Impaired Risk Awareness during Intoxication in Recidivist DUI Offenders

Alcohol-related traffic fatality and injury continue to be a major public health problem in the United States. Driving under the influence (DUI) remains one of the most frequently repeated offenses, with over one-third of offenders being charged with a second DUI offense within five years. Prevention programs involve motivational interviewing and education with emphasis on increasing the offender’s perceptions of the risks associated with alcohol use (i.e., increasing “risk awareness”). Our laboratory research has examined acute responses to alcohol in DUI offenders and showed they display heightened impulsivity and reduced perceptions of impairment. This suggests a lack of risk awareness in the intoxicated state, when critical decisions are made about whether or not to drive. This 4-year R01 proposal builds on this evidence by testing the efficacy of feedback-based training to increase DUI offenders’ perceptions of risk associated with alcohol use. DUI offenders will undergo experiential feedback-based training in which they are administered controlled doses of alcohol and receive structured feedback and training to accurately appraise the behavioral impairing effects of the dose and accurately estimate their breath alcohol concentration. The research tests the hypothesis that this training will increase risk awareness among DUI offenders during intoxication as evident by reduced disinhibiting and risk-taking effects in response to alcohol. Our evidence for atypical reactions to alcohol among DUI offenders truly breaks new ground and identifies promising treatment targets for new interventions to reduce recidivism. Testing the efficacy of this experiential-based feedback approach represents a logical next step that advances the field by building upon the basic science to date.