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Döbler NA, Carbon CC. Adapting Ourselves, Instead of the Environment: An Inquiry into Human Enhancement for Function and Beyond. Integr Psychol Behav Sci 2024; 58:589-637. [PMID: 37597122 PMCID: PMC11052783 DOI: 10.1007/s12124-023-09797-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/29/2023] [Indexed: 08/21/2023]
Abstract
Technology enables humans not only to adapt their environment to their needs but also to modify themselves. Means of Human Enhancement - embodied technologies to improve the human body's capabilities or to create a new one - are the designated means of adapting ourselves instead of the environment. The debate about these technologies is typically fought on ethical soil. However, alarmist, utopian, and science fiction scenarios distract from the fact that Human Enhancement is a historical and pervasive phenomenon incorporated into many everyday practices. In the vein of disentangling conceptual difficulties, we claim that means of Human Enhancement are either physiologically or psychologically embodied, rendering the merging with the human user their most defining aspect. To fulfill its purpose, an enhancement must pass the test-in-the-world, i.e., assisting with effective engagement with a dynamic world. Even if failing in this regard: Human Enhancement is the fundamental and semi-targeted process of changing the users relationship with the world through the physical or psychological embodiment of a hitherto external object and/or change of one's body. This can potentially change the notion of being human. Drawing on a rich body of theoretical and empirical literature, we aim to provide a nuanced analysis of the transformative nature of this phenomenon in close proximity to human practice. Stakeholders are invited to apply the theory presented here to interrogate their perspective on technology in general and Human Enhancement in particular.
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Affiliation(s)
- Niklas Alexander Döbler
- Department for General Psychology and Methodology, University of Bamberg, Bamberg, Germany.
- Research group EPÆG (Ergonomics, Psychological Æsthetics, Gestalt), Bamberg, Germany.
- Bamberg Graduate School of Affective and Cognitive Sciences (BaGrACS), Bamberg, Germany.
| | - Claus-Christian Carbon
- Department for General Psychology and Methodology, University of Bamberg, Bamberg, Germany
- Research group EPÆG (Ergonomics, Psychological Æsthetics, Gestalt), Bamberg, Germany
- Bamberg Graduate School of Affective and Cognitive Sciences (BaGrACS), Bamberg, Germany
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Looby A, Piccorelli AV, Zimmerman L, Falco C, Livingston NR, Akin C, Benton S, Juliano LM. Expectancy for Adderall influences subjective mood and drug effects regardless of concurrent caffeine ingestion: A randomized controlled trial. Psychopharmacology (Berl) 2024; 241:109-118. [PMID: 37740001 DOI: 10.1007/s00213-023-06467-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 09/07/2023] [Indexed: 09/24/2023]
Abstract
RATIONALE Nonmedical prescription stimulant use (NPS; use without a prescription or in ways other than prescribed) is common among college students. Despite the potential for negative consequences, students continue engaging in NPS for cognitive enhancement purposes, which may be maintained by expectancy and placebo effects. OBJECTIVES This study examined if a placebo administered under the guise of Adderall influenced subjective mood/drug effects and cognitive performance. Furthermore, this study examined if concurrent caffeine ingestion incrementally enhanced Adderall-related placebo effects. METHODS Undergraduate students with features that put them at elevated risk for NPS (N = 121) completed measures of mood and drug effects and cognitive assessments on two separate laboratory visits in this parallel randomized controlled trial. Visit 1 was a baseline control visit, on which no drug was expected or received. On visit 2, subjects were randomized to: (1) expect/receive no drug (control); (2) expect Adderall/receive placebo; or (3) expect Adderall/receive 200 mg caffeine. RESULTS There were several significant condition × visit interactions for subjective effects, including amphetamine effects, energy and efficiency effects, and feeling high. In most cases, participants who expected Adderall reported greater positive subjective effects on visit 2 compared to controls; however, there were generally not incremental enhancements for those ingesting caffeine compared to placebo. There were no significant effects for any cognitive tests. CONCLUSIONS Expectation for prescription stimulant effects influenced subjective outcomes in a sample of high-risk college students. These findings may inform expectancy challenge interventions to reduce NPS. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT03648684.
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Affiliation(s)
- Alison Looby
- Department of Psychology, University of Wyoming, 1000 E. University Ave, Department 3415, Laramie, WY, 82071, USA.
| | - Annalisa V Piccorelli
- Kaiser Permanente Washington Health Research Institute, Biostatistics Division, 1730 Minor Avenue, Ste 1600, Seattle, WA, 98101, USA
| | - Lauren Zimmerman
- Department of Psychology, University of Wyoming, 1000 E. University Ave, Department 3415, Laramie, WY, 82071, USA
| | - Caitlin Falco
- Department of Psychology, University of Wyoming, 1000 E. University Ave, Department 3415, Laramie, WY, 82071, USA
| | - Nicholas R Livingston
- Department of Psychology, University of Wyoming, 1000 E. University Ave, Department 3415, Laramie, WY, 82071, USA
| | - Cody Akin
- Department of Psychology, University of Wyoming, 1000 E. University Ave, Department 3415, Laramie, WY, 82071, USA
| | - Samuel Benton
- Department of Psychology, University of Wyoming, 1000 E. University Ave, Department 3415, Laramie, WY, 82071, USA
| | - Laura M Juliano
- Department of Psychology, American University, 4400 Massachusetts Avenue NW, Washington, DC, 20016, USA
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Parents’ Perceptions on the Debated Parenting Practice of Cognitive Enhancement in Healthy Children and Adolescents. JOURNAL OF COGNITIVE ENHANCEMENT 2022; 6:373-388. [PMID: 35966365 PMCID: PMC9360129 DOI: 10.1007/s41465-022-00243-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Accepted: 04/13/2022] [Indexed: 12/03/2022]
Abstract
First evidence shows that some parents engage in the health-endangering practice of (mis-)using prescription drugs to boost their children’s school performance. But little is known about parental perspectives on this phenomenon. This study aims to better understand parents’ perspectives on the non-medical use of prescription drugs to improve healthy children’s cognitive functioning. We conducted twelve semi-structured face-to-face interviews with a diverse sample of parents in Germany, and applied qualitative content analysis to explore their perspectives on instrumentalizing prescription drugs for improving the performance of healthy children, including their underlying knowledge (gaps), moral evaluations, evaluations of accompanied risks and benefits, opinions on potential motivators, and wishes regarding policy-making. The results show that parents typically believed themselves knowledgeable about such prescription drug (mis-)use, although they were not aware of anyone in their social environment taking them for enhancement. Parents generally considered such behavior to be morally reprehensible, cheating, and similar to doping in sports, and they typically claimed that no situation or occasion could motivate them to administer prescription drugs to their healthy children. Health risks (including side effects or addiction) were a typical expectation of drug use. That doctors should give such drugs to healthy young people was seen as unjustifiable. The results suggest that morality and risk–benefit evaluations of parents play a major role in their decision-making concerning this potentially risky instrumentalization of non-medical drugs. These insights are of distinct importance, especially for future research and further discussions on this topic, such as an evidence-based public dialog and ethics debates.
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Schuenemann L, Scherenberg V, von Salisch M, Eckert M. "I'll Worry About It Tomorrow" - Fostering Emotion Regulation Skills to Overcome Procrastination. Front Psychol 2022; 13:780675. [PMID: 35391959 PMCID: PMC8980531 DOI: 10.3389/fpsyg.2022.780675] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Accepted: 02/03/2022] [Indexed: 01/11/2023] Open
Abstract
Procrastination remains an omnipresent phenomenon impeding especially students' academic performance and well-being. Preliminary findings suggest that procrastination emerges due to dysfunctional emotion regulation efforts to regulate aversive emotions. This study's objective was to clarify whether the enhancement of general adaptive emotion regulation skills reduces subsequent procrastination. For the purpose of this study, data from a two-armed randomized controlled trial (RCT) with (N = 148) university students, comprising an active intervention (IG) and a passive wait-list control (WLC) group, was collected. Participants of the intervention group were provided with an online emotion regulation training over a period of 9 weeks. The results showed that the enhancement of general emotion regulation skills significantly reduced subsequent procrastination behavior within the IG as compared to the untreated WLC. Moreover, subsequent mediation analyses revealed that the reduction of procrastination was significantly mediated by the increase in general ER skills. The present results suggest that trainings which enhance general ER skills are an appropriate measure to reduce procrastination behavior among university students. The practical value of ER training interventions, particularly for student populations, is discussed.
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Affiliation(s)
- Laura Schuenemann
- Department of Psychology, Leuphana University of Lüneburg, Lüneburg, Germany
| | - Viviane Scherenberg
- Department of Psychology and Education, Apollon University of Applied Sciences, Bremen, Germany
| | - Maria von Salisch
- Institute of Psychology, Leuphana University of Lüneburg, Lüneburg, Germany
| | - Marcus Eckert
- Department of Psychology and Education, Apollon University of Applied Sciences, Bremen, Germany
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Feigning Symptoms to Obtain Prescription Stimulants: A Vignette-Based Study on Its Conditions. JOURNAL OF DRUG ISSUES 2021. [DOI: 10.1177/00220426211055433] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This vignette-based study examined the willingness to feign symptoms to obtain a prescription following an analysis on who might use prescription stimulants to enhance performance ( N = 3,468). It experimentally manipulated three factors: the social disapproval of prescription stimulant use for enhancement purposes, the physicians’ diagnostic efforts, and the medical condition (attention-deficit/hyperactivity disorder and narcolepsy); respondent characteristics of self-control, personal morality, and self-efficacy were also measured. Our results showed that social disapproval of prescription drug use, a personal morality that disapproves of drug use, high self-control, and high self-efficacy were negatively associated with the willingness to use. Willingness increased especially in situations of social approval when there was a stronger personal approval of drug use, or surprisingly when physicians’ diagnostic efforts were higher. The feigning willingness was lower in situations of social disapproval and when personal morality disapproved of feigning. Thus, personal and situational characteristics are relevant to understand both behaviors.
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Sattler S, Linden P. Unhealthy parenting strategies: Situational (Dis-)Incentives, Machiavellian personality, and their interaction on misuse of ADHD medication for healthy children. SOCIAL SCIENCE RESEARCH 2021; 97:102559. [PMID: 34045007 DOI: 10.1016/j.ssresearch.2021.102559] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 03/02/2021] [Accepted: 03/23/2021] [Indexed: 06/12/2023]
Abstract
Some parents engage in the potentially unhealthy and morally debateable parenting practice of giving prescription stimulant drugs to healthy children to boost their school and extracurricular performance. However, the parents' underlying reasoning remains unexamined. This web-based study (NRespondents = 1360) simultaneously investigates eight experimentally-varied situational (dis-)incentives (e.g., financial gains and drug properties) within a factorial vignette survey (NVignettes = 256), Machiavellianism as a measured socially relevant personality trait, and possible interaction effects. Results show that approximately 40% of the described situations (NEvaluations = 5440) provoked some willingness to medicate healthy children. Multilevel mixed-effect models revealed that this willingness was higher, for example, with increasing financial gains and weaker side effects. Machiavellians disclosed a higher willingness. They were more responsive to financial gains and threats (e.g., probable side effects). Respondents' sex, age, ethnicity, and experience with prescription drugs also had effects. Prevention measures might emphasize the dangers and limited potential of prescription drugs for healthy children.
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Affiliation(s)
- Sebastian Sattler
- Institute of Sociology and Social Psychology, University of Cologne, Greinstrasse 2, 50939, Cologne, Germany; Pragmatic Health Ethics Research Unit, Institut de Recherches Cliniques de Montréal, 110, Avenue des Pins Ouest, Montréal, Québec, H2W 1R7, Canada.
| | - Philipp Linden
- Institute of Sociology and Social Psychology, University of Cologne, Greinstrasse 2, 50939, Cologne, Germany; Seminar for Social Sciences, University of Siegen, Adolf-Reichwein-Str. 2, 57068, Siegen, Germany.
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Racine E, Sattler S, Boehlen W. Cognitive Enhancement: Unanswered Questions About Human Psychology and Social Behavior. SCIENCE AND ENGINEERING ETHICS 2021; 27:19. [PMID: 33759032 PMCID: PMC7987623 DOI: 10.1007/s11948-021-00294-w] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Accepted: 02/10/2021] [Indexed: 05/23/2023]
Abstract
Stimulant drugs, transcranial magnetic stimulation, brain-computer interfaces, and even genetic modifications are all discussed as forms of potential cognitive enhancement. Cognitive enhancement can be conceived as a benefit-seeking strategy used by healthy individuals to enhance cognitive abilities such as learning, memory, attention, or vigilance. This phenomenon is hotly debated in the public, professional, and scientific literature. Many of the statements favoring cognitive enhancement (e.g., related to greater productivity and autonomy) or opposing it (e.g., related to health-risks and social expectations) rely on claims about human welfare and human flourishing. But with real-world evidence from the social and psychological sciences often missing to support (or invalidate) these claims, the debate about cognitive enhancement is stalled. In this paper, we describe a set of crucial debated questions about psychological and social aspects of cognitive enhancement (e.g., intrinsic motivation, well-being) and explain why they are of fundamental importance to address in the cognitive enhancement debate and in future research. We propose studies targeting social and psychological outcomes associated with cognitive enhancers (e.g., stigmatization, burnout, mental well-being, work motivation). We also voice a call for scientific evidence, inclusive of but not limited to biological health outcomes, to thoroughly assess the impact of enhancement. This evidence is needed to engage in empirically informed policymaking, as well as to promote the mental and physical health of users and non-users of enhancement.
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Affiliation(s)
- Eric Racine
- Pragmatic Health Ethics Research Unit, Institut de recherches cliniques de Montréal (IRCM), 110, avenue des Pins Ouest, Montréal, QC, H2W 1R7, Canada.
- Department of Medicine and Department of Social and Preventive Medicine, Université de Montréal, 7101, Av du Parc, Montréal, QC, H3N 1X9, Canada.
- Departments of Neurology and Neurosurgery, Experimental Medicine, and Biomedical Ethics Unit, McGill University, 3801, University Street, Montréal, QC, H3A 1X1, Canada.
| | - Sebastian Sattler
- Pragmatic Health Ethics Research Unit, Institut de recherches cliniques de Montréal (IRCM), 110, avenue des Pins Ouest, Montréal, QC, H2W 1R7, Canada.
- Department of Sociology, University of Cologne, Universitätsstrasse 24, 50931, Cologne, Germany.
| | - Wren Boehlen
- Pragmatic Health Ethics Research Unit, Institut de recherches cliniques de Montréal (IRCM), 110, avenue des Pins Ouest, Montréal, QC, H2W 1R7, Canada
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Sattler S, Mehlkop G, Bahr V, Betsch C. Why Parents Misuse Prescription Drugs to Enhance the Cognitive Performance of Healthy Children: The Influence of Peers and Social Media. JOURNAL OF DRUG ISSUES 2021. [DOI: 10.1177/0022042621994547] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The mechanisms affecting parents’ misuse of prescription stimulant drugs to boost healthy children’s school performance are hardly unknown. Using four web-based factorial vignette surveys (2×2 between-subjects design experiment), we investigated the willingness of U.S. parents with school-aged children to medicate a fictitious 13-year-old child whose grades had declined. We examined mechanisms of informational and normative social influence on their decision-making: others’ behavior ( NExperiment 1 = 359), others’ definitions ( NExperiment 2 = 326), social control ( NExperiment 3 = 325), and others’ experience ( NExperiment 4 = 313). In addition, we explored the moderating role of influential sources (close friends vs. social media). Parents were more willing to engage in said behavior when others reported engagement in this behavior or positive drug experiences, especially if both influences were transmitted via social media. Others’ definitions and social control had no effect. Thus, social media might be a channel for the prevention of pharmacological cognitive enhancement.
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Affiliation(s)
- Sebastian Sattler
- University of Cologne, Köln, Germany
- Institut de recherches cliniques de Montréal, Quebec, Canada
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Nguyen NT, Rakow T, Gardner B, Dommett EJ. Understanding the relationship between safety beliefs and knowledge for cognitive enhancers in UK university students. PLoS One 2021; 16:e0244865. [PMID: 33508011 PMCID: PMC7842904 DOI: 10.1371/journal.pone.0244865] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Accepted: 12/17/2020] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Cognitive enhancers (CE) are prescription drugs taken, either without a prescription or at a dose exceeding that which is prescribed, to improve cognitive functions such as concentration, vigilance or memory. Previous research suggests that users believe the drugs to be safer than non-users and that they have sufficient knowledge to judge safety. However, to date no research has compared the information sources used and safety knowledge of users and non-users. OBJECTIVES This study compared users and non-users of CE in terms of i) their sources of knowledge about the safety of CE and ii) the accuracy of their knowledge of possible adverse effects of a typical cognitive enhancer (modafinil); and iii) how the accuracy of knowledge relates to their safety beliefs. METHODS Students (N = 148) from King's College London (UK) completed an anonymous online survey assessing safety beliefs, sources of knowledge and knowledge of the safety of modafinil; and indicated whether they used CE, and, if so, which drug(s). RESULTS The belief that the drugs are safe was greater in users than non-users. However, both groups used comparable information sources and have similar, relatively poor drug safety knowledge. Furthermore, despite users more strongly believing in the safety of CE there was no relationship between their beliefs and knowledge, in contrast to non-users who did show correlations between beliefs and knowledge. CONCLUSION These data suggest that the differences in safety beliefs about CE between users and non-users do not stem from use of different information sources or more accurate safety knowledge.
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Affiliation(s)
- Ngoc Trai Nguyen
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
| | - Tim Rakow
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
| | - Benjamin Gardner
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
| | - Eleanor J. Dommett
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
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Sousa A, Dinis-Oliveira RJ. Pharmacokinetic and pharmacodynamic of the cognitive enhancer modafinil: Relevant clinical and forensic aspects. Subst Abus 2020; 41:155-173. [PMID: 31951804 DOI: 10.1080/08897077.2019.1700584] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Modafinil is a nonamphetamine nootropic drug with an increasingly therapeutic interest due to its different sites of action and behavioral effects in comparison to cocaine or amphetamine. A review of modafinil (and of its prodrug adrafinil and its R-enantiomer armodafinil) chemical, pharmacokinetic, pharmacodynamic, toxicological, clinical and forensic aspects was performed, aiming to better understand possible health problems associated to its unconscious and unruled use. Modafinil is a racemate metabolized mainly in the liver into its inactive acid and sulfone metabolites, which undergo primarily renal excretion. Although not fully clarified, major effects seem to be associated to inhibition of dopamine reuptake and modulation of several other neurochemical pathways, namely noradrenergic, serotoninergic, orexinergic, histaminergic, glutamatergic and GABAergic. Due its wake-promoting effects, modafinil is used for the treatment of daily sleepiness associated to narcolepsy, obstructive sleep apnea and shift work sleep disorder. Its psychotropic and cognitive effects are also attractive in several other pathologies and conditions that affect sleep structure, induce fatigue and lethargy, and impair cognitive abilities. Additionally, in health subjects, including students, modafinil is being used off-label to overcome sleepiness, increase concentration and improve cognitive potential. The most common adverse effects associated to modafinil intake are headache, insomnia, anxiety, diarrhea, dry mouth and raise in blood pressure and heart rate. Infrequently, severe dermatologic effects in children, including maculopapular and morbilliform rash, erythema multiforme and Stevens-Johnson Syndrome have been reported. Intoxication and dependence associated to modafinil are uncommon. Further research on effects and health implications of modafinil and its analogs is steel needed to create evidence-based policies.
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Affiliation(s)
- Ana Sousa
- Department of Public Health and Forensic Sciences, and Medical Education, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Ricardo Jorge Dinis-Oliveira
- Department of Public Health and Forensic Sciences, and Medical Education, Faculty of Medicine, University of Porto, Porto, Portugal.,IINFACTS - Institute of Research and Advanced Training in Health Sciences and Technologies, Department of Sciences, University Institute of Health Sciences (IUCS), CESPU, CRL, Gandra, Portugal.,UCIBIO, REQUIMTE, Laboratory of Toxicology, Department of Biological Sciences, Faculty of Pharmacy, University of Porto, Porto, Portugal
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In search of optimal psychoactivation: stimulants as cognitive performance enhancers. Arh Hig Rada Toksikol 2019; 70:150-159. [PMID: 32597132 DOI: 10.2478/aiht-2019-70-3298] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2019] [Accepted: 08/01/2019] [Indexed: 12/21/2022] Open
Abstract
An increasing number of people, students in particular, seek substances that improve their cognitive functioning. The most popular group of pharmacological cognitive enhancers (PCEs) are stimulants. Available studies suggest a small beneficial effect of methylphenidate and amphetamine on memory, executive functions, and processing speed. However small, this effect can make the difference between success and failure. In recent years, research has focused on the additional beneficial effect on the emotional state, increased motivation, and placebo-induced cognitive enhancement. This paper briefly reviews the latest and most important research on the relationship between popular stimulants and cognitive enhancement. One cannot understand this relationship without understanding the Yerkes-Dodson law, which explains the relationship between the degree of arousal and performance. It suggests that the effect of stimulants is a dose-dependent continuum. This law has repeatedly been confirmed by studies in which an optimal level of psychoactivation for cognitive enhancement was obtained with low stimulant doses, whereas exceeding the effective dose resulted in cognitive deficits, psychomotor agitation, and addiction. A separate section has been devoted to modafinil, an increasingly popular stimulant that differs from the rest in neurochemical profile and behavioural effects.
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"The White Version of Cheating?" Ethical and Social Equity Concerns of Cognitive Enhancing Drug Users in Higher Education. JOURNAL OF ACADEMIC ETHICS 2019; 17:111-130. [PMID: 31447620 DOI: 10.1007/s10805-018-9320-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
So-called cognitive enhancing drugs (CEDs) are relatively common in higher education, especially among students who are white, male, and attend highly selective institutions. Using qualitative data from a diverse sample of 32 students at an elite university, the present study aims to examine whether students perceive CED use to be advantageous, equitable, and fair. Participants were either medical or nonmedical users of CEDs-primarily ADHD stimulant medications such as Adderall. Data were first coded openly, then axially into themes, and finally arranged to respond to research aims around social and ethical concerns. Ethical perceptions and behavioral justifications varied by participants' personal use frequency, class standing, and perceived social norms surrounding CEDs. Among the salient themes to emerge was the belief that CED use is a lesser or more tenable form of cheating, that the vagueness and prevalence of ADHD justifies nonmedical use, and that above all, CEDs are advantageous. Some participants expressed concern about the advantageousness of CEDs when coupled with a perceived imbalance of their use among students from traditionally underrepresented backgrounds, with one calling it "the white version of cheating." Implications for cheating and drug use prevention are discussed, situating cognitive enhancement as an emerging ethical and social equity concern in higher education.
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Coveney C, Williams SJ, Gabe J. Enhancement imaginaries: exploring public understandings of pharmaceutical cognitive enhancing drugs. DRUGS-EDUCATION PREVENTION AND POLICY 2019. [DOI: 10.1080/09687637.2019.1593318] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Catherine Coveney
- Social and Policy Studies Unit, School of Social Sciences, Loughborough University, Loughborough, UK
| | | | - Jonathan Gabe
- Department of Criminology and Sociology, School of Law, Royal Holloway University of London, Egham, UK
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Sattler S. Nonmedical use of prescription drugs for cognitive enhancement as response to chronic stress especially when social support is lacking. Stress Health 2019; 35:127-137. [PMID: 30378254 DOI: 10.1002/smi.2846] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Revised: 09/05/2018] [Accepted: 10/22/2018] [Indexed: 11/06/2022]
Abstract
The nonmedical use of prescription drugs to improve cognitive performance has gained attention due to concerns over its social and political implications as well as side effects and long-term health consequences. Some researchers expect a future trend of an instrumental use of drugs for cognitive enhancement (CE). Thus, getting insights about causes of CE-drug consumption is warranted before the prevalence increases. Because perceived stress is ubiquitous in universities and may decrease cognitive performance, one reaction to cope with stress and its consequences might be the instrumental use of drugs for CE, especially if other resources, such as social support, are lacking. With a prospective design, randomly selected students from four German universities were invited to a web-based survey and reinterviewed after 6 months (N = 2,203). Results show a 6-month prevalence rate of self-reported CE-drug use of about 2%. Higher reported chronic stress is positively associated with CE-drug use. Although social support has no main effect, stress-buffering effects were found. In men with low stress, more support is associated with a higher chance of self-reported CE-drug use. These findings can inform intervention and prevention strategies such as changes in drug regulation or sensitizing (potential) users to unwanted health consequences.
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Affiliation(s)
- Sebastian Sattler
- Institute for Sociology and Social Psychology, University of Cologne, Cologne, Germany.,Pragmatic Health Ethics Research Unit, Institut de recherches cliniques de Montréal, Montréal, Québec, Canada
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Champagne J, Gardner B, Dommett EJ. Modelling predictors of UK undergraduates' attitudes towards smart drugs. Trends Neurosci Educ 2019; 14:33-39. [PMID: 30929857 DOI: 10.1016/j.tine.2019.02.001] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2018] [Revised: 11/26/2018] [Accepted: 02/06/2019] [Indexed: 10/27/2022]
Abstract
BACKGROUND Smart drug use is increasing but we have little insight into their use. We hypothesized that use is predicted by attitudes and various factors including incremental morality and entity intelligence beliefs would be associated with positive attitudes, whilst perception of unfairness would be associated with negative attitudes. METHODS UK undergraduates completed an online survey to establish attitudes towards smart drugs, previous use and likely future use as well as measures of several factors hypothesized to predict attitudes. RESULTS Attitudes were found to predict previous and likely future use. Attitudes were more positive in those who believed that smart drugs were harmless and those who felt they knew enough to use them safely. By contrast, perceived unfairness was associated with negative attitudes. CONCLUSIONS Interventions to reduce smart drug use should focus on attitudinal beliefs around potential harm and safety, as well as emphasizing the debate around unfairness.
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Affiliation(s)
- Jacqueline Champagne
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, 2nd Floor Addison House, London, SE1. 1UL, UK
| | - Benjamin Gardner
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, 2nd Floor Addison House, London, SE1. 1UL, UK
| | - Eleanor J Dommett
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, 2nd Floor Addison House, London, SE1. 1UL, UK.
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Pighi M, Pontoni G, Sinisi A, Ferrari S, Mattei G, Pingani L, Simoni E, Galeazzi GM. Use and Propensity to Use Substances as Cognitive Enhancers in Italian Medical Students. Brain Sci 2018; 8:brainsci8110197. [PMID: 30423911 PMCID: PMC6266090 DOI: 10.3390/brainsci8110197] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Revised: 10/31/2018] [Accepted: 11/06/2018] [Indexed: 02/06/2023] Open
Abstract
International media has paid attention to the use of substances by healthy subjects to enhance cognitive performance. Medical students are liable to use cognitive enhancers (CE) with the aim of improving academic performance. The study explored use and attitudes toward the use of CE in Italian medical students. The authors anonymously surveyed 433 medical students of the University of Modena and Reggio Emilia with an ad hoc 36-items questionnaire. CE were broadly defined as any substance taken with the purpose of improving cognitive functions, from readily available beverages and substances, such as coffee, tea, energy drinks, and supplements to prescription only medication, such as psychostimulants and modafinil. Response rate was 83.8% (n = 363). While the majority of the students (74.7%; n = 271) said that they had used substances to improve cognitive functions, only 2 students (0.6%) reported the use of prescription-only medications in the last 30 days. Main reasons for not taking prescription-only drugs were concerns about safety and side effects, reported by 83.3% of students (n = 295). A positive attitude toward use was held by 60.3% (n = 219) subjects. The surveyed Italian medical students used many substances as CE, but this did not seem to apply significantly to psychostimulants. A multivariable analysis showed that the following variables were related to the propensity to use substances as CE: male gender, self-reported memory impairment, concerns about worsening of cognitive performance, lifetime use of at least one illegal substance, use of any substance (both legal or illegal) in the last 30 days.
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Affiliation(s)
- Marcella Pighi
- Villa Rosa, Private Accreditated Hospital, Modena 41125, Italy.
| | - Giancarlo Pontoni
- Psychiatry Section, Psychophysiological Selection Office, Italian Army National Recruitment and Selection Center, Foligno 06034 (PG), Italy.
| | - Arianna Sinisi
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena 41124, Italy.
| | - Silvia Ferrari
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena 41124, Italy.
| | - Giorgio Mattei
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena 41124, Italy.
- Marco Biagi Department of Economics & Marco Biagi Foundation, University of Modena and Reggio Emilia, Modena, 41121 Modena, Italy.
| | - Luca Pingani
- Human Resources, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia 42122, Italy.
| | - Elena Simoni
- Villa Rosa, Private Accreditated Hospital, Modena 41125, Italy.
| | - Gian Maria Galeazzi
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena 41124, Italy.
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Dietz P, Iberl B, Schuett E, van Poppel M, Ulrich R, Sattler MC. Prevalence Estimates for Pharmacological Neuroenhancement in Austrian University Students: Its Relation to Health-Related Risk Attitude and the Framing Effect of Caffeine Tablets. Front Pharmacol 2018; 9:494. [PMID: 29946254 PMCID: PMC6006370 DOI: 10.3389/fphar.2018.00494] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2017] [Accepted: 04/25/2018] [Indexed: 01/22/2023] Open
Abstract
Background: Pharmacological neuroenhancement (PN) is defined as the use of illicit or prescription drugs by healthy individuals for cognitive-enhancing purposes. The present study aimed (i) to investigate whether including caffeine tablets in the definition of PN within a questionnaire increases the PN prevalence estimate (framing effect), (ii) to investigate whether the health-related risk attitude is increased in students who use PN. Materials and methods: Two versions of a paper-and-pencil questionnaire (first version included caffeine tablets in the definition of PN, the second excluded caffeine tablets) were distributed among university students at the University of Graz, Austria. The unrelated question model (UQM) was used to estimate the 12-month PN prevalence and the German version of the 30-item Domain-Specific Risk-Taking (DOSPERT) scale to assess the health-related risk attitude. Moreover, large-sample z-tests (α = 0.05) were performed for comparing the PN prevalence estimates of two groups. Results: Two thousand four hundred and eighty-nine questionnaires were distributed and 2,284 (91.8%) questionnaires were included in analysis. The overall PN prevalence estimate for all students was 11.9%. One-tailed large-sample z-tests revealed that the PN estimate for students with higher health-related risk attitude was significantly higher compared to students with lower health-related risk attitude (15.6 vs. 8.5%; z = 2.65, p = 0.004). Furthermore, when caffeine tablets were included into the example of PN, the prevalence estimate of PN was significantly higher compared to the version without caffeine tablets (14.9 vs. 9.0%; z = 2.20, p = 0.014). Discussion: This study revealed that the PN prevalence estimate increases when caffeine tablets are included in the definition of PN. Therefore, future studies investigating the prevalence of, and predictors for, PN should be performed and interpreted with respect to potential framing effects. This study further revealed that the PN prevalence estimate is increased in students with a higher health-related risk attitude compared to students with a lower one. Therefore, future education and prevention programs addressing PN in the collective of students should not only inform about potential side effects of its use but also address the limited effects on cognition and potential alternatives of PN.
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Affiliation(s)
- Pavel Dietz
- Research Group of Physical Activity and Public Health, Institute of Sports Science, University of Graz, Graz, Austria
- Working Group Social and Health Sciences of Sport, Institute for Sports and Sports Science, Karlsruhe Institute of Technology, Karlsruhe, Germany
| | - Benedikt Iberl
- Research Group of Cognition and Perception, Institute of Psychology, University of Tübingen, Tübingen, Germany
| | - Emanuel Schuett
- Research Group of Cognition and Perception, Institute of Psychology, University of Tübingen, Tübingen, Germany
| | - Mireille van Poppel
- Research Group of Physical Activity and Public Health, Institute of Sports Science, University of Graz, Graz, Austria
- Working Group Social and Health Sciences of Sport, Institute for Sports and Sports Science, Karlsruhe Institute of Technology, Karlsruhe, Germany
| | - Rolf Ulrich
- Research Group of Cognition and Perception, Institute of Psychology, University of Tübingen, Tübingen, Germany
| | - Matteo Christian Sattler
- Research Group of Physical Activity and Public Health, Institute of Sports Science, University of Graz, Graz, Austria
- Working Group Social and Health Sciences of Sport, Institute for Sports and Sports Science, Karlsruhe Institute of Technology, Karlsruhe, Germany
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Bard I, Gaskell G, Allansdottir A, da Cunha RV, Eduard P, Hampel J, Hildt E, Hofmaier C, Kronberger N, Laursen S, Meijknecht A, Nordal S, Quintanilha A, Revuelta G, Saladié N, Sándor J, Santos JB, Seyringer S, Singh I, Somsen H, Toonders W, Torgersen H, Torre V, Varju M, Zwart H. Bottom Up Ethics - Neuroenhancement in Education and Employment. NEUROETHICS-NETH 2018; 11:309-322. [PMID: 30220937 PMCID: PMC6132847 DOI: 10.1007/s12152-018-9366-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Accepted: 04/18/2018] [Indexed: 10/28/2022]
Abstract
Neuroenhancement involves the use of neurotechnologies to improve cognitive, affective or behavioural functioning, where these are not judged to be clinically impaired. Questions about enhancement have become one of the key topics of neuroethics over the past decade. The current study draws on in-depth public engagement activities in ten European countries giving a bottom-up perspective on the ethics and desirability of enhancement. This informed the design of an online contrastive vignette experiment that was administered to representative samples of 1000 respondents in the ten countries and the United States. The experiment investigated how the gender of the protagonist, his or her level of performance, the efficacy of the enhancer and the mode of enhancement affected support for neuroenhancement in both educational and employment contexts. Of these, higher efficacy and lower performance were found to increase willingness to support enhancement. A series of commonly articulated claims about the individual and societal dimensions of neuroenhancement were derived from the public engagement activities. Underlying these claims, multivariate analysis identified two social values. The Societal/Protective highlights counter normative consequences and opposes the use enhancers. The Individual/Proactionary highlights opportunities and supports use. For most respondents these values are not mutually exclusive. This suggests that for many neuroenhancement is viewed simultaneously as a source of both promise and concern.
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Affiliation(s)
- Imre Bard
- Department of Methodology, London School of Economics, London, UK
| | - George Gaskell
- Department of Methodology, London School of Economics, London, UK
| | | | | | - Peter Eduard
- Experimentarium, Science Communication Centre, Copenhagen, Denmark
| | - Juergen Hampel
- Center for Interdisciplinary Risk and Innovation Studies, Stuttgart University, Stuttgart, Germany
| | - Elisabeth Hildt
- Center for the Study of Ethics in the Professions, Illinois Institute of Technology, Chicago, IL USA
| | - Christian Hofmaier
- Center for Interdisciplinary Risk and Innovation Studies, Stuttgart University, Stuttgart, Germany
| | - Nicole Kronberger
- Department of Social and Economic Psychology, Johannes Kepler University, Linz, Austria
| | - Sheena Laursen
- Experimentarium, Science Communication Centre, Copenhagen, Denmark
| | - Anna Meijknecht
- Tilburg Institute for Law, Technology, and Society, Tilburg University, Tilburg, The Netherlands
| | - Salvör Nordal
- Centre for Ethics University of Iceland, Reykjavik, Iceland
| | | | - Gema Revuelta
- Centre on Science, Communication and Society Universitat Pompeu Fabra, Barcelona, Spain
| | - Núria Saladié
- Centre on Science, Communication and Society Universitat Pompeu Fabra, Barcelona, Spain
| | - Judit Sándor
- The Center for Ethics and Law in Biomedicine Central European University, Budapest, Hungary
| | | | - Simone Seyringer
- Department of Social and Economic Psychology, Johannes Kepler University, Linz, Austria
| | - Ilina Singh
- Department of Psychiatry and Oxford Uehiro Centre University of Oxford, Oxford, UK
| | - Han Somsen
- Tilburg Institute for Law, Technology, and Society, Tilburg University, Tilburg, The Netherlands
| | - Winnie Toonders
- Institute for Science, Innovation and Society, Radboud University Nijmegen, Nijmegen, The Netherlands
| | - Helge Torgersen
- Institute of Technology Assessment Austrian Academy of Sciences, Vienna, Austria
| | - Vincent Torre
- Centre for Neurobiology, International School for Advanced Studies, Trieste, Italy
| | - Márton Varju
- The Center for Ethics and Law in Biomedicine Central European University, Budapest, Hungary
| | - Hub Zwart
- Institute for Science, Innovation and Society, Radboud University Nijmegen, Nijmegen, The Netherlands
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Cognitive Enhancement and Coping in an Australian University Student Sample. JOURNAL OF COGNITIVE ENHANCEMENT 2017. [DOI: 10.1007/s41465-017-0046-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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20
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Brand R, Wolff W, Ziegler M. Drugs As Instruments: Describing and Testing a Behavioral Approach to the Study of Neuroenhancement. Front Psychol 2016; 7:1226. [PMID: 27582720 PMCID: PMC4987358 DOI: 10.3389/fpsyg.2016.01226] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2016] [Accepted: 08/02/2016] [Indexed: 11/13/2022] Open
Abstract
Neuroenhancement (NE) is the non-medical use of psychoactive substances to produce a subjective enhancement in psychological functioning and experience. So far empirical investigations of individuals' motivation for NE however have been hampered by the lack of theoretical foundation. This study aimed to apply drug instrumentalization theory to user motivation for NE. We argue that NE should be defined and analyzed from a behavioral perspective rather than in terms of the characteristics of substances used for NE. In the empirical study we explored user behavior by analyzing relationships between drug options (use over-the-counter products, prescription drugs, illicit drugs) and postulated drug instrumentalization goals (e.g., improved cognitive performance, counteracting fatigue, improved social interaction). Questionnaire data from 1438 university students were subjected to exploratory and confirmatory factor analysis to address the question of whether analysis of drug instrumentalization should be based on the assumption that users are aiming to achieve a certain goal and choose their drug accordingly or whether NE behavior is more strongly rooted in a decision to try or use a certain drug option. We used factor mixture modeling to explore whether users could be separated into qualitatively different groups defined by a shared "goal × drug option" configuration. Our results indicate, first, that individuals' decisions about NE are eventually based on personal attitude to drug options (e.g., willingness to use an over-the-counter product but not to abuse prescription drugs) rather than motivated by desire to achieve a specific goal (e.g., fighting tiredness) for which different drug options might be tried. Second, data analyses suggested two qualitatively different classes of users. Both predominantly used over-the-counter products, but "neuroenhancers" might be characterized by a higher propensity to instrumentalize over-the-counter products for virtually all investigated goals whereas "fatigue-fighters" might be inclined to use over-the-counter products exclusively to fight fatigue. We believe that psychological investigations like these are essential, especially for designing programs to prevent risky behavior.
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Affiliation(s)
- Ralf Brand
- Sport and Exercise Psychology, University of PotsdamPotsdam, Germany
| | - Wanja Wolff
- Department of Sport Science, Sport Psychology, University of KonstanzKonstanz, Germany
| | - Matthias Ziegler
- Department of Psychology, Psychological Diagnostics, Humboldt Universität zu BerlinBerlin, Germany
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Sattler S, Singh I. Cognitive Enhancement in Healthy Children Will Not Close the Achievement Gap in Education. THE AMERICAN JOURNAL OF BIOETHICS : AJOB 2016; 16:39-41. [PMID: 27216098 DOI: 10.1080/15265161.2016.1170240] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
- Sebastian Sattler
- a University of Cologne and Institut de recherches cliniques de Montréal
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Brand R, Koch H. Using Caffeine Pills for Performance Enhancement. An Experimental Study on University Students' Willingness and Their Intention to Try Neuroenhancements. Front Psychol 2016; 7:101. [PMID: 26903909 PMCID: PMC4746440 DOI: 10.3389/fpsyg.2016.00101] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2015] [Accepted: 01/19/2016] [Indexed: 11/26/2022] Open
Abstract
Recent research has indicated that university students sometimes use caffeine pills for neuroenhancement (NE; non-medical use of psychoactive substances or technology to produce a subjective enhancement in psychological functioning and experience), especially during exam preparation. In our factorial survey experiment, we manipulated the evidence participants were given about the prevalence of NE amongst peers and measured the resulting effects on the psychological predictors included in the Prototype-Willingness Model of risk behavior. Two hundred and thirty-one university students were randomized to a high prevalence condition (read faked research results overstating usage of caffeine pills amongst peers by a factor of 5; 50%), low prevalence condition (half the estimated prevalence; 5%) or control condition (no information about peer prevalence). Structural equation modeling confirmed that our participants’ willingness and intention to use caffeine pills in the next exam period could be explained by their past use of neuroenhancers, attitude to NE and subjective norm about use of caffeine pills whilst image of the typical user was a much less important factor. Provision of inaccurate information about prevalence reduced the predictive power of attitude with respect to willingness by 40-45%. This may be because receiving information about peer prevalence which does not fit with their perception of the social norm causes people to question their attitude. Prevalence information might exert a deterrent effect on NE via the attitude-willingness association. We argue that research into NE and deterrence of associated risk behaviors should be informed by psychological theory.
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Affiliation(s)
- Ralf Brand
- Sport and Exercise Psychology, University of Potsdam Potsdam, Germany
| | - Helen Koch
- Sport and Exercise Psychology, University of Potsdam Potsdam, Germany
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23
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Sattler S, Schunck R. Associations Between the Big Five Personality Traits and the Non-Medical Use of Prescription Drugs for Cognitive Enhancement. Front Psychol 2016; 6:1971. [PMID: 26779083 PMCID: PMC4700267 DOI: 10.3389/fpsyg.2015.01971] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2015] [Accepted: 12/09/2015] [Indexed: 11/17/2022] Open
Abstract
While the number of studies of the non-medical use of prescription drugs to augment cognitive functions is growing steadily, psychological factors that can potentially help explain variance in such pharmaceutical cognitive enhancement (CE) behavior are often neglected in research. This study investigates the association between the Big Five personality traits and a retrospective (prior CE-drug use) as well as a prospective (willingness to use CE drugs) measure of taking prescription drugs with the purpose of augmenting one's cognitive functions (e.g., concentration, memory, or vigilance) without medical necessity. We use data from a large representative survey of German employees (N = 6454, response rate = 29.8%). The Five Factor Model (FFM) of Personality was measured with a short version of the Big Five Personality Traits Inventory (BFI-S), which includes: openness to experience, conscientiousness, extraversion, agreeableness, and neuroticism. Together with this, demographic variables such as gender, age, education, and income were used as potential confounders in multiple logistic regression models. Our results show a 2.96% lifetime prevalence of CE-drug use and a 10.45% willingness to (re)use such drugs in the future. We found that less conscientious and more neurotic respondents have a higher probability of prior CE-drug use and a greater willingness to use CE drugs in the future. No significant effects were found for openness, extraversion, or agreeableness. Prior CE-drug use was strongly associated with a greater willingness to take such drugs in the future. This study shows that specific personality traits are not only associated with prior enhancement behavior, but also affect the willingness to (re)use such drugs. It helps increase understanding of the risk factors of CE-drug use, which is a health-related behavior that can entail severe side-effects for consumers. The knowledge gathered can thus help improve interventions aimed at minimizing health problems.
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Affiliation(s)
- Sebastian Sattler
- Institute of Sociology and Social Psychology, University of Cologne Cologne, Germany
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Robitaille C, Collin J. Prescription Psychostimulant Use Among Young Adults: A Narrative Review of Qualitative Studies. Subst Use Misuse 2016; 51:357-69. [PMID: 26886251 DOI: 10.3109/10826084.2015.1110170] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Within the last decade, the nonmedical use of prescription drugs has raised concern, particularly among young adults. Psychostimulants, that is to say amphetamine and its derivatives, are pharmaceuticals, which contribute to what has come to be known in Canada and the United States as the "prescription drug crisis." Research in the fields of public health, addiction studies, and neuroethics has attempted to further understand this mounting issue; however, there is a paucity of data concerning the underlying social logics related to the use of these substances. OBJECTIVES The objective of this article is to provide an overview of the current literature related to the social context of prescription psychostimulant use among young adults, and to discuss theoretical considerations as well as implications for future research. METHODS A narrative review of the literature was performed. RESULTS We found that research efforts have chiefly targeted college students, yet there is a lack of knowledge concerning other social groups likely to use these pharmaceuticals nonmedically, such as persons with high strain employment. Three main emerging patterns related to prescription psychostimulant use were identified: (1) control of external stressors, (2) strategic use toward the making of the self, and (3) increasing one's performance. CONCLUSIONS Prescription psychostimulant use among young adults is anchored in contemporary normativity and cannot be separated from the developing performance ethic within North-American and other Western societies. We suggest that pharmaceuticalization and Actor-Network Theory are useful conceptual tools to frame future research efforts.
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Affiliation(s)
- Caroline Robitaille
- a Social and Preventive Medicine, University of Montreal , Montreal , Canada
| | - Johanne Collin
- b Faculty of Pharmacy, University of Montreal , Montreal , Canada
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Maier LJ, Liakoni E, Schildmann J, Schaub MP, Liechti ME. Swiss University Students' Attitudes toward Pharmacological Cognitive Enhancement. PLoS One 2015; 10:e0144402. [PMID: 26657300 PMCID: PMC4675521 DOI: 10.1371/journal.pone.0144402] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2015] [Accepted: 11/17/2015] [Indexed: 11/18/2022] Open
Abstract
Pharmacological cognitive enhancement (PCE) refers to the nonmedical use of prescription or recreational drugs to enhance cognitive performance. Several concerns about PCE have been raised in the public. The aim of the present study was to investigate students' attitudes toward PCE. Students at three Swiss universities were invited by e-mail to participate in a web-based survey. Of the 29,282 students who were contacted, 3,056 participated. Of these students, 22% indicated that they had used prescription drugs (12%) or recreational substances including alcohol (14%) at least once for PCE. The use of prescription drugs or recreational substances including alcohol prior to the last exam was reported by 16%. Users of pharmacological cognitive enhancers were more likely to consider PCE fair (24%) compared with nonusers (11%). Only a minority of the participants agreed with the nonmedical use of prescription drugs by fellow students when assuming weak (7%) or hypothetically strong efficacy and availability to everyone (14%). Two-thirds (68%) considered performance that is obtained with PCE less worthy of recognition. Additionally, 80% disagreed that PCE is acceptable in a competitive environment. More than half (64%) agreed that PCE in academia is similar to doping in sports. Nearly half (48%) claimed that unregulated access to pharmacological cognitive enhancers increases the pressure to engage in PCE and educational inequality (55%). In conclusion, Swiss students' main concerns regarding PCE were related to coercion and fairness. As expected, these concerns were more prevalent among nonusers than among users of pharmacological cognitive enhancers. More balanced information on PCE should be shared with students, and future monitoring of PCE is recommended.
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Affiliation(s)
- Larissa J. Maier
- Swiss Research Institute for Public Health and Addiction (ISGF), Associated Institute at the University of Zurich and WHO Collaborating Centre, Zurich, Switzerland
| | - Evangelia Liakoni
- Division of Clinical Pharmacology and Toxicology, Department of Clinical Research, University Hospital Basel, Basel, Switzerland
| | - Jan Schildmann
- Institut für Medizinische Ethik und Geschichte der Medizin, Ruhr-Universität Bochum, Bochum, Deutschland
| | - Michael P. Schaub
- Swiss Research Institute for Public Health and Addiction (ISGF), Associated Institute at the University of Zurich and WHO Collaborating Centre, Zurich, Switzerland
| | - Matthias E. Liechti
- Division of Clinical Pharmacology and Toxicology, Department of Clinical Research, University Hospital Basel, Basel, Switzerland
- * E-mail:
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Zelli A, Lucidi F, Mallia L. The Complexity of Neuroenhancement and the Adoption of a Social Cognitive Perspective. Front Psychol 2015; 6:1880. [PMID: 26648906 PMCID: PMC4664612 DOI: 10.3389/fpsyg.2015.01880] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2015] [Accepted: 11/20/2015] [Indexed: 11/13/2022] Open
Abstract
This contribution attempts to provide a broad perspective to the psychological study of neuroenhancement (NE). It departs from the assumption that, as the use of performance enhancing substances in sport, the use of substances with the aim of improving one's cognitive, motivational and affective functioning in academic domains is a goal-directed behavior. As such, its scientific study may very well benefit from an analysis taking into account the psychological processes regulating people's behavioral intentions and decisions. Within this broad framework, this contribution addresses several issues that currently seem to characterize the debate in the literature on neuroenhancement substances (NES) use. The first conceptual issue seeks to determine and define the "boundaries" of the phenomenon. The second issue concerns the empirical evidence on the prevalence of using certain substances for the purpose of NE. Finally, there is a debate around the ethical and moral implications of NE. Along these lines, the existing psychological research on NE has adopted mainly sociological and economic decision-making perspectives, greatly contributing to the psychological discourse about the phenomenon of NE. However, we argue that the existing psychological literature does not offer a common, explicit and integrated theoretical framework. Borrowing from the framework of doping research, we recommend the adoption of a social cognitive model for pursuing a systematic analysis of the psychological processes that dynamically regulate students' use of NES over time.
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Affiliation(s)
- Arnaldo Zelli
- Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, Rome, Italy
| | - Fabio Lucidi
- Department of Psychology of Development and Socialization Processes, Sapienza University of Rome, Rome, Italy
| | - Luca Mallia
- Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, Rome, Italy
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The importance of stress, self-efficacy, and self-medication for pharmacological neuroenhancement among employees and students. Drug Alcohol Depend 2015; 156:221-227. [PMID: 26455555 DOI: 10.1016/j.drugalcdep.2015.09.012] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2015] [Revised: 09/10/2015] [Accepted: 09/14/2015] [Indexed: 02/03/2023]
Abstract
OBJECTIVES This study examined the relationship between stress, self-efficacy, self-medication, and pharmacological neuroenhancement (PNE) in the Swiss general population. METHODS Using the largest Swiss Internet panel, a sample of 10,171 employees and students (unweighted N=10,084) aged 15-74 years was recruited and asked to complete a self-administered online survey. The data were weighted for age, sex, and language region to provide results that were representative of the Swiss population. Multinomial logistic regression models were conducted to identify predictors of pharmacological cognitive enhancement (PCE) and pharmacological mood enhancement (PME) over the past year. Two self-medication models and an overall model were determined. RESULTS Current medical treatment for a mental disorder was the best predictor of both PCE and PME use as serious self-medication. The overall model revealed that cannabis use, frequent stress, and long-term stress were predictors of both PCE and PME, whereas negative stressors and time pressure at work did not remain in the final model. Furthermore, past-year PCE with and without PME was associated with being male, being a student, and using illegal drugs other than cannabis, whereas being female and having low self-efficacy predicted past-year PME only. CONCLUSIONS Consideration of the predictor variables identified in this study may help to identify the potential PCE and PME users for whom measures to prevent drug abuse and manage stress are most appropriate. More specifically, the use of PCE and PME as self-medication to enhance performance at work or while studying needs further consideration in the neuroenhancement debate.
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28
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The increasing lifestyle use of modafinil by healthy people: safety and ethical issues. Curr Opin Behav Sci 2015. [DOI: 10.1016/j.cobeha.2015.05.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Maier LJ, Schaub MP. The Use of Prescription Drugs and Drugs of Abuse for Neuroenhancement in Europe. EUROPEAN PSYCHOLOGIST 2015. [DOI: 10.1027/1016-9040/a000228] [Citation(s) in RCA: 57] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Abstract. Pharmacological neuroenhancement, defined as the misuse of prescription drugs, illicit drugs, or alcohol for the purpose of enhancing cognition, mood, or prosocial behavior, is not widespread in Europe – nevertheless, it does occur. Thus far, no drug has been proven as safe and effective for cognitive enhancement in otherwise healthy individuals. European studies have investigated the misuse of prescription and illicit stimulants to increase cognitive performance as well as the use of tranquilizers, alcohol, and cannabis to cope with stress related to work or education. Young people in educational settings report pharmacological neuroenhancement more frequently than those in other settings. Although the regular use of drugs for neuroenhancement is not common in Europe, the irregular and low-dose usage of neuroenhancers might cause adverse reactions. Previous studies have revealed that obtaining adequate amounts of sleep and using successful learning techniques effectively improve mental performance, whereas pharmacological neuroenhancement is associated with ambiguous effects. Therefore, non-substance-related alternatives should be promoted to cope with stressful situations. This paper reviews the recent research on pharmacological neuroenhancement in Europe, develops a clear definition of the substances used, and formulates recommendations for practitioners regarding how to react to requests for neuroenhancement drug prescriptions. We conclude that monitoring the future development of pharmacological neuroenhancement in Europe is important to provide effective preventive measures when required. Furthermore, substance use to cope with stress related to work or education should be studied in depth because it is likely more prevalent and dangerous than direct neuroenhancement.
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Affiliation(s)
- Larissa J. Maier
- Swiss Research Institute for Public Health and Addiction (ISGF), Associated Institute at the University of Zurich and WHO Collaborating Centre, Zurich, Switzerland
| | - Michael P. Schaub
- Swiss Research Institute for Public Health and Addiction (ISGF), Associated Institute at the University of Zurich and WHO Collaborating Centre, Zurich, Switzerland
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Maier LJ, Wunderli MD, Vonmoos M, Römmelt AT, Baumgartner MR, Seifritz E, Schaub MP, Quednow BB. Pharmacological Cognitive Enhancement in Healthy Individuals: A Compensation for Cognitive Deficits or a Question of Personality? PLoS One 2015; 10:e0129805. [PMID: 26107846 PMCID: PMC4479570 DOI: 10.1371/journal.pone.0129805] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2015] [Accepted: 05/12/2015] [Indexed: 11/26/2022] Open
Abstract
The ongoing bioethical debate on pharmacological cognitive enhancement (PCE) in healthy individuals is often legitimated by the assumption that PCE will widely spread and become desirable for the general public in the near future. This assumption was questioned as PCE is not equally save and effective in everyone. Additionally, it was supposed that the willingness to use PCE is strongly personality-dependent likely preventing a broad PCE epidemic. Thus, we investigated whether the cognitive performance and personality of healthy individuals with regular nonmedical methylphenidate (MPH) use for PCE differ from stimulant-naïve controls. Twenty-five healthy individuals using MPH for PCE were compared with 39 age-, sex-, and education-matched healthy controls regarding cognitive performance and personality assessed by a comprehensive neuropsychological test battery including social cognition, prosocial behavior, decision-making, impulsivity, and personality questionnaires. Substance use was assessed through self-report in an interview and quantitative hair and urine analyses. Recently abstinent PCE users showed no cognitive impairment but superior strategic thinking and decision-making. Furthermore, PCE users displayed higher levels of trait impulsivity, novelty seeking, and Machiavellianism combined with lower levels of social reward dependence and cognitive empathy. Finally, PCE users reported a smaller social network and exhibited less prosocial behavior in social interaction tasks. In conclusion, the assumption that PCE use will soon become epidemic is not supported by the present findings as PCE users showed a highly specific personality profile that shares a number of features with illegal stimulant users. Lastly, regular MPH use for PCE is not necessarily associated with cognitive deficits.
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Affiliation(s)
- Larissa J. Maier
- Swiss Research Institute for Public Health and Addiction (ISGF), Associated Institute at the University of Zurich and WHO Collaborating Centre, Zurich, Switzerland
| | - Michael D. Wunderli
- Experimental and Clinical Pharmacopsychology, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital of the University of Zurich, Zurich, Switzerland
| | - Matthias Vonmoos
- Experimental and Clinical Pharmacopsychology, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital of the University of Zurich, Zurich, Switzerland
| | - Andreas T. Römmelt
- Center of Forensic Hairanalytics, Institute of Forensic Medicine, University of Zurich, Zurich, Switzerland
| | - Markus R. Baumgartner
- Center of Forensic Hairanalytics, Institute of Forensic Medicine, University of Zurich, Zurich, Switzerland
| | - Erich Seifritz
- Department of Psychiatry, Psychotherapy, and Psychosomatics, Psychiatric Hospital University of Zurich, Zurich, Switzerland
- Neuroscience Center Zurich, University of Zurich and Swiss Federal Institute of Technology, Zurich, Switzerland
| | - Michael P. Schaub
- Swiss Research Institute for Public Health and Addiction (ISGF), Associated Institute at the University of Zurich and WHO Collaborating Centre, Zurich, Switzerland
| | - Boris B. Quednow
- Experimental and Clinical Pharmacopsychology, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital of the University of Zurich, Zurich, Switzerland
- Neuroscience Center Zurich, University of Zurich and Swiss Federal Institute of Technology, Zurich, Switzerland
- * E-mail:
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Wiegel C, Sattler S, Göritz AS, Diewald M. Work-related stress and cognitive enhancement among university teachers. ANXIETY STRESS AND COPING 2015; 29:100-17. [PMID: 25747817 DOI: 10.1080/10615806.2015.1025764] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND Working conditions of academic staff have become increasingly complex and occupational exposure has risen. This study investigates whether work-related stress is associated with the use of prescription drugs for cognitive enhancement (CE). METHODS The study was designed around three web-based surveys (n1 = 1131; n2 = 936; n3 = 906) to which university teachers at four German universities were asked to respond. It assessed past CE-drug use and the willingness to use CE-drugs as factors influencing future use. Overlap among participants across the surveys allowed for analyses of stability of the results across time. RESULTS Our study suggests a currently very low prevalence of CE-drug use as well as a low willingness to use such drugs. The results showed a strong association between perceptions of work-related stress and all measures of CE-drug use (when controlling for potential confounding factors). They also showed that past use of CE-drugs increased participants' willingness to use them again in the future, as did lower levels of social support. Two different measures showed that participants' moral qualms against the use of CE-drugs decreased their probability of using them. CONCLUSIONS The results increase our knowledge about the prevalence of CE-drug use and our understanding of what motivates and inhibits the use of CE-drug.
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Affiliation(s)
- Constantin Wiegel
- a International Institute for Empirical Social Economics , Stadtbergen , Germany.,b Faculty of Sociology , Bielefeld University , Bielefeld , Germany
| | - Sebastian Sattler
- b Faculty of Sociology , Bielefeld University , Bielefeld , Germany.,c Institute for Sociology and Social Psychology , University of Cologne , Cologne , Germany.,d Cologne Graduate School in Management, Economics and Social Sciences , University of Cologne , Cologne , Germany
| | - Anja S Göritz
- e Department of Psychology , University of Freiburg , Freiburg , Germany
| | - Martin Diewald
- b Faculty of Sociology , Bielefeld University , Bielefeld , Germany
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Cabrera LY, Fitz NS, Reiner PB. Reasons for Comfort and Discomfort with Pharmacological Enhancement of Cognitive, Affective, and Social Domains. NEUROETHICS-NETH 2014. [DOI: 10.1007/s12152-014-9222-3] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Wolff W, Brand R, Baumgarten F, Lösel J, Ziegler M. Modeling students' instrumental (mis-) use of substances to enhance cognitive performance: Neuroenhancement in the light of job demands-resources theory. Biopsychosoc Med 2014; 8:12. [PMID: 24904687 PMCID: PMC4046050 DOI: 10.1186/1751-0759-8-12] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2014] [Accepted: 05/20/2014] [Indexed: 11/10/2022] Open
Abstract
Background Healthy university students have been shown to use psychoactive substances, expecting them to be functional means for enhancing their cognitive capacity, sometimes over and above an essentially proficient level. This behavior called Neuroenhancement (NE) has not yet been integrated into a behavioral theory that is able to predict performance. Job Demands Resources (JD-R) Theory for example assumes that strain (e.g. burnout) will occur and influence performance when job demands are high and job resources are limited at the same time. The aim of this study is to investigate whether or not university students’ self-reported NE can be integrated into JD-R Theory’s comprehensive approach to psychological health and performance. Methods 1,007 students (23.56 ± 3.83 years old, 637 female) participated in an online survey. Lifestyle drug, prescription drug, and illicit substance NE together with the complete set of JD-R variables (demands, burnout, resources, motivation, and performance) were measured. Path models were used in order to test our data’s fit to hypothesized main effects and interactions. Results JD-R Theory could successfully be applied to describe the situation of university students. NE was mainly associated with the JD-R Theory’s health impairment process: Lifestyle drug NE (p < .05) as well as prescription drug NE (p < .001) is associated with higher burnout scores, and lifestyle drug NE aggravates the study demands-burnout interaction. In addition, prescription drug NE mitigates the protective influence of resources on burnout and on motivation. Conclusion According to our results, the uninformed trying of NE (i.e., without medical supervision) might result in strain. Increased strain is related to decreased performance. From a public health perspective, intervention strategies should address these costs of non-supervised NE. With regard to future research we propose to model NE as a means to reach an end (i.e. performance enhancement) rather than a target behavior itself. This is necessary to provide a deeper understanding of the behavioral roots and consequences of the phenomenon.
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Affiliation(s)
- Wanja Wolff
- Department of Sport and Exercise Psychology, University Potsdam, Am Neuen Palais 10, 14469 Potsdam, Germany
| | - Ralf Brand
- Department of Sport and Exercise Psychology, University Potsdam, Am Neuen Palais 10, 14469 Potsdam, Germany
| | - Franz Baumgarten
- Department of Sport and Exercise Psychology, University Potsdam, Am Neuen Palais 10, 14469 Potsdam, Germany
| | - Johanna Lösel
- Department of Sport and Exercise Psychology, University Potsdam, Am Neuen Palais 10, 14469 Potsdam, Germany
| | - Matthias Ziegler
- Psychological Institute, Humboldt University of Berlin, Unter den Linden 6, 10099 Berlin, Germany
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Schelle KJ, Faulmüller N, Caviola L, Hewstone M. Attitudes toward pharmacological cognitive enhancement-a review. Front Syst Neurosci 2014; 8:53. [PMID: 24860438 PMCID: PMC4029025 DOI: 10.3389/fnsys.2014.00053] [Citation(s) in RCA: 87] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2014] [Accepted: 03/21/2014] [Indexed: 11/13/2022] Open
Abstract
A primary means for the augmentation of cognitive brain functions is “pharmacological cognitive enhancement” (PCE). The term usually refers to the off-label use of medical substances to improve mental performance in healthy individuals. With the final aim to advance the normative debate taking place on that topic, several empirical studies have been conducted to assess the attitudes toward PCE in the public, i.e., in groups outside of the academic debate. In this review, we provide an overview of the 40 empirical studies published so far, reporting both their methodology and results. Overall, we find that several concerns about the use of PCE are prevalent in the public. These concerns largely match those discussed in the normative academic debate. We present our findings structured around the three most common concerns: medical safety, coercion, and fairness. Fairness is divided into three subthemes: equality of opportunity, honesty, and authenticity. Attitudes regarding some concerns are coherent across studies (e.g., coercion), whereas for others we find mixed results (e.g., authenticity). Moreover, we find differences in how specific groups—such as users, nonusers, students, parents, and health care providers—perceive PCE: a coherent finding is that nonusers display more concerns regarding medical safety and fairness than users. We discuss potential psychological explanations for these differences.
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Affiliation(s)
- Kimberly J Schelle
- Department of Industrial Design, Eindhoven University of Technology Eindhoven, Netherlands
| | - Nadira Faulmüller
- Department of Experimental Psychology, University of Oxford Oxford, UK ; Department of Values, Technology and Innovation, Delft University of Technology Delft, Netherlands
| | - Lucius Caviola
- Department of Experimental Psychology, University of Oxford Oxford, UK
| | - Miles Hewstone
- Department of Experimental Psychology, University of Oxford Oxford, UK
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