Feigning Symptoms to Obtain Prescription Stimulants: A Vignette-Based Study on Its Conditions

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.

Characteristics and outcomes of cases with methylphenidate abuse, dependence or withdrawal: an analysis of spontaneous reports in EudraVigilance

“…In narcolepsy, nonspecific symptoms, especially in cases without cataplexy, and high rates of comorbidities may lead to inappropriate treatment or unsupervised self-treatment along with a higher risk for substance abuse/dependence (Lazareck et al, 2012;Dunne et al, 2016;Ruoff et al, 2017). Further, there have been reports of the imitation of narcoleptic symptoms by illegal substances, especially cannabis, or the feigning of narcoleptic symptoms (or ADHD characteristics), to obtain stimulants for resale or personal misuse/abuse (Dzodzomenyo et al, 2015;Dunne et al, 2016;Fuermaier et al, 2021;van Veen et al, 2022). Therefore, incorrect diagnoses might also have contributed to the higher proportion of narcolepsy in our study.…”

“…Most studies on MPH abuse or misuse so far have been limited to regional or national data, people with a known SUD or certain age groups, typically college students (Teter et al , 2006; Kaloyanides et al , 2007; Frauger et al , 2011, 2013; 2016; Cairns et al , 2016; Faraone et al , 2020; Fuermaier et al , 2021; van Veen et al , 2022). There are almost no studies addressing MPH abuse in narcolepsy (Auger et al , 2005; Mantyh et al , 2016).…”

Working with a sleep‐deprived or a cognitively enhanced team member compromises motivation to contribute to group performance

“…To evaluate and improve the instructions and instruments, the survey materials underwent pretesting (N = 5) using the think-aloud technique and probing questions (Van Someren et al, 1994) and a further pretest under naturalistic conditions (N = 34). The results of these pretests demonstrated the materials were clear, understandable and suitable for the nationwide sample.…”

“…It has been shown that these pharmaceuticals can also improve cognitive abilities (i.e., memory, attention) in healthy individuals (Battleday & Brem, 2015; Roberts et al., 2020). For many, these substances are readily available via friends, family, by feigning symptoms at a doctor's office or via the black market (Faraone et al., 2020; van Veen et al., 2022). One study found that one in five people in the United States aged 16 to 65 reported taking enhancement drugs in the past year (Maier et al., 2018).…”

Effort–Reward Imbalance at Work and Prescription Drug Misuse—Prospective Evidence from Germany

“…Interestingly, people with low or a lack of overcommitment are less likely to misuse drugs when effort is high. Thus, their work motivation may not be high enough to make them willing to take the risk of experiencing side effects or face the challenge of obtaining such drugs, e.g., by feigning symptoms at the doctor's or finding relatives or friends who may share their medication [52][53][54]. These findings also suggest that, in the absence of a main effect of work stress on the outcome (here prescription drug misuse), work stress may exert differential effects, i.e., the investigated type of drug misuse follows different patterns depending on the combination of the extrinsic and the intrinsic component of the model.…”