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PubMed1987

Drinking-driving and health lifestyle in the United States: Behavioral Risk Factors Surveys.

National patterns of self-reported drinking-driving were examined using aggregated Behavioral Risk Factor Survey data. Drinking-driving is reported by 6.1% of U.S. adults, is almost three times more prevalent among men than women and is most prevalent in 18-24-year-old men (15.4%). Sociodemographic characteristics of self-reported drinking drivers correspond with those characteristics based on alcohol-associated motor vehicle accident and arrest data. Heavy smokers and those who fail to use seatbelts are more likely to drink and drive than those without these health-risk behaviors. Men reporting stress in interpersonal relationships are more likely to drink and drive. Individuals who drink or smoke in response to stress are more likely to drink and drive than those who exercise in response to stress. The concurrent practice of drinking-driving with lack of seatbelt use, use of alcohol in response to stress and smoking probably contributes substantially to the risk of accident and serious injury among drinking drivers and has implications for both prevention and treatment programs.

Accidents, Traffic↗
PubMed1998

Adolescents, bush parties and drinking-driving.

OBJECTIVE: We describe the prevalence of bush party (an outdoor gathering of youth) attendance and examine predictors of attendance and of driving after drinking at bush parties. METHOD: The 1995 Ontario Student Drug Use Survey (OSDUS) data on students (n = 1,853) in schools across the province in grades 7, 9, 11 and 13 are employed to estimate prevalence of bush party attendance within the previous 12 months. The 1994 Graduated Licensing Study (GLS), a multi-community survey of drivers (n = 1,157, 53.6% male) in grades 11 and 12 in Ontario, data are employed to study predictors of attendance and of drinking-driving. RESULTS: Based on the OSDUS, the prevalence of bush party attendance is 37.6%. Based on the GLS, 38.4% attended bush parties, and among attenders 71.5% drank at bush parties, 63.5% observed drinking-driving, 16.1% rode with a drinking-driver and 16.6% drove after drinking at bush parties. Logistic regression reveals that attendance at bush parties is positively associated with number of other places alcohol was consumed, tobacco use, number of alcohol-related problems, number of kilometers ever driven, sensation seeking and northern residents. Among attenders who drank at bush parties, males were three and a half times more likely to drive after drinking at a bush party, and the probability of drinking and driving increased with the number of other drugs used. CONCLUSIONS: Despite important differences in the design and purpose of the two surveys, both indicate that bush party attendance is prevalent among adolescents. Driving after drinking at these events is common and warrants community action.

Adolescent↗
PubMed2001

MADD victim impact panels and stages-of-change in drunk-driving prevention.

OBJECTIVE: To assess the additional effects of Mothers Against Drunk Driving (MADD) Victim Impact Panels (VIPs) over the effects of a DWI (driving while intoxicated) school, on (1) moving individuals through the stages-of-change toward not drinking while driving and (2) drunk-driving recidivism. METHOD: A randomized experiment with 813 (75% male) DWI offenders in New Mexico measured progress through the stages-of-change at pretest, posttest, 1-year follow-up and 2-year follow-up. In addition, drunk-driving recidivism over 2 years was measured from state driving records. Individuals were randomly assigned to a DWI school or a DWI school plus a MADD VIP. RESULTS: No significant difference in movement through the stages-of-change, or in recidivism, occurred between respondents in the DWI-school-only treatment, and those in the DWI school plus VIP treatment. CONCLUSIONS: There was no additional effect of the MADD VIP, a relatively emotional intervention, over that of the DWI school, a relatively informational approach, on DWI behavior (whether measured by stages-of-change or by DWI rearrest data) over the 2-year period following the two interventions.

Adult↗
PubMed2004

Adolescent developmental antecedents of risky driving among young adults.

OBJECTIVE: The risk of injury or death due to motor vehicle crash is highest from ages 16 to 35. Crash rates are associated with driver's gender, age, inexperience, emotional states, thrill seeking, personality factors and substance use. The developmental trajectories of psychosocial and nondriving problem behavior that lead to risky driving behavior, however, are not well understood. This study examined the longitudinal patterns of adolescent psychosocial behavior and substance use of five risky driving groups. METHOD: Longitudinal data were gathered from 2,085 subjects (1,110 women) surveyed in young adulthood and at least once previously in high school (i.e., 10th and/or 12th grade). Based on young adult data, participants were classified into five groups differing in type and level of risky driving. Analyses compared the adolescent psychosocial and substance use development of the participants in the risky driving groups. RESULTS: A low level of parental monitoring, greater parental permissiveness, a weaker social bond and high levels of and rapid increases in substance use characterized the developmental trajectories of young adult risky drivers. CONCLUSIONS: These developmental traits identify individuals who are likely to endanger themselves and others through risky driving and who should receive early interventions to reduce the likelihood of subsequent risky driving.

Accidents, Traffic↗
PubMed1999

[Effect of the long distance truck driving in Hokkaido on cardiovascular system].

We took the blood pressure and ECG of 8 male truck drivers who drive long distances in Hokkaido and observed the conditions under which they work. Most of their driving routes included steep passes, and the weather and the road conditions became worse in winter. Their tasks were not only the driving and waiting but also such manual labor as loading, etc. The mean driving distance of one route was 705 km and it ranged from 159 km to 1,210 km. The mean number of working hours was 27.8 h, and it ranged from 9.2 h to 46.9 h. Blood pressure was higher when driving or loading than when resting or on a day off. The mean systolic blood pressure was over 140 mmHg in 6 cases, and arrhythmia occurred frequently in 4 cases during driving or loading. In 2 cases, in which the driver met with accident, the blood pressure was remarkably high and arrhythmia occurred frequently. Most drivers worked for a very long time in poor conditions and environment. The results of our study suggested that such a heavy work load will affect the cardiovascular system.

Accidents, Traffic↗
PubMed2000

Further evidence of associations of type a personality scores and driving-related attitudes and behaviors.

The present study examined the effects of Type A personality on specific self-reported driving attitudes and behaviors when operating a motor vehicle. 102 undergraduate students completed the student version of the Jenkins Activity Survey (Form T) and several questionnaires asking participants about their driving history, driving attitudes, and driving behaviors. When the full range of Type A scores were examined, Type A personality was significantly related to more traffic accidents, greater frequency of breaking traffic laws, higher impatience when driving, more displays of aggression on the road, and engaging in more risky driving behaviors (rs<.17). When extreme Type A and Type B scores were compared, Type A drivers reported being involved in significantly more motor vehicle accidents and reported displaying more aggression on the road. Further research should examine actual behavioral data using more diverse samples to validate the results.

Adolescent↗
PubMed2002

Effects of manual versus voice-activated dialing during simulated driving.

We measured driving performance (lane-keeping errors, driving times, and glances away from the road scene) in a video driving simulator for 24 volunteers who each drove alone on a 10.6-km multicurved course while simultaneously placing calls on a mobile phone subscribed to a voice-activated dialing system. Driving performance also was measured for the same distance while participants manually dialed phone numbers and while they drove without dialing. There were 22% fewer lane-keeping errors (p<.01) and 56% fewer glances away from the road scene (p<.01) when they used voice-activated dialing as compared to manual dialing. Significantly longer driving times in both of the dialing conditions as compared to the No Dialing condition are discussed in terms of the hypothesis that drivers decrease driving speed to compensate for the demands of the secondary phone tasks.

Acceleration↗
PubMedDate not supplied

Driving vigilance simulator test.

Drivers suffering from sleepiness at the wheel run the risk of being involved in car accidents. To evaluate whether objective data of driving performance can be assessed in patients with excessive tendency of falling asleep at the wheel, two test versions of a computerized driving program were created to fit an advanced driving simulator. For the evaluation 15 male drivers with habitual sleep spells whilst driving were selected among patients with the clinical features of the sleep apnoea syndrome. The brake reaction time and the deviations from straight road-line were significantly increased when compared to the performance of 10 matched controls. Irrespective of test version, the driving simulator with the program used was found to be a sensitive method to ascertain driving vigilance impairment in quantitative terms. It would also be a valuable method to evaluate the efficiency of treatment in selected patients.

Accidents, Traffic↗
PubMed1981

Driving while under the influence of alcohol: relationship to attitudes and beliefs in a college population.

Two social psychological theories (the Fishbein Model and the Health Belief Model) were used to derive attitude and belief factors to predict intentions to drive while under the influence of alcohol and actual drinking-driving behavior in a college population. The results revealed strong support for the Fishbein theory; attitudes and normative beliefs predicted intentions, while intentions were the best predictor of subsequent behavior. From the Health Belief Model, specific beliefs regarding one's effectiveness at being able to avoid getting caught by the police and cause an accident while driving under the influence of alcohol were also significantly related to drinking-driving intentions and behavior. These findings indicate that decisions to drink and drive are the result of one's personal evaluation of this behavior and one's perceived ability to control the threatening consequences. Thus drinking and driving may continue to be so prevalent in a college population because they erroneously believe that they are still safe drivers and effective at controlling the attendant risks.

Adolescent↗
PubMed1990

Monitoring parent concerns about teenage drinking and driving: a random digit dial telephone survey.

A random telephone survey was conducted in a suburban community in the Washington, D.C. metropolitan area to assess the perceptions of parents about teenage drinking and driving. A total of 807 completed interviews were conducted. The results indicated that while most parents viewed teen drinking (69%) and drinking and driving (65%) to be a prevalent, relatively few seem to be engaging in behaviors likely to influence this. Thirty-two percent said they never discuss drinking and driving with their children, and over 65% said they never talk to other parents about how to talk to their children about drinking and driving, nor have any interest in doing so. Although slightly more than half said they had family policies concerning drinking, less than 20% said there were penalties for violating these policies. Over 70% expressed their willingness to watch a special show on TV about how parents can talk to their children about alcohol. Parents of teenagers appear to be far more likely to think that their teen's friends drink and drive (36%) than they are to think that their teen drinks and drives (10%). The results of this survey indicate a significant lack of parental awareness of teen drinking and a denial of their own teen's involvement in it.

Accidents, Traffic↗
PubMed1987

Young driver risk taking: a description of dangerous driving situations among 16- to 19-year-old drivers.

Dangerous drinking and driving situations contribute heavily to morbidity and mortality among older adolescents. One hundred ninety-two high school drivers related 662 dangerous driving incidents (430 by males, 232 by females) in which they were involved in the preceding 6 months. Dangerous driving incidents were characterized by reckless intent, driving late at night, riding with other peers involving alcohol and drugs, reporting impaired driving, and distractions in the car. Adolescent drivers are commonly involved in dangerous drinking-driving situations with peers and without significant consequences. There are points along the continuum leading up to, during, and after such events that offer opportunities for significant prevention and intervention. Such strategies are reviewed.

Accidents, Traffic↗
PubMed2006

Antidepressants and driving ability: results from a clinical study.

OBJECTIVE: Psychomotor disturbances can frequently be found in depressed patients and may have an important influence on the ability to drive. Additionally, effects of sedation, as seen with some antidepressants, probably impair driving performance. The present study was designed to evaluate the effects of antidepressant monotherapy on psychomotor functions related to car-driving skills in depressive patients in a routine clinical setting. METHOD: Inpatients (N = 100) who met the ICD-10 and DSM-IV criteria for major depressive disorder were tested under steady-state plasma level conditions prior to being discharged to out-patient treatment. The study ran from January 2004 through March 2005. All patients participated voluntarily and gave informed consent. According to the German guidelines for road and traffic safety, data were collected with the computerized Act & React Testsystem ART-90 and the Wiener Testsystem, measuring visual perception, reaction time, selective attention, vigilance, and stress tolerance. Psychopathologic symptoms were rated with the Hamilton Rating Scale for Depression. RESULTS: Before discharge to outpatient treatment, 24% of the patients tested were without clinically relevant psychomotor disturbances. In 60% of the cases, mild to moderate impairments could be seen, and about 16% of the patients were considered as severely impaired in psychomotor functions related to car-driving abilities. Data show that patients treated with selective serotonin reuptake inhibitors (SSRIs) or the noradrenergic and specific serotonergic antidepressant (NaSSA) mirtazapine had an altogether better test performance in comparison with patients receiving tricyclic antidepressants (TCAs). Differences were most pronounced in measures of reactivity, stress tolerance, and selective attention. Statistically significant differences between patients treated with TCAs or the serotonin-norepinephrine reuptake inhibitor (SNRI) venlafaxine could not be found. Among the newer antidepressants there is an advantage for patients treated with mirtazapine, especially in tasks with high multi-channel perception and output demands. CONCLUSION: About 16% of depressive patients discharged from hospital to outpatient treatment must be considered unfit to drive. In 60% of the cases, patients performed at a questionable level of fitness for driving, and it seems justified to counsel patients individually, taking into account compensational factors. Data point to an advantage for patients treated with SSRIs or mirtazapine when compared with TCAs or venlafaxine. However, causal relationships cannot be drawn from our data.

Adult↗
PubMed1992

Driving after cerebral damage: a model with implications for evaluation.

Evaluation of the ability of cerebrally injured patients to return to driving is an important task for rehabilitation specialists. These evaluations require predictively valid methods of assessment based on identification of relevant skills and abilities. The present study tested a hypothetical model for driving after cerebral injury and determined its use in evaluating fitness to drive. Thirty-five patients with cerebral damage due to head injury or cerebrovascular accident participated in the study. All were administered (a) a predriver evaluation, that is, a battery of neuropsychological tests chosen a priori to test the model, (b) a simulator evaluation, and (c) a behind-the-wheel evaluation consisting of driving on a protected course and in traffic. The results showed that 93% of the driving outcome in traffic was explained cumulatively by findings from the predriver and simulator evaluations as well as from behavioral and operational measures during evaluation on the protected lot. These results supported the predictive validity of the model and are discussed in terms of methodology for evaluation of return to driving.

Adolescent↗
PubMed1997

Off-road driving evaluations for persons with cerebral injury: a factor analytic study of predriver and simulator testing.

OBJECTIVES: Off-road evaluations composed of psychometric testing and simulator driving are commonly used in rehabilitation settings to assess a person's fitness to resume driving after a cerebral injury. Although the results of these evaluation methods separately provide information about ability to drive, there is no clear understanding about what is measured in comprehensive off-road evaluations as a whole. This study explored the interrelationship of perceptual, cognitive, behavioral, and operational variables that form the basis for off-road evaluations in order to determine whether there are basic dimensions underlying performance in these evaluations and to derive a small set of variables that could help in refining methods for evaluating persons with cerebral injuries. METHODS: One-hundred six persons with cerebral damage due to brain injury or cerebrovascular accident were administered a predriver evaluation that consisted of selected neuropsychometric tests. Subjects were also evaluated in a driving simulator that measured their operational responses to filmed driving situations and assessed their behaviors. Principal component analysis was used to identify manifest and latent variables contributing to the results of the evaluations. RESULTS: The analysis produced a model with five independent (orthogonal) eigenvectors, or factors, for this population: Higher Order Visuospatial Abilities, Basic Visual Recognition and Responding, Anticipatory Braking, Defensive Steering, and Behavioral Manifestations of Complex Attention. These factors accounted for 66.14% of the total variance in the subjects' responses to comprehensive off-road evaluations. CONCLUSION: These factors were useful in understanding driving performance and the role of predriver and simulator testing in driver evaluations.

Adolescent↗
PubMedDate not supplied

Validity of the Cognitive Behavioral Driver's Inventory in predicting driving outcome.

OBJECTIVE: This study seeks to (a) compare Cognitive Behavioral Driver's Inventory (CBDI) scores for clients who passed and failed a driving evaluation and for diagnostic groups (left cerebrovascular accident [CVA], right CVA, traumatic brain injury [TBI], and cognitive decline); (b) determine sensitivity, specificity, and positive and negative predictive values of the CBDI; (c) compare validity of the CBDI with other tools; and (d) identify factors associated with outcome. PARTICIPANTS: This historical cohort study included clients with neurological conditions who completed a driving evaluation. MEASURES: CBDI, Motor-Free Visual Perception Test (MVPT), Bells test, and driving results were extracted from the charts. RESULTS: Mean CBDI (p < 0.0001) and MVPT (p < 0.0001) scores were significantly worse for those failing compared to passing the driving evaluation. Sensitivity of the CBDI was 62%, specificity was 81%, positive predictive values were 73%, and negative predictive values were 71%. Results varied according to diagnostic group. CONCLUSIONS: The CBDI is not sufficiently predictive of outcome to replace a driving evaluation, and is predictive only for clients with R-CVA and TBI. Evaluation of driving should vary according to diagnosis.

Automobile Driver Examination↗
PubMed1990

Driving-impaired patients leaving the emergency department. The problem of inadequate instructions.

STUDY OBJECTIVE: We evaluated the frequency with which blood alcohol concentrations were obtained in emergency department patients with presumed alcohol impairment, whether physicians counseled impaired patients not to drive, and whether safe transportation was available. DESIGN: Retrospective chart review and search of the North Carolina Driver History file. SETTING: Emergency departments of a university and affiliated Veterans Affairs Medical Center (VAMC). PATIENTS: Consecutive adult patients at the university (n = 1554) and VAMC (n = 1461) emergency departments. Patients with presumed alcohol-induced impairment (university, 75; VAMC, 88) who did not require hospital admission were identified. Presumed alcohol-induced impairment was defined by any of the following: nurse or physician note specifying the patient was intoxicated; indication in the medical record that the patient had alcohol on their breath; claim by the patient of alcohol use the day of evaluation; or measurement of blood alcohol concentration. MEASUREMENTS AND MAIN RESULTS: Blood alcohol concentrations were measured in 80% of presumed alcohol-impaired university patients (median blood alcohol concentration, 45 mmol/L) and 68% of VAMC patients (median blood alcohol concentration, 58 mmol/L). Driving skills deteriorate with blood alcohol concentrations of 11 mmol/L or greater; however, 63% of university and 88% of VAMC patients with measured blood alcohol concentrations of 11 mmol/L or greater were still impaired when discharged. Only 3.5% of university and 8.7% of VAMC patients impaired at discharge were advised not to drive, whereas 31% of university and 20% of VAMC patients impaired at discharge were supervised by a responsible person. The prevalence of previous driving-while-impaired convictions was high (university, 34%; VAMC, 58%). CONCLUSIONS: Presumed alcohol-impaired patients seen in emergency departments frequently have blood alcohol concentrations measured. Despite documented evidence of driving impairment there is little evidence that such patients are counseled not to drive or that safe transportation home is available.

Adult↗
PubMed2000

Driving simulation with EEG monitoring in normal and obstructive sleep apnea patients.

STUDY OBJECTIVES: To measure simulated driving performance in obstructive sleep apnea patients and its relationship with EEG defined attention lapses. DESIGN: Prospective, mixed design comparing apnea patients and control subjects over a 60-minute driving simulation task while continuously recording both driving performance and EEG measures. SETTING: Sleep disorders center. PARTICIPANTS: 15 polysomnographically diagnosed obstructive sleep apnea patients (mean age 42 +/- 6 yrs.) and 15 healthy volunteers (mean age 38 +/- 6 yrs.). INTERVENTIONS: NA. MEASUREMENTS AND RESULTS: A computer based driving simulator recorded lane position variability, speed variability, steering rate variability, and crash frequency. The frequency and duration of EEG-defined attention lapses were also measured. The results demonstrated that the apnea group had significantly greater variability in lane position, steering rate, and speed than the control group. The apnea group also had more crashes. In addition, the apnea group had more EEG-defined attention lapses of longer duration. Except for speed and steering rate variability, these differences increased over the 60-minute task. Measures of lane position variability and crash frequency had a significant positive correlation with attention lapse frequency and duration. CONCLUSIONS: The driving simulation task unmasked and quantified marked performance impairments in the sleep apnea group that increased over time. The poor performance appeared related to the EEG-defined attention lapses. Lane position variability appeared to be the most sensitive measure for assessing and quantifying impairment. This study suggests that poorer driving performance and crashes are not entirely due to overt sleep, but inattention due to sleepiness.

Accidents, Traffic↗
PubMed2000

The Driving Vengeance Questionnaire (DVQ): the development of a scale to measure deviant drivers' attitudes.

The Driving Vengeance Questionnaire (DVQ) was developed and administered to assess drivers' use of vengeance when faced with common driving situations. Subjects in the development of the scale were 266 male and female university students. The scale was then administered to 271 university students (both male and female) and 74 male inmates who were classified as either violent or nonviolent offenders on the basis of the amount of force used in committing the offence. A Cronbach alpha of .83 (M = 40.76, n = 310) indicated a high level of internal consistency for the DVQ. Younger drivers (18-23 years old) indicated higher levels of vengeance while driving than did older drivers (24-66 years old, M = 44.35 and 37.81, respectively). Those with less driving experience (0-6 years) expressed higher levels of vengeance while driving than more experienced drivers (6+ years, M = 42.95 and 38.81, respectively). Male drivers responded with greater vengeance to the questionnaire items than females (M = 42.07 and 39.62, respectively). The level of force used in commission of crime failed to correlate with the DVQ. A factor analysis was performed with a different sample of subjects using a slightly modified version of the DVQ to deal with the issue of whether horn honking constituted an appropriate measure of aggression. When the two relevant DVQ items were changed to read "leaning on horn" rather than mere honking, a strong, single factor of vengeance was found to characterize the scale. Suggestions were made for the use of DVQ in the screening of driving license applicants and in the study of problem drivers.

Adolescent↗