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. 2019 Jun;143(6):e20182305.
doi: 10.1542/peds.2018-2305. Epub 2019 May 20.

Traffic Crashes, Violations, and Suspensions Among Young Drivers With ADHD

Allison E Curry  1   2 , Benjamin E Yerys  3   4 , Kristina B Metzger  5 , Meghan E Carey  5 , Thomas J Power  2   4
Affiliations

Traffic Crashes, Violations, and Suspensions Among Young Drivers With ADHD

Allison E Curry et al. Pediatrics. 2019 Jun.

Abstract

Objectives: To compare monthly rates of specific types of crashes, violations, and license suspensions over the first years of licensure for drivers with and without attention-deficit/hyperactivity disorder (ADHD).

Methods: We identified patients of New Jersey primary care locations of the Children's Hospital of Philadelphia who were born in 1987-1997, were New Jersey residents, had their last primary care visit at age ≥12 years, and acquired a driver's license (N = 14 936). Electronic health records were linked to New Jersey's licensing, crash, and violation databases. ADHD diagnosis was based on International Classification of Diseases, Ninth Revision, Clinical Modification diagnostic codes. We calculated monthly per-driver rates of crashes (at fault, alcohol related, nighttime, and with peers), violations, and suspensions. Adjusted rate ratios were estimated by using repeated-measures Poisson regression.

Results: Crash rates were higher for drivers with ADHD regardless of licensing age and, in particular, during the first month of licensure (adjusted rate ratio: 1.62 [95% confidence interval: 1.18-2.23]). They also experienced higher rates of specific crash types: their 4-year rate of alcohol-related crashes was 2.1 times that of drivers without ADHD. Finally, drivers with ADHD had higher rates of moving violations (for speeding, seat belt nonuse, and electronic equipment use) and suspensions. In the first year of driving, the rate of alcohol and/or drug violations was 3.6 times higher for adolescents with ADHD.

Conclusions: Adolescents with ADHD are at particularly high crash risk in their initial months of licensure, and engagement in preventable risky driving behaviors may contribute to this elevated risk. Comprehensive preventive approaches that extend beyond current recommendations are critically needed.

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Conflict of interest statement

POTENTIAL CONFLICT OF INTEREST: Dr Yerys was part of a single consultation meeting with Aevi Genomic Medicine about development of a novel treatment of attention-deficit/hyperactivity disorder; the other authors have indicated they have no potential conflicts of interest to disclose.

Figures

FIGURE 1
FIGURE 1
Flowchart revealing selection of study cohort. Gray boxes reveal individuals who were excluded from the study.
FIGURE 2
FIGURE 2
A, Monthly observed rate per 10 000 driver-months of crash involvement. B, Monthly observed rate per 10 000 driver-months of moving violations. Drivers with and without ADHD were compared over the first 4 years of licensure. Purple lines indicate drivers with ADHD and orange lines indicate drivers without ADHD.
FIGURE 3
FIGURE 3
AdjRRs and 95% CIs for crash outcomes; comparing drivers with and without ADHD. Dots indicate the estimated adjRR, and lines indicate the width of the 95% CI from repeated-measures Poisson regression models. Purple dots and lines compare outcomes for 12 months after licensure. Orange dots and lines compare outcomes for 48 months after licensure.
FIGURE 4
FIGURE 4
AdjRRs and 95% CIs for violation and license suspension outcomes; comparing drivers with and without ADHD. Dots indicate the estimated adjRR, and lines indicate the width of the 95% CI from repeated-measures Poisson regression models. Purple dots and lines compare outcomes for 12 months after licensure. Orange dots and lines compare outcomes for 48 months after licensure.
See this image and copyright information in PMC

References

    1. American Psychiatric Association Diagnostic and Statistical Manual of Mental Disorders (DSM-5). 5th ed. Washington, DC: American Psychiatric Association; 2013
    1. Mannuzza S, Klein RG. Long-term prognosis in attention-deficit/hyperactivity disorder. Child Adolesc Psychiatr Clin N Am. 2000;9(3):711–726 - PubMed
    1. Winston FK, Senserrick TM. Competent independent driving as an archetypal task of adolescence. Inj Prev. 2006;12(suppl 1):i1–i3 - PMC - PubMed
    1. Barkley RA. ed. Attention-Deficit Hyperactivity Disorder: A Handbook for Diagnosis and Treatment. 4th ed. New York, NY: The Guilford Press; 2014
    1. Willcutt EG, Doyle AE, Nigg JT, Faraone SV, Pennington BF. Validity of the executive function theory of attention-deficit/hyperactivity disorder: a meta-analytic review. Biol Psychiatry. 2005;57(11):1336–1346 - PubMed

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