Road rage: a psychiatric phenomenon?

Analysis of students' anger during riding electric bicycles on campus

This paper presents a study of the causes of anger of students who ride electric bicycles on a university campus. A questionnaire survey of 370 students in university was conducted using a electric bicycle rider anger scale. Structural equation model is used to analyze the interaction between pedestrians, traffic management, other riders and environment and riders themselves. The results show that the overall level of students' riding anger on the campus was not high, and the interaction with the surrounding environment mainly reflected the riding anger of college students. The interaction of students' anger with campus traffic management requirements was relatively low. Based on the study results, several campus traffic management and safety education recommendations are made.

Typology of aggressive and transgressive drivers

The present study investigates the pattern in which transgressive and aggressive driving motives and aggressive driving were ordered in different clusters of drivers. To establish the difference between profiles, anger disorders, state-trait anger, and motives for transgression and respect for traffic rules were studied and compared between clusters. A total of 383 participants (laypersons), of all age and gender, filled out self-report measures evaluating aggressive driving, state-trait anger, anger disorders, aggressive driving motives, and motives for transgression and respect for traffic rules. Results show the emergence of four profiles of drivers: Respectful, Aggressive-Avenger, Aggressive-Dominant, and Aggressive-Situational. The difference between these clusters has been confirmed by the high tendency of anger disorders for Aggressive-Dominant, low tendency of aggressive driving for Respectful, high tendency for motives for aggressive driving as altruistic protection for Aggressive-Avenger, and high tendency of speeding for Aggressive-Situational. Our findings strongly support the importance of creating programs adapted to each driver's profile.

Psychiatry, the law and death on the roads

The motor vehicle on the road has a history of only just over 100 years. It is a major form of personal and public transport, but is also associated with hazards and risks. Many more people are killed on the roads each year in Britain than are the victims of homicide. General and forensic pyschiatric evaluation of offenders charged with or convicted of motoring offences is, however, infrequent, despite the presence of mental health problems in some of them. I describe psychiatric, criminological and legal factors associated with driving of motor vehicles, as many psychiatric patients have driving licences and have access to a vehicle or, indeed, may decide to drive unlicensed.

Anger expression among Danish cyclists and drivers: A comparison based on mode specific anger expression inventories

Based on the short form of the driving anger expression inventory (DAX-short, 15-item), the present study developed an adapted version of the DAX for cyclists (CAX, 14 items). The data basis was an online survey of 2000 inhabitants of Denmark. A principle component analysis on the translated DAX-short confirmed the 4-factor solution of the original study differentiating between (1) personal physical aggressive expression, (2) use of a vehicle to express anger, (3) verbal aggressive expression and (4) adaptive/constructive expression. In case of cycling, the factor "use of a vehicle to express anger" only included one item and was left out. Based on the results, reliable subscales were developed. Drivers scored higher in verbal aggressive expression than cyclists, while there was no significant difference in constructive expression. The subscales for drivers and cyclists showed significant relations to age, gender, self-reported aggressive behaviours and traffic fines: Women scored for instance lower in physical expression, while older people scored higher in constructive expression. The effect of age and gender on anger expression among drivers and cyclists remained significant when controlling for exposure and other factors in linear regression analyses. These analyses also showed a relationship between a positive attitude towards driving and higher levels of anger expression among drivers, while this was not the case for cyclists.

A Fuzzy DEMATEL Analysis of Cultural Variables in Traffic Rules Violation

Traffic rules violation stems from numerous causes such as the lack of appropriate traffic rules training, non-institutionalization of respect to the rights of others especially pedestrians, and more importantly self-preference. There is a need for accidents prevention and deeper analysis of the multi-attributes which lead to unwanted accidents and lethal crashes resulting in death. Most of these elements are cultural variables. In this study, the cultural variables affecting traffic rules violation are investigated. From among many cultural variables, 6 most important factors were examined. For this aim, 10 traffic officers who have more than 10 years' experience and 10 citizens with master's degree and at least 6 years driving experience, participated in this research. For determining the cause and effect relations between them, fuzzy DEMATEL is applied. Findings show that unawareness of traffic rules has the greatest importance because it is the premier causal factor from one hand and on the other hand, it has the maximum relation with the other cultural variables.

Exploring associations between self-regulatory mechanisms and neuropsychological functioning and driver behaviour after brain injury

The objective of this prospective one-year follow-up study was to explore the associations between self-regulatory mechanisms and neuropsychological tests as well as baseline and follow-up ratings of driver behaviour. The participants were a cohort of subjects with stroke and traumatic brain injury (TBI) who were found fit to drive after a multi-disciplinary driver assessment (baseline). Baseline measures included neuropsychological tests and ratings of self-regulatory mechanisms, i.e., executive functions (Behavior Rating Inventory of Executive Function-Adult Version; BRIEF-A) and impulsive personality traits (UPPS Impulsive Behavior Scale). The participants rated pre-injury driving behaviour on the Driver Behaviour Qestionnaire (DBQ) retrospectively at baseline and after one year of post-injury driving (follow-up). Better performance on neuropsychological tests was significantly associated with more post-injury DBQ Violations. The BRIEF-A main indexes were significantly associated with baseline and follow-up ratings of DBQ Mistakes and follow-up DBQ Inattention. UPPS (lack of) Perseverance was significantly associated with baseline DBQ Inattention, whereas UPPS Urgency was significantly associated with baseline DBQ Inexperience and post-injury DBQ Mistakes. There were no significant changes in DBQ ratings from baseline (pre-injury) to follow-up (post-injury). It was concluded that neuropsychological functioning and self-regulatory mechanisms are related to driver behaviour. Some aspects of driver behaviour do not necessarily change after brain injury, reflecting the influence of premorbid driving behaviour or impaired awareness of deficits on post-injury driving behaviour. Further evidence is required to predict the role of self-regulatory mechanisms on driver behaviour and crashes or near misses.

Traumatic brain injury, driver aggression and motor vehicle collisions in Canadian adults

OBJECTIVE

This study examines the associations between lifetime traumatic brain injury (TBI), driver aggression, and motor vehicle collisions among a population sample of adults who reside in the province of Ontario, Canada.

METHOD

A cross-sectional sample of 3993 Ontario adults, aged 18-97 were surveyed by telephone in 2011 and 2012 as part of Center for Addiction and Mental Health's ongoing representative survey of adult mental health and substance use in Canada. TBI was defined as trauma to the head that resulted in loss of consciousness for at least five minutes or overnight hospitalization.

RESULTS

An estimated 91% (95% CI: 90.0, 91.9) of individuals in this sample held a valid Ontario driver's license at the time of testing. Among those, 16.7% reported a history of lifetime TBI and 83.3% reported no TBI. The prevalence of TBI was higher among men than women. Relative to licensed adults without TBI, adults with a history of TBI had significantly higher odds of engaging in serious driver aggression in the past 12 months, such as making threats to hurt another driver, passenger or their vehicle (AOR=4.39). These individuals also reported significantly higher odds (AOR=1.74) of being involved in a motor vehicle collision that resulted in hurting themselves, their passenger(s) or their vehicle.

CONCLUSION

This is the first population-based study to demonstrate a relationship between a history of TBI and higher rates of serious driver aggression and collision involvement. Given the large proportion of adult drivers with a history of TBI, these individuals may account for a disproportion burden of all traffic safety problems. Whether the increased road safety risk of adults with a history of TBI is reflective of neurocognitive deficits or is merely evidence of a cluster of unsafe activities produced by a higher risk lifestyles requires further research attention.

Driving frequency and Its impact on road rage offending and victimization: a view from opportunity theory

Road rage has been described as a key criminal justice and public health concern. Although research attention to this issue has expanded dramatically, most of this work has focused on the identification of predisposing individual factors. It is equally important to begin to assess those factors that may modify the likelihood of road rage including the broader structural opportunities that are connected with the propensity to be involved in a road rage incident. Drawing on opportunity theory, this article examines whether there is a relationship between increased opportunities to be involved in road rage and an increased likelihood of being a road rage victim or offender. The analysis is further extended to specifically test whether this relationship is linear, thereby examining the applicability of the opportunity saturation hypothesis. Using data from the Centre for Addiction and Mental Health (CAMH) Monitor, our findings support both the application of opportunity theory to understanding road rage and the presence of opportunity saturation. Although a clear relationship exists between kilometers driven and experiences of road rage, evidence emerged suggesting there may be a threshold whereby increased opportunities for road rage do not lead to road rage behavior.

Victims of road rage: a qualitative study of the experiences of motorists and vulnerable road users

OBJECTIVE

To gain an in-depth understanding of road rage incidents from the victims' perspectives.

METHODS

The data consisted of 30- to 60-min in-depth semistructured phone interviews with 29 self-identified victims of road rage. Twenty of the participants were in a motor vehicle, whereas 9 were pedestrians/cyclists. A qualitative Grounded Theory approach was used to inductively code and analyze the transcripts.

RESULTS

Victims reported a correlation between their vulnerability and the perceived intensity/severity of the road rage incidents. The most vulnerable victims (pedestrians and cyclists) were the least likely to view road rage incidents as a random event and the most likely to feel that they were specifically targeted. Road rage incidents tended to evolve more rapidly when there was a greater real or perceived power imbalance between the victims and perpetrators. The most vulnerable victims were the most likely to have long-term physical and mental health consequences from the incident, and to significantly modify their behavior after the incident.

CONCLUSIONS

Our analysis suggests that issues of victim vulnerability play a major role in determining the intensity, severity, and psychological consequences of road rage incidents. This seems particularly true for the most vulnerable of road users, such as pedestrians and cyclists.

Aggression in borderline personality disorder: evidence for increased risk and clinical predictors

This article aimed to systematically review the current literature regarding elevated risk of aggression in borderline personality disorder (BPD) and to review factors that differentiate aggressive from nonaggressive individuals with BPD. It has done so via a systematic review of the literature using Ovid MEDLINE and PsycINFO from 1980 to June 2010. Results indicate that BPD does not appear to be independently associated with increased risk of violence in the general population. History of childhood maltreatment, history of violence or criminality, and comorbid psychopathy or antisocial personality disorder appear to be predictors of violence in patients with BPD. This review concludes that the current evidence suggests that patients with BPD are not more violent than individuals in the general population. More studies are needed on factors that predict risk of aggression at an individual level.

Road rage: relationships with borderline personality and driving citations

OBJECTIVE

The objectives of this study were to determine: (1) the prevalence of self-reported road rage in a primary care sample; (2) the relationship, if any, between road rage and borderline personality disorder (BPD); and (3) whether those with road rage have a greater prevalence of different types of driving citations compared to those without road rage.

METHOD

Using a consecutive, cross-sectional sample of primary care outpatients, we surveyed 419 individuals.

RESULTS

The prevalence of self-reported road rage in this sample was 35.3%. BPD was significantly more prevalent among participants with road rage (24.8% vs. 9.8%). Compared to those without road rage, those with road rage reported statistically significantly higher numbers of different types of driving citations, including moving and non-moving violations, as well as having had a driver's license suspended. There were no differences between the groups with regard to vehicular crashes or driving while intoxicated.

CONCLUSIONS

About one-third of individuals reported road rage. The prevalence of BPD was significantly higher among those with road rage compared to those without road rage, and is likely to be one of the contributory variables to reckless driving. Individuals who reported road rage appear to be less disciplined drivers and are subject to more types of driving citations, although they do not report greater rates of vehicular crashes or driving while intoxicated.

Road rage victimization among adolescents

PURPOSE

Although much has been learned about road rage among adults, data on road rage experiences among adolescents has not been available previously. We examine the prevalence and demographic correlates of road rage victimization based on a population survey of Ontario students.

METHODS

Based on the 2005 Ontario Student Drug Use Survey, a self-administered survey of Ontario students in grades 7-12 (n = 7726), the contribution of demographic factors (gender, region, driver's license status, grade, overall marks) to three road rage victimization measures was examined with logistic regression analysis.

RESULTS

Just over half of students (53.2%) had been victims of shouts, curses and rude gestures in the past year, 8.9% were threatened with damage to their vehicle or personal injury and 6.2% experienced an attempt or actual damage to their vehicle or personal injury. Logistic regression analyses revealed that being a victim of shouting was significantly related to region, driver's license status, and grade. Victimization by threats was significantly related to gender, driver's license, grade, and marks. Being a victim of attempts or actual vehicle damage or injury was significantly related to region, driver's license, and marks.

CONCLUSION

This study provides the first indication of prevalence of road rage victimization among adolescents. Road rage victimization in its milder form is common, involving just over half of Ontario students in grades 7-12. About 1 in 10 students were threatened with vehicle damage or personal injury, and about 1 in 20 were victims of attempts or actual damage or injury.

Is an armed society a polite society? Guns and road rage

BACKGROUND

While concerns about road rage have grown over the past decade, states have made it easier for motorists to carry firearms in their vehicles. Are motorists with guns in the car more or less likely to engage in hostile and aggressive behavior?

METHODS

Data come from a 2004 national random digit dial survey of over 2,400 licensed drivers. Respondents were asked whether, in the past year, they (1) made obscene or rude gestures at another motorist, (2) aggressively followed another vehicle too closely, and (3) were victims of such hostile behaviors.

RESULTS

Seventeen percent admitted making obscene or rude gestures, and 9% had aggressively followed too closely. Forty-six percent reported victimization by each of these behaviors in the past year. Males, young adults, binge drinkers, those who do not believe most people can be trusted, those ever arrested for a non-traffic violation, and motorists who had been in a vehicle in which there was a gun were more likely to engage in such forms of road rage.

CONCLUSION

Similar to a survey of Arizona motorists, in our survey, riding with a firearm in the vehicle was a marker for aggressive and dangerous driver behavior.

Assessing road rage victimization and perpetration in the Ontario adult population: the impact of illicit drug use and psychiatric distress

BACKGROUND

To investigate the association among illicit drug use, psychiatric distress and road rage victimization and offending. Particular attention is given to the most serious forms of road rage behaviour.

METHODS

The data are based on the 2002 CAMH Monitor and include a sample of 2,421 Ontario adults aged 18 and older. Logistic regression analyses were conducted with illicit drug use and psychiatric distress (GHQ) and demographic factors as independent variables.

RESULTS

Past-year road rage victimization was reported by 42% of the sample and 31% reported any type of road rage offending. Approximately 5% were classified as respondents with serious road rage involvement. The logistic regression analyses revealed significant relationships between illicit drug use and road rage outcomes. Cannabis use was significantly associated with general road rage victimization and offending, while stimulant use substantially increased the likelihood of victimization and membership in the serious road rage classification. Psychiatric distress significantly increased the odds of both road rage victimization and serious road rage involvement.

CONCLUSION

These data reveal different indicators of road rage offending, victimization and serious involvement. Further work is needed to clarify the mechanisms associated with the relationship among stimulant use, psychiatric distress and serious road rage involvement.

Can we prevent road rage?

Road rage has become a serious concern in many countries, and preventive efforts are required. This article reviews what can be done to prevent road rage by exploring potential prevention avenues in five areas. First, legal changes aimed at increasing the penalties for road rage behavior could be instituted, drawing on models from aggressive-driving or impaired-driving laws. A second approach would involve the adoption of court programs for convicted road ragers. Third, car redesign offers a means of reducing crime through environmental design. Fourth, mass media education could be implemented to inform drivers of the risk from road rage and how to avoid situations that facilitate road rage. Finally, prevention efforts could be directed to long-term societal changes that emphasize structural modifications, such as reducing congestion on the roads, reduced driver stress, or promoting public transportation. The strengths and weaknesses of these strategies are discussed.

Psychiatric and behavioral problems in aggressive drivers

Motor vehicle accidents (MVAs) are a leading cause of accidental death and injury, and aggressive driving has been identified as a risk factor for MVAs. Assessing psychiatric and behavioral disturbances in aggressive drivers is germane to the development of prevention and intervention programs for this population. The present study compared the prevalence of psychiatric diagnoses and behavioral problems in young adult drivers with self-reported high driving aggression to that of drivers with low driving aggression. Aggressive drivers evidenced a significantly higher current and lifetime prevalence of Oppositional Defiant Disorder, Alcohol and Substance Use Disorders, and Cluster B Personality Disorders, and a significantly greater lifetime prevalence of Conduct Disorder, Attention-Deficit/Hyperactivity Disorder, and Intermittent Explosive Disorder. Aggressive drivers also had a significantly greater prevalence of self-reported problems with anger, as well as a greater family history of anger problems and conflict. The findings suggest that prevention and intervention programs designed to reduce aggressive driving may need to address the presence of psychiatric and behavioral problems that could potentially complicate treatment or impede responses to treatment.

'Big build': hidden depression in men

OBJECTIVE

To investigate men's experience of depression.

METHOD

A sample of male and female teachers and students was recruited from four sites of a tertiary education institution to a series of focus groups. A grounded theory approach to qualitative data analysis was used to elucidate men's experience of depression. Content analysis was applied to the women's data to examine similarities and contrasts with the men. Standard measures of mood and dispositional optimism confirmed the non-clinical status of the group.

RESULTS

The findings suggest that some men who are depressed can experience a trajectory of emotional distress manifest in avoidant, numbing and escape behaviours which can lead to aggression, violence and suicide. Gender differences appear not in the experience of depression per se, but in the expression of depression.

CONCLUSION

Emotional distress, constrained by traditional notions of masculinity, may explain why depression in men can often be hidden, overlooked, not discussed or 'acted out'. There are implications for the types of questions asked of men to detect depressive symptoms.

A City-Level Study of Aggressive Road Behaviours: Magnitude, and Predictors and Implications for Traffic Safety

Road rage and aggressive driving behaviours are reported to be huge public problems. There is a paucity of scientific South African data on driver aggression. Accordingly, a cross-sectional descriptive study was undertaken to determine the nature, extent and profile of aggressive and other hazardous road behaviours. The different categories of aggressive road behaviours were located on a continuum comprising four levels. Together with other hazardous driving behaviours, they were measured using a modified semantic differential on a scale of 1 to 10. Additionally, multiple linear regression modelling was used to identify various predictor variables for the different levels of aggressive road behaviour. The high prevalence data as well as many of the predictors of aggressive road behaviours that were found in the study are consistent with international findings. The utility of the data is discussed as part of a recommended ecological and health promotion approach for the prevention of aggressive road behaviours.

Traffic stress, vehicular burden and well-being: a multilevel analysis

This study examined whether health is associated with individually perceived traffic stress and as well as ecologically measured vehicular burden using multi-level analysis. Data from the Chinese American psychiatric epidemiologic study (N = 1503) are linked to data from the 1990 Census in the United States. Hierarchical linear modeling was used to analyze the cross-sectional relationship between traffic stress, neighborhood conditions, depression and health status. Perceived traffic stress is associated with both general health status and depression in multivariate multilevel models, such that persons reporting traffic stress had lower health status and more depressive symptoms. Further, there is an interaction between vehicular burden and traffic stress for both health outcomes. Persons who lived in areas with greater vehicular burden and who reported the most traffic stress also had the lowest health status and greatest depressive symptoms. These findings suggest that traffic stress may represent an important factor that influences the well-being of urban populations, and that studies which examine factors at only one level (either individual level only or ecological level only) may underestimate the effect of the social environment.

Psychiatric distress among road rage victims and perpetrators

OBJECTIVE

To investigate the relation between psychiatric distress and road rage, paying particular attention to the potential link between psychiatric illness and frequent involvement in serious forms of road rage.

METHOD

This study reports data on road rage involvement, demographic characteristics, and mental health for a representative sample of 2610 adults in Ontario. The mental health indicator was the 12-item General Health Questionnaire.

RESULTS

A cluster analysis revealed 5 distinct groups of people affected by road rage. The most serious offenders (referred to hereafter as the hard core road rage group), representing 5.5% of those affected, exhibited frequent involvement in the most severe forms of road rage and were the most likely (27.5%) to report psychiatric distress.

CONCLUSIONS

Road rage, particularly experiences of victimization, is related to psychiatric distress. Evidence of psychiatric distress was highest among hard core road rage perpetrators, individuals noted for frequent involvement in serious aggressive and violent conduct. Further research is needed on violence and road rage and its link to mental health.

The prevalence of road rage: estimates from Ontario

BACKGROUND

"Road rage" has increasingly generated public concern, however, the prevalence of this behaviour has not been available. We examine the prevalence and demographic correlates of road rage victimization and perpetration based on a population survey of adults in Ontario.

METHODS

Data are based on the CAMH Monitor, a repeated cross-sectional telephone survey of Ontario adults (n = 1,395). The contribution of demographic factors to road rage was examined with logistic regression analysis.

RESULTS

About half of respondents (46.6%) were shouted at, cursed at or had rude gestures directed at them in the past year, and 7.2% were threatened with damage to their vehicle or personal injury. Nearly a third of respondents (31.7%) admitted to shouting, cursing, etc. at someone, and 2.1% threatened to hurt someone or damage their vehicle. Being a Toronto resident, being younger, and earning a higher income were associated with greater likelihood of being a victim of shouting, cursing and rude gestures; however, income was not associated with being threatened with vehicle damage or injury. The likelihood of admitting to shouting, etc. at someone was greater for males, younger respondents, Toronto residents, higher income earners, and never married respondents; however, threatening someone was associated with younger age and lower education level.

CONCLUSION

These results provide a first indication of the prevalence of road rage in Ontario. Road rage, in its milder forms, appears to be common, involving between a third and a half of respondents as either a victim or a perpetrator. Nearly 1 in 10 Ontario residents were threatened with damage or personal injury.