Prescription Stimulant Misuse and ADHD Symptomatology Among College Students in Iceland

Abstract

As growing numbers of students with attention deficit hyperactivity disorder (ADHD) pursue postsecondary education, the availability of psychostimulant medications on college campuses has steadily increased. Although a large body of research has documented that misuse of prescription stimulant medication is a prevalent problem on American college campuses, few studies have been conducted beyond the United States. Iceland, closely followed by the United States, has the highest stimulant medication prescription rates in the world; however, no systematic efforts have been made to investigate to what extent these medications are being misused within the Icelandic college student population. Therefore, the purpose of the present study was to: a) examine the prevalence of prescription stimulant misuse among N=521 college students in Iceland as well as factors that are potentially predictive of stimulant misuse, including ADHD symptomatology, symptoms of depression, anxiety, and stress, self-reported grade-point average (GPA), and student sex; and b) identify the prevalence of significant ADHD symptomatology within this population.Results revealed the prevalence of lifetime stimulant misuse behavior was approximately 13% within the overall sample, 11% among participants without a prescription for stimulant medication, and 42% among participants holding a prescription. The primary reported reason for misuse was academic enhancement, similar to findings from the United States and Europe. Findings also suggested risk factors for prescription stimulant misuse among college students in Iceland included male sex, anxiety symptoms, and a history of ADHD symptoms. Approximately 8% of participants reported persistent, elevated ADHD symptomatology, while approximately 9% reported a previous diagnosis of ADHD.The present findings have implications for public health policy in Iceland, particularly as it relates to the college population. Limitations of the study and suggestions for future research are discussed.iv ACKNOWLEDGEMENTS

Assessing prevalence, knowledge and use of cognitive enhancers among university students in the United Arab Emirates: A quantitative study

“…Around two thirds of CE users were males, a finding which is consistent with several previous studies [ 7 , 13 , 38 – 40 ]. Indeed, there may be gender-related different attitudes towards both recreational [ 41 ] and CE drug use [ 5 , 42 , 43 ] worldwide, although some conflicting results have been published [ 44 , 45 ].…”

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“…Munro, Weyandt, Marraccini, and Oster [ 22 ] recently studied college students from six public universities located in various regions of the United States and reported that students with clinically significant executive function deficits reported significantly higher rates of prescription stimulant misuse. Prescription stimulant misuse has also been reported among college students in other countries including Germany [ 23 ], Iceland [ 24 ], Switzerland [ 25 ], and the United Kingdom [ 26 ] with rates similar to those found in the USA. Interestingly, and similar to results from studies conducted in the USA, Gudmundsdottir and colleagues [ 24 ] found that ADHD symptomatology and anxiety was significantly associated with prescription stimulant misuse behavior.…”

“…Prescription stimulant misuse has also been reported among college students in other countries including Germany [ 23 ], Iceland [ 24 ], Switzerland [ 25 ], and the United Kingdom [ 26 ] with rates similar to those found in the USA. Interestingly, and similar to results from studies conducted in the USA, Gudmundsdottir and colleagues [ 24 ] found that ADHD symptomatology and anxiety was significantly associated with prescription stimulant misuse behavior. Other international studies have reported similar findings [ 27 ] underscoring that this behavior is present across cultures.…”

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“…Specifically, academic and/or cognitive enhancement appears to be the primary motive for misuse behavior, and overall, male sex (Dietz et al, 2013; Gudmundsdottir & Weyandt, 2016), ADHD symptomatology (Gudmundsdottir & Weyandt, 2016), as well as psychological distress (e.g., Gudmundsdottir & Weyandt, 2016; Maier, Liechti, Herzig, & Schaub, 2013) have been found to contribute significantly to misuse behavior. Prevalence rates of prescription stimulant misuse in these countries have ranged from approximately 3% to 13%, which indicates this behavior indeed occurs cross-culturally, highlighting the need for policy, prevention, and intervention to address this issue.…”

“…Although only a small number of studies have been conducted internationally, including in Germany, Iceland, and Switzerland, to name a few countries (e.g., Deline et al, 2014; Dietz et al, 2013; Gudmundsdottir & Weyandt, 2016; Mache et al, 2012; Maier, Liechti, Herzig, & Schaub, 2013), findings generally echo those from the United States. Specifically, academic and/or cognitive enhancement appears to be the primary motive for misuse behavior, and overall, male sex (Dietz et al, 2013; Gudmundsdottir & Weyandt, 2016), ADHD symptomatology (Gudmundsdottir & Weyandt, 2016), as well as psychological distress (e.g., Gudmundsdottir & Weyandt, 2016; Maier, Liechti, Herzig, & Schaub, 2013) have been found to contribute significantly to misuse behavior.…”