Task-induced fatigue and collisions in adult drivers with attention deficit hyperactivity disorder

OBJECTIVE: This study compares collision involvement between adult drivers with attention deficit hyperactivity disorder (ADHD) and control participants in a simulation experiment designed to enhance the effects of fatigue. Because the effects of ADHD include difficulties in maintaining attention, drivers with ADHD were hypothesized to be more susceptible to the effects of fatigue while driving. METHODS: Data are drawn from a validated driving simulation study, portions of which were focused on enhancing the effects of fatigue. The simulator data are supplemented with written questionnaire data. Drivers with ADHD were compared with controls. RESULTS: The self-report data indicated that drivers with ADHD were more likely to report having been involved in an accident within the previous five years. Simulation data showed that time of day of participation in the experiment were significantly related to likelihood of collision, and that these effects were further exacerbated by ADHD status. Participants with ADHD were more likely than controls to be involved in a crash in the simulator regardless of time of day, but the effects were particularly pronounced in the morning, and the rate of increase in accident involvement from the late afternoon into the evening was greater among participants with ADHD. No differences in self-reported sleep patterns or caffeine use were found between participants with ADHD and controls. CONCLUSIONS: The results suggest that drivers with ADHD became fatigued more quickly than controls. Such drivers thus face greater risk of involvement in accidents on highways or open roadways where the visual and task monotony of the environment contribute to greater driver fatigue.