Driving anxiety and anxiolytics while driving: Their impacts on behaviour and cognition behind the wheel

Introduction: The interaction between road safety and drivers’ mental health is a key issue in transportation and safety research. This review specifically examines the link between anxiety and driving from two complementary perspectives. Method: A systematic review following PRISMA guidelines was conducted across Scopus, Web of Science, TRID, and PubMed. Twenty-nine papers were retained. First, we synthesize research on the cognitive and behavioral effects of driving anxiety, irrespective of onset, when anxious individuals drive. Second, we compile evidence on the influence of legal anxiolytic drugs on actual driving tasks. Results: Eighteen papers addressed driving anxiety, showing associations with exaggerated caution, negative feelings, and avoidance of driving situations. Most conclusions derive from self-reports; little is known from in-situ or objective measures. For legal drugs, benzodiazepines were most studied; they affect attentional processes and can slow reaction times depending on population and treatment characteristics, with increases in standard deviation of lateral position during driving. Conclusions: Considering both standpoints, we propose research directions to address understudied aspects of driving anxiety and driving under anxiolytics. Practical applications: Studying driving anxiety is crucial for traffic safety and for designing effective awareness campaigns. Standardized evaluations of driving anxiety and thorough investigations of anxiolytics use are important for traffic policies.