Contribution of cognitive factors to the prediction of post-traumatic stress disorder, phobia and depression after motor vehicle accidents

Past research into the psychological consequences of traumatic events has largely focused on post-traumatic stress disorder (PTSD), although other anxiety disorders and depression are also common in the aftermath of trauma. Little is known about differential predictors of these conditions. The present study investigated the extent to which theoretically derived cognitive variables predict PTSD, phobias and depression after motor vehicle accidents. The cognitive predictors were compared to a set of established, mainly non-cognitive predictors. In addition, we tested how disorder-specific the cognitive predictors are. Participants (n=101) were interviewed within a year after having been injured in a motor vehicle accident. Diagnoses of PTSD, travel phobias and depression, symptom severities and predictor variables were assessed with self-report questionnaires and structured interviews. In multiple regression analyses, the sets of cognitive variables derived from disorder-specific models explained significantly greater proportions of the variance of the symptom severities than the established predictors (PTSD 76% vs. 45%, depression 72% vs. 46% and phobia 66% vs. 40%), and than cognitive variables derived from the models of the other disorders. In addition, the majority of individual cognitive variables showed the expected pattern of differences between diagnostic groups. The results support the hypothesis that disorder-specific sets of cognitive factors contribute to the development and maintenance of PTSD, phobias and depression following traumatic events.     

Prevalence of poor psychological morbidity following a minor road traffic accident (RTA): The clinical implications of a prospective longitudinal study

Few Road Traffic Accident (RTA) victims have their psychological needs attended to in hospital or afterwards. We conducted a small-scale preliminary investigation exclusively focussing on the prevalence of poor psychological morbidity following minor road traffic accidents (RTAs). Participants (N?=?50) completed assessments one-month after their minor RTA and (N?=?39) at 4-months follow-up. The identification of clinically significant anxiety, depression and post traumatic stress disorder (PTSD) in this minor RTA sample supports both evidence reported elsewhere and our specific predictions. Seven (14%) participants at baseline and five (12.8%) at follow-up met diagnostic criteria for PTSD. The clinical implications for identifying and meeting the psychological needs of minor RTA victims are discussed in the context of cognitive behavioural conceptualizations of mental disorder.     

Safety perceptions and reported behavior related to cycling in mixed traffic: A comparison between Brisbane and Copenhagen

This study explores the differences in safety perceptions and reported behavior of cyclists in mixed traffic between an emerging cycling city (Brisbane, Australia) and an established cycling city (Copenhagen, Denmark). Perceptions and reported behavior were retrieved from a custom-designed web-based survey administered among cyclists in the two cities. Elicited items concerned perceived risk of infrastructure layouts, fear of traffic, cycling while distracted, use of safety gear, cycling avoidance due to feeling unsafe, and avoidance to cycle in mixed traffic conditions. The data were analyzed with structural equation models. Results show that, in comparison with cyclists in Copenhagen, cyclists in Brisbane perceive mixed traffic infrastructure layouts as less safe, feel more fear of traffic, and are more likely to adopt cycling avoidance as a coping strategy. Results also show that cyclists in Copenhagen tend to use less helmets and to cycle more while being distracted.     

Investigating the individual and organisational predictors of work-related driving crash involvement in Ethiopia

The rate of road traffic injury and death in Ethiopia is at a critical level when compared to rates in high-income countries. Considering the enormity of this issue, research is to identify groups of high-risk road users and the factors contributing to their crash involvement. This study focuses on work-related drivers. This study explores driving behaviour as a mediator of the relationship between organisational and individual attribute factors and self-reported crashes in a sample of 213 work-related drivers in Addis Ababa, Ethiopia. The hypothesised framework identifies driving behaviour as the most proximal determinant of self-reported crashes, and safety values, role overload and self-efficacy as antecedents of driving behaviour. With the exception of the relationship between self-efficacy and driving behaviour, all the hypothesised relationships were supported. We make recommendations for intervention approaches that are theoretically focused and sensitive to the cultural context.     

Secondary task engagement and vehicle automation – Comparing the effects of different automation levels in an on-road experiment

Recent and upcoming advances in vehicle automation are likely to change the role of the driver from one of actively controlling a vehicle to one of monitoring the behaviour of an assistant system and the traffic environment. A growing body of literature suggests that one possible side effect of an increase in the degree of vehicle automation is the tendency of drivers to become more heavily involved in secondary tasks while the vehicle is in motion. However, these studies have mainly been conducted in strictly controlled research environments, such as driving simulators and test tracks, and have mainly involved either low levels of automation (i.e., automation of longitudinal control by Adaptive Cruise Control (ACC)) or Highly automated driving (i.e., automation of both longitudinal and lateral control without the need for continuous monitoring). This study aims to replicate these effects during an on-road experiment in everyday traffic and to extend previous findings to an intermediate level of automation, in which both longitudinal and lateral control are automated but the driver must still monitor the traffic environment continuously (so-called Partial automation). N = 32 participants of different age groups and different levels of familiarity with ACC drove in rush-hour traffic on a highway segment. They were assisted by ACC, ACC with steering assistance (ACC+SA), or not at all. The results show that while subjective and objective driving safety were not influenced by the degree of automation, drivers who were already familiar with ACC increased the frequency of interactions with an in-vehicle secondary task in both assisted drives. However, participants generally rated performing the secondary task as less effortful when being assisted, regardless of the automation level (ACC vs. ACC+SA). The results of this on-road experiment thus validate previous findings from more-controlled research environments and extend them to Partially automated driving.     

Manual drivers’ experience and driving behavior in repeated interactions with automated Level 3 vehicles in mixed traffic on the highway

In the near future, conditionally automated vehicles (CAVs; SAE Level 3) will travel alongside manual drivers (≤ SAE level 2) in mixed traffic on the highway. It is yet unclear how manual drivers will react to these vehicles beyond first contact when they interact repeatedly with multiple CAVs on longer highway sections or even during entire highway trips. In a driving simulator study, we investigated the subjective experience and behavioral reactions of N = 51 manual drivers aged 22 to 74 years (M = 41.5 years, SD = 18.1, 22 female) to driving in mixed traffic in repeated interactions with first-generation Level 3 vehicles on four highway sections (each 35 km long), each of which included three typical speed limits (80 km/h, 100 km/h, 130 km/h) on German highways. Moreover, the highway sections differed regarding the penetration rate of CAVs in mixed traffic (within-subjects factor; 0%, 25%, 50%, 75%). The drivers were assigned to one of three experimental groups, in which the CAVs differed regarding their external marking, (1) status eHMI, (2) no eHMI, and (3) a control group without information about the mixed traffic. After each highway section, drivers rated perceived safety, comfort, and perceived efficiency. Drivers were also asked to estimate the penetration rate of CAVs on the previous highway section. In addition, we analyzed drivers’ average speed and their minimum time headways to lead vehicles for each speed zone (80 km/h, 100 km/h, 130 km/h) as well as the percentage of safety critical interactions with lead vehicles (< 1 s time headway). Results showed that manual drivers experienced driving in mixed traffic, on average, as more uncomfortable, less safe and less efficient than driving in manual traffic, but not as dangerous. A status eHMI helps manual drivers identify CAVs in mixed traffic, but the eHMI had no effect on manual drivers’ subjective ratings or driving behavior. Starting at a level of 25% Level 3 vehicles in mixed traffic, participants' average speed decreased significantly. At the same time, the percentage of safety critical interactions with lead vehicles increased with an increasing penetration rate of CAVs. Accordingly, additional measures may be necessary in order to at least keep the existing safety level of driving on the highway.     

Occupational Therapy in the Rehabilitation of the Patient with Anorexia Nervosa

The first part of this paper develops an ecological and rehabilitative stance for the occupational therapist in relation to the anorexic patient. Maximizing the individual's level of psychosocial functioning is regarded as the primary aim of treatment. A model for approaching the anorexic patient is described which examines environmental factors, and the importance of assessment and follow up. The cognitive behavioral approach is discussed and suggestions are made for adapting it to the occupational therapist's orientation towards practical activity. In the second part of the paper concrete suggestions for therapy are made.     

Factors underlying bus-related crashes in Hanoi,Vietnam

Road traffic crashes accounted for almost 13% of the total mortality recorded at the public health facilities in Vietnam in 2010. This qualitative study investigated factors related to bus-related crashes in Hanoi, Vietnam using focus group discussions and in-depth interviews among 75 participants who are bus drivers, motorcycle users, bus passengers, bus company managers, traffic policemen and local authorities. The results suggested that bus drivers were not the sole contributor to road traffic crashes with other vehicles. The rapid population growth due to rural to urban migration and the poor transport system appeared to be important contributing factors. In addition, “village culture” was likely to influence both the traffic behaviors of road users and the practices of law enforcement officers. Moreover, drink-driving behaviors appeared to be an important contributor to bus-related crashes. Supervision and penalty policies of bus companies also appeared to influence the driving performance of bus drivers. For a long-term solution to reduce bus-related crashes, it is vital to improve the transport infrastructure and the state management capacity regarding road safety as well as to assist the positive transition of citizens migrating from rural areas to their new urban lifestyle.     

Holistic thinking and air traffic controllers' decision making in conflict resolution

When facing potential conflicts, whether to make interventions is an important decision for air traffic controllers and vital for aviation safety and efficiency. While many task-related factors in influencing such decisions have been identified, the large portion of individual differences has remained insufficiently explained. This paper proposes that controllers with a more holistic thinking style will be more likely to make interventions because they envision more uncertainties in the system which can lead to a higher level of perceived risk and a greater likelihood to take proactive measures. To test these hypotheses, forty-two licensed controllers were invited to complete a questionnaire measuring holistic thinking style and later a conflict detection/resolution task. Multilevel regression analyses showed that (1) when the real risk level (the minimum lateral distance between two converging aircraft) dropped, controllers who think more holistically still tended to maintain a higher risk perception level (perceived likelihood of aircraft collision in the future) which lead to a higher intervention ratio and (2) even when real and perceived risk levels were controlled, those who think more holistically were more likely to make interventions. These findings are discussed with reference to literature in cognitive style, risk perception and workload management. Potential implications for personnel selection and training are also discussed.