Risk perception and impulsivity: association with risky behaviors and substance abuse disorders

Low risk perception and high impulsivity, in conjunction with substance abuse disorders, are associated with the occurrence of injury in the general population. The study described in this article investigated the association of risk perception and impulsivity with risky behaviors (infrequent seat belt use, drinking and driving, riding with a drunk driver, binge drinking, and speeding for the thrill) among adults with unintentional blunt trauma. Patients (N = 756) were assessed for substance abuse disorders and participation in risky behaviors. Risk perception and impulsivity were measured by questionnaire. Pearson's chi-square statistic was used to investigate risk perception, impulsivity, substance abuse, and possible confounders relative to risky behaviors. Odds ratios were calculated using logistic regression methodology. Univariate results indicated that low risk perception and high impulsivity were significant risk factors for risky behaviors. After adjustment for confounding factors, low risk perception and high impulsivity remained significantly associated with risky behaviors in the trauma patient population.     

Age of drinking onset, driving after drinking, and involvement in alcohol related motor-vehicle crashes.

This study assessed whether persons who begin drinking at younger ages are more likely to report drunk driving and alcohol-related crash involvement over the life course, even after controlling analytically for diagnosis of alcohol dependence, years of drinking alcohol, and other personal characteristics associated with the age respondents started drinking. A national survey asked 42,862 respondents the age that they started drinking, whether they drove after drinking too much, and whether they were in motor-vehicle crashes because of their drinking. This analysis focused on 27,081 (65%), who reported ever drinking in their lifetime. The earlier the age respondents started drinking, the more likely they were to report driving after drinking too much and being in a motor-vehicle crash because of their drinking even after adjusting for current/ever diagnosis of alcohol dependence, number of years respondents had been drinking, and other characteristics and behaviors associated with the age respondents started drinking. Particularly, among persons who were never alcohol-dependent, those who began drinking in each age group under 21, relative to those starting at age 21 or older, were more likely to report "ever" and "in the past year" being in a crash after drinking too much. The traffic safety benefits of delaying drinking may extend well beyond the legal drinking age of 21.     

Road traffic accidents among alcohol-dependent patients: the effect of treatment

It is well known that driving under the influence of alcohol increases the risk of traffic accidents. Alcohol-dependent patients are responsible for two-thirds of motor vehicle crashes involving alcohol. Studies carried out on the general population have shown a relation between alcohol dependence and traffic accidents. The aim of the study is to analyse the effect on traffic accidents of treatment of patients with alcohol-related problems. To do so, the prevalence of traffic problems in a sample of patients with a diagnosed dependence on alcohol was assessed for three periods: during their lifetime, in the year preceding the start of treatment and over the year of treatment. A prospective study was carried out of 176 patients (147 males, 29 females; mean age 42.9 years) diagnosed as alcohol dependent according to the DSM-IV criteria in three alcoholic treatment centres in Castilla y León, Spain. 36.9% of the alcohol-dependent patients had had some kind of traffic problem during their life and 8.5% in the year prior to starting treatment. The most frequent problem was positive breath tests, followed by accidents with damage to the vehicle. Sixty-nine of the 176 patients were still receiving treatment after a year. The prevalence of traffic problems among those patients who followed treatment for 1 year (4.3%) was lower than in the year before treatment (15.9%). The study showed that the treatment is also effective in reducing traffic problems.     

Prevalence of impaired driving behaviors in a diverse, rural, southern middle school

Little research has been reported on the risky behaviors of pre-driving adolescents revolving around alcohol use, in particular impaired driving behaviors, which in general have been shown to be higher in rural areas. This study investigated the prevalence of drinking while driving and riding with a drinking driver among 290 middle school students in a Mississippi Delta area middle school. Just under half (45.3%) responded that at least once in the past 30 days they had ridden with a drinking driver and 17% indicated they had driven an automobile after drinking alcohol. The prevalence of underage drinking, driving under the influence of alcohol, and riding with a drinking driver among our sample of middle school students is alarming. This study shows alcohol-related driving behaviors are not solely performed by those who are legally licensed to drive, but simply by those who have access to vehicles. The authors recommend that prevention programs focusing on reducing the incidence of impaired driving should start in early adolescence.     

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.     

Gender differences in psychosocial predictors of texting while driving

A sample of 158 male and 357 female college students at a midwestern university participated in an on-line study of psychosocial motives for texting while driving. Men and women did not differ in self-reported ratings of how often they texted while driving. However, more women sent texts of less than a sentence while more men sent texts of 1–5 sentences. More women than men said they would quit texting while driving due to police warnings, receiving information about texting dangers, being shown graphic pictures of texting accidents, and being in a car accident. A hierarchical regression for men’s data revealed that lower levels of feeling distracted by texting while driving (20% of the variance), higher levels of cell phone dependence (11.5% of the variance), risky behavioral tendencies (6.5% of the variance) and impulsivity (2.3%) of the variance) were significantly associated with more texting while driving (total model variance = 42%). A separate regression for women revealed that higher levels of cell phone dependence (10.4% of the variance), risky behavioral tendencies (9.9% of the variance), texting distractibility (6.2%), crash risk estimates (2.2% of the variance) and driving confidence (1.3% of the variance) were significantly associated with more texting while driving (total model variance = 31%.) Friendship potential and need for intimacy were not related to men’s or women’s texting while driving. Implications of the results for gender-specific prevention strategies are discussed.     

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.     

An examination of gender differences in traffic accident risk perception.

Excessively optimistic judgements of driving competency and accident risk have often been implicated in the disproportionate involvement of young males in traffic crashes. In this study, young male and female drivers (ages 18-24) were asked to judge their relative driving safety, skill, and accident likelihood. Comparisons were made using both peers and the average motorist as referent groups. Subjects then rated 15 risky driving behaviors on four dimensions: frequency in everyday driving, seriousness, accident potential, and apprehension likelihood. Self-report driving experience/history data were also collected. Substantial optimism was evident in both sexes, but males tended to be more optimistic, particularly when judging their driving skill. Males were equally optimistic with respect to the two referent groups; females tended to be less optimistic when making comparisons to the average motorist. Males and females held similar perceptions concerning the frequency and accident likelihood of the risky behaviors, but males perceived the behaviors as generally less serious and less likely to results in accidents. Regression analyses showed that considerably more variance in optimism could be explained for males than females. Driving record was the single best predictor of perceived safety; its role, however, was diminished for perceived skill and subjectively estimated accident likelihood.     

The bold and the fearless among us: Elevated psychopathic traits and levels of anxiety and fear are associated with specific aberrant driving behaviors

In spite of the well-documented connection between personality traits like impulsivity, sensation seeking and fearlessness with aberrant driving behaviors, scarce research exists to examine the association between risky and aggressive driving and psychopathic characteristics, which encompass the above traits. The present investigation examines in two studies the association between specific sub-types of driving misconduct, i.e., unintentional mistakes and deliberate rule violations with psychopathic characteristics, with a focus on the role of levels of fear and anxiety in aberrant driving. Findings support the hypotheses that fearlessness, i.e., the bold, unemotional aspect of psychopathic traits, characterizes drivers who engage in frequent deliberate driving code violations, whereas the more impulsive/antisocial aspect of psychopathy, associated with higher levels of fear and anxiety, is more characteristic of drivers who engage in unintentional mistakes. Fearless features are also associated with higher self-reported driving misconduct and accidents. Study 2 conceptually replicated this finding by showing that mistakes are positively related to high sensitivity to punishment, while violations are negatively related to it. Findings are discussed in light of psychopathy theory and in relation to prevention and intervention.     

Commentary on statistical issues underlying the evaluation of a social policy change on motor vehicle accident involvement

This commentary addresses the statistical issues which are involved in assessing whether a causal interpretation can be given to an association between a change in social policy such as lowering the legal age for drinking alcohol and a change in the nature of accident involvement frequency for a particular sub-population of drivers like 18–20 year olds. In this regard, two methodological concerns are emphasized. The first is the resolution of a possible paradox in the nature of an association in the sense that individuals with a greater tendency to accident involvement may also have a greater tendency to alcohol usage so that their alcohol related accident involvement is coincidental rather than causal. For this setting, alcohol would be an “after the fact” correlate with accident involvement as opposed to a possible cause. Similarly, the second concern is the role of population exposure as an explanation for the change in alcohol related accident frequency for a particular age group. Since availability naturally increases the size of the population at risk for such accidents, the corresponding accident frequency may similarly increase even though the corresponding accident rates may have remained unchanged or perhaps even decreased. For these reasons, although associations with change in social policy are definitely of general interest, their interpretation in a causal sense should be viewed with substantial caution until the implications of competing explanations are reconciled. This assertion, however, does not mean that such associations are not useful for policy purposes, but rather that they lack sufficiently targeted statistical validity to be the primary basis for such change. In other words, if there is a strong rationale on economic, political, or social grounds for a policy change, then data presenting meaningful associations which are compatible with it can often play an important supportive role for it.     

Cycling to work in Brazil: Users profile, risk behaviors, and traffic accident occurrence

In 2006, we carried out a cross-sectional study in the urban area of Pelotas, Southern Brazil, with the aim of outlining the profile of bicycle commuters, analyzing their use of safety equipment and risk behaviors and the association between these variables and involvement in traffic accidents in the previous 12 months. This study was based on the baseline survey carried out prior to an educational intervention aimed at reducing accidents among cyclists. The sample included 1133 male subjects aged 20 years or more, and who used a bicycle for commuting. Crude and adjusted analyses were carried out using Poisson regression. We recorded a total of 152 reported traffic accidents in the 12 months preceding the interview, involving 10.8% of subjects. Most risk behaviors studied and the use of safety equipment showed no significant association with accidents. Only commuting by bicycle seven days per week, as opposed to five or six, and a combination of extremely imprudent behaviors such as zigzagging through traffic, riding after ingesting alcohol, and high-speed riding were found to be risk factors for accidents. Our findings suggest that in the context where the study was done (poor road signaling, limited policing, aggressive driving) changing cyclist behavior may not have substantial impact in terms of accident reduction before other road traffic interventions are implemented.     

How reinforcement sensitivity and perceived risk influence young drivers’ reported engagement in risky driving behaviors

Gray's reinforcement sensitivity theory (RST), implementing Carver and White's behavior inhibition system (BIS) and behavior approach system (BAS) scales, was used to predict reported engagement in 10 risky driving behaviors: speeding (2 levels), driving under the influence of alcohol, racing other vehicles, cell phone use (hand-held and hands free), tailgating, unsafe overtaking, driving while fatigued, and not wearing a seatbelt. Participants were 165 young male and female (n = 101) drivers aged 17–25 years who held a valid Australian driver's license. Effects of the explanatory variables and specific risk perceptions upon engagement in the reported risky driving behaviors were examined using SEM analyses. Also of interest was whether perceived risk mediated the relationship between the personality variables and reported engagement in risky driving behaviors. RST variables, negative reactivity, reward responsiveness and fun seeking, accounted for unique variance in young drivers’ perceived risk. Reward responsiveness and perceived risk accounted for unique variance in young drivers’ reported engagement in risky driving behaviors. Negative reactivity was completely mediated by perceived risk in its negative relationship with reported engagement. To better understand driving related risk decision making, future research could usefully incorporate drivers’ motivation systems. This has the potential to lead to more tailored approaches to identifying risk-prone drivers and provide information for the development and implementation of media campaigns and educational programs.     

Road rage among drug dependent patients

The consumption of alcohol, cocaine and cannabis is associated with aggressive behaviour, being a victim of injuries from various causes, and suffering traffic accidents. On the other hand, there is a significant association between road rage and traffic accidents, yet this has not been studied in persons suffering a substance dependence disorder. This study analyses the prevalence of road rage in substance dependent patients undergoing treatment. 100 patients randomly selected at an outpatient treatment centre were included in the study. 63% of the patients had experienced road rage in the year prior to the interview, and 18% were serious perpetrators. There was a higher frequency among drivers and those who were starting treatment for cocaine and cocaine + heroin. The study shows that road rage is very frequent among patients with disorders due to substance dependence who are undergoing treatment, in particular the most severe form (“serious perpetrators”). Special attention should be addressed to the issue of driving and road rage during the treatment of these patients.     

Impulsivity and risky decision making among taxi drivers in Hong Kong: An event-related potential study

Taxi drivers play an important role in providing safe and professional public transport services. However, they tend to be more involved than other professional driver groups in accidents caused by deliberate recklessness. This study used an event-related potential (ERP) experiment to examine risk-taking behavior arising from impulsivity by comparing the underlying neural processes of taxi drivers with and without traffic offence records in Hong Kong. A sample of 15 traffic offenders and 15 nonoffenders, matched by sociodemographic characteristics, was recruited. The results show that the offender group demonstrated significantly less negative-going (less negative) feedback-related negativity but more positive-going (more positive) feedback-related P300 when than with their nonoffending counterparts. These findings show that taxi drivers with traffic offence records were less sensitive to the consequences of behavior and more attuned to the magnitude of potential reward. In addition, behavioral data revealed that they were more willing to make risky decisions. All these characteristics pertain to impulsive personality traits. Based on these findings, we can conclude that the offenders in this sample were more impulsive than their nonoffending counterparts.     

Effect of lowering the alcohol limit in Denmark

On 1 March 1998, the Danish per se limit was lowered from 0.08 to 0.05% blood alcohol concentration (BAC) for motor vehicle drivers. Based on accident data and drivers' drinking habits before and after the amendment, the effect of the new limit has been evaluated. Interviews revealed a significant decrease in the number of drinks that drivers allow themselves to drink within a 2-h period before driving. The proportion of drivers, who would not drink at all or only have one drink, increased from 71% before the amendment to 80% after the amendment. Drivers with changed drinking habits most often stated the lower limit as the main reason for having less alcohol. However, based on accident data from the first year after the amendment, this has not resulted in a marked decrease in the proportion of injury accidents with impaired motor vehicle drivers (BAC>/=0.05%) compared to all injury accidents. On the contrary, the proportion of fatal accidents with drink-drivers compared to all fatal accidents has increased in the after-period. The total number of drink-driving sentences were a little larger in 1999 than in 1997 because of the lower limit, but a significant change from higher towards lower alcohol levels can be seen.     

Hurried driving: Relationship to distress tolerance,driver anger,aggressive and risky driving in college students

Being a hurried driver is associated with a variety of risky driving behaviors, yet the mechanisms underlying this behavior remain unknown. Distress tolerance, defined as an individual's capability to experience and endure negative emotional states, was examined as a predictor of hurried driving among 769 college students. Results indicate that after controlling for age, gender, race, ethnicity, the student's year in school, their grade point average, driving frequency, angry driving, aggressive driving as well as other forms of self-reported risky driving; hurried driving was significantly associated with lower levels of distress tolerance. Hurried drivers also reported greater levels of frustration and impatience with other drivers, suggesting that they have difficulty in withstanding or coping with negative psychological states when driving. Traditional traffic safety campaigns that emphasize enforcement may be less successful with these drivers. The need to develop campaigns that address the affective coping abilities that contribute to this behavioral pattern is discussed.     

Alcohol and traffic in Finland

This paper describes historical trends in drunken driving and traffic accidents in Finland since 1930 and discusses the relationship between alcohol policy, alcohol consumption, and drunken driving. It first describes the development of laws dealing with drunken driving and actual punishments for drunken driving. Secondly, it describes quantitative changes in drunken driving and traffic accidents, giving particular attention to alcohol-related traffic accidents. Thirdly, it analyses the connection between alcohol consumption and drunken driving. Finally, the relationship between alcohol policy and alcohol consumption in Finland is discussed. The role of the alcoholic beverages industry is also scrutinized. The paper shows that there are links among alcohol control policy, alcohol consumption, drinking habits, drunken driving, and alcohol-related traffic accidents. However, these ties are manifested through numerous mediating factors and alcohol is not the sole decisive factor. The paper also shows that drunken driving in Finland has increased and that alcohol-related traffic accidents are an important social problem.     

Evaluating a model linking assessed parent factors to four domains of youth risky driving

Motor vehicle collisions are the leading cause of death in youth aged 15–19. Research has consistently shown that driver education programs do not result in safer youth driving. Indeed, the biggest predictor of collisions involving youth is parental history of collisions. The current study examined how parental modeling of and teaching about risky driving behaviors related to youth practices within four domains of risky driving (aggressive, substance use, distracted, moving violations), and evaluated whether the Prototype-Willingness Model explains links from parent to teen driving practices. Participants (N = 432) were undergraduate students (mean age 18 years, age range 17–22 years) who had obtained their G2 driver's license within the past year; the G2 driver's license allows youth to drive alone on all municipal roads, with some restrictions on their blood alcohol level and the number of passengers they can carry. Results revealed that parental modeling was more predictive than parental teaching for all domains of risky driving examined. Youth whose parents modeled risky driving behaviors were found to be more likely to have engaged in those risky driving behaviors in the past, as well as to be more willing to engage in the behaviors in the future. The Prototype-Willingness Model was not a good fit to explain these relations. Findings from this study highlight the role parents play in the development of youth risky driving practices.     

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.