Potential driving issues in combat returnees

Abstract

The driving abilities of service members returning from Operation Enduring Freedom and Operation Iraqi Freedom (OEF/OIF) have not been well reported and are an important aspect of their return to normal life. This article reviews the unique risk factors for unsafe driving in this cohort. In particular, the cognitive and psychological symptoms of mild traumatic brain injury and postraumatic stress disorder, two of the most common diagnoses affecting these returning warriors, are specified, and their possible association with impaired driving is examined. The potential negative impact of the "battlemind driving tactics" (i.e., evasive driving skills) acquired by these service members as part of their military tours is also highlighted. The article concludes with comments about the functional consequences of impaired driving in this population, including limits to participation in rehabilitation and community reintegration, as well as recognition of the need for further research in this area.

Postdeployment Driving Stress and Related Occupational Limitations Among Veterans of Operation Iraqi Freedom and Operation Enduring Freedom

“…Moreover, participants who drove off base more frequently during deployment showed higher scores on the DSP than those who drove less frequently, and those who assumed both driver and passenger roles during deployment scored significantly higher than those who were only a passenger. Combat veterans have acknowledged that one of their postdeployment driving issues is unintentionally reverting to evasive or battlefield driving tactics in the civilian setting, which can result in considerable stress and aggressive behavior in driving (Killgore et al, 2008;Lew et al, 2010).…”

“…Although combat veterans were reportedly able to resume driving instantly on their reentry in civilian society (Lew et al, 2010), paramount to the subject matter is how long it may take for their postdeployment driving to return to normal. Our study revealed individual differences in the length of time required to resume normal driving in the civilian setting.…”

“…The reasons for this increased risk are not completely understood, but some believe it is because of a higher risk-taking tendency and unsafe behavior in veterans (Killgore et al, 2008). Four explanations for unsafe driving behaviors in veterans of OIF-OEF have been put forth: (1) driving stress, (2) substance and alcohol abuse, (3) posttraumatic stress disorder (PTSD), and (4) traumatic brain injury (TBI; Burke, Olney, & Degeneffe, 2009;Lew, Amick, Kraft, Stein, & Cifu, 2010;Sayer et al, 2010;Stern, Prudencio, & Sadler, 2011).…”

“…Other authors have attributed postdeployment driving stress to the evasive or battlefield driving tactics taught to military personnel before deployment, including speeding, driving down the center of or off the road, swerving around objects in the road, ignoring traffic signals and signs (to avoid attack), and not wearing a seatbelt (to enable a quick escape; Lew et al, 2010;Stern et al, 2011). These driving behaviors, taught as life-saving techniques, are strongly reinforced during deployment to such a degree that they may become automatic driving habits (Stern et al, 2011).…”

Cognitive–Behavioral Group Treatment for Driving‐Related Anger, Aggression, and Risky Driving in Combat Veterans: A Pilot Study

“…Aggressive driving contributes to over half of all motor-vehicle accident (MVA) fatalities and increased risk for MVA injuries (AAA Foundation for Traffic Safety, 2009). Although aggressive and risky driving behavior can result from many things (e.g., impulse control problems), research suggests that military training, warzone exposure, exposure to driving-related traumatic events, and postdeployment mental health problems (e.g., posttraumatic stress disorder [PTSD], posttraumatic brain injury [TBI] symptoms) contribute to aggressive and risky driving behaviors (Kuhn et al, 2010;Lew, Amick, Kraft, Stein, & Cifu, 2010). Several controlled studies have demonstrated the effectiveness of cognitive-behavioral and relaxation strategies for reducing aggressive and risky driving behaviors in civilian populations (Deffenbacher, Huff, Lynch, Oetting, & Salvatore, 2000;Deffenbacher, Filetti, Lynch, Dahlen, & Oetting, 2002;Galovski & Blanchard, 2002).…”