The importance of stress, self-efficacy, and self-medication for pharmacological neuroenhancement among employees and students

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 to 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 selfmedication 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. This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. Page 1 of 32A c c e p t e d M a n u s c r i p t A c c e p t e d M a n u s c r i p t 2 ABSTRACTObjectives: This study examined the relationship between stress, self-efficacy, selfmedication, 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 to 74 years was recruited and asked to complete a selfadministered 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 me...

Nonmedical use of prescription drugs for cognitive enhancement as response to chronic stress especially when social support is lacking

“…This finding resembles several prior studies on different substances specific or unspecific to CE (Brown et al, ; Lazuras et al, ; Maier, Haug, & Schaub, ; Middendorff et al, ; Peck et al, ; Schröder et al, ; Wolff & Brand, ). However, some studies found no effects of different indicators for stress (Lazuras et al, ; Maier, Haug, & Schaub, ). The finding of this study could be understood from different theoretical perspectives (e.g., self‐medication hypothesis, stress coping, strain theory, and the job demands–resources theory).…”

“…Findings on age are also mixed. Several studies found a higher likelihood of prescription drug use (including for CE) in younger populations (Maier, Haug, & Schaub, ; Novak et al, ; Schröder et al, ). Few studies found the opposite (Singh et al, ).…”

“…Other studies also present reasons of CE-drug use descriptively (Mache, Eickenhorst, Vitzthum, Klapp, & Groneberg, 2012;Schröder et al, 2015) and list dealing with high demands, performance pressure, or stress as reasons. Several quantitative studies specifically investigating prescription drug use for CE found positive associations with different indicators of stress (e.g., burnout; Lazuras et al, 2017;Maier, Haug, & Schaub, 2015;Middendorff et al, 2012;Schröder et al, 2015;Wolff & Brand, 2013). However, some indicators (e.g., the quantitative extent of work demands) were not associated with CE-drug use (Lazuras et al, 2017;Maier, Haug, & Schaub, 2015).…”

“…Thereby, several theoretically overlapping approaches on the relation between substance use and stress include the self-medication hypothesis, stress coping, strain theory, and the job demands-resources theory (Khantzian, 1997;Müller & Schumann, 2011;Sattler & Wiegel, 2013;Wiegel, Sattler, Göritz, & Diewald, 2016;Wolff, Brand, Baumgarten, Lösel, & Ziegler, 2014) can help advance the understanding of why stress might be related to CE-drug use. These theories all assume that stress increases substance use, not only including alcohol and nicotine but also CE-drugs (Agnew, 2013;Barbieri & Connell, 2017;Ford & Schroeder, 2008;Lazuras et al, 2017;Maier, Haug, & Schaub, 2015;Müller & Schumann, 2011;Peck et al, 2018;Peirce, Frone, Russell, & Cooper, 1996;Steptoe et al, 1996;Wiegel et al, 2016;Wolff & Brand, 2013;Wolff et al, 2014).…”

“…If legal coping strategies fail or do not exist, deviant and criminal coping might be chosen to achieve valued goals, protect positive stimuli, and reduce the effect of noxious stimuli (Ford & Schroeder, 2008;Maahs et al, 2016). From the perspective of strain theory, but also from the self-medication hypothesis and the perspective of instrumental drug use (Khantzian, 1997;Maier, Haug, & Schaub, 2015;Müller & Schumann, 2011;Sattler & Wiegel, 2013;Wolff et al, 2014), CE-drugs might be perceived as relevant coping instruments because they promise increased alertness, concentration, wakefulness, and learning and thereby help manage busy schedules and competitive situations. Thus, these drugs can be understood as a resource or means to an end to maintain, extend, or rebuild desired mental states (Müller & Schumann, 2011).…”