Author(s): Wickens, Mann, Ialomiteanu, Vingilis, Seeley, Erickson, Kolla
Dr. Charles H. Miller Award
A number of studies have identified an increased risk of collision among those affected by mental health issues. However, given divergent symptoms, it is important to address each mental health issue independently.
Conduct disorder (CD) is diagnosed based on an extended pattern of antisocial behaviour including the serious breach of laws and social norms. Comorbid presentation of other disorders is possible, including most commonly attention deficit hyperactivity disorder (ADHD) and oppositional defiant disorder. There has been relatively little research examining the impact of CD on driver behaviour, yet what research has been conducted has identified an association between CD and various risky driver behaviours, including driver aggression, driving after drinking, and other traffic citations. The purpose of the current study was to utilize an existing population-level dataset to estimate the association between probable CD during childhood and past-year collision risk, both unadjusted and adjusted for demographic characteristics, driving exposure, and other risk factors. Data are based on telephone interviews with 5,299 respondents who reported having driven in the past year, derived from the 2011-2013 cycles of the CAMH Monitor, an ongoing cross-sectional survey of adults in Ontario, Canada aged 18 years and older. A sequential binary logistic regression of self-reported collision involvement in the previous 12 months was conducted, consisting of measures of demographic characteristics, driving exposure, demonstrated symptoms of ADHD, driver aggression, driving after drinking, and childhood (before age 15 years) symptoms of CD. The unadjusted odds ratio of past-year collision involvement for those reporting childhood symptoms of CD was 1.76 (p=0.018). Controlling for demographic characteristics, driving exposure, ADHD symptom status, and risky driver behaviour, self-reporting childhood symptoms of CD was significantly associated with a 78% increase in the odds of a crash (p=.045). Results suggest that symptoms of CD during childhood are associated with significantly increased odds of self-reported past-year collision involvement during adulthood. Even after adjusting for a number of relevant factors known to increase collision risk, including ADHD symptoms, driver aggression, and driving after drinking, the relationship between childhood symptoms of CD and collision risk persisted. These findings add to a growing literature and suggest that treatment for CD should include a focus on driver safety. Moreover, future research is needed to identify other potential mechanisms, beyond driver aggression and driving after drinking, by which CD may impact driver safety.