Development and Evaluation of an Exposure Therapy in Driving Simulation for Treatment of Driving Phobia After Driving Accidents

Status:

completed 08/2017

Aims:

Following a traffic accident, up to 50% of the involved persons suffer from stress related symptoms often coming along with enduring fear of driving. Virtual reality exposure (VRE) offers major therapeutical advantages for anxiety disorders, but with respect to fear of driving it has been hardly investigated so far.

Activities/Methods:

Thus, in the present study a driving simulator treatment for patients with fear of driving after a traffic accident was developed and evaluated. The therapy was carried out according to a standardized manual including 13 sessions (anamnesis, medical examination, two preparative psychotherapy sessions, five VRE sessions, a final behavioral avoidance test (BAT) in real traffic with a driving instructor, a closing session, two Follow-up phone calls after six/twelve weeks). The VRE sessions were carried out in a driving simulator with a fully equipped mockup (Opel Insignia). The exposure scenarios were individually tailored to the patients’ anxiety hierarchy. A total of 14 patients subdivided into a treatment and a waiting group were included. Parameters on the subjective, behavioral and physiological level were assessed.

Results:

Results have proven excellent success. All of the patients mastered driving tasks in the final BAT that they had avoided before. 71% also showed an adequate driving behavior as assessed by the driving instructor. 79% felt less anxiety during the BAT than anticipated prior to the treatment. 93% could maintain their treatment success until the second Follow-up phone call.

No improvement was observed over the waiting period of the waiting group starting therapy seven days after anamnesis. In the final evaluation phone all but one subject rated the treatment to be good or very good. VRET in driving simulators is a highly promising tool to treat fear of driving. A major advantage is that traffic scenarios can be selectively designed and presented to perfectly fit the individuals' anxieties. Further research is necessary to compare efficacy as compared to an active control group. Moreover, lower configuration stages of driving simulators have to be tested to allow a broad availability for patients.

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