Mental health symptoms associated with risky driving behaviors in novice teen drivers

Mental health symptoms related to attention deficit-hyperactivity disorder (ADHD) and conduct disorder are associated with increased errors in a driving simulator and self-reported risky driving behaviors in adolescents, according to study in Nursing Research, published by Wolters Kluwer.

"Inattention is associated with more errors in the driving simulator, and self-reported symptoms of hyperactivity and conduct disorder are independently associated with self-reported risky driving behaviors," comments lead author Catherine C. McDonald, PhD, RN, FAAN, of the University of Pennsylvania School of Nursing and the Center for Injury Research and Prevention at Children's Hospital of Philadelphia. The findings suggest that mental health issues might contribute to the risk of crashes in newly licensed adolescent drivers.

Symptoms of ADHD and Conduct Disorder Affect Teens' Driving Performance

The study included 60 young drivers, aged 16 to 17, who had received their license within the past 90 days. The teens were tested using a high-fidelity driving simulator, which assessed their responses to various types of common but avoidable crash scenarios. They also completed a self-report questionnaire on risky driving behaviors--for example, speeding, not wearing a seat belt, or nighttime driving with other teens as passengers.

The adolescents were also assessed on a measure of mental health symptoms, focusing on three conditions potentially associated with risky driving: ADHD, conduct disorder, and depression. Lastly, parents filled out a questionnaire about their teens' mental health.

A teen's self-report of inattention was the only mental health symptom to be related to errors on the driving simulator assessment. The higher the score for inattention, as rated by the teens themselves, the higher the rate of driving performance errors. Unexpectedly, teens with higher scores for depression symptoms made fewer errors in the simulator.

Teens with higher self-rated scores for hyperactivity/impulsivity and conduct disorder also scored higher for risky driving behaviors. Overall, parents' reports of the adolescents' mental health symptoms were not related to the teens' self-reported symptoms or their risky driving behaviors (self-reported or in the simulator).

The researchers emphasize that it was symptoms of hyperactivity and impulsivity--not necessarily the diagnosis of ADHD--that were associated with risky driving behaviors. However, teens who met the cutoff points for clinical follow-up for ADHD and conduct disorder had higher scores for risky driving.

Motor vehicle crashes are the leading cause of death in adolescents, but little is known about the mental health factors affecting crash risk. Mental health may be especially important for newly licensed teen drivers, who are at higher risk of crashes. The new study suggests that risky driving behaviors during this time might be related to symptoms of inattention, hyperactivity, and conduct disorder.

The increase in self-reported risky driving behavior is consistent with the mental health symptoms involved, according to the work of Dr. McDonald and colleagues. "With hyperactivity-impulsivity, rule violations may stem from inherent problems with self-control," they write. "With conduct disorder, rule violations may be an attempt to take advantage of a situation or express hostility."

Understanding the role of mental health factors might help in reducing risky driving behaviors in novice teen drivers, with the goal of lowering crash risk in this vulnerable population. Dr. McDonald and coauthors conclude, "Nurses are well-positioned in a variety of clinical settings to counsel adolescents, addressing the multidimensional nature of risks associated with mental health and risk behaviors."