Publication year
2011
Citation Title
Prevalence and characteristics of driving difficulties in Operation Iraqi Freedom/Operation Enduring Freedom combat returnees.
Journal Name
Journal of Rehabilitation Research & Development
Journal Volume
48
Issue Number
8
Page Numbers
913-926
DOI
10.1682/JRRD.2010.08.0140
Summary
A sample of 205 OIF/OEF Veterans who had been seen in a Veterans Affairs (VA) polytrauma clinic for Traumatic Brain Injury (TBI) or posttraumatic stress disorder (PTSD) participated in a study to document the prevalence and types of driving difficulties. Nearly all (93%) of the participants reported more difficulties with driving in at least one domain of driving since deployment. Veterans with PTSD (with or without traumatic brain injury) reported the most significant impairments in driving.
Key Findings
Driving problems were common among Veterans seen in a VA polytrauma clinic; 93% of participants reported a negative change in driving ability since returning from deployment.
The most common driving problems reported were increased anger or impatience, general driving difficulties, and almost getting into accidents. This pattern held for all four diagnostic groups (traumatic brain injury only, PTSD only, traumatic brain injury and PTSD, and neither traumatic brain injury or PTSD).
Qualitative survey data suggested that difficulties with anger, unlearning battlemind driving behaviors, and sustaining attention while driving were commons problems encountered in driving after deployment.
Implications for Program Leaders
Offer classes for Service members about possible driving difficulties after deployment and how to cope if difficulties arise
Host workshops that teach family members sensitive, supportive manners of communicating with Service members about driving issues, especially when the Veteran’s driving behavior may place the family in danger
Disseminate information regarding possible symptoms of mental health problems Service members may face after deployment and where individuals and families can find help for those problems
Implications for Policy Makers
Recommend assessments for all Service members for driving difficulties upon their return from deployment
Continue to support programs that address the unique challenges faced by deployed Service members and their families
Recommend education for service providers around the possible effects of deployment on Service members’ families
Methods
Veterans who had been seen in a VA polytrauma outpatient clinic between October 2006 and May 2009 were sent letters and surveys in the mail that contained a brief driving questionnaire and military service questions; some participants were interviewed via telephone and provided additional qualitative information about their driving.
All potential participants had previously undergone a comprehensive traumatic brain injury evaluation; participants could be classified as traumatic brain injury only, PTSD only, traumatic brain injury and PTSD, or neither.
Statistical analyses were conducted to compare mean levels of variables and to test for the presence or absence of traumatic brain injury or PTSD.
Participants
Two hundred and five OIF/OEF Veterans participated (75% were interviewed over the phone).
Ninety-three percent of the sample were male with a total mean age of 33.50 years (SD = 10.00 years). The participants were 73% White, 11% Latino/Latina, 9% Black. Most had some college or technical training (58%) and almost half (48%) were single.
Among the participants, 66% were Army, 28% were Marines, while 67% frequently drove in combat, and most (90%) had at least one combat tour. The average length of time since last deployment was 3.73 (SD = 1.39) years.
Limitations
The sample was recruited from a single VA polytrauma center and the rates of PTSD and TBI are likely higher than in a general OIF/OEF population; this population is also more likely to be having difficulties in multiple areas of functioning (of which driving could be one). Therefore, these results do not likely generalize beyond this sample.
Participants were asked to recall driving behaviors from nearly four years prior (immediately after return from deployment); therefore, their recall may be biased.
Qualitative data were not gathered nor analyzed in a structured manner, limiting the reliability and validity of these data.
Avenues for Future Research
Gather prospective data from Veterans longitudinally and assess driving problems immediately after homecoming from deployment
Collect data from secondary sources (e.g., partners)
Examine the role substance use may have in Service members' driving behaviors, both before and after deployment
Focus
Multiple Branches
Target Population
Population Focus
Military Component
Abstract
We studied the prevalence and characteristics of selfreported driving difficulties and examined their association with traumatic brain injury (TBI) and/or posttraumatic stress disorder (PTSD) in Operation Iraqi reedom/Operation Enduring Freedom(OIF/OEF) veterans who were seen at a Department of Veterans Affairs outpatient polytrauma clinic. In this study, we used a brief driving questionnaire and chart reviews to assess the prevalence and characteristics of driving difficulties in the following four groups of patients: TBI only, PTSD only, TBI + PTSD, and Neither (neither TBI nor PTSD). Compared with before deployment, 93% of OIF/OEF veterans seen in the polytrauma clinic reported more di fficulties with driving in at least one domain, with the most common areas of d ifficulty being (1) problems with anger or impatience (82%), (2) general driving difficulties (65%), and (3) experiences with near misses (57%). Patients with PTSD (with or without TBI) reported the most significant driving impairments, whereas respondents with a history of only TBI endorsed driving difficulties similar to veterans without either diagnosis. Qualitative an alysis of veterans’ comments also revealed similar patterns. Self-reported driving problems were common among OIF/OEF returnees. Respondents who had a diagnosis of PTSD (with or without TBI) reported the most severe driving difficulties since returning from deployment. The association between PTSD and driving problems warrants further investigation.
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