Longitudinal study of adverse driving outcomes among adolescents with ADHD

多动症青少年不良驾驶结果的纵向研究

• 批准号: 10678656
• 负责人: Allison Elizabeth Curry
• 金额: $ 71.8万
• 依托单位: CHILDREN'S HOSP OF PHILADELPHIA
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-09-22 至 2026-07-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10678656
• 关键词: Accelerometer; Address; Adolescence; Adolescent; Alcohol consumption; Attention deficit hyperactivity disorder; Automobile Driving; Behavior; Cause of Death; Cellular Phone; Childhood; Complement; Data; Disease; Disruptive Behavior Disorder; Distal; Ecological momentary assessment; Economics; Environment; Event; Executive Dysfunction; Eye; Family; Foundations; Goals; Impairment; Individual; Intervention; Knowledge; Learning; Licensing; Licensure; Link; Longitudinal Studies; Measurement; Measures; Methods; Modernization; Monitor; Outcome; Parents; Participant; Patient Self-Report; Pattern; Performance; Persons; Pharmaceutical Preparations; Phase; Policies; Population Study; Prevalence; Prospective, cohort study; Records; Research; Research Design; Resources; Risk; Risk Factors; Safety; Seat Belts; Societies; Speed; Stimulant; Subgroup; Surveys; System; Technology; Teenagers; Text; Time; Vehicle crash; Work; Young driver; adverse outcome; aged; behavioral outcome; cohort; data warehouse; design; driving behavior; driving safety; evidence base; executive function; high risk; innovation; kinematics; modifiable risk; programs; recruit; risky driving; skills; social; teen drivers; therapy development; unsafe driving

Project Abstract ADHD is one of the most common childhood disorders and often persists into adolescence—a period in which many individuals get licensed to drive. The ability to drive is important to an individual's participation in modern society, as it enhances independence and social and economic opportunity. However, motor vehicle crashes are the leading cause of death among teens. Skills that are critical in driving, including executive functioning, are frequently impaired in individuals with ADHD. Thus, research is critically needed to establish the scientific foun- dation for driving risks among teens with ADHD so that evidence-based countermeasures to reduce crash risk can be developed. Our initial R01 project established that the risk of crash involvement for newly licensed teen drivers with ADHD is 30%-40% higher than same-aged drivers without ADHD (Curry 2017 and 2019). This R01 renewal directly addresses the next logical critical gap: understanding why crash risk is elevated for teen drivers with ADHD. Our overall objective is to identify specific factors that heighten driving risks for teen drivers with ADHD. We will accomplish this with three specific aims. In Aim 1 we will identify distal factors (outside vehicle environment) that heighten risk of adverse driving outcomes for teens with ADHD. In Aim 2 we will identify prox- imal factors (within vehicle environment) that heighten risk. Finally, in Aim 3 we will examine (among drivers with ADHD) the association between ADHD-related factors—including medication use, current ADHD impairment, and the presence of co-occurringdisruptivebehavioral disorder—andadversedriving outcomes. To achieveAim 1, we will conduct a prospective cohort study of 1,000 teen-parent dyads (500 with ADHD, 500 without ADHD). Participants will complete a baseline and four wave surveys that span from the learner phase through the first 15 months of independent driving. Survey data will be linked to objective driving outcomes captured via a smartphone data logger and existing state-level administrative data on moving violations and crashes. To achieve Aims 2 and 3, we will conduct a naturalistic driving study that will include 90 teens from Study 1 as they obtain an intermediate license (10 without ADHD, 40 with ADHD and prescribed ADHD medication, 40 with ADHD and not prescribed ADHD medication). Innovative in-vehicle technology in teens' vehicles will continu- ously monitor driving patterns, behaviors, and performance for the first 12 months of licensure. We will also collect daily medication use for the first 3 months of licensure utilizing innovative ecological momentary assess- ment methods via text prompts. This will enable us to conduct the first examination of how ADHD medication use influences real-world naturalistic driving performance. We expect that the rich foundational information gen- erated from this project will provide critical knowledge about driving risks for teens with ADHD. The project will make a positive impact in that it will enable us to begin addressing the pressing need for targeted interventions for teens with ADHD and their families during the learning-to-drive period—ultimately optimizing their safety as independent drivers.

项目摘要 多动症是最常见的儿童疾病之一，经常持续到青少年，这是一个时期 许多人被许可开车。驾驶能力对于个人参与现代很重要 社会可以增强独立性，社会和经济机会。但是，汽车坠毁 是青少年死亡的主要原因。驾驶至关重要的技能，包括执行功能，是 患有多动症的人经常受到损害。这是需要进行研究的，以建立科学的Foun- 因多动症的青少年驾驶风险而出发 可以开发。我们最初的R01项目确定，新许可的青少年发生崩溃的风险 ADHD的驾驶员比没有多动症的同一驾驶员高30％-40％（Curry 2017和2019）。此R01 续签直接解决下一个逻辑关键差距：了解为什么青少年司机的崩溃风险升高 与多动症。我们的总体目标是确定特定因素，以增加对青少年驾驶员的驾驶风险 多动症。我们将以三个具体的目标来实现这一目标。在AIM 1中，我们将确定远端因素（外辆外辆 环境）增加了ADHD青少年的不利驾驶结果的风险。在AIM 2中，我们将确定Prox- IMAL因素（在​​车辆环境中）增加了风险。最后，在AIM 3中，我们将检查（在驾驶员中 ADHD）与多动症相关因素之间的关联 - 包括药物使用，当前的多动症障碍， 并存在同时性的干扰性行为障碍 - 和逆转的结果。到Achieveaim 1，我们将对1,000名青少年二元组（500多种多动症，无多动症500）进行前瞻性队列研究。 参与者将完成一个从学习阶段到第一个的基线和四个浪潮调查 15个月独立驾驶。调查数据将链接到通过A捕获的客观驾驶结果 智能手机数据记录仪和现有的有关移动违规和崩溃的州级管理数据。到 达到目标2和3，我们将进行一项自然主义驾驶研究，其中包括研究1的90名青少年 获得中级许可（10个没有多动症的10，40岁的ADHD和规定的ADHD药物，40 多动症，未开处方多动症药物）。青少年工具中的创新车载技术将继续 - 在前12个月的许可证中，请监视驾驶模式，行为和性能。我们也会 利用创新的生态瞬时评估，收集每日用药的前三个月许可证 - 通过文本提示进行方法。这将使我们能够对ADHD药物进行首次检查 使用会影响现实世界的自然主义驾驶性能。我们期望丰富的基础信息基础 - 从该项目中获得的将提供有关ADHD青少年驾驶风险的重要知识。该项目将 产生积极的影响，使我们能够开始解决针对性干预的紧迫需求 对于在学习到驱动时期的ADHD及其家人的青少年来说，将其安全性优化为 独立司机。

项目成果

Comparison of Motor Vehicle Crashes, Traffic Violations, and License Suspensions Between Autistic and Non-Autistic Adolescent and Young Adult Drivers.

• DOI: 10.1016/j.jaac.2021.01.001
• 发表时间: 2021-07
• 期刊: Journal of the American Academy of Child and Adolescent Psychiatry
• 影响因子: 13.3
• 作者: Curry AE;Metzger KB;Carey ME;Sartin EB;Huang P;Yerys BE
• 通讯作者: Yerys BE

Characterizing the Learning-to-Drive Period for Teens with Attention Deficits.

描述注意力缺陷青少年学习驾驶时期的特征。

• DOI: 10.1097/dbp.0000000000000706
• 发表时间: 2019
• 期刊: Journal of developmental and behavioral pediatrics : JDBP
• 作者: Bishop,HaleyJ;Curry,AllisonE;Stavrinos,Despina;Mirman,JessicaH
• 通讯作者: Mirman,JessicaH

Editorial: Paving the Way Toward Improving Safety Among Drivers With Attention-Deficit/Hyperactivity Disorder.

• DOI: 10.1016/j.jaac.2020.02.012
• 发表时间: 2020-08
• 期刊: Journal of the American Academy of Child and Adolescent Psychiatry
• 影响因子: 13.3
• 作者: Curry AE;Power TJ
• 通讯作者: Power TJ

Validation of the Use of Electronic Health Records for Classification of ADHD Status.

• DOI: 10.1177/1087054716672337
• 发表时间: 2019-11-01
• 期刊: Journal of attention disorders
• 影响因子: 3
• 作者: Gruschow SM;Yerys BE;Power TJ;Durbin DR;Curry AE
• 通讯作者: Curry AE

Chronic Care for Attention-Deficit/Hyperactivity Disorder: Clinical Management from Childhood Through Adolescence.

• DOI: 10.1097/dbp.0000000000000772
• 发表时间: 2020
• 期刊: JOURNAL OF DEVELOPMENTAL AND BEHAVIORAL PEDIATRICS
• 影响因子: 2.4
• 作者: Moss, Cierra M.;Metzger, Kristina B.;Carey, Meghan E.;Blum, Nathan J.;Curry, Allison E.;Power, Thomas J.
• 通讯作者: Power, Thomas J.