Adolescent Girls' ADHD Symptoms and Young Adult Driving: The Role of Perceived Deviant Peer Affiliation

Abstract

Our goal was to examine the role of adolescent perceived deviant peer affiliation in mediating or moderating the association between adolescent attention-deficit/hyperactivity disorder (ADHD) symptoms and young adult driving risk in females with and without ADHD. The overall sample included 228 ethnically and socioeconomically diverse girls with or without a diagnosis of ADHD in childhood (Wave 1; 6–12 years) followed through adolescence (Wave 2; 11–18 years) and into young adulthood (Wave 3; 17–24 years). A subsample of 103 girls with a driving license by Wave 3 and with full data for all study variables was utilized in this investigation. In adolescence, mothers and teachers reported on ADHD symptoms (inattention and hyperactivity/impulsivity), and participants reported on perceived deviant peer affiliation. In young adulthood, participants reported on driving behavior and outcomes, including number of accidents, number of moving vehicle citations, and ever having driven illegally. Covariates included age and adolescent oppositional defiant disorder/conduct disorder. Inattention directly predicted citations. Perceived deviant peer affiliation mediated the association between inattention and (a) accidents and (b) citations. In addition, perceived deviant peer affiliation moderated the association between hyperactivity/impulsivity and accidents, with hyperactivity/impulsivity predicting accidents only for those with low perceived deviant peer affiliation. Perceived deviant peer affiliation appears to play an important role in the association between ADHD symptoms and driving outcomes. Our findings provide preliminary evidence that both ADHD symptoms and peer processes should be targeted in interventions that aim to prevent negative driving outcomes in young women with and without ADHD.

Acknowledgments

This project was supported by NIMH Grant R01 45064. We gratefully acknowledge the girls—now young women—who have participated in our ongoing investigation, along with their caregivers and our large numbers of graduate students and research assistants. Their remarkable dedication has made this research possible.

Notes

Note: N = 103. Descriptive statistics are presented as unwinsorized values for ease of interpretation. ODD/CD and Illegal Driving are dichotomous variables. Age = age in months at Wave 1 (baseline); Freq. = percentage of young adults with a score greater than 0 for each of the driving variables. Hyper. = hyperactivity; Dev. = deviant.

†p < .055. *p < .05. **p < .01. ***p < .001.

Note: N = 103. Mediated effects are considered significant if the confidence interval (CI) does not contain zero. Illegal Driving is a dichotomous outcome variable. IA = inattention; HI = hyperactivity/impulsivity; DP = perceived deviant peer affiliation.

¹We also conducted exploratory analyses to determine the independent contribution of each symptom dimension to driving risk. For mediation models, when controlling for IA in HI analyses and HI in IA analyses, all significant direct effects remained significant, but there were no indirect effects. Although it is possible that neither symptom dimension independently contributes to indirect effects on driving risk via perceived deviant peer affiliation, the lack of significant findings may well relate to the substantial overlap in these symptom clusters (r = .72), which may result in overcontrol (see Miller & Chapman, 2001, for discussion of this issue), as well as lack of power. For moderation models, all significant results remained significant when controlling for IA in HI analyses and when controlling for HI in IA analyses.