Adult attention-deficit hyperactivity disorder, risky behaviors, and motorcycle injuries: a case-control study

Abstract

BackgroundThe aim of this study was to assess the association of motorcycle traffic injuries with motorcycle riding behavior and subtypes of attention-deficit hyperactivity disorder (ADHD) while controlling for individual correlates of motorcycle traffic injuries.MethodsA case-control study was carried out in 298 patients with motorcycle trauma along with 151 control patients admitted to the Shohada and Imam Reza university hospitals as the two referral specialty centers in the East Azarbyjan Province of Iran in 2013. The Persian version of the Motorcycle Riding Behavior Questionnaire and the Persian version of Conner’s Adult ADHD Rating Scales (the self-report short version) were used to assess riding behavior and screen for adult ADHD, respectively. The scale has four subscales, comprising subscale A (inattention), subscale B (hyperactivity, impulsivity), subscale C (A + C), and subscale D (ADHD index). The statistical analysis was done using Stata version 11.ResultsAll subjects were male and aged 13–79 years. Approximately 54% of the participants were married and 13% had academic education. Approximately 18% of the motorcycle riders stated that their motorcycle riding was only for fun purposes. More than two thirds of the participants did not have a motorcycle riding license. Variables found to be significantly associated with motorcycle injuries in bivariate analysis included age, marital status, educational level, having a motorcycle riding license, using a helmet while riding, daily amount of riding, riding just for fun, riding behavior score, and ADHD scale scores. It was found in multivariate analysis that if the ADHD index (subscale D) score was used to assess the association of ADHD with motorcycle injuries, a protective role for ADHD was observed. However, the two other subscales showed a different predictive pattern for subscale A versus subscale B, with only subscale B increasing the likelihood of motorcycle traffic injuries. The score based on motorcycle rider behavior was found to be associated with motorcycle injuries. Other variables that were significant in multivariate models were the purpose of riding, educational level, economic status, and marital status.ConclusionADHD and riding behavior scores affect the likelihood of motorcycle traffic injuries among motorcycle riders independent of other injury indicators, and include education, purpose of riding, and economic status.

Role of ADHD in risky riding behavior: a statistical modeling

“…The sample size was calculated utilizing the information on the main outcome, the relation between MRB and ADHD, and the information was attained from the study by Abedi et al (Sadeghi-Bazargani et al, 2015a). By the confidence level of 95 and 80% power, 227 subjects were estimated to participate in the study.…”

“…Similarly, in the study by Özkan et al (2012), higher scores on the speed violations and the stunts scales of MRB were significantly related to more self-reported offenses (Özkan et al, 2012). The other studies reported the same set of predictors and mainly ADHD (and the subscales) as the determinates of risky riding behavior in Iran (Sadeghi-Bazargani et al, 2015b, Sadeghi-Bazargani et al, 2019, Safiri et al, 2013. MRB may intentionally or unintentionally lead to or prevent RTA (Haque et al, 2010, Stephens et al, 2017, Truong et al, 2018.…”

“…Riders with ADHD are 3-4 times more likely to get into an accident than riders without ADHD (Barkley et al, 1993). Other studies also reported ADHD as a predictor of injuries in motorcyclists (Sadeghi-Bazargani et al, 2015a. Identifying the role of ADHD can be regarded as a valuable achievement in traffic safety (Shappell andWiegmann 2012, Weiss et al, 1979) both directly and by mediating via other variables.…”

“…On the other hand, choosing optimal statistical techniques is crucial to achieving minimum bias and guarantees lower error probability and hence better decision making (Anderson, 1996). All previous studies utilized Generalized Linear Models (GLM) (Sadeghi-Bazargani et al, 2015a, Sakashita et al, 2014, Safiri et al, 2013, Babajanpour et al, 2017 which have some limitations. These models did not take into account the measurement error and the causality in the relations.…”

Does Severity of Attention Deficit /Hyperactivity Disorder impact Trauma in Children?

“…Based on a systematic review, people with ADHD are more likely to be injured; the risk is reported as two-fold. 12 Considering that there is no similar study in the region, if this study shows a relationship between the severity of trauma and ADHD symptoms in children, the next step will be conduction of a research on making home and school settings safe for them. Since trauma is related to road accidents, this study can lay the ground for further investigations and enrich the existing knowledge.…”