Amy J. Jeffers

Misuse of prescription stimulants for weight loss, psychosocial variables, and eating disordered behaviors

In recent years there has been a dramatic increase in the non-medical use of prescription drugs among young adults including an increase in the use of prescription stimulants normally used to treat ADHD. Reported motivations for the non-medical use of prescription stimulants (NPS) include enhancing academic performance and to get high. Although a common side effect of these medications is appetite suppression, research examining weight loss as a motivation for NPS among young adults is sparse. In the present study, undergraduate students (n=705) completed an online survey assessing weight loss behaviors, motivations for weight loss, and eating behaviors. Nearly 12% of respondents reported using prescription stimulants to lose weight. Participants who reported using prescription stimulants for weight loss had greater appearance-related motivations for weight loss, greater emotion and stress-related eating, a more compromised appraisal of their ability to cope, lower self-esteem, and were more likely to report engaging in other unhealthy weight loss and eating disordered behaviors. Results suggest some young adults are misusing prescription stimulants for weight loss and that this behavior is associated with other problematic weight loss strategies. Interventions designed to reduce problematic eating behaviors in young adults may wish to assess the misuse of prescription stimulants.

Alcohol mixed with energy drinks are robustly associated with patterns of problematic alcohol consumption among young adult college students.

BACKGROUND Young adults are a population at great risk for problematic health behaviors. Alcohol mixed with energy drink (AmED) consumption is a relatively popular health risk behavior among young adults. AmED consumption continues to illustrate negative outcomes in the research literature, having been linked with other substance use, high-risk sexual behavior, and sexual victimization. Limited research to date has examined associations between AmED consumption and patterns of alcohol dependence. METHODS Undergraduate college students (n=757) filled out an online survey which assessed their drinking habits in the past week and month, including their consumption of AmED beverages, personality characteristics, substance use, and problematic alcohol consumption via the Alcohol Use Disorders Identification Test (AUDIT). RESULTS A minority of participants reported AmED consumption in both the past month (11.6%) and past week (9.7%). Compared to their alcohol-only drinking counterparts, AmED consumers scored significantly higher on measures of impulsivity, and lower on anxiety sensitivity when compared to their alcohol-only drinking counterparts. In multivariate analyses, AmED consumption was robustly associated with patterns of alcohol dependence (AUDIT score≥8) among young adult college students, while controlling for energy drink use, alcohol use, personality factors, substance use, and demographic variables. CONCLUSIONS AmED consumption in the past month is robustly associated with problematic alcohol consumption. The present study describes harmful outcomes associated with AmED consumption, and extends the literature on the combined effects of alcohol and energy drinks on young adult risk behaviors. Further research needs to address causal mechanisms for the AmED and problematic alcohol consumption relation.

Non-medical use of prescription stimulants for weight loss, disordered eating, and body image

OBJECTIVE There has been minimal research on the non-medical use of prescription stimulants (NMUPS), such as Adderall and Ritalin, normally used to treat Attention Deficit Hyperactivity Disorder (ADHD) for the purpose of weight loss. The current study examined the prevalence and correlates of this use in a young adult sample. METHOD College students (N=707) completed an online survey assessing NMUPS, in general and for weight loss, disordered eating behaviors and attitudes, body image, and recreational drug use. RESULTS Overall, 4.4% of participants reported NMUPS for the purpose of weight loss with 56.7% reporting receiving the medication from friends. Individuals reporting NMUPS for weight loss had higher body image concerns and had higher eating disorder symptomatology. Vomiting for weight loss as well as laxative, diet pill, or diuretic use were robustly associated with NMUPS for weight loss. DISCUSSION Results suggest that NMUPS for weight loss is relatively common and that this behavior is related to other harmful behaviors. Eating disorder prevention and intervention work should include this behavior when assessing unhealthy weight control behaviors.

BMI and depressive symptoms: the role of media pressures.

Obese and overweight individuals experience higher risk for depression and emotional distress. One factor that may contribute to depression in obese or overweight individuals is exposure to unrealistic images in the media. Indeed, overall media consumption is associated with body image dissatisfaction in adolescents and young adults. Despite these compelling links, prior work has not examined the mediating effect of media pressures on the link between BMI and depression. In the present study, young adults (N = 743) completed an online survey assessing demographic information, perceived pressure from the media to conform to a certain body standard, and symptoms of depression. Structural equation modeling analyses indicated a direct effect of BMI on media pressure, a direct effect of media pressure on depressive symptoms, and an indirect effect of BMI on depressive symptoms mediated by media pressures. Findings indicate that higher BMI levels are associated with greater depressive symptoms when there is greater perceived media pressure on body image. Results suggest the need for clinicians to assess media consumption and perceived pressure to conform to physical appearance standards in individuals who are obese or overweight as well as individuals at risk for eating disorders.

Energy Drinks, Weight Loss, and Disordered Eating Behaviors.

Abstract Objective: The present study examined energy drink consumption and relations with weight loss attempts and behaviors, body image, and eating disorders. Participants/Methods: This is a secondary analysis using data from 856 undergraduate students who completed the American College Health Association–National College Health Assessment II confidentially online during February 2012. Results: This study revealed that the majority reported lifetime consumption of energy drinks (68.4%) and a substantial minority (30.2%) reported past-30-day consumption. Chi-square and t test results suggest that consumption is associated with concerns about personal appearance, weight loss attempts, and disordered eating behaviors (eg, vomiting). Hierarchical logistic regressions revealed that after controlling for demographics, the relations between energy drink consumption and the act of trying to lose weight, the use of diet pills, and the use of vomiting/laxatives remained significant. Conclusions: The current findings suggest that energy drink consumption is associated with weight loss attempts, poor body image, and unhealthy weight loss behaviors. Future research should examine the prevalence of energy drink consumption for the purpose of weight loss.

Driving Under the Influence of Prescription Drugs Used Nonmedically: Associations in a Young Adult Sample

BACKGROUND Over the past 20 years, there has been a dramatic increase in the nonmedical use of prescription drugs (NMUPD). However, minimal attention has been given to driving under the influence of prescription drugs used nonmedically. METHODS This study examines attitudes and characteristics that might be associated with driving while engaging in NMUPD. College students (N = 763) aged 18-25 years completed online surveys assessing demographic information, NMUPD, recreational use of other drugs, psychological variables, attitudes towards NMUPD and driving, and driving behavior. RESULTS Overall, 28.0% of participants reported lifetime NMUPD; 12.2% reported ever driving while engaging in NMUPD; and 7.9% reported this behavior in the past 3 months. Participants who reported engaging in NMUPD while driving were significantly more likely to report the use of alcohol, marijuana, ecstasy, cocaine, methamphetamine, ketamine, GHB (γ-hydroxybutyric acid), rohypnol, and mephedrone. These participants also scored higher on measures of hopelessness, impulsivity, and sensation seeking. Individuals who engaged in NMUPD while driving also reported lower perceptions of the risks of this behavior and believed that NMUPD is more common in young adults. CONCLUSIONS A significant percentage of college students engage in driving under the influence of prescription drugs. Public health interventions designed to increase driving safety may wish to focus attention on this type of drugged driving.

Motivational interviewing with parents of overweight children: Study design and methods for the NOURISH + MI study

There is an urgent need for innovative approaches to pediatric obesity treatment. There is also a demand for targeted strategies that reduce attrition and improve treatment adherence. Intervening exclusively with parents of overweight children is a novel approach with demonstrated efficacy in reducing child body mass index (BMI) percentile. Motivational interviewing (MI), a brief communication style for exploring and resolving ambivalence about behavior change, might enhance treatment engagement when implemented as part of obesity interventions. The aim of this report is to provide the rationale and methods for a novel study of MI with parents in the treatment of their childrens overweight. We designed and are currently implementing NOURISH+MI, a randomized controlled trial examining the feasibility and efficacy of an adjunct values-based MI intervention, implemented within a culturally-tailored parent intervention for overweight children ages 5-11 years, NOURISH(+) (Nourishing Our Understanding of Role modeling to Improve Support and Health). Specifically, we are randomly assigning 60 parents to this adjunctive treatment, and investigating if adding two MI sessions prior to the NOURISH(+) group intervention will enhance treatment effects. We will be able to compare NOURISH+MI participants with those from the two NOURISH(+) treatment conditions (NOURISH(+) and control). We hypothesize that children whose parents participate in NOURISH+MI will demonstrate lower attrition and greater adherence with NOURISH(+), ultimately leading to greater treatment effects, compared with children whose parents are randomized to NOURISH(+) or a control group. Findings will contribute to the emerging literature examining the efficacy of MI within pediatric obesity interventions.

Health anxiety and the non-medical use of prescription drugs in young adults: A cross-sectional study

INTRODUCTION Studies have demonstrated a relation between health anxiety (hypochondriasis) and substance use, but this minimal body of literature has focused on alcohol or illicit drugs. The use of medications without a physicians prescription (i.e., non-medical use of prescription drugs, NMUPD) is increasingly prevalent among young adults. Health anxiety, a tendency to worry excessively about health, is a factor that could contribute to NMUPD, but this has not been examined. The purpose of the current study was to examine the relations among health anxiety, NMUPD, and other psychological variables related to substance use. METHODS In the present study, young adult college students (N = 758), ages 18-25, completed an anonymous online survey assessing demographics, health anxiety, NMUPD, and other psychological characteristics, including depression and general anxiety. RESULTS Participants who reported NMUPD had higher scores in health anxiety, as well as more frequent healthcare appointments, and were more likely to report having a chronic health condition. Given that multiple factors influence a decision to engage in NMUPD, a multivariable logistic regression analysis was performed. Results suggested that hopelessness, sensation-seeking, and health anxiety were risk factors for NMUPD, and that health anxiety predicted NMUPD over and above these other variables. CONCLUSIONS Medical professionals and mental health service providers should be aware of the increased risk of NMUPD for patients with health anxiety. Future research on NMUPD should more closely examine the role of health anxiety.

Non-Medical Use of ADHD Stimulants for Appetite Suppression and Weight Loss

The non-medical use of prescription stimulants is a public health concern. Medications used to treat attention deficit hyperactivity disorder (ADHD) have a side effect of appetite suppression and some college students misuse stimulants for weight loss. These individuals are more likely to report appearance-related motivations, stress-related eating, poorer body image, unhealthy weight loss behaviours (e.g. smoking cigarettes), and eating disorder symptomatology (e.g. vomiting). This is concerning given the emphasis many young adults place on body image. Stimulant medication may seem like an easy way to lose weight. Future research should assess other young adult samples, adolescents, and situations that promote this behaviour.

Religiosity in the non-medical use of prescription medication in college students

Abstract Background: The non-medical use of prescription drugs (NMUPD) is a hazardous health behavior popular among young adults and college students. Past research has documented prevalence rates and risk factors associated with NMUPD, while little research has addressed protective factors. Objective: The present study examined the associations of religiosity and NMUPD in a sample of college students. Methods: Young adult (ages 18–25) college students (n = 767) completed an anonymous online survey assessing demographic variables, NMUPD, personality factors, perceptions of risk, mental health, and religiosity. Results: Results showed that greater religiosity scores were consistently associated with lower odds of engaging in NMUPD in the past 3 months. These associations were partially mediated by the personality characteristics of conscientiousness and openness to experience as well as perceived risk of NMUPD. The effect of religiosity on NMUPD was moderated by Greek (i.e. fraternity or sorority) membership, such that those in a Greek organization showed no relation between religiosity and NMUPD, while religiosity served as a protective factor for NMUPD among those who did not have Greek membership. Conclusion: These results extend past research demonstrating that religiosity is protective against substance abuse/misuse. Greek status appears to negate the protective influence of religiosity on NMUPD.