Psychiatric Disorders and Driving Performance

This chapter discusses the continuum of driving performance in healthy individuals under adverse conditions and specific psychopathologies ranging from anxiety disorders to mood disorders, psychotic disorders, attention deficit hyperactivity disorder (ADHD), and personality disorders. Driving simulators are being used in a number of domains in psychiatric research and practice: (1) design of experimental protocols addressing epidemiological findings related to driving safety for specific conditions in a controlled setting; (2) diagnostic use of simulators as baseline performance-based “probes” of neurocognitive function in untreated patients; (3) related to this, tracking of performance over a treatment period, i.e., in a clinical trial context; (4) assessment of safety and therapeutic effect of medications used to treat psychiatric illness with respect to psychomotor function; (5) medicolegal assessments of fitness-to-drive; and (6) skills training and rehabilitation. Skills training and phobia desensitization models have been shown to generalize to improved clinical outcome and on-road performance in anxiety disorders. Targeted training of strategy application and spatial navigation may improve frontal/executive impairments found in ADHD, and mood and psychotic disorders. Pharmacologic studies have been useful in the study of acute psychomotor and next-day sedative effects of psychotropics; generally, studies have demonstrated superiority of novel antidepressant and antipsychotic medication with respect to psychomotor function. Studies on use of stimulants in ADHD suggest improved short-term performance, however data on long-term effects are needed and trends related to multitasking while driving need to be taken into account. This chapter highlights a continuum-based model of “Type 1/Type 2” crash risk scenarios, related to underarousal versus overarousal of the human perceptual apparatus and low versus high presence states. In this model, “Type 1” crashes are provoked by excessively monotonous driving conditions resulting in perceptual disengagement and “Type 2” crashes occur under excessively complex driving conditions; the more variable, challenging, and stimulus-rich a scenario is, the greater the “Type 2” crash risk. Relevant variables include reaction time, braking accuracy, road position, which can be continuously monitored, and specific driving errors such as lane incursions and collisions. While scenario design may be modeled based on presumed functional impairments in specific psychiatric disorders, simulator models need to individualize platforms when testing complex scenarios assaying attentional and executive function or interpersonal aspects of driving such as road rage.

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  • Corporate Authors:

    CRC Press

    6000 Broken Sound Parkway, NW, Suite 300
    Boca Raton, FL  United States  33487
  • Authors:
    • Moller, Henry
  • Publication Date: 2011

Language

  • English

Media Info

  • Media Type: Print
  • Features: Figures; Photos; References; Tables;
  • Pagination: pp 47-1 – 47-14
  • Monograph Title: Handbook of Driving Simulation for Engineering, Medicine and Psychology

Subject/Index Terms

Filing Info

  • Accession Number: 01351586
  • Record Type: Publication
  • ISBN: 9781420061000
  • Files: TRIS
  • Created Date: Sep 9 2011 10:18AM