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      Impact of Contextual Factors and Substance Characteristics on Perspectives toward Cognitive Enhancement

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          Abstract

          Enhancing cognitive performance with substances–especially prescription drugs–is a fiercely debated topic among scholars and in the media. The empirical basis for these discussions is limited, given that the actual nature of factors that influence the acceptability of and willingness to use cognitive enhancement substances remains unclear. In an online factorial survey, contextual and substance-specific characteristics of substances that improve academic performance were varied experimentally and presented to respondents. Students in four German universities rated their willingness to use and moral acceptance of different substances for cognitive enhancement. We found that the overall willingness to use performance enhancing substances is low. Most respondents considered the use of these substances as morally unacceptable. Situational influences such as peer pressure, policies concerning substance use, relative performance level of peers, but also characteristics of the substance, such as perceptions of substance safety, shape the willingness and acceptability of using a substance to enhance academic performance. Among the findings is evidence of a contagion effect meaning that the willingness was higher when the respondents have more CE drug users in their social network. We also found deterrence effects from strong side effects of using the substance, as well as from policy regulations and sanctions. Regulations might activate social norms against usage and sanctions can be seen as costly to users. Moreover, enhancement substances seem to be most tempting to low performers to catch up with others compared to high performers. By identifying contextual factors and substance characteristics influencing the willingness and acceptability of cognitive enhancers, policy approaches could consider these insights to better manage the use of such substances.

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          Most cited references38

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          Towards responsible use of cognitive-enhancing drugs by the healthy.

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            Modafinil and methylphenidate for neuroenhancement in healthy individuals: A systematic review.

            The term neuroenhancement refers to improvement in the cognitive, emotional and motivational functions of healthy individuals through, inter alia, the use of drugs. Of known interventions, psychopharmacology provides readily available options, such as methylphenidate and modafinil. Both drugs are presumed to be in widespread use as cognitive enhancers for non-medical reasons. Based on a systematic review and meta-analysis we show that expectations regarding the effectiveness of these drugs exceed their actual effects, as has been demonstrated in single- or double-blind randomised controlled trials. Only studies with sufficient extractable data were included in the statistical analyses. For methylphenidate an improvement of memory was found, but no consistent evidence for other enhancing effects was uncovered. Modafinil on the other hand, was found to improve attention for well-rested individuals, while maintaining wakefulness, memory and executive functions to a significantly higher degree in sleep deprived individuals than did a placebo. However, repeated doses of modafinil were unable to prevent deterioration of cognitive performance over a longer period of sleep deprivation though maintaining wakefulness and possibly even inducing overconfidence in a person's own cognitive performance. Copyright 2010 Elsevier Ltd. All rights reserved.
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              Non-medical use of prescription stimulants among US college students: prevalence and correlates from a national survey.

              To examine the prevalence rates and correlates of non-medical use of prescription stimulants (Ritalin, Dexedrine or Adderall) among US college students in terms of student and college characteristics. A self-administered mail survey. One hundred and nineteen nationally representative 4-year colleges in the United States. A representative sample of 10 904 randomly selected college students in 2001. Self-reports of non-medical use of prescription stimulants and other substance use behaviors. The life-time prevalence of non-medical prescription stimulant use was 6.9%, past year prevalence was 4.1% and past month prevalence was 2.1%. Past year rates of non-medical use ranged from zero to 25% at individual colleges. Multivariate regression analyses indicated non-medical use was higher among college students who were male, white, members of fraternities and sororities and earned lower grade point averages. Rates were higher at colleges located in the north-eastern region of the US and colleges with more competitive admission standards. Non-medical prescription stimulant users were more likely to report use of alcohol, cigarettes, marijuana, ecstasy, cocaine and other risky behaviors. The findings of the present study provide evidence that non-medical use of prescription stimulants is more prevalent among particular subgroups of US college students and types of colleges. The non-medical use of prescription stimulants represents a high-risk behavior that should be monitored further and intervention efforts are needed to curb this form of drug use.
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                Author and article information

                Contributors
                Role: Editor
                Journal
                PLoS One
                PLoS ONE
                plos
                plosone
                PLoS ONE
                Public Library of Science (San Francisco, USA )
                1932-6203
                2013
                5 August 2013
                : 8
                : 8
                : e71452
                Affiliations
                [1 ]Faculty of Sociology, Bielefeld University, Bielefeld, Germany
                [2 ]Institut de recherches cliniques de Montréal, Unité de recherche en neuroéthique, Montréal, Canada
                [3 ]McGill University, Montréal, Canada
                [4 ]Université de Montréal, Montréal, Canada
                [5 ]Collaborative Research Center 882, Bielefeld University, Bielefeld, Germany
                The Ohio State University, United States of America
                Author notes

                Competing Interests: The authors have declared that no competing interests exist.

                Conceived and designed the experiments: SS CF ER CS. Performed the experiments: SS. Analyzed the data: CS SS. Contributed reagents/materials/analysis tools: SS CS. Wrote the paper: SS CF ER CS.

                Article
                PONE-D-13-00039
                10.1371/journal.pone.0071452
                3733969
                23940757
                f290b8d8-1298-4e16-9837-720e1cb65fdb
                Copyright @ 2013

                This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 13 December 2012
                : 2 July 2013
                Page count
                Pages: 12
                Funding
                This research was funded by the Federal Ministry of Education and Research (FMER; grant number: 01PH08024, headed by Sebastian Sattler and Martin Diewald; http://www.bmbf.de/en/index.php). Carsten Sauer gratefully acknowledges a grant from the Bielefeld Graduate School in History and Sociology (BGHS; http://www.uni-bielefeld.de/(en)/bghs/) and Sebastian Sattler a Rectorate Fellowship of the Bielefeld University (grant number: 3521.01; http://www.uni-bielefeld.de/(en)/nachwuchs/finanzierung_und_foerderung/promovierende/rektoratsstipendien.html). Doctoral award from the Fonds de recherché du Québec-Santé (CF; http://www.frsq.gouv.qc.ca/en/index.shtml). The authors acknowledge the support for the publication fee by the Deutsche Forschungsgemeinschaft and the Open Access Publication Funds of Bielefeld University. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
                Categories
                Research Article
                Biology
                Bioethics
                Medicine
                Clinical Research Design
                Survey Research
                Non-Clinical Medicine
                Health Care Policy
                Drug Policy
                Medical Ethics
                Medical Sociology
                Public Health
                Drug Policy
                Social and Behavioral Sciences
                Sociology
                Social Research

                Uncategorized
                Uncategorized

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