Road Crashes in Adults with Attention Deficit Hyperactivity Disorder and Risky Driving Behavior
Objective: Attention deficit hyperactivity disorder (ADHD) is one of the most common problems in adolescents. Risky behaviors in patients with ADHD are due to impaired impulse control resulting from problems with inhibition of proponent responses, controlling interference, and stopping ongoing responses after feedback on errors. The present study investigated the relationship between ADHD and risky driving behavior and the likelihood of car accident in Arak, Iran, in 2015-16.
Method: This case-control study was conducted in the Emergency Department of Vali-Asr hospital in Arak (Iran) on drivers who met the inclusion criteria. The data gathering tools included the Demographic Questionnaire, Manchester Driving Behavior Questionnaire (MDBQ), and Wender Utah Rating Scale (WURS). Statistical analyses were performed using SPSS version 20 software.
Results: The mean of ADHD (±SD) was higher among cases (81.64 [26.78]) than in controls (64 [24.28], P = 0.000). The mean of risky driving behaviors (±SD) was higher among cases (66.41[26.78]) than in controls (36.79 [25.42]). There was a significant relationship between ADHD, risky behavior, lapse errors, slips, deliberate violation, and unintentional violation and car accident (P = 0.000).
Conclusion: This study showed that ADHD increases the risk of road crashes and motor vehicle injuries. These drivers tend to drive at unauthorized speed, have less control over the vehicle, drive more carelessly, and are more likely to have an accident.
2. Amiri S, Ranjbar F, Sadeghi-Bazargani H, Jodeiri Eslami A, Navali AM, Saedi F. Association of adult attention deficit/hyperactivity disorder and traffic injuries in tabriz - iran. Iran J Psychiatry. 2011;6(2):61-5.
3. Sadock BJ, Sadock VA. Kaplan and Sadock's synopsis of psychiatry: Behavioral sciences/clinical psychiatry: Lippincott Williams & Wilkins; 2011.
4. Jerome L, Habinski L, Segal A. Attention-deficit/hyperactivity disorder (ADHD) and driving risk: a review of the literature and a methodological critique. Current psychiatry reports. 2006;8(5):416-26.
5. Flory K, Molina BS, Pelham WE, Jr., Gnagy E, Smith B. Childhood ADHD predicts risky sexual behavior in young adulthood. Journal of clinical child and adolescent psychology : the official journal for the Society of Clinical Child and Adolescent Psychology, American Psychological Association, Division 53. 2006;35(4):571-7.
6. Groen Y, Gaastra GF, Lewis-Evans B, Tucha O. Risky behavior in gambling tasks in individuals with ADHD--a systematic literature review. PloS one. 2013;8(9):e74909.
7. Rooney M, Chronis-Tuscano A, Yoon Y. Substance use in college students with ADHD. J Atten Disord. 2012;16(3):221-34.
8. Kirov R, Brand S. Sleep problems and their effect in ADHD. Expert review of neurotherapeutics. 2014;14(3):287-99.
9. Yordanova J, Albrecht B, Uebel H, Kirov R, Banaschewski T, Rothenberger A, et al. Independent oscillatory patterns determine performance fluctuations in children with attention deficit/hyperactivity disorder. Brain. 2011;134(Pt 6):1740-50.
10. Fischer M, Barkley RA, Smallish L, Fletcher K. Hyperactive children as young adults: driving abilities, safe driving behavior, and adverse driving outcomes. Accident; analysis and prevention. 2007;39(1):94-105.
11. Groom MJ, van Loon E, Daley D, Chapman P, Hollis C. Driving behaviour in adults with attention deficit/hyperactivity disorder. BMC psychiatry. 2015;15:175.
12. Yang J, Du F, Qu W, Gong Z, Sun X. Effects of personality on risky driving behavior and accident involvement for Chinese drivers. Traffic Inj Prev. 2013;14(6):565-71.
13. Jafarpour S, Rahimi-Movaghar V. Determinants of risky driving behavior: a narrative review. Med J Islam Repub Iran. 2014;28:142.
14. Shams M, Rahimi-Movaghar V. Risky driving behaviors in Tehran, Iran. Traffic Inj Prev. 2009;10(1):91-4.
15. El Farouki K, Lagarde E, Orriols L, Bouvard MP, Contrand B, Galera C. The increased risk of road crashes in attention deficit hyperactivity disorder (ADHD) adult drivers: driven by distraction? Results from a responsibility case-control study. PLoS One. 2014;9(12):e115002.
16. Chen G, Smith GA, Deng S, Chen D, Kelleher K, Xiang H. Psychological symptoms and nonfatal unintentional injuries among Chinese adolescents: a prospective study. Journal of Adolescent Health. 2005;37(6):460-6.
17. Chiu HJ, Chan CL, Hsu JC, Chung CY, Yu IL, Renn JH, et al. Nationwide retrospective cohort survey of orthopedic injuries in members of the Taiwanese population with psychiatric disorders, 2000-2005. J Orthop Sci. 2013;18(3):456-64.
18. Graziano PA, Reid A, Slavec J, Paneto A, McNamara JP, Geffken GR. ADHD symptomatology and risky health, driving, and financial behaviors in college: the mediating role of sensation seeking and effortful control. J Atten Disord. 2015;19(3):179-90.
19. Kieling RR, Szobot CM, Matte B, Coelho RS, Kieling C, Pechansky F, et al. Mental disorders and delivery motorcycle drivers (motoboys): a dangerous association. Eur Psychiatry. 2011;26(1):23-7.
20. Sadeghi-Bazargani H, Maghsoudi H, Soudmand-Niri M, Ranjbar F, Mashadi-Abdollahi H. Stress disorder and PTSD after burn injuries: a prospective study of predictors of PTSD at Sina Burn Center, Iran. Neuropsychiatr Dis Treat. 2011;7:425-9.
21. Oreyzi HR, Haghayegh SA. Psychometric properties of the Manchester driving behavior questionnaire. Payesh (Health Monitor). 2010;9(1):21-8.
22. Gmesh E. The families of children with attention deficit and hyperactivity disorder. J Educ Retard Child. 2006;55(1):3-16.
23. Farokhzadi F, Mohammadi MR, Salmanian M. Discriminant of validity the Wender Utah rating scale in Iranian adults. Acta Medica Iranica. 2014:360-9.
24. Farokhzadi F, Mohammadi MR, Salmanian M. Discriminant of validity the Wender Utah rating scale in Iranian adults. Acta Med Iran. 2014;52(5):360-9.
25. Ward MF, Wender PH, Reimherr FW. The Wender Utah Rating Scale: an aid in the retrospective diagnosis of childhood attention deficit hyperactivity disorder. Am J Psychiatry. 1993;150(6):885-90.
26. Katragadda S, Schubiner H. ADHD in Children, Adolescents, and Adults. Prim Care 2007;34(2):317-41.
27. Cox DJ, Madaan V, Cox BS. Adult attention-deficit/hyperactivity disorder and driving: why and how to manage it. Curr Psychiatry Rep. 2011;13(5):345-50.
28. Narad M, Garner AA, Brassell AA, Saxby D, Antonini TN, O'Brien KM, et al. Impact of distraction on the driving performance of adolescents with and without attention-deficit/hyperactivity disorder. JAMA Pediatr. 2013;167(10):933-8.
29. Oliver ML, Nigg JT, Cassavaugh ND, Backs RW. Behavioral and cardiovascular responses to frustration during simulated driving tasks in young adults with and without attention disorder symptoms. J Atten Disord. 2012;16(6):478-90.
30. Reimer B, D'Ambrosio LA, Gilbert J, Coughlin JF, Biederman J, Surman C, et al. Behavior differences in drivers with attention deficit hyperactivity disorder: the driving behavior questionnaire. Accid Anal Prev. 2005;37(6):996-1004.
31. Richards TL, Deffenbacher JL, Rosen LA, Barkley RA, Rodricks T. Driving anger and driving behavior in adults with ADHD. J Atten Disord. 2006;10(1):54-64.
32. Vaa T. ADHD and relative risk of accidents in road traffic: a meta-analysis. Accid Anal Prev. 2014;62:415-25.