Journal of Traumatic Stress June 2013, 26, 405–408 BRIEF REPORT Cognitive–Behavioral Group Treatment for Driving-Related Anger, Aggression, and Risky Driving in Combat Veterans: A Pilot Study Thad Strom, 1,2, * Jennie Leskela, 1,2 Elizabeth Possis, 1 Paul Thuras, 1,2 Melanie E. Leuty, 1 Bridget M. Doane, 1 Kathryn Wilder-Schaaf, 1 and Lisa Rosenzweig 1 1 Minneapolis Veterans Affairs Health Care System, Minneapolis, Minnesota, USA 2 Department of Psychiatry, University of Minnesota Medical School, Minneapolis, Minnesota, USA The present study examined the preliminary effects of an 8-session group cognitive–behavioral treatment (CBT) designed to reduce driving- related anger, aggression, and risky driving behaviors in veterans. Participants (N = 9) with self-reported aggressive and risky driving problems completed self-report measures at pretreatment, posttreatment, and 1-month follow-up. Of those completing the treatment, 89% demonstrated reliable change in driving-related aggression and 67% evidenced reliable change in driving-related anger. Similar changes were found for secondary treatment targets. Recent research has documented aggressive and risky driv- ing behaviors (e.g., speeding, driving recklessly) among vet- erans (Fear et al., 2008; Kuhn, Drescher, Ruzek, & Rosen, 2010; Strom et al., 2012). Aggressive driving contributes to over half of all motor-vehicle accident (MVA) fatalities and increased risk for MVA injuries (AAA Foundation for Traffic Safety, 2009). Although aggressive and risky driving behav- ior can result from many things (e.g., impulse control prob- lems), research suggests that military training, warzone expo- sure, exposure to driving-related traumatic events, and post- deployment mental health problems (e.g., posttraumatic stress disorder [PTSD], posttraumatic brain injury [TBI] symptoms) contribute to aggressive and risky driving behaviors (Kuhn et al., 2010; Lew, Amick, Kraft, Stein, & Cifu, 2010). Sev- eral controlled studies have demonstrated the effectiveness of cognitive–behavioral and relaxation strategies for reducing ag- gressive and risky driving behaviors in civilian populations (Deffenbacher, Huff, Lynch, Oetting, & Salvatore, 2000; Def- fenbacher, Filetti, Lynch, Dahlen, & Oetting, 2002; Galovski & Blanchard, 2002). At present, however, there are no pub- lished trials evaluating the effectiveness of clinical interven- tions for aggressive and risky driving behaviors in veterans. Given the unique set of contributing factors (e.g., warzone ex- Correspondence concerning this article should be addressed to Thad Strom, Minneapolis Veterans Affairs Health Care System, One Veterans Drive (116A), Minneapolis, MN 55417. E-mail: thad.strom@va.gov Published 2013. This article is a US Government work and is in the public domain in the USA. View this article online at wileyonlinelibrary.com DOI: 10.1002/jts.21808 posure, military-specific driving training) and the seriousness of driving-related outcomes (e.g., MVA injuries and death), such research is needed. The purpose of the present study was to ex- amine the preliminary effects of an 8-session group treatment on driving-related anger and aggression. A secondary goal was to examine the effect of the treatment on risky driving behavior and overall mental health functioning (e.g., depression). Method Participants Participants with recent self-reported aggressive and risky driv- ing problems were recruited from a large Midwest VA hos- pital. Exclusion criteria included active psychosis, imminent homicidality–suicidality, and active substance dependence. All procedures were approved by the local institutional review board. The present sample was comprised of the first nine veterans to complete the intervention. Each cohort was facilitated by one doctoral-level psychologist and a predoctoral psychology intern. All consent documents and assessments were individu- ally administered by a project interviewer not involved in the veteran’s treatment. Thirteen participants were consented for the treatment, four in each of the first two cohorts, and five in the third cohort. Four participants dropped out for reasons un- related to the treatment (i.e., obtaining employment, divorce), and three veterans completed each cohort. No significant dif- ferences were observed between completers and dropouts on baseline measures or demographic factors. 405