Vocational Safety Preference of College Men with and without Attention-Deficit/Hyperactivity Disorder: An Exploratory Study.

For college students with attention-deficit/hyperactivity disorder (ADHD),which is associated with increased accidental injury, mindfulness regarding safety issues in vocational choice may be indicated. In this study, a group of male college students with ADHD-predominantly inattentive type (ADHD-IA) reported placing less emphasis on job safety than did their peers when considering their professional direction. College counselors might help prevent work-related injury for similar clients by broaching the topic of safety when discussing vocational choice. ********** Attention-deficit/hyperactivity disorder (ADHD) is a syndrome with primary symptoms of behavioral and cognitive disinhibition (e.g., hyperactivity, inattention) and is among the most prevalent psychiatric conditions in both childhood (3%-12% prevalence; American Psychiatric Association [APA], 2000; Faraone, Sergeant, Gillberg, & Biederman, 2003) and adulthood (2%-6% prevalence; Wender, 1995). Among other salient impairments (e.g., academic, social; Shaw-Zirt, Popali-Lehane, Chaplin, & Bergman, 2005), ADHD has been associated with vocational underachievement. Existent studies have shown those with ADHD to hold lower status jobs than non-diagnosed peers and to show higher rates of job instability by the time they are in their 30s (Mannuzza, Klein, Bessler, Malloy, & LaPadula, 1998; Murphy & Barkley, 1996; G. Weiss, Hechtman, Milroy, & Perlman, 1985). As Murphy (2006) wrote, "impulsivity, inattention, careless mistakes, disorganization, poor time management, tardiness, short temper, missing deadlines, and inconsistency are just some of the things" (p. 700) that can characterize the adult with ADHD at work, giving ample reasons for their elevated rate of job termination. Although this body of prior work casts some light on the vocational adjustment of adults with ADHD, one aspect of their work that has not yet been examined has to do with physical safety. Issues regarding discrimination in hiring and work tenure (e.g., Americans With Disabilities Act [ADA] provisions) perhaps have impeded direct investigation of safety outcomes in high-risk work settings. However, empirical data collectively suggest that work safety could be problematic for adults with ADHD. For instance, motor coordination problems (Rasmussen & Gillberg, 2000) as well as general accidental injury (Rowe, Maughan, & Goodman, 2004; Swensen et al., 2004) have been shown to occur more frequently for individuals with ADHD than for others. The increased risk in adulthood is far from trivial. On the basis of their review of medical claims from a national manufacturer's database of more than 100,000 individuals, Swensen et al. reported that 38% of adults with ADHD filed an accident-related claim in 1998, whereas only 18% of their nondiagnosed peers did so. Using logistic regression modeling, an adult ADHD diagnosis translated into an estimated 90% increased risk of accident (i.e., odds ratio of 1.9; Swensen et al., 2004). Recent studies have also shown that this disorder is associated with substantial impairment in the ability to operate a motor vehicle (e.g., more frequent and severe accidents and moving violations; BarNey, Murphy, DuPaul, & Bush, 2002; Woodward, Fergusson, & Horwood, 2000), a task that is requisite in some jobs (e.g., law enforcement/emergency services) and quite similar to demands in others (e.g., operation of industrial vehicles and other machinery). Indeed, it seems logical that those with ADHD, a group that commonly has problems sustaining attention, would be at elevated risk for accidents and injury wherever work conditions require maintaining focus to adequately monitor potential hazards. However, some suggest that "relative to school, work can be an ADHD-friendly situation" (M. Weiss, Hechtman, & Weiss, 1999, p. 219) in that during adulthood, individuals with ADHD can move into work roles that de-emphasize their weaknesses. …