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Study 1: Evaluating the Effects of Psycho-Stimulant Use on Academic Performance

Question:

Discuss about the Life of Pharmacological Academic Performance.

Evaluation of a research article can be defined as the process by which the worth or value of the research interventions proposed in the article are determined by judging it against predetermined and explicit standards (Greenhalgh et al., 2017). Obtaining evidence for a particular intervention encompasses interpretation of the empirical data that has been derived from the systematic investigation. ADHD or attention deficit hyperactivity disorder is a chronic neurodevelopmental condition, characterized by poor attention and impulsive behaviour among children (Ronald et al., 2014). Psycho-stimulants are generally used to treat ADHD. However, there a number of college students who get addicted to misuse of these psycho-stimulants, in spite of being not affected with ADHD. Some of the students use these drugs purely for recreation. However, major effects of these stimulants include enhancement of academic and classroom performance. However, substance abuse of these drugs is illegal and can create potential harm to the health. In this assignment, I will be critically evaluating the evidences that suggest use of smart drugs in improving academic performance. I will focus on two studies that evaluated the effectiveness of these drugs on academic enhancement.

Authorship- Klaus Lieb and Andreas Günter Franke belong to the department of Psychiatry and Psychotherapy, University Medical Centre Mainz (Germany). The department is headed by Klaus Lieb while, Franke works as a trainee under his supervision. The other author Elisabeth Hildt is an expert in neuroethics and from the department of Philosophy. Thus, all the three authors are well qualified to conduct the study. There exist some discrepancies regarding the academic results that the authors have achieved and the subjective experiences of their respondents.

Research Aims- In this study, the authors aimed to investigate the effects of psycho-stimulant use (through prescribed usage and illicit usage) on enhancement of academic performance. The effect of stimulants that the study intended to evaluate on university students was methylphenidate and amphetamines. The authors specifically wanted to evaluate the experiences of the students subjected to the drug administration and the influence of other factors such as peer or academic pressure that increased their desire to excel in academics and personal life (Hildt, Lieb & Franke, 2014).

Design- Participants were collected from the University of Mainz campus by posting placards related to use of psycho-stimulants. Healthy students without previous reports of psychiatric disorders were selected for conduction of semi-structured face-to-face interviews. Questions were mainly asked related to illicit or prescribed intake of stimulants. Respondents were also questioned related to their individual perception on the effects of stimulants related to improvement in academics and related negative effects. After being transcribed verbatim, the responses were systematically analyzed using a qualitative approach.

Study 2: Exploring the Association Between Non-Prescribed Use of Psycho-Stimulants and Executive Functioning in College Students

Findings- Out of the 22 interviews that were carried out, only 18 were analyzed for final results. 14 participants reported use of illicit stimulants and 4 were under prescribed stimulant usage. It was found that in addition to using stimulants to gain study time, facilitate exam preparation and prepare a term paper, several students reported taking stimulants to achieve and pursue individual projects that were outside their academic domain. Performance and time pressure were found to influence the intake. Furthermore, the findings also suggested that the participants were not aware of the stimulants creating any positive effect on their overall academic performance. Some of them reported an increase in motivation or reduction in sleep after use of the drugs. The analysis also revealed the stimulants to increase energy for leisure activities (Spencer, Devilbiss & Berridge, 2015). Thus, I can deduce from the findings that the two most important effects of the stimulants were boosting motivation and maximizing time.


Strengths and weaknesses- There were several limitations in the study. One of them was the inclusion of 18 interviews for the survey. Although the university had more than 36,000 registered students, only 30 of them contacted the authors after seeing the placards and 22 showed willingness to participate. The stigma related to drug abuse accounted for the low participation rate. Secondly the type of students who were willing to participate and exclusion of willing participants who reported psychiatric disorders or were under prescribed psychoactive medications led to selection bias. Moreover, the spontaneous answers given by the participants could have been influenced by social desirability, time frame or behavioural aspects. The strength lies in the fact that it could act as a starting point for conduction of future qualitative and quantitative studies that would investigate student motivation for pharmacological neuro-enhancement and its observable effects on academic performance.

Authorship- Lisa L. Weyandt is a professor at the department of Psychology, University of Rhode Island and Danielle R. Oster is a doctoral student there. Bailey A. Munro is a Doctoral Research Assistant at the Interdisciplinary Neuroscience Program, in the same university. Marisa E. Marraccini is an Assistant Professor at the Alpert Medical School of Brown University. Hence, they are adequately qualified to conduct the study. There were few discrepancies regarding generalization of the study and presence of voluntary participants.

Research Aims- Executive functioning is the key factor responsible for the enhancement of academic performances. Executive functioning (EF) involves cognitive flexibility, self regulation, lf activities to achieve the goals.  The aim of this study is to understand the association between the non prescribed use of the psycho stimulants and the executive functioning in a sample population of the college students (Munro et al., 2017). 

Barriers for the Application of Evidence in Practice

Design- Six public universities and schools from different region were considered for the study. The faculties and the staffs were contacted via e-mail seeking for the permission of the study and to provide suitable participants for the study. Interested participants were imparted with all information associated to the study. The participants were instructed to complete two sets of questionnaire. One was a demographic questionnaire consisting questions about gender, age, name of the university, whether a member of fraternity or sonority.  Another questionnaire was based on the non medical use of the psycho stimulants. The Barkley deficits scale was used in this study to assess the dimensions of the adult executive functioning. It is used to generate a total EF summary score of the population. Finally statistical method was used to analyse the results.


Findings- This study was the first study to point out the relationship between the Executive functioning of the brain and the non medical use of the psycho-stimulants. Results show that students having self reported deficit in EF have higher score of the SSQ (stimulant survey questionnaire), which indicates higher use of the psycho stimulants (Gerlach et al., 2014). Students having deficit in EF are found to use psycho stimulants more than those with moderate EF.

Strengths and weaknesses- This study could successfully point out the fact that psycho-stimulants have relation between the executive functioning of the brain as the survey had given positive results in support of the use of psycho stimulants by the college students. One limitation is the generalization of the study. The sample contained disproportionate number of females and the whites. The study contained only three participants having GPA score lower than 2. Thus it was difficult to assess the affectivity of the psycho stimulants o the brain. Furthermore, the study contained voluntary participants, which might not be the suitable representatives of the entire population. Chances of response bias and social desirability bias can be present, as the study was based on self-reported data.

Barriers for the application of evidence in practice- Evidence-based practice (EBP) can be defined as a problem solving approach that aims to improve health outcomes among patients by integrating best research evidence from studies that are well designed. Some of the most common barriers that exist while implementing EBP are inadequate knowledge, time management, and lack of motivation, limited IT skills and access and patient factors (Oliver, Lorenc & Innvær, 2014). Often adequate knowledge is not available on application of evidence based research findings in the practical environment. In this particular context, I felt that I did not have a basic knowledge on psycho-stimulants. My previous experiences provided me the idea that these drugs are used to treat children with ADHD. However, I was not adequately prepared to understand its effects on academic performance, as had been reported by the University students. Further, the criteria that reflect a high quality research should be properly recognized. Lack of access to an adequate computer resource or a large library is another barrier in implementation of EBP (Schaffer, Sandau & Diedrick, 2013). Time commitment is another barrier. Implementing EBP in practice is time consuming and replacing the traditional treatment plans with new emerging evidence often creates difficulties.

Alignment with PICO Elements


Alignment with PICO elements- The 2 research studies were aligned with the PICO format because they used a well formulated structured format to improve the scientific rigour of the study (Brignardello-Petersen et al., 2015).

P (Population)

I (Intervention)

C (Comparison)

O (Outcome)

University students under use of psycho-stimulants

Effect of psycho-stimulants on academic performance

Participants compared to those who received placebo pills

Effects of stimulants analysed by interviews

PICO format for second study

P (Population)

I (Intervention)

C (Comparison)

O (Outcome)

Students from 6 public universities

Nonmedical use of prescribed stimulants

Participants compared to those without executive functioning deficits

Effects of stimulants on executive brain functioning

Conclusion

Thus, I conclude from the above findings that every drug has some potential side effects in addition to enhancing some functions. The assignment critically analysed the effects of non-prescribed psycho-stimulants on students from universities, who tried to achieve academic excellence.  Most of the students are of the general opinion that these drugs increase alertness and help them to stay focused. Both of the papers showed that there is a lack of valid evidence, which can prove the association of use of these drugs with improved cognitive function among the students. While the first research study helped to provide evidence on the positive effects of stimulants on alertness and staying awake, it failed to show long term academic benefits among the students. Furthermore, the findings also suggested that motivation for leisure activities increase upon administration of these drugs. The second study on the other hand showed that non-medical use of stimulants did not modify executive functioning among university students. Thus, I conclude that none of the two studies could provide evidence for positive effects of stimulants on improving cognitive function and academic performance of students.

References

Brignardello-Petersen, R., Carrasco-Labra, A., Glick, M., Guyatt, G. H., & Azarpazhooh, A. (2015). A practical approach to evidence-based dentistry: III: how to appraise and use an article about therapy. The Journal of the American Dental Association, 146(1), 42-49.

Gerlach, K. K., Dasgupta, N., Schnoll, S. H., & Henningfield, J. E. (2014). Epidemiology of stimulant misuse and abuse: implications for future epidemiologic and neuropharmacologic research. Neuropharmacology, 87, 91-96.

Greenhalgh, T.M., Bidewell, J., Crisp, E., Lambros, A., & Warland, J. (2017). Understanding research methods for evidence-based practice in health 1e Wileyplus learning space Wiley e-text powered by Vitalsource. Wiley. Retrieved from https://acu-edu-primo.hosted.exlibrisgroup.com/primo-explore/fulldisplay?docid=61ACU_ALMA21112742500002352&context=L&vid=61ACU&search_scope=61ACU_All&tab=61acu_all&lang=en_US

Hildt, E., Lieb, K., & Franke, A. G. (2014). Life context of pharmacological academic performance enhancement among university students–a qualitative approach. BMC medical ethics, 15(1), 23.

Munro, B. A., Weyandt, L. L., Marraccini, M. E., & Oster, D. R. (2017). The relationship between nonmedical use of prescription stimulants, executive functioning and academic outcomes. Addictive behaviors, 65, 250-257.

Oliver, K., Lorenc, T., & Innvær, S. (2014). New directions in evidence-based policy research: a critical analysis of the literature. Health Research Policy and Systems, 12(1), 34.

Ronald, A., Larsson, H., Anckarsäter, H., & Lichtenstein, P. (2014). Symptoms of autism and ADHD: A Swedish twin study examining their overlap. Journal of abnormal psychology, 123(2), 440.

Schaffer, M. A., Sandau, K. E., & Diedrick, L. (2013). Evidence?based practice models for organizational change: overview and practical applications. Journal of Advanced Nursing, 69(5), 1197-1209.

Spencer, R. C., Devilbiss, D. M., & Berridge, C. W. (2015). The cognition-enhancing effects of psychostimulants involve direct action in the prefrontal cortex. Biological psychiatry, 77(11), 940-950.

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