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Wright State University School of Medicine, Dayton, Ohio 45435, USA
This study tests the hypothesis that there is a high prevalence of undocumented disabilities among persons convicted of impaired driving (DWI). Reasons for this prevalence could include co-morbidity of mental and cognitive problems among heavy drinkers, substance misuse contributing to the acquisition of a disability, and the tendency to avoid confronting persons with disabilities about undesirable or harmful practices.
This poster reports results of clinical screenings for disability conducted among 500 randomly selected DWI offenders. Details of the screening instrument are included. Results have ramifications for how substance abuse assessments and interventions are conducted, as well as influencing the educational and confrontational formats within chemical dependency treatment programs.
There has been no lack of evidence that alcohol abuse often contributes to the acquisition of a disability (Cherpitel, 1988; Anda, et al., 1988; Heinemann, et al., 1989; Ford and Moore, 1992). In previous studies, researchers also speculated that there was a high incidence of attentional or cognitive disabilities among alcoholics or drunk drivers (Tarter, et al., 1977; Donovan, 1989). Reasons for this speculation include the fact that people with congenital or chronic disabilities do not experience interventions prior to the onset of serious symptoms of abuse, such as DWI's (Moore & Polsgrove, 1991). The speculation was further supported by a recent study of people with disabilities applying for vocational rehabilitation services. It was found that 23.8% of men in the sample had experienced alcohol-related arrests, most often DWI (Moore & Li, 1994).
This pilot study tests the hypothesis that there is a high prevalence of disabilities (as qualifying under the American with Disability Act of 1990) among persons convicted of impaired driving (DWI). It is expected that some disabilities are hidden, or undocumented, in this population.
All subjects for this study were recruited through the Weekend Intervention Program (WIP), a three day intervention and assessment program for convicted impaired drivers. This program is located in the School of Medicine at Wright State University, Dayton Ohio, and attendees at the WIP are referred by the court of jurisdiction in lieu of incarceration. All WIP attendees since the inception of the study have been approached and to date 242 individuals have voluntarily participated in this study. Less than 10% of WIP attendees have refused to participate in the study. The respondent profile is 79.8% male, 79% Caucasian, 8% African Americans, and the median age is 32 years.
Data collection consisted of two phases. First respondents completed a paper/pencil questionnaire on disability-related information. This two-page instrument was developed utilizing disability determination questions, including aspects based on the DSM-IV (American Psychiatric Association, 1994) and PRIME-MD (Spitzer, et al., 1994) in order to solicit mental illness disabilities. Positive responses likely to qualify for disability determination then were interviewed by trained medical and other graduate students utilizing a structured protocol. For example, if an individual reported a loss of consciousness as the result of a head injury, a follow-up interview determined if persisting functional limitations such as diminished cognitive functioning since the injury would qualify the individual for traumatic brain injury, or previous enrollment in special education classes is pursued for the presence of a persisting cognitive or learning disability.
A clinical assessment of disability status followed. Four masters degree level rehabilitation professionals reviewed questionnaires and interviews to evaluate the likelihood for physical, cognitive, emotional, or sensory disabilities. A disability was assigned through consensus by all clinical reviewers, and the determination was made based on obvious and current functional limitations.
Of 242 project participants to date, 11.6% reported that they had a disability. However, the clinical raters had sufficient documentation to establish the prevalence of ADA-qualified disabilities as 32.2% of the sample.
WIP participants were also evaluated in terms of various disability categories. Approximately 10.3% of the sample had a traumatic brain injury, and mental illness was documented as a disability for 7.4% of the sample. A total of 6.6% had a back or spinal cord injury causing some functional impairment. About 5% of the WIP participants were identified with a learning disability, and slightly less than 3% with hearing or visual impairments. Furthermore, based on self-reports and clinical assessments, about 17% of the convicted impaired drivers in this study had a secondary disability in addition to primary disability.
This study provides preliminary data in what may be the only examination to date of disabilities among convicted impaired drivers. The findings strongly suggest that persons with disabilities disporportionately incur drunk driving arrests. The etiology of the disability may be important to consider in this area. In light of lifestyle, health, and other behavioral characteristics of heavy drinkers which may lead to the acquisition of a disability, the prevalence findings of this study are plausible.
There are several important implications of these findings. Foremost is the ramification for impaired driver education and rehabilitation. With so many individuals presenting for treatment with personality, cognitive, or other conditions which adversely affects ones ability to learn it is critically important that programs have flexible curricula and learning approaches which match the characteristics of individual clients. It also is imperative that medical and vocational rehabilitation programs which treat and educate persons with disabilities be cognizant of the risks for substance abuse which are represented within this population.
American Psychiatry Association, 1994. Diagnostic and Statistical Manual of Mental Disorder: DSM-IV. Washington D.C.: American Psychiatric Association.
Anda, Robert F., Williamson, David F., and Remington, Patrick L. 1988. "Alcohol and Fatal Injuries among U.S. Adults." JAMA, 260: 2529-2532.
Cherpitel, Cheryl J. 1988. "Drinking Patterns and Problems Associated with Injury Status in Emergency Room Admissions." Alcoholism: Clinical and Experimental Research, 12: 105-110.
Ford, Jo Ann and Moore, Dennis. 1992. Substance Abuse Resources and Disability Issues: Training Manual. Dayton, OH: Wright State University.
Heinemann, Allen W., Doll, Mathew, and Schnoll, Sidney, 1989. "Treatment of Alcohol Abuse in Persons with Recent Spinal Cord Injuries." Alcohol Health & Research World, 13: 110- 117.
Moore, Dennis and Li, Li. 1994. "Alcohol Use and Drinking-Related Consequences Among Consumers of Disability Services." Rehabilitation Counseling Bulletin, 38(2): 124-133.
Moore, Dennis and Polsgrove, Lewis. 1991. "Disability, Developmental Handicaps and Substance Abuse: A Review." The International Journal of the Addictions, 26: 65-90.
Spitzer, Robert L., Williams, Janet B. W., Kroenke, K., Linzer, M., deGruy, F. V., Hahn, S. R., Brody, D., and Johnson, J. 1994. "Utility of a New Procedure for Diagnosing Mental Disorders in Primary Care." JAMA, 272: 1749-1756.
Tarter, R. E., McBride, H., and Buonpane, N. 1977. "Differentiation of Alcoholics According to Childhood History of Minimal Brain Dysfunction, Family History and Drinking Pattern." Archive of Gen Psychiatry, 34: 761-768.