EXPERIMENTAL REPORT: Wanna drive?

TITLE: Wanna drive? driving anxiety and fear in a New Zealand community sample
AUTHOR: Taylor, J & Paki, D.
JOURNAL: New Zealand Journal of Psychology, July 2008
ABSTRACT: "Driving anxiety can impact everyday functioning and is common following motor vehicle crashes. However, no research has investigated its general community prevalence, despite the consistent finding that driving anxiety is not always a function of a vehicle crash. The present study explored the frequency and characteristics of driving anxiety and fear in a general community convenience sample of 100 participants who completed a questionnaire about driving anxiety, avoidance behaviour, and types of driving-related cognitions. Most of the sample described no anxiety, fear, or avoidance in relation to driving. However, 8% reported moderate to extreme anxiety about driving, and 7% described moderate to extreme driving fear. Women reported more driving anxiety, fear, and avoidance than men. These results indicate the need for more formal methods of establishing prevalence to clearly ascertain the extent of population-based driving anxiety and fear and its effects, so that research can begin to focus on developing effective treatment approaches for those whose anxiety has a psychological and functional impact." [full text]

MY TAKE: This study is trying to find out how common driving anxiety is in the general public.  Moderate to severe anxiety (significant enough to have a noticeable effect on their life) was found in 8% of the sample. I think that would have to be considered a pretty large proportion. As is usually the case driving anxiety was more common in women, although general trait anxiety was the same in both genders. The situations rated as most stressful were being tailgated, motorways, fog and heavy traffic.

REVIEW ARTICLE: Virtual Reality in Anxiety Disorders by Gorini, A & Riva, G

Virtual reality is a method for exposing phobic drivers to the situations they fear under controlled, interactive and safe conditions. The paper described below explains how virtual reality is used in the treatment of a range of phobias and provides a good background before tackling the more detailed experimental papers relating to the use of virtual reality in treating driving phobia (such as Ward & Taylor, 2000). Free full text of this review article is available online.

TITLE: Virtual reality in anxiety disorders: the past and present
AUTHOR: Gorini, A & Riva, G
JOURNAL: Expert Reviews of Neurotherapeutics, 2008, 8, 215-33.
ABSTRACT: "One of the most effective treatments of anxiety is exposure therapy: a person is exposed to specific feared situations or objects that trigger anxiety. This exposure process may be done through actual exposure, with visualization, by imagination or using virtual reality (VR), that provides users with computer simulated environments with and within which they can interact. VR is made possible by the capability of computers to synthesize a 3D graphical environment from numerical data. Furthermore, because input devices sense the subject's reactions and motions, the computer can modify the synthetic environment accordingly, creating the illusion of interacting with, and thus being immersed within the environment. Starting from 1995, different experimental studies have been conducted in order to investigate the effect of VR exposure in the treatment of subclinical fears and anxiety disorders. This review will discuss their outcome and provide guidelines for the use of VR exposure for the treatment of anxious patients." [PUBMED abstract, Full Text pdf]

SUMMARY/TAKE HOME MESSAGE:
This article provides a good overview of the theoretical purpose of virtual reality treatemnt for phobias, the equipment and procedures used, and research to date. There is relatively breif coverage of driving phobia, specifically:

"Driving phobia, defined as a specific phobia, situational type in Diagnostic and Statistical Manual of Mental Disorders (DSM)-IV, is characterized by intense and persistent fear of driving, which increases as a person anticipates or is exposed to driving stimuli. People with driving phobia acknowledge that their fears are excessive or unreasonable, yet are unable to drive, or tolerate driving with considerable distress. The inability to drive results in a major loss of mobility and independence, which interferes with daily activities.

Currently, the only three studies we have found in literature suggest that VRET may be a quite promising intervention for treating driving phobia, but obviously, more controlled trials and follow-up evaluations are necessary to support these preliminary findings" (p218).

The studies referred to are:
* Wald J. Efficacy of virtual reality exposure therapy for driving phobia: a multiple
baseline across-subjects design. Behav. Ther. 35, 621–635 (2004).
* Wald J, Taylor S. Efficacy of virtual reality exposure therapy to treat driving phobia: a case report. J. Behav. Ther. Exp. Psychiatry 31(3–4), 249–257 (2000).
* Walshe DG, Lewis EJ, Kim SI, O’Sullivan K, Wiederhold BK. Exploring the use of computer games and virtual reality in exposure therapy for fear of driving following a motor vehicle accident. Cyberpsychol. Behav. 6(3), 329–334 (2003).

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

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