Driving Simulation as Virtual Reality Exposure Therapy to Rehabilitate Patients with Driving Fear After Traffic Accidents

Following a traffic accident, up to 30% of the involved persons suffer from stress related symptoms often coming along with enduring fear of driving. Virtual reality exposure therapy (VRET) offers major advantages for treating anxiety disorders, but with respect to fear of driving it has been hardly investigated so far. In the present study a driving simulator exposure treatment for patients with fear of driving after a traffic accident was developed and evaluated. The therapy followed a standardized manual of 13 sessions including anamnesis, medical examination, two preparative psychotherapy sessions, five virtual reality exposure (VRE) sessions, a final behavioral avoidance test in real traffic with a driving instructor, a closing session, plus follow-up phone calls after six and twelve weeks. The exposure scenarios were individually tailored to the patients’ anxiety hierarchy. 14 patients were treated. Results indicate excellent treatment success. In the final behavioral avoidance test, all patients mastered driving tasks they had avoided before, 71% showed an adequate driving behavior as assessed by the driving instructor, 93% could maintain their treatment success until the second follow-up phone call. We conclude that VRET in a driving simulator is a highly promising tool to treat fear of driving. Major advantages are that traffic scenarios are highly controllable, safe and can be designed and presented to perfectly fit the individuals\u27 anxieties

Treating patients with driving phobia by virtual reality exposure therapy – a pilot study

Objectives Virtual reality exposure therapy (VRET) is a promising treatment for patients with fear of driving. The present pilot study is the first one focusing on behavioral effects of VRET on patients with fear of driving as measured by a post-treatment driving test in real traffic. Methods The therapy followed a standardized manual including psychotherapeutic and medical examination, two preparative psychotherapy sessions, five virtual reality exposure sessions, a final behavioral avoidance test (BAT) in real traffic, a closing session, and two follow-up phone assessments after six and twelve weeks. VRE was conducted in a driving simulator with a fully equipped mockup. The exposure scenarios were individually tailored to the patients’ anxiety hierarchy. A total of 14 patients were treated. Parameters on the verbal, behavioral and physiological level were assessed. Results The treatment was helpful to overcome driving fear and avoidance. In the final BAT, all patients mastered driving tasks they had avoided before, 71% showed an adequate driving behavior as assessed by the driving instructor, and 93% could maintain their treatment success until the second follow-up phone call. Further analyses suggest that treatment reduces avoidance behavior as well as symptoms of posttraumatic stress disorder as measured by standardized questionnaires (Avoidance and Fusion Questionnaire: p < .10, PTSD Symptom Scale–Self Report: p < .05). Conclusions VRET in driving simulation is very promising to treat driving fear. Further research with randomized controlled trials is needed to verify efficacy. Moreover, simulators with lower configuration stages should be tested for a broad availability in psychotherapy

EMPHASIS - Effort-Management und Performance-Handling in sicherheitsrelevanten Situationen. Wirkungen von Assistenz und Automation auf Fahrerzustand und Fahrsicherheit Abschlussbericht

SIGLEAvailable from TIB Hannover: F03B224 / FIZ - Fachinformationszzentrum Karlsruhe / TIB - Technische InformationsbibliothekBundesministerium fuer Bildung und Forschung, Berlin (Germany)DEGerman