Potential risk groups and psychological, psychosocial, and health behavioral predictors of pharmacological neuroenhancement among university students in Germany

Abstract

Aiming to develop and implement intervention strategies targeting pharmacological neuroenhancement (PN) among university students more specifically, we (1) assessed the prevalence of PN among German university students, (2) identified potential sociodemographic and study-related risk groups, and (3) investigated sociodemographic, psychological, study-related psychosocial, general psychosocial and health behavior related factors predicting the 12-month prevalence of PN. Therefore, a cross-sectional online survey was administered to students of the University of Mainz, Germany. A binary logistic regression with stepwise inclusion of the five variable groups was performed to predict PN. A total number of 4351 students out of 31,213 registered students (13.9%) participated in the survey, of which N = 3984 answered the question concerning PN. Of these, 10.4% had used one substance for PN at least once in the past 12 months. The regression analysis revealed 13 variables that were significantly related to the 12-month prevalence of PN. Specifically, the group of health behavior related variables showed the strongest relationship with PN. Therefore, an approach to the prevention of PN should be multifactorial so that it addresses social conditions, as well as education on substance use and healthy behaviors in terms of non-pharmacological strategies as alternatives of PN.

The Prevalence of Pharmacological Neuroenhancement Among University Students Before and During the COVID-19-Pandemic: Results of Three Consecutive Cross-Sectional Survey Studies in Germany

“…To be able to plan evidence-based and effective PN-prevention initiatives for university students, it is important to understand the conditions and factors predicting PN among this target group. In this context, using a stepwise binary logistic regression model, Heller et al ( 24 ) showed that specific varibles of health behavior predicted the use of PN among university students indicating that initiatives strengthening health behavior may prevent PN. This is in line with other research indicating that strengthening health-related key skills and ressources (in the sense of positive coping strategies) leads to a decrease in the prevalence of PN.…”

“…For example, Bagusat et al ( 26 ) concluded that tailored resilience interventions that improve the ability to adapt to and recover from stressors prevent the use of PN. Consequently, we recommend that initiatives aiming to prevent PN among university students have to be multifactorial taking the specific conditons of studying into account and have to focus on strengthening competences with regard to health behavior, mental health literacy and non-pharmacological ressources and strategies ( 24 , 46 , 47 ). Especially during the COVID-19-pandemic and in times of distance-teaching, online programs are of particular relevance.…”

“…PN was investigated in all surveys as part of the health behavior questions following the same methodical approach published for example, by Heller et al ( 24 ) and others ( 4 , 5 ). Accordingly, the translated question to assess the prevalence PN was: “Have you ever used the following substance/-s without medical necessity, for the purpose of enhancing your cognitive performance or to better handle your studies (not for reasons of enjoyment)?” The following illicit or prescription drugs could be selected via multiple-choice, and each with the scale “never,” “within the last 30 days,” “within the last 12 months,” or “more than 12 months ago”: methylphenidate (e.g., Ritalin ® ), amphetamine preparation (e.g., Adderall ® ), atomoxetine (e.g., Strattera ® ), modafinil (e.g., Provigil ® ), ecstasy, ephedrine, cocaine, illicit amphetamines (e.g., Speed), crystal meth, cannabis, and “other substances.” To be able to investigate potential changes in the prevalence of PN over time, the 12-month prevalence (dichotomous: “yes”/“no”) instead of the lifetime prevalence was used for all further analyses.…”

“…Consequently, health promotion and prevention in this collective would be sustainable and beneficial for the general society ( 22 , 23 ). Aiming to develop and implement prevention strategies of PN among university students more specifically, Heller et al ( 24 ) investigated potential sociodemographic and study-related risk groups as well as predictors of PN taking sociodemographic, psychological, study-related, general psychosocial factors, as well as health behavior-related variables into account. They concluded that specific health behavior variables such as physical activity or nutrition had the most decisive influence on the explained variance of PN, supporting the results of previous studies ( 13 , 25 ).…”

Do Medical Universities Students Use Cognitive Enhancers while Learning?—Conclusions from the Study in Poland

“…The prevalence was higher in men than women (60.5% vs. 49%) and in older than younger students (59.4% vs. 47.6%). In the study of the use of CEs among medical students in Lithuania, men also took CEs more often (almost three times greater prevalence) than women [ 19 ], and significant differences, with a higher percentage of men taking illicit or prescription drugs for cognitive enhancement, were also noticed in the study in Germany [ 26 ]. Similarly, in Iran, men were more likely to use CEs than women.…”