Driving anxiety and anxiolytics while driving: Their impacts on behaviour and cognition behind the wheel
DOI: 10.1016/j.heliyon.2023.e16008
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Summary
This systematic review investigates the intersection of mental health and road safety, specifically examining how driving anxiety and the use of anxiolytic medications impact driver behavior and cognition. Motivated by the increasing prevalence of anxiety disorders and the critical need to ensure safe transportation, the authors address two primary research questions: the cognitive and behavioral effects of driving anxiety itself, and the influence of legal anxiety-reducing drugs on actual driving tasks. The study aims to identify gaps in current literature and propose directions for future research and policy. The authors conducted a systematic review following PRISMA guidelines, searching four databases (Scopus, Web of Science, TRID, and PubMed) for studies published between 1990 and 2021. They retained 29 primary studies: 18 focused on driving anxiety and 11 on the effects of anxiolytics. For the anxiety component, inclusion criteria required explicit measurement of driving anxiety and exclusion of confounding factors such as PTSD, neurological disorders, or general anxiety disorders. For the medication component, the review focused on legal drugs, primarily benzodiazepines, examining their impact on driving performance through experimental or survey-based data. Regarding driving anxiety, the review found that most existing evidence relies on self-reported questionnaires rather than objective behavioral measures. Key findings indicate that driving anxiety is associated with exaggerated cautious driving, performance deficits such as increased lapses and errors, and significant avoidance behaviors, including the restriction of driving in specific contexts like tunnels or highways. Avoidance was noted to be more prevalent among women. Only one study provided objective on-road data, which confirmed impaired performance but lacked replicability due to subjective expert evaluation. Concerning anxiolytics, benzodiazepines were the most studied class. Results indicated that these drugs increase the standard deviation of lateral position, slow reaction times, and decrease alertness, thereby affecting attentional processes and driving safety. However, discrepancies existed, and many studies lacked control groups or relied on retrospective self-reports. The authors conclude that significant gaps exist in the literature, particularly the lack of objective, experimental studies on the cognitive impacts of driving anxiety. They recommend future research utilize simulation and virtual reality to objectively measure attentional and executive functions under controlled conditions. Additionally, they highlight the need to study specific populations, such as older drivers or those with neurological conditions, and to assess anxiety related to modern vehicles like electric and autonomous cars. The findings underscore the importance of developing standard evaluations for driving anxiety and designing public awareness campaigns to address both the psychological barriers to driving and the risks associated with medication use.
Provenance
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| Stage | Outcome | Tool | Model | Prompt | Attempts | Completed |
|---|---|---|---|---|---|---|
| discover | success | Crossref | — | — | 1 | 2026-06-18 |
| archive | success | openalex | — | — | 5 | 2026-06-25 |
| extract | success | cached | — | — | 2 | 2026-06-26 |
| clean | success | clean | — | — | 1 | 2026-06-20 |
| chunk | success | chunk | — | — | 1 | 2026-06-20 |
| embed | success | embed | Qwen/Qwen3-Embedding-8B | — | 1 | 2026-06-20 |
| enrich | success | openalex | — | — | 1 | 2026-06-20 |
| promote | success | — | — | — | 1 | 2026-06-18 |
| summarize | success | llm | qwen3.6-27b-prismaquant | summ-v5 | 1 | 2026-06-26 |
| tag | success | vector_similarity | — | — | 6 | 2026-06-20 |
| verify | success | — | — | — | 1 | 2026-06-26 |
Summary generated by qwen3.6-27b-prismaquant on 2026-06-26; verification: verified.
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- Empirical Findings: behavioral performance data, observational prevalence
- Theoretical Contribution: theory or model