Impulsivity,risky behaviors and accidents in alcohol-dependent patients

Impulsivity and alcohol drinking are both considered as important predictors of unintentional as well as intentional injuries. However, relationships of impulsivity with risky behaviors and a history of accidents have not been investigated in alcohol dependence. The aim of this study was to analyze relationships between the frequency of risky behaviors and level of behavioral as well as cognitive impulsivity in alcohol-dependent patients. By means of Barratt's Impulsiveness Scale (BIS) and stop-signal task, the levels of cognitive and behavioral impulsivity among 304 alcohol-dependent patients were measured. Also, patients were asked to answer questions from the Short Inventory of Problems applying to risky behaviors and accidents after alcohol drinking. In addition participants completed a questionnaire to assess frequency of other behaviors from the analyzed spectrum (use of other drugs, driving or aggressive behavior after alcohol drinking). The statistical analysis revealed a significant association between impulsivity and frequency of risky behaviors in alcohol-dependent patients. Individuals with higher scores in BIS behaved more frequently in a risky way and had significantly more accidents after alcohol drinking. The association with risky behaviors was strongest for non-planning and attentional impulsivity subscales, whereas frequency of accidents was particularly associated with motor impulsivity. A multivariate analysis revealed that impulsivity was the most important predictor of risky behaviors, but did not significantly predict a history of accidents. Our study confirms that impulsivity is an important correlate of risky behaviors in alcohol-dependent individuals, along with global psychopathology and severity of alcohol dependence.     

Social, behavioral and driving characteristics of injured pedestrians: a comparison with other unintentional trauma patients

Pedestrian injuries represent 11% of all motor vehicle related injuries in the USA. This study attempts to define the epidemiology of the pedestrian victim. Patients admitted to a regional adult trauma center were interviewed and evaluated for substance abuse. Pedestrians were compared with the remaining unintentional trauma patients with regard to demographics, socioeconomics, possession of a driver's license, injury prone behaviors, risk taking dispositions, and BAC levels using the Student's t-test and Pearson's chi2 statistic (alpha=0.05). Multivariate logistic regression models were built with pedestrian mechanism as the outcome. When compared to the remaining unintentional trauma population (N=661), pedestrians (N=113) were significantly more likely to be black, not married, unemployed, binge drinkers, alcohol dependent, drug dependent, BAC+, to have a low income, low educational achievement, younger age, and to not have a driver license. Black race, unemployment of 1 year or more, never licensed, lapsed license, revoked license and BAC>200 mg/dl showed statistical significance in the multiple logistic regression. Pedestrians represent a sub-population with a low socioeconomic status and high incidence of substance abuse. Unemployment, not having a driver's license, black race, and a BAC>200 mg/dl were strongly linked to being an injured pedestrian.     

Age and gender differences in risky driving: the roles of positive affect and risk perception

A phone survey of 504 teen (age 16–20) and 409 adult (age 25–45) drivers in the US state of Alabama was conducted to examine the relationships among risk perception, positive affect and risky driving. Male drivers reported engaging in risky driving behaviors more frequently than female drivers and teen drivers reported engaging in risky driving behaviors more frequently than adult drivers. Positive affect (liking for risky driving behaviors) and perceived risk mediated the relationships of age and gender with risky driving. Affect and risk perception were independent predictors of risky driving behavior. Interactions of positive affect and perceived risk with gender and age showed that positive affect more strongly predicted risky driving for teen and male drivers than for adult and female drivers. These findings are interpreted in the context of dual process models of behavioral decision making. Future research into interventions designed to moderate the positive affect surrounding driving may have promise for reducing risky driving behavior.     

Predicting risky and angry driving as a function of gender

The present study was designed to examine putative risk factors of driving anger, traffic citations, and traffic-related injuries as a function of gender. Participants included 785 (65% men) drivers identified by the Washington State Department of Licensing. Just over half of participants (55%) were identified as high-risk drivers based on multiple traffic violations, whereas 45% were recruited from a random sample of drivers. Participants completed a mailed survey assessing indicators of risky driving and risk factors including sensation seeking, stressful events, negative affect, tobacco use, and drinking behavior. Hierarchical regression analysis was used to evaluate risky driving outcomes as a function of theoretically prioritized risk factors and to evaluate gender as a moderator. Overall, men reported more traffic citations and injuries, but did not differ from women in reported driving anger. All putative risk factors were associated with one or more indicators of risky driving. Moderation results revealed that the positive relationship between drinking frequency and driving anger was stronger for women. In contrast, typical number of drinks consumed was negatively associated with driving anger, which was also more evident for women. In addition, the positive association between sensation seeking and number of traffic citations was stronger among women.     

Drug and alcohol use among drivers admitted to a Level-1 trauma center

The purpose of this research was to determine the incidence and prevalence of drug use, alcohol use, and the combination of drug and alcohol use among motor vehicle crash (MVC) victims admitted to a Level-1 trauma center. In a 90-day study, nearly two-thirds of trauma center admissions were victims of motor vehicle crashes. Blood and urine was collected from 168 MVC victims of whom 108 were identified as the driver in the crash. Toxicology results indicated that 65.7% of drivers tested positive for either commonly abused drugs or alcohol. More than half of the drivers tested positive for drugs (50.9%) other than alcohol, with one in four drivers testing positive for marijuana use. About one-third of those using drugs had also been drinking, but alcohol was detected in only 30.6% of all injured drivers. Within the total MVC patient pool, passenger drug/alcohol use was equivalent to the driver population; however, injured pedestrians had higher rates of alcohol only than other MVC victims. There were no significant differences in drug and alcohol use between MVCs and trauma admissions of other causes. Of the patients with positive toxicology results, less than half (42%) were referred for evaluation for substance abuse disorders.     

Beyond general behavioral theories: Structural discrepancy in young motorcyclist's risky driving behavior and its policy implications

While many studies examine the mean score differences of psychological determinants between heterogeneous driver groups, this study reveals a structural discrepancy in a causal behavioral framework. Using young motorcyclists (ages 18–28) as subjects, this study investigates the various roles of key influential factors in determining risky driving behavior. Multi-group analysis of structural equation modeling shows that age and gender are two factors that can effectively distinguish heterogeneous driver groups exhibiting different decision-making mechanisms in shaping their risky driving behaviors. When encountering undesirable traffic conditions, road rage can immediately increase male motorcyclists’ intentions to engage in risky driving behaviors; on the other hand, young female motorcyclists further calculate their perceived risk to determine whether to engage in risky driving behaviors. This result shows that there is a significant link between risk perception and traffic condition awareness for experienced drivers (ages 25–28), but not for younger drivers (ages 18–24). This finding shows that while well-developed theories such as planned behavior and risk homeostasis provide general frameworks to explain risky driving behavior, heterogeneous driver groups may exhibit structural discrepancies that reflect their various decision-making mechanisms. This suggests that, in addition to mean differences, understanding structural discrepancies among heterogeneous groups could help researchers identify effective intervention strategies.     

Motivational counseling reduces future police charges in court referred youth

By the age of 18, between 16 and 27% of adolescents in the U.S. have been arrested for an offense and by the age of 23 this increases to a staggering 25–41%. Most youth that get into legal trouble have a substance abuse problem and many youth report high risk driving behaviors. Adjudication of adolescents for an offense may provide an opportunity to provide a secondary prevention program for such high risk behaviors. In this regard the primary aim of the present study was to test two hypotheses: (1) that interventions involving group motivational interviewing would decrease future legal charges beyond those achieved by the combination of sanctions and remedial actions otherwise mandated by the court; and (2) that the addition of a trauma room exposure to the group MI intervention would increase the effectiveness of MI in decreasing these future legal charges.     

The contribution of alcohol to night time crash risk and other risks of night driving

Many studies show that driving at night is more risky in terms of crash involvements per distance travelled than driving during the day. The reasons for this include the more prevalent use of alcohol by drivers at night, the effects of fatigue on the driving task and the risk associated with reduced visibility. Although the consumption of alcohol prior to driving occurs most commonly at night, drink-driving is not inherently a night time risk factor. This study decomposes the New Zealand risk of driving at night into risk associated with alcohol and risk associated with inherently night time factors. The overall risk associated with alcohol use by drivers was shown to decrease with increasing age for the most risky situation analysed (male drivers on weekend nights). Given the levels of drinking and driving on weekend nights, the overall effect of alcohol was shown to contribute almost half of weekend night time risk for drivers aged under 40 on lower volume roads, but to contribute little to overall risk on higher-volume roads, consistent with other research showing that higher-volume roads are not favoured by drinking drivers. Risk at night relative to risk during the day (excluding risk associated with drinking and driving) was shown to decrease with age. Roads with illumination at night are less risky at night relative to during the day than roads without illumination. The risks estimated in this paper reflect the behaviour of the road users studied and their prevalence on the roads under the conditions analysed.     

Risky driving among young Australian drivers II: Co-occurrence with other problem behaviours

This study examined the co-occurrence of risky driving with a range of externalising and internalising problems among 1055 young Australian drivers participating in an ongoing, 23-year longitudinal study. This issue was examined by: (1) investigating the co-occurrence of risky driving and other problem outcomes at 19-20 years; (2) exploring the rate of single and multiple problems among high, moderate and low young risky drivers and (3) investigating connections between risky driving in early adulthood and adolescent problem behaviours. Concurrent and longitudinal associations between risky driving and both substance use (alcohol, cigarette and marijuana use, binge drinking) and antisocial behaviour were found. However, risky driving generally appeared unrelated to internalising problems (depression, anxiety) and early sexual activity. Overall, young risky drivers varied considerably in the number and types of problem behaviours exhibited, although the great majority (70%) had displayed at least one other type of problem behaviour.     

Personality and behavioral predictors of traffic accidents: testing a contextual mediated model

A contextual mediated model was proposed to distinguish the distal (i.e. personality factors) and proximal (i.e. aberrant driving behaviors) factors in predicting traffic accident involvement. Turkish professional drivers (N=295) answered a questionnaire including various measures of personality factors, driver behaviors, and accident history. Results of the latent variable analysis with LISREL indicated that latent variables in the distal context (i.e. psychological symptoms, sensation seeking, and aggression) predicted at least one of the proximal elements (i.e. aberrant behaviors, dysfunctional drinking, and preferred speed) with relatively high path coefficients. While aberrant driver behaviors yielded a direct effect on accident involvement, psychological symptoms yielded an indirect effect mediated by driver behaviors. Further analyses revealed that personality factors had an impact on road accidents via their effects on actual driving-related behaviors although the path coefficients in predicting accidents were relatively weaker than those predicting risky driving behaviors and habits. Results were discussed considering the implications for classifying the accident correlates in a contextual framework and binominal-poisson distribution of self-reported accidents.     

Alcohol-impaired driving behavior and sensation-seeking disposition in a college population receiving routine care at campus health services centers

Accidents stemming from alcohol-impaired driving are the leading cause of injury and death among college students. Research has implicated certain driver personality characteristics in the majority of these motor vehicle crashes. Sensation seeking in particular has been linked to risky driving, alcohol consumption, and driving while intoxicated. This study investigated the effect of sensation seeking on self-reported alcohol-impaired driving behavior in a college student population while adjusting for demographics, residence and drinking locations. A total of 1587 college students over the age of 18 completed a health screening survey while presenting for routine, non-urgent care at campus heath services centers. Student demographics, living situation, most common drinking location, heavy episodic drinking, sensation-seeking disposition and alcohol-impaired driving behavior were assessed. Using a full-form logistic regression model to isolate sensation seeking after adjusting for covariates, sensation seeking remains a statistically significant independent predictor of alcohol-impaired driving behavior (OR = 1.52; CI = 1.19-1.94; p < 0.001). Older, white, sensation-seeking college students who engage in heavy episodic drinking, live off-campus, and go to bars are at highest risk for alcohol-impaired driving behaviors. Interventions should target sensation seekers and environmental factors that mediate the link between sensation seeking and alcohol-impaired driving behaviors.     

Temporal distribution of motorcyclist injuries and risk of fatalities in relation to age, helmet use, and riding while intoxicated in Khon Kaen, Thailand

This study investigated the temporal distribution of risky behaviors among injured motorcyclists, that is, riding unhelmeted or while intoxicated, and showed how they are associated with risk of fatal injuries. Data of motorcyclists injured in Khon Kaen municipality in northeastern Thailand and transferred to Khon Kaen Regional Hospital were obtained from the trauma registry system of the hospital. Case fatalities were compared by time of day, age group, helmet use, and alcohol intoxication. Unhelmeted riding peaked late in the evening and riding while intoxicated peaked around midnight. Both were associated with increased fatality risk after stratification by time of day; the odds ratios were 3.49 (95% confidence interval (CI) = 1.48-9.36) and 3.01 (CI = 1.71-5.19), respectively. Nighttime injuries were not significantly associated with increased fatality risk after stratification by helmet use or alcohol intoxication. Unhelmeted driving was prevalent and associated with higher fatality risk among younger drivers, whereas intoxicated driving was less prevalent among teens but associated with increased risk among those aged 20-39 years. This study shows that riding unhelmeted or while intoxicated can explain the increased fatality risk at night, suggesting that safety education or enforcements should be targeted at specific age groups and appropriate times.     

How to identify the key factors that affect driver perception of accident risk. A comparison between Italian and Spanish driver behavior

Road crashes can be caused by different factors, including infrastructure, vehicles, and human variables. Many research studies have focused solely on identifying the key factors that cause road crashes. From these studies, it emerged that human factors have the most relevant impact on accident severity. More specifically, accident severity depends on several factors related directly to the driver, i.e., driving experience, driver's socio-economic characteristics, and driving behavior and attitudes. In this paper, we investigate driver behaviors and attitudes while driving and specifically focus on different methods for identifying the factors that most affect the driver's perception of accident risk. To this end, we designed and conducted a survey in two different European contexts: the city of Cosenza, which is located in the south of Italy, and the city of Granada, which is located in the south of Spain. Samples of drivers were contacted for their opinions on certain aspects of driving rules and attitudes while driving, and different types of questions were addressed to the drivers to assess their judgments of these aspects. Consequently, different methods of data analysis were applied to determine the aspects that heavily influence driver perception of accident risk. An experiment based on the stated preferences (SP) was carried out with the drivers, and the SP data were analyzed using an ordered probit (OP) model. Interesting findings emerged from different analyses of the data and from the comparisons among the data collected in the two different territorial contexts. We found that both Italian and Spanish drivers consider driving in an altered psychophysical state and violating the overtaking rules to be the most risky behaviors.     

Sensation seeking, risky driving and behavioral adaptation

A study on the relationship between sensation seeking (SS) and risky driving, aggressive driving and behavioral adaptation is reported on. College students completed a questionnaire concerning their driving behavior and level of sensation seeking. Results indicated that high SS's were significantly more likely than low SS's to speed, not wear belts, drink frequently, drive after drinking, perceive a low risk of detection for impaired driving, and perceive that they could drink more beer before being impaired. High SS's were also more likely to report aggressive driving habits. High SS's were significantly more likely than low SS's to say that they would drive faster on highways and on wet roads and drive after drinking, if operating a vehicle equipped with anti-lock brakes. The results are consistent with previous research.     

Increased patterns of risky behaviours among helmet wearers in skiing and snowboarding

Background

There has been an ongoing debate as to whether wearing helmets in skiing and snowboarding increases the risk tolerance of participants.

Objective

To investigate the roles of demographic and personality variables, and helmet usage in predicting risk taking behaviours in a cross-sectional sample of intermediate and proficient skiers and snowboarders.

Methods

Risk taking in skiing was measured using a validated 10-item self-report measure which was designated as the outcome variable in a three step hierarchical regression. Independent predictors included age, sex, education, sport, ability, helmet usage, and personality traits that have been associated with risk taking: impulsivity and sensation seeking.

Results

In the final regression model, helmet use significantly predicted variance in risk taking (standardized β = .10, p = .024), and the relationship remained after accounting for variance due to demographic variables and general trait measures. The partial relationship between risk taking and sex, ability, impulsivity, and sensation seeking were also significant (p < .05).

Conclusion

High sensation seeking, high impulsivity, male sex, and proficiency were associated with increased patterns of risky behaviours in skiers and snowboarders, and after accounting for these factors, helmet use was a significant predictor of risk taking. The relationship between helmet use and risk taking was modest suggesting that the costs of increased risk taking is not likely to outweigh the protective benefits of a helmet.     

Driving under the influence of cannabis: Links with dangerous driving, psychological predictors, and accident involvement

Driving under the influence of cannabis (DUIC) has become a growing concern. Studies investigating the impact of DUIC on traffic safety have shown evidence that, during the acute period of cannabis intoxication, cannabis diminishes driving faculties and is associated with an elevated risk of collision. However, DUIC drivers seem to exhibit a general reckless driving style that may contribute to an over-estimation of DUIC-related collisions among this group. In this study, we investigated DUIC drivers with respect to self-reported dangerous driving habits (e.g., risky driving, aggressive driving and negative emotional driving), behaviours observed in a driving simulator, psychological predictors and crash involvement. Results suggest that DUIC is associated with self-reported and observed risky driving and negative emotional driving. We also found that sensation seeking and impulsivity are independent psychological predictors of DUIC. Finally, a trend suggests that self-reported DUIC is associated with an increased risk of being involved in a car accident, after controlling for dangerous driving and demographic variables. Implications for interventions are discussed.     

Risky and aggressive driving in young adults: Personality matters

Young, novice drivers constitute a disproportionate percentage of fatalities and injuries in road traffic accidents around the world. This study, attempts to identify motivational factors behind risky driving behavior, and examines the role of personality, especially sensation seeking, impulsivity and sensitivity to punishment/reward in predicting negative driving outcomes (accident involvement and traffic offences) among young drivers. Gender and driver's age are additional factors examined in relation to driving outcomes and personality. Adopting the contextual mediated model of traffic accident involvement (Sümer, 2003), the study is based on the theory that personality, age and gender represent distal factors that predict accident involvement indirectly through their relationship with stable tendencies towards aberrant driving behavior. Results from correlations and Structural Equation Modeling using AMOS 6 indicated that direct personality effects on driving outcomes were few, whereas personality had significant correlations with aberrant driving behavior, showing that personality is a distal but important predictor of negative driving outcomes. These high risk traits appear to be at a peak among young male drivers. Thus, personality is important in understanding aggressive and risky driving by young adults and needs to be taken into consideration in designing targeted accident prevention policies.     

Identifying factors that increase the likelihood of driving after drinking among college students

Driving after drinking (DAD) is a serious public health concern found to be more common among college students than those of other age groups or same-aged non-college peers. The current study examined potential predictors of DAD among a dual-site sample of 3753 (65% female, 58% Caucasian) college students. Results showed that 19.1% of respondents had driven after 3 or more drinks and 8.6% had driven after 5 or more drinks in the past 3 months. A logistic regression model showed that male status, fraternity or sorority affiliation, family history of alcohol abuse, medium or heavy drinking (as compared to light drinking), more approving self-attitudes toward DAD, and alcohol expectancies for sexual enhancement and risk/aggression were independently associated with driving after drinking over and above covariates. These results extend the current understanding of this high risk drinking behavior in collegiate populations and provide implications for preventive strategies. Findings indicate that in addition to targeting at-risk subgroups, valuable directions for DAD-related interventions may include focusing on lowering both self-approval of DAD and alcohol-related expectancies, particularly those associated with risk/aggression and sexuality.     

Acceptance of drinking and driving and alcohol-involved driving crashes in California

BackgroundAlcohol-impaired driving accounts for substantial proportion of traffic-related fatalities in the U.S. Risk perceptions for drinking and driving have been associated with various measures of drinking and driving behavior. In an effort to understand how to intervene and to better understand how risk perceptions may be shaped, this study explored whether an objective environmental-level measure (proportion of alcohol-involved driving crashes in one’s residential city) were related to individual-level perceptions and behavior.MethodsUsing data from a 2012 cross-sectional roadside survey of 1147 weekend nighttime drivers in California, individual-level self-reported acceptance of drinking and driving and past-year drinking and driving were merged with traffic crash data using respondent ZIP codes. Population average logistic regression modeling was conducted for the odds of acceptance of drinking and driving and self-reported, past-year drinking and driving.ResultsA non-linear relationship between city-level alcohol-involved traffic crashes and individual-level acceptance of drinking and driving was found. Acceptance of drinking and driving did not mediate the relationship between the proportion of alcohol-involved traffic crashes and self-reported drinking and driving behavior. However, it was directly related to behavior among those most likely to drink outside the home.DiscussionThe present study surveys a particularly relevant population and is one of few drinking and driving studies to evaluate the relationship between an objective environmental-level crash risk measure and individual-level risk perceptions. In communities with both low and high proportions of alcohol-involved traffic crashes there was low acceptance of drinking and driving. This may mean that in communities with low proportions of crashes, citizens have less permissive norms around drinking and driving, whereas in communities with a high proportion of crashes, the incidence of these crashes may serve as an environmental cue which informs drinking and driving perceptions. Perceptual information on traffic safety can be used to identify places where people may be at greater risk for drinking and driving. Community-level traffic fatalities may be a salient cue for tailoring risk communication.     

Personality, safety attitudes and risky driving behaviors—Evidence from young Taiwanese motorcyclists

This paper's main objective is to explore the relationships between personality factors, attitudes toward traffic safety and risky driving behaviors among young Taiwanese motorcyclists. A second objective is to examine the gender difference in the effects of personality and safety attitudes on risky driving behaviors. The study sample consisted of 257 student participants from a Taiwanese university. The results show attitudes toward traffic safety are directly associated with risky driving behaviors while having direct effects on attitudes toward traffic safety, personality traits are also found to influence risky driving behaviors indirectly mediated by traffic safety attitudes. Practical implications for traffic safety of young motorcyclists are also discussed.