Department of Sociology, University of Antwerp, Antwerp, Belgium.
Department of Communication Sciences, IMEC-MICT-Ghent University, Ghent, Belgium.
Subst Use Misuse. 2022;57(4):621-631. doi: 10.1080/10826084.2022.2034870. Epub 2022 Feb 10.
The misuse of prescription stimulants among students has been identified as a public health problem. To date, most research has focused on determinants of stimulant misuse, making research on the context of students' misuse a priority. This study aims to test the applicability of the Theory of Triadic Influence, capturing three influence streams (personal, social and cultural) and three causational levels (ultimate, distal and proximal).
A questionnaire on stimulant misuse was distributed among all bachelor's and master's students from the five Flemish medical faculties. In total, 3159 students participated (48.99% response rate). Data were analyzed using structural equation modeling.
Multiple (i.e., fear of failure, procrastination, self-perceived ADHD, sensation-seeking, academic stress, controllability), (i.e., living situation, peer endorsement, social norm) and (i.e., competitive study-environment, financial worries, positive and negative expectancies, attitude) factors were identified as risk factors of misuse intention. The strongest ultimate to distal pathway was found between self-perceived ADHD and positive expectancies, meaning that students who believed they have ADHD, although not diagnosed, were more likely to have positive expectancies about stimulants. Moreover, the strongest distal to proximal pathways were found between expectancies and attitudes toward stimulant misuse (i.e., more positive and fewer negative expectancies were associated with more favorable attitudes). Finally, attitudes were most strongly related to misuse intention.
The current study shows that the TTI is an important framework to understand the risk factors of stimulant misuse among medical students. This study offers a strong basis for prevention initiatives.
学生中处方兴奋剂的滥用已被确定为一个公共卫生问题。迄今为止，大多数研究都集中在兴奋剂滥用的决定因素上，因此优先研究学生滥用兴奋剂的背景。本研究旨在测试三元影响理论的适用性，该理论捕捉了三个影响流（个人、社会和文化）和三个因果水平（终极、远程和近端）。
在弗拉芒语的五所医学系的所有学士和硕士学生中分发了关于兴奋剂滥用的问卷。共有 3159 名学生参加（48.99%的回应率）。使用结构方程模型对数据进行了分析。
多种 （即，对失败的恐惧、拖延、自我感知的注意力缺陷多动障碍、寻求刺激、学业压力、可控制性）、 （即，生活状况、同伴认可、社会规范）和 （即，竞争学习环境、经济忧虑、积极和消极的期望、态度）因素被确定为滥用意图的风险因素。自我感知的注意力缺陷多动障碍和积极期望之间发现了最强的终极到远程途径，这意味着虽然没有被诊断出患有注意力缺陷多动障碍，但认为自己有注意力缺陷多动障碍的学生更有可能对兴奋剂有积极的期望。此外，期望与对兴奋剂滥用的态度之间发现了最强的远程到近端途径（即，更多的积极期望和更少的消极期望与更有利的态度相关）。最后，态度与滥用意图的关系最为密切。
本研究表明，TTI 是理解医学生兴奋剂滥用风险因素的重要框架。本研究为预防措施提供了坚实的基础。
