Factors contributing to anxious driving behavior: the role of stress history and accident severity.

Although fear and travel avoidance among anxious drivers are well documented, relatively little is known about the behavior of anxious individuals who continue to drive. Previous research has identified three broad domains of anxious driving behavior: exaggerated safety/caution behaviors, anxiety-based performance deficits, and hostile/aggressive driving behaviors. In an effort to explicate factors associated with the development of anxious driving behavior, associations with objective accident severity, accident-related distress, and life stress history were explored among individuals reporting accident involvement (N=317). Interactive effects of accident distress and self-reported stress history were noted across all three domains of anxious driving behavior. Examination of these effects indicates unique associations between accident distress and anxious behavior only in those reporting more severe life stress. Consistent with contemporary models of anxiety, these data suggest stress history may serve as a general vulnerability factor for development of anxious driving behavior following accident involvement.

Management of psychosocial distress by oncologists.

OBJECTIVE: Little is known about the nature of psychosocial care delivered by oncologists. The goal of this study was to survey oncologists about their management of psychosocial distress, referencing the National Comprehensive Cancer Network guidelines. METHODS: A random sample of 1,000 oncologists were sent an e-mail requesting their participation in an online survey; nonrespondents were sent the survey through postal mail. Regression analyses were conducted to identify independent predictors of care. RESULTS: Forty-six percent (448 of 965) of oncologists responded. Practice locations included: community (63%), cancer center (25%), and hospital (7%). Respondents estimated that over one-third of their patients (mean+/-SD=38%+/-22%) experience psychosocial distress warranting intervention, although only 225 of 447 (50%) indicated having mental health services affiliated with their practice. Nearly half (212 of 447, 47%) reported only initiating a referral for psychosocial services, and 214 of 447 (48%) reported both making a referral and starting psychiatric medications, mainly selective serotonin reuptake inhibitors and benzodiazepines. CONCLUSIONS: Most oncologists delivered some level of psychosocial care, although only half had affiliated mental health services.