May reducing driving-related phobia recover developmental topographical disorientation? A case report

Developmental topographical disorientation (DTD) is more common than expected in healthy populations and can cause psychological disorders, leading to feelings of frustration and failure due to poor navigation. Due to the strict relation and the frequent association between DTD and psychological disorders, it is crucial to understand the impact of spatial anxiety and specific phobias, such as driving-related fear (DRF), on one's ability to autonomously navigate in the environment. Here, we report the case of a girl with DTD and DRF who struggled to learn driving routes due to her phobia. Her score in learning a computerized environment (The short version of the Computerized Ecological Navigational Battery:LBS) was low, and her performance in the other rating scales was below the cutoff, confirming the presence of DTD. However, after receiving psychological treatment for her DRF, she became faster in moving through LBS, but the assessment of navigational skills still indicated the presence of DTD, suggesting the independence of the two disorders. When addressing both DTD and psychological disorders, clinicians must prioritize which issue to tackle first. Here are some suggestions to help decide when to prioritize one aspect over the other to provide the best possible care for the patient.