Ponnet Koen, Wouters Edwin, Van Hal Guido, Heirman Wannes, Walrave Michel
a Department of Sociology , University of Antwerp , Antwerp , Belgium .
Psychol Health Med. 2014;19(3):286-95. doi: 10.1080/13548506.2013.802361. Epub 2013 May 29.
The non-medical use of methylphenidate for cognitive enhancement becomes a more and more common practice among college and university students. Although physicians are a source of access, little is known about the underlying mechanisms that might lead to physicians' intention and behaviour of prescribing methylphenidate to improve students' academic performance. Applying Ajzen's theory of planned behaviour (TPB), we tested whether attitudes, subjective norms (controllability and self-efficacy) and perceived behavioural control predicted the intention and the prescribing behaviour of physicians. Participants were 130 physicians (62.3% males). Structural equation modelling was used to test the ability of TPB to predict physicians' behaviour. Overall, the present study provides support for the TPB in predicting physicians' prescribing behaviour of methylphenidate for cognitive enhancement. Subjective norms, followed by attitudes, are the strongest predictors of physicians' intention to prescribe methylphenidate. To a lesser extent, controllability predicts the intention of physicians, and self-efficacy predicts the self-reported behaviour. Compared to their male colleagues, female physicians seem to have more negative attitudes towards prescribing methylphenidate for cognitive enhancement, feel less social pressure and perceive more control over their behaviour. Intervention programmes that want to decrease physicians' intention to prescribe methylphenidate for improving academic performance should primarily focus on alleviating the perceived social pressure to prescribe methylphenidate and on converting physician neutral or positive attitudes towards prescribing methylphenidate into negative attitudes.
哌甲酯用于认知增强的非医疗用途在大学生中越来越普遍。尽管医生是获取哌甲酯的一个渠道，但对于可能导致医生为提高学生学业成绩而开具哌甲酯的潜在机制却知之甚少。应用阿詹的计划行为理论（TPB），我们测试了态度、主观规范（可控性和自我效能感）以及感知行为控制是否能预测医生的意图和开具处方行为。参与者为130名医生（男性占62.3%）。采用结构方程模型来测试TPB预测医生行为的能力。总体而言，本研究为TPB在预测医生开具哌甲酯用于认知增强的行为方面提供了支持。主观规范，其次是态度，是医生开具哌甲酯意图的最强预测因素。在较小程度上，可控性预测医生的意图，自我效能感预测自我报告的行为。与男同事相比，女医生似乎对开具哌甲酯用于认知增强持更消极的态度，感受到的社会压力更小，且对自己的行为有更多的掌控感。想要降低医生为提高学业成绩而开具哌甲酯意图的干预项目应主要侧重于减轻开具哌甲酯所感知到的社会压力，并将医生对开具哌甲酯的中立或积极态度转变为消极态度。
