Elisabeth Wells-Parker

Impaired driving is a leading cause of alcohol-related deaths and injuries. Rehabilitation or remedial programs, involving assessment and screening of convicted impaired drivers to determine problem severity and appropriate programs, are an important component of society’s response to this problem. Ontario’s remedial program, Back on Track (BOT), involves an assessment process that includes administration of the Research Institute on Addictions Self-Inventory (RIASI) to determine assignment to an education or treatment program. The purpose of this study is to identify factors within the RIASI and examine how factor scores are associated with alcohol use and problem indicators at assessment and six-month follow-up. The sample included 22,298 individuals who completed BOT from 2000 to 2005. Principal component factor analysis with varimax rotation was conducted on RIASI data and an eight factor solution was retained: (1) Negative Affect, (2) Sensation Seeking, (3) Alcohol-Quantity, (4) Social Conformity, (5) High Risk Lifestyle, (6) Alcohol Problems, (7) Interpersonal Competence, and (8) Family History. Regression analyses were conducted to examine associations between factors and alcohol and problem measures obtained at assessment and at follow-up. Most factors, except for Interpersonal Competence, were associated with more alcohol use and problems at assessment. A similar pattern was observed at 6-month follow-up, but interestingly some factors (Negative Affect, Sensation Seeking, Alcohol-Quantity and Family History) predicted fewer days of alcohol use. The Interpersonal Competence factor was associated with significantly lower levels of alcohol use and problems at both assessment and follow-up. This work suggests that the RIASI provides information on several domains that have important relationships with alcohol problem severity and outcomes.

This review summarizes evidence on negative affect among drinking drivers. Elevations in negative affect, including depressed mood, anxiety and hostility, have long been noted in convicted drinking drivers, and recent evidence suggests an association between negative affect and driving after drinking in the general population. Previous efforts to understand the significance of this negative affective state have ranged from suggestions that it may play a causal role in drinking driving to suggestions that it may interfere with response to treatment and remedial interventions. Recent studies have uncovered an important paradox involving negative affect among convicted drinking drivers (hereafter DUI offenders). DUI offenders with high levels of negative affect recidivated more frequently following a DUI program than did those reporting no or minimal negative affect. However, when a brief supportive motivational intervention was added to the program, offenders with high negative affect levels showed lower recidivism rates than did those with no or minimal negative affect. The review includes studies from the general literature on alcohol treatment in which the same negative affect paradox was reported. In an attempt to understand this paradox, we present a conceptual model involving well-established psychological processes, with a focus on salient discrepancy, the crucial component of cognitive dissonance. In this model, negative affect plays an important role in motivating both continued high-risk drinking as well as therapeutic change. This model suggests that links between motivational states and negative affective processes may be more complex than previously thought. Implications for intervention with DUI offenders are discussed.

The purpose of the research was to determine whether the effectiveness of a traditional DUI (Driving Under the Influence) group intervention program could be enhanced by the addition of two brief individual intervention sessions and a follow-up. The differential effectiveness of the individual intervention component was examined for four offender subgroups (young minorities, problem drinkers, women and depressed offenders) that had been previously identified as at high risk or vulnerable. Adjudicated first DUI offenders (N = 4,074), of whom 776 (19%) were female, were randomly assigned to a standard first-offender program or an enhanced standard program that included two short individual sessions and a brief follow-up session. The setting was a mandated first-offender program in 10 Mississippi locations. Depressed offenders who were assigned to the enhanced program were 35% less likely to recidivate than those assigned to the standard program. The effectiveness of the two programs did not differ significantly for offenders who self-reported low depression. No significant interaction effects were found between program type and age, minority status or gender. After depressed mood was controlled for, problem-drinker status was not related to program effectiveness; however, problem drinkers had higher depression rates. Results suggest that the combination of a standard first-offender program with brief individual counseling can be effective for DUI offenders who report depressed mood and who are at high risk for recidivism. A five-item screen for sad/depressed mood from a widely used DUI risk assessment instrument identified offenders who benefited from the enhanced intervention.

Eight types of drinking driver groups were compared on several personality and behavior traits. It was found that impaired drivers arrested after an accident or moving violation were significantly higher in hostility, psychopathic deviance, nontraffic arrests, frequency of impaired driving, accidents after drinking, and drinks consumed per week than impaired drivers caught in roadblocks. Neither impaired drivers stopped in roadblocks nor impaired drivers never arrested differed from nonimpaired drinking drivers or nondrinking drivers on most measures examined