{{Unreliable sources|date=June 2020|some=not true}}{{Infobox medical condition |name = |synonym = |image = |image_size = |alt = |caption = |pronounce = |specialty = psychology |symptoms = |complications = }}
'''Driving phobia''',<ref name=":0">{{Cite journal|last1=Zinzow|first1=Heidi M.|last2=Jeffirs|first2=Stephanie M.|date=January 2018|title=Driving Aggression and Anxiety: Intersections, Assessment, and Interventions|journal=Journal of Clinical Psychology|volume=74|issue=1|pages=43–82|doi=10.1002/jclp.22494|issn=1097-4679|pmid=28636768}}</ref> '''driving anxiety''',<ref name=":0" /> '''vehophobia''',<ref>{{cite news|url= https://www.nbcnewyork.com/news/local/study-reveals-tri-states-most-searched-phobia-fears-new-york-ny-jersey-nj-connecticut-ct-afraid/1820770/|title= Aahhh! Study Reveals Tri-State's Most-Searched Phobias|agency=[[WNBC]]|date=October 9, 2018|access-date=February 4, 2022}}</ref> '''amaxophobia''' or '''driving-related fear''' ('''DRF''')<ref name=":1" /> is a pathological fear of driving. It is an intense, persistent fear of participating in car traffic (or in other vehicular transportation) that affects a person's [[Lifestyle (sociology)|lifestyle]], including aspects such as an inability to participate in certain jobs due to the pathological avoidance of driving.<ref name="Taylor et al., 2000">{{Cite journal|last1=Taylor|first1=Joanne E.|last2=Deane|first2=Frank P.|last3=Podd|first3=John V.|date=September–October 2000|title=Determining the focus of driving fears|journal=[[Journal of Anxiety Disorders]]|volume=14|issue=5|pages=453–470|doi=10.1016/s0887-6185(00)00033-5|pmid=11095540}}</ref><ref name=":1">{{Cite journal|last1=Taylor|first1=Joanne|last2=Deane|first2=Frank|last3=Podd|first3=John|date=June 2002|title=Driving-related Fear: A Review|journal=[[Clinical Psychology Review]]|volume=22|issue=5|pages=631–645|doi=10.1016/s0272-7358(01)00114-3|pmid=12113199}}</ref><ref>{{Cite thesis|last=Taylor|first=Joanne E.|date=2002|title=Understanding Driving-Related Fear|degree=PhD|publisher=[[Massey University]]}}</ref> The fear of driving may be triggered by specific driving situations, such as expressway driving or dense traffic.<ref>{{Cite journal|last1=Mathew|first1=R. J.|last2=Weinman|first2=M. L.|last3=Semchuk|first3=K. M.|last4=Levin|first4=B. L.|date=August 1982|title=Driving phobia in the city of Houston: a pilot study|journal=[[American Journal of Psychiatry]]|volume=139|issue=8|pages=1049–1051|doi=10.1176/ajp.139.8.1049|pmid=7091430}}</ref> Driving anxiety can range from a mild cautious concern to a [[phobia]].
==Symptoms== The fear of driving is associated with various physical and subjective emotional symptoms that somewhat vary from individual to individual. Driving alone can intensify fears due to breakdowns, isolation, or no help, worsening at night.<ref>{{Cite web|title=Understanding and Managing Driving Anxiety (Amaxophobia): A Comprehensive Guide|url=https://anxietychecklist.com/amaxophobia-fear-of-driving|website=anxietychecklist.com|access-date=2026-02-01|language=en}}</ref> For example, the physical symptoms might involve increased [[perspiration]] or [[tachycardia]] (pathologically accelerated heart rate), or [[hyperventilation]]. On the cognitive level, the patient may experience a loss of sense of reality, or thoughts of losing control while driving, even in situations that are reasonably safe.<ref name="Beck & Coffey, 2007">{{Cite journal|last1=Beck|first1=J. Gayle|last2=Coffey|first2=Scott F.|date=December 2007|title=Assessment and treatment of PTSD after a motor vehicle collision: Empirical findings and clinical observations|journal=[[Professional Psychology: Research and Practice]]|volume=38|issue=6|pages=629–639|doi=10.1037/0735-7028.38.6.629|pmc=2396820|pmid=18509507}}</ref> On a behavioral level, the avoidance of driving tends to perpetuate the phobia. Patients who developed their amaxophobia after a serious [[traffic collision]] frequently develop the [[post-traumatic stress disorder]] (PTSD) that may involve experiencing [[intrusive thoughts]] or anxious dreams of the original collision and/or other typical PTSD symptoms.<ref name="Beck & Coffey, 2007" /> One part of post-collision symptomatology is the '''phantom brake syndrome'''. It is the passenger's partly involuntary or unintended pressing the foot on the floor of the car in a reflexive attempt "to brake." This unintended behavior usually occurs in skilled drivers when they are seated as a passenger next to a less competent person who drives the vehicle as a reflexive response to potentially dangerous traffic situations. The phantom brake syndrome is particularly common in survivors of serious car collisions.<ref>{{Cite journal|last1=Cernovsky|first1=Zack Z.|last2=Fattahi|first2=Milad|date=2021-06-15|title=Phantom Brake Phenomenon in Survivors of Car Accidents|url=https://www.ej-clinicmed.org/index.php/clinicmed/article/view/68|journal=European Journal of Clinical Medicine|language=en|volume=2|issue=3|pages=9–13|doi=10.24018/clinicmed.2021.2.3.68|s2cid=237395446|issn=2736-5476|doi-access=free}}</ref>
===Associated conditions=== Some patients who present with phobia of driving also describe features consistent with various other [[anxiety disorders]], including [[panic disorder]], [[agoraphobia]], [[specific phobia]], and [[social phobia]].<ref name="Taylor et al., 2000" /> The majority of survivors of serious car collisions tend to experience only the phobia of driving, but they often report generalized anxiety as a part of their post-traumatic adjustment disorder.{{cn|date=May 2025}}<ref>{{Cite journal|last1=Kuch |first1=Klaus |last2=Swinson |first2=Richard P. |last3=Kirby |first3=Marlene |title=Post-traumatic stress disorder after car accidents|journal=Canadian Journal of Psychiatry |date=1985-10-02|issn=0706-7437|pmid=4063939|pages=426–427|volume=30|issue=6|doi=10.1177/070674378503000610}}</ref> The amaxophobia tends to be perpetuated by persistent [[pain]] caused by the car crash, and by pain related [[insomnia]], and also by persistent [[Post-concussion syndrome|post-concussion]] and [[Whiplash (medicine)|whiplash]] symptoms caused by the crash. The PTSD symptoms, e.g., in the forms of [[Flashback (psychology)|flashbacks]] such as intrusive images of a bleeding person injured in the same car crash, may also contribute to amaxophobia. Correlations of PTSD scores to scores on measures of driving anxiety are significant and range from .31 to .79.<ref>{{Cite journal|last1=Cernovsky|first1=Zack Z.|last2=Fattahi|first2=Milad|last3=Litman|first3=Larry C.|last4=Diamond|first4=David M.|date=2021-04-19|title=Validation of the PTSD Checklist for DSM-5 (PCL-5) on Patients Injured in Car Accidents|url=https://www.ejmed.org/index.php/ejmed/article/view/790|journal=European Journal of Medical and Health Sciences|volume=3|issue=2|pages=154–159|doi=10.24018/ejmed.2021.3.2.790|s2cid=236610072|issn=2593-8339|doi-access=free}}</ref>
==Causes== There are three major categories of driving phobia, distinguished by their onset.<ref>{{Cite web |last=Advice |first=Health Daily |date=2023-09-22 |title=Common Causes of Amaxophobia |url=https://www.healthdailyadvice.com/amaxophobia/common-causes-of-amaxophobia/ |access-date=2023-09-30 |website=Health Daily Advice |language=en-US}}</ref>
The most common cause of a fear of driving is traffic collisions. Thus, the amaxophobia often develops as a reaction to a particularly traumatic vehicular collision. Beck and Coffey reported that 25–33% of people involved in a car collision associated with injuries and related evaluation in a hospital experience subsequent fear of driving.<ref name="Beck & Coffey, 2007"/> Hickling and Blanchard<ref>{{Cite journal|last1=Hickling|first1=Edward J.|last2=Blanchard|first2=Edward B.|date=July–September 1992|title=Post-traumatic stress disorder and motor vehicle accidents|journal=[[Journal of Anxiety Disorders]]|volume=6|issue=3|pages=285–291|doi=10.1016/0887-6185(92)90040-E}}</ref> and Kuch, Swinson, and Kirby<ref>{{Cite journal|last1=Kuch|first1=Klaus|last2=Swinson|first2=Richard P.|last3=Kirby|first3=Marlene|date=October 1985|title=Post-traumatic Stress Disorder After Car Accidents|journal=[[The Canadian Journal of Psychiatry]]|volume=30|issue=6|pages=426–427|doi=10.1177/070674378503000610|pmid=4063939|s2cid=6092875}}</ref> found higher rates of driving phobia, ranging from 42% to 77%. The majority of experienced drivers with fear of driving in the aftermath of their serious collisions rate themselves as safer drivers than average, though they feel physically and emotionally too uncomfortable.<ref name="Taylor et al., 2000" /> For some patients, the fear escalates in very specific situations such as when near large vehicles (transport trucks, buses), but in others, the fear may be triggered already just by getting seated in the car or even just by thinking about having to again travel in a car in the near future. Several psychological questionnaires have been developed for clinicians to assess the situational intensity and facets of driving anxiety in novice drivers or also in experienced drivers traumatized by a recent car collision.<ref>{{Cite journal |last1=Taylor |first1=Joanne E. |last2=Stephens |first2=Amanda N. |last3=Sullman |first3=Mark J. M. |date=2021-01-01 |title=Psychometric properties of the Driving Cognitions Questionnaire, Driving Situations Questionnaire, and Driving Behavior Survey |url=https://www.sciencedirect.com/science/article/pii/S1369847820305726 |journal=Transportation Research Part F: Traffic Psychology and Behaviour |volume=76 |pages=202–214 |doi=10.1016/j.trf.2020.11.010 |bibcode=2021TRPF...76..202T |issn=1369-8478|url-access=subscription }}</ref> Some novice drivers and passengers who were never involved in a serious car collision also report symptoms of amaxophobia.<ref name="Taylor et al., 2000" /> The driving fear may be, in some patients, an extension of agoraphobia.<ref name="Taylor et al., 2000" />
Additional factors contributing to driving phobia include a fear of losing control, anticipation of accidents, or previous exposure to unsafe driving conditions. In some cases, individuals may experience driving anxiety due to pre-existing conditions such as generalized anxiety disorder (GAD) or post-traumatic stress disorder ([[Post-traumatic stress disorder|PTSD]]). [[Cognitive distortion|Cognitive distortions]], like overestimating the likelihood of danger, can further reinforce the fear.<ref>{{Cite web |date=2 January 2025 |title=Understanding and Managing Driving Anxiety: A Comprehensive Guide |url=https://anxietychecklist.com/fear-of-driving |website=Anxiety Checklist}}</ref>
== Treatment == The most common treatment for both driving phobia and milder forms of driving anxiety is [[behavior therapy]]<ref name="Wolpe, 1958">{{Cite journal|last=Wolpe|first=Joseph|title=Psychotherapy by Reciprocal Inhibition|journal=Conditional Reflex|publisher=Stanford University Press|year=1968|volume=3|issue=4|pages=234–40|doi=10.1007/BF03000093|pmid=5712667|isbn=978-0804705097|s2cid=46015274|lccn=58006709|author-link=Joseph Wolpe|url=https://link.springer.com/article/10.1007/BF03000093|url-access=subscription}}</ref> in the form of [[systematic desensitization]].<ref name="Wolpe, 1958" /><ref>{{Cite journal|last=Rachman|first=S.|date=1967|title=Systematic desensitization|journal=[[Psychological Bulletin]]|volume=67|issue=2|pages=93–103|doi=10.1037/h0024212|pmid=6045340}}</ref><ref>{{Cite journal|last=Lauer|first=G.|date=1992|title=The Treatment of Driving Phobia|journal=[[International Journal of Psychology]]|volume=27|issue=3–4|page=469|doi=10.1080/00207599208246897|doi-access=free}}</ref> An emerging treatment approach to treating amaxophobia is through the use of [[virtual reality therapy]].<ref>{{Cite journal|last1=Walshe|first1=David G.|last2=Lewis|first2=Elizabeth J.|last3=Kim|first3=Sun I.|last4=O'Sullivan|first4=Kathleen|last5=Wiederhold|first5=Brenda K.|date=June 2003|title=Exploring the Use of Computer Games and Virtual Reality in Exposure Therapy for Fear of Driving Following a Motor Vehicle Accident|url=https://vrphobia.eu/files/60.-109493103322011641_.pdf|url-status=live|journal=CyberPsychology & Behavior|volume=6|issue=3|pages=329–234|doi=10.1089/109493103322011641|pmid=12855091|archive-url=https://web.archive.org/web/20200619031614/https://vrphobia.eu/files/60.-109493103322011641_.pdf|archive-date=June 19, 2020}}</ref> With repeated exposure such as via devices similar to video games, the subjective distress is gradually reduced: the patient may subsequently be more willing to proceed to engaging in driving in real life situations, as the next stage of [[exposure therapy]].{{citation needed|date=June 2020}}<ref>{{Cite journal|title=Virtual reality exposure therapy for fear of driving: analysis of clinical characteristics, physiological response, and sense of presence|journal=Revista Brasileira de Psiquiatria |date=2018|issn=1809-452X|pmc=6900765|pmid=29451586|pages=192–199|volume=40|issue=2|doi=10.1590/1516-4446-2017-2270|first1=Rafael T. da|last1=Costa|first2=Marcele R. de|last2=Carvalho|first3=Pedro|last3=Ribeiro|first4=Antonio E.|last4=Nardi}}</ref>
== Psychological assessment == A variety of [[inventory|inventories]] have been developed to assess driving anxiety. * The ''Driving Behavior Survey (DBS)''<ref>{{Cite journal|last1=Clapp|first1=Joshua D.|last2=Olsen|first2=Shira A.|last3=Beck|first3=J. Gayle|last4=Palyo|first4=Sarah A.|last5=Grant|first5=DeMond M.|last6=Gudmundsdottir|first6=Berglind|last7=Marques|first7=Luana|display-authors=1|date=January 2011|title=The Driving Behavior Survey: Scale construction and validation|journal=[[Journal of Anxiety Disorders]]|volume=25|issue=1|pages=96–105|doi=10.1016/j.janxdis.2010.08.008|pmc=3006470|pmid=20832988}}</ref> consists of 20 items, each of which is rated on a 1–7 scale; for example, "I have trouble staying in the correct lane". * The ''Driving Cognition Questionnaire (DCQ)''<ref>{{Cite journal|last1=Ehlers|first1=Anke|author-link=Anke Ehlers|last2=Taylor|first2=Joanne E.|last3=Ehring|first3=Thoams|last4=Hofmann|first4=Stefan G.|author-link4=Stefan Hofmann|last5=Deane|first5=Frank P.|last6=Roth|first6=Walton T.|author-link6=Walton T. Roth|last7=Podd|first7=John V.|display-authors=1|date=2007|title=The Driving Cognitions Questionnaire: Development and preliminary psychometric properties|journal=[[Journal of Anxiety Disorders]]|volume=21|issue=4|pages=493–509|doi=10.1016/j.janxdis.2006.08.002|pmid=16982173|s2cid=7839401 }}</ref> also consists of 20 items. These are rated on a 0–4 scale. Some items of this questionnaire assess related social anxieties and self-image issues, e.g., "People will think I am a bad driver". Such [[self-image]] issues are relatively uncommon in patients with a post-crash amaxophobia some of whom drove without collisions and without emotional discomfort for decades. * The ''Driving and Riding Avoidance Scale (DRAS)''<ref>{{Cite journal|last1=Stewart|first1=Alan E.|last2=St. Peter|first2=Claire C.|date=August 2004|title=Driving and riding avoidance following motor vehicle crashes in a non-clinical sample: psychometric properties of a new measure|journal=[[Behaviour Research and Therapy]]|volume=42|issue=8|pages=859–879|doi=10.1016/S0005-7967(03)00203-1|pmid=15178463}}</ref> also consists of 20 items. These are scored from 0 to 4. Its 20 items describe various situations in which driving is avoided. As discussed by Taylor and Sullman,<ref>{{Cite journal|last1=Taylor|first1=Joanne E.|last2=Sullman|first2=Mark J. M.|date=May 2009|title=What does the Driving and Riding Avoidance Scale (DRAS) measure?|journal=[[Journal of Anxiety Disorders]]|volume=23|issue=3|pages=504–510|doi=10.1016/j.janxdis.2008.10.006|pmid=19062251}}</ref> the wording of DRAS items allows for responses that are not necessarily based on fear of driving, but could also involve economic or practical issues. For instance, the travel via subway trains or streetcars within the center of some major North American or European cities is far more rapid than in cars and/or it saves both gasoline and parking fees.
== Epidemiology ==
Little is known about the prevalence of driving anxiety. One study found that 16% of New Zealand adults have "moderate to severe driving anxiety".<ref>{{Cite journal|last=Taylor|first=Joanne E.|date=2018-10-01|title=The extent and characteristics of driving anxiety|url=https://www.sciencedirect.com/science/article/pii/S1369847817304837|journal=Transportation Research Part F: Traffic Psychology and Behaviour|language=en|volume=58|pages=70–79|doi=10.1016/j.trf.2018.05.031|bibcode=2018TRPF...58...70T |s2cid=149785869|issn=1369-8478|url-access=subscription}}</ref>
== See also == {{Portal|Psychology}} * [[List of phobias]] * [[Hodophobia]] - The phobia of travel
==References== {{Reflist}}
[[Category:Driving]] [[Category:Situational phobias]]