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神经认知增强还是损害?对处方兴奋剂对处理速度、决策、计划和认知坚持性影响的系统荟萃分析。

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

作者信息

Marraccini Marisa E, Weyandt Lisa L, Rossi Joseph S, Gudmundsdottir Bergljot Gyda

机构信息

Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Bradley Hasbro Research Center.

Department of Psychology, The University of Rhode Island.

出版信息

Exp Clin Psychopharmacol. 2016 Aug;24(4):269-84. doi: 10.1037/pha0000079.

Abstract

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

摘要

越来越多的成年人,尤其是大学生,主要为了提高认知能力/学业成绩而滥用处方兴奋剂,因此,探究实证研究结果是否支持处方兴奋剂对神经认知有益至关重要。以往的荟萃分析研究支持处方兴奋剂对抑制控制和记忆等认知领域有微小益处;然而,尚无荟萃分析研究考察其对处理速度的影响或对包括计划、决策和认知坚持性在内的其他认知领域的潜在损害。因此,本研究对现有文献进行了荟萃分析,以考察处方兴奋剂对健康成年人群处理速度、计划、决策和认知坚持性的具体测量指标的影响。荟萃分析结果表明,处方兴奋剂药物对处理速度准确性有积极影响,总体平均效应量g = 0.282(95%置信区间[0.077, 0.488];n = 345)。在计划时间、计划准确性、有利决策或认知坚持性方面,既未发现改善也未发现损害;然而,研究结果受到考察这些结果的研究数量较少的限制。研究结果支持,处方兴奋剂药物确实可能作为一种神经认知增强剂,提高处理速度的准确性测量指标,而不会妨碍其他认知领域。鉴于成年人已经在非法使用处方兴奋剂来提高学业成绩,以及兴奋剂滥用可能产生严重副作用,围绕这一问题开展跨学科研究所形成的公共政策的制定,无论是限制性的还是宽松的,都至关重要。(PsycINFO数据库记录)

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