Research Papers

Attention Deficit Hyperactivity Disorder, Other Disorders and Driving: Population-based Examination in a Canadian Sample

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Date added June 17, 2014
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Category 2014 CMRSC XXIV Vancouver
Tags Research and Evaluation, Session 6B
Author/Auteur Evelyn Vingilis, Robert E. Mann, Patricia Erickson, Maggie Toplak, Umesh Jain, Nathan Kolla, Jane Seeley
Stream/Volet Research and Evaluation

Slidedeck Presentation Only (no paper submitted)

6B Vingilis_Attention Deficit Hyperactivity Disorder, Other Disorders and Driving

Abstract

Background: Attention Deficit Hyperactivity Disorder (ADHD) has been associated with increased risk of traffic offences and collisions. However, these results may be partially mediated by other co-morbid externalizing disorders, such as antisocial personality disorder. Additionally, some research has shown that those with ADHD have higher odds of substance use, externalizing and internalizing disorders. Thus, questions about the relationships among ADHD, other psychiatric disorders, substance use and driving-related outcomes need to be explored.

Aims: To examine the relationships among ADHD, other psychiatric problems, alcohol and drug use and driving-related outcomes among a provincially representative sample of adults 18 years and older living in the province of Ontario, Canada.

Method: The Centre for Addictions and Mental Health (CAMH) Ontario Monitor is an ongoing repeated cross-sectional telephone survey of Ontario adults (18 and over) which includes validated measures: ADHD measures (Adult ADHD Self-Report Scale-V1.1 (ASRS-V1.1), previous ADHD diagnosis, ADHD medication use); psychiatric distress (anxiety/depression) measures (General Health Questionnaire (GHQ12), anxiety/depression medication use); antisocial behaviour measure (The Antisocial Personality Disorder Scale from the Mini-International Neuropsychiatric Interview (MINI-APD)); substance use and abuse measures (quantity and frequency questions for alcohol, tobacco, cannabis and cocaine (Q-F substances), Alcohol Use Disorders Identification Test (AUDIT), Alcohol, Smoking and Substance Involvement Screening Test (ASSIST)); driving-related outcomes (driving after drinking, driving after cannabis use, road rage, collisions in past year) and socio-demographics (gender, age). This study presents statistically weighted results of the first two years survey sample of a 3-year study.

Results: A total of 3361 Ontario residents were sampled, of which 105 (3.1%) screened positively for ADHD on the ASRS-V1.1 screening tool. Of those who screened positively for ADHD, 54.3% were female and 45.7% were male. For the age breakdown of ADHD positive screen, 5.7% were aged 18-24, 3.8% were aged 25-44, 2.9% were aged 45-64 and 0.006% were 65 years and older. A significantly greater percentage of those who screened ADHD positive (12.4%) reported at least one crash in the past year compared with those who screened ADHD negative (5.6%), although there were no differences between the ADHD positive and negative screened respondents on driving a motor vehicle after having two or more drinks in the previous hour, driving a motor vehicle within an hour of using cannabis, marijuana or hash, road rage or street racing. When a sequential regression was conducted to predict self-reported crashes, only age, weekly km driven and lifetime cannabis use predicted crashes, while ADHD positive screen, antisocial personality screen, distress screen, lifetime cocaine use, anxiety, depression and pain medication use did not.

Discussion and Conclusions: This study is the first population-based study of a representative sample of adults 18 years and older living in Ontario, Canada. These early results showed no relationship between the ADHD screen and crashes when age, sex and kilometres driven are controlled for, although lifetime cannabis use was a significant predictor. However, these analyses are based on self-report screeners and not psychiatric diagnoses and small sample of ADHD respondents. Thus, these results should be interpreted with caution.

Evelyn Vingilis, Robert E. Mann, Patricia Erickson, Maggie Toplak, Umesh Jain, Nathan Kolla, Jane Seeley