Impact of Methylphenidate Delivery Profiles on Driving Performance of Adolescents With Attention-Deficit/Hyperactivity Disorder: A Pilot Study

Cox, Daniel J.; Merkel, R. Lawrence; Penberthy, J. Kim; Kovatchev, Boris; Hankin, Cheryl S.

doi:10.1097/00004583-200403000-00007

Cited by 91 publications

(45 citation statements)

References 27 publications

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“…It is interesting to note that the control variables in this study, as observed in the previous simulator driving study, 14 were not affected by treatment with stimulants. This can be interpreted in 2 possible ways: given the high number of speeding errors, either adolescents typically engage in speeding, or alternatively, treatment with MPH does not address issues related to speed control.…”

Section: Discussionsupporting

confidence: 64%

“…Although previous research has demonstrated that MPH improves driving performance on a simulator, 9,14 this is the first study to demonstrate that controlled-release MPH is effective in reducing inattention while adolescent male subjects with ADHD drive their own cars on an actual road segment. Specifically, controlled-release MPH seemed to reduce inattention while driving.…”

Section: Discussionmentioning

confidence: 76%

“…Items on this checklist were based on our driving simulation findings. 9,14 Because speed control was not previously affected by stimulant medications using the driving simulator, 9,14 speed control (speeding and driving too slow relative to traffic) were used as a control variable for any placebo effect and were not anticipated to change in this study. The remaining variables were positively affected by stimulant medication and this was anticipated to be the case for this study.…”

Section: Methodsmentioning

confidence: 99%

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Controlled-Release Methylphenidate Improves Attention During On-Road Driving by Adolescents with Attention-Deficit/Hyperactivity Disorder

Cox

Humphrey²,

Merkel³

et al. 2004

The Journal of the American Board of Family Medicine

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Background: Attention-deficit/hyperactivity disorder (ADHD) is associated with a 3-to 4-fold increase in both driving-related accidents and associated injuries. Methylphenidate (MPH) is the most commonly prescribed psychostimulant medication for ADHD. It has been demonstrated to improve performance on a driving simulator. This study investigated whether a once-daily, long-acting, osmotic, controlledrelease MPH formulation improves the driving performance of ADHD adolescents while driving their own car on an actual road segment.Methods: Twelve ADHD-diagnosed male adolescent drivers (mean age, 17.8 years) prescribed a standard dose of 1.0 mg/kg (if they were not already taking methylphenidate) of controlled-release MPH participated in this repeated-measures crossover study. On 2 separate occasions (off/on medication randomized), participants drove a standard 16-mile road course incorporating rural, highway, and urban streets. A rater, blind to medication conditions, sat in the back seat and rated impulsive (eg, "cutting off" another driver) and inattentive (eg, drove past designated turn) driving errors.Results: Impulsive driving errors were observed to occur rarely under both medication and no medication conditions. Inattentive driving errors were more common and were significantly reduced while the subject was on medication (4.6 versus 7.8; P < .01). The improvement in driving performance (change in number of errors recorded) from first to second testing was positively correlated with medication dosage (r ‫؍‬ 0.60; P < .01). Conclusions

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Section: Discussionsupporting

confidence: 64%

Section: Discussionmentioning

confidence: 76%

Section: Methodsmentioning

confidence: 99%

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Controlled-Release Methylphenidate Improves Attention During On-Road Driving by Adolescents with Attention-Deficit/Hyperactivity Disorder

Cox

Humphrey²,

Merkel³

et al. 2004

The Journal of the American Board of Family Medicine

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“…The issue is one of measurement validity: To what extent does the simulator produce driving behaviors that are comparable to real driving behaviors? The issue of validity is particularly acute as researchers seek to understand the impact of various medical conditions and interventions on driving behaviors (e.g., for ADHD, see Cox, Merkel, Penberthy, Kovatchev, & Hankin, 2004; for schizophrenia, see Brunnauer, Laux, Geiger, & Möller, 2004; for Alzheimer's disease, see Rizzo, Reinach, McGehee, & Dawson, 1997). The gold standard of validating simulation protocols has typically been through a comparison of simulation data with data collected from on-road driving; however, in this study, we take a different approach.…”

mentioning

confidence: 99%

Using self-reported data to assess the validity of driving simulation data

Reimer

D’Ambrosio

Coughlin

et al. 2006

Behavior Research Methods

100

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In this article, we use self-reported driving behaviors from a written questionnaire to assess the measurement validity of data derived from a driving simulation. The issue of validity concerns the extent to which measures from the experimental context map onto constructs of interest. Following a description of the experimental methods and setting, an argument for the face validity of the data is advanced. Convergent validity was assessed by regressing behaviors observed in the driving simulator on self-reported measures of driving behaviors. Significant relationships were found across six measures: accidents, speeding, velocity, passing, weaving between traffic, and behavior at stop signs. Concurrent validity was evaluated with an analysis of simulator accident involvement and attention deficit hyperactivity disorder status. Discriminant validity was assessed using a multitrait-multimethod matrix of simulator and questionnaire data. We concluded that although the relationship between self-reported behaviors and observed responses in the simulator falls short of perfect correspondence, the data collected from the driving simulator are valid measures of the behaviors of interest.

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“…44 Compared with 3-times-a-day dosing of methylphenidate, longer-acting, controlled-release medication may result in better driving throughout the day and, particularly, during the evening hours. 45 …”

Section: Attention-deficit/hyperactivity Disordermentioning

confidence: 99%

The Teen Driver

Alderman¹,

Johnston²,

Prevention³

2006

Pediatrics

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Motor vehicle-related injuries to adolescents continue to be of paramount importance to society. Since the original policy statement on the teenaged driver was published in 1996, there have been substantial changes in many state laws and much new research on this topic. There is a need to provide pediatricians with up-to-date information and materials to facilitate appropriate counseling and anticipatory guidance. This statement describes why teenagers are at greater risk of motor vehicle-related injuries, suggests topics suitable for office-based counseling, describes innovative programs, and proposes preventive interventions for pediatricians, parents, legislators, educators, and other child advocates. MAGNITUDE OF THE PROBLEMMotor vehicle crashes continue to be the leading cause of death for 16-to 20-year-olds, accounting for approximately 5500 occupant fatalities annually (27 deaths per 100 000 population). 1 Each year, approximately 450 000 teenagers are injured, and 27 000 of them require hospitalization. 1,2 Of those killed, approximately 63% are drivers and 37% are passengers. Two thirds of the teenagers who die in automobile crashes are male. 1 In 2004, 7700 teenaged drivers were involved in a crash in which someone died. Although the 12 million adolescent drivers represent only approximately 6% of total drivers, they account for approximately 14% of the fatal crashes. 3 In terms of total crashes per million miles driven, 16-to 19-year-olds have a crash rate almost twice that of 20-to 24-year-olds, almost 3 times that of 25-to 29-year-olds, and more than 4 times that of 30-to 69-year olds. 4 Within the 16-to 19-year age range, the youngest drivers have the highest risk. The crash rate for 16-year-olds (35 crashes per million miles) is much higher than that even for 17-year-olds (20 crashes per million miles) and is almost 9 times greater than that of the general population of drivers (4 crashes per million miles). ADOLESCENT RISK FACTORS InexperienceThe adolescent, as a novice driver, lacks the experience and ability to perform many of the complex tasks of ordinary driving. Compared with experienced drivers, the novice adolescent driver is less proficient in detecting and responding to hazards and controlling the vehicle, especially at higher speeds. The risk of having a crash during the learner-permit stage is low, because the teenager is supervised and is generally not driving in high-risk conditions. 4 In contrast, data from Nova Scotia show that the highest crash rate is seen during the first month after the teenager gets his or her license (120 crashes per 10 000 drivers). 5 After the first month, the crash rate decreases rather quickly over the next 5 months (70 crashes per 10 000 drivers) and then shows a slower decline for the next 18 months (50 crashes per 10 000 drivers). Because rapid improvement is seen over such a short time period, inexperience appears to be a much more important factor in crash rates than young age. Although these data also show that driver experience improves dri...

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Impact of Methylphenidate Delivery Profiles on Driving Performance of Adolescents With Attention-Deficit/Hyperactivity Disorder: A Pilot Study

Cited by 91 publications

References 27 publications

Controlled-Release Methylphenidate Improves Attention During On-Road Driving by Adolescents with Attention-Deficit/Hyperactivity Disorder

Controlled-Release Methylphenidate Improves Attention During On-Road Driving by Adolescents with Attention-Deficit/Hyperactivity Disorder

Using self-reported data to assess the validity of driving simulation data

The Teen Driver

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