Temporal Dashboard Gaze Variance (TDGV) Changes for Measuring Cognitive Distraction While Driving.

A difficult challenge for today's driver monitoring systems is the detection of cognitive distraction. The present research presents the development of a theory-driven approach for cognitive distraction detection during manual driving based on temporal control theories. It is based solely on changes in the temporal variance of driving-relevant gaze behavior, such as gazes onto the dashboard (TDGV). Validation of the detection method happened in a field and in a simulator study by letting participants drive, alternating with and without a secondary task inducing external cognitive distraction (auditory continuous performance task). The general accuracy of the distraction detection method varies between 68% and 81% based on the quality of an individual prerecorded baseline measurement. As a theory-driven system, it represents not only a step towards a sophisticated cognitive distraction detection method, but also explains that changes in temporal dashboard gaze variance (TDGV) are a useful behavioral indicator for detecting cognitive distraction.

Emergency Braking Evoked Brain Activities during Distracted Driving.

Electroencephalogram (EEG) was used to analyze the mechanisms and differences in brain neural activity of drivers in visual, auditory, and cognitive distracted vs. normal driving emergency braking conditions. A pedestrian intrusion emergency braking stimulus module and three distraction subtasks were designed in a simulated experiment, and 30 subjects participated in the study. The common activated brain regions during emergency braking in different distracted driving states included the inferior temporal gyrus, associated with visual information processing and attention; the left dorsolateral superior frontal gyrus, related to cognitive decision-making; and the postcentral gyrus, supplementary motor area, and paracentral lobule associated with motor control and coordination. When performing emergency braking under different driving distraction states, the brain regions were activated in accordance with the need to process the specific distraction task. Furthermore, the extent and degree of activation of cognitive function-related prefrontal regions increased accordingly with the increasing task complexity. All distractions caused a lag in emergency braking reaction time, with 107.22, 67.15, and 126.38 ms for visual, auditory, and cognitive distractions, respectively. Auditory distraction had the least effect and cognitive distraction the greatest effect on the lag.

Evaluating Driver Features for Cognitive Distraction Detection and Validation in Manual and Level 2 Automated Driving.

OBJECTIVE: This study aimed to investigate the impacts of feature selection on driver cognitive distraction (CD) detection and validation in real-world nonautomated and Level 2 automated driving scenarios. BACKGROUND: Real-time driver state monitoring is critical to promote road user safety. METHOD: Twenty-four participants were recruited to drive a Tesla Model S in manual and Autopilot modes on the highway while engaging in the N-back task. In each driving mode, CD was classified by the random forest algorithm built on three "hand-crafted" glance features (i.e., percent road center [PRC], the standard deviation of gaze pitch, and yaw angles), or through a large number of features that were transformed from the output of a driver monitoring system (DMS) and other sensing systems. RESULTS: In manual driving, the small set of glance features was as effective as the large set of machine-generated features in terms of classification accuracy. Whereas in Level 2 automated driving, both glance and vehicle features were less sensitive to CD. The glance features also revealed that the misclassified driver state was the result of the dynamic fluctuations and individual differences of cognitive loads under CD. CONCLUSION: Glance metrics are critical for the detection and validation of CD in on-road driving. APPLICATIONS: The paper suggests the practical value of human factors domain knowledge in feature selection and ground truth validation for the development of driver monitoring technologies.

Distraction by a cognitive task has a higher impact on electrophysiological measures compared with conditioned pain modulation.

BACKGROUND: Conditioned pain modulation (CPM) evaluates the effect of a painful conditioning stimulus (CS) on a painful test stimulus (TS). Using painful cutaneous electrical stimulation (PCES) as TS and painful cold water as CS, the pain relief was paralleled by a decrease in evoked potentials (PCES-EPs). We now aimed to compare the effect of CPM with cognitive distraction on PCES-induced pain and PCES-EP amplitudes. METHODS: PCES was performed using surface electrodes inducing a painful sensation of 60 (NRS 0-100) on one hand. In a crossover design healthy subjects (included: n = 38, analyzed: n = 23) immersed the contralateral hand into 10 °C cold water (CS) for CPM evaluation and performed the 1-back task for cognitive distraction. Before and during the CS and 1-back task, respectively, subjects rated the pain intensity of PCES and simultaneously cortical evoked potentials were recorded. RESULTS: Both CPM and cognitive distraction significantly reduced PCES-EP amplitudes (CPM: 27.6 ± 12.0 µV to 20.2 ± 9.5 µV, cognitive distraction: 30.3 ± 14.2 µV to 13.6 ± 5.2 µV, p < 0.001) and PCES-induced pain (on a 0-100 numerical rating scale: CPM: 58 ± 4 to 41.1 ± 12.3, cognitive distraction: 58.3 ± 4.4 to 38.0 ± 13.0, p < 0.001), though the changes in pain intensity and PCES-amplitude did not correlate. The changes of the PCES-EP amplitudes during cognitive distraction were more pronounced than during CPM (p = 0.001). CONCLUSIONS: CPM and cognitive distraction reduced the PCES-induced pain to a similar extent. The more pronounced decrease of PCES-EP amplitudes after distraction by a cognitive task implies that both conditions might not represent the general pain modulatory capacity of individuals, but may underlie different neuronal mechanisms with the final common pathway of perceived pain reduction.

Research on a Cognitive Distraction Recognition Model for Intelligent Driving Systems Based on Real Vehicle Experiments.

The accurate and prompt recognition of a driver's cognitive distraction state is of great significance to intelligent driving systems (IDSs) and human-autonomous collaboration systems (HACSs). Once the driver's distraction status has been accurately identified, the IDS or HACS can actively intervene or take control of the vehicle, thereby avoiding the safety hazards caused by distracted driving. However, few studies have considered the time-frequency characteristics of the driving behavior and vehicle status during distracted driving for the establishment of a recognition model. This study seeks to exploit a recognition model of cognitive distraction driving according to the time-frequency analysis of the characteristic parameters. Therefore, an on-road experiment was implemented to measure the relative parameters under both normal and distracted driving via a test vehicle equipped with multiple sensors. Wavelet packet analysis was used to extract the time-frequency characteristics, and 21 pivotal features were determined as the input of the training model. Finally, a bidirectional long short-term memory network (Bi-LSTM) combined with an attention mechanism (Atten-BiLSTM) was proposed and trained. The results indicate that, compared with the support vector machine (SVM) model and the long short-term memory network (LSTM) model, the proposed model achieved the highest recognition accuracy (90.64%) for cognitive distraction under the time window setting of 5 s. The determination of time-frequency characteristic parameters and the more accurate recognition of cognitive distraction driving achieved in this work provide a foundation for human-centered intelligent vehicles.

Classification of Driver Distraction: A Comprehensive Analysis of Feature Generation, Machine Learning, and Input Measures.

OBJECTIVE: The objective of this study was to analyze a set of driver performance and physiological data using advanced machine learning approaches, including feature generation, to determine the best-performing algorithms for detecting driver distraction and predicting the source of distraction. BACKGROUND: Distracted driving is a causal factor in many vehicle crashes, often resulting in injuries and deaths. As mobile devices and in-vehicle information systems become more prevalent, the ability to detect and mitigate driver distraction becomes more important. METHOD: This study trained 21 algorithms to identify when drivers were distracted by secondary cognitive and texting tasks. The algorithms included physiological and driving behavioral input processed with a comprehensive feature generation package, Time Series Feature Extraction based on Scalable Hypothesis tests. RESULTS: Results showed that a Random Forest algorithm, trained using only driving behavior measures and excluding driver physiological data, was the highest-performing algorithm for accurately classifying driver distraction. The most important input measures identified were lane offset, speed, and steering, whereas the most important feature types were standard deviation, quantiles, and nonlinear transforms. CONCLUSION: This work suggests that distraction detection algorithms may be improved by considering ensemble machine learning algorithms that are trained with driving behavior measures and nonstandard features. In addition, the study presents several new indicators of distraction derived from speed and steering measures. APPLICATION: Future development of distraction mitigation systems should focus on driver behavior-based algorithms that use complex feature generation techniques.

Does Pregnancy Play a Role? Association of Body Dissatisfaction, Body Appearance Cognitive Distraction, and Sexual Distress.

INTRODUCTION: Pregnancy is characterized by physical, hormonal, and psychological changes that can affect women's sexuality, and, for those who are in a dyadic relationship, it also affects the couple's sexual relationship. On the other hand, the pregnancy state can function as a protective factor for body dissatisfaction as women embrace a new phase of the life cycle when body changes, namely more body volume, are expected. AIM: To examine whether the effect of body dissatisfaction on sexual distress is mediated by cognitive distraction with the appearance of the body and to test a moderated mediation model of the impact of body dissatisfaction on sexual distress, with pregnancy used as the moderating factor. METHODS: In this cross-sectional study, 87 cisgender heterosexual women (50.6% pregnant; n = 44), aged between 25 and 40 years old (mean = 31.93; SD = 3.46) involved in an exclusive and committed dyadic relationship completed a web-based questionnaire. MAIN OUTCOME MEASURES: Validated measures consisted of a validated general measure of body dissatisfaction (global body dissatisfaction scale), sexual distress (adapted from the National Survey of Sexual Attitudes and Lifestyles), and cognitive distraction based on body appearance during sexual activity (body appearance cognitive distraction scale). RESULTS: Results indicated that body dissatisfaction and sexual distress are related, but they are fully mediated by cognitive distraction. The mediation effect of cognitive distraction did not differ significantly by pregnancy status, after controlling for the trimester of pregnancy. CLINICAL IMPLICATIONS: This study advances our understanding of sexuality during pregnancy by evaluating sexual distress and establishing that it is a clinically relevant variable related to body dissatisfaction that deserves attention from healthcare providers. STRENGTH & LIMITATIONS: This preliminary study uses a robust method of data analysis to test a theory-based cognitive model of sexual distress in pregnant women; however, no causality can be established. CONCLUSION: The data highlights that pregnancy may not be a protective factor for the impact of body dissatisfaction on sexual distress. Pascoal PM, Rosa PJ, Coelho S. Does Pregnancy Play a Role? Association of Body Dissatisfaction, Body Appearance Cognitive Distraction, and Sexual Distress. J Sex Med 2019;16:551-558.

Detection-Response Task-Uses and Limitations.

The Detection-Response Task is a method for assessing the attentional effects of cognitive load in a driving environment. Drivers are presented with a sensory stimulus every 3-5 s, and are asked to respond to it by pressing a button attached to their finger. Response times and hit rates are interpreted as indicators of the attentional effect of cognitive load. The stimuli can be visual, tactile and auditory, and are chosen based on the type of in-vehicle system or device that is being evaluated. Its biggest disadvantage is that the method itself also affects the driver's performance and secondary task completion times. Nevertheless, this is an easy to use and implement method, which allows relevant assessment and evaluation of in-vehicle systems. By following the recommendations and taking into account its limitations, researchers can obtain reliable and valuable results on the attentional effects of cognitive load on drivers.

Impaired laparoscopic performance of novice surgeons due to phone call distraction: a single-centre, prospective study.

BACKGROUND: Distractions such as phone calls during laparoscopic surgery play an important role in many operating rooms. The aim of this single-centre, prospective study was to assess if laparoscopic performance is impaired by intraoperative phone calls in novice surgeons. METHODS: From October 2015 to June 2016, 30 novice surgeons (medical students) underwent a laparoscopic surgery training curriculum including two validated tasks (peg transfer, precision cutting) until achieving a defined level of proficiency. For testing, participants were required to perform these tasks under three conditions: no distraction (control) and two standardised distractions in terms of phone calls requiring response (mild and strong distraction). Task performance was evaluated by analysing time and accuracy of the tasks and response of the phone call. RESULTS: In peg transfer (easy task), mild distraction did not worsen the performance significantly, while strong distraction was linked to error and inefficiency with significantly deteriorated performance (P < 0.05). Precision cutting (difficult task) was not slowed down by mild distraction, but surgical and cognitive errors were significantly increased when participants were distracted (P < 0.05). Compared to mild distraction, participants reported a more severe subjective disturbance when they were diverted by strong distraction (P < 0.05). CONCLUSION: Our data reveals that phone call distractions result in impaired laparoscopic performance under certain circumstances. To ensure patient safety, phone calls should be avoided as far as possible in operating rooms.

Beliefs About Appearance, Cognitive Distraction and Sexual Functioning in Men and Women: A Mediation Model Based on Cognitive Theory.

INTRODUCTION: Dysfunctional beliefs about body appearance and cognitive distraction from body appearance during sexual activity have been associated with sexual problems, particularly in women. However, there are no studies examining the interplay between these dimensions and the mechanisms by which they affect sexual functioning. AIM: To examine the mediating role of cognitive distraction with body appearance on the relation between beliefs about appearance and sexual functioning. METHODS: The study sample consisted of 426 heterosexual participants (129 men and 297 women) involved in an exclusive dyadic committed relationship who answered an online questionnaire. MAIN OUTCOME MEASURES: The Body Appearance Cognitive Distraction Scale, the Beliefs About Appearance Scale, the International Index of Erectile Function, and the Female Sexual Function Index. RESULTS: The findings indicated that cognitive distraction with body appearance fully mediated the relation between beliefs about appearance and sexual functioning in men and women. CONCLUSION: The results support the role of beliefs about appearance and cognitive distraction based on body appearance in predicting sexual functioning, reaffirming the role of cognitive models in explaining sexual functioning in men and women.

Evaluation of Strategies for Integrated Classification of Visual-Manual and Cognitive Distractions in Driving.

BACKGROUND: Prior studies have demonstrated unique driver behavior outcomes when visual and cognitive distraction occurs simultaneously as compared to the occurrence of one form of distraction alone. This situation implies additional complexity for the design of robust distraction detection systems and vehicle automation for hazard mitigation. OBJECTIVE: This study evaluated the effectiveness of two distraction classification strategies: (a) a "two-stage" classifier, first detecting visual-manual distraction and then identifying dual or cognitive distraction states, and (b) a "direct-mapping" classifier developed to identify all distraction states at the same time. METHOD: Driving performance data were collected on 20 participants under different known states of distraction (none, visual-manual, cognitive, and combined). A support vector machine (SVM) was used as a base algorithm for both classifiers and performance data as well as the level of driving control (tactical and operational), which served as inputs and modifiers to the classification process. RESULTS: The two-stage strategy was found to be sensitive for identifying states of visual-manual distraction; however, the strategy also produced a higher false alarm rate than direct-mapping. Consideration of driving control levels during classification also improved classification accuracy. Future work needs to account for strategic levels of vehicle control.

Driven to Distraction.

We address several themes that emerged in the commentaries related to our target article. First, we consider the relationship between cognitive distraction and crash risk. Second, we discuss the development of our cognitive distraction scale. Third, we weigh issues of self-regulation, appropriate baselines, and satisficing. Finally, we identify several areas where additional research is needed to refine our understanding of driver distraction and crash risk.

Assessing Cognitive Distraction in the Automobile.

OBJECTIVE: The objective was to establish a systematic framework for measuring and understanding cognitive distraction in the automobile. BACKGROUND: Driver distraction from secondary in-vehicle activities is increasingly recognized as a significant source of injuries and fatalities on the roadway. METHOD: Across three studies, participants completed eight in-vehicle tasks commonly performed by the driver of an automobile. Primary, secondary, subjective, and physiological measures were collected and integrated into a cognitive distraction scale. RESULTS: In-vehicle activities, such as listening to the radio or an audio book, were associated with a low level of cognitive workload; the conversation activities of talking to a passenger in the vehicle or conversing with a friend on a handheld or hands-free cell phone were associated with a moderate level of cognitive workload; and using a speech-to-text interfaced e-mail system involved a high level of cognitive workload. CONCLUSION: The research established that there are significant impairments to driving that stem from the diversion of attention from the task of operating a motor vehicle and that the impairments to driving are directly related to the cognitive workload of these in-vehicle activities. Moreover, the adoption of voice-based systems in the vehicle may have unintended consequences that adversely affect traffic safety. APPLICATION: These findings can be used to help inform scientifically based policies on driver distraction, particularly as they relate to cognitive distraction stemming from the diversion of attention to other concurrent activities in the vehicle.

Anthropogenic noise interacts with the predation risk assessment in a free-ranging bird.

Anthropogenic noise can affect a number of behavioral, physiological, and ecological aspects of animals from major taxonomic groups, raising serious conservation concerns. For example, noise pollution impacts communicative behavior and perception of signals, movements and distribution, as well as predator-prey interactions, such as hunting success or predator detection and predation risk assessment. We have carried out an experimental playback study, in which we investigated whether exposure to anthropogenic noise (sound of a tractor) distracts free-ranging barn swallows Hirundo rustica from paying attention to an approaching human "predator" (the "cognitive distraction" hypothesis), or whether noise leads to increased responsiveness to this "predator" (the "increased threat" hypothesis). The subjects were male barn swallows attending their breeding territories during the time when the females were incubating. We found that barn swallow males initiated flight at significantly greater distances to the approaching human "predator" in the noise treatment than during the quiet control trials. These results suggest that anthropogenic noise causes increased vigilance and reactivity rather than a distraction, enabling birds to avoid the "predator" more quickly. We further discuss the mechanism behind the increased alertness in response to noise and contrast the "increased threat" mechanism, usually tested in previous studies, with an alternative "cognitive sensitization" mechanism.

Associations between body mass index and episodic memory for recent eating, mindful eating, and cognitive distraction: A cross-sectional study.

Objectives: Eating while distracted has been associated with a higher body mass index (BMI), whereas mindful eating and episodic memory for recent eating have shown the opposite pattern. This pre-registered, global study (https://osf.io/rdjzk) compared the relative association between these variables (and four "positive controls": restraint, disinhibition, emotional eating, plate clearing) and self-reported BMI. The timing of data collection (April-May 2020) during the SARS-CoV-2 pandemic enabled an investigation of the impact of stay-at-home restrictions imposed on the UK population on the measures of eating behavior. Methods: An online survey was completed, including: (i) demographic data (e.g., self-reported BMI), (ii) Likert ratings assessing episodic memory for recent eating, mindful eating, cognitive distraction, restrained eating, emotional eating, disinhibition and plate clearing over the last 12 months and the last 7 days (during the first UK COVID-19 lockdown), and (iii) the Mindful Eating Questionnaire (MEQ). Results: A large adult sample participated (N = 846; mean (SD) age = 33.0 (14.3) years; mean (SD) BMI = 24.6 (5.6) kg/m2). Mindful eating (MEQ-total score) was associated with a lower self-reported BMI (ß = -0.12; 95% CI = -0.20, -0.04; p = 0.004), whereas disinhibited eating was associated with a higher self-reported BMI (ß = 0.30; 95% CI = 0.21, 0.38; p < 0.001). In UK participants (n = 520), consistent changes in eating behavior during lockdown were not found. For those that did experience change, decreases were reported in; emotional eating, disinhibited eating, focusing on taste during a meal (a measure of mindful eating), and using a smart phone while eating. Conclusions: These findings provide evidence in a large global sample for associations between BMI and (i) mindful eating, and (ii) disinhibited eating. Future research should evaluate whether mindful eating demonstrates a prospective association with body weight and should consider mechanisms of action.

Noisy condition and three-point shot performance in skilled basketball players: the limited effect of self-talk.

In modern basketball, the three-point shot plays an important tactical role. Basketball players often face the distraction from audience and opponents, necessitating psychological skill to maintain their performance. The study examined the effects of self-talk interventions on the three-point shot performance under quiet and noisy conditions. It involved 42 national second-level basketball players and used a 2 (Condition: quiet condition, noisy condition) × 3 (Intervention: control group, motivational self-talk, instructional self-talk) mixed design to investigate the performance of the static and dynamic three-point shots tasks. The results revealed that the static three-point shot score was significantly lower in noisy condition compared to quiet condition (p = 0.016), while the main effect of Intervention and the interaction effect of Condition × Intervention were not significant. Post-hoc analysis indicated that only the control group showed significantly lower scores in the noisy condition (p = 0.043). For the dynamic three-point shots performance, there were no significant main effects of Intervention or Condition, nor any significant interaction effect between Condition and Intervention. In conclusion, noise distraction negatively affects the static three-point shots task, and although self-talk interventions can mitigate such negative effects, their effectiveness is limited for dynamic three-point shots task with high physical demands.

Body Dissatisfaction, Cognitive Distraction, and Sexual Satisfaction in a Sample of LGB+ People: A Mediation Study Framed by Cognitive Psychology Models of Sexual Response.

Introduction: Body dissatisfaction is a well-established risk factor for emotional problems and low levels of well-being indicators, such as sexual health. Cognitive models propose that dissatisfaction with one's body can cause cognitive distraction related to physical appearance during sexual activity. This may compromise sexual response, namely, sexual satisfaction in heterosexual cis women. However, this relationship has only been studied within heterosexual samples. The present study aims to test a mediation model using cognitive distraction related to body appearance during sexual activity as a mediator between body dissatisfaction and sexual satisfaction in LGB+ cis people (lesbian, gay, bisexual, and other minority sexual orientations). Methods: This cross-sectional online study comprised 165 cisgender LGB+ participants (n = 67 cis women, 40.6%; n = 98 cis men, 59.4%). Self-report questionnaires were used: the Global Body Dissatisfaction Scale, the Body Appearance Distraction Scale, and a Single-Item Measure of Sexual Satisfaction. Results: Cis women and cis men experience similar levels of body dissatisfaction, cognitive distraction with body appearance during sexual activity, and sexual satisfaction. Body appearance cognitive distraction during sexual activity mediated the relationship between body dissatisfaction and sexual satisfaction only in the men's sample. Discussion: Overall, in terms of gender and body dissatisfaction, our results reveal a reversed pattern than those found in heterosexual samples. This may be because LGB+ cis women may conform less to societal pressure, leading to less meaning given to body dissatisfaction in relation to sexuality, which may lead to more positive sexual outcomes. Likewise, LGB+ cis men present higher body dissatisfaction and experience lower sexual satisfaction, possibly due to the emphasis on physical appearance in the gay subculture. The results confirm the validity of cognitive models of sexual response.

Eyes on the road: brain computer interfaces and cognitive distraction in traffic.

Novel wearable neurotechnology is able to provide insight into its wearer's cognitive processes and offers ways to change or enhance their capacities. Moreover, it offers the promise of hands-free device control. These brain-computer interfaces are likely to become an everyday technology in the near future, due to their increasing accessibility and affordability. We, therefore, must anticipate their impact, not only on society and individuals broadly but also more specifically on sectors such as traffic and transport. In an economy where attention is increasingly becoming a scarce good, these innovations may present both opportunities and challenges for daily activities that require focus, such as driving and cycling. Here, we argue that their development carries a dual risk. Firstly, BCI-based devices may match or further increase the intensity of cognitive human-technology interaction over the current hands-free communication devices which, despite being widely accepted, are well-known for introducing a significant amount of cognitive load and distraction. Secondly, BCI-based devices will be typically harder than hands-free devices to both visually detect (e.g., how can law enforcement check when these extremely small and well-integrated devices are used?) and restrain in their use (e.g., how do we prevent users from using such neurotechnologies without breaching personal integrity and privacy?). Their use in traffic should be anticipated by researchers, engineers, and policymakers, in order to ensure the safety of all road users.

Measuring the effects of mind wandering in people with insomnia: A driving simulator study.

Purpose: Studies have shown that individuals with insomnia experience more frequent and longer episodes of mind wandering (MW) while driving. However, the effect of the interaction between insomnia and MW on driving behavior is not fully understood. This study aimed to gain deeper insights into the relationships among insomnia, MW, and driving behavior. Patients and methods: Forty-two participants (21 diagnosed with insomnia and 21 controls) were recruited, and subjective sleep quality and cognitive function were assessed. A driving simulator experiment with a within-subject design was performed, involving two distraction tasks (no-distraction task versus MW task) and two driving scenarios (lane-keeping versus lane-changing). Results: In the lane-keeping scenario, there was no significant between-group difference (people with insomnia and controls) in longitudinal driving performance for the no-distraction task, although the interaction between MW and insomnia significantly increased drivers' longitudinal control variation. Correlation analysis confirmed that longitudinal driving performance was positively correlated with sleep quality and the cognitive level. Unlike longitudinal driving performance, lateral driving performance was significantly weaker in people with insomnia than in controls under both distraction tasks. In the lane-changing scenario, although there was no between-group difference in driving performance, the MW task led to significant changes in driving performance within each group compared with the no-distraction task, and these findings were associated with cognitive function, but not with sleep quality. Conclusion: These findings show that insomnia and MW combined can lead to reduced driving performance. Further research is needed to elucidate the factors that influence this phenomenon.

Impacts of visual and cognitive distractions and time pressure on pedestrian crossing behaviour: A simulator study.

Distractions have been recognised as one important factor associated with pedestrian injuries, as the increasing use of cell phones and personal devices. However, the situation is less clear regarding the differences in the effects of visual-manual and auditory-cognitive distractions. Here, we investigated distracted pedestrians in a one-lane road with continuous traffic using an immersive CAVE-based simulator. Sixty participants were recruited to complete a crossing task and perform one of two distractions, a visual-manual task and an auditory-cognitive task. Moreover, normal and time pressure crossing conditions were included as a baseline and comparison. For the first time, this study directly compared the impacts of visual-manual, auditory-cognitive distractions, and time pressure on pedestrian crossing behaviour and safety in a controlled environment. The results indicated that although pedestrian safety was compromised under both types of distraction, the effects of the applied distractions were different. When engaged in the visual-manual distraction, participants crossed the road slowly, but there was no significant difference in gap acceptance or initiation time compared to baseline. In contrast, participants walked slowly, crossed earlier, and accepted smaller gaps when performing the auditory-cognitive distraction. This has interesting parallels to existing findings on how these two types of distractions affect driver performance. Moreover, the effects of the visual-manual distraction were found to be dynamic, as these effects were affected by the gap size. Finally, compared to baseline, time pressure resulted in participants accepting smaller time gaps with shorter initiation times and crossing durations, leading to an increase in unsafe decisions and a decrease in near-collisions. These results provide new evidence that two types of distraction and time pressure impair pedestrian safety, but in different ways. Our findings may provide insights for further studies involving pedestrians with different distraction components.