Driving anxiety (also called driving phobia) is more common than many people realise, including those suffering from the condition who often suffer in silence or experience considerabel ridicule. Driving anxiety is a "situational phobia" distinguished mainly by the symptoms of fear or anxiety in relation to driving and avoidance of driving either in general or under certain circumstances (such as one freeways).
The role of instigating events
Motor vehicle accident
It may occur as a result of a motor vehicle accident (
Mayou, 2002;
Vingilis, 1996). After an accident about half of drivers reduce their driving behavior, but the effect is generally temporary (
Rajalin & Summala, 1997).
No instigating event
There is a tendency to assume psychological disorders have an instigating event, or to assume an events immediately prior to the onset fo severe symptoms are causal. However many psychological conditions are known to occur without any obvious precipitating conflict, trauma or significant experience. For example: 45% of hoarders do not report any stressful life event before the onset of their maladaptive behavior (Grisham et al, 2006). Many people develop driving anxiety despite never experiencing a motor vehicle accident (
Taylor et al, 2000;
Taylor & Deane, 1999). At this time driving anxiety is still commony assumed to be a learned fear but this assumotion is being considerably undermined as more data is collected (see Poulton & Menzies, 2002). It is possble that diving phobia has more of a evolutionary/biological basis, like the fear of spiders.
Predisposing Factors
Gender
Suffers of driving anxiety are more likely to me female than male (e.g.
Levinson, 1989;
Taylor & Paki, 2008).
Vestibular Function
It has been suggested that individuals with impaired vestibular (inner ear) function might be more likely to develop phobias sich as driving anxiety, due to their increased likelihood if experiencing feelings such as vertigo, nausea and disorientation (
Levinson, 1989)
Measuring driving anxiety
Driving situations can be safely reprodiced using 'virtual reality' and simulators (
Matthews et al, 1998). And driving anxiety can be measured in a range of ways including verbal reports and physiological responses including heart rate, skin conductivity and salivary cortisol (
Alpers et al, 2003).
Treating driving anxiety
There are three general approaches to treatment: Pavlovian, psychoanalysis, and cognitive therapy.
Pavlovian approaches required controlled exposure to the stressful situation. As real driving situation can be uncontrolled and dangerous, virtual reality is being explored as an alternative (
Wald & Turner, 2007;
Mühlberger, 2007). Virtual relaity is defined as a computer generated environment that a person can interact with (
Gorini & Riva, 2008).
References
- Alpers GW et al 2003 Salivary cortisol response during exposure treatment in driving phobics. Psychosomatic Medicine 65:679-687.
- Grisham JR Frost RO Steketee G Kim HJ Hood S 2006 Age of onset of compulsive hoarding' Journal of Anxiety Disorders 20 675-686.
- Mühlberger A, Bülthoff HH, Wiedemann G, Pauli P 2007 Virtual reality for the psychophysiological assessment of phobic fear: responses during virtual tunnel driving. Psychological Assessment 19 340-6.
- Poulton, R & menzies, R.G. (2002). Non-associative fear aquisition: a review of the evidence for retrospective and longitudinal research. Behaviour Research and Therapy 40, 127-149.
Wish I Could Be There: Notes from a Phobic Life by Allen Shawn is a mixture of lay science and psychology with a meandering memoir. 
