ADHD Symptoms Linked to Risky Driving in New Teen Drivers

Catherine C. McDonald, PhD, RN

Risky driving can be a hallmark of the teenage years. Young people aged 16 to 19 are almost 3 times more likely to be involved in fatal accidents than older drivers, according to the US Centers for Disease Control and Prevention (CDC).

Now researchers have identified a connection between driving behaviors and mental health symptoms including attention-deficit hyperactivity disorder (ADHD).

“Our findings demonstrate that symptom severity of inattention, and not just ADHD diagnostic status, is associated with performance errors,” lead study author Catherine C. McDonald, PhD, RN, told MD Magazine, referring to mistakes teen drivers made in a driving simulator.

“The analysis also highlighted that increased hyperactivity/impulsivity and conduct disorder symptoms were uniquely associated with increased self-reported risky driving behaviors,” said McDonald, an Assistant Professor at the University of Pennsylvania School of Nursing (Penn Nursing).

To determine possible associations between risky driving behaviors and mental health symptoms in novice adolescent drivers, McDonald and a team from Penn Nursing, Children's Hospital of Philadelphia (CHOP), and Utah State University recruited 60 Pennsylvania teens aged 16 and 17 who had their driver’s licenses for no more than 90 days.

The young people completed a simulated driving assessment that exposed them to 21 potential crash situations. The researchers then analyzed the simulator data on the participants' actions involving stop signs, braking and other behaviors in potentially dangerous situations.

The teens also responded to several questionnaires to self-report symptoms of ADHD, conduct disorder and depression. Another survey asked about their driving behaviors, such as speeding, use of cell phones, and number of passengers they carried.

“This study used both driving simulation and self-reported driving behaviors to further our understanding of how risky driving behavior is associated with mental health symptoms,” McDonald said.

The team found that the higher the score for inattention, as rated by the teens themselves, the higher the rate of driving performance errors in the simulator, she said. Teens with higher self-rated scores for hyperactivity/impulsivity and conduct disorder also scored higher for risky driving behaviors.

“A teen’s self-report of inattention was the only mental health symptom to be related to errors on the driving simulator assessment,” McDonald said.

In one surprise, teens with elevated scores for depression symptoms made fewer errors in the simulator, she said.

The researchers also found that parent-reported symptoms regarding their child’s mental health did not match the child’s own evaluation.

Does this mean that the parents were mistaken?

“We would not conclude that the parents were wrong,” McDonald said. “Rather, we think that adolescents have particular insight into their own behaviors, such as when they are behind the wheel.’’

One goal of the study is to make parents aware of how their teens perceive their own mental health symptoms and their participation in risky driving behaviors. Parents will then have a better sense of when and where their teens may be at risk, she said.

The study may also help medical professionals.

“Clinicians are well-positioned in a variety of settings to counsel adolescents, addressing the multidimensional nature of risks associated with mental health and risk behaviors, including those that can affect driving performance,” said McDonald, who is building a program of research aimed at promoting health and reducing injury in youth.

“Our study contributes to the understanding of how and when teens may be at risk for unsafe driving,” she said. “Attention to the roadway is a critical component of safe driving behavior.”

The study, “Simulated Driving Performance, Self-Reported Driving Behaviors, and Mental Health Symptoms in Adolescent Novice Drivers,” was published in Nursing Research.