Alcohol-impaired driving in the lab: Efforts to reduce the incidence of drinking and driving

Transcription

1 Alcohol-impaired driving in the lab: Efforts to reduce the incidence of drinking and driving Nicholas A. Van Dyke, M.S. Department of Psychology An Equal Opportunity University

2 Research Interests General interests Drug addiction, substance abuse Drug-related cognitive/mental impairments Traffic safety - alcohol-impaired and distracted driving An Equal Opportunity University

3 Research on Alcohol-impaired Driving Alcohol s effect on aspects of driving behavior Role of impulsivity in risky drinking and driving behaviors Performance feedback to modify perceptions Examination of high-risk populations DUI offenders, ADHD An Equal Opportunity University

4 General Study Characteristics Male and female adults (21-34 years) Sample ns (10-50 subjects) Background drinking measures Drug-free task practice Socially-relevant alcohol doses (e.g., 0.50 g/kg; 0.65 g/kg) Breath alcohol concentrations (BrACs) approx mg/100 ml Placebo controlled Safely examine behaviors impaired by alcohol in controlled environment STISIM Drive, Systems Technology, Inc.

5 Modeling Alcohol-impaired Driving Driving simulators replicate real-world scenarios and behaviors High-fidelity with naturalistic vehicle configurations E.g., acceleration, braking, steering Isolate specific behaviors Driving skill Risky driving

6 How is driving performance measured? Skill-based drive scenarios: Standard deviation of vehicle s lane position Steering rate Lane exceedances Drive speed Risky drive scenarios: Primarily time-to-collision

7 Impulsivity and the DUI Offender Costs associated with alcoholrelated traffic crashes and fatalities have prompted considerable research aimed at identifying characteristics of DUI drivers Survey studies report impulsivity among DUI offenders (Donovan et al., 1983; Chalmers et al., 1993; Hubicka et al., 2010; Ryb et al., 2006) Driving records of DUI offenders show increased moving violations, speeding, accidents (Bishop, 2011) Prevention and treatment efforts have shown limited efficacy as recidivism rates remain high

8 Hypothesized Characteristics of the DUI Offender 1. Poorer driving performance that is predicted by level impulse control 2. Greater sensitivity to the acute disruptive effects of alcohol on driving performance and impulse control 3. Poorer ability to self-evaluate driving performance level, particularly in the intoxicated state when driving performance is impaired.

9 DUI Offenders vs. Non-offenders DUI offenders and non-offenders appeared similar in many ways Equally impaired on tests of driving performance and levels of inhibitory control Estimated similar levels of intoxication across declining limb However, DUI offenders selfreport an increased willingness and ability to drive

10 Development of Risk-taking Model Existing drive tests focused primarily on skillbased behaviors Ability to maintain lane position Distinction between driver skill and risk-taking existed since the 70s, yet not often tested Assesses drivers timeto-collision (TTC) Levandowski (2012) Automation

11 Lab Findings Increased risky driving at 0.08% BrAC relative to placebo (Laude and Fillmore, 2015; Van Dyke and Fillmore, 2017) Risky driving found to be distinct from drivers level of skill Relationship between degree of underestimating actual BrAC and degree of risky driving (Laude and Fillmore, 2016) Lower BrAC estimations associated with highest levels of risky driving

12 Dose-response Testing Well known that multiple skill-based driving behaviors impaired at or below current legal driving limit (e.g., Fell and Voas, 2006; Moskowitz and Fiorentino, 2000) Recent study from our lab found significant decrease in risk-taking from 0.08% to 0.05% (Van Dyke and Fillmore, 2017)

13 Other Factors to Consider Many of these tasks examine isolated behaviors in sterile environments Everyday real-world driving scenarios are complex Cell phones, dashboard controls Simple distraction task exacerbates alcoholinduced impairment of driving by 2-4x (Van Dyke and Fillmore, 2014)

14 Possible Targets for Intervention Degradation of driving skill while intoxicated only part of the issue Increased risk-taking while intoxicated might be particularly important Degree of risky driving Self-reported willingness and ability to drive Especially relevant to individuals and populations characterized by traits of impulsivity DUI offenders, binge drinkers, younger adults

15 Changing The DUI Offender s Willingness to Drive Caused by increased perception of ability to drive after drinking Treatment target: challenge this perception Behavioral feedback to contradict perception

16 Procedure Day one Alcohol Administration Perceived Ability Simulated Driving Test Behavioral Feedback Day two Alcohol Administration Perceived Ability

17 Behavioral Feedback

18 Drivers Perceived Ability to Drive DUI Control g/kg 0.65 g/kg 0.65 g/kg + expectancy Group

19 DUI Offenders: What we now know Increased self-reported impulsivity Increased attentional bias to alcohol Less perceived impairment from alcohol More willing to drive following alcohol Less consideration of the risk-relevant situational factors in deciding to drive time since last drink, distance to drive, probable BAC, etc

20 1/3 re-offend within 5 years The Recidivist Offender Limited treatment, reliance on punishment model recidivism attributed to alcohol addiction not supported by drinking data a problem of self-regulation, behavioral control, not simply addiction Need to focus on their: Reduced perceptions of impairment Heightened attention to alcohol the stimulus control that alcohol cues have over repeat offenders, resulting in a compulsion to drink in unfavorable contexts, such as when the drinker had not intended to drink

21 Current and Future Directions Expand on model to challenge perceptions of risk in DUI offenders Inclusion of brief interventions to increase recognition of intoxication Mindfulness components, etc.

22 Acknowledgements Mark T. Fillmore, Ph.D. Jen Laude, Ph.D. Melissa Miller, Ph.D. Walter Roberts, Ph.D. Jessica Weafer, Ph.D. Jaime Brown, B.A. NIAAA R01 AA12895, R01 AA NIDA T32 DA An Equal Opportunity University