In a new study, researchers wanted to know how the specific symptoms found in attention-deficit/ hyperactivity disorder (ADHD) might affect teens’ new driving skills. They discovered that teens with greater symptoms of inattention made more mistakes in a driving simulator test, while those with symptoms of hyperactivity and conduct disorder were more likely to engage in risky driving behaviors.
Their findings are published in the journal Nursing Research.
Research has shown that teen drivers aged 16 to 19 have triple the risk of being in a fatal car accident compared to older drivers. In addition, around 20 percent of teens in this age group are affected by symptoms of a mental health disorder, and 9 percent have a lifetime history of ADHD.
Nursing researcher Catherine McDonald from the University of Pennsylvania studies what distracts these newest drivers on the road. In the new study, she looked at data from 60 teens who completed a simulated driving assessment as well as 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 looked for associations between teens’ mistakes behind the wheel and self-reported symptoms of ADHD and other mental-health disorders. Shedding light on these connections can identify problem behaviors that, when corrected, can help make the roads safer for teens and others.
“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 involved 16- and 17-year-olds in Pennsylvania who had recently earned their driver’s licenses (no more than 90 days). At the beginning of the study, participants rated how closely several 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.
The teens also answered 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 typically carried. In addition, 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 underwent an assessment in the driving simulator at CIRP. During the test drives, teens were exposed to different crash scenarios, such as a rear-end collision or a hidden hazard. These were all avoidable, however, if they proceeded to drive safely.
By the end of the assessment, the teens had maneuvered through 21 potential crash situations. The researchers analyzed the simulator data on a variety of the participants’ actions, including how they behaved at simulated stop signs, in which lane they drove, where they looked on the road, and how they applied the brake in potentially dangerous situations.
The researchers noticed a clear connection: 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.”
Source: University of Pennsylvania