Simulated driving performance of adults with ADHD: Comparisons with alcohol intoxication.

Abstract

Previous research has demonstrated that adults with ADHD are more likely to experience drivingrelated problems, which suggests that they may exhibit poorer driving performance. However, direct experimental evidence of this hypothesis is limited. The current study involved two experiments that evaluated driving performance in adults with ADHD in terms of the types of driving decrements typically associated with alcohol intoxication. Experiment 1 compared the simulated driving performance of 15 adults with ADHD to 23 adult control participants, who performed the task both while sober and intoxicated. Results showed that sober adults with ADHD exhibited decrements in driving performance compared to sober controls, and that the profile of impairment for the sober ADHD group did in fact resemble that of intoxicated drivers at the BAC level for legally impaired driving in the United States. Driving impairment of the intoxicated individuals was characterized by greater deviation of lane position, faster and more abrupt steering maneuvers, and increased speed variability. Experiment 2 was a dose-challenge study in which 8 adults with ADHD and 8 controls performed the driving simulation task under three doses of alcohol: 0.65 g/kg, 0.45 g/kg, and 0.0 g/kg (placebo). Results showed that driving performance in both groups was impaired in response to alcohol, and that individuals with ADHD exhibited generally poorer driving performance than did controls across all dose conditions. Together the findings provide compelling evidence to suggest that the cognitive and behavioral deficits associated with ADHD might impair driving performance in such a manner as to resemble that of an alcohol intoxicated driver. Moreover, alcohol might impair the performance of drivers with ADHD in an additive fashion that could considerably compromise their driving skill even at blood alcohol concentrations below the legal limit.The behavioral problems associated with attention deficit/hyperactivity disorder (ADHD) in adult populations have been the focus of increased interest among researchers in recent years. Although the majority of diagnoses occur during childhood, recent studies suggest that the disorder persists into adulthood in approximately 60% to 80% of cases (e.g., Barkley, Fischer, Smallish, & Fletcher, 2002;Weiss, Hechtman, & Weiss, 1999;Wender, 1995). During childhood, the problems associated with ADHD are characterized by heightened impulsivity and impaired inhibitory and attentional mechanisms. These cognitive and behavioral problems adversely impact the child's academic performance as evident by Correspondence concerning this article should be addressed to Mark Fillmore, Ph.D., Department of Psychology, University of Kentucky, Lexington, Fax (859) ; fillmore@uky.edu. NIH Public Access NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author Manuscript poor grades and disruptive classroom behavior (Frazier, Youngstrom, Glutting, & Watkins, 2007). Not surprisingly, for adults with ADHD, the cognitive impairments ...

Adult Attention-Deficit/Hyperactivity Disorder and Driving: Why and How to Manage It

“…The results showed that sober adults with ADHD were comparable to intoxicated controls with regard to lane deviation, fast/abrupt steering maneuvers, and speed variability. In addition, alcohol consumption was shown to further compromise the attention and driving performance of adults with ADHD [21,22]. These findings are further supported by data showing greater disinhibitory effects of alcohol on adults with (n=10) versus without (n=12) ADHD on a cued go/no-go task [23•].…”

“…In 2010, Reimer et al [20•] compared 60 drivers (25 young adults with, 35 without ADHD) while they manipulated boredom or challenge of the drive and concluded that drivers with ADHD appeared to be particularly susceptible to distraction during periods of low-stimulus driving. Weafer et al [21] compared the driving performance of sober and intoxicated ADHD (n= 15) and non-ADHD adults (n=23 adults) (alcohol dose, 0.65 g/kg). The results showed that sober adults with ADHD were comparable to intoxicated controls with regard to lane deviation, fast/abrupt steering maneuvers, and speed variability.…”

Driving Under the Influence of ADHD: Research and Policy Implications

“…As discussed above, we have demonstrated significantly worse driving performance in adults with ADHD relative to controls under both a moderate and high dose of alcohol in our lab (Weafer et al, 2008). In fact, on some driving measures, those with ADHD displayed significant impairment relative to placebo in response to the moderate dose of alcohol, which produced mean BACs around .05% (well under the legal limit of intoxication).…”

“…The cognitive deficits present in those with the disorder set the stage for potentially seriously impaired driving performance, and for this reason it is imperative that researchers, clinicians, and individuals with the disorder (and those close to them) learn as much as possible about the dangers and ways in which they can be prevented. Here, we wish to summarize research findings from an article we recently published in the journal Experimental and Clinical Psychopharmacology and highlight several policy implications (Weafer, Camarillo, Fillmore, Milich, & Marczinski, 2008).…”

“…To test this hypothesis, we conducted a study in which simulated driving performance of individuals with ADHD (medication free) was compared to that of both sober and intoxicated healthy controls (Weafer et al, 2008). The simulated drive was approximately 20 minutes long and consisted of a winding road and occasional hills presented in a rural wooded area with a few buildings.…”