Risky Driving in Adolescents and Young Adults with Childhood ADHD: Mediation by ADHD Symptoms, Irritability, and Conduct Problems at Follow-up

As driving is a task that requires vigilance and planful behavior, adolescents and young adults with a history of attention deficit hyperactivity disorder (ADHD) are an important population to study in regard to risky driving behaviors. This study provides a comprehensive examination of risky driving behaviors- beyond tickets and accidents and including alcohol-impaired driving- in a large sample of adolescents and young adults diagnosed in childhood with ADHD and demographically similar community controls without childhood ADHD. Self-report of citations and accidents, alcohol impaired driving, and risky driving behaviors (speeding, following too closely, etc.) were examined, in relation to the presence or absence of a childhood diagnosis of ADHD, potential age related interactions, and the self- and parent-report of current levels of hyperactivity-impulsivity, inattention, irritability, and conduct problems. Results indicate that probands were more likely than controls to have ever driven without a license, to receive more traffic citations, and to be involved in more accidents; there was a trend toward more license suspensions in the ADHD group. No group differences were found for the risky driving and alcohol-impaired driving scales. Multiple regression revealed that hyperactivity-impulsivity was associated with risky driving above and beyond the contribution of conduct problems, while irritability at follow-up was significantly associated with alcohol-impaired driving. In addition, exploratory mediational analyses indicated that hyperactivity-impulsivity and irritability at follow-up (when tested separately) were significant mediators of the association between childhood ADHD and number of tickets and accidents. Findings inconsistent with previous literature are explained in terms of the validity of self-report in the ADHD population, the nature of the proband sample, and potential measurement bias. The unique contributions of hyperactivity-impulsivity, inattention, irritability, and conduct problems are discussed