Preliminary findings of a novel measure of driving behaviors in Veterans with comorbid TBI and PTSD

Abstract

Abstract-Veterans of the military operations in Iraq andAfghanistan are at an elevated risk of driving-related accidents and fatalities compared with civilians. Combat exposure, military driving training, risk-seeking, traumatic brain injury (TBI), and posttraumatic stress disorder (PTSD) are all factors associated with driving-related risk. However, few empirical studies have observed driving patterns in this population, and the influence of these contributing factors remains unclear. This study utilized a novel self-report measure to assess driving behaviors, driving-related anxiety, and emotional experiences of military Veterans who have returned to civilian driving. This questionnaire was completed by 23 combat Veterans diagnosed with comorbid TBI and PTSD and 10 nondisabled combat Veterans. Drivers with TBI and PTSD reported more frequent high-risk driving behaviors and higher levels of anxiety while driving in certain situations than nondisabled combat Veterans. These preliminary findings highlight the importance of studying on-the-road situations and cues that produce anxiety in Veterans, particularly those with TBI and PTSD. A greater understanding of driving-related anxiety is needed to inform targeted and effective interventions for unsafe driving in Veterans.

Driving Outside the Wire: Examining Factors Impacting Veterans’ Postdeployment Driving

“…Also similar to Whipple et al, and in line with the findings of Hannold et al (2013), our focus group participants reported awareness of both their driving deficits and described their adoption of cognitive and behavioral strategies to facilitate appropriate driving. Similar to Zinzow et al (2013) and Whipple et al (2016), our Veteran participants reported experiencing environmental and social triggers while driving (e.g., unexpected items by the side of the road) that reminded them of deployment experiences, and which increased driving-related stress, anxiety, or anger. Driving difficulties such as increased driving stress, anxiety, and fatigue may make it challenging for Veterans to fully engage in daily activities or in community mobility to participate in their desired activities.…”

“…While driving on civilian roads, Veterans reported using similar tactics as those used during combat, such as battlemind training, straddling the middle of the road, not stopping at red lights, and making risky driving maneuvers (e.g., illegal U-turns). Whipple and colleagues (2016) studied driving behaviors in Veterans with comorbid TBI and PTSD, reporting that Veterans commonly experience frequent episodes of impatience, irritability, and frustration. Our participants demonstrated high-risk behaviors similar those described in the Whipple et al’s study, such as speeding, or accelerating through yellow lights.…”

Problematic driving in former service members: An evaluation of the Driving Behavior Survey in veterans with posttraumatic stress disorder

“…Interpretation of results should be made within the context of the study's strengths and limitations. These data, along with preliminary work by Whipple et al (2016), are among the first to examine the characteristics of a structured driving measure in a sample of former service members. The availability of a large clinical dataset and the incorporation of goldstandard, interview-based measures of PTSD are notable strengths of the project.…”

“…Established measures or scales derived from validated instruments are used in some research, although phenomena captured in these assessments generally target only a subset of problematic behavior (e.g., driving anger; Hwang et al, 2014;Strom et al, 2013). Whipple, Schultheis, and Robinson (2016)) begin to fill gaps in this literature with the introduction of the Veteran Driving Questionnaire (VDQ). Initial scale development examines situational anxiety, driving behaviors, and affective states in a small sample of well-adjusted veterans and veterans with comorbid brain injury and PTSD.…”

Simulated Driving Errors: Indicators of Real-World Driving Events in Returning Combat Veterans

“…In fact, PTSD or TBI are associated with an increased risk of aggressive driving in Veterans (Kuhn et al, 2010). Veterans with PTSD or TBI showed higher risky-driving behaviors and anxiety levels when driving under conditions, such as being “boxed in by other cars,” compared with nondisabled Veterans (Whipple et al, 2016). During deployment, Veterans are trained to execute battle-mind driving tactics, such as speeding, ignoring traffic rules, and driving in the middle of the road (Lew et al, 2010).…”