Both worldwide and in the UnitedStates, major contributors to adolescent and early adult mortality and morbidity arise from health risks characterized as behavioral misadventure. The large majority of deaths among 10-to 24-year olds are due to risk-related events, and morbidity statistics for nonfatal events show a similar pattern. Motor-vehicle crashes account for over one-third of adolescent deaths. The reason for this elevated risk is likely multifactorial, implicating developmental, environmental, and biological mechanisms. One leading theory suggests a developmental maturity mismatch (DMM) between an earlier and faster-developing limbic-based “bottom-up” neural system characterized by heightened reactivity to motivational stimuli and rewards, while the prefrontally organized “top down” system that enables more effective cognitive control and judgment matures more slowly. This DMM is hypothesized to contribute to elevated risk. Circadian timing may independently contribute to and interact with this DMM, increased risk for behavioral misadventure, and driver error. Both an evening chronotype and circadian misalignment are associated with decrements in sleep duration and sleep continuity, along with increased risk-taking and cognitive impairment. Thus, circadian mechanisms may affect neurocognitive pathways regulating reward-related behavior and decision making. Drowsy driving is common in adolescents and is a health-risk behavior that lends itself to exploring how the interaction of DMM and the regulation of the sleep-wake cycle may predispose novice, adolescent drivers to a set of developmentally unique vulnerabilities. There is thus a critical need to understand the mechanisms contributing to drowsy driving among novice, adolescent drivers, in order to improve preventive interventions, develop novel ones, and address potential changes in social and educational policies that can mitigate this major population health burden. The proposed research aims to characterize the role of chronotype and circadian misalignment in drowsy-driving and risky-driving behaviors, and the potentially mediating neurocognitive factors of impaired executive function and risk-reward processing. (Author/publisher)
Samenvatting