Effects of Sweetness and Energy in Drinks on Food Intake Following Exercise

Exercise is known to cause physiological changes that could affect the impact of nutrients on appetite control. This study was designed to assess the effect of drinks containing either sucrose or high-intensity sweeteners on food intake following exercise. Using a repeated-measures design, three drink conditions were employed: plain water (W), a low-energy drink sweetened with artificial sweeteners aspartame and acesulfame-K (L), and a high-energy, sucrose-sweetened drink (H). Following a period of challenging exercise (70% VO2 max for 50 min), subjects consumed freely from a particular drink before being offered a test meal at which energy and nutrient intakes were measured. The degree of pleasantness (palatability) of the drinks was also measured before and after exercise. At the test meal, energy intake following the artificially sweetened (L) drink was significantly greater than after water and the sucrose (H) drinks (p < 0.05). Compared with the artificially sweetened (L) drink, the high-energy (H) drink suppressed intake by approximately the energy contained in the drink itself. However, there was no difference between the water (W) and the sucrose (H) drink on test meal energy intake. When the net effects were compared (i.e., drink + test meal energy intake), total energy intake was significantly lower after the water (W) drink compared with the two sweet (L and H) drinks. The exercise period brought about changes in the perceived pleasantness of the water, but had no effect on either of the sweet drinks. The remarkably precise energy compensation demonstrated after the higher energy sucrose drink suggests that exercise may prime the system to respond sensitively to nutritional manipulations. The results may also have implications for the effect on short-term appetite control of different types of drinks used to quench thirst during and after exercise.

The risky behaviour of young drivers : developing a measurement tool

The contribution of risky behaviour to the increased crash and fatality rates of young novice drivers is recognised in the road safety literature around the world. Exploring such risky driver behaviour has led to the development of tools like the Driver Behaviour Questionnaire (DBQ) to examine driving violations, errors, and lapses [1]. Whilst the DBQ has been utilised in young novice driver research, some items within this tool seem specifically designed for the older, more experienced driver, whilst others appear to asses both behaviour and related motives. The current study was prompted by the need for a risky behaviour measurement tool that can be utilised with young drivers with a provisional driving licence. Sixty-three items exploring young driver risky behaviour developed from the road safety literature were incorporated into an online survey. These items assessed driver, passenger, journey, car and crash-related issues. A sample of 476 drivers aged 17-25 years (M = 19, SD = 1.59 years) with a provisional driving licence and matched for age, gender, and education were drawn from a state-wide sample of 761 young drivers who completed the survey. Factor analysis based upon a principal components extraction of factors was followed by an oblique rotation to investigate the underlying dimensions to young novice driver risky behaviour. A five factor solution comprising 44 items was identified, accounting for 55% of the variance in young driver risky behaviour. Factor 1 accounted for 32.5% of the variance and appeared to measure driving violations that were transient in nature - risky behaviours that followed risky decisions that occurred during the journey (e.g., speeding). Factor 2 accounted for 10.0% of variance and appeared to measure driving violations that were fixed in nature; the risky decisions being undertaken before the journey (e.g., drink driving). Factor 3 accounted for 5.4% of variance and appeared to measure misjudgment (e.g., misjudged speed of oncoming vehicle). Factor 4 accounted for 4.3% of variance and appeared to measure risky driving exposure (e.g., driving at night with friends as passengers). Factor 5 accounted for 2.8% of variance and appeared to measure driver emotions or mood (e.g., anger). Given that the aim of the study was to create a research tool, the factors informed the development of five subscales and one composite scale. The composite scale had a very high internal consistency measure (Cronbach’s alpha) of .947. Self-reported data relating to police-detected driving offences, their crash involvement, and their intentions to break road rules within the next year were also collected. While the composite scale was only weakly correlated with self-reported crashes (r = .16, p < .001), it was moderately correlated with offences (r = .26, p < .001), and highly correlated with their intentions to break the road rules (r = .57, p < .001). Further application of the developed scale is needed to confirm the factor structure within other samples of young drivers both in Australia and in other countries. In addition, future research could explore the applicability of the scale for investigating the behaviour of other types of drivers.

Managing illegal street racing and associated risky driving behaviour : An Australian perspective

Illegal street racing has received increased attention in recent years from the media, governments and road safety professionals. At the same time, there has been a shift from treating illegal street racing as a public nuisance issue to a road safety problem in Australia, as this behaviour now attracts a penalty of increased periods of vehicle impoundment leading to permanent vehicle forfeiture for repeat offences. This severe vehicle sanction is typically applied to repeat drink driving offenders and drivers who breach suspensions and disqualifications in North American jurisdictions, but was first introduced in Australia to deal with illegal street racing and associated risky driving behaviours, grouped together under the label of ‘hooning’ in Australian jurisdictions. This paper describes how Australian jurisdictions are dealing with this issue. The research described in this paper drew on multiple data sources to explore illegal street racing and the management of this issue in Australia. First, the paper reviews the relevant legislation in each Australian state to describe the cross-jurisdictional similarities and differences in approaches. It also describes some results from focus group discussions and a quantitative online survey with drivers who self-report engaging in illegal street racing and associated behaviours in Queensland, Australia. It was found that approaches to dealing with illegal street racing and associated risky driving behaviours in each Australian state are similar, with increasing periods of vehicle impoundment (leading to vehicle forfeiture) applied to repeat hooning offences within prescribed periods. Participants in the focus groups and respondents to the questionnaire generally felt these penalty periods were severe, with perceptions of severity increasing with the length of the penalty period. It was concluded that there is a need for each jurisdiction to objectively evaluate the effectiveness of their vehicle impoundment and forfeiture programs for hooning. These evaluations should compare the relative costs of these programs (e.g., enforcement, unrecovered towing and storage fees, and court costs) to the observed benefits (e.g., reduction in target behaviours, reduction in community complaints, and reduction in the number and severity of associated crashes).

Safety impacts of alcohol and other drugs in the construction industry : a research methodology

Anecdotal evidence from the infrastructure and building sectors highlights issues of drugs and alcohol and its association with safety risk on construction sites. Operating machinery and mobile equipment, proximity to live traffic together with congested sites, electrical equipment and operating at heights conspire to accentuate the potential adverse impact of drugs and alcohol in the workplace. While most Australian jurisdictions have identified this as a critical safety issue, information is limited regarding the prevalence of alcohol and other drugs in the workplace and there is limited evidential guidance regarding how to effectively and efficiently address such an issue. No known study has scientifically evaluated the relationship between the use of drugs and alcohol and safety impacts in construction, and there has been only limited adoption of nationally coordinated strategies, supported by employers and employees to render it socially unacceptable to arrive at a construction workplace with impaired judgement from drugs and alcohol. A nationally consistent collaborative approach across the construction workforce - involving employers and employees; clients; unions; contractors and sub-contractors is required to engender a cultural change in the construction workforce – in a similar manner to the on-going initiative in securing a cultural change to drink-driving in our society where peer intervention and support is encouraged. This study has four key objectives. Firstly, using the standard World Health Organisation AUDIT, a national qualitative and quantitative assessment of the use of drugs and alcohol will be carried out. This will build upon similar studies carried out in the Australian energy and mining sectors. Secondly, the development of an appropriate industry policy will adopt a non-punitive and rehabilitative approach developed in consultation with employers and employees across the infrastructure and building sectors, with the aim it be adopted nationally for adoption at the construction workplace. Thirdly, an industry-specific cultural change management program will be developed through a nationally collaborative approach to reducing the risk of impaired performance on construction sites and increasing workers’ commitment to drugs and alcohol safety. Finally, an implementation plan will be developed from data gathered from both managers and construction employees. Such an approach stands to benefit not only occupational health and safety, through a greater understanding of the safety impacts of alcohol and other drugs at work, but also alcohol and drug use as a wider community health issue. This paper will provide an overview of the background and significance of the study as well as outlining the proposed methodology that will be used to evaluate the safety impacts of alcohol and other drugs in the construction industry.

Improving road safety through deterrence-based initiatives : a review of research

The efficacy of road safety countermeasures to deter motorists from engaging in illegal behaviours is extremely important when considering the personal and economic impact of road accidents on the community. Within many countries, deterrence theory has remained a cornerstone to criminology and criminal justice policy, particularly within the field of road safety, as policy makers and enforcement agencies attempt to increase perceptions regarding the certainty, severity and swiftness of sanctions for those who engage in illegal motoring behaviours. Using the Australian experience (particularly the tremendous amount of research into drink driving), the current paper reviews the principles underpinning deterrence theory, the utilisation of the approach within some contemporary road safety initiatives (e.g., Random Breath Testing) as well as highlights some methods to enhance a deterrent effect. The paper also provides direction for future deterrence-based research, in particular, considering the powerful impact of non-legal sanctions, punishment avoidance as well as creating culturally embedded behavioural change.

Managing driver fatigue : education or motivation?

Fatigue has been recognised as the primary contributing factor in approximately 15% of all fatal road crashes in Australia. To develop effective countermeasures for managing fatigue, this study investigates why drivers continue to drive when sleepy, and driver perceptions and behaviours in regards to countermeasures. Based on responses from 305 Australian drivers, it was identified that the major reasons why these participants continued to drive when sleepy were: wanting to get to their destination; being close to home; and time factors. Participants’ perceptions and use of 18 fatigue countermeasures were investigated. It was found that participants perceived the safest strategies, including stopping and sleeping, swapping drivers and stopping for a quick nap, to be the most effective countermeasures. However, it appeared that their knowledge of safe countermeasures did not translate into their use of these strategies. For example, although the drivers perceived stopping for a quick nap to be an effective countermeasure, they reported more frequent use of less safe methods such as stopping to eat or drink and winding down the window. This finding suggests that, while practitioners should continue educating drivers, they may need a greater focus on motivating drivers to implement safe fatigue countermeasures.

Who are the real “first offenders”?

Drink driving causes more fatal crashes than any other single factor on Australian roads, with a third of crashes having alcohol as a contributing factor. In recent years there has been a plateau in the numbers of drink drivers apprehended by RBT, and around 12% of the general population in self report surveys admit to drinking and driving. There is limited information about the first offender group, particularly the subgroup of these offenders who admit to prior drink driving, the offence therefore being the “first time caught”. This research focuses on the differences between those who report drink driving prior to apprehension for the offence and those who don’t. Methods: 201 first time drink driving offenders were interviewed at the time of their court appearance. Information was collected on socio-demographic variables, driving behaviour, method of apprehension, offence information, alcohol use and self reported previous drink driving. Results: 78% of respondents reported that they had driven over the legal alcohol limit in the 6 months prior to the offence. Analyses revealed that those offenders who had driven over the limit previously without being caught were more likely to be younger and have an issue with risky drinking. When all variables were taken into account in a multivariate model using logistic regression, only risky drinking emerged as significantly related to past drink driving. High risk drinkers were 4.8 times more likely to report having driven over the limit without being apprehended in the previous 6 months. Conclusion: The majority of first offenders are those who are “first time apprehended” rather than “first time drink drivers”. Having an understanding of the differences between these groups may alter the focus of educational or rehabilitation countermeasures. This research is part of a larger project aiming to target first time apprehended offenders for tailored intervention.

The Culture of Older Women’s Drinking in Australia

The purpose of this investigation was to undertake pilot research to develop an understanding of the current culture of older Australian women’s (35-50 years) drinking behaviour from a uniquely female perspective. Methods Two separate focus group interviews were undertaken with women (N = 11) aged between 35 and 50 years living in South-East Queensland, Australia. Women were asked to openly discuss how and why they drink alcohol (ie., their regular drinking behaviour), how this has changed over time, and the attitudes and values that influence their behaviour. Results Participants reported that their consumption of alcohol was more regulated and controlled and although some women drank more frequently, the quantity consumed at each drinking occasion had decreased significantly. Occasional consumption of large amounts of alcohol tended to be the result of ‘incidental drinking’ as opposed to ‘determined drinking’. The reasons for alcohol consumption were found to be internal as well as social. Internal reasons included stress relief, increased relaxation and self reward. Further, alcohol was used as a social lubricant. This cohort also reported being influenced by the drinking patterns of their partners. Social group matching was however found to have a negative impact on alcohol consumption as social groups most commonly endorsed lesser levels of intoxication. Further, the women reported that they were of an age in which they felt excessive drinking to be ‘undignified’. Personal reasons such as vocational and family responsibilities further modified the levels of consumption for individual women. Finally, it was reported that perceived health risks that can result from excessive and/or repetitive drinking led to a decreased in consumption. Conclusion It is proposed that the findings of this investigation could be used to improve current knowledge regarding more mature women’s drinking culture, associated risks and risk prevention strategies.

Trends in impaired driving in Australia in 2010 : a status report

This paper reviews the status of alcohol, drugs and traffic safety in Australia, with particular emphasis on developments in the period 2008-2010. Australian jurisdictions have made impressive improvements in road safety since the early 1970s. Enforcement and public education campaigns that specifically target drink driving have been successful, with resultant long-term reduction in alcohol-related fatalities. There is a high level of community disapproval of drink driving and strong support for countermeasures. Many best-practice countermeasures targeting impaired driving are in place, including general prevention/ deterrence programs such as random breath testing (RBT), random roadside drug testing legal alcohol limits, responsible service of alcohol programs, public education and advertising campaigns and designated driver programs, and offender management programs such as driver licensing penalties and fines, alcohol ignition interlocks and vehicle impoundment for high risk drink drivers, and offender education programs. There continue to be enhancements occurring, particularly in the areas of drug-impaired driving and offender management, but also in addressing the fundamental policy and legislative framework to address impaired driving (e.g., a current national debate about lowering the permissible blood alcohol for all drivers from 0.05 to 0.02 or 0.00 gm/100 ml BAC). However, there are major challenges that may be impacting on programs targeting impaired driving, including the rapid development of a binge drinking culture among young Australians, the extension of trading hours of licensed premises, continued problems with secondary supply of alcohol to minors, and increases in the marketing of alcopops and ready-to-drink spirit-based beverages. This paper addresses the question: Are impaired driving countermeasures in Australia continuing to achieve reductions in road traumas and rates of offending, or are they plateauing? If they are plateauing, is this due to declining effectiveness of countermeasures or the need to ‘hold the line’ against societal influences encouraging impaired driving?

Social control of the drinking driver

It is more that 20 years since the “Social Control of the Drink Driver” edited by Laurence, Snortum and Zimring (1988) were published. It was, and remains a major examination of the issue involving 17 scientists from all relevant disciplines and policy centres and represents the current practice and experience at the time. While much of, but by no means all, the content is centred on the North American experience the scholarship and range of research data explored through the investigative lens of lawyers, pharmacologists, psychologists, sociologists, criminologists and economists covers all the major issues being examined in Europe, and Australia at the time. More importantly, it presents the policy aspirations and goals of nine countries and includes a comparison of deterrence and the legal context in six countries; emerging technologies for control and the potential contributions of education and rehabilitation. The experience of promoting evidence based policies and practices are generally experienced in all countries as both laborious and painfully slow. However, this ICADTS meeting in Norway provides an opportunity to challenge these feelings by re-examining the current situation compared with that documented over 20yrs ago. This presentation will undertake a reality check on just what we have achieved within that time and try to attribute success and failure towards recommendations for our future endeavours.

Risk factors for fatal crashes in rural Australia

This paper presents findings from the rural and remote road safety study, conducted in Queensland, Australia, from March 2004 till June 2007, and compares fatal crashes and non-fatal but serious crashes in respect of their environmental, vehicle and operator factors. During the study period there were 613 non-fatal crashes resulting in 684 hospitalised casualties and 119 fatal crashes resulting in 130 fatalities. Additional information from police sources was available on 103 fatal and 309 non-fatal serious crashes. Over three quarters of both fatal and hospitalised casualties were male and the median age in both groups was 34 years. Fatal crashes were more likely to involve speed, alcohol and violations of road rules and fatal crash victims were 2 and a 1/2 times more likely to be unrestrained inside the vehicle than non-fatal casualties, consistent with current international evidence. After controlling for human factors, vehicle and road conditions made a minimal contribution to the seriousness of the crash outcome. Targeted interventions to prevent fatalities on rural and remote roads should focus on reducing speed and drink driving and promoting seatbelt wearing.

Illegal street racing and associated (hooning) behaviours

In an Australian context, the term hooning refers to risky driving behaviours such as illegal street racing and speed trials, as well as behaviours that involve unnecessary noise and smoke, which include burn outs, donuts, fish tails, drifting and other skids. Hooning receives considerable negative media attention in Australia, and since the 1990s all Australian jurisdictions have implemented vehicle impoundment programs to deal with the problem. However, there is limited objective evidence of the road safety risk associated with hooning behaviours. Attempts to estimate the risk associated with hooning are limited by official data collection and storage practices, and the willingness of drivers to admit to their illegal behaviour in the event of a crash. International evidence suggests that illegal street racing is associated with only a small proportion of fatal crashes; however, hooning in an Australian context encompasses a broader group of driving behaviours than illegal street racing alone, and it is possible that the road safety risks will differ with these behaviours. There is evidence from North American jurisdictions that vehicle impoundment programs are effective for managing drink driving offenders, and drivers who continue to drive while disqualified or suspended both during and post-impoundment. However, these programs used impoundment periods of 30 – 180 days (depending on the number of previous offences). In Queensland the penalty for a first hooning offence is 48 hours, while the vehicle can be impounded for up to 3 months for a second offence, or permanently for a third or subsequent offence within three years. Thus, it remains unclear whether similar effects will be seen for hooning offenders in Australia, as no evaluations of vehicle impoundment programs for hooning have been published. To address these research needs, this program of research consisted of three complementary studies designed to: (1) investigate the road safety implications of hooning behaviours in terms of the risks associated with the specific behaviours, and the drivers who engage in these behaviours; and (2) assess the effectiveness of current approaches to dealing with the problem; in order to (3) inform policy and practice in the area of hooning behaviour. Study 1 involved qualitative (N = 22) and quantitative (N = 290) research with drivers who admitted engaging in hooning behaviours on Queensland roads. Study 2 involved a systematic profile of a large sample of drivers (N = 834) detected and punished for a hooning offence in Queensland, and a comparison of their driving and crash histories with a randomly sampled group of Queensland drivers with the same gender and age distribution. Study 3 examined the post-impoundment driving behaviour of hooning offenders (N = 610) to examine the effects of vehicle impoundment on driving behaviour. The theoretical framework used to guide the research incorporated expanded deterrence theory, social learning theory, and driver thrill-seeking perspectives. This framework was used to explore factors contributing to hooning behaviours, and interpret the results of the aspects of the research designed to explore the effectiveness of vehicle impoundment as a countermeasure for hooning. Variables from each of the perspectives were related to hooning measures, highlighting the complexity of the behaviour. This research found that the road safety risk of hooning behaviours appears low, as only a small proportion of the hooning offences in Study 2 resulted in a crash. However, Study 1 found that hooning-related crashes are less likely to be reported than general crashes, particularly when they do not involve an injury, and that higher frequencies of hooning behaviours are associated with hooning-related crash involvement. Further, approximately one fifth of drivers in Study 1 reported being involved in a hooning-related crash in the previous three years, which is comparable to general crash involvement among the general population of drivers in Queensland. Given that hooning-related crashes represented only a sub-set of crash involvement for this sample, this suggests that there are risks associated with hooning behaviour that are not apparent in official data sources. Further, the main evidence of risk associated with the behaviour appears to relate to the hooning driver, as Study 2 found that these drivers are likely to engage in other risky driving behaviours (particularly speeding and driving vehicles with defects or illegal modifications), and have significantly more traffic infringements, licence sanctions and crashes than drivers of a similar (i.e., young) age. Self-report data from the Study 1 samples indicated that Queensland’s vehicle impoundment and forfeiture laws are perceived as severe, and that many drivers have reduced their hooning behaviour to avoid detection. However, it appears that it is more common for drivers to have simply changed the location of their hooning behaviour to avoid detection. When the post-impoundment driving behaviour of the sample of hooning offenders was compared to their pre-impoundment behaviour to examine the effectiveness of vehicle impoundment in Study 3, it was found that there was a small but significant reduction in hooning offences, and also for other traffic infringements generally. As Study 3 was observational, it was not possible to control for extraneous variables, and is, therefore, possible that some of this reduction was due to other factors, such as a reduction in driving exposure, the effects of changes to Queensland’s Graduated Driver Licensing scheme that were implemented during the study period and affected many drivers in the offender sample due to their age, or the extension of vehicle impoundment to other types of offences in Queensland during the post-impoundment period. However, there was a protective effect observed, in that hooning offenders did not show the increase in traffic infringements in the post period that occurred within the comparison sample. This suggests that there may be some effect of vehicle impoundment on the driving behaviour of hooning offenders, and that this effect is not limited to their hooning driving behaviour. To be more confident in these results, it is necessary to measure driving exposure during the post periods to control for issues such as offenders being denied access to vehicles. While it was not the primary aim of this program of research to compare the utility of different theoretical perspectives, the findings of the research have a number of theoretical implications. For example, it was found that only some of the deterrence variables were related to hooning behaviours, and sometimes in the opposite direction to predictions. Further, social learning theory variables had stronger associations with hooning. These results suggest that a purely legal approach to understanding hooning behaviours, and designing and implementing countermeasures designed to reduce these behaviours, are unlikely to be successful. This research also had implications for policy and practice, and a number of recommendations were made throughout the thesis to improve the quality of relevant data collection practices. Some of these changes have already occurred since the expansion of the application of vehicle impoundment programs to other offences in Queensland. It was also recommended that the operational and resource costs of these laws should be compared to the road safety benefits in ongoing evaluations of effectiveness to ensure that finite traffic policing resources are allocated in a way that produces maximum road safety benefits. However, as the evidence of risk associated with the hooning driver is more compelling than that associated with hooning behaviour, it was argued that the hooning driver may represent the better target for intervention. Suggestions for future research include ongoing evaluations of the effectiveness of vehicle impoundment programs for hooning and other high-risk driving behaviours, and the exploration of additional potential targets for intervention to reduce hooning behaviour. As the body of knowledge regarding the factors contributing to hooning increases, along with the identification of potential barriers to the effectiveness of current countermeasures, recommendations for changes in policy and practice for hooning behaviours can be made.

Response : letter to the editor by Al-Azri and Al-Maniri

Firstly, the authors would like to thank the editor for the opportunity to respond to Dr Al-Azri’s and Dr Al-Maniri’s letter. Secondly, while the current authors also accept that deterrence-based approaches should act as only one corner-stone of a suite of interventions and public policy initiatives designed to improve road safety, deterrence-based approaches have nonetheless consistently proven to be a valuable resource to improve road safety. Dr Al-Azri and Dr Al-Maniri reinforce their assertion about the limited utility of deterrence by citing drink driving research, and the issue of drink driving is particularly relevant within the current context given that the problem of driving after drinking has historically been addressed through deterrence-based approaches. While the effectiveness of deterrence-based approaches to reduce drink driving will always be dependent upon a range of situational and contextual factors (including police enforcement practices, cultural norms, etc), the utilisation of this approach has proven particularly effective within Queensland, Australia. For example, a relatively recent comprehensive review of Random Breath Testing in Queensland demonstrated that this initiative not only had a deterrent impact upon self-reported intentions to drink and drive, but was also found to have significantly reduced alcohol-related fatalities in the state. However, the authors agree that deterrence-based approaches can be particularly transient and thus require constant “topping up” not least through sustained public reinforcement, which was clearly articulated in the seminal work by Homel.

The psychosocial factors influencing aggressive driving behaviour

Many drivers in highly motorised countries believe that aggressive driving is increasing. While the prevalence of the behaviour is difficult to reliably identify, the consequences of on-road aggression can be severe, with extreme cases resulting in property damage, injury and even death. This research program was undertaken to explore the nature of aggressive driving from within the framework of relevant psychological theory in order to enhance our understanding of the behaviour and to inform the development of relevant interventions. To guide the research a provisional ‘working’ definition of aggressive driving was proposed encapsulating the recurrent characteristics of the behaviour cited in the literature. The definition was: “aggressive driving is any on-road behaviour adopted by a driver that is intended to cause physical or psychological harm to another road user and is associated with feelings of frustration, anger or threat”. Two main theoretical perspectives informed the program of research. The first was Shinar’s (1998) frustration-aggression model, which identifies both the person-related and situational characteristics that contribute to aggressive driving, as well as proposing that aggressive behaviours can serve either an ‘instrumental’ or ‘hostile’ function. The second main perspective was Anderson and Bushman’s (2002) General Aggression Model. In contrast to Shinar’s model, the General Aggression Model reflects a broader perspective on human aggression that facilitates a more comprehensive examination of the emotional and cognitive aspects of aggressive behaviour. Study One (n = 48) examined aggressive driving behaviour from the perspective of young drivers as an at-risk group and involved conducting six focus groups, with eight participants in each. Qualitative analyses identified multiple situational and person-related factors that contribute to on-road aggression. Consistent with human aggression theory, examination of self-reported experiences of aggressive driving identified key psychological elements and processes that are experienced during on-road aggression. Participants cited several emotions experienced during an on-road incident: annoyance, frustration, anger, threat and excitement. Findings also suggest that off-road generated stress may transfer to the on-road environment, at times having severe consequences including crash involvement. Young drivers also appeared quick to experience negative attributions about the other driver, some having additional thoughts of taking action. Additionally, the results showed little difference between males and females in the severity of behavioural responses they were prepared to adopt, although females appeared more likely to displace their negative emotions. Following the self-reported on-road incident, evidence was also found of a post-event influence, with females being more likely to experience ongoing emotional effects after the event. This finding was evidenced by ruminating thoughts or distraction from tasks. However, the impact of such a post-event influence on later behaviours or interpersonal interactions appears to be minimal. Study Two involved the quantitative analysis of n = 926 surveys completed by a wide age range of drivers from across Queensland. The study aimed to explore the relationships between the theoretical components of aggressive driving that were identified in the literature review, and refined based on the findings of Study One. Regression analyses were used to examine participant emotional, cognitive and behavioural responses to two differing on-road scenarios whilst exploring the proposed theoretical framework. A number of socio-demographic, state and trait person-related variables such as age, pre-study emotions, trait aggression and problem-solving style were found to predict the likelihood of a negative emotional response such as frustration, anger, perceived threat, negative attributions and the likelihood of adopting either an instrumental or hostile behaviour in response to Scenarios One and Two. Complex relationships were found to exist between the variables, however, they were interpretable based on the literature review findings. Factor analysis revealed evidence supporting Shinar’s (1998) dichotomous description of on-road aggressive behaviours as being instrumental or hostile. The second stage of Study Two used logistic regression to examine the factors that predicted the potentially hostile aggressive drivers (n = 88) within the sample. These drivers were those who indicated a preparedness to engage in direct acts of interpersonal aggression on the road. Young, male drivers 17–24 years of age were more likely to be classified as potentially hostile aggressive drivers. Young drivers (17–24 years) also scored significantly higher than other drivers on all subscales of the Aggression Questionnaire (Buss & Perry, 1992) and on the ‘negative problem orientation’ and ‘impulsive careless style’ subscales of the Social Problem Solving Inventory – Revised (D’Zurilla, Nezu & Maydeu-Olivares, 2002). The potentially hostile aggressive drivers were also significantly more likely to engage in speeding and drink/drug driving behaviour. With regard to the emotional, cognitive and behavioural variables examined, the potentially hostile aggressive driver group also scored significantly higher than the ‘other driver’ group on most variables examined in the proposed theoretical framework. The variables contained in the framework of aggressive driving reliably distinguished potentially hostile aggressive drivers from other drivers (Nagalkerke R2 = .39). Study Three used a case study approach to conduct an in-depth examination of the psychosocial characteristics of n = 10 (9 males and 1 female) self-confessed hostile aggressive drivers. The self-confessed hostile aggressive drivers were aged 24–55 years of age. A large proportion of these drivers reported a Year 10 education or better and average–above average incomes. As a group, the drivers reported committing a number of speeding and unlicensed driving offences in the past three years and extensive histories of violations outside of this period. Considerable evidence was also found of exposure to a range of developmental risk factors for aggression that may have contributed to the driver’s on-road expression of aggression. These drivers scored significantly higher on the Aggression Questionnaire subscales and Social Problem Solving Inventory Revised subscales, ‘negative problem orientation’ and ‘impulsive/careless style’, than the general sample of drivers included in Study Two. The hostile aggressive driver also scored significantly higher on the Barrett Impulsivity Scale – 11 (Patton, Stanford & Barratt, 1995) measure of impulsivity than a male ‘inmate’, or female ‘general psychiatric’ comparison group. Using the Carlson Psychological Survey (Carlson, 1982), the self-confessed hostile aggressive drivers scored equal or higher scores than the comparison group of incarcerated individuals on the subscale measures of chemical abuse, thought disturbance, anti-social tendencies and self-depreciation. Using the Carlson Psychological Survey personality profiles, seven participants were profiled ‘markedly anti-social’, two were profiled ‘negative-explosive’ and one was profiled as ‘self-centred’. Qualitative analysis of the ten case study self-reports of on-road hostile aggression revealed a similar range of on-road situational factors to those identified in the literature review and Study One. Six of the case studies reported off-road generated stress that they believed contributed to the episodes of aggressive driving they recalled. Intense ‘anger’ or ‘rage’ were most frequently used to describe the emotions experienced in response to the perceived provocation. Less frequently ‘excitement’ and ‘fear’ were cited as relevant emotions. Notably, five of the case studies experienced difficulty articulating their emotions, suggesting emotional difficulties. Consistent with Study Two, these drivers reported negative attributions and most had thoughts of aggressive actions they would like to take. Similarly, these drivers adopted both instrumental and hostile aggressive behaviours during the self-reported incident. Nine participants showed little or no remorse for their behaviour and these drivers also appeared to exhibit low levels of personal insight. Interestingly, few incidents were brought to the attention of the authorities. Further, examination of the person-related characteristics of these drivers indicated that they may be more likely to have come from difficult or dysfunctional backgrounds and to have a history of anti-social behaviours on and off the road. The research program has several key theoretical implications. While many of the findings supported Shinar’s (1998) frustration-aggression model, two key areas of difference emerged. Firstly, aggressive driving behaviour does not always appear to be frustration driven, but can also be driven by feelings of excitation (consistent with the tenets of the General Aggression Model). Secondly, while the findings supported a distinction being made between instrumental and hostile aggressive behaviours, the characteristics of these two types of behaviours require more examination. For example, Shinar (1998) proposes that a driver will adopt an instrumental aggressive behaviour when their progress is impeded if it allows them to achieve their immediate goals (e.g. reaching their destination as quickly as possible); whereas they will engage in hostile aggressive behaviour if their path to their goal is blocked. However, the current results question this assertion, since many of the hostile aggressive drivers studied appeared prepared to engage in hostile acts irrespective of whether their goal was blocked or not. In fact, their behaviour appeared to be characterised by a preparedness to abandon their immediate goals (even if for a short period of time) in order to express their aggression. The use of the General Aggression Model enabled an examination of the three components of the ‘present internal state’ comprising emotions, cognitions and arousal and how these influence the likelihood of a person responding aggressively to an on-road situation. This provided a detailed insight into both the cognitive and emotional aspects of aggressive driving that have important implications for the design of relevant countermeasures. For example, the findings highlighted the potential value of utilising Cognitive Behavioural Therapy with aggressive drivers, particularly the more hostile offenders. Similarly, educational efforts need to be mindful of the way that person-related factors appear to influence one’s perception of another driver’s behaviour as aggressive or benign. Those drivers with a predisposition for aggression were more likely to perceive aggression or ‘wrong doing’ in an ambiguous on-road situation and respond with instrumental and/or hostile behaviour, highlighting the importance of perceptual processes in aggressive driving behaviour.

Drinking and driving in Vietnam : perceptions and risk

Road traffic injuries are a major global public health problem but continue to receive inadequate attention. Alcohol influences both risk and consequence of road traffic injury but the scale of the problem is not well understood in many countries. In Vietnam, economic development has brought a substantial increase in the number of registered motorcycles as well as alcohol consumption. Traffic injury is among the leading causes of death in Vietnam but there is little local information regarding alcohol related traffic injuries. The primary goal of this study is to explore the drinking and driving patterns of males and their perceptions towards drink-driving and to determine the relationship between alcohol consumption and road traffic injuries. Furthermore, this thesis aims to present the situation analysis for choosing priority actions to reduce drinking and driving in Vietnam. The study is a combination of two cross-sectional surveys and a pilot study. The pilot study, involving 224 traffic injured patients, was conducted to test the tools and the feasibility of approach methods. In the first survey, male patrons (n=464) were randomly selected at seven restaurants. Face-to-face interviews were conducted when patrons just arrived and breath tests were collected when they were about to leave the restaurant. In the second survey, male patients admitted to hospital following a traffic injury (n=480, of which 414 were motorcycle or bicycle riders) were interviewed and their blood alcohol concentration (BAC) measured by breathalyzer. The results show broadly similar patterns of drinking and driving among male patrons and male traffic injured patients with a high frequency of drinking and drink-driving reported among the majority of the two groups. A high proportion of male patrons were leaving restaurants with a BAC over the legal limit. Factors that significantly associate with the number of drinks and BAC were age, hazardous drinking, frequency of drink-driving in the past year, self-estimated number of drinks consumed to drive legally, perceived family’s disapproval of drink-driving, and perceived legal risk and physical risk. The proportion of patrons and patients with BAC above the legal limit of 0.05 were 86.7% and 60.4% respectively, which was much higher than found in previous studies. In addition, both groups had a high prevalence of BAC over 0.15g/100ml (39.7% of patrons and 45.6% patients), a level that can seriously affect driving capacity. Results from the case-crossover analysis for patients indicate a dose-response relationship between alcohol consumption and the risk of traffic injury. The risk of traffic injury increased when alcohol was consumed before driving and there was a more than 13 fold increase when six or more drinks were consumed. Regarding perceptions towards drinking and driving, findings corroborate the low awareness among males in Vietnam, with a majority of respondents holding a low knowledge of safe and legally permissible alcohol use, and a low perceived risk of drinking and driving. The results also indicate a huge gap in prevention skills in terms of planning ahead or using alternative transport to avoid drink-driving and a perception by patrons and patients of a low rate of disapproval of drink-driving from peers and family. Findings in this study have considerable implications for national policy, injury prevention, clinical practice, reporting systems, and for further research. The low rate of compliance with existing laws and a generally low perceived legal risk toward drink-driving in this study call for the strengthening of enforcement along with mass media campaigns and news coverage in order to decrease the widespread perception of impunity and thereby, to reduce the level of drink-driving. In addition, no significant difference was found in this study on risk of traffic injuries between car drivers and motorcycle drivers. The current inconsistency between legal BAC for drivers of motorcycles, compared to cars, thus needs addressing. Furthermore, as drinking was found to be very common, rather than solely targeting drink-driving, it is important to call for a more strategic and comprehensive approach to alcohol policy in Viet Nam. This study also has considerable implications for clinical practice in terms of screening and brief interventions. Our study suggests that the short form of the AUDIT (AUDIT-C) screening tool is appropriate for use in busy emergency departments. The high proportion of traffic injured patients with evidence of alcohol abuse or hazardous drinking suggests that brief interventions by alcohol and drug counselors in emergency departments are a sensible option to addressing this important problem. The significance of this study is in the combination of the systematic collection of breath test and use of case-crossover design to estimate the risk of traffic injuries after alcohol consumption. The results provide convincing evidence to policy makers, health authorities and the media to help raise community awareness and policy advocacy toward the drinkdriving problem in Vietnam. The findings suggest an urgent need for a multi-sectoral approach to curtail drink-driving in Vietnam, especially programs to raise community awareness and effective legal enforcement. Furthermore, serving as a situation analysis, the thesis should inform the formulation of interventions designed to curtail drinking and driving in Vietnam and other developing countries.