Medicate to Graduate: Academic Strain and Nonmedical Prescription Stimulant Use Among Graduate and Undergraduate Students

Abstract

The nonmedical use of prescription stimulants has been prevalent on college campuses in recent years. Previously, nonmedical prescription stimulant use (NMPSU) has been associated with increased use of other illicit substances, drug abuse, school dropout, and arrest. It is, therefore, imperative to understand the etiology of NMPSU for prevention, intervention, and harm reduction purposes. This study builds upon previous research on the role of academic strain in NMPSU by (a) considering a measure of strain that is more consistent with strain theory and (b) extending the examination to include graduate students. By utilizing an original data set of 1,121 undergraduate and graduate students at a Southern urban university, our overall results are consistent with general strain theory but mixed with respect to the role of academic strain in particular. The implications of our study for academic strain are discussed.

Keywords

nonmedical prescription stimulant use prescription stimulant misuse strain academic strain general strain theory graduate students

Get full access to this article

View all access options for this article.

References

Abraham

H. D.

Fava

(1999). Order of onset of substance abuse and depression in a sample of depressed outpatients. Comprehensive Psychiatry, 40(1), 44–50.

Adler

L. A.

Spencer

Faraone

S. V.

Kessler

R. C.

Howes

M. J.

Biederman

Secnik

(2006). Validity of pilot Adult ADHD Self-Report Scale (ASRS) to rate adult ADHD symptoms. Annals of Clinical Psychiatry, 18, 145–148.

Agnew

(2002). Experienced, vicarious, and anticipated strain: An exploratory study on physical victimization and delinquency. Justice Quarterly, 19, 603–632.

Agnew

(2006). Pressured into crime: An overview of general strain theory. Oxford University Press.

Agnew

(2009). General strain theory: Current status and directions for further research. In Cullen

F. T.

Wright

Blevins

(Eds.), Taking stock: The status of criminological theory (pp. 101–123). Transaction Publishers.

Agnew

White

H. R.

(1992). An empirical test of general strain theory. Criminology, 30, 475–499.

Arria

A. M.

Caldeira

K. M.

O’Grady

K. E.

Vincent

K. B.

Johnson

E. P.

Wish

E. D.

(2008). Nonmedical use of prescription stimulants among college students: Associations with ADHD and polydrug use. Pharmacotherapy, 28(2), 156–169.

Arria

A. M.

Caldeira

K. M.

Vincent

K. B.

O’Grady

K. E.

Wish

E. D.

(2008). Perceived harmfulness predicts nonmedical use of prescription drugs among college students: Interactions with sensation-seeking. Prevention Science, 9(3), 191–201.

Arria

A. M.

DuPont

R. L.

(2010). Nonmedical prescription stimulant use among college students: Why we need to do something and what we need to do. Journal of Addictive Disorders, 29(4), 417–426.

10.

Arria

A. M.

Garnier-Dykstra

L. M.

Caldeira

K. M.

Vincent

K. B.

Winick

E. R.

O’Grady

K. E.

(2013). Drug use patterns and continuous enrollment in college: Results from a longitudinal study. Journal of Studies on Alcohol and Drugs, 74(1), 71–83.

11.

Arria

A. M.

O’Grady

K. E.

Caldeira

K. M.

Vincent

K. B.

Wish

E. D.

(2008). Nonmedical use of prescription stimulants and analgesics: Associations with social and academic behaviors among college students. Journal of Drug Issues, 38(4), 1045–1060.

12.

Baron

R. M.

Kenny

D. A.

(1986). The moderator–mediator variable distinction in social psychological research: Conceptual, strategic, and statistical considerations. Journal of Personality and Social Psychology, 51(6), 1173–1182.

13.

Barrett

S. P.

Darredeau

Bordy

L. E.

Pihl

R. O.

(2005). Characteristics of methylphenidate misuse in a university student sample. The Canadian Journal of Psychiatry, 50(8), 457–461.

14.

Bossaer

J. B.

Gray

J. A.

Miller

S. E.

Enck

Gaddipati

V. C.

Enck

R. E.

(2013). The use and misuse of prescription stimulants as “cognitive enhancers” by students at one academic health sciences center. Academic Medicine, 88(7), 967–971.

15.

Brook

D. M.

Brook

J. S.

Zhang

Cohen

Whiteman

(2002). Drug use and the risk of major depressive disorder, alcohol dependence, and substance use disorders. Archives of General Psychiatry, 59, 1039–1044.

16.

Carroll

B. C.

McLaughlin

T. J.

Blake

D. R.

(2006). Patterns and knowledge of nonmedical use of students among college students. The Archives of Pediatrics and Adolescent Medicine, 160, 481–485.

17.

Cipriani

G. P.

(2018). Gender difference in willingness to guess after a failure. Research in Economic Education, 49(4), 299–306.

18.

Croson

Gneezy

(2009). Gender differences in preferences. Journal of Economic Literature, 47(2), 448–474.

19.

Davis

Uezato

Newell

J. M.

Frazier

(2008). Major depression and comorbid substance use disorders. Current Opinion in Psychiatry, 21(1), 14–18.

20.

De Bruyn

Wouters

Ponnet

Van Hal

(2019). Popping smart pills in medical school: Are competition and stress associated with the misuse of prescription stimulants among students? Substance Use & Misuse, 54(7), 1191–1202.

21.

DeSantis

A. D.

Hane

A. C.

(2010). “Adderall is definitely not a drug”: Justifications for the illegal use of ADHD stimulants. Substance Use & Misuse, 45, 31–46.

22.

DeSantis

A. D.

Noar

S. M.

Webb

E. M.

(2010). Speeding through the frat house: A qualitative exploration of nonmedical ADHD stimulant use in fraternities. Journal of Drug Education, 40(2), 157–171.

23.

DeSantis

A. D.

Webb

E. M.

Noar

S. M.

(2008). Illicit use of prescription ADHD medications on a college campus: A multimethodological approach. Journal of American College Health, 57(3), 315–323.

24.

DuPont

R. L.

Coleman

J. J.

Bucher

R. H.

Wilford

B. B.

(2008). Characteristics and motives of college students who engage in nonmedical use of methylphenidate. The American Journal on Addictions, 17(3), 167–171.

25.

Enhancing, not cheating. (2007). Nature, 450(7), Article 320.

26.

Evans

T. M.

Bira

Gastelum

J. B.

Weiss

L. T.

Vanderford

N. L.

(2018). Evidence for a mental health crisis in graduate education. Nature Biotechnology, 36(6), 282–284.

27.

Ford

J. A.

Schroeder

R. D.

(2009). Academic strain and non-medical use of prescription stimulants among college students. Deviant Behavior, 30(1), 26–53.

28.

Garnier-Dykstra

L. M.

Caldeira

K. M.

Vincent

K. B.

O’Grady

K. E.

Arria

A. M.

(2012). Nonmedical use of prescription stimulants during college: Four-year trends in exposure opportunity, use, motives, and sources. Journal of American College Health, 60(3), 226–235.

29.

Goode

(2019). Drugs in American society (10th ed.). McGraw-Hill.

30.

Gottfredson

M. R.

Hirschi

(1990). A general theory of crime. Stanford University Press.

31.

Grady

R. K.

La Touche

Oslawski-Lopez

Powers

Simacek

(2014). Betwixt and between: The social position and stress experiences of graduate students. Teaching Sociology, 42(1), 5–16.

32.

Grasmick

H. G.

Tittle

C. R.

Bursik

R. J.

Jr. Arneklev

B. J.

(1993). Testing the core empirical implications of Gottfredson and Hirschi’s general theory of crime. Journal of Research in Crime and Delinquency, 30(1), 5–29.

33.

Griffith

A. N.

Hurd

N. M.

Hussain

S. B.

(2017). “I didn’t come to school for this”: A qualitative examination of experiences with race-related stressors and coping responses among black students attending a predominantly White institution. Journal of Adolescent Research, 34(2), 115–139.

34.

Henry

K. L.

Huizinga

D. H.

(2007). School-related risk and protective factors associated with truancy among urban youth placed at risk. The Journal of Primary Prevention, 28(6), 505–519.

35.

Hurst

ten Bensel

Baldwin

Laan

(2016a, November). Got health? Examining the relationships between well-being, substance use/misuse, and delinquency [Presented presentation]. The annual meeting of the American Society of Criminology.

36.

Hurst

ten Bensel

Baldwin

Laan

(2016b, March). Medicate to graduate: Prescription stimulant misuse by college students [Presented presentation]. The annual meeting of the Academy of Criminal Justice Sciences.

37.

Ickes

M. J.

Brown

Reeves

Zephyr

P. M. B.

(2015). Differences between undergraduate and graduate students in stress and coping strategies. California Journal of Health Promotion, 13(1), 13–25.

38.

Johnston

L. D.

O’Malley

P. M.

Bachman

J. G.

Schulenberg

J. E.

Miech

R. A.

(2016). Monitoring the future national survey results on drug use, 1975–2015: Vol. 2. College students and adults ages 19–55. Institute for Social Research, The University of Michigan.

39.

Johnston

L. D.

O’Malley

P. M.

Miech

R. A.

Bachman

J. G.

Schulenberg

J. E.

(2014). Monitoring the future national survey results on drug use: 1975-2013: Overview, key findings on adolescent drug use. Institute for Social Research, University of Michigan.

40.

Judson

Langdon

S. W.

(2009). Illicit use of prescription stimulants among college students: Prescription status, motives, theory of planned behavior, knowledge and self-diagnostic tendencies. Psychology, Health, and Medicine, 14(1), 97–104.

41.

Kenny

D. A.

(2018). Mediation. http://davidakenny.net/cm/mediate.htm

42.

Leite

Machado

L. N.

Lara

D. R.

(2014). Emotional traits and affective temperaments in alcohol users, abusers and dependents in a national sample. Journal of Affective Disorders, 163, 65–69.

43.

Lord

Downs

Furtaw

Chaudhuri

Silverstein

Gammaitoni

Budman

(2009). Nonmedical use of prescription opioids and stimulants among student pharmacists. Journal of American Pharmaceutical Associations, 49, 519–528.

44.

Low

K. G.

Gendaszek

A. E.

(2002). Illicit use of psychostimulants among college students: A preliminary study. Psychology, Health, and Medicine, 7(3), 283–287.

45.

Maahs

J. R.

Weidner

R. R.

Smith

(2016). Prescribing some criminological theory: An examination of the illicit use of prescription stimulants among college students. International Journal of Offender Therapy and Comparative Criminology, 60(2), 146–164.

46.

MacKinnon

D. P.

Fairchild

A. J.

Fritz

M. S.

(2007). Mediation analysis. Annual Review of Psychology, 58, 593–614.

47.

Martin

C. C.

(2019). High socioeconomic status predicts substance use and alcohol consumption in US undergraduates. Substance Use & Misuse, 54(6), 1035–1043.

48.

McCabe

S. E.

Boyd

C. J.

Teter

C. J.

(2006). Medical use, illicit use, and diversion of abusable prescription drugs. Journal of American College Health, 54(5), 269–278.

49.

McCabe

S. E.

Knight

J. R.

Teter

C. J.

Wechsler

(2005). Non-medical use of prescription stimulants among US college students: Prevalence and correlates from a national survey. Addiction, 100, 96–106.

50.

McCabe

S. E.

Teter

C. J.

Boyd

C. J.

(2006). Medical use, illicit use and diversion of prescription stimulant medication. Journal of Psychoactive Drugs, 38, 43–56.

51.

McCabe

S. E.

Teter

C. J.

Boyd

C. J.

Wilen

T. E.

Schepis

T. S.

(2018). Sources of prescription medication misuse among young adults in the United States: The role of educational status. Journal of Clinical Psychiatry, 79(2), Article 17m11958.

52.

McHorney

C. A.

Ware

J. E.

Raczek

A. E.

(1993). The MOS 36-Item Short-Form Health Survey (SF-36): II. Psychometric and clinical tests of validity in measuring physical and mental health constructs. Medical Care, 31, 247–263.

53.

McIntyre

Platania

(2009). Giving in to group pressure: The impact of socialization and risk on perceived outcomes. Current Research in Social Psychology, 15(2), 15–32.

54.

Merton

R. K.

(1938). Social structure and anomie. American Sociological Review, 3(5), 672–682.

55.

Mineo

Sarraf

Ingram

Hanauer

Infortuna

Chisud

Aguglia

Battaglia

(2018). Affective temperaments and stimulant medications misuse for neuroenhancement in graduate students. Journal of Substance Use, 23(2), 124–129.

56.

National Center for Education Statistics. (2016, December). Digest of education statistics: 2015. https://nces.ed.gov/programs/digest/d15/

57.

Neblett

Philip

C. L.

Cogburn

C. D.

Sellers

R. M.

(2006). African American adolescents’ discrimination experiences and academic achievement: Racial socialization as a cultural compensatory and protective factor. Journal of Black Psychology, 32(2), 199–218.

58.

Nolen-Hoeksema

(2001). Gender differences in depression. Current Directions in Psychological Science, 10(5), 173–176.

59.

Norman

L. B.

Ford

J. A.

(2018). Undergraduate prescription stimulants misuse: The impact of academic strain. Substances Use and Misuse, 53(9), 1482–1491.

60.

Norman

L. B.

Ford

J. A.

(2019). Undergraduate prescription stimulant misuse and academic strain: The role of college major and graduate school plans. Journal of Drug Issues, 49(4), 756–771.

61.

O’Malley

P. M.

Johnston

L. D.

(2002). Epidemiology of alcohol and other drug use among American college students. Journal of Studies on Alcohol Supplement, 14, 23–39.

62.

Osborne

J. W.

(1997). Race and academic disidentification. Journal of Educational Psychology, 89, 728–735.

63.

Pate

M. C.

Bolin

R. M.

(2018). Examining the relationship between strain and the use of nonmedical prescription drugs among college students. Journal of Drug Issues, 49(1), 163–182.

64.

Peck

J. H.

Childs

K. K.

Jennings

W. G.

Brady

C. M.

(2018). General strain theory, depression, and substance use: Results from a nationally representative, longitudinal sample of White, African-American, and Hispanic adolescents and young adults. Journal of Child & Adolescent Substance Abuse, 27(1), 11–28.

65.

Prosek

E. A.

Giordano

A. L.

Turner

K. D.

Bevly

C. M.

Reader

E. A.

LeBlanc

Molina

C. E.

Vera

R. A.

Garber

S. A.

(2018). Prevalence and correlates of stimulants medication misuse among the collegiate population. Journal of College Student Psychotherapy, 32(1), 10–22.

66.

Rabiner

D. L.

Anastopoulos

A. D.

Costello

E. J.

Hoyle

R. H.

McCabe

S. E.

Swartzwelder

H. S.

(2008). Motives and perceived consequences of nonmedical ADHD medication use by college students: Are students treating themselves for attention problems? Journal of Attention Deficit Disorder, 13, 259–270.

67.

Roberts

B. W.

Caspi

(2003). The cumulative continuity model of personality development: Striking a balance between continuity and change in personality traits across the life course. In Staudinger

U. M.

Lindenberger

(Eds.), Understanding human development (pp. 183–214). Springer.

68.

Rubin

D. B.

(2004). Multiple imputation for nonresponse in surveys. John Wiley.

69.

Sharp

S. F.

Terling-Watt

T. L.

Atkins

L. A.

Gilliam

J. T.

Sanders

(2001). Purging behavior in a sample of college females: A research note on general strain theory and female deviance. Deviant Behavior, 22(2), 171–188.

70.

Smith

Brooks

(2015). Graduate student mental health 2015. National Associate of Graduate-Professional Students. http://nagps.org/wordpress/wp-content/uploads/2015/06/NAGPS_Institute_mental_health_survey_report_2015.pdf

71.

Substance Abuse and Mental Health Services Administration. (2016, September). Prescription drug use and misuse in the United States: Results from the 2015 national survey on drug use and health [NSDUH data review]. https://www.samhsa.gov/data/sites/default/files/NSDUH-FFR2-2015/NSDUH-FFR2-2015.pdf

72.

Substance Abuse and Mental Health Services Administration. (2019). Key substance use and mental health indicators in the United States: Results from the 2018 national survey on drug use and health (HHS Publication No. PEP19-5068, NSDUH Series H-54). Center for Behavioral Health Statistics and Quality. https://www.samhsa.gov/data/

73.

Tenenbaum

H. R.

Crosby

F. J.

Gliner

M. D.

(2001). Mentoring relationships in graduate school. Journal of Vocational Behavior, 59, 326–341.

74.

Teter

C. J.

Falone

A. E.

Cranford

J. A.

Boyd

C. J.

McCabe

S. E.

(2010). Nonmedical use of prescription stimulants and depressed mood among college students: Frequency and routes of administration. Journal of Substance Abuse Treatment, 38(3), 292–298.

75.

Teter

C. J.

McCabe

S. E.

Cranford

J. A.

Boyd

C. J.

Guthrie

S. K.

(2005). Prevalence and motives for illicit use of prescription stimulants in an undergraduate student sample. Journal of American College Health, 53(6), 253–262.

76.

Tuttle

J. P.

Scheurich

N. E.

Ranseen

(2010). Prevalence of ADHD diagnosis and nonmedical prescription stimulant use in medical students. Academic Psychiatry, 34(3), 220–223.

77.

Van Buuren

Groothuis-Oudshoorn

(2011). mice: Multivariate imputation by chained equations in R. Journal of Statistical Software, 45(3), 1–67.

78.

Verdi

Weyandt

L. L.

Zavras

B. M.

(2016). Non-medical prescription stimulant use in graduate students: Relationship with academic self-efficacy and psychological variables. Journal of Attention Disorders, 20(9), 741–753.

79.

Vowell

P. R.

Chen

(2004). Predicting academic misconduct: A comparative test of four sociological explanations. Sociological Inquiry, 74(2), 226–249.

80.

Ware

J. E.

Sherbourne

C. D.

(1992). The MOS 36-item short-form health survey (SF-36): I. Conceptual framework and item selection. Medical Care, 30, 473–483.

81.

Webb

J. R.

Valasek

M. A.

North

C. S.

(2013). Prevalence of stimulant use in a sample of US medical students. Annals of Clinical Psychiatry, 25(1), 27–32.

82.

Weidman

J. C.

Stein

E. L.

(2003). Socialization of doctoral students to academic norms. Research in Higher Education, 44(6), 641–656.

83.

White

P. B.

Becker-Blease

K. A.

Grace-Bishop

(2006). Stimulant medication use, misuse, and abuse in an undergraduate and graduate student sample. Journal of American College Health, 54(5), 261–268.

84.

Wilens

T. E.

Adler

L. A.

Adams

Sgambati

Rotrosen

Sawtelle

Utzinger

Fusillo

(2008). Misuse and diversion of stimulants prescribed for ADHD: A systematic review of the literature. Journal of the American Academy of Child and Adolescent Psychiatry, 47(1), 21–31.

85.

Zhao

Lynch

J. G.

Jr. Chen

(2010). Reconsidering Baron and Kenny: Myths and truths about mediation analysis. Journal of Consumer Research, 37(2), 197–206.

86.

Zullig

K. J.

Divin

A. L.

(2012). The association between non-medical prescription drug use, depressive symptoms, and suicidality among college students. Addictive Behaviors, 37(8), 890–899.