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Nurs Res. 2018 May/Jun;67(3):202-211. doi: 10.1097/NNR.0000000000000270.

Simulated Driving Performance, Self-Reported Driving Behaviors, and Mental Health Symptoms in Adolescent Novice Drivers.

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Catherine C. McDonald, PhD, RN, FAAN, is Assistant Professor, School of Nursing, University of Pennsylvania; Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania; and Center for Injury Research and Prevention, Children's Hospital of Philadelphia, Pennsylvania. Marilyn S. Sommers, PhD, RN, FAAN, is Professor Emerita, School of Nursing, University of Pennsylvania, Philadelphia. Jamison D. Fargo, PhD, is Professor, Department of Psychology, Utah State University, Logan. Thomas Seacrist, MBE, is Director of Training, Project Manager-Biomechanics, The Center for Injury Research and Prevention, Children's Hospital of Philadelphia, Pennsylvania. Thomas Power, PhD, is Director of Center for Management of ADHD, Department of Pediatrics and Department of Child and Adolescent Psychiatry and Behavioral Sciences at Children's Hospital of Philadelphia, and Professor of School Psychology in Pediatrics and Psychiatry at Perelman School of Medicine at University of Pennsylvania, Philadelphia.



Risky driving behaviors contribute to adolescent injury, disability, and death, yet little is known about how mental health factors are associated with adolescent driving behaviors.


The purpose of the research was to determine the association of risky driving behaviors and mental health symptoms in novice adolescent drivers.


We recruited a convenience sample (n = 60) of adolescents to complete an assessment of driving performance errors in a high-fidelity simulator (Simulated Driving Assessment [SDA] Error Score) and a self-report measure of risky driving (Behavior of Young Novice Drivers Survey [BYNDS]). Participants also completed a mental health assessment of self-reported symptoms of depression (Center for Epidemiologic Studies-Depression Scale) and attention-deficit/hyperactivity disorder (ADHD; inattention and hyperactivity-impulsivity), conduct disorder, and oppositional defiant disorder (Conners-3 self-report and parent report). We evaluated the cross-sectional relationships between SDA Error Score, BYNDS, and mental health survey data with descriptive statistics, bivariate correlations, and linear regression.


In linear regression models, higher self-reported inattentive ADHD T-scores were associated with higher SDA Error Score (model adjusted R = .20). Higher self-reported T-scores of hyperactive-impulsive ADHD and conduct disorder were associated with higher BYNDS total scores (model adjusted R = .32). Parent report measures were not associated with adolescent BYNDS total score or SDA Error Score.


These data highlight the association of risky driving with adolescent symptoms of inattention, hyperactivity, and conduct disorder. The early stage of independent driving is an important time for addressing the relationship between driving performance and mental health conditions.


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