Background: Steiner’s Automobile Anxiety Inventory (AAI) is a 23 item questionnaire which provides a quantitative measure of vehicular anxiety (amaxophobia), common in survivors of motor vehicle accidents (MVAs). The present study examines criterion and convergent validity of the AAI. Method: De-identified data from a sample of 50 patients (mean age=39.1, SD=12.1; 17 men, 33 women) injured in high impact MVAs included the scores on Steiner’s AAI, as well as the pain ratings on the Brief Pain Inventory (BPI), scores on the Insomnia Severity Index (ISI), the Rivermead Post-Concussion Symptoms Questionnaire, Subjective Neuropsychological Symptoms Scale (SNPSS), Whetstone Vehicle Anxiety Questionnaire, and on Driving Anxiety Questionnaire (DAQ). The patients’ scores were compared to de-identified AAI data of 22 normal controls (mean age=45.9, SD=21.3; 10 men, 12 women). Results: Mean score of the patients on Steiner’s AAI (mean=15.0, SD=2.5) was significantly higher than the one of normal controls (mean=3.2, SD=3.8) in a t-test (t=15.6, df=70, p<.001). The underlying correlation is very high (r=.88): this indicates an excellent criterion validity. Satisfactory convergent validity is suggested by significant correlations (p<.001) of Steiner’s AAI scores to the Whetstone Vehicle Anxiety Questionnaire (r=.58) and Driving Anxiety Questionnaire (r=.52). The AAI correlated at p<.001 with post-accident neuropsychological impairments as measured by Rivermead (r=.89) and SNPSS (r=.72). Internal consistency of the AAI is satisfactory (Cronbach alpha=.95). Discussion and Conclusion: The results indicate satisfactory criterion and convergent validity of the Automobile Anxiety Inventory.

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Background: The PTSD Checklist for DSM-5 (PCL-5), is presently the most widely used psychological measure of PTSD along the criteria of DSM-5. We examined the criterion validity of PCL-5 separately for each of its 20 items by comparing scores of patients injured in high impact motor vehicle accidents (MVAs) to scores of persons in a control group. In addition, we evaluated criterion and convergent validity of the PCL-5 total scores. Method: De-identified data of 80 post-MVA patients (mean age 38.9 years, SD=12.8) included their scores on the PCL-5, Brief Pain Inventory (BPI), Insomnia Severity Index (ISI), Rivermead Post-concussion Symptoms Questionnaire, Subjective Neuropsychological Symptoms Scale (SNPSS), ratings of depression, anger, and anxiety (Items 10 to 12 of the Whiplash Disability Questionnaire), and three questionnaire measures of driving anxiety (Steiner’s, Whetstone’s, and DAQ). The patients were assessed, on the average, 49.7 weeks (SD=36.3) after their MVA, but all still experienced active post-MVA symptoms requiring therapy. The PCL-5 scores were also available from 21 controls (mean age 43.0 years, SD=20.3). Results and Discussion: With respect to criterion validity of the PCL-5, the post-MVA patients differed significantly from the control group not only with respect to their total PCL-5 scores, but also on all 20 individual items of the PCL-5, and also on all 4 subscales of PCL-5 (Intrusion, Avoidance, Altered Cognitions/Mood, and Arousal). The PCL-5 total scores correlated significantly to all three measures of post-MVA driving anxiety, post-MVA pain and insomnia, post-MVA depression, anger, and generalized anxiety, and to post-MVA subjective neuropsychological symptoms in the post-concussion and whiplash spectrum. Conclusions: Both the criterion and convergent validity of the PCL-5 for the use on post-MVA patients are excellent.

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Background: Formication is the sensation or feeling as if insects were crawling on or under the skin. It is observed in a variety of clinical situations including drug intoxications, multiple sclerosis, and diabetic neuropathy, among many others. Furthermore, it can be associated with injuries incurred during motor vehicle accidents (MVAs). We examined the frequency of reports of formication in a normal control sample as well as in a sample of motorists who sustained concussive and whiplash injuries following high impact MVAs. We also evaluated the correlations of the formication to measures of pain, insomnia, and of various post-accident neuropsychological symptoms. Method: De-identified data on 23 injured motorists (mean age=38.0 years, SD=12.8) and on 20 normal controls (mean age 42.8 years, SD=19.9) were available. All motorists responded to the following True/False item: “I have pain in my body which seems to feel like bugs crawling under the surface of my skin.” Their data were also available on the Brief Pain Inventory, Post-MVA Neurological Symptoms (PMNS) scale, Insomnia Severity Index, and on the Rivermead Post-Concussion Symptoms Questionnaire. The data of normal controls included responses to the following specific item of the formication questionnaire: “Do you sometimes have an annoying feeling in some of your limbs or in some other part of your body as if insects were crawling on or under your skin?” The participants were to circle one of the following responses: “never, very rarely, sometimes, often, or almost constantly.” Results and Discussion: Almost a third (30.4%) of the motorists who sustained whiplash trauma in their MVA reported the formication. In contrast, only one of the 20 normal controls (i.e., 5%) reported formication (this was an elderly man with MRI documented pathology in lumbosacral spine). Notably, formication correlated significantly with the ratings of “reduced feeling in the limbs” (r=.55, p=.010), but not with ratings of “tingling in the limbs” (r=.21, p>.05). Conclusion: The painful form of formication has been reported by almost a third of motorists who sustained whiplash injuries in their accident.