Repeat Driving Under The Influence Offenders Research Articles

Drinking and driving relapse: Data from BAC and MMPI-2.

Road traffic injuries are the ninth cause of death across all age groups, globally (WHO, 2015). Many road traffic crashes are caused by Driving Under the Influence (DUI) of alcohol by persons who have previously had their license suspended for the same reason. The aim of this study was to identify specific risk factors and personality characteristics in repeat offenders. The sample was comprised of 260 subjects who were not repeat DUI offenders (DUI-NR), but had a single license suspension between 2010 and 2011; and 97 repeat offenders who received at least two DUI convictions within a period of 5 years. At the time of their first driving license suspension, participants provided their blood alcohol content (BAC) and completed a valid MMPI-2 test. ANOVA and MANOVAs were performed to determine whether there were significant differences in BAC and MMPI-2 profiles between DUI-NR and DUI-R participants and a logistic regression was run to identify whether BAC at the time of the first suspension and specific personality features could predict recidivism. A two-step cluster analysis was run to identify recidivist typologies. Results showed that, relative to DUI-NR participants, DUI-R participants had higher BAC at the time of their first conviction and more problematic MMPI-2 profiles, despite the presence of social desirability responding. The best predictors of recidivism were BAC and the scales of Lie (L), Correction (K), Psychopathic Deviate (4-Pd), Hypomania (9-Ma), and Low Self-Esteem (LSE). Two-step cluster analyses identified two recidivist profiles, according to 32 selected MMPI-2 validity, clinical, content, supplementary, and PSY-5 scales. Comparisons with previous research are discussed and ideas for further study are generated.

Externalizing and self-medicating: Heterogeneity among repeat DUI offenders

AimDespite significant reductions in Driving Under the Influence (DUI) in the United States during recent decades, DUI continues to be a major public health threat. The current study investigated the intersection of two domains known to influence DUI: criminal history and psychiatric comorbidity. MethodsDUI recidivists (N = 743) attending a court-mandated two-week inpatient DUI program completed a computerized mental health assessment as part of their intake to that program. Participants’ criminal records were obtained 4–5 years after program attendance. FindingsThis study identified three primary repeat DUI offender subtypes with distinct patterns of criminal behavior and psychiatric comorbidity: (Type I) those whose DUI emerges from a pattern of drinking to cope with mood and anxiety problems, (Type II) those whose DUI emerges as part of a larger pattern of externalizing and criminal behavior, and (Type III) those whose DUI offenses reflect more acute triggers and isolated episodes of excessive drinking. ConclusionThese findings suggest that current treatment models used in DUI programs are inadequate to address the heterogeneity in the population of DUI recidivists and that earlier and more comprehensive screening would allow for better targeting of resources to DUI offender subtypes.

Using Behavioral Triage in Court-Supervised Treatment of DUI Offenders

In 2008, San Joaquin County, California, implemented a system change where all repeat Driving Under the Influence (DUI) offenders in the largest judicial district (mainly the City of Stockton) are required to participate in a DUI Monitoring Court program. The program follows a behavioral triage system where offenders are placed into one of two tracks. Track 1 (monitoring) is a less intensive system where participants are required to come to court infrequently to report on progress in completing the terms of their probation, including Department of Motor Vehicle (DMV) requirements, to qualify to get their license returned. Track 2 is for participants who demonstrate through their behavior (i.e., behavioral triage) that they are unable to comply with Track 1 requirements and who are assessed as needing drug and alcohol treatment. Track 2 follows a drug court model. All repeat DUI offenders convicted after 2008 (i.e., program participants) and a comparison group of all repeat DUI offenders convicted in the 2 years prior to program implementation were tracked for 18 months from the time of their DUI conviction. DMV data were used to examine new DUI convictions and traffic accidents for both groups. The results showed that program participants had significantly fewer new DUI convictions, accidents related to drug and alcohol consumption, and accidents resulting in injury. Participants were also significantly more likely to comply with court, probation, and DMV requirements, and to regain their driver's licenses. The model implemented by the San Joaquin DUI Monitoring Court showed substantial promise for increasing public safety by reducing drunk driving and traffic accidents.

Recidivism Risk of Repeat Intoxicated Drivers Monitored with Alcohol Biomarkers

This feasibility study analyzed the effects of alcohol biomarker testing in reducing the rearrest rates and/or lengthening the time between rearrests in repeat intoxicated drivers in Waukesha County. Participants were 250 repeat offenders who underwent monitoring with biomarker testing after being arrested for driving under the influence (DUI) of alcohol between 2006 and 2009. In 2012, their traffic records were reviewed to determine any subsequent drunk driving arrests since their assessments in 2006 to 2009. Regression analysis was used to determine the relationship between the length of biomarker monitoring (LOM) and the time to recidivism (TTR). LOM was defined as the time between the offender's first test at enrollment in this study (baseline Early Detection of Alcohol Consumption [EDAC]) and the last test at the end of monitoring. TTR was defined as the length of time from baseline EDAC until the driver's next subsequent DUI offense. The results showed that 32 of the 250 drivers enrolled in this pilot were rearrested during the study period for an overall recidivism rate of 12.8%. The rearrested drivers were mostly men (88%), young adults (34 years), employed (84%), and predominantly single or divorced (86%). Their drinking profile at baseline showed that 93% claimed at least one month of abstinence before their first sample was collected yet almost one half (48%) of them tested positive for biomarkers. Regression analysis showed a positive and significant correlation between LOM and TTR (r = 0.41; p < 0.05; coefficient for LOM = 1.28; N = 23) indicating that for every additional day of biomarker monitoring the time to re-arrest increased by more than one day. This feasibility study provides preliminary evidence suggesting that repeat DUI offenders monitored with alcohol biomarkers take longer to get rearrested with a subsequent DUI than those not monitored with biomarkers.

Types of crimes committed by repeat DUI offenders

This study investigates whether repeat driving under the influence (DUI) offenders have more extensive histories of violent, property, and drug crimes than first-time drunk drivers. It also offers an exploratory investigation into the extent of their criminal specialization. Negative binomial regression was performed on arrest and criminal history data from a systematic random sample of 429 DUI arrestees. Analyses controlling for age, gender, ethnicity, and employment found that being a repeat DUI offender increased the total number of violent and property convictions (regardless of severity) and petty misdemeanor/violation property convictions. The results suggest DUI recidivists are generalists rather than specialists and that impaired driving is best viewed as just one manifestation of a host of deviant behaviors. They also illustrate the challenges of rehabilitating and deterring DUI recidivists and the potential differences between first-time and repeat DUI offenders. The findings should not be interpreted as support of enforcement or deterrent DUI policies that focus on repeat offenders, as limited resources are most efficiently directed at the general population of impaired drivers.

The Criminal History of Repeat DUI Offenders

This study tested whether repeat driving under the influence (DUI) offenders have more extensive criminal histories, exclusive of DUI and traffic offenses, than first-time offenders. Analysis of arrest and criminal history data from a random sample of 429 DUI arrestees found that being a repeat DUI offender increased the total number of convictions (regardless of severity), misdemeanor convictions, and petty misdemeanor/violation convictions. The results illustrate the challenges of rehabilitating and deterring DUI recidivists and the potential differences between first-time and repeat DUI offenders. Among DUI recidivists, impaired driving is best viewed as just one manifestation of a host of deviant behaviors.

PTSD among a treatment sample of repeat DUI offenders

Recent studies indicate that posttraumatic stress disorder (PTSD) is one of the most common psychiatric comorbidities among driving-under-the-influence (DUI) offenders in treatment. Investigation of DUI offenders' PTSD and clinical characteristics could have important implications for prevention and treatment. This prospective study examined the demographic and clinical characteristics of repeat DUI offenders with PTSD symptoms at baseline and 1-year follow-up. Seven hundred twenty-nine DUI offenders admitted to a 2-week inpatient program participated in the study. Participants with PTSD evidenced more severe psychiatric comorbidity and reported a higher DUI recidivism rate at 1-year than those without PTSD. This study suggests a need to address PTSD among DUI offenders, as well as to further develop methodologies for accurately reporting DUI recidivism.

Is 24/7 sobriety a good goal for repeat driving under the influence (DUI) offenders?

This editorial considers whether a goal of constant sobriety is appropriate for drivers found guilty of repeat episodes of driving under the influence (DUI). The authors first briefly review the impact of DUI, including the numbers of arrests and the methods used to deter repeat offenses, such as suspending or revoking licenses, impounding cars or requiring breath alcohol ignition interlock devices. The authors then describe the approach adopted by South Dakota, a state in the northern plains of the United States. Its ‘24/7 Sobriety’ program attempts to prevent repeat DUI offenders from drinking through frequent testing. Rrepeat DUI arrestees to submit to twice-daily (7–9 a.m. and 7–9 p.m.) breath testing as a condition of bail; missed tests lead to issuance of an arrest warrant. The program has teeth; the punishment for a failed test is immediate and automatic incarceration. However, incarceration is so brief (24 hours), and compliance rates so high, that total sanctioning may actually have declined. South Dakota’s fundamental innovation is to require offenders to stop drinking, rather than stop driving. The authors then report that the statistics available suggest that the program has achieved remarkable success. Traffic fatalities involving alcohol impairment dropped from 71 in 2004 to 34 in 2008; some have suggested that there are favorable effects on other alcohol-associated crimes (e.g. domestic violence). The authors note that the 24/7 Sobriety program has not been evaluated scientifically, so the only firm conclusion to be drawn now is that such an evaluation is needed. They also briefly consider the administrative impact (positive and negative) of implementing this approach to recidivism in DUI.

Persistence Pays Off: Follow-Up Methods for Difficult-to-Track Longitudinal Samples

Evolving privacy and confidentiality regulations make achieving high completion rates in longitudinal studies challenging. Periodically reviewing the methods researchers use to retain participants throughout the follow-up period is important. We review the effectiveness of methods to maximize completion rates in a 1-year longitudinal study of repeat driving-under-the-influence (DUI) offenders. During the course of 21 months, we attempted to follow-up with 704 participants of a licensed residential treatment facility for repeat DUI offenders. High rates of lifetime Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, substance-use disorders (97.6%) and nonsubstance- or nongambling-related psychiatric disorders (44.5%) among the sample made tracking participants difficult. To locate participants and complete follow-up interviews, we obtained baseline information, contacted collaterals, sent mailed reminders, searched Internet databases, and gave a monetary incentive for completing study interviews. We located 608 participants with active telephone numbers (87.4%) and completed interviews with 488 (70.1% of the entire eligible sample and 80.3% of those with active telephone numbers), after an average (SD) of 8.6 (9.1) calls (median = 5.0). Increasing the number of calls continued to yield additional completions at 10, 20, and 30 calls; at approximately 40 telephone calls, the potential return for additional calls did not justify the added effort. These results suggest that researchers need to (1) employ more than 10 telephone calls to adequately track difficult-to-follow substance-using populations, and (2) prepare for a subsample of participants who might require more extensive contact. These results highlight the importance of using empirical guidelines to plan estimates for the number of contacts needed to achieve an adequate follow-up completion rate.

Bipolar disorder as a risk factor for repeat DUI behavior

Background Bipolar disorder (BD) is more prevalent among people with substance use disorders (SUD) than the general population. SUD among recidivist driving under the influence (DUI) populations are extremely prevalent; not surprisingly, recent evidence suggests that rates of BD also are elevated among DUI offenders. Studies of BD patients with SUD have found high prevalence of other psychiatric disorders and relatively low rate of treatment engagement. This study examines both the prevalence of other mental disorders and treatment status among a cohort of DUI offenders with BD and SUD. Methods A consecutively selected cohort ( N = 729) of repeat DUI offenders attending a two-week inpatient treatment program completed a standardized diagnostic interview (the Composite International Diagnostic Interview: CIDI). The CIDI generated DSM-IV diagnoses. Results This study yielded three main results for this repeat DUI offender sample: (1) BD is associated with significantly higher lifetime prevalence of alcohol, drug, and non-substance psychiatric disorders (e.g., PTSD); (2) approximately one quarter of BD participants have not discussed their mania with a professional; and (3) only half of the BD participants in this cohort have had mania treatment they consider effective and even fewer have had any treatment during the past twelve months. Limitations Participants were predominantly Caucasian males attending treatment as a sentencing option in a single Massachusetts DUI program. Conclusion These findings suggest that clinicians in DUI treatment settings should consider both evaluating for BD and initiating therapy.

Substance and Psychiatric Disorders Among Men and Women Repeat Driving Under the Influence Offenders Who Accept a Treatment-Sentencing Option

Driving under the influence (DUI) continues to be a serious public health concern in the United States. Research suggests that the substance use/abuse and psychiatric histories of repeat offenders might contribute to the persistence of this phenomenon. Because psychiatric histories could be important to recovery and likely differ substantially between men and women, the present study examined psychiatric and substance-use histories of male and female DUI repeat offenders in treatment. Seven hundred twenty-nine residents at the Middlesex Driving Under the Influence of Liquor program in Tewksbury, MA, a licensed residential facility providing treatment and education to repeat DUI offenders, participated in the current study during the course of 12 months. These participants completed a standardized diagnostic interview-12 modules of the Composite International Diagnostic Interview-as part of their intake interview. Female repeat offenders in this study were substantially different from male repeat offenders in lifetime and past-year psychiatric comorbidity patterns. Women had more extensive histories of psychiatric morbidity (i.e., psychiatric disorder in addition to substance abuse/dependence, alcohol abuse/dependence, and pathological gambling) and were more likely than men to report a history of multiple morbidities (i.e., multiple psychiatric disorders in addition to substance-related or gambling disorders). Both male and female repeat DUI offenders have extensive but different psychiatric histories that might play a significant role in DUI recidivism. These differences in psychiatric and substance-use histories among men and women could have important implications for treatment and prevention of DUI.

Randomized sanctions to reduce re‐offense among repeat impaired‐driving offenders

This study, conducted within a driving under the influence (DUI) court intervention, evaluated the degree to which removing electronic monitoring (EM) and/or mandatory vehicle sales requirements increased rates of post-sentence traffic violations among repeat DUI offenders. Randomized trial. A total of 477 repeat DUI offenders entering the Driving under the Influence of Intoxicants (DUII) Intensive Supervision Program (DISP), Multnomah County, Oregon. Subjects were randomized into four intervention groups. Group 1: standard DISP with EM and vehicle sales requirements; group 2: standard DISP with mandatory vehicle sale, but without EM; group 3: standard DISP with EM, but without mandatory vehicle sale; and group 4: standard DISP without EM or mandated vehicle sale. Standard DISP includes treatment for alcohol abuse and dependence, polygraph testing, regular court appearances, and probation or court-based monitoring. The risk of re-arrest for traffic violations was compared among the four groups using hazard ratio estimates from complementary log-log regression models. Compared with group 1, subjects in group 2 initially had increased re-arrest risks, but this effect dissipated within 3 years of entering DISP. Group 3 subjects had a 96% increase in re-arrest rates. Group 4 subjects had smaller increased risks than predicted, with re-arrest rates similar to those of group 1 at the end of the follow-up period. Although some of the findings suggest that mandatory vehicle sales may deter future traffic violations, inconsistent results across groups make this finding equivocal. Positive effects of EM, while large in the short term, appear to have a relatively small long-term value in reducing traffic arrest rates.

The epidemiology of psychiatric disorders among repeat DUI offenders accepting a treatment-sentencing option.

Psychiatric comorbidity likely contributes to driving under the influence (DUI) of alcohol among repeat offenders. This study presents one of the first descriptions of the prevalence and comorbidity of psychiatric disorders among repeat DUI offenders in treatment. Participants included all consenting eligible admissions (N = 729) to a 2-week inpatient treatment facility for court-sentenced repeat DUI offenders (i.e., offenders electing treatment in place of prison time) from April 17, 2005, to April 23, 2006. Participants completed the Composite International Diagnostic Interview, which assessed the following disorders using criteria from the Diagnostic and Statistical Manual of Mental Disorders (4th ed.; American Psychiatric Association, 1994): alcohol use and drug use, bipolar, generalized anxiety, posttraumatic stress, intermittent explosive, conduct, attention deficit, nicotine dependence, pathological gambling, and major depressive. Repeat DUI offenders evidenced higher lifetime and 12-month prevalence of alcohol use and drug use disorders, conduct disorder, posttraumatic stress disorder, generalized anxiety disorder, and bipolar disorder compared with the general population. Almost half qualified for lifetime diagnoses of both addiction (i.e., alcohol, drug, nicotine, and/or gambling) and a psychiatric disorder. Lifetime and past-year comorbidity rates were higher among participants than in the general population. These results suggest that clinicians should consider multimorbidity within DUI treatment protocols.

Is the drug court model exportable? The cost-effectiveness of a driving-under-the-influence court

We assessed the cost-effectiveness of the Rio Hondo driving-under-the-influence (DUI) court, a therapeutic court intervention in Los Angeles County targeted to repeat DUI offenders. The effectiveness of this court intervention was determined through a randomized controlled field experiment. Although prior research does not identify differences in alcohol-related or criminal behavior between treated and control individuals at follow-up, we found improvements in behavior for all program participants regardless of treatment status. A cost-minimization analysis found that, on average, costs of the DUI court exceeded traditional court expenditures for second-time offenders but produced cost savings for third-time offenders. This suggests that implementing a DUI-specific court intervention for serious DUI recidivists is a worthwhile investment of public resources. The unique legal treatment of DUI offenders in California may hide additional cost savings that could be accrued in other jurisdictions through the adoption of DUI court programs.

Acculturation and Driving Under the Influence: A Study of Repeat Offenders

In California, driving under the influence (DUI) arrest and conviction rates are disproportionately higher among the Hispanic population. Acculturation and other factors associated with drinking and driving may help explain this disparity. Interviews with Hispanic repeat DUI offenders were conducted immediately prior to sentencing and 2 years later. Arrest records from these offenders were also examined. Analyses were performed to examine the association between acculturation and other sociodemographic characteristics at baseline with DUI arrests and convictions at a 2-year follow-up. Logistic regression modeling showed that acculturation was significantly related to self-reported DUI recidivism even after controlling for other factors associated with DUI convictions during a 2-year follow-up. Acculturation was not found to have a statistically significant relation to DUI arrest rates during that same period. Among a Hispanic sample of repeat DUI offenders, the less-acculturated members were more likely to report a repeat DUI conviction at 2-year follow-up than the more-acculturated ones, even after controlling for other characteristics associated with DUI behaviors, such as drinking severity and marital status. The same pattern was not found between acculturation and arrest rates. Acculturation may serve as a risk factor for repeat convictions. Efforts to reduce multiple DUI convictions may need to consist of ways to target persons who are less acculturated.

Relapse to driving under the influence (DUI): A review

Driving under the influence (DUI) is a major public health problem. In 2003, there were 17,401 alcohol-related crash fatalities. Although there has been a large decrease in the fatality rates over the past two decades, further progress has stalled in recent years. This plateau in the injury and death rates resulting from impaired driving has been attributed, in part, to the persistent or repeat DUI offender. Broadly defined, repeat offenders are those individuals who, following an initial DUI arrest, relapse to driving under the influence of alcohol and other drugs. In this paper, we first provide a brief overview of several models of DUI relapse. We then review the empirical literature on DUI relapse, the data describing characteristics of first-time and repeat DUI offenders, and, especially, studies that have evaluated the impact of legal sanctions and rehabilitation programs on subsequent DUI behavior. The data reveal that DUI offenders are a heterogeneous group, and that simple models relying on only one or two behavioral domains (e.g., driving characteristics, demographics) to explain DUI relapse are insufficient to account for the DUI behavior of offenders. To advance our understanding of DUI relapse, we argue for development and testing of multifactorial models focusing on the interplay of legal, social and psychological factors that describe and explain relapse among DUI offenders. By recognizing the heterogeneity within the offender population it will be easier for researchers and clinicians to identify subgroups that are at high-risk for relapse and which should be targeted by prevention and intervention programs.

Drink-driving and DUI recidivists' attitudes and beliefs: a longitudinal analysis.

Cross-sectional survey research has shown correlations between drink-driving behavior and people's beliefs concerning the riskiness, social acceptability and morality of driving under the influence of alcohol. The current study examines the association between such beliefs and subsequent alcohol-impaired driving in a sample of offenders who were driving under the influence (DUI). Repeated interviews were conducted with 182 multiple DUI offenders. Baseline data included measures of moral and prescriptive beliefs concerning alcohol-impaired driving (internal behavioral controls), perceived risks of criminal punishment and crashes associated with alcohol-impaired driving (external behavioral controls) and perceived peer-group attitudes toward alcohol-impaired driving (social control). The dependent variable in the study was a measure of self-reported alcohol-impaired driving over the preceding 2 years, collected at 2-year follow-up from baseline. Results from multiple regression modeling showed significant protective effects associated with the beliefs that driving after drinking is immoral and that random police sobriety checks are a good idea (internal control items). Results also showed that a social desirability control measure was predictive of increased risk, at follow-up, for driving after drinking. These results suggest that internal controls may protect against alcohol-impaired driving behavior, even in a high-risk sample of repeat DUI offenders. The results also suggest that future policy interventions to curtail drink-driving might profitably be designed to promote these sorts of behavioral controls.

How can repeat drunk drivers be influenced to change? Analysis of the association between drunk driving and DUI recidivists' attitudes and beliefs.

Public policy interventions designed to deter or prevent drunk driving depend, in part, on modifying beliefs concerning the riskiness, social acceptability and immorality of driving under the influence of alcohol. The current study examines the association of these beliefs with the incidence of alcohol-impaired driving. Interviews were conducted with 273 people with multiple driving under the influence (DUI) offenses. Data included self-reported frequency of driving after drinking in the past year, as well as measures of moral and prescriptive beliefs concerning alcohol-impaired driving (internal behavioral controls), perceived risks of criminal punishment and accidents associated with alcohol-impaired driving (external behavioral controls) and perceived peer group attitudes toward alcohol-impaired driving (social controls). Logit regression modeling showed significant, unique protective associations with behavioral control items in each category. Behavioral controls may protect against alcohol-impaired driving behavior even in a high-risk sample of repeat DUI offenders. Policy interventions designed to curtail drunk driving might seek to enhance these sorts of behavioral controls among DUI offenders.

Cognitive impairment screening in second offense DUI programs.

Patients enrolled in alcohol treatment programs for driving under the influence (DUI) offenders are at elevated risk of cognitive impairment, but are not systematically screened. We developed a 30-min screening battery that can be administered in a group setting to test patients' ability to handle the cognitive demands of psychoeducational treatment. Testing of 134 volunteers identified 73% as having one or more clinically significant cognitive deficits. A majority of subjects scored below the 50th percentile on tests of word fluency, vocabulary, sustained attention, memory, executive functioning, and impulse control. The prevalence of cognitive impairment in the repeat DUI offender population is extremely high, making DUI treatment programs an ideal venue for screening and referral. Treatment programs should be responsive to the special needs of this population, incorporating teaching techniques that address short attention span, poor memory, lack of verbal fluency, and lack of impulse control.

The long-term traffic safety impact of a pilot alcohol abuse treatment as an alternative to license suspensions

During the 4-year period following a repeat driving under the influence (DUI) conviction, participants in 12-month treatment programs had worse overall traffic safety records than did recipients of license suspensions. The results from a series of analyses using repeated measures analysis of covariance showed that, in comparison with license-suspension recipients: (i) participants had significantly higher rates (70%) of nonalcohol-related accidents and convictions, (ii) participants had a significantly lower rate (9%) of alcohol-related convictions, but no difference was found on alcohol-related accidents, and (iii) participants had a significantly higher rate (30%) of total accidents ( p < .05). These results suggest that the use of license-suspension waiver as an incentive to participate in a drinking driver program had a negative imapct on traffic safety. The predicted reductions in alcohol-related accidents among program participants did not occur, and reductions in nonalcohol-related accidents, which could have been achieved with license suspensions, were sacrificed. It was recommended that some other alternative besides license-suspension waivers be used as an inducement for repeat DUI offenders to participate in treatment.