Linking teen driving behaviors to ADHD, other mental health factors

March 30, 2018, University of Pennsylvania

Teenage drivers ages 16 to 19 are three times more likely to get into fatal accidents than their older counterparts. In this age group, around 20 percent in the United States have been affected by symptoms associated with mental health disorders, including 9 percent with a lifetime history of attention deficit hyperactivity disorder (ADHD).

What's the relationship between these well-documented conclusions? That's what University of Pennsylvania nursing researcher Catherine McDonald wanted to find out.

McDonald studies what distracts these newest drivers on the road. Analyzing data from 60 teens who completed a simulated driving assessment and several questionnaires, she and colleagues from Penn Medicine, the Center for Injury Research and Prevention (CIRP) at the Children's Hospital of Philadelphia (CHOP), and Utah State University linked mistakes behind the wheel to self-reported symptoms of ADHD and other , findings they published in the journal Nursing Research. Paying attention to this connection can expose problem behaviors that, when corrected, can help make teenaged drivers safer.

"Previous studies have shown increases in crash risk related to an ADHD diagnosis," says McDonald, who has secondary appointments in Penn Medicine and at CIRP. "We wanted to tease apart the nuances behind that. Is it about risk-taking, skill, or performance deficits? Is it about decision-making? In the capacity of a simulator as well as self-reported behaviors, we wanted to see if our data could get at the why of what is happening around driving behaviors."

The research team began by recruiting 16- and 17-year-olds in Pennsylvania who had had their driver's licenses no more than 90 days. At the outset, participants rated how closely numerous statements aligned with how they felt and thought. For example, one question assessing symptoms of ADHD asked if they had trouble keeping their mind on what people say. Another, about conduct disorder, asked if they bullied or threatened others.

Participants also completed a questionnaire about depressive symptoms and another about their driving behaviors on the road, such as tendency to speed, use of cell phones, and number of passengers they carried. In conjunction, parents assessed their child for ADHD symptoms and other mental-health problems.

"We know that about 5 percent of older adolescents meet criteria for ADHD, so we weren't expecting too many in our sample to meet the threshold for diagnosis," McDonald says. "For that reason, we looked at symptom measures instead. That gives us an idea of the severity of symptoms, even if they are not high enough to meet the criteria for a full diagnosis."

Next, all participants completed an assessment in the driving simulator at CIRP. During the experimental drives, teens were exposed to different crash scenarios—a rear-end collision or a hidden hazard, for instance—avoidable if they drive safely. By the end of the simulated assessment, they had been presented with 21 potential crash situations. The researchers analyzed the simulator data on a variety of the participants' actions, including how they behaved at stimulated stop signs, in which lane they drove, where they looked on the road, and how they applied the brake in potentially dangerous circumstances.

McDonald and colleagues noticed a clear link: The more inattention symptoms a teen reported, the more mistakes that driver made in the simulator. McDonald says knowing this offers a clear opening for health-care providers.

"Inattention was associated with more errors in the simulator, and self-reported symptoms of hyperactivity and conduct disorder were related to more self-reported risky driving behaviors," she says. "This presents an opportunity to help intervene with patients and their families, to talk about the child's whole health and mental well-being and how it might relate to driving behaviors."

The researchers acknowledge several limitations to the work. For one, the study cohort was predominantly white and thus not representative of the young-driver population overall. Second, McDonald and colleagues didn't seek out participants already diagnosed with disorders such as ADHD but rather assessed for symptoms once an adolescent agreed to participate. Finally, they could not measure all contributors to risky driving and performance errors. Some of these limitations McDonald says she hopes to mitigate in future research.

"We would like to learn more about the relationship of mental-health symptoms to driving behavior in a sample with higher rates and severity of ADHD," McDonald says, "so we can examine the impact of inattention and hyperactivity-impulsivity severity across the full range of these dimensions."

That next step could help move the research toward its ultimate goal: tailoring interventions for teens drivers at risk in different ways.

Explore further: Mental health issues linked to risky driving in newly licensed teens

More information: Catherine C. McDonald et al, Simulated Driving Performance, Self-Reported Driving Behaviors, and Mental Health Symptoms in Adolescent Novice Drivers, Nursing Research (2018). DOI: 10.1097/NNR.0000000000000270

Related Stories

Mental health issues linked to risky driving in newly licensed teens

March 27, 2018
Mental health symptoms related to attention deficit-hyperactivity disorder (ADHD) and conduct disorder are associated with increased errors in a driving simulator and self-reported risky driving behaviors in adolescents, ...

Licensing, motor vehicle crash risk among teens with ADHD

June 12, 2017
Adolescents with attention-deficit/hyperactivity disorder (ADHD) are licensed to drive less often and, when this group is licensed, they have a greater risk of crashing, according to a new study published by JAMA Pediatrics.

Study finds children with autism and ADHD at higher rise for anxiety

March 30, 2018
Children with both autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD) are at increased risk for being diagnosed with or treated for anxiety and mood disorders, according to a study published ...

ADHD and texting found to significantly impair teenage driving

August 12, 2013
ADHD and texting both significantly impair driving performance among teenagers, according to a study published online today in JAMA Pediatrics.

ADHD medications may reduce the risk of sexually transmitted infection

January 2, 2018
Attention-deficit/hyperactivity disorder (ADHD) increases the risk of subsequent sexually transmitted infections (STIs) among adolescent and young adult populations by about three times, reports a study published in the January ...

Can adults develop ADHD? New research says probably not

October 20, 2017
Adults likely do not develop ADHD, according to new research by FIU clinical psychologist Margaret Sibley.

Recommended for you

Global study finds youngest in class more likely to be diagnosed with ADHD

October 15, 2018
A new global study involving the University of Adelaide has found that children who are the youngest in their classroom are more likely to be diagnosed with Attention Deficit Hyperactivity Disorder (ADHD) than their older ...

Much still unclear about relationship between screen media use and ADHD in children

October 5, 2018
There is a statistically small relationship between children's screen media use and ADHD-related behaviours. This is the finding of an extensive literature review on this subject carried out by researchers from the UvA's ...

Brain scans reveal common patterns can predict variations in ADHD

September 24, 2018
Distinct brain patterns can help explain variations in the way children present with attention deficit hyperactivity disorder (ADHD), paving a course towards improved treatment and support for the common neurodevelopmental ...

ADHD may increase risk of Parkinson's disease and similar disorders

September 12, 2018
While about 11 percent of children (4-17 years old) nationwide have been diagnosed with attention-deficit hyperactivity disorder (ADHD), the long-term health effects of having ADHD and of common ADHD medications remains understudied. ...

Over past 20 years, percentage of children with ADHD nearly doubles

September 3, 2018
The number of children diagnosed with attention deficit hyperactivity disorder has reached more than 10 percent, a significant increase during the past 20 years, according to a study released Friday.

ADHD rates rising sharply in US kids

August 31, 2018
(HealthDay)—The number of ADHD diagnoses among children has risen dramatically in the past two decades, going from 6 percent to 10 percent, a new report shows.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.