Driving Intervention for Returning Combat Veterans: Interim Analysis of a Randomized Controlled Trial

Abstract

Date Presented 3/31/2017 Motor vehicle collisions are a leading cause of deaths for combat veterans, and effective occupational therapy driving interventions (OT–DIs) are needed. We conducted an analysis of an efficacy trial comparing an OT–DI with traffic safety education and demonstrated a reduction in driving errors for the OT–DI group. Primary Author and Speaker: Sherrilene Classen Additional Authors and Speakers: Sandra Winter Contributing Authors: Charles Levy, Abraham Yarney, Miriam Monahan

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

“…The strength of the convergent relation with depression, combined with the prominence of this association in previous research (i.e., Clapp et al, 2014), is consistent with the conceptualization of performance deficits occurring as a result of cognitive demands associated with rumination and heightened anxiety. These data, as well as others demonstrating associations between anxiety and impaired driving performance (e.g., Amick et al, 2013;Lew et al, 2011;Matthews et al, 1998;Taylor et al, 2007), suggest that anxiety management or other emotion regulation techniques could be used to augment existing driving-focused interventions (e.g., Classen et al, 2017).…”

“…Lew et al (2011) similarly found that post-9/11 conflict veterans with diagnoses of PTSD were more likely to acknowledge becoming lost or disoriented during postdeployment travel than were non-PTSD controls. Deficits observed in driving simulation research offer convergent evidence of self-reported difficulties in service members with PTSD (Amick et al, 2013;Classen et al, 2017). Finally, existing data offers robust support for associations between trauma-related symptoms and self-reported driving-related anger and aggression (e.g., Kuhn et al, 2010;Lew et al, 2011).…”

“…Although self-report scores do not limit assessment of the structural properties of the DBS, access to observational and/or archival indicators of problematic driving (e.g., traffic records, informant reports, road tests, simulator performance) could provide external confirmation of respondent-identified difficulties. Behavioral measures of performance have become increasingly common in the larger driving literature (e.g., Amick et al, 2013;Classen et al, 2017;Taylor et al, 2007) and will be an important consideration in the continued validation of self-report assessments.…”

“…Veteran status is also associated with an increase in the occurrence of traffic violations and non-fatal accidents (e.g., Amick, Kraft, & McGlinchey, 2013). Difficulties with travelrelated hypervigilance, disorientation, and aggression are shown to be further elevated in service members with symptoms of posttraumatic stress (Classen et al, 2017;Kuhn, Drescher, Ruzek, & Rosen, 2010;Lew et al, 2011), placing this population at greater risk for negative social, health, and financial outcomes associated with collisions and repeated citations (e.g., Hickling, Blanchard, Silverman, & Schwarz, 1992;Mayou, Bryant, & Ehlers, 2001; Possis et al, 2014). Despite recognition as a significant veteran health issue (Hwang, Peyton, Kim, Nakama-Sato, & Noble, 2014;Possis et al, 2014;Zinzow, Brooks, & Stem, 2013), few measures have been validated to assess problematic driving in former military.…”

“…Recognition of these difficulties has prompted the development of treatment packages targeting maladaptive driving in former service members (e.g., Classen et al, 2017;Strom et al, 2013). Research is complicated, however, by a lack of validated measures targeting problematic driving in this population.…”