Department of Psychology, Texas State University, 601 University Drive, San Marcos, TX 78666.
Department of Psychology, Texas State University, San Marcos, Texas, USA.
J Clin Psychiatry. 2020 Nov 3;81(6):20m13302. doi: 10.4088/JCP.20m13302.
While prescription stimulant misuse (PSM) is common in adolescents and young adults (AYAs), PSM motives are poorly understood. This study examined a number of PSM motives across the AYA age spectrum using the 2015-2018 National Survey on Drug Use and Health.
In all, 86,918 AYAs (aged 14-25 years) were included. Individual PSM motives (eg, to study) and motive categories (ie, cognitive enhancement only, recreational only, weight loss only, and combined motives) were examined by age. Logistic regression models examined links between individual motives or motive categories and educational status, substance use, DSM-IV substance use disorders (SUD), and mental health correlates.
Significant differences were found across AYAs in cognitive enhancement only (14 years = 40.4%; 24 and 25 years = 71.2%; P < .0001) and recreational only (14 years = 25.8%; 24 and 25 years = 9.8%; P < .0001) or combined PSM motives, (14 years = 32.3%; 24 and 25 years = 18.0%; P = .008); college students and graduates had particularly high rates of cognitive enhancement only (college = 78.2%; graduates = 74.7%; non-college = 63.5%). Recreational-only and combined motives were significantly elevated in AYAs with any past-year SUD, especially to get high (78%-136% higher in those with SUD; P ≤ .001). While any PSM was associated with higher odds of SUD and mental health outcomes, including suicidal ideation, odds were highest for recreational or combined motives.
Cognitive enhancement with PSM occurs more often in young adults compared to adolescents, college students endorse more cognitive enhancement than those not in school, and the presence of any PSM in AYAs is linked to more substance use, suicidal ideation, and other psychopathology. PSM prevention in adolescents as well as screening and intervention among AYA is highly recommended.
虽然处方兴奋剂滥用（PSM）在青少年和年轻人（AYAs）中很常见，但对 PSM 动机的了解甚少。本研究使用 2015-2018 年全国毒品使用与健康调查，在 AYA 年龄范围内研究了多种 PSM 动机。
共有 86918 名 AYA（年龄 14-25 岁）被纳入研究。根据年龄检查了个人 PSM 动机（例如，学习）和动机类别（即仅认知增强、仅娱乐、仅减肥和综合动机）。逻辑回归模型检查了个人动机或动机类别与教育状况、物质使用、DSM-IV 物质使用障碍（SUD）和心理健康相关因素之间的联系。
在 AYA 中，仅认知增强（14 岁=40.4%；24 和 25 岁=71.2%；P<.0001）和仅娱乐（14 岁=25.8%；24 和 25 岁=9.8%；P<.0001）或综合 PSM 动机存在显著差异，（14 岁=32.3%；24 和 25 岁=18.0%；P=.008）；大学生和毕业生的仅认知增强率特别高（大学生=78.2%；毕业生=74.7%；非大学生=63.5%）。在过去一年有任何 SUD 的 AYA 中，仅娱乐和综合动机显著升高，尤其是为了获得快感（在有 SUD 的人中升高 78%-136%；P≤.001）。虽然任何 PSM 都与更高的 SUD 和心理健康结果相关，包括自杀意念，但对于娱乐或综合动机，可能性最高。
与青少年相比，认知增强型 PSM 在年轻人中更为常见，与不在校的学生相比，大学生更倾向于进行认知增强，并且 AYA 中任何 PSM 的存在都与更多的物质使用、自杀意念和其他精神病理学相关。强烈建议在青少年中预防 PSM，并对 AYA 进行筛查和干预。
