Depression and thoughts of self-harm or suicide among gender and sexually diverse people in a regional Australian community.

ISSUES ADDRESSED: There is a paucity of data regarding depression and thoughts of self-harm or suicide among gender and sexually diverse (GSD) people living within Australian regional/rural locations. This study aims to elucidate these issues and fill a critical gap. METHODS: The sample included 91 GSD people from a regional community in South-West Queensland utilising the PHQ-9 to determine presence/severity of depression and self-harm/suicide ideation. These data were drawn from a larger health and wellbeing survey. Raw mean scores were calculated to determine prevalence/severity of clinical symptoms. Bayesian ordinal regression models were employed to analyse between-subgroup differences in depression and self-harm/suicide ideation. RESULTS: Overall, 80.2% of GSD sample experienced depression (35.2% severe, 45.1% mild/moderate) and 41.8% experienced self-harm/suicide ideation in the past two-weeks. Trans and nonbinary people experienced higher levels of depressions than sexually diverse cisgender people. Pansexual and bisexual people experienced higher levels of depression than gay people. Trans people experienced higher prevalence of self-harm/suicide ideation than cisgender and nonbinary people, with no differences between sexuality subgroups. CONCLUSIONS: These findings contribute to deeper and more nuanced insights regarding clinically salient depressive and self-harm/suicide ideation symptoms among trans, nonbinary, bisexual, pansexual and queer people in regional Australian communities, with the aim to ultimately reduce mental health prevalence, improve mental health outcomes and health promotion among GSD people. SO WHAT?: The current findings revealed GSD people experience high prevalence of depression and self-harm/suicide ideation indicating tailored mental health awareness-raising, training and health promotion is warranted to enhance psychological support.

Driving anxiety and anxiolytics while driving: Their impacts on behaviour and cognition behind the wheel.

Introduction: The interaction between road safety and drivers' mental health is an important issue to take into consideration on transportation and safety research. The present review deals specifically with the link between anxiety and driving activity from two complementary points of view. Method: A systematic review into primary studies, following the PRISMA statement, was carried out in four databases: Scopus, Web of Science, Transport Research International Documentation and Pubmed. A total of 29 papers were retained. On the one hand, we present a systematic review of research articles exploring the cognitive and behavioural effects of driving anxiety, regardless its onset, when concerned people have to drive. The second goal of the review is to compile the available literature on the influence of legal drugs, which are used to fight against anxiety, on actual driving tasks. Results: Eighteen papers have been retained for the first question, whose main findings show that exaggerated cautious driving, negative feelings and avoidance are associated with driving anxiety. Most of the conclusions were drawn from self-reported questionnaires and little is known about the effects in situ. Concerning the second question, benzodiazepines are the most studied legal drugs. They affect different attentional processes and could slow reaction times down depending on the population and treatment features. Conclusions: The two standpoints included in the present work allow us to propose some possible lines of research to study certain aspects that have not been explored in depth about people who either feel apprehensive about driving or who drive under the effects of anxiolytics. Practical applications: The study on driving anxiety may be crucial to estimate the consequences for traffic safety. Furthermore, it is relevant to design effective campaigns to raise awareness about the issues discussed. To propose standard evaluations of driving anxiety and exhaustive research works to find out the extent of anxiolytics use are also important to be considered for traffic policies.

Cognitive and body manifestations of driving anxiety according to different onsets.

BACKGROUND: Driving anxiety can have deleterious effects not only on driving behavior, but also on life quality. The interaction between motor vehicle collision (MVC) experiences and driving anxiety has been studied from different standpoints. However, the comparison with other events triggering it has been scarcely considered. Objectives: To analyze the body manifestations and the driving cognitions related to the accident, social and panic concerns in people suffering from different levels of driving anxiety. Method: A total of 260 participants suffering from driving anxiety were included in a survey, including Driving Cognition Questionnaire and Body Sensation Questionnaire. Results: Panic attacks and criticisms are the most relevant onsets of driving anxiety, more than MVC. Only 11.4% of MVC victims considered it as the onset. People with MVC history showed lower scores in social concerns than people without MVC experience and neither the responsibility of the MVC nor the role (driver/passenger) seemed to have an impact on the anxiety level. Conclusions: Although the most relevant body sensations, heart palpitations and sweating, were the same in people with panic attack experiences and MVC victims, a discrimination of the emotions behind the concept of "driving anxiety" is desirable to clarify the psychological effects of different onsets.

Hemodynamic responses to visual cues during attentive listening in autonomous versus manual simulated driving: A pilot study.

Emerging automation technologies could have a strong impact on the allocation of drivers' attentional resources. The first objective of this pilot study is to investigate the hemodynamic responses evoked to relevant visual stimuli in manual and autonomous driving. The second aim is to examine how the inclusion of a secondary task (attentive listening to a broadcast) modulates these hemodynamic responses in both driving situations. Frontal, temporo-parietal and occipital activations were recorded using a functional Near-InfraRed Spectroscopy (fNIRS) system. Event-related analysis was used to determine whether visual cue processing (specifically, the lighting of a lead vehicle's brake-lights) could induce different brain responses depending on the driving mode and on the presence or absence of a competing task. Mind-wandering as reported by the participants was more pronounced during autonomous compared to manual driving. Our results showed an increase in the OxyHb concentration in the right temporo-parietal and occipital areas during manual compared to autonomous driving, suggesting greater allocation of attentional resources for processing visual cues in the first condition. Finally, an event-related decrease in right frontal activity during autonomous driving when listening was observed, suggesting that attentional resources were more focused on the secondary task than on monitoring the driving scene.

Do distinct mind wandering differently disrupt drivers? Interpretation of physiological and behavioral pattern with a data triangulation method.

MW is damaging for tasks requiring sustained and divided attention, for example driving. Recent findings seem to be indicating that off-task thoughts differently disrupt drivers. The present paper delved into characteristics of off-task thoughts to assess their respective detrimental impact on driving. Twenty volunteers had to declare their MW thoughts and get intentionally involved in Problem-Solving Thoughts (PST) according to instructions. Heart rate and oculometric behavior were collected during the two sessions. Results showed that MW and PST led to a fixed gaze. MW might also led to a cognitive effort necessary to switch from task-unrelated to task-related focus. Similarities and differences between intentional and unintentional off-task thoughts were discussed in greater detail. By designing a detection algorithm, it could be possible to detect disruptive MW during risky situations while permitting the mind to wander when the driving demand is low.

Respiration and Heart Rate Modulation Due to Competing Cognitive Tasks While Driving.

Research works on operator monitoring underline the benefit of taking into consideration several signal modalities to improve accuracy for an objective mental state diagnosis. Heart rate (HR) is one of the most utilized systemic measures to assess cognitive workload (CW), whereas, respiration parameters are hardly utilized. This study aims at verifying the contribution of analyzing respiratory signals to extract features to evaluate driver's activity and CW variations in driving. Eighteen subjects participated in the study. The participants carried out two different cognitive tasks requiring different CW demands, a single task as well as a competing cognitive task realized while driving in a simulator. Our results confirm that both HR and breathing rate (BR) increase in driving and are sensitive to CW. However, HR and BR are differently modulated by the CW variations in driving. Specifically, HR is affected by both driving activity and CW, whereas, BR is suitable to evidence a variation of CW only when driving is not required. On the other hand, spectral features characterizing respiratory signal could be also used similarly to HR variability indices to detect high CW episodes. These results hint the use of respiration as an alternative to HR to monitor the driver mental state in autonomic vehicles in order to predict the available cognitive resources if the user has to take over the vehicle.

Digital, analogue, or redundant speedometers for truck driving: Impact on visual distraction, efficiency and usability.

Existing literature does not draw conclusions as to which speedometer type is better for truck driving. A digital speedometer would be more beneficial when obtaining absolute and relative readings, while an analogue speedometer would be more efficient and less distracting when detecting dynamic speed changes. Redundant speedometers, which simultaneously present digital and analogue speedometers, appear increasingly in vehicles, but no information is available on their ergonomic qualities. This study compared three speedometers: digital speedometers, analogue speedometers, and redundant speedometers. This study compared the efficiency, usability and visual distraction measures for all three types of speedometers in a simulated truck driving setting. The task-dependant results were confirmed for the digital and analogue speedometer. The redundant speedometer combined the benefits of each type presented separately, which highlights interesting theoretical and applied implications.

Automotive HMI design and participatory user involvement: review and perspectives.

Automotive human-machine interface (HMI) design is facing new challenges due to the technological advances of the last decades. The design process has to be adapted in order to address human factors and road safety challenges. It is now widely accepted that user involvement in the HMI design process is valuable. However, the current form of user involvement in industry remains at the stages of concept assessment and usability tests. Moreover, the literature in other fields (e.g. information systems) promotes a broader user involvement with participatory design (i.e. the user is fully involved in the development process). This article reviews the established benefits of participatory design and reveals perspectives for automotive HMI quality improvement in a cognitive ergonomic framework. Practitioner Summary: Automotive HMI quality determines, in part, drivers' ability to perform primary driving tasks while using in-vehicle devices. User involvement in the design process is a key point to contribute to HMI quality. This article reports the potential benefits of a broad involvement from drivers to meet automotive HMI design challenges.

Attention and driving performance modulations due to anger state: Contribution of electroencephalographic data.

Driver internal state, including emotion, can have negative impacts on road safety. Studies have shown that an anger state can provoke aggressive behavior and impair driving performance. Apart from driving, anger can also influence attentional processing and increase the benefits taken from auditory alerts. However, to our knowledge, no prior event-related potentials study assesses this impact on attention during simulated driving. Therefore, the aim of this study was to investigate the impact of anger on attentional processing and its consequences on driving performance. For this purpose, 33 participants completed a simulated driving scenario once in an anger state and once during a control session. Results indicated that anger impacted driving performance and attention, provoking an increase in lateral variations while reducing the amplitude of the visual N1 peak. The observed effects were discussed as a result of high arousal and mind-wandering associated with anger. This kind of physiological data may be used to monitor a driver's internal state and provide specific assistance corresponding to their current needs.

The impact of false warnings on partial and full lane departure warnings effectiveness and acceptance in car driving.

In the past, lane departure warnings (LDWs) were demonstrated to improve driving behaviours during lane departures but little is known about the effects of unreliable warnings. This experiment focused on the influence of false warnings alone or in combination with missed warnings and warning onset on assistance effectiveness and acceptance. Two assistance unreliability levels (33 and 17%) and two warning onsets (partial and full lane departure) were manipulated in order to investigate interaction. Results showed that assistance, regardless unreliability levels and warning onsets, improved driving behaviours during lane departure episodes and outside of these episodes by favouring better lane-keeping performances. Full lane departure and highly unreliable warnings, however, reduced assistance efficiency. Drivers' assistance acceptance was better for the most reliable warnings and for the subsequent warnings. The data indicate that imperfect LDWs (false warnings or false and missed warnings) further improve driving behaviours compared to no assistance. Practitioner Summary: This study revealed that imperfect lane departure warnings are able to significantly improve driving performances and that warning onset is a key element for assistance effectiveness and acceptance. The conclusion may be of particular interest for lane departure warning designers.

The restless mind while driving: drivers' thoughts behind the wheel.

UNLABELLED: Recent research has clearly shown that inattention when driving has an indisputable impact on road safety. "Mind wandering" (MW), an inattentional state caused by a shift in attention from the ongoing task to inner thoughts, is not only frequent in everyday activities but also known to impact performance. There is a growing body of research investigating the concept of MW, suggesting potential causes that could foster such a phenomenon. Only one epidemiological study has focused on this issue in a critical driving context (Galéra et al., 2012), and it revealed the harmful effects of MW in increasing the risk of a car crash. Experimental studies rather consider that driver would adduce in MW (Lemercier et al., 2014). When the driving context is too hard or the thought too difficult to proceed, driver reduced their MW. The aim of this paper is to examine this issue using the most recent trip of ordinary drivers whose MW state did not lead to a road accident. Using a questionnaire, information was collected about the participants' most recent trip as a driver, including: (1) personal characteristics, (2) context in which MW occurs, (3) awareness of MW episodes and finally (4) characteristics of the thoughts. RESULTS: revealed that MW affected 85.2% of the drivers, who spent on average 34.74% of their trip in a MW state. Moreover, we found that the contexts which favor MW are situations in which less of the driver's attention is needed to drive, such as familiar commutes, monotonous motorways or by-passes, or when drivers were alone in their cars. In these MW situations, the drivers quickly became aware of their MW episodes. Thoughts tend to involve neutral private concerns, related to present- or future-oriented content. Our findings suggest that MW is a functional state aiming to solve current problems. Future investigations should focus on this critical concept of MW when driving, both to identify safety issues and to provide suitable solutions for drivers subject to a wandering mind.

Assessing the Impact of Anger State on the Three Attentional Networks with the ANT-I.

Anger is a negative and highly aroused emotion. Previous research has revealed that a high level of arousal can induce the participant in a physical preparation and self-awareness. The aim of this research was to study the influence of anger on the attentional network using the Attention Network Test-Interactions (ANT-I). This test has been developed in order to assess 3 attentional networks: alerting, orienting, and executive control. Here, participants were induced in anger using the autobiographic recall procedure or in a neutral mood before the realization of the ANT-I. As expected, the results showed a better alerting score for the angry group. The possible origin of this alerting gain related to the high level of arousal is discussed. The results obtained should enlighten the interaction between emotion and the functioning of the attentional system. They also may be relevant for applied fields related to anger.

Distraction and driving: results from a case-control responsibility study of traffic crash injured drivers interviewed at the emergency room.

BACKGROUND: Use of cellular phones has been shown to be associated with crashes but many external distractions remain to be studied. OBJECTIVE: To assess the risk associated with diversion of attention due to unexpected events or secondary tasks at the wheel. DESIGN: Responsibility case-control study. SETTING: Adult emergency department of the Bordeaux University Hospital (France) from April 2010 to August 2011. PARTICIPANTS: 955 injured drivers presenting as a result of motor vehicle crash. MAIN OUTCOME MEASURES: The main outcome variable was responsibility for the crash. Exposures were external distraction, alcohol use, psychotropic medicine use, and sleep deprivation. Potential confounders were sociodemographic and crash characteristics. RESULTS: Beyond classical risk factor found to be associated with responsibility, results showed that distracting events inside the vehicle (picking up an object), distraction due to driver activity (smoking) and distracting events occurring outside were associated with an increased probability of being at fault. These distraction-related factors accounted for 8% of injurious road crashes. LIMITATIONS: Retrospective responsibility self-assessment. CONCLUSIONS: Diverted attention may carry more risk than expected. Our results are supporting recent research efforts to detect periods of driving vulnerability related to inattention.

Effectiveness of a Forward Collision Warning System in simple and in dual task from an electrophysiological perspective.

Forward Collision Warning Systems (FCWS) are expected to assist drivers; however, it is not completely clear whether these systems are of benefit to distracted drivers as much as they are to undistracted drivers. This study aims at investigating further the analysis of the effectiveness of a surrogate FCWS according to the attentional state of participants. In this experiment electrophysiological and behavioural data were recording while participants were required to drive in a simple car simulator and to react to the braking of the lead vehicle which could be announced by a warning system. The effectiveness of this warning system was evaluated when drivers were distracted or not by a secondary cognitive task. In a previous study, the warning signal was not completely effective likely due to the presence of another predictor of the forthcoming braking which competes with the warning. By eliminating this secondary predictor in the present study, the results confirmed the negative effect of the secondary task and revealed the expected effectiveness of the warning system at behavioural and electrophysiological levels.

Impact of totally and partially predictive alert in distracted and undistracted subjects: An event related potential study.

Rear-end collisions represent about 30% of all car crashes and generate a significant economic cost for society. Driver inattention has been identified as the most important contributing factor in rear-end collisions. One possible countermeasure is the use of systems that warn drivers of potential collisions. Nevertheless, because of technical constraints, the conception of perfect warning systems is difficult to achieve and technical literature shows that these kinds of systems can be prone to false alerts or misses. The main objective of this study is to assess the impact of such a warning system on the processing of a relevant driving visual cue while taking into account the reliability of the system and the attentional state of the participants. For this, we designed a laboratory experiment during which we recorded behavioral data and brain activity (event related potential, ERP) following the detection of a visual target. Three warning conditions were designed: (1) no alert was presented before the visual target; (2) an auditory alert was presented before each target; (3) an alert was presented before the target in 70% of the trials (15% only had the alert without the target, and 15% only had the target without the alert). In addition, participants had to perform this visual detection task either alone (simple task) or with a concurrent problem-solving task (dual task). Behavioral and electrophysiological data contribute to revealing (1) that there is a behavioral gain induced by the alert and (2) that this gain is at least linked with a time-saving aspect at both the sensory and cognitive stages of neural information processing. Nevertheless, this impact depends on the attentional states of the participant and on the reliability of the alert.

Mind wandering and driving: responsibility case-control study.

OBJECTIVE: To assess the association between mind wandering (thinking unrelated to the task at hand) and the risk of being responsible for a motor vehicle crash. DESIGN: Responsibility case-control study. SETTING: Adult emergency department of a university hospital in France, April 2010 to August 2011. PARTICIPANTS: 955 drivers injured in a motor vehicle crash. MAIN OUTCOME MEASURES: Responsibility for the crash, mind wandering, external distraction, negative affect, alcohol use, psychotropic drug use, and sleep deprivation. Potential confounders were sociodemographic and crash characteristics. RESULTS: Intense mind wandering (highly disrupting/distracting content) was associated with responsibility for a traffic crash (17% (78 of 453 crashes in which the driver was thought to be responsible) v 9% (43 of 502 crashes in which the driver was not thought to be responsible); adjusted odds ratio 2.12, 95% confidence interval 1.37 to 3.28). CONCLUSIONS: Mind wandering while driving, by decoupling attention from visual and auditory perceptions, can jeopardise the ability of the driver to incorporate information from the environment, thereby threatening safety on the roads.

An electrophysiological study of the impact of a Forward Collision Warning System in a simulator driving task.

Driver distraction has been identified as the most important contributing factor in rear-end collisions. In this context, Forward Collision Warning Systems (FCWS) have been developed specifically to warn drivers of potential rear-end collisions. The main objective of this work is to evaluate the impact of a surrogate FCWS and of its reliability according to the driver's attentional state by recording both behavioral and electrophysiological data. Participants drove following a lead motorcycle in a simplified simulator with or without a warning system which gave forewarning of the preceding vehicle braking. Participants had to perform this driving task either alone (simple task) or simultaneously with a secondary cognitive task (dual task). Behavioral and electrophysiological data contributed to revealing a positive effect of the warning system. Participants were faster in detecting the brake light when the system was perfect or imperfect, and the time and attentional resources allocation required for processing the target at higher cognitive level were reduced when the system was completely reliable. When both tasks were performed simultaneously, warning effectiveness was considerably affected at both performance and neural levels; however, the analysis of the brain activity revealed fewer differences between distracted and undistracted drivers when using the warning system. These results show that electrophysiological data could be a valuable tool to complement behavioral data and to have a better understanding of how these systems impact the driver.

Attentional demand and processing of relevant visual information during simulated driving: a MEG study.

It is a well-known fact that attention is crucial for driving a car. This innovative study aims to assess the impact of attentional workload modulation on cerebral activity during a simulated driving task using magnetoencephalography (MEG). A car simulator equipped with a steering wheel, turn indicators, an accelerator and a brake pedal has been specifically designed to be used with MEG. Attentional demand has been modulated using a radio broadcast. During half of the driving scenarios, subjects could ignore the broadcast (simple task, ST) and during the other half, they had to actively listen to it in order to answer 3 questions (dual task, DT). Evoked magnetic responses were computed in both conditions separately for two visual stimuli of interest: traffic lights (from green to amber) and direction signs (arrows to the right or to the left) shown on boards. The cortical sources of these activities have been estimated using a minimum-norm current estimates modeling technique. Results show the activation of a large distributed network similar in ST and DT and similar for both the traffic lights and the direction signs. This network mainly involves sensory visual areas as well as parietal and frontal regions known to play a role in selective attention and motor areas. The increase of attentional demand affects the neuronal processing of relevant visual information for driving, as early as the perceptual stage. By demonstrating the feasibility of recording MEG activity during an interactive simulated driving task, this study opens new possibilities for investigating issues regarding drivers' activity.

Is the auditory sensory memory sensitive to visual information?

The mismatch negativity (MMN) component of auditory event-related brain potentials can be used as a probe to study the representation of sounds in auditory sensory memory (ASM). Yet it has been shown that an auditory MMN can also be elicited by an illusory auditory deviance induced by visual changes. This suggests that some visual information may be encoded in ASM and is accessible to the auditory MMN process. It is not known, however, whether visual information affects ASM representation for any audiovisual event or whether this phenomenon is limited to specific domains in which strong audiovisual illusions occur. To highlight this issue, we have compared the topographies of MMNs elicited by non-speech audiovisual stimuli deviating from audiovisual standards on the visual, the auditory, or both dimensions. Contrary to what occurs with audiovisual illusions, each unimodal deviant elicited sensory-specific MMNs, and the MMN to audiovisual deviants included both sensory components. The visual MMN was, however, different from a genuine visual MMN obtained in a visual-only control oddball paradigm, suggesting that auditory and visual information interacts before the MMN process occurs. Furthermore, the MMN to audiovisual deviants was significantly different from the sum of the two sensory-specific MMNs, showing that the processes of visual and auditory change detection are not completely independent.

Task-dependent activation latency in human visual extrastriate cortex.

Event related potentials (ERPs) were recorded from subjects who had to perform either an identification task or a simple detection task on moving visual stimuli. Results showed that the amplitude of the so-called visual "N1" component was larger for identification than for mere detection, replicating previous data obtained with static stimuli. However, we also found that: (i) the onset, peak and offset latencies of the visual N1 to dynamic stimuli were significantly earlier in the detection task than in the identification task, and (ii) in both conditions, the coordinates of the equivalent current dipoles best explaining the visual N1 component were consistent with those of the human motion visual area MT+/V5 in the extrastriate cortex. Altogether, these results indicate that dynamic stimuli may activate (at least partly) different pathways and processes in extrastriate cortex according to the nature of the task required on these stimuli.