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.
Highlights
The term “pharmacological neuroenhancement (PN)” – called “pharmacological cognitive enhancement” – is generally defined as the use of illicit or prescription drugs by healthy individuals for cognitive-enhancing purposes such as improving vigilance, attention, concentration, or mood (Franke and Lieb, 2010; Dietz et al, 2013b; Sattler, 2016)
Whether the Pharmacological neuroenhancement (PN) prevalence estimate increases when caffeine tablets are included in the definition of PN
One hundred and eighty students stated that they had already participated in the survey in a previous class/lecture and these students were excluded from data analysis resulting in a total number of 2,284 (91.8%) questionnaires for the analysis
Summary
The term “pharmacological neuroenhancement (PN)” – called “pharmacological cognitive enhancement” – is generally defined as the use of illicit (e.g., illicit stimulants, cocaine, ecstasy) or prescription drugs (e.g., stimulants such as methylphenidate and amphetamines, modafinil as well as antidementives and antidepressants) by healthy individuals for cognitive-enhancing purposes such as improving vigilance, attention, concentration, or mood (Franke and Lieb, 2010; Dietz et al, 2013b; Sattler, 2016). For university students the lifetime prevalence was about 5% for the use of prescription drugs for cognitiveenhancing purposes among German students (Sattler and Wiegel, 2013), 7.6% among Swiss students (Maier et al, 2013), around 2% among Dutch students (Schelle et al, 2015), 16% for the use of drugs among Italian students (Castaldi et al, 2012), and about 4% for the use of methylphenidate, 6% for modafinil, and 2% for Adderall for cognitive-enhancing purposes among students in Ireland/United Kingdom (Singh et al, 2014). Using an indirect survey technique, Dietz et al (2013a) estimated a 12month prevalence of 20% for PN for German university students including prescription drugs, illicit drugs, and caffeine tablets. 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
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