Effects of Childhood and Adult Persistent Attention-Deficit/Hyperactivity Disorder on Risk of Motor Vehicle Crashes: Results From the Multimodal Treatment Study of Children With Attention-Deficit/Hyperactivity Disorder

Arunima Roy; Annie A Garner; Jeffery N Epstein; Betsy Hoza; J Quyen Nichols; Brooke S G Molina; James M Swanson; L Eugene Arnold; Lily Hechtman

doi:10.1016/j.jaac.2019.08.007

Effects of Childhood and Adult Persistent Attention-Deficit/Hyperactivity Disorder on Risk of Motor Vehicle Crashes: Results From the Multimodal Treatment Study of Children With Attention-Deficit/Hyperactivity Disorder

J Am Acad Child Adolesc Psychiatry. 2020 Aug;59(8):952-963. doi: 10.1016/j.jaac.2019.08.007. Epub 2019 Aug 22.

Authors

Arunima Roy¹, Annie A Garner², Jeffery N Epstein³, Betsy Hoza⁴, J Quyen Nichols⁴, Brooke S G Molina⁵, James M Swanson⁶, L Eugene Arnold⁷, Lily Hechtman⁸

Affiliations

¹ The Royal's Institute of Mental Health Research, University of Ottawa, Ontario, Canada.
² Saint Louis University, St. Louis, Missouri.
³ University of Cincinnati College of Medicine and the Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Ohio.
⁴ University of Vermont, Burlington.
⁵ University of Pittsburgh School of Medicine, Pennsylvania.
⁶ Child Development Center, School of Medicine, University of California, Irvine.
⁷ Nisonger Center, Ohio State University, Columbus.
⁸ Division of Child Psychiatry, Montreal Children's Hospital, McGill University, Quebec, Canada. Electronic address: lhechtman@hotmail.com.

Abstract

Objective: To determine motor vehicle crash (MVC) risk in adults with a history of childhood attention-deficit/hyperactivity disorder (ADHD) and persistent ADHD symptoms.

Method: Participants with (n = 441) and without (n = 239; local normative comparison group) childhood ADHD from the Multimodal Treatment of Attention-Deficit/Hyperactivity Disorder (MTA) Study were included. Participants provided self-reports on total number of MVCs they had been involved in and the time of licensure. Driving experience was estimated as the number of months since licensure. Total number of MVCs by adulthood was regressed on baseline ADHD status adjusting for sex, age at follow-up, driving experience, baseline oppositional defiant disorder/conduct disorder comorbidity, baseline household income level, adult oppositional defiant disorder/conduct disorder symptoms, adolescent and adult substance use, and adult antisocial personality disorder symptoms. We repeated the analysis using adult ADHD status (persistent versus desistant versus local normative comparison group) and symptom level as the predictor variables. Results are presented as incidence rate ratio (IRR) and CI.

Results: Childhood ADHD was associated with a higher number of MVCs (IRR = 1.45, CI = 1.15-1.82), and adult ADHD symptom persistence was associated with more MVCs than desistance (IRR = 1.46, CI = 1.14-1.86). ADHD desistance was not associated with a significantly increased risk for MVCs compared with the local normative comparison group (IRR = 1.24, CI = 0.96-1.61). Concurrent symptoms of inattention and hyperactivity/impulsivity predicted MVC risk.

Conclusion: Persistence of ADHD into adulthood is a stronger predictor of MVC risk than childhood-limited ADHD.

Clinical trial registration information: Multimodal Treatment of Attention Deficit Hyperactivity Disorder (MTA) Study; https://clinicaltrials.gov; NCT00000388.

Keywords: ADHD persistence; attention-deficit/hyperactivity disorder (ADHD); comorbidity; driving; motor vehicle crashes.

Publication types

Research Support, N.I.H., Extramural

MeSH terms

Accidents, Traffic
Adolescent
Adult
Attention Deficit Disorder with Hyperactivity* / epidemiology
Attention Deficit Disorder with Hyperactivity* / therapy
Attention Deficit and Disruptive Behavior Disorders
Child
Combined Modality Therapy
Comorbidity
Humans
Motor Vehicles

Associated data

ClinicalTrials.gov/NCT00000388

Abstract

Publication types

MeSH terms

Associated data

Grants and funding