Friday, November 8, 2013
Helping GIs shift gears
Members of our armed forces serving in war zones take tremendous risks, even when just driving down a street.
Because of threats from IEDs, snipers, or insurgents waiting to attack, service men and women develop driving habits like running stop signs and swerving wide for any irregularity in the road.
But back home, driving habits that may have saved their lives can put them, and the lives and safety of others, at risk. To help service members returning from deployment readjust, University of Minnesota researcher Erica Stern studies the driving behaviors that many soldiers bring home and suggests ways to help them change those habits.
“For example, when they are deployed, any irregularity in the road could hide an IED, so soldiers swerve 10 feet [to avoid them],” says Stern, an associate professor in the U’s Program in Occupational Therapy, Allied Health Programs. “So returning soldiers tend not to straddle a pothole as we do. Instead, they might change lanes or go onto the shoulder. It’s a high-anxiety situation for them.
“These driving behaviors are adaptive in war zones. They are a logical response to a stressful environment.”
Stern spent several years as a faculty fellow in the Rehabilitation and Reintegration Division of the Office of The Surgeon General of the Army. At the same time, she, along with two graduate students, surveyed the driving behaviors of 150 regional National Guard members who had returned from overseas deployments and 49 never deployed military (mostly ROTC students at the U).
Then, based on the survey results, one group of her advisees researched ideas for interventions and another used these ideas to draft self-help brochures, one for service members (pdf) with driving issues and another for their families (pdf).
Same planet, different worlds
The survey shed plenty of light on the origins of driving issues. For example, soldiers developed behaviors regardless of whether they were usually a driver or a passenger while deployed.
“Everybody in a military vehicle has a responsibility for surveillance, watching for an IED or an insurgent attack,” Stern explains. “So driver and passengers both come back with behaviors.”
Soldiers can come back with quite different issues, says Stern. For example, those whose convoy would barely creep along to avoid being surprised by IEDs may, when driving U.S. roads, become anxious about driving fast because "they can't watch the environment carefully enough." Likewise, a soldier who had to jackrabbit between points A and B in Iraq may become anxious about slow driving back home and be more likely to speed on residential streets.
A common source of stress showed up in comments like “my wife/girlfriend doesn’t understand this.”
“People, even family, may misinterpret the driving behavior,” says Stern. “And service members may not always be clear with their family [about the cause of their driving behavior]. The service member may not even think of it as a problem, because it wasn’t a problem during deployment. So they might, for example, think that taking a ‘slow and go’ approach when gliding through a stop sign is okay at home as long as they don’t get a ticket.”
And often, they don't get tickets. For example, Stern notes, “we found that 10 percent of our sample of returnees had had a warning for a moving violation in the last 30 days.”
In following the progress of returnees across three months, the researchers found that driving behaviors gradually lessened and largely disappeared during that time, although anecdotes indicated that some specific behaviors may persist for 12 months or more. As for driving anxiety, it persisted at a higher level for returnees than for the nondeployed even after 90 days.
Also, the USAA insurance and investment company, which specializes in service members and veterans, reported (pdf) that service members have higher rates of self-reported at-fault crashes during the six months following deployment than during the six months preceding deployment.
Ongoing research—and help
Since completing the regional study, Stern and co-principal investigator Todd Rockwood, an associate professor and expert in survey development and analysis in the School of Public Health's Division of Health Policy and Management, have been carrying out a national survey funded by the Department of Defense. They are comparing the driving behaviors of soldiers who returned from deployment injury-free and soldiers who returned with a traumatic brain injury (TBI) to a control group that has never been deployed. The data are still coming in.
“Our goal is to offer suggestions for treatment,” says Stern. “We have already prepared the skeleton of a brochure for those with TBI.”
Meanwhile, “if service members' problems are significant enough to cause distress, they may want to seek a referral to an occupational therapist for driving. An OT should be able to work on these issues.”
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