Letter to the Editor Re: Motivation and Mechanism in Motor Vehicle Collisions Dear Editor: We applaud Dr Dumais and others ’ article on “Psychiatric Risk Factors for Motor Fatalities in Young Men ” published

Psychiatry (1). The authors did not discuss the possible underlying mechanisms leading to fatal collisions. How might psychiatric risk factors manifest in functional driving impairments and automobile fatalities? We would like to offer some speculations of our own. The authors make no mention of an important Axis I diagnosis strongly associated with motor vehicle collisions: attention deficit-hyperactivity disorder (ADHD). The likelihood of this association with ADHD is strengthened by demographic data on accident victims that showed significant deficits in education levels and academic achievement, which is quite commonly associated with both learning disabilities and ADHD. The literature is clear about the significantly increased risk of car accidents for adults with ADHD (2). This condition is comorbid wit