Driving behaviors, triggers and management strategies reported by Veterans with mTBI/PTSD: A pilot study

Hannold EM, Classen S, Lanford D. Driving behaviors, triggers and management strategies reported by Veterans with mTBI/PTSD: A pilot study. Poster session presented at: American Congress of Rehabilitation Medicine / American Society of Neuroradiology Annual Meeting; 2011 Oct 13; Atlanta, GA.

BACKGROUND:Motor vehicle crashes (MVC) among post deployed Combat Veterans (CV) are one of the top four causes of injury and disability, hospitalization, and outpatient visits across the military, and is a leading cause of death among Army service members. The risk of MV death is significantly increased in years immediately following return from the battlefield. In sum, the effects of TBI/ PTSD/ other blast related injuries, combined with the "battlefield" mindset and lack of community reintegration programs place CV at risk for MVC and fatalities. The need for efficient assessments and interventions to reduce MVC post deployment has never been greater. OBJECTIVES:To define and describe the pre- and post-deployment driving experiences of CVs with mild traumatic brain injury and post-traumatic stress disorder (mTBI/PTSD). METHODS:IRB approved qualitative, phenomenological design. Single, structured interviews were conducted with five combat veterans during Driving Behavior Assessments. The Interviewer digitally recorded all interviews and recorded hand-written notes. Interviews and notes were transcribed verbatim, verified, and then imported into NVIVO software for coding. We used the constant comparative method to analyze data. STATUS:We have completed data analysis for this project. FINDINGS:Participants reported driving more aggressively (as trained in the battlefield) and making more driving errors following return to civilian life. Themes, patterns and relationships emerging from the data provided a context for understanding these behavior changes. Data suggested that combat-related injuries and experiences may alter a Veteran's pre-deployment driving identity; resulting in driving-related anxiety and aggressive driving (e.g., over speeding) post-deployment. Data indicated that risky driving behaviors were responses to driving-related anxieties. Veterans identified specific driving-anxiety triggers, and triggers that led to speeding and to road rage. Data also indicated that Veterans use a variety of strategies to manage their driving anxiety but continue to drive aggressively. IMPACT:Veterans' driving experiences offer insight into their aggressive driving behaviors. Findings suggest that Veterans are aware of these behaviors, but require effective strategies for managing them. OEF/OIF veterans may require individualized driving evaluations and interventions. Interventional and outcomes studies are needed to comprehensively address the driving needs of returning Veterans.