title: Self-Regulation of Driving Behavior in People with Parkinson Disease.
abstract: OBJECTIVE
  To determine the extent and nature of driving self-regulation in drivers with Parkinson disease (PD) and factors associated with self-regulatory practices.
  
  
  BACKGROUND
  Although people with PD have consistently been shown to have driving impairments, few studies have examined self-regulatory driving practices and their relationship to driving performance.
  
  
  METHODS
  We used a self-report driving questionnaire to examine driving self-regulation in 37 drivers with PD and 37 healthy age-matched controls. We also analyzed factors associated with self-regulatory practices, primarily demographic, disease-related, psychological, and simulated driving performance variables.
  
  
  RESULTS
  The drivers with PD reported significantly higher rates of self-perceived decline in their driving ability (P=0.008) and driving significantly shorter distances per week (P=0.004) than controls. Unfamiliar situations (P=0.009), in-car distractions (P<0.001), low visibility conditions (P=0.004), and long journeys (P=0.003) were particularly challenging for the drivers with PD, and their pattern of driving avoidance mirrored these difficulties. The use of self-regulatory strategies among drivers with PD was associated with female sex (rho=0.42, P=0.009) and perceived decline in driving ability (rho=-0.55, P<0.001), but not with age or objective measures of disease severity, cognition, or simulated driving performance.
  
  
  CONCLUSIONS
  Drivers with PD reported driving less overall and restricting their driving to avoid particularly difficult circumstances. Further research is warranted on effective use of self-regulation strategies to improve driving performance in people with PD.
authors.affiliation: *School of Psychological Sciences †Monash University Accident Research Centre, Monash University, Clayton, Victoria, Australia ‡Clinical Research Centre for Movement Disorders and Gait, Kingston Centre, Cheltenham, Victoria, Australia.
authors.forename: Renerus J
authors.initials: RJ
authors.lastname: Stolwyk
authors.forename: Karen A
authors.initials: KA
authors.lastname: Scally
authors.forename: Judith L
authors.initials: JL
authors.lastname: Charlton
authors.forename: John L
authors.initials: JL
authors.lastname: Bradshaw
authors.forename: Robert
authors.initials: R
authors.lastname: Iansek
authors.forename: Nellie
authors.initials: N
authors.lastname: Georgiou-Karistianis
mesh_terms: D000063:Accidents, Traffic; D000328:Adult; D000368:Aged; D001334:Automobile Driving / Q000523:psychology*; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000503:physiopathology / Q000523:psychology*; D011597:Psychomotor Performance; D057566:Self Report; D000068356:Self-Control; D011795:Surveys and Questionnaires