The driving behavior survey as a measure of behavioral stress responses to MVA-Related PTSD

Numerous treatments are available that address the core symptoms of posttraumatic stress disorder (PTSD). However, there are a number of related behavioral stress responses that are not assessed with PTSD measures, yet these behavioral stress responses affect quality of life. The goal of the current study was to investigate whether a recently developed measure of behavioral stress response, the Driving Behavior Survey (DBS), was sensitive to change associated with treatment among a group of participants diagnosed with PTSD. The DBS indexes anxious driving behavior, which is frequently observed among individuals with motor vehicle accident-related PTSD. Participants (n=40) were racially diverse adults (M age=40.78, 63% women) who met diagnostic criteria for motor vehicle accident-related PTSD. Hierarchical linear modeling analyses indicated that participants who were assigned to a brief, exposure-based intervention displayed significant reductions on the DBS subscales relative to participants assigned to the wait-list control condition (r=.4143). Moreover, mediational analyses indicated that the observed reductions on the DBS subscales were not better accounted for by reductions in PTSD. Taken together, these findings suggest that the DBS subscales are sensitive to changes associated with PTSD treatment and can be used to augment outcome assessment in PTSD treatment trials. © 2014

Properties of the Driving Behavior Survey among individuals with motor vehicle accident-related posttraumatic stress disorder

Data suggest anxious drivers may engage in problematic behaviors that place themselves and others at increased risk of negative traffic events. Three domains of problematic behavior - exaggerated safety/caution, performance deficits, and hostile/aggressive behaviors - previously were identified during development of the Driving Behavior Survey (DBS), a novel measure of anxiety-related behavior. Extending this research, the current study examined the psychometric properties of DBS scores among individuals with posttraumatic stress disorder (PTSD) subsequent to motor vehicle trauma (N= 40). Internal consistencies and 12-week test-retest reliabilities for DBS scales ranged from good to excellent. Comparison of scores to normative student data indicated dose-response relationships for safety/caution and performance deficit subscales, with increased frequency of anxious behavior occurring within the PTSD sample. Associations with standard clinical measures provide additional evidence for anxiety-related driving behavior as a unique marker of functional impairment, distinct from both avoidance and disorder-specific symptoms. © 2013 Elsevier Ltd

Problematic driving in former service members: An evaluation of the Driving Behavior Survey in veterans with posttraumatic stress disorder

Despite high levels of traffic-related mortality, injury, and impairment among former service members, measures validated to assess problematic driving in this population remain limited. The current study examined characteristics of the Driving Behavior Survey (DBS) in male veterans (76.3% White; age: M = 56.4, SD = 12.3) meeting criteria for PTSD. Confirmatory factor analyses indicated acceptable fit of a 3-factor model specifying dimensions of anxiety-based performance deficits, exaggerated safety/caution, and hostile/aggressive driving behavior. Concurrent associations with indices of anxiety, depression, trauma history, and clinician-rated PTSD were consistent with small (r = .10–.29) to medium (r = .30–.49) effects. Discriminative validity was noted through elevations in performance deficit (d = .26), safety/caution (d = .50), and hostile/aggressive (d = .39) scales relative to published data from student drivers. Scores comparable to civilian motorists with accident-related PTSD help to qualify the severity of problematic driving behavior in trauma-exposed veterans

Alliance across group treatment for veterans with posttraumatic stress disorder: The role of interpersonal trauma and treatment type

The authors examined initial levels and pattern of change of alliance in group treatment for posttraumatic stress disorder (PTSD) for veterans. One hundred and 78 male veterans with PTSD were recruited for this study. Participants were randomly assigned to either group cognitive-behavioral therapy (GCBT) or to group present-centered therapy (GPCT). Alliance with fellow group members was assessed every other session throughout the group (total of seven assessments). Hierarchical linear modeling was used to determine whether treatment condition or index trauma type (interpersonal or noninterpersonal) impacted initial levels of alliance or change in alliance over time. Alliance increased significantly throughout treatment in both conditions. The presence of an interpersonal index event, compared to a noninterpersonal index event, did not significantly impact either initial levels of alliance or change in alliance over time. Participants in the GCBT condition experienced significantly greater growth in alliance over time compared to those in the GPCT condition (p ± .05) but did not have significantly different initial alliance ratings. The components and focus of the GCBT treatment may have facilitated more rapid bonding among members. Interpersonal traumatic experience did not negatively impact group alliance

Freedpeople, Politics, and the State in Civil War America

In early November 1863, Union Army officials gathered at Goodrich’s Landing, in northern Louisiana, to speak to an audience of soldiers and freedpeople. Since the war began, the small outpost on the Mississippi River had become a crucial base of operations for the Union, and a magnet for African Americans from all over the Mississippi Valley. The purpose of the event was, in many ways, to rectify the growing problem that freedpeople posed to Union operations. Officials sought to reaffirm the Lincoln government’s position regarding emancipation, while at the same time outlining the limits of what African Americans could expect from this. Before a colorfully dressed and overwhelmingly black audience—which included children from a local school, who were marched in front of the crowd, reciting sections of their grammar primer from memory—Union officials spoke with one voice about what the war would bring, and what emancipation demanded of African Americans. Bearing a message that would become all too familiar by the end of the Civil War, Lorenzo Thomas, Adjutant-General of the United States, asserted that emancipation had extended freedom to black slaves but nothing more: “You have none now on whom you can lay the burden of your cares. Your welfare depends solely on your own efforts. You have none who possess or assume the right to crush or oppress you. Your sorrows and trials will be the result of your own folly or incapacity.” After Thomas had finished speaking, a black preacher seemingly echoed his words on the challenges of freedom but gave them different meaning. The message he delivered was that emancipation had only replaced one authority with another because devotion to the rule of law was still necessary. “Everything must have a head,” he called out to the crowd, “the plantation, the house, the steamboat, the army, and to obey that head was to obey the law.

The Driving Behavior Survey as a Measure of Behavioral Stress Responses to MVA-Related PTSD

Numerous treatments are available that address the core symptoms of posttraumatic stress disorder (PTSD). However, there are a number of related behavioral stress responses that are not assessed with PTSD measures, yet these behavioral stress responses affect quality of life. The goal of the current study was to investigate whether a recently developed measure of behavioral stress response, the Driving Behavior Survey (DBS), was sensitive to change associated with treatment among a group of participants diagnosed with PTSD. The DBS indexes anxious driving behavior, which is frequently observed among individuals with motor vehicle accident-related PTSD. Participants (n = 40) were racially-diverse adults (M age =40.78, 63% women) who met diagnostic criteria for motor vehicle accident-related PTSD. Hierarchical linear modeling analyses indicated that participants who were assigned to a brief, exposure-based intervention displayed significant reductions on the DBS subscales relative to participants assigned to the waitlist control condition (r = .41-.43). Moreover, meditational analyses indicated that the observed reductions on the DBS subscales were not better accounted for by reductions in PTSD. Taken together, these findings suggest that the DBS subscales are sensitive to changes associated with PTSD treatment and can be used to augment outcome measures in PTSD treatment trial

Properties of the Driving Behavior Survey among individuals with motor vehicle accident-related posttraumatic stress disorder

Data suggest anxious drivers may engage in problematic behaviors that place themselves and others at increased risk of negative traffic events. Three domains of problematic behavior – exaggerated safety/caution, performance deficits, and hostile/aggressive behaviors – previously were identified during development of the Driving Behavior Survey (DBS), a novel measure of anxiety-related behavior. Extending this research, the current study examined the psychometric properties of DBS scores among individuals with posttraumatic stress disorder (PTSD) subsequent to motor vehicle trauma (N = 40). Internal consistencies and 12-week test-retest reliabilities for DBS scales ranged from good to excellent. Comparison of scores to normative student data indicated dose-response relationships for safety/caution and performance deficit subscales, with increased frequency of anxious behavior occurring within the PTSD sample. Associations with standard clinical measures provide additional evidence for anxiety-related driving behavior as a unique marker of functional impairment, distinct from both avoidance and disorder-specific symptoms