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PubMed1992

Assessment of driving performance in patients with retinitis pigmentosa.

The driving performance of 21 subjects with retinitis pigmentosa (RP) and varying degrees of peripheral field loss was compared with the performance of 31 normally sighted control subjects who did not differ statistically from the subjects with RP in age, gender, years of driving experience, or miles driven per year. Driving performance was assessed by self-reported accident frequency and by an evaluation of performance on an interactive driving simulator. A significantly greater proportion of individuals had self-reported accidents in the RP group than in the normal group. Likewise, a significantly greater proportion of subjects with RP than normal subjects had accidents on the driving simulator. Logistic regression analyses indicated that binocular horizontal field extent and binocular field area significantly differentiated between those having no self-reported accidents and those subjects with RP having one or more self-reported accidents. Because the simulator indexes were correlated with visual field measures for the subjects with RP, no additional information was incorporated into the regression model by adding the simulator measures. Therefore, our results indicate that visual field loss is a primary correlate of automotive accidents in individuals with RP.

Accidents, Traffic↗
PubMed1993

Evaluation of driving performance in patients with juvenile macular dystrophies.

The driving performance of 20 subjects with central vision impairment due to either Stargardt disease or cone-rod dystrophy (visual acuity, 20/40 to 20/70) was compared with that of 29 control subjects with normal vision who had similar driving histories. Driving performance was defined by accident involvement based on self-report and state records and by an evaluation of performance on an interactive driving simulator. The proportion of individuals involved in accidents in the central vision loss group was comparable to that of the control group. For 13 of the 20 subjects with central vision loss who did not restrict their driving to daylight hours, there was a greater likelihood of involvement in nighttime accidents than in the control group. Visual function measures and simulator indexes did not predict accident involvement for the central visual loss group, although these subjects showed longer braking response times and a greater number of lane boundary crossings than the control group. These findings are in contrast to our previously published report of subjects with retinitis pigmentosa, who were more likely to have been involved in both daytime and nighttime accidents than a control group and for whom visual field extent was significantly related to accident involvement.

Accidents, Traffic↗
PubMed1995

Long-term effect of uvulopalatopharyngoplasty on driving performance.

OBJECTIVE: It has been questioned whether the effect of uvulopalatopharyngoplasty lasts as years go by. From a previous study it is known that patients with severe rhonchopathy, complaining of sleepiness at the wheel, improve their vigilance and driving performance immediately following uvulopalatopharyngoplasty, but is this effect persisting? DESIGN: In a cohort study, the long-term effect of surgical treatment on driving vigilance was evaluated on 13 middle-aged (median, 52 years) male patients and five matched controls. Three to 4 years postoperatively, they were subjected to a boring 90-minute-long retest in an advanced driving simulator and daytime polysomnography, identical to those performed preoperatively. Factors measured were brake reaction time, lateral position deviation, and off-road incidents. The patients were also asked to assess their driving skills on a self-report and their vigilance on a visual analogue scale. RESULTS: All but one patient reported themselves as being more vigilant and safe drivers following surgery. Objective results showed that the initial improvement in brake reaction time, lateral position deviation, and number of off-road incidents was sustained, but not always in concordance with the apnea index. CONCLUSION: The positive effect of uvulopalatopharyngoplasty on vigilance and driving performance remains after 4 years. This may have a substantial impact on traffic safety.

Accidents, Traffic↗
PubMed2003

Olfaction and social drive in schizophrenia.

BACKGROUND: The neurobiology of social dysfunction in schizophrenia is unknown, but smell identification deficits (SIDs) exist in schizophrenia, and olfaction is related to social affiliation in other mammals. The SIDs have been linked with negative symptoms and the deficit syndrome, but any specificity of SIDs for social dysfunction is unstudied. Low intelligence might explain this relationship, if it is associated with both negative symptoms and SIDs. We examined whether SIDs in schizophrenia were related broadly to negative symptoms, as are a number of other neuropsychological measures, or whether they might show a more specific relationship with social drive. METHODS: Smell Identification Test scores, Wechsler Adult Intelligence Scale-Revised IQ, symptomatology assessed with the Positive and Negative Syndrome Scale, and the deficit syndrome were determined in 70 patients with DSM-IV schizophrenia. RESULTS: The SIDs were related to negative symptoms and the deficit syndrome, but the association of SIDs with diminished social drive explained both relationships. Smell identification was also related to Wechsler Adult Intelligence Scale-Revised IQ, but intelligence was independent of the relationship of SID and social drive. The worse Smell Identification Test scores in male patients were attributable to a greater preponderance of men with the deficit syndrome. CONCLUSIONS: These analyses demonstrated independent relationships of Smell Identification Test scores to social drive and intelligence that together accounted for almost 50% of the variance in Smell Identification Test scores. There may be common neural substrates for the low social drive and SIDs in schizophrenia.

Drive↗
PubMed2000

Body dissatisfaction, bulimia, and depression among women: the mediating role of drive for thinness.

OBJECTIVE: Past research has called into question the apparent relationship between body dissatisfaction and bulimia among women once effects of depression are statistically controlled. We further investigated interrelations among body dissatisfaction, depression, and bulimia, as well as considered individual differences in drive for thinness, within two samples of young adult women. METHOD: The first sample included women diagnosed with anorexia nervosa (n = 91) or bulimia nervosa (n = 142), whereas the second sample included college student women (N = 228). Respondents completed self-report measures of bulimia, drive for thinness, negative affect, and body dissatisfaction. RESULTS: At the univariate level, all of the above constructs were significantly related to body dissatisfaction. In multiple regression analyses using depression and bulimia as predictors of body dissatisfaction, both were uniquely related to body dissatisfaction. These findings were similar to the results of previous research. However, when drive for thinness was added to the regression equations, drive for thinness was a unique predictor of body dissatisfaction whereas bulimia was not (neither was depression among college women). DISCUSSION: Bulimia, depression, and body dissatisfaction may be the results of incorporation of cultural standards regarding thinness, hence the apparent relationships among these variables. The role of drive for thinness in the pathogenesis of depression and body dissatisfaction among women needs to be investigated further.

Adolescent↗
PubMed2005

Body dissatisfaction and drive for thinness in young adult twins.

OBJECTIVE: We explored correlates of the Eating Disorder Inventory subscales Body Dissatisfaction (BD) and Drive for Thinness (DT) and genetic and environmental influences on these traits. METHOD: In a population-based sample of 4,667 Finnish twins aged 22-27 years, we conducted twin modeling to explore genetic and environmental contributions to body dissatisfaction and drive for thinness. Logistic regression was used for the correlational analysis. RESULTS: Various eating and body size-related factors and psychosomatic symptoms were significantly associated with high body dissatisfaction and drive for thinness in both genders. In women, early puberty onset, early initiation of sexual activity, and multiple sex partners were statistically significant risk factors of body dissatisfaction. In gender-specific univariate twin models, additive genes accounted for 59.4% (95% confidence interval [CI] = 53.2-64.7%) of the variance in body dissatisfaction and for 51.0% (95% CI = 43.7-57.5%) of the variance in drive for thinness among females, but for none of the variance among males. DISCUSSION: There are very distinct gender differences in the heritability patterns of body dissatisfaction and drive for thinness in young adults.

Adult↗
PubMed2006

The assessment of fitness to drive in people with dementia.

OBJECTIVE: To determine whether cognitive tests predict fitness to drive in patients with dementia. DESIGN: Two group comparison of patients with dementia and healthy elderly volunteers, and comparison of patients with dementia who were found safe to drive and those found unsafe, followed by a validation study. PARTICIPANTS: Forty-two people with dementia and 33 healthy elderly volunteers with no known memory problems who were driving. Of the 42 people with dementia 37 were assessed on the road. A second sample of 17 people with dementia was also assessed on the road. MAIN MEASURES: Stroke Drivers Screening Assessment, Mini Mental State Examination, Salford Objective Recognition Test, Stroop Test, Test of Everyday Attention, Visual Object and Space Perception Battery, Behavioural Assessment of the Dysexecutive Syndrome, Adult Memory and Information Processing Battery. RESULTS: All healthy elderly volunteers were safe to drive but 10 of the 27 patients with dementia were unsafe. Discriminant function analysis identified a combination of tests, which correctly classified 92% of drivers with dementia as safe or unsafe. Validation of this prediction on an independent sample had 59% accuracy using a cut-off of 0 but 88% accuracy using a cut-off of 5. CONCLUSIONS: Safety to drive in people with dementia could be predicted from a combination of six cognitive tests. These correctly identified 67% of safe drivers in a validation sample. This assessment could be used to identify those who need evaluation of their safety on the road.

Aged↗
PubMed2002

Evaluation of sleep and driving performance in six patients with Parkinson's disease reporting sudden onset of sleep under dopaminergic medication: a pilot study.

Six patients with Parkinson's disease (PD) reporting unusually fast or sudden onset of sleep under the addition of dopamine agonists to a previous levodopa-containing therapy were examined using a sleep-wake diary, the Epworth sleepiness scale (ESS), polysomnography, multiple sleep latency tests (MSLT), a standardized vigilance test, and driving simulation. In all patients, ESS scores were increased and polysomnography showed disruption of the sleep pattern, a tendency towards poor sleep efficiency, and reduced proportions of slow- wave and rapid eye movement sleep. Pathological results in the MSLT or the vigilance test were obtained in five cases. For evaluation of driving performance, the standard deviation from the mean lane position during driving simulation was calculated. Three of five patients had clearly increased mean SDLP values. With respect to the measurement of daytime sleepiness (ESS, MSLT, vigilance test, and driving simulation), each patient had pathological results in at least two of these examinations. However, only a limited transfer of the routine vigilance assessment to driving performance was possible. In summary, this pilot study indicates that unusually fast or sudden onset of sleep in PD patients is a phenomenon of daytime sleepiness.

Adult↗
PubMed1993

Evaluation of the critical value of driving fatigue based on the fuzzy sets theory.

Applying the newly developed multistage evaluation method based on the fuzzy sets theory, we have evaluated the sense of driving fatigue of 8 male drivers who covered 400 km in 8 hr in the daytime, empirically revealing the distribution of the degree of driving fatigue. The critical values from "no" to "a bit" and "a bit" to "fatigued" are 1 and 5.5 hr, respectively. Finally, a tentative study of the psychophysical relations between driving time and driving fatigue has been made, leading to a curve of driving fatigue under the conditions of this experiment.

Adult↗
PubMed1989

Willingness to drive when drunk and personality: a twin study.

In a laboratory study of psychomotor sensitivity to alcohol, twins were asked "Would you drive a car now?" at 1, 2, and 3 h after drinking a standard dose of ethanol (0.75 g/kg). Correlations among these binary items, the Eysenck personality scales, and age were investigated using PRELIS and LISREL. Willingness to drive and Extraversion correlate at all three times in both males and females. In males, willingness to drive also correlates with Psychoticism, and in females it correlates negatively with the Lie (or Social Desirability) scale. Most correlations between cotwins in willingness to drive were significant in both monozygotic (MZ) and dizygotic (DZ) male twins but correlations were lower in female twins. Factor and Markovian models were fitted. In males there seem to be both genetic and cultural influences on willingness to drive when drunk. About half the genetic variance seems to be the pleiotropic effects of genes influencing Extraversion. The correlations with Psychoticism, on the other hand, seem to be largely environmental in origin. The small sample size and lack of proper significance tests mean that these results must be interpreted with caution.

Adult↗
PubMed1994

Effects of mizolastine and clemastine on actual driving and psychomotor performance in healthy volunteers.

The acute effect of doses of mizolastine 5, 10, 20 and 40 mg, an active control (clemastine 2 mg) and placebo on actual car driving and psychomotor performance have been compared. Twenty four healthy volunteers were treated according to a double-blind, 6-way cross-over design. In the driving test, lasting about 1 h, lateral position control and speed were continuously measured; the psychomotor test battery, lasting 50 min, comprised critical flicker-fusion frequency, critical instability tracking, divided attention, memory search and choice reaction time, and vigilance studies; and mood changes and possible adverse-effects were rated on visual analogue scales. The results showed a dose-response relationship: mizolastine 40 and 20 mg impaired driving and psychomotor performance. The effect of mizolastine 40 mg on driving was strongly correlated with that of clemastine (r = 0.78) and was comparable to the effect of a blood ethanol level of 0.8 mg.ml-1. Mizolastine 5 mg and 10 mg did not have a significant effect on driving performance and psychomotor tests. It was concluded that at a 10 mg dose of mizolastine, the therapeutic dose, it could be considered a safe anti-histamine, although individual adverse reactions cannot be completely ruled out.

Adult↗
PubMed1990

Repeated dose effects of lormetazepam and flurazepam upon driving performance.

The residual effects of lormetazepam 1 mg and 2 mg in soft gelatine capsules on driving performance were assessed and compared to those of flurazepam 30 mg, which is also a powerful hypnotic, but possesses a far less favourable pharmacokinetic profile with a long-acting sedative metabolite. Driving performance was tested 10 to 11 h and 16 to 17 h post administration, after 2 days on placebo (baseline), and 2, 4 and 7 days of drug treatment (active), and after 1 and 3 days following the resumption of placebo (washout). The driving test consisted of operating an instrumented motor-vehicle over a 72 km highway circuit in light traffic. Flurazepam 30 mg significantly impaired the ability to control the lateral position of the vehicle compared to placebo baseline measurements. The degree of impairment was substantial in the female subjects and was greater in the morning than in the afternoon. Lormetazepam 1 mg showed no residual effect on driving performance. Lormetazepam 2 mg impaired driving performance to some extent on the following morning, 10 to 11 h post administration, but no residual effect was found in the afternoon. All drugs improved sleep quality and prolonged sleep duration to more or less the same extent.

Adult↗
PubMedDate not supplied

Neuropsychological analysis of some dynamic aspects of the sexual drive in men and women.

In previous works the author has proposed the conception of an affect-behavioral system as the neuropsychological basis of fundamental emotions and drives. It consists of ten subsystems (SS) integrated with relations of reciprocal induction and facilitation. The SSs are: (1) SS of flight, (2) SS of aggression, (3) SS of socially channeled attack, (4) SS of mutual aid, (5) SS of autoaggression, (6) SS of food taking, (7) SS of inhibition of food taking, (8) SS of vomiting, (9) SS of sexual contacts, and (10) SS of inhibition of sexual contacts. To the activity of the different SSs correspond fundamental emotions and drives. Thus, to the activity of the SS of flight corresponds fear; to the activity of the SS of aggression, socially uncultivated anger; to the activity of the SS of sexual contacts, sexual drive; and so forth. In the paper, appropriate observations are analyzed. They reveal that the activity of the SSs of flight and vomiting can inhibit reciprocally the sexual drive; whereas, the activity of the SSs of socially channeled attack, of mutual help, and of aggression can facilitate it. The activity of the SS of autoaggression is two-sided: According to the personality structure and the situation, it can inhibit or facilitate the sexual drive.

Adult↗
PubMed2001

Subchronic effects of the GABA-agonist lorazepam and the 5-HT2A/2C antagonist ritanserin on driving performance, slow wave sleep and daytime sleepiness in healthy volunteers.

RATIONALE: Lorazepam, a benzodiazepine anxiolytic, may increase daytime sleepiness and impair psychomotor performance, which is hazardous for patients engaging in daily activities such as car driving. Given current prescription practice, information on the repeated dose effects is required. The 5-HT2A/2C antagonist ritanserin was originally developed as a safer alternative to the benzodiazepines, yet having limited clinical efficacy. 5HT2A/2C receptors have been implicated in regulating slow-wave sleep but little is known about their role in human performance. OBJECTIVE: The present study investigated the subchronic effects of the benzodiazepine anxiolytic lorazepam and the 5-HT2A/2C antagonist ritanserin on actual driving performance, objective and subjective sleepiness, and nocturnal slow wave sleep. METHODS: Eighteen healthy volunteers were treated twice daily for 7 days with ritanserin 5 mg, lorazepam 1.5 mg or placebo. Treatments were administered according to a double-blind, cross-over design. Tests were performed on day 7 of each treatment week. Sleep EEG was recorded during the preceding night. RESULTS: Lorazepam had a pronounced impairing effect on lateral position control and induced daytime sleepiness, while having no effect on other parameters. In contrast, ritanserin did not impair driving performance or affect objectively measured daytime sleepiness, while subjects reported to feel more alert during daytime. Moreover, consistent with its effects on 5-HT2 receptors, ritanserin increased the amount of nocturnal slow wave sleep. There were no relationships between changes in slow wave sleep and performance parameters. CONCLUSIONS: Lorazepam administered for 7 consecutive days may be hazardous for patients who engage in driving activities. Antagonism of 5-HT2A/2C receptors, as accomplished by ritanserin, increases slow wave sleep and is devoid of effects on objective sleepiness and driving behaviour. Whether this extends to other cognitive and psychomotor domains remains to be established.

Adult↗
PubMed2006

Influence of the Pulfrich phenomenon on driving performance.

BACKGROUND: The Pulfrich stereoillusion occurs spontaneously in diseases inducing asymmetric visual pathway delays. Its influence on driving performance has never been investigated and was, therefore, assessed using a three-dimensional (3D) computer driving simulation. METHODS: A 3D driving scenery of a road with obstacles was visualised on an autostereoscopic 3D display. Seven normal subjects drove at a speed of 6 m/s using a steering wheel and three angles of view of the scenery (0 degrees, 45 degrees to left, and 90 degrees to left) with different interocular delays (25 ms on the right, 25 ms on the left, and no delay). One subject drove the scenery at an angle of 90 degrees without delay and with a delay of 8 ms, 16 ms, and 25 ms on the right and left, respectively, at speeds of 6 m/s, 12 m/s and 18 m/s. RESULTS: Stereo-illusion only influenced car position if the angle of view was 90 degrees (p<0.05). At this angle, increasing car speeds were associated with larger car displacements (delay on right p<0.001, on left p<0.01) and smaller delays with smaller car displacements (p<0.001). CONCLUSIONS: This study showed that Pulfrich phenomenon has an influence on car position only if the viewing angle is 90 degrees. No influence could be found if the driving direction corresponded to the visual axis of the driver. These findings are in agreement with reports of patients with spontaneous Pulfrich phenomenon who indicate that while driving, distances are only misjudged when looking sideways.

Adult↗
PubMed1987

Driving patterns before and after hospitalization for heart disease.

Persons hospitalized with heart disease were licensed as often in the pre-hospital period and drove slightly (but not significantly) fewer miles than did healthier persons of similar age, sex and neighborhood. After discharge, those who returned to driving reduced their mileage and drove under different conditions. This occurred both because of overall changes in life style (e.g. retirement) associated with illness and because of health effects on driving per se. In fact, while activities changed, the methods of transportation used to accomplish these remained the same, with driving oneself being the preferred mode. Physicians advised patients only about driving during the immediate recovery period rather than with an eye toward long-term safety risk. Few people reported their heart condition to the Department of Motor Vehicles. A functional severity score based on primary and comorbid conditions was developed to distinguish individuals with different amounts of impairment relevent to driving.

Aged↗
PubMed1989

Assessing one's own and others' driving ability: influences of sex, age, and experience.

Observational studies of drivers' involvements in dangerous situations suggest that young males drive differently from other road users. Studies of drivers' assessments of their own ability appear to show that they believe they drive better than their peers and that, while young males equate their ability with that of older male drivers, the latter group see themselves as superior to their younger counterparts but of equivalent ability to peers. It is unclear from previous studies what the influence of driving experience is on such assessments and, indeed, what female drivers feel about their ability. The present studies suggest that the widely reported tendency for people to overestimate their ability may be largely artifactual, that males and females describe their performance similarly, and that previously reported age differences disappear when driving experience is controlled. Among the differences that remain is the reported greater "recklessness" and comparative lack of "smoothness" of young males' driving. The implications of these findings for our understanding of risk assessment and acceptance are discussed.

Adult↗
PubMed1994

An experimental study to evaluate the effectiveness of different methods and intensities of law enforcement on driving speed on motorways.

Two field experiments were conducted to establish the most effective method of enforcement in reducing driving speed and to establish the most efficient strategy in terms of police force personnel required. In the first experiment, the effect of three variables on driving speed on motorways was studied. The first variable, intensity of enforcement, was manipulated by creating three different objective levels of apprehension for detected speeding drivers. The second variable was method of enforcement. On-view stopping and ticketing of offenders was compared to mailing of fines on the basis of the car's licence plate number. The third variable manipulated was the time delay in the mailing of fines. Time delay between detection of the offence and feedback to the driver was shortened in one condition. In a second experiment, police enforcement effort was optimized by relating intensity level of enforcement to the proportion of speeding vehicles. In the first experiment, police enforcement was applied for four weeks; in the second experiment, enforcement activities were continued for 12 consecutive weeks. In both cases the main dependent variable was driving speed. Before, during, and after the application of enforcement, speed was registered using induction loops. In addition, driver opinion about speeding and speed enforcement was studied using postal questionnaire surveys. The results show the largest and longest lasting reduction in driving speed in the highest intensity level-condition, giving support for a relation between objective chance of apprehension and speed choice. On-view stopping of offenders was shown to be a more effective method to reduce driving speed than mailing of fines. Some of these results are discussed in the light of game theory. The questionnaire surveys indicated that most drivers did not notice the recurrence in enforcement activities due to infrequent passing of the sections of motorways studied. The preventive effect of police enforcement appeared to be far more substantial than its repressive effect. Enforcement primarily deters the current nonoffender from speeding.

Automobile Driving↗