Faculty of Medicine and Health Sciences, University of Sherbrooke, Longueuil, Quebec, Canada2Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland.
Douglas Hospital Research Centre, McGill University, Montreal, Quebec, Canada.
JAMA Pediatr. 2014 Jun;168(6):517-22. doi: 10.1001/jamapediatrics.2013.5387.
Road traffic crashes are one of the leading causes of injury and death among teenagers worldwide. Better understanding of the individual pathways to driving risk may lead to better-targeted intervention in this vulnerable group.
To examine the relationship between cortisol, a neurobiological marker of stress regulation linked to risky behavior, and driving risk.
DESIGN, SETTING, AND PARTICIPANTS: The Naturalistic Teenage Driving Study was designed to continuously monitor the driving behavior of teenagers by instrumenting vehicles with kinematic sensors, cameras, and a global positioning system. During 2006-2008, a community sample of 42 newly licensed 16-year-old volunteer participants in the United States was recruited and driving behavior monitored. It was hypothesized in teenagers that higher cortisol response to stress is associated with (1) lower crash and near-crash (CNC) rates during their first 18 months of licensure and (2) faster reduction in CNC rates over time.
Participants' cortisol response during a stress-inducing task was assessed at baseline, followed by measurement of their involvement in CNCs and driving exposure during their first 18 months of licensure. Mixed-effect Poisson longitudinal regression models were used to examine the association between baseline cortisol response and CNC rates during the follow-up period.
Participants with a higher baseline cortisol response had lower CNC rates during the follow-up period (exponential of the regression coefficient, 0.93; 95% CI, 0.88-0.98) and faster decrease in CNC rates over time (exponential of the regression coefficient, 0.98; 95%, CI, 0.96-0.99).
Cortisol is a neurobiological marker associated with teenaged-driving risk. As in other problem-behavior fields, identification of an objective marker of teenaged-driving risk promises the development of more personalized intervention approaches.
道路交通碰撞是全球青少年受伤和死亡的主要原因之一。更好地了解导致驾驶风险的个体途径，可能会使这一脆弱群体得到更有针对性的干预。
研究皮质醇与驾驶风险的关系，皮质醇是一种与危险行为相关的神经生物学应激调节标志物。
设计、环境和参与者：青少年自然驾驶研究旨在通过运动传感器、摄像机和全球定位系统为车辆配备仪器，连续监测青少年的驾驶行为。2006 年至 2008 年，在美国招募了一个由 42 名新获得驾驶执照的 16 岁志愿者组成的社区样本，并对其驾驶行为进行了监测。研究假设，青少年皮质醇对压力的反应越高，（1）在获得驾照后的头 18 个月里，碰撞和接近碰撞（CNC）的发生率越低，（2）随着时间的推移，CNC 发生率的下降速度越快。
在基线时评估参与者在压力诱发任务中的皮质醇反应，然后在获得驾照后的头 18 个月内测量他们参与 CNC 及驾驶暴露情况。使用混合效应泊松纵向回归模型来检验基线皮质醇反应与随访期间 CNC 发生率之间的关系。
基线皮质醇反应较高的参与者在随访期间 CNC 发生率较低（回归系数的指数，0.93；95%置信区间，0.88-0.98），并且 CNC 发生率随时间的下降速度更快（回归系数的指数，0.98；95%置信区间，0.96-0.99）。
皮质醇是与青少年驾驶风险相关的神经生物学标志物。与其他行为问题领域一样，确定青少年驾驶风险的客观标志物有望开发出更具个性化的干预方法。
