Relationship of Alcohol Problems, Psychiatric Symptoms, and Treatment Attendance to Aggressive Driving in a Sample of Drinking Drivers

Background and purpose. Aggressive driving as well as impaired driving has been associated with high rates of crashes and fatalities. In particular, impaired drivers who drive aggressively are at especially high risk for crashes and fatalities. Indeed, some impaired driver interventions focus on driver education as a means to prevent harm associated with aggressive and impaired driving. However, the antecedents of aggressive driving are not well understood and, consequently, impaired driver interventions may not be doing all that they can to reduce future harm. The present study examined how aggressive driving changed over time in a sample of drinking drivers as a function of treatment, psychological distress, and alcohol problems.

Methods. Data were drawn from a larger study of drinking drivers (n = 403) in Western New York.  Donovan’s driving-related attitude measures developed for DWI populations were used (Donovan, 1980; Donovan & Marlatt, 1982; Donovan et al., 1983).  The attitudes assessed included a 12-item driving-related aggression scale. Other measures included the SCL-90, which measured psychiatric severity (Derogatis, 1983), a count of the number of items endorsed in obtaining a DSM-III-R diagnosis of alcohol abuse (Robins, Helzer, Cottler, & Goldring, 1989) and a history of substance use and mental health treatment (including AA). All measures were completed at baseline (time 1). Follow up interviews occurred between 18 and 36 months later (time 2).

Results. Aggressive driving decreased slightly. Cross-lagged panel analysis indicated that aggressive driving at follow up was a function of alcohol problems at time 1 and time 2; psychiatric severity at time 1 and time 2; and previous aggressive driving. Although alcohol problems and psychiatric severity predicted mental health treatment use during the study period, mental health treatment did not predict alcohol problems, psychiatric severity or aggressive driving at time 2. All paths in the final model are significant (p’s <.05) and model fit indices are above generally accepted standards (CFI = 1.00; TLI = 1.003; Χ² = .55). Many significant indirect paths were also found.

Conclusions and implications. Taken together, these findings indicate that existing treatment approaches with DWI offenders that provide driver education may not be effective at addressing antecedents to aggressive driving. However, since alcohol problems and psychiatric symptoms are related to aggressive driving, our findings suggest that aggressive driving can be targeted by intervening on the modifiable risk factors of alcohol problems and psychiatric symptoms. Future research, especially collaborations with justice systems and clinical treatment programs, may be able to identify effective interventions with this population, furthering prevention of accidents caused by aggressive driving. However, it will require policy makers and clinicians to revise the paradigms that guide present intervention efforts. Social workers may be especially well-positioned to advocate for these changes, given that their training helps them think through how policy guides intervention practices.