Characterizing Impaired Driving in Adults With Attention-Deficit/Hyperactivity Disorder: A Controlled Study.
J Clin Psychiatry 2006;67(4):567-574
© Copyright 2014 Physicians Postgraduate Press, Inc.
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Objective: We sought to confirm
previously documented findings that individuals with
attention-deficit/hyperactivity disorder (ADHD) demonstrate impaired driving behavior
when compared with controls.
Method: Subjects were adults with
(N = 26) and without (N = 23) DSM-IV ADHD ascertained through clinical referrals to an adult ADHD
program and through advertisements in the local media. Driving behavior was assessed using
the Manchester Driving Behavior Questionnaire (DBQ) and 10 questions from a driving
history questionnaire. Neuropsychological testing
and structured interviews were also administered
to all subjects.
Results: Substantially more ADHD
subjects had been in an accident on the highway (35%
vs. 9%, p = .03) or had been rear-ended (50% vs. 17%, p = .02) compared with controls.
Analysis of the DBQ findings showed that ADHD
subjects had significantly higher mean ± SD scores
than control subjects on the total DBQ (34.1 ± 15.2
vs. 18.0 ± 8.6, p < .001) and in all 3 subscales of
the DBQ: errors (9.3 ± 5.4 vs. 4.6 ± 3.5,
p < .001), lapses (12.4 ± 6.2 vs. 6.1 ± 3.5, p < .001),
and violations (12.4 ± 5.2 vs. 7.4 ± 4.1,
p < .001). Using the score that separated ADHD from
control drivers on the DBQ as a cutoff, ADHD drivers at high risk for poor driving outcomes
had more severe rates of comorbidity and exhibited more impaired scores on
Conclusions: Our results confirm and
extend previous work documenting impaired driving behavior in subjects with ADHD. Results
also suggest that ADHD individuals at high risk
for poor driving behavior might be distinguishable from other ADHD individuals on DBQ
scores, neuropsychological deficits, and patterns of