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Acad. Anal. & Pro’. Vol. 21. No. 5, pp. 493-508. 1989 LwJl-4575189 s3.00+ .oo
Printed in Great Britain. 0 1989 Pergamon Press plc
A COMPARISON OF THE PSYCHOSOCIAL CHARACTERISTICS OF ALCOHOLICS RESPONSIBLE FOR IMPAIRED AND NONIMPAIRED COLLISIONS*
SCOTT MACDONALD Addiction Research Foundation, University of Western Ontario,
London, Ontario N6A 5B9, Canada
(Received 15 August 1988)
Abstract-In this study, the psychosocial characteristics of male alcoholics with different collision records were examined. Male hospitalized alcoholics were divided into three groups: (1) collision- free drivers, (2) those responsible for collision(s) in which they were impaired by alcohol, and (3) those responsible for collision(s) in which they were not impaired by alcohol. People in each of the three groups were compared. People responsible for impaired collisions were significantly lower in socioeconomic status, drove while impaired with more dangerous styles of driving, and had more disrespect for authorities than the noncollision group. By contrast, those responsible for nonimpaired collisions possessed a variety of personality characteristics that distinguished them from people with no collisions. Specifically, those with nonimpaired collisions were sig- nificantly less responsible, more impulsive, more depressed, more aggressive, and experienced more undesirable life events than people without collisions. The results are suggestive that male alcoholics with impaired collisions might have differences from those people with nonimpaired collisions that enhance their driving risk.
INTRODUCTION
Several authors have suggested that accident-prone drivers (i.e. collisions without alcohol involvement) and impaired drivers share similar characteristics that enhance their risk of being involved in traffic collisions (Clay 1972; Zylman 1976; Donovan et al. 1985; Mercer 1986). The conclusion that these two groups are similar in terms of their psy- chosocial characteristics is largely derived from two kinds of studies: (1) those that have compared people with bad driving records (i.e. people with moving violations and/or collisions) to people from the general population of drivers; and (2) those that have compared impaired drivers (i.e. people with driving while impaired (DWI) charges) to the general population of drivers. Both of these kinds of studies have shown that people with bad driving records and impaired driving offences have similar psychosocial char- acteristics. However, from the review, it was determined that for studies in which com- parisons were made between impaired drivers and drivers from the general population the relationships found may have been due to confounding by two variables: alcoholism and gender. In other words, variables that distinguished the two groups may have been attributable to alcohol dependence or gender, rather than reflecting differences associ- ated with impaired driving. When these two variables are controlled, strong relationships between the psychosocial characteristics and impaired collisions may disappear. This alternative explanation for the associations found in other studies provided the rationale for the present study.
PSYCHOSOCIAL VARIABLES ASSOCIATED WITH TRAFFIC COLLISIONS
AND/OR MOVING VIOLATIONS WITHOUT ALCOHOL INVOLVEMENT
Studies of psychosocial factors in relation to traffic collisions and moving violations are divergent in their methodologies and the questions they investigated. Typically,
*The research was supported in part by the National Health Research and Development Program through the National Health Fellowship to Scott Macdonald. Contents of this paper are derived from data of a Ph.D. thesis at the Department of Epidemiology and Biostatistics, University of Western Ontario. The views expressed in this publication are those of the author and do not necessarily reflect those of the Addiction Research Foundation.
MP 21:5-F 493
Tab
le
1. P
sych
osoc
ial
fact
ors
asso
ciat
ed
with
tra
ffic
co
llisi
ons
and/
or
mov
ing
viol
atio
ns
Bea
mis
h an
d M
aife
tli
1962
Con
ger
et a
l. 19
59
Pinc
h an
d Sm
ith 1
970
Har
ano
et a
l. 19
’75
(1)
Mal
e re
ferr
als
to j
uve-
ni
le c
ourt
w
ith t
wo
or
mor
e m
ovin
g vi
olat
ions
(2
) L
icen
sed
mal
es,
16-U
ye
ars
old,
fr
om
high
sc
hool
s w
ith n
o vi
ola-
tio
n (o
ther
co
mbi
na-
tions
of
driv
ers
wer
e al
so u
sed)
A
irm
en,
Den
ver
(1)
Tw
o or
mor
e co
llisi
ons
(2)
No
colli
sion
s
(I)
Dri
vers
W
ed
in a
uto-
m
obile
co
llisi
ons
(2)
Dri
vers
fr
om t
he g
en-
eral
pop
ulat
ion
Dep
t. of
Mot
or
Veh
icle
fi
les
(1)
Thr
ee
or m
ore
colli
sion
s (2
) C
ollis
ion-
free
Jam
ison
an
d M
cGlo
thlin
Ps
ycho
ther
apy
patie
nts
1973
(I
) N
o ac
cide
nts
or v
iola
- tio
ns
(2)
No
acci
dent
s
Mac
Mill
an
1975
(3)
One
or
mor
e ac
cide
nts
(4)
Tw
o or
mor
e m
ovin
g V
i-
olat
ions
R
ando
m
sam
ple
of d
rive
rs/
peop
le
wer
e cl
assi
fied
ac
- co
rdin
g to
the
ir
num
ber
of c
ollis
ions
an
d m
ovin
g vi
olat
ions
M
ayer
and
Tre
at
1977
St
udy
1: L
icen
sed
driv
ers
in
a ps
ycho
fogy
co
urse
g4
Em
otio
nal
~nst
ah~l
~t~
186
Hos
tile,
in
tole
rant
of
10
te
nsio
n,
self
-cen
tere
d,,
10
preo
ccup
ied
with
fan
- ta
sy s
atis
fact
ion,
fe
ar-
ful
of l
oss
of l
ove
25
Ris
k-ta
king
, us
ing
a ca
r as
exp
ress
ion
of e
mo-
19
6 tiw
n 23
1 43
Sens
atio
n-se
ekin
g,
risk
- ta
king
61
12
1 52
643
Tm
puls
ivity
, ex
tcra
al
lo+
cu
s of
con
troi
, ne
aa-
Non
c~nf
orm
ity~
soci
a-
bilit
y, p
erso
nal
rela
- tio
ns,
rehg
ious
an
d po
litic
al
activ
ity
Stre
ssfu
l ev
ents
su
ch
as j
ob p
robl
ems,
fi-
nanc
ial
diff
icul
ties,
an
d in
terp
ersa
nat
conf
licts
L
ow s
ocio
econ
omic
st
atus
, so
cial
dev
i-
ance
, un
mar
ried
Lib
eral
po
litic
ally
an
d so
cial
ly,
owns
res
i-
denc
e,
relig
ious
at
- te
ndan
ce,
mal
e
Con
tact
w
ith s
ocia
l ag
enci
es,
soci
al
prob
lem
sc
ore,
yo
unge
r ag
e, d
rivi
ng
expo
sure
A
ntis
ocia
l te
nden
cies
, sc
hool
soc
ializ
atio
n,
t-te
s1s
Des
crip
tive
stud
y
x2 (
p <
.ool
)
Mul
tiple
re
gres
sion
, A
NO
VA
, cl
uste
r an
al-
ysis
, xz
t-
test
s
x2 (
p <
.0
5)
t-te
sts,
dis
- cr
imin
ant
Mat
ched
co
ntro
ls
sele
cted
fr
om
a pr
evio
us
stud
y th
at
in-
clud
ed 2
64 a
ir-
men
McG
uire
19
56
McM
urra
y 19
70
(1)
Thr
ee
or m
ore
colli
sion
s (2
) C
ollis
on-f
ree
mat
ched
fo
r ag
e, s
ex,
and
annu
al
mile
age
Stud
y II
(1
) D
rive
rs
in c
ollis
ions
at
fa
ult
(2)
Dri
vers
in
col
lisio
ns
not
at f
ault
(1)
Rec
ent
colli
sion
(s)
and
mov
ing
viol
atio
n(s)
(2
) A
ccid
ent-
an
d vi
olat
ion-
fr
ee
(1)
Indi
vidu
als
invo
lved
in
di
vorc
e pr
ocee
ding
s (2
) E
ntir
e dr
ivin
g po
pula
- tio
n of
Was
hing
ton
Parr
y 19
68
(1)
Thr
ee
colli
sion
gr
oups
: ve
ry s
erio
us,
seri
ous,
an
d m
inor
Rom
mel
19
59
(2)
Eve
ry
nth
vehi
cle
Hig
h sc
hool
st
uden
ts
(1)
Tw
o or
mor
e co
llisi
ons
(2)
No
colli
sion
s
&hu
man
et
al.
1967
U
nmar
ried
m
ale
driv
ers,
ag
ed
16-2
4 in
Mic
higa
n/
Peop
le
wer
e cl
assi
fied
by
th
is n
umbe
r of
tra
ffic
ac
- ci
dent
s or
mov
ing
viol
a-
tions
.
30
30
177
110
67
67
410
382
Agg
ress
ion,
an
xiet
y
25
25
288
tivis
m,
risk
-tak
ing,
ge
nera
l ps
ycho
path
ol-
ogy,
anx
iety
Psyc
hopa
thic
de
viat
e,
schi
zoph
reni
a,
ego-
de
fens
ive,
ne
ed
per-
si
sten
ce
Hyp
oman
ia,
psyc
ho-
path
ic
devi
ate,
un
so-
cial
ized
, dr
ivin
g at
titud
e Im
puls
e ex
pres
sion
, fr
ustr
atio
ns,
anxi
etie
s
juve
nile
de
linqu
ency
an
alys
is
The
tot
al
num
ber
of
acci
dent
s an
d vi
ola-
tio
ns
was
104
%
high
er
for
pers
ons
unde
rgoi
ng
divo
rce
proc
eedi
ngs.
D
riv-
in
g re
cord
s in
the
ye
ar o
f di
vorc
e w
as
wor
se
than
av
erag
e.
Dri
ving
re
cord
s w
ere
wor
st
thre
e m
onth
s fo
llow
ing
di-
vorc
e pr
ocee
ding
. Y
oung
er
age,
lo
wer
so
cial
cla
ss
Ow
ns c
ar,
empl
oyed
N
o st
atis
tical
vs
. in
sch
ool
test
Uns
peci
fied
st
atis
tical
te
sts
(p
<
.OS)
Pe
rcen
tage
s
f-te
sts,
co
rre-
la
tion
t-te
sts
Tab
le
1.
(Con
tinue
d).
Aut
hor/
date
Sa
mpl
e/gr
oup(
s)
N
Psyc
holo
gica
l So
cial
St
atis
tical
te
sts
Com
men
ts
Schu
ster
an
d G
uilf
ord
1964
(1
) H
igh
traf
fic
acci
dent
s or
m
ovin
g vi
olat
ions
(2
) N
o ac
cide
nts
or
mov
ing
viol
atio
ns
Seiz
er
1969
(1
) D
rive
rs
invo
lved
in
fat
al
colli
sion
s (2
) C
ontr
ols
mat
ched
fo
r ag
e,
sex,
an
d re
side
nce
Selz
er
and
Vin
okur
19
74
Mic
higa
n dr
iver
s (1
) D
rive
rs
sent
to
sc
hool
fo
r m
ovin
g vi
olat
ions
(2
) D
rive
rs
rene
win
g th
eir
licen
se
Shaw
19
65
Bus
dr
iver
s,
Sout
h A
fric
a G
roup
s de
fine
d by
ps
ycho
- so
cial
te
sts;
tr
affi
c co
lli-
sion
is
the
de
pend
ent
vari
able
2,00
0 N
eed
for
free
dom
, ir
re-
spon
sibl
e,
mal
ajus
ted,
ag
gres
sion
, re
sent
ful
of
auth
ority
, la
cks
re-
spon
sibi
lity,
im
pul-
si
ve,
driv
ing
attit
udes
, am
bitio
usne
ss,
per-
so
nal
rela
tions
, 96
Pa
rano
id,
prev
ious
su
i-
cide
at
tem
pt,
pre-
96
vi
ous
viol
ence
, de
pres
sion
A
ggre
ssio
n,
phys
ical
17
2 st
ress
re
spon
ses
102
470
Lac
ks
self
-con
trol
, ag
- gr
essi
ve,
self
-cen
- te
red,
an
tisoc
ial
attit
udes
, ov
erco
nfi-
de
nt,
blam
e-av
oida
nt.
resi
sts
auth
ority
, la
cks
insi
ght,
fata
listic
, m
enta
lly
defe
ctiv
e,
unin
telli
gent
, di
sor-
ga
nize
d,
emot
iona
lly
unst
able
, te
nsio
n-ri
d-
den,
se
nsiti
ve
to
criti
-
Num
ber
of
empl
oyer
s
Low
er
soci
al
clas
s,
vo-
catio
nal
and
fina
n-
cial
st
ress
, pe
rson
al
cris
es
Low
er
inco
me,
al
co-
hol
use,
di
stur
banc
e w
ith
in-l
aws
Reg
ress
ion
anal
ysis
x2 t
ests
Cor
rela
tions
(P
< .0
5)
xZ t
ests
; w
hich
in
clud
es
all
vari
able
s,
was
us
ed
on
a pr
evio
us
sam
ple
(P
< .O
l)
Con
trol
gr
oup
mat
ched
fo
r ag
e an
d an
nual
m
ileag
e
Pros
pect
ive
stud
y.
used
pr
ojec
tive
test
s.
Few
st
a-
tistic
al
anal
- ys
es.
Till
man
and
Hob
bs
1949
T
axi
driv
ers,
L
ondo
n,
Ont
ario
(1
) H
igh
colli
sion
(2
) L
ow c
ollis
ion
(1)
Four
or
mor
e co
llisi
ons
(2)
Con
trol
gr
oup
mat
ched
on
age
and
sex
W
aile
r 19
67
Oak
land
, C
alif
orni
a (1
) M
ovin
g vi
olat
ions
, tr
affi
c co
llisi
ons,
vi
ola-
tio
n pl
us w
arra
nt
(2)
No
traf
fic
colli
sion
s or
m
ovin
g vi
olat
ions
W
illet
197
3 (1
) Se
vere
m
otor
of
fend
ers
(2)
Lic
ense
d dr
iver
s w
ith
mov
ing
viol
atio
ns
20
20
96
100
131
117 19
15
0
187
cism
, in
deci
sive
, po
or
conc
entr
atio
n,
easi
ly
intim
idat
ed,
suic
idal
te
nden
cies
, ad
dict
ed
to a
lcoh
ol,
pers
onal
- ity
tha
t pr
edis
pose
s to
dr
ink
or a
buse
dr
ugs
Agg
ress
ive,
an
tisoc
ial
char
acte
rist
ics,
im
ma-
tu
re,
easi
ly d
istr
acta
- bl
e,
impu
lsiv
e
Ass
ertiv
e,
self
-con
fi-
dent
, lo
wer
int
elli-
ge
nce,
le
ss p
rone
to
fe
elin
gs
of g
uilt,
les
s se
lf-c
ontr
ol
Pare
ntal
di
vorc
e,
Prim
arily
a
poor
er
wor
k re
c-
desc
ript
ive
ords
, kn
own
to
stud
y co
mm
unity
ag
enci
es
Kno
wn
to c
omm
unity
U
nspe
cifi
ed
agen
cies
st
atis
tical
te
sts
(p
<
.Ol)
f-te
sts
Not
es:
In s
ome
inst
ance
s,
mor
e th
an
one
com
pari
son
grou
p w
as u
sed,
bu
t in
the
ta
ble
only
th
e m
ost
rele
vant
co
mpa
riso
n gr
oups
w
ere
incl
uded
. O
ccas
iona
lly,
term
inol
ogy
of o
rigi
nal
auth
ors
was
cha
nged
to
enh
ance
cl
arity
an
d pe
rmit
brev
ity.
Stud
ies
that
fo
cuss
ed
prim
arily
on
soc
iode
mog
raph
ic
vari
able
s w
ere
not
incl
uded
. In
som
e in
stan
ces
vari
able
s fo
und
to b
e po
sitiv
ely
rela
ted
to c
ollis
ion
or m
ovin
g vi
olat
ions
w
ere
not
incl
uded
if
the
y w
ere
not
stud
ied
or s
uppo
rted
by
con
clus
ions
of
oth
er
auth
ors.
In
som
e in
stan
ces,
au
thor
s an
alyz
ed
seve
ral
grou
ps
defi
ned
by t
heir
num
ber
of m
ovin
g vi
olat
ions
an
d co
llisi
ons.
V
aria
bles
lis
ted
are
gene
ral
find
ings
fr
om
all
thes
e an
alys
es.
498 S. MACDONALD
people with a high frequency of traffic collisions and moving violations have been com- pared to people with a lower frequency. Samples have included comparisons within the general population and special populations such as bus drivers and airmen. Considerable variability also exists in relation to sample size and type of statistical analyses used. Table 1 lists the relevant studies and includes a description of the samples used, samples sizes, the psychosocial variables found to be associated with traffic collisions and/or moving violations, statistical tests utilized, and other comments.
The psychosocial variables that appear most related to traffic collisions and/or moving violations are described in this section of the review. Variables are treated as equivalent if they have the same or nearly identical meanings even though they may have been labelled differently. Numerous psychological characteristics have been found to be related to traffic collisions and moving violations: aggressive (Kraus et al. 1970; Pelz and Schuman 1973; Willet 1973), impulsiveness (Tillman and Hobbs 1945); Schuman et al. 1967; Mozdzierz et al. 1975), risk-taking (Jamison and McGlothlin 1073; Harano et al. 1975; Mayer and Treat 1977), low self-esteem (Shaw lY65), depression (Selzer 1961; Schuster and Guilford 1964), and low responsibility or antisocial attitudes (Conger et al. 19.59; Schuster and Guilford 1964; Pelz and Schuman lY73; Willet lY73). Psychosocial variables such as undesirable life events (McMurray lY70: Selzer and Vi- nokur 1974; Mayer and Treat 1977) have also been identified as possible determinants of traffic collisions. Sociodemographic variables such as lower age (Pelz and Schuman 1973) and lower socioeconomic class (Selzer and Vinokur lY74) have been often men- tioned.
STUDIES THAT COMPARED THE PSYCHOSOCIAL CHARACTERISTICS OF DWI
OFFENDERS WITH THE GENERAL POPULATION
Comparisons have been made between the psychosocial characteristics of people convicted for DWI and people in the general population (see Table 2). These studies are reviewed here because no study has been found that focussed on people responsible for impaired collisions. Although impaired collisions is the focus of the present research, it is reasonable to expect that the characteristics of people with DWI offences may be similar to the characteristics of people with impaired collisions since there is an overlap between the two (approximately 20% of people have been arrested for DWI because of involvement in a collision).
Studies of DWI offenders have provided valuable information concerning the social characteristics of DWI offenders. Recent evidence indicates that younger people (i.e. between the ages of 20 and 35) are overrepresented in terms of DWI arrests (Donelson 1985; Mercer 1986). Several studies have determined that, compared to the general population, a greater than expected proportion of DWI offenders are single, separated, or divorced (Waller 1967; Hyman 1968; Yoder and Moore 1973). In addition. DWI offenders are overrepresented in terms of lower socioeconomic status (Hyman 196X; Chi et al. 1973; Donovan et al. 1985).
Several psychosocial variables have been found that significantly differentiate people convicted for DWI from drivers in the general population: low self-esteem, low self-control (i.e. impulsivity), low responsibility, aggression, and depression (Selzer and Barton 1977; Selzer et al. 1977). Studies have also shown that people arrested for DWI tend to have more disrespect for authorities than the general population. DWI offenders have been found to lack of moral attachment to the law (Norstrom 197X), have more negative attitudes toward legal authorities (Wilson and Jonah lYX5). and have more contact with legal authorities (Zelhart et al. 1975; Argeriou et al. lY85).
A major difference between DWI convictions and traffic collisions or moving vio- lations is that the former always involve ingestion of alcohol. Therefore, variables related to drinking may be associated with DWI arrests. Increased amount of drinking has been found to be related to DWI arrests (Selzer and Barton 1977: Norstrom 197X; Wilson and Jonah 1983; Argeriou et al. 1986). The nature of the relationship between frequency of drinking and DWI is unclear as some studies have found that more frequent drinkers
Characteristics of alcoholics responsible for collisions 499
had a lower relative crash risk at any given Blood Alcohol Concentration (BAC) (Brenner and Selzer 1969; Hurst 1974), whereas others have found that less frequent drinkers are at high risk (Duncan and Vogel-Sprott 1978; Wilson and Jonah 1983). Reactions to drinking, such as feeling more powerful or depressed after drinking, have been found to be related to DWI convictions (Selzer and Barton 1977).
The list of psychosocial characteristics of DWI offenders is similar to the list of psychosocial characteristics of people who have poor driving records without alcohol involvement. A drawback of all studies that compared DWI offenders to drivers in the general population is that since a much larger than expected proportion of people con- victed for DWI are known to be alcohol-dependent (as compared to the general pop- ulation of drivers), variables that distinguish the two groups might be attributable to alcohol dependence rather than reflecting differences associated with drinking and driv- ing. This argument is especially strong because a review of the literature has shown that alcoholics are more likely than nonalcoholics to possess most of these same psychosocial characteristics (Nerviano and Gross 1983). Another potential confounder in these studies was gender. Psychosocial variables that emerge as significant in studies where both the DWI and comparison groups are matched in terms of alcoholism and gender provide stronger evidence than the aforementioned studies that these variables are causally related to DWI arrests.
PSYCHOSOCIAL CHARACTERISTICS OF ALCOHOLICS WHO DISPLAY
HIGH-RISK DRIVING
High-risk driving refers to either driving while impaired or driving recklessly, which is usually measured by involvement in collisions or moving violations. In this section, studies are reviewed that focus on such driving behaviours of alcoholics. As mentioned above, these studies have methodological advantages. Only one study (from which data for this paper was taken) was found that examined the characteristics of alcoholics with DWI arrests or convictions (Macdonald 1987). Male alcoholics with zero and one DWI arrest were found to be nearly identical for the variables examined; however, people with multiple DWI arrests were quite different from the others. The variables listed in Table 3 indicate how multiple offenders were different.
Studies of alcoholics who display other types of high-risk driving (i.e. collisions and moving violations without alcohol involvement) are explored in the remainder of this section. Selzer (1961) speculated that alcoholics with poor driving records possess several psychosocial characteristics. Intensive interviews with three alcoholics provided some support for his hypothesis that “the alcoholic’s drinking often releases behaviour mo- tivated by underlying personality traits, which may then result in serious collisions or traffic violations” (p. 302).
Zelhart (1972) had 73 clinical alcoholics complete the 16 Personality Factor Ques- tionnaire (Lawlis and Rubin 1971) and classified subjects into three groups: Group X, described as inhibited and frustrated; Group Y, described as lacking the ability to interact socially; and Group Z, described as unsocialized and aggressive. Statistical analyses comparing frequency of traffic citations for the groups revealed that Group X had the best driving records and Group Z had the worst records (p < .Ol). A separate analysis of frequency of DWI arrests, however, showed no significant differences among groups.
Mozdzierz et al. (1975) compared two groups of voluntarily admitted clinical al- coholics: those with one or two collisions or violations; and those with five or more collisions or violations. The subjects were administered the Guilford-Zimmerman Tem- perament Scales (GZTS) and the Minnesota Multiphasic Personality Inventory (MMPI). The GZTS showed significant differences on the scales of restraint-seriousness, ascend- ence-social boldness, and personal relations-cooperativeness; and the MMPI showed significant differences on depression and hypomania. The authors concluded that the bad drivers showed a greater tendency to manipulate and control others, and tendencies towards impulsivity, recklessness, and irresponsibility.
The psychosocial characteristics of alcoholics who are high-risk drivers has been
Tab
le 2
. Ps
ycho
soci
al
fact
ors
asso
ciat
ed
with
dri
ving
whi
le i
mpa
ired
Aut
hor/
rkat
ts
Sam
ple
grou
ps
N
Psyc
holo
gica
l So
cial
St
atis
tical
te
st8
Seiz
er a
nd B
arto
n 19
77
Cal
ifor
nia
(1)
DW
I of
fend
ers
(2)
C~m
xs
of p
eopk
in
CsX
ifor
nia
You
th ~
~v~r
am 5
% 14
%
(1)
Con
vict
Ed
for
DW
E
(2)
Not
con
vict
ed
Ran
dom
aa
mpl
e of
Sw
edis
h dr
iver
s:
(1 j
Selb
repo
rted
D
WL
(2
1 W
o se
lf-r
epor
ted
I2W
I Ve
rmon
t
I72
#epE
es-e
d, fa
wx a
m-
I.54
timal
adj
ust
men
t,
sens
atio
n-se
ekin
g,
ho*t
ility
/agg
ress
ian
194
Setf
”cor
&Si
%e,
ag
gres
-
4:
sion
, C
hiE
dfta
aci s
ecu-
ri
ty a
nd i
ndep
ende
nce
1,54
1 M
oral
atta
chm
ent
to t
he.
law
Ten
sion
re
lief
by d
rink
” 30
6 in
g, s
ocia
l re
lax&
d,
294
effe
cts
of ~
r~~k
~~~,
m
erho
ds
of t
apin
g,
~ne
mp~
y~~
la
wer
inco
me,
m
are
aico
hot-
rela
ted
ar-
rest
s,
mor
e pr
evio
us
trea
t-
men
ts
for
alco
holis
m,
mot
e dr
inks
pe
r oc
casi
on,
mar
e m
ean
rrm
st d
rink
s,
high
er
BA
Cs
at a
rrt?
st,
mor
e fr
e-
quer
it dr
i&%
%
&B
=zer
age,
k%
%zr
e&ca
tion,
lo
wer
SE
5
Age
s 2.
5~45
, low
er
SES,
m
ales
Cor
&ct
ions
fo
r o?
her
crim
es,
pare
ntal
co
&ct
, ag
gres
- si
ons,
am
3 al
coho
lism
A
ge (
unde
r 30
yrs
),
mal
es,
unm
arri
ed,
annu
al
mile
age,
hi
gher
co
nsum
ptio
n af
alc
u*
Fam
ily p
robl
ems,
di
vorc
ed
or
sepa
rate
d,
blue
col
lar,
ol
d ag
e,
amcm
mt
of d
rink
&
per
occa
sian
I-te
rn
AN
CW
A
Freq
uenc
ies
Path
ana
lysi
s
Dis
crim
inar
it an
al-
ysis
Stud
ent
t-te
sts
(p
< .o
lj
Wai
ler
1967
Wel
ls-P
arke
r et
al
. 19
83
Wils
on
and
Jona
h 19
85
Yod
er
and
Moo
re
1973
Zel
hart
et
al
. 19
75
Oak
land
, C
alif
orni
a (1
) C
onse
cutiv
e ar
rest
s fo
r D
WI
(2)
No
traf
fic
colli
sion
s
(1)
DW
I co
nvic
tions
ag
ed
60
and
over
(2
) C
ontr
ol
grou
p of
no
noff
en-
ders
m
atch
ed
for
drin
king
an
d
age
Ran
dom
sa
mpl
e of
C
anad
ian
driv
ers
(1)
Self
-rep
orte
d D
WI
(2)
No
self
-rep
orte
d D
WI
Cal
ifor
nia
(1)
Rep
eat
DW
I of
fend
ers
(2)
One
-tim
e D
WI
offe
nder
s A
lber
ta
(1)
Con
vict
ed
DW
I of
fend
ers
part
icip
atio
n in
an
impa
ired
dr
iver
s pr
ogra
m
(2)
Vol
unte
ers
from
th
e R
CM
P an
d th
e A
ttorn
ey
Gen
eral
’s
offi
ce.
Mod
erat
e dr
inke
rs
or
abst
aine
rs.
high
-str
ung,
ne
rvou
s,
neur
otic
ism
, se
lf-e
s-
teem
, se
lf-c
ontr
ol,
re-
spon
sibi
lity,
de
pres
sion
, ag
gres
sion
150
150 92
68
2ooo
104
206
201
Stre
ssfu
l ev
ents
Hig
h-ri
sk
beha
viou
rs,
at-
titud
es
tow
ards
D
WI
and
lega
l au
thor
ities
or
pr
actic
es
Supe
r eg
o,
soci
alab
ility
, in
feri
ority
Kno
wn
to
wel
fare
de
part
- m
ent,
know
n to
pr
obat
ion
depa
rtm
ent,
trea
ted
in s
tate
m
enta
l ho
spita
l, se
en
at
al-
coho
lism
cl
inic
, kn
own
to
fam
ily
serv
ice
agen
cies
You
nger
ag
e,
been
w
ith
som
eone
im
pair
ed,
aver
age
alco
hol
cons
umpt
ion
Prev
ious
ar
rest
s fo
r an
y ca
use,
hi
gher
B
AC
s at
ar
- re
st,
mor
e al
coho
lics
Mor
e co
ntac
t w
ith
lega
l au
- th
oriti
es
Uns
peci
fied
st
atis
- tic
al
test
s (p
<
.Ol)
f-te
sts
Fact
or
anal
ysis
, m
ultip
le
regr
es-
sion
, di
scri
mi-
na
nt
anal
ysis
c-
test
s
Dis
crim
inan
t an
al-
ysis
Not
es:
In
som
e in
stan
ces,
m
ore
than
on
e co
mpa
riso
n w
as
used
, bu
t in
th
e ta
ble
only
th
e m
ost
rele
vant
co
mpa
riso
n gr
oup
is i
nclu
ded.
T
erm
s us
ed
are
usua
lly
the
term
s us
ed
by
the
orig
inal
au
thor
s,
but
occa
sion
ally
te
rmin
olog
y w
as
chan
ged
to
enha
nce
clar
ity
and
perm
it br
evity
. In
so
me
inst
ance
s,
vari
able
s fo
und
to b
e po
sitiv
ely
rela
ted
to D
WI
are
not
incl
uded
if
the
y ar
e no
t re
late
d to
the
va
riab
les
of i
nter
est
as o
utlin
ed
in t
he
revi
ew
of t
he
liter
atur
e.
S. MACDONALD
Characteristics of alcoholics responsible for collisions 503
investigated in few studies. Many psychosocial variables remain unexplored for this group of people. Furthermore, no study has been found where comparisons were made between the characteristics of alcoholics in non-alcohol-related collisions and alcoholics in im- paired collisions.
OBJECTIVE
The objective of this study is to explore selected variables associated with two types of collisions where the driver was judged to be at fault: (1) collisions when the driver was not impaired, and (2) collisions when the driver was impaired by alcohol. Variables were selected for inclusion in this study on the basis of wheher other studies indicated that they may be useful predictors of high-risk driving.
METHODS
The design of the study was cross-sectional with a retrospective component, as driving records from the previous seven years were used to classify people. The sample consisted of males admitted for treatment of alcohol dependence at two hospitals in Ontario, Canada. Eligibility to participate in the study was restricted to people aged 19 to 65, who had driven an automobile at least 3,000 miles in the last three years, and had an Ontario driver’s license sometime within the last three years.
Each consecutive admission was provided a letter that outlined the nature of the study and requested their participation. Appointments were made to complete the ques- tionnaires between two and three weeks from initial admission. The short time lag likely improved the honesty of responses and prevented interference with the treatment pro- cess. Questionnaires were administered in a group setting with typically two to seven patients in a session and a test administrator was available to answer any questions. Data collection took place from March 1985 to May 1986.
Another source of data, information routinely collected by the hospitals for all patients, was used to compare participants and nonparticipants for the possibility of selective bias. The final source of data was official driving records of Ontario, which contained information on each individual’s number of collisions for which they were judged legally responsible and whether or not they were impaired by alcohol at the time.
The questionnaire for the study was composed primarily of scales developed by other authors, chosen on the basis of their validity and reliability. The scales and authors are: aggression, harm avoidance, impulsivity (Jackson 1984); responsibility (Jackson 1976); depression (Jackson 1974); self-esteem (Rosenberg 1965); reactions to drinking (Beckman 1980). Newly developed scales were major undesirable life events (derived from instruments by Health and Welfare, 1978; and Dohrenwend et al. 1978), dangerous styles of drinking and driving, and disrespect for authority (Macdonald 1987).
Other questions were also included to assess the specific constructs of interest. Socioeconomic status was determined by categorizing occupations according to the Blishen and McRoberts scale (1976). Frequency of driving while impaired was deter- mined by asking respondents how many times per month they drove after drinking at least three standard drinks in an hour (or four drinks in two hours or five drinks in three hours, etc.). Consumption of these amounts of alcohol in the specified times will normally produce a BAC level of 80 mg% (i.e. legal impairment in Canada) for a 175pound person. Participants were also asked to estimate the most number of standard drinks they have ever consumed in a day and their average number of drinks per occasion.
RESULTS
Three hundred and sixty-two consecutive admissions were approached to participate in the study, 258 people completed the questionnaire, and official driver records could be accessed for 224 of this latter group. To assess the possibility of selective bias, participants and nonparticipants were compared for variables routinely collected at the
504 S. MACDONALD
hospitals. Since the two groups were very similar for most variables, the sample is likely fairly representative of male alcoholics in treatment at other institutions. The 224 subjects with driver records were categorized into three groups: Group 1 contained 154 people with no collisions, Group 2 contained 27 people with at least one collision in which they were found to be impaired by alcohol (i.e. a blood alcohol contact of .(X3% mg), and Group 3 contained 43 individuals with at least one collision in which the drivers were not legally impaired. If individuals were involved in collisions but not judged to be at fault, they were categorized as being in no collisions. Although 43 people were at fault for nonimpaired collisions, 23 of these people had been drinking but were not impaired. Interestingly, no individuals had both impaired and nonimpaired collisions.
A one-way analysis of variance was performed (see Table 4) to determine whether the means among the three groups were significantly different. The probability value corresponding to the between groups F ratio showed whether any two groups were significantly different. When this value is significant (i.e. p < .OS) further comparisons between any two groups is warranted. Two-tailed, post-hoc comparisons between the three groups were used, using Student-Newman-Keuls procedures to reduce the pos- sibility of Type I errors. The sample sizes, means, and standard deviations for each group are found in Table 5.
Three of the 19 variables for comparisons between people with impaired collisions (Group 2) and no collisions (Group 1) had significant probability values. The impaired collision group was significantly lower in socioeconomic status. had more disrespect for authorities such as the police, and reported that they engaged in more dangerous driving practices when drinking and driving.
The configuration of significant variables between those with nonimpaired collisions (Group 3) and those with no collisions (Group 1) was somewhat different from the
aforementioned comparisons (i.e. Group 1 and Group 2). Eight of 19 variables were significant. One of the four variables significant for the Group 1 and Group 2 comparisons (Socioeconomic Status) was also significant for the Group 1 and Group 3 comparisons; however, no overlap existed for any other comparisons. Those with nonimpaired colli- sions scored higher on Driving Expressiveness, which was not unexpected. Perhaps most interesting was the fact that the nonimpaired colliders differed from those with no collisions in terms of several psychosocial variables. People with nonimpaired collisions
were significantly more impulsive, more depressed, more aggressive, and experienced more undesirable life events. None of these variables were implicated for impaired
collisions. Only one variable between the two collision groups (i.e. Groups 2 and 3) was
significant. Those involved in impaired collisions reported significantly more dangerous styles of drinking and driving than people with nonimpaired collisions. The failure to
achieve statistical significance for other variables for these two groups might have been attributable to very poor statistical power, as both collision groups had small sample sizes.
In addition to the aforementioned analyses, the contrast procedure was used to compare the averages of the two collision groups combined with the noncollision group. People in the two collision groups were found to be significantly younger, lower in socioeconomic status, drank higher numbers of most drinks ever consumed in a day, drove more dangerously when impaired, scored higher on driving expressiveness, more disrespect for authority, less likely to avoid risk for potential bodily harm, more im- pulsive, more depressed, more aggressive, and experienced more negative life events. These analyses show that the two collision groups combined are significantly different from the noncollision group for a large proportion of the variables.
DISCUSSION
Three limitations should be noted about this study. First, since the sample included male alcoholics in treatment, the results can not be generalized beyond this population. This study should be replicated for other populations such as females and lighter drinkers
Tab
le 4
. Pr
obab
ility
va
lues
ass
ocia
ted
with
the
bet
wee
n gr
oup
Frat
ios
and
sign
ific
ance
(p
< .
05)
of t
ests
bet
wee
n co
llisi
on g
roup
s u
sin
g S
tud
ent-
New
man
- K
euls
pro
ced
ure
Var
iabl
e na
me
Prob
abili
ty
valu
e fo
r G
roup
1
(no
colli
sion
s)
Gro
up
2 (n
o co
llisi
ons)
G
roup
2
(im
pair
ed
betw
een-
grou
p F
and
grou
p 2
(im
pair
ed
and
gro
up
3
colli
sion
) an
d gr
oup
3 ra
tio
colli
sion
s)
fnon
imoa
ired
co
llisi
ons)
(n
onim
pair
ed
colli
sion
)
Dem
ogra
phic
va
riab
les
Age
So
cioe
cono
mic
st
atus
E
duca
tion
Dri
nkin
g re
late
d va
riab
les
Mos
t nu
mbe
r of
dri
nks
in a
day
(tr
ansf
orm
ed)
Num
ber
of d
rink
s pe
r oc
casi
on
(tra
nsfo
rmed
) Fr
eque
ncy
of d
rink
ing
Rea
ctio
n to
dri
nkin
g sc
ale
Dri
ving
rel
ated
va
riab
les
Ave
rage
nu
mbe
r of
day
s dr
inki
ng
and
driv
ing
per
mon
th
Dan
gero
us
styl
es o
f dr
inki
ng
and
driv
ing
scal
e (t
rans
form
ed)
Dan
gero
us
styl
es o
f dr
ivin
g sc
ale
Psyc
hoso
cial
va
riab
les
Res
pons
ibili
ty
scal
e D
isre
spec
t fo
r au
thor
ity
Har
m
avoi
danc
e sc
ale
Impu
lsiv
enes
s sc
ale
Dep
ress
ion
scal
e Se
lf-e
stee
m
scal
e A
ggre
ssiv
enes
s sc
ale
Maj
or l
ife
even
t sc
ale
,016
s *
.001
8 *
* .5
667
.034
9 .3
458
.728
3 ‘6
387
.266
7 .0
019
.034
0 z
.098
1
.029
8 *
.011
1 .0
479
.043
4 *
.042
3 *
.286
8 .0
324
* .0
016
*
*
*Gro
ups
are
sign
ific
antly
di
ffer
ent
(p
<
.05)
usi
ng S
tude
nt-N
ewm
an-K
euls
co
rrec
tion
form
ula
for
mul
itipl
e co
mpa
riso
ns.
506 S. MACDONALD
Table 5. Number of cases, means, and standard deviations for the three groups of people, defined by their involvement in collisions
Variable name Grow Number of Standard
cases Mean deviation
Socioeconomic status
Education
Most drinks in a day
Average number of drinks per occasion
Frequency of drinking
Reactions to drinking
Frequency of drinking and driving
Dangerous styles of drinking and driving
Driving expressiveness
Dangerous styles of driving
Responsibility
Disrespect for authority
Harm avoidance
Impulsiveness
Depression
Self-esteem
Aggressiveness
Undesirable life events
1. No collisions 2. Impaired collisions 3. Nonimpaired collisions 1. No collisions 2. Impaired collisions 3. Nonimpaired collisions 1. No collisions 2. Impaired collisions 3. Nonimpaired collisions 1. No collisions 2. Impaired collisions 3. Nonimoaired collisions 1. No collisions 2. Impaired collisions 3. Nonimvaired collisions 1. No collisions 2. Impaired collisions 3. Nonimpaired collisions 1. No collisions 2. Impaired collisions 3. Nonimpaired collisions 1. No collisions 2. Impaired collisions 3. Nonimpaired collisions 1. No collisions 2. Impaired collisions 3. Nonimpaired collisions 1. No collisions 2. Impaired collisions 3. Nonimpaired collisions 1. No collisions 2. Impaired collisions 3. Nonimpaired collisions 1. No collisions 2. Impaired collisions 3. Nonimpaired collisions 1. No collisions 2. Impaired collisions 3. Nonimpaired collisions 1. No collisions 2. Impaired collisions 3. Nonimpaired collisions 1. No collisions 2. Impaired collisions 3. Nonimuaired collisions 1. No collisions 2. Impaired collisions 3. Nonimpaired collisions 1. No collisions 2. Impaired collisions 3. Nonimpaired collisions 1. No collisions 2. Impaired collisions 3. Nonimpaired collisions 1. No collisions 2. Impaired collisions 3. Nonimpaired collisions
154 43.36 10.68 27 38.52 10.90 43 38.86 12.71
143 46.70 14.84 24 37.96 10.75 40 39.73 13.27
1.54 4.54 2.59 26 4.00 2.06 43 4.30 2.62
150 23.07 11.07 23 27.78 16.40 43 27.88 14.31
149 12.X7 8.40 23 13.74 6.07 43 14.84 6.74
150 5.70 1.73 25 5.48 1.64 43 5.81 1.47
153 24.12 5.56 26 24.50 6.02 43 25.05 6. IO
139 8.70 x.55 I7 11.88 10.66 41 10.44 9.87
150 20.06 4.03 25 23.44 5.08 42 21.02 5.22
153 4.28 2.68 27 4.83 2.70 43 5.51 3.08
153 2.06 1.65 27 2.08 2.13 43 2.72 2.05
154 12.87 3.71 27 12.70 4.04 43 11.12 4.11
154 3.22 1.78 27 4.30 2.10 43 3.79 2.09
151 10. I3 3.94 27 8.78 4.34 43 X.59 4.48
154 5.60 3.53 27 6.1X 3.59 43 7.12 3.53
140 6.76 3.55 26 7.3X 3.10 41 X.34 3.73
154 7.22 1.66 27 7.08 I .32 43 6.76 1.87
147 7.47 2.84 27 x.74 3.40 43 8.58 3.59
139 51.66 x.94 25 53.88 9.x2 41 5X.02 12.51
to make the findings more generalizable. A second limitation of this study is the small sample size for the collision groups (i.e. 27 people with impaired collisions and 43 people with nonimpaired collisions). These small sample sizes made direct comparisons between these two groups unreliable. Since the samples were small it is possible that other variables may have become significant with an increased sample and, therefore, the results should be treated as exploratory. However, any differences found were very large and therefore likely important. The final limitation is that a large proportion (53%) of the people involved in nonimpaired collisions had been drinking (i.e. less than 80 mg%)
Characteristics of alcoholics responsible for collisions 507
at the time of their collision. Therefore, drinking might have been a confounding factor. Due to these limitations, conclusions from this research must be treated tentatively.
Some results from this study are suggestive that people with impaired collisons and nonimpaired collisions might have different risk factors (a risk factor is any variable that significantly distinguishes the collision group from a comparison group). Only three variables (Socioeconomic Status, Dangerous Styles of Drinking and Driving, and Dis- respect for Authority) were predictive of impaired collisions. Nonimpaired collisions was more related to psychological traits and psychosocial characteristics. One cluster of characteristics (Low Responsibility, Aggressiveness, Impulsiveness, Depression as a trait, and High Harm Avoidance) describes characteristics of an antisocial personality. Another important psychosocial characteristic that does not belong to this group was Undesirable Life Events. Some of the results (i.e. the contrast procedure) were also suggestive that the collision groups were from a similar population.
The results presented in this paper were taken from data of a larger study of driving while impaired (DWI) arrests among alcoholics (see Macdonald 1987). When comparing results from this larger study to these results, more variables were predictive of multiple DWI arrests (see Table 3) than of impaired collisions. This might have been attributable to the smaller sample size for impaired collisions in this study. It is interesting that none of the psychological variables were predictive of either DWI arrests or impaired collisions, but that several psychological variables were predictive of nonimpaired collisions. A possible conclusion that may be drawn from all the results is that for alcoholics the characteristics predictive of impaired collisions are different than those predictive of nonimpaired collisions.
Acknowledgements-The author is indebted to the Donwood Institute (Toronto, Ontario) and the Addiction Unit, St. Thomas Psychiatric Hospital (St. Thomas, Ontario) for permitting data to be collected from the patients undergoing treatment for alcohol dependence. As well, Steve Dooley provided useful comments on drafts of this paper.
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