This association might be of particular interest for the student population, since the Centers for Disease Control and Prevention of the United States and others have shown that students engage in various health risk behaviors and ignore preventive safety habits, which may have long-term implications for their health Centers for Disease Control and Prevention, ; Steptoe and Wardle, ; Steptoe et al. Therefore, we conclude that prevention and education programs addressing PN in the collective of students likely fail if they only inform about potential side effects of its use approach of deterrence.
In fact, such programs have to further share knowledge about the limited efficacy of PN in healthy individuals Repantis et al. In addition, students have to be informed about potential alternatives of PN which are discussed to have cognitive-enhancing effects, such as sports and exercise Tomporowski, ; Lambourne and Tomporowski, ; Dietz, , nutrition Chung et al.
The overall month PN prevalence estimate of As stated above, the differences across studies may be attributed to various methodological factors. Additionally, the Dutch study did not include caffeine tablets whereas the German study did. Since the present overall prevalence estimate is a mix of both versions with caffeine tablets and without it is quite plausible that this PN prevalence estimate is quite in the middle of the Dutch and the German prevalence.
Finally, although the present study was the first large survey assessing the prevalence of PN in Austrian University students using RRT, the present results are not representative for Austria because the survey was restricted to the University of Graz. Nonetheless, we were able to demonstrate that the used study design and survey techniques are highly appropriate to detect cross-sectional associations between potential predictor variables and PN. The variables gender and semester did not significantly influence PN prevalence estimates.
For gender, our results support the outcomes of other studies indicating that there is no difference in the PN usage between female and male students Teter et al. Yet some studies reported gender differences, with males having a higher risk for PN compared to females DeSantis et al. In a recent meta-analysis by Benson et al. This heterogeneous result pattern may reflect differences in methodology, for example, by using cross-sectional and longitudinal study designs, different survey techniques as well as assessing prevalences for different time periods such as lifetime versus last-year prevalence Benson et al.
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In contrast to the present study, a survey among university students in Germany reported that students of the first semester were of higher risk for PN compared to higher semester students. In the present survey, only participants were first semester students. Therefore, we could not calculate a reliable PN prevalence estimate for the first semester students Ulrich et al. To examine the influence of time spent at the university on the prevalence of PN, future studies should collect longitudinal data, which may enable researchers to assess changes in PN consumption over time.
One limitation of the present study might be that we used a self-designed question to assess the overall prevalence of PN. This has been done for the following reason. It is known from previous studies e. One objection against this definition might be that it excludes substances that can only be bought in a pharmacy e. Therefore, we provided concrete examples of substances in order to increase the comprehension of our question.
It is likely that prevalence estimates are influenced by how such questions are posed. Another limitation of the study might be that we were not able to identify specific substances for PN by using the present RRT design to investigate an overall prevalence estimate of PN. This gap should be closed by future RRT studies that are tailored to address specific substance prevalences. Unrelated question model was used in the present study to assess the PN prevalence estimate.
In their meta-analysis of 38 randomized response validation studies, Lensvelt-Mulders et al. Using the UQM participants get randomly assigned to answer one of two questions, the sensitive or a neutral one. However, a participant that has been assigned to answer the sensitive answer may avoid this question and respond to the neutral question instead.
As shown by Ulrich et al. This study revealed that the PN prevalence estimate increases when caffeine tablets are included in the definition of PN. PD, BI, ES, RU, and MS made substantial contributions to the conception and design of the study, the data acquisition, analysis, interpretation of data, and the preparation of the manuscript. MvP made substantial contributions to the interpretation of data and the preparation of the manuscript. All authors proofread and accepted the final version of the manuscript.
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The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The reviewer JD and handling Editor declared their shared affiliation. Special thanks to the volunteers that distributed the questionnaires during classes and enabled us to collect a large number of questionnaires in short time: Stefan Florjancic, Philipp Klaindl, Christian Gerhard Petrovcic, and Peter Stueger.
We also thank the lecturers allowing us to visit their classes and collect data for this survey. We acknowledge the help of Dr. Estelle Watson from the University of the Witwatersrand, Johannesburg, South Africa for improving the readability of the manuscript. National Center for Biotechnology Information , U. Journal List Front Pharmacol v. Front Pharmacol. Published online Jun Author information Article notes Copyright and License information Disclaimer.
Reviewed by: Boris B. This article was submitted to Neuropharmacology, a section of the journal Frontiers in Pharmacology. Received Dec 15; Accepted Apr The use, distribution or reproduction in other forums is permitted, provided the original author s and the copyright owner are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. This article has been cited by other articles in PMC. PDF K. Abstract Background: Pharmacological neuroenhancement PN is defined as the use of illicit or prescription drugs by healthy individuals for cognitive-enhancing purposes.
Keywords: message frame, cognitive bias, cognitive enhancing drugs, risk behavior, substance abuse detection, statistical distributions, epidemiologic methods, randomized response technique. Materials and Methods Survey Procedure A paper-and-pencil survey was conducted among university students at the University of Graz, Austria.
Questionnaire The anonymous paper-and-pencil questionnaire was two pages long and, after a short introduction explaining the content of the study and that participation would be anonymous and voluntary, was comprised of three parts. Table 1 Characteristics of the respondents. Open in a separate window. The items for the variable field of study were grouped on the basis of two previous studies and modified according to the local affiliation of the different fields to the faculties.
Table 2 Estimated month prevalence for pharmacological neuroenhancement. Dichotomized by median. Discussion The present study addressed two questions. Conclusion This study revealed that the PN prevalence estimate increases when caffeine tablets are included in the definition of PN.
Author Contributions PD, BI, ES, RU, and MS made substantial contributions to the conception and design of the study, the data acquisition, analysis, interpretation of data, and the preparation of the manuscript. Conflict of Interest Statement The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
Acknowledgments Special thanks to the volunteers that distributed the questionnaires during classes and enabled us to collect a large number of questionnaires in short time: Stefan Florjancic, Philipp Klaindl, Christian Gerhard Petrovcic, and Peter Stueger. Click here for additional data file. References Altman D. How to randomise.
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The problems of researching sensitive topics: an overview and introduction. How to improve the efficiency of randomised response designs. Meta-analysis of randomized response research thirty-five years of validation. Methods Res. PLoS One 10 : e Attention regulation and monitoring in meditation. Trends Cogn. Cognitive-enhancing substance use at German universities: frequency, reasons and gender differences. Nature — In the non-textual and political historians, the coat of the Edge, deposits of Europeans was advised to have powered by means. In the other and Special requirements, the end of the history, Africans of Europeans delivered found to be accredited by tips.
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