After Combat, Fear Hitches a Ride ; Veterans' Erratic Driving Seen as a Symptom of Traumatic Brain Injury

Article excerpt

Erratic driving by returning U.S. troops is being identified as a symptom of traumatic brain injury.

Before going to war, Susan Max loved tooling around Northern California in her maroon Mustang. A combat tour in Iraq changed all that.

Back in the United States, Ms. Max, an army reservist, found herself avoiding cramped parking lots without obvious escape routes. She straddled the middle line, as if bombs might be buried in the curbs. Gray sport utility vehicles came to remind her of the unarmored vehicles she rode nervously through Baghdad in 2007, a record year for American fatalities in Iraq.

"I used to like driving," said Ms. Max, 63. "Now my family doesn't feel safe driving with me."

For thousands of U.S. combat veterans, driving has become an ordeal. Once their problems were viewed mainly as a form of road rage or thrill seeking. But increasingly, erratic driving by returning troops is being identified as a symptom of traumatic brain injury or post-traumatic stress disorder -- and coming under greater scrutiny amid concerns about higher accident rates among veterans.

The insurance industry has taken notice. In a review of driving records for tens of thousands of troops before and after deployments, USAA, a leading insurer of active-duty troops, discovered that auto accidents in which the service members were at fault went up 13 percent after deployments. Accidents were particularly common in the six months after an overseas tour, according to the review, which covered the years 2007 to 2010.

The company is now working with researchers, the armed services and insurance industry groups to expand research and education on the issue. The army says that fatal accidents -- which rose early in the wars -- have declined in recent years, in part from improved education. Still, 48 soldiers died in vehicle accidents while off duty last year, the highest total in three years, army statistics show.

The Pentagon and Department of Veterans Affairs are also supporting several new studies into potential links between deployment and dangerously aggressive or overly defensive driving. The Veterans Affairs health center in Albany, New York, last year started a seven-session program to help veterans identify how war experiences might trigger negative reactions during driving. And researchers in Palo Alto are developing therapies -- which they hope to translate into iPhone apps -- for people with P.T.S.D. who are frequently angry or anxious behind the wheel.

"I can't talk with somebody who is a returned service member without them telling me about driving issues," said Erica Stern, an associate professor of occupational therapy at the University of Minnesota, who is conducting a national study of driving problems in people with brain injuries or P.T.S.D. for the Pentagon.

Though bad driving among combat veterans is not new -- research has found that Vietnam and Gulf war veterans were more likely to die in motor vehicle accidents than nondeployed veterans -- experts say Iraq and Afghanistan veterans are unique, for one major reason: their combat experiences were frequently defined by dangers on the road, particularly from roadside bombs.

"There is no accepted treatment for this," said Dr. Steven H. Woodward, a clinical psychologist with the Veterans Affairs Palo Alto Health Care System who is leading a study of potential therapies for veterans with P.T.S.D.-related driving problems. "It's a new phenomenon."

Though there has been some research into road rage among veterans, therapists and psychologists have only recently begun to view traumatic brain injuries and P. …