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Grieving while driving.

Secondary analysis of data from 84 people in 2 interview studies shows that some bereaved people grieve actively while driving. The grief can be intense, even years after a death. Grief while driving may erupt spontaneously or be set off by a wide range of reminders. Some bereaved people seem to save their grieving for times when they drive, because that is when they have the time and privacy to think and feel, but it would be safer for them and others if they would avoid driving while grieving intensely.

Adaptation, Psychological↗

Effects of gender and athletic participation on driving capability.

This study sought to determine if spatiotemporal skills, represented by success in high level sport, transfer to driving and, if so, whether such transfer is mediated by the gender of the driver. Using an emergency-braking test, we compared the driving ability of male and female athletes and non-athletes and showed that athletes achieved significantly longer and therefore superior durations for time-to-contact. The advantage of athletic participation thus did not appear in movement time but rather in the ability to produce desirable performance in context. We found that males and females did not differ significantly with respect to driving, however, involvement in sport apparently transfers to aspects of driving and so provides benefits beyond the intrinsic reward of the sports activities themselves.

Adolescent↗

Worldwide trends in alcohol and drug impaired driving.

Improved laws, enhanced enforcement, and public awareness brought about by citizens' concern, during the 1980s led to dramatic declines in drinking and driving in the industrialized world. The declines included about 50% in Great Britain, 28% in The Netherlands, 28% in Canada, 32% in Australia, 39% in France, 37% in Germany, and 26% in the United States. Some of these declines may be due in part to lifestyle changes, demographic shifts, and economic conditions. In most countries the declines reversed in the early 1990s and drinking and driving began to increase. By the middle of that decade the increases stabilized and the rates of drinking and driving again began to decline. These decreases were much less dramatic than those in the 1980s. Approaching the end of the 1990s and early in the new century, the record has been mixed. Some countries (France and Germany (until 2002)) continued to reduce drinking and driving while in other countries (Canada, the Netherlands, Great Britain, and the United States), there was stagnation and in some cases small increases or even large increase as was the case in Sweden. Complacency and attention to other issues in recent years have been difficult to overcome in some countries. Harmonization of traffic safety laws in the European Union has strengthened laws in some countries but threatens existing strong policies in others. It may be that the major gains have already been made and that additional progress will require a much greater level of scientific knowledge, use of new and emerging technologies, and political and social commitment to put in place proven countermeasures.

Accidents, Traffic↗

Preventing impaired driving using alcohol policy.

Considerable progress has been made in the reduction of impaired driving crashes during the last two decades. Much of this progress is attributable to strengthening laws against impaired driving along with vigorous enforcement efforts aimed at deterring impaired driving. In addition, many useful strategies can also be applied that focus on the control of alcohol availability, use, and promotion. Alcohol policies include controls on the price of alcohol, the location, density, and opening hours of sales outlets, controls on the social availability of alcohol, and on the promotion and advertising of alcohol. Enforcement of these policies is an important aspect of their effectiveness. These strategies have been shown to be effective or promising in reducing impaired driving as well as other consequences related to alcohol use and misuse.

Alcohol Drinking↗

Reliability and validity of aggressive driving measures in China.

The present research was designed to examine the psychometric properties of Chinese versions of the Self Report Driver Behavior Aggression and Assertiveness subscales, the Driving Vengeance Questionnaire, and the Violent Driving Questionnaire. Study 1 found that the all scales demonstrated good internal consistency, with alphas ranging from .76 to .87 and that assertive driving was related to demerit points received over the past 12 months while driver aggression and violence were linked to collisions over the past 12 months. Study 2 found that the scales exhibited reasonable test-retest reliability, with correlations ranging from .82 to .89. Finally, Study 3 showed that each scale was predicted by other dangerous driving attitudes and behaviors, similar to the original versions. The consistency between the translated and original scales, the implications for use in a Chinese sample, and the uniformity of actions in the traffic environment across cultures are discussed.

Accidents, Traffic↗

Lessons about sleepiness and driving from the Selby rail disaster case: R v Gary Neil Hart.

In April 2003, near the town of Selby in North Yorkshire, England, a motor vehicle went off the road to cause a train collision, killing 10 and injuring more than 70 people. The driver of the vehicle, Gary Neil Hart, had allegedly fallen asleep while driving, and was charged and subsequently convicted of causing death by dangerous driving. Evidence from an expert witness was led by the prosecution to establish that Hart had in fact fallen asleep, and that prior to falling asleep, he knew (or ought to have known) that he was at risk of falling asleep but nevertheless continued to drive. The issue of whether and to what extent individuals are aware that they are about to fall asleep has significant implications for criminal prosecutions. Generally, the definition of a criminal offense includes a mental element such as intent or knowledge. Therefore, it is imperative that issues such as whether in every individual there is forewarning of sleep and the degree to which individuals are able to self-assess their ability to continue driving under conditions of extreme sleepiness must be resolved. Sleepiness is now regarded as the largest identifiable and preventable cause of accidents in all modes of transportation. Litigation for such accidents is likely to increase, and therefore it is of great importance that further research be undertaken to examine the process of falling asleep, especially the subjective experiences immediately preceding sleep.

Accidents, Traffic↗

Predicting drunk driving: contribution of alcohol use and related problems, traffic behaviour, personality and platelet monoamine oxidase (MAO) activity.

AIMS: The aim of the study was to characterize the predictive value of socio-economic data, alcohol consumption measures, smoking, platelet monoamine oxidase (MAO) activity, traffic behaviour habits and impulsivity measures for actual drunk driving. METHODS: Data were collected from 203 male drunk driving offenders and 211 control subjects using self-reported questionnaires, and blood samples were obtained from the two groups. RESULTS: We identified the combination of variables, which predicted correctly, approximately 80% of the subjects' belonging to the drunk driving and control groups. Significant independent discriminators in the final model were, among the health-behaviour measures, alcohol-related problems, frequency of using alcohol, the amount of alcohol consumed and smoking. Predictive traffic behaviour measures were seat belt use and paying for parking. Among the impulsivity measures, dysfunctional impulsivity was the best predictor; platelet MAO activity and age also had an independent predictive value. CONCLUSIONS: Our results support the notion that drunk driving is the result of a combination of various behavioural, biological and personality-related risk factors.

Accidents, Traffic↗

Perceptual dysfunction in hemiplegia and automobile driving.

Sixteen post-stroke, hemiplegic patients, who requested that they be allowed to return to driving, were extensively evaluated by a physiatrist, psychologist, occupational therapist, and driver training specialist. After they completed a driver training program, the patients were divided into three groups based on their driving program success and follow-ups. Significant differences in the psychological test results were found between Group I (those who drove without any difficulty) and Groups II and III (those who drove limited distance or who failed driver training). Results suggest that patients with significant cognitive and perceptual problems who take training and limit their driving can be safe drivers when they return to driving.

Accidents, Traffic↗

Musculoskeletal problems and driving in police officers.

The Occupational Health Department of a rural police force in the UK had concerns regarding sickness absence levels due to musculoskeletal problems, particularly in officers who drove as part of their job. It was decided to conduct an interview survey comparing two groups of police officers with differing levels of exposure to driving, recording sickness absence and prevalence data related due to musculoskeletal troubles. The results indicate that exposure to car driving, both in terms of distance and hours driven, had a significant effect on self-reported low back trouble. Officers whose job mainly involved driving also experienced more low back trouble over the last 12 months than those whose job primarily involved sitting (not driving), standing and lifting tasks. Police motorcyclists had significantly higher prevalence figures for reported shoulder trouble than police car drivers.

Adult↗

Driving of motor vehicles as a risk factor for acute herniated lumbar intervertebral disc.

In a case-control study of the epidemiology of acute herniated lumbar intervertebral disc in the New Haven, Connecticut, area, it was found that driving of motor vehicles was associated with an increased risk for developing this disease. It was estimated that men who spend half or more of their time on their job driving a motor vehicle are about three times as likely to develop an acute herniated lumbar disc as those who do not hold such jobs. Persons of either sex who said that they drove a car (either away from work or at work) were more likely to develop an acute herniated lumbar disc than those who did not drive at all. These associations between driving and acute herniated lumbar disc could not be attributed to any confounding variables considered in this study.

Acute Disease↗

Prevalence of driver sleepiness in a random population-based sample of car driving.

STUDY OBJECTIVES: To obtain reliable estimates of the prevalence of driver sleepiness. DESIGN: A two-stage cluster sampling technique was employed to obtain a sample of car drivers representative of time spent driving on public roads in a geographically defined region. Data were collected by interviewer-administered questionnaire, and analysed in accordance with the sampling design. SETTING: The Auckland region of New Zealand, between April 1998 and July 1999. PARTICIPANTS: 588 drivers of cars and other light vehicles recruited at 69 roadside survey sites. MEASUREMENTS AND RESULTS: Of 746 eligible participants, 79% were interviewed, 12% refused, 8% were untraceable, and 1% were unable to give informed consent. From this sample we estimated that 58.7% of driving was undertaken by men. The vast majority of driving (90.8%) was undertaken by drivers with Epworth Sleepiness scores in the normal range (<10), but a significant minority was undertaken by drivers with one or more characteristics likely to impair alertness. 3.1% had < or = 5 hours sleep in the previous 24 hours, and 21.9% had < or = 4 full nights sleep in the previous week. The triad of symptoms associated with sleep apnea (snoring, choking, and breathing pauses while sleeping) was present in 1.6%; and 8.1% worked a pattern of shifts likely to interfere with normal sleep. CONCLUSION: The prevalence of sleepiness amongst a random sample of New Zealand car driving was low, and less than suggested by previous studies.

Adolescent↗

Low levels of alcohol impair driving simulator performance and reduce perception of crash risk in partially sleep deprived subjects.

STUDY OBJECTIVES: Partial sleep deprivation and alcohol consumption are a common combination, particularly among young drivers. We hypothesized that while low blood alcohol concentration (<0.05 g/dL) may not significantly increase crash risk, the combination of partial sleep deprivation and low blood alcohol concentration would cause significant performance impairment. DESIGN: Experimental SETTING: Sleep Disorders Unit Laboratory PATIENTS OR PARTICIPANTS: 20 healthy volunteers (mean age 22.8 years; 9 men). INTERVENTIONS: Subjects underwent driving simulator testing at 1 am on 2 nights a week apart. On the night preceding simulator testing, subjects were partially sleep deprived (5 hours in bed). Alcohol consumption (2-3 standard alcohol drinks over 2 hours) was randomized to 1 of the 2 test nights, and blood alcohol concentrations were estimated using a calibrated Breathalyzer. During the driving task subjects were monitored continuously with electroencephalography for sleep episodes and were prompted every 4.5 minutes for answers to 2 perception scales-performance and crash risk. MEASUREMENTS AND RESULTS: Mean blood alcohol concentration on the alcohol night was 0.035 +/- 0.015 g/dL. Compared with conditions during partial sleep deprivation alone, subjects had more microsleeps, impaired driving simulator performance, and poorer ability to predict crash risk in the combined partial sleep deprivation and alcohol condition. Women predicted crash risk more accurately than did men in the partial sleep deprivation condition, but neither men nor women predicted the risk accurately in the sleep deprivation plus alcohol condition. CONCLUSIONS: Alcohol at legal blood alcohol concentrations appears to increase sleepiness and impair performance and the detection of crash risk following partial sleep deprivation. When partially sleep deprived, women appear to be either more perceptive of increased crash risk or more willing to admit to their driving limitations than are men. Alcohol eliminated this behavioral difference.

Accidents, Traffic↗

Suicide by gunshot while driving a motor vehicle. Two additional cases.

Suicide by means of a motor vehicle occurs more frequently than is generally realized, and may be difficult to prove. Suicide by other means while driving a motor vehicle is far less frequent. Only two cases of suicide by gunshot while driving an automobile have been previously, and recently, reported. The author reports two additional cases of suicide by gunshot while driving a motor vehicle. Each case was a young man who had been suffering from depression; who obtained a firearm apparently for the express purpose of committing suicide; and who shot himself while driving a motor vehicle on an Interstate highway. Contrary to the usual finding in a series of suicides, three of the four cases now reported each left a suicide note or notes. What is apparently a fatal single-vehicle-single-occupant vehicular mishap may in fact be a suicide at the wheel by other means. What is apparently suicide by means of motor vehicle may in fact be an attempt to disguise homicide. Medicolegal offices are urged to routinely perform complete autopsies in fatal single-vehicle-single-occupant vehicular mishaps so that cause and manner of death may be documented without question.

Accidents, Traffic↗

Attention and driving in traumatic brain injury: a question of coping with time-pressure.

BACKGROUND: Diffuse and focal traumatic brain injury (TBI) can result in perceptual, cognitive, and motor dysfunction possibly leading to activity limitations in driving. Characteristic dysfunctions for severe diffuse TBI are confronted with function requirements derived from the hierarchical task analysis of driving skill. OBJECTIVE: Specifically, we focus on slow information processing, divided attention, and the development of procedural knowledge. Also the effects of a combination of diffuse and focal dysfunctions, specifically homonymous hemianopia and the dysexecutive syndrome, are discussed. Finally, we turn to problems and challenges with regard to assessment and rehabilitation methods in the areas of driving and fitness to drive.

Adaptation, Psychological↗

Divided attention and driving: a pilot study using virtual reality technology.

BACKGROUND: Virtual reality (VR) was used to investigate the influence of divided attention (simple versus complex) on driving performance (speed control). DESIGN: Three individuals with traumatic brain injury (TBI) and three healthy controls (HC), matched for age, education, and gender, were examined. RESULTS: Preliminary results revealed no differences on driving speed between TBI and HC. In contrast, TBI subjects demonstrated a greater number of errors on a secondary task performed while driving. CONCLUSION: The findings suggest that VR may provide an innovative medium for direct evaluation of basic cognitive functions (ie, divided attention) and its impact on everyday tasks (ie, driving) not previously available through traditional neuropsychological measures.

Adult↗

Simulators for assessing driving skills in demented patients.

This paper reviews the appropriate use of simulators to assess driving abilities in individuals with dementing illnesses. Several points are addressed: What is a driving simulator? What are the characteristics of a simulator? What are the strengths and weaknesses of various types of simulators? The potential role of driving simulators for predicting future driving safety is discussed.

Automobile Driving↗

The role of selective attention in driving and dementia of the Alzheimer type.

This paper examines the relationship between cognitive processes and driving in aging and dementia of the Alzheimer type. Several studies that have explored the relationship between neuropsychological test performance and various indicators of driving safety are reviewed. It is argued that deficits in selective attention are specific to impaired driving performance in dementia of the Alzheimer type. Results from a recent study supporting this notion are presented. It is suggested that screening measures that emphasize the ability to selectively attend to relevant information and inhibit irrelevant information should be used to identify mildly demented individuals who are at risk for unsafe driving.

Alzheimer Disease↗

Effects of age and hemianopic visual field loss on driving.

PURPOSE: With the use of an interactive driving simulator, we examined the driving performance of older patients with either homonymous or quadrantic hemianopsia with primarily occipital lobe damage resulting from cerebrovascular accidents (CVA's). METHODS: We compared the performance of these patients with that of a normally sighted, age-similar control group and that of a normally sighted younger group. RESULTS: The driving performance of the patients was either worse than, or similar to, that of the older control group; all of the older individuals (both patients and normally sighted subjects) had worse performance than the younger group. CONCLUSIONS: Age-related effects combined with the effects of visual field losses in older patients with cerebrovascular accidents had a negative impact on driving skills.

Aged↗