motor vehicle collisions: a follow-up study

AUTHORS: Vingilis E, Larkin E, Stoduto G, Parkinson-Heyes A, McLellan B.
JOURNAL: Accident; Analysis and Prevention, 1996

ABSTRACT: One-hundred-and-forty-nine motor vehicle collision trauma victims were interviewed one year after discharge from a Regional Trauma Unit. Follow-up data indicated major post trauma problems such depression, anxiety, family stress, financial problems and driving fears. Almost 40% reported drinking driving after the crash with a greater proportion of alcohol (blood alcohol content) positive drivers engaging in drinking driving than blood alcohol content negative drivers. Notably, almost 16% of the blood alcohol content positive and 13% of the blood alcohol content negative reported involvement in another crash in the year since discharge.. [Abstract here; Keywords: Canada; Trauma; Motor vehicle injuries; Alcohol; Sequelae; Psychosocial ]

SUMMARY: A Canadian study of 149 people who suffered injuries (requiring hospital treatment) from a car crash found that 25-50% had post-traumatic problems as a result. One third experienced driving anxiety and 1/4 fear of cars. After one year 16% had not resumed driving. Driving who had no blood alcohol at the time of their crash were more likely to develop fear of driving and take longer to resume driving.

MY THOUGHTS: The consequences of traumatic crashes are often diverse and serious, often including severe driving anxiety.

TAKE HOME MESSAGE: It seems driving anxiety is a relatively common result of a driving accident resulting in trauma. Although it is not clear what proportion of people suffering from driving anxiety develop it as a result of a crash.

Phobic drivers go to class to learn mastery of fear

POPULAR PRESS
AUTHOR: Glenn Ruffenach
PUBLICATION: The Wall Street Journal, 1990

ABSTRACT: N/A.

SUMMARY: A journalist account of Charles Melville's group treatment course for driving anxiety. Interesting quotes:

"Fears links to driving may be the most common."

"Heredity seems to be part of the problem, but no one is immune...."

"Most of the nine seated around Mr. Melville had their first attach while driving. It occurred for no apparent reason."

"Mr. Melville ... says such attacks are often an "accumulation of life stresses"."

The treatment seems to be primarily systematic desensitization.

MY THOUGHTS: If driving anxiety has genetic (biological) input, occurred spontaneously (no initiating assocation with an unconditioned stressor), and in response to generalised stress (operant conditioning?)--why is the treatment based on the idea of Pavlovian conditioning?

TAKE HOME MESSAGE: The article concentrates on one participant who recovered fully... but what happened to the other nine? This is why I generally focus on peer-reviewed scientific reports.

What does driving and riding avoidance scale (DRAS) measure?

AUTHORS: Taylor JE & Sullman MJM
JOURNAL: Journal of Anxiety Disorders, 2008

ABSTRACT: Driving anxiety can have a significant impact on everyday functioning and usually results in some kind of avoidance behaviour. The Driving and Riding Avoidance Scale (DRAS; Stewart, A. E., & St. Peter, C. C. (2004). Driving and riding avoidance following motor vehicle crashes in a non-clinical sample: psychometric properties of a new measure. Behaviour Research and Therapy, 42, 859–879) shows promise in the self-report assessment of the degree of such avoidance. The present study investigated the psychometric properties of the DRAS in a sample of 301 university students. Internal consistency for the DRAS was 0.89 and temporal stability over two months was 0.71. The factor structure of the DRAS supported the use of the general and traffic avoidance subscales but not the weather and riding avoidance subscales in the present non-clinical sample. However, a significant limitation of the DRAS is that it does not assess the reasons for driving avoidance, and is therefore not a measure of avoidance that is due to driving anxiety. Some items may be rated highly for practical reasons, such as avoidance because of increasing fuel and other costs associated with driving. Modified instructions for the DRAS should ensure that it measures anxiety-related avoidance behaviour. [Abstract here; Keywords: Driving and Riding Avoidance Scale; Avoidance; Measurement; Assessment]

SUMMARY: The DRAS is a twenty question survey taken by people with driving anxiety which is intended to measure how much they avoid driving or riding in cars. However surveys depend on people reporting accurately. This study of undergraduates (mean age 24 years). There was no effect of gender. The test was administered twice, two-months apart, and results changed significantly over this time. The participants showed low level of avoidance.

MY THOUGHTS: Undergraduates may be the most studies subject other than the albino rat, but that has more to do with convenience than validity. DRAS can be used equally with a history of motor vehicle crash experience or not--but may also respond to cause other than driving anxiety. But this is basically yet another study concluding that there is a need for more studies.

TAKE HOME MESSAGE: In a practical sense, limited.

J TAYLOR, M SULLMAN (2008). What does the Driving and Riding Avoidance Scale (DRAS) measure? Journal of Anxiety Disorders DOI: 10.1016/j.janxdis.2008.10.006