Marisa E. Marraccini

Misuse of prescription stimulants among college students: a review of the literature and implications for morphological and cognitive effects on brain functioning.

Prescription stimulant medication, the most frequently recommended treatment for college students with attention deficit/hyperactivity disorder (ADHD), has become increasingly available on college campuses. Research investigating prescription stimulant misuse among college students indicates that significant numbers of students without ADHD are taking prescription stimulants to enhance their cognitive performance. This article systematically reviews studies concerning misuse of prescription stimulants among college students with and without ADHD as well as the cognitive and morphological brain changes associated with prescription stimulants in humans and other animals. Whether these morphological changes are accompanied by improved cognitive performance remains equivocal. Implications of this body of literature are discussed and suggestions for future research are advanced.

Pharmacological interventions for adolescents and adults with ADHD: stimulant and nonstimulant medications and misuse of prescription stimulants

Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterized by symptoms of inattention, hyperactivity, and impulsivity that cause functional impairment. Recent research indicates that symptoms persist into adulthood in the majority of cases, with prevalence estimates of approximately 5% in the school age population and 2.5%–4% in the adult population. Although students with ADHD are at greater risk for academic underachievement and psychosocial problems, increasing numbers of students with ADHD are graduating from high school and pursuing higher education. Stimulant medications are considered the first line of pharmacotherapy for individuals with ADHD, including college students. Although preliminary evidence indicates that prescription stimulants are safe and effective for college students with ADHD when used as prescribed, very few controlled studies have been conducted concerning the efficacy of prescription stimulants with college students. In addition, misuse of prescription stimulants has become a serious problem on college campuses across the US and has been recently documented in other countries as well. The purpose of the present systematic review was to investigate the efficacy of prescription stimulants for adolescents and young adults with ADHD and the nonmedical use and misuse of prescription stimulants. Results revealed that both prostimulant and stimulant medications, including lisdexamfetamine dimesylate, methylphenidate, amphetamines, and mixed-amphetamine salts, are effective at reducing ADHD symptoms in adolescents and adults with ADHD. Findings also suggest that individuals with ADHD may have higher rates of stimulant misuse than individuals without the disorder, and characteristics such as sex, race, use of illicit drugs, and academic performance are associated with misuse of stimulant medications. Results also indicate that individuals both with and without ADHD are more likely to misuse short-acting agents than long-acting agents. These findings have implications for intervention, prevention, and future research.

Interpersonal Autonomic Physiology A Systematic Review of the Literature

Interpersonal autonomic physiology is defined as the relationship between people’s physiological dynamics, as indexed by continuous measures of the autonomic nervous system. Findings from this field of study indicate that physiological activity between two or more people can become associated or interdependent, often referred to as physiological synchrony. Physiological synchrony has been found in both new and established relationships across a range of contexts, and it correlates with a number of psychosocial constructs. Given these findings, interpersonal physiological interactions are theorized to be ubiquitous social processes that co-occur with observable behavior. However, this scientific literature is fragmented, making it difficult to evaluate consistency across reports. In an effort to facilitate more standardized scholarly approaches, this systematic review provides a description of existing work in the area and highlights theoretical, methodological, and statistical issues to be addressed in future interpersonal autonomic physiology research.

School Connectedness and Suicidal Thoughts and Behaviors: A Systematic Meta-Analysis.

Among the protective factors associated with reduced risk for suicide, scientific inquiries into school connectedness are especially important considering that schools are ideally situated to provide interventions reaching the vast majority of youth. Although there is a wealth of research that supports the association between school connectedness and reduced self-report of adolescents having a suicidal thought or making a suicide attempt, inconsistencies in the way studies have measured and operationalized school connectedness limit synthesis across findings. This meta-analytic study investigates the literature exploring associations between school connectedness and suicidal thoughts and behaviors across general and subpopulations (high risk and sexual minority youth) using a random effects model. Eligible studies examined a measure of school connectedness explicitly referred to as “school connectedness” or “connections at school” in relation to suicidal ideation or suicide attempts among youth enrolled in school (Grades 6–12). Multiple metaregression analyses were conducted to explore the influence of school connectedness measurement variation, as well as participant characteristics. Results, including 16 samples, support that higher school connectedness is associated with reduced reports of suicidal thoughts and behaviors across general (odds ratio [OR] = 0.536), high-risk (OR = 0.603), and sexual minority (OR = 0.608) adolescents. Findings are consistent when analyzed separately for suicidal ideation (OR = 0.529) and suicide attempts (OR = 0.589) and remain stable when accounting for measurement variability. Although limited by its cross-sectional nature, findings support recent calls to increase school connectedness and proffer important implications for screening and intervention efforts conducted in schools.

Neurocognitive enhancement or impairment? A systematic meta-analysis of prescription stimulant effects on processing speed, decision-making, planning, and cognitive perseveration.

Increasing numbers of adults, particularly college students, are misusing prescription stimulants primarily for cognitive/academic enhancement, so it is critical to explore whether empirical findings support neurocognitive benefits of prescription stimulants. Previous meta-analytic studies have supported small benefits from prescription stimulants for the cognitive domains of inhibitory control and memory; however, no meta-analytic studies have examined the effects on processing speed or the potential impairment on other domains of cognition, including planning, decision-making, and cognitive perseveration. Therefore, the present study conducted a meta-analysis of the available literature examining the effects of prescription stimulants on specific measures of processing speed, planning, decision-making, and cognitive perseveration among healthy adult populations. The meta-analysis results indicated a positive influence of prescription stimulant medication on processing speed accuracy, with an overall mean effect size of g = 0.282 (95% CI [0.077, 0.488]; n = 345). Neither improvements nor impairments were revealed for planning time, planning accuracy, advantageous decision-making, or cognitive perseveration; however, findings are limited by the small number of studies examining these outcomes. Findings support that prescription stimulant medication may indeed act as a neurocognitive enhancer for accuracy measures of processing speed without impeding other areas of cognition. Considering that adults are already engaging in illegal use of prescription stimulants for academic enhancement, as well as the potential for stimulant misuse to have serious side effects, the establishment of public policies informed by interdisciplinary research surrounding this issue, whether restrictive or liberal, is of critical importance. (PsycINFO Database Record

Teaching Antiracism College Students’ Emotional and Cognitive Reactions to Learning About White Privilege

Class discussions of White privilege can increase sociocultural and international awareness in our students. Therefore, instructors should be encouraged to teach this topic in introductory college survey courses (e.g., psychology and sociology), although negative reactions by White students can affect student evaluations of an instructor’s teaching skills. We decided to further explore college students’ cognitive and emotional reactions to this topic. Principal components analysis revealed four factors. Agreement with items related to the factor Societal (e.g., American society is not a meritocracy) was associated with understanding White privilege. Agreement with items associated with the factor Personal (e.g., feeling personally attacked) was associated with failure to understand this concept. The remaining two factors, Denial and The Bad Guys (feeling like one of “the bad guys” in society), were not significantly associated with understanding White privilege. These findings are discussed in the context of successfully teaching antiracism.

The relationship between nonmedical use of prescription stimulants, executive functioning and academic outcomes

The nonmedical use of prescription stimulants (NMUPS) is a prevalent issue among college students. The primary reason college students report NMUPS is for academic enhancement i.e., to perform better on schoolwork/tests and focus better in class. Executive functioning (EF), which includes abilities that allow for planning, cognitive flexibility, self-regulation, and goal-directed behavior, are potential mechanisms underlying academic performance. Preliminary research has revealed that college students with EF deficits are more likely to have educational difficulties and take part in risky behavior. Based on the literature, it is possible that students with EF deficits are engaging in NMUPS to help them overcome these deficits to succeed academically. Therefore, the purpose of the present study was to examine the relationship between NMUPS and EF among a sample of college students. The sample included 308 students from six public universities located in various regions of the United States. Measures used in this study were the SSQ, BDEFS and GPA. Results revealed 18.8% of the general sample reported NMUPS. Participants with clinically significant EF deficits reported significantly higher rates of NMUPS, compared to those without deficits in EF. NMUPS, however, did not moderate the relationship between EF and GPA. The present findings have implications for identifying sub-populations of college students who might be at risk for engaging in NMUPS and to improve prevention and intervention strategies aimed at reducing NMUPS. Limitations and suggestions for future research are discussed.

Exploring Placentophagy in Humans: Problems and Recommendations

Placentophagy, the practice of afterbirth ingestion among humans, has grown among middle-class, white women in Western societies. Although the reasons for placentophagy are varied, it is generally promoted as a means to help postpartum women stabilize mood, enhance recovery, and increase milk production. Virtually no studies have explored the effects of placentophagy on humans, and several researchers have called for studies examining the effects of human placentophagy. However, prior to examining the effects of placentophagy, a number of methodological issues need to be addressed. The present review explores research examining the effects of placentophagy in animals and humans and presents the theoretical assumptions behind placentophagy and its effects. Methodological issues related to placentophagy research are clarified, and existing research related to the nutritional and hormonal components of the placenta and their effects on milk production and postpartum depression are reviewed. Finally, implications and recommendations for future research are discussed.

Prescription stimulant medication misuse: Where are we and where do we go from here?

Prescription stimulants, including methylphenidate (e.g., Ritalin) and amphetamine compounds (e.g., dextroamphetamine; Adderall), have been approved by the U.S. Food and Drug Administration for the treatment of attention-deficit/hyperactivity disorder (ADHD) and are classified by the United States Drug Enforcement Administration as Schedule II medications because of their high potential for abuse and dependence (Drug Enforcement Administration, U.S. Department of Justice, 2015). Despite the potential health and judicial consequences, misuse of prescription stimulants, typically defined as taking stimulants without a valid prescription, or use of stimulants other than as prescribed, has become a serious problem in the United States and abroad, especially on college campuses. The purpose of the present article is to review historical information concerning prescription stimulants and to summarize the literature with respect to misuse among adults, particularly college students, including risk factors, mediators and moderators, and motivations for prescription stimulant misuse. In addition, evidence is presented concerning the question of whether prescription stimulants truly enhance cognitive functioning in individuals with and without ADHD, and the ethical and professional implications of these findings are explored. Lastly, recommendations for addressing prescription stimulant misuse and suggestions for future research are advanced. (PsycINFO Database Record

Association of Posttraumatic Stress Disorder With rs2267735 in the ADCYAP1R1 Gene: A Meta-Analysis: Meta-Analysis of ADCYAP1R1 Polymorphism and PTSD

Recent studies point to the potential role of the (pituitary) adenylate cyclase activating polypeptide receptor 1 (ADCYAP1R1) gene, which has been implicated in stress response, in posttraumatic stress disorder (PTSD). Multiple genetic association studies have examined potential PTSD risk related to this gene, with mixed results. We conducted a meta-analysis of rs2267735 in ADCYAP1R1 in PTSD. A literature search was conducted using PubMed and PsycINFO, resulting in nine studies that met criteria for inclusion in analysis. Biostats Comprehensive Meta-Analysis was used to conduct the main meta-analysis on the combined sex sample, as well as two subanalyses examining effects separately in female and male participants. Results indicated that the C allele of rs2267735 conferred significant risk for PTSD in the combined sex data, OR = 1.210, 95% CI [1.007, 1.454], p = .042, and in the subsample of women and girls, OR = 1.328, 95% CI [1.026, 1.719], p = .031; but not in the subsample of men and boys, OR = 0.964, 95% CI [0.733, 1.269], p = .796. These results provide evidence for an association between ADCYAP1R1 and PTSD and indicate that there may indeed be sex differences. Implications of these findings, including the role of rs2267735 as one modulator of the stress system, are discussed.