Adverse Childhood Experiences and Prescription Stimulant Use in Adults: A Systematic Review.

Nonmedical prescription stimulant use (NPSU) is an ongoing public health crisis in the United States. There exists, however, a dearth of research investigating specific childhood risk factors that may contribute to this illicit use. Adverse childhood experiences (ACEs) may be a significant risk factor to address in the prevention and treatment of NPSU, as research has provided evidence for increased substance use, potentially including prescription stimulant misuse, among individuals who have experienced trauma. A systematic review of the literature was conducted to gather and synthesize research articles specifically examining the relationship between nonmedical prescription stimulant use in adults and the experience of adverse childhood experiences (ACEs). Four studies met all inclusion criteria and were included in the review. The results demonstrated that the nonmedical use of prescription stimulants in adults is significantly associated with ACEs, with a higher numerical count of ACEs associated with a greater likelihood of nonmedical prescription stimulant use. Gaps in the literature were identified, specifically noting a lack of information available regarding the relationship between ACEs and NPSU within gender- and racially diverse populations. The findings have implications for informing interventions related to ACEs and the misuse of prescription stimulant medication in adults.

Prescription Stimulant Misuse Among Nursing Students: A Systematic Review.

ABSTRACT: Nonmedical prescription stimulants are used to reduce symptoms of inattention, impulsivity, and hyperactivity in children and adults with attention-deficit hyperactivity/disorder. They are Schedule II controlled substances because of their high potential for dependence, and individuals who misuse them without a valid prescription are subject to criminal charges. Stimulant medications are also associated with common side effects (e.g., insomnia) as well as more serious but less common side effects (e.g., arrhythmias). Despite the potential health and legal consequences, misuse of prescription stimulants has become a public health crisis on college campuses in the United States. Neurocognitive enhancement is the primary reason that college students report misusing prescription stimulants, despite no enhancement of cognitive functioning when taken by healthy adults. Nursing students may be at risk for misuse because of their high levels of academic and clinical demands and because many start misusing in nursing school. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, the databases PubMed, Science Direct, EBSCOhost, and Academic OneFile were systematically searched to investigate the (a) percentage of prescription stimulant misuse studies that have included nursing students, (b) prevalence of prescription stimulant misuse among nursing students, (c) motivations for prescription stimulant misuse among nursing students, and (d) demographic factors associated with increased use among nursing students. Results revealed that of the 197 studies conducted within the past decade (2010-2021), only 1.02% (two) included nursing students. Future studies must investigate the prevalence and nature of prescription stimulant misuse among nursing students.

Longitudinal Examination of Sexual Risk Behavior in College Students With and Without Attention-Deficit/Hyperactivity Disorder.

The present study sought to identify differences in the rates and predictors of risky sexual behavior among college students with and without attention-deficit hyperactivity disorder (ADHD). Current ADHD diagnosis, medication status among those with ADHD, executive functioning, substance use, comorbid anxiety, comorbid depression, and gender were identified as potential predictors of increased risky sexual behavior. Multiple group latent growth curve modeling was used to estimate trajectories of risky sexual behavior across four years of college among college students with ADHD (nmedicated = 99, nunmedicated = 105) and a comparison group (n = 217) recruited from colleges throughout the eastern United States (M age = 18.23 years, 53% female, 70% White). First-year college students with ADHD reported significantly higher rates of sexual risk behavior than their peers without ADHD, with no significant differences found based on medication status. Students with ADHD who were taking medication for ADHD reported significant decreases in risky sexual behavior over time. Among college students with ADHD, anxiety was related to increased current risky sexual behavior in the medicated group, while depression was predictive of decreased future risky sexual behavior in the unmedicated group. Alcohol and cannabis use were significantly associated with increased mean levels of risky sexual behavior across all three groups, and cannabis use was associated with decreased future risky sexual behavior within the comparison group. Executive functioning deficits and male gender were predictive of risky sexual behavior within the comparison group. The results demonstrate that college students with ADHD, regardless of medication status, are at an increased likelihood of engaging in risky sexual behavior.

An Investigation of Diversity in Childhood and Adolescent Antidepressant Studies: A Systematic Review.

Objectives: Childhood mental illness is an ongoing public health crisis which is accompanied by an increase in antidepressant (i.e., serotonin reuptake inhibitors and serotonin-norepinephrine reuptake inhibitors) use in children. Recent evidence highlighting the cultural differences in the utilization, efficacy, and tolerability of antidepressants in children underscores the need for diverse samples in studies examining antidepressant use. Furthermore, the American Psychological Association in recent years has emphasized the importance of including participants from diverse backgrounds in research studies, including investigations of medication efficacy. The present study, therefore, examined the demographic composition of samples used and reported in antidepressant efficacy and tolerability studies with children and adolescents experiencing anxiety and/or depression in the last decade. Methods: A systematic literature review utilizing two databases was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. In line with the extant literature, antidepressants were operationalized as Sertraline, Duloxetine, Escitalopram, Fluoxetine, and Fluvoxamine. Results: Out of the 11 articles included in this review, 71% reported having a primarily adolescent sample (i.e., over 50% of the sample was 12 years or older). In addition, all studies omitted any transgender, genderqueer, or gender-nonconforming demographics, and one study omitted all racial demographic information. While 64% of studies only partially reported racial demographic information, 36% of studies omitted ethnicity demographics altogether. Conclusions: The present study addresses a gap in the literature by supporting a lack of diversity in studies examining antidepressant use in children and adolescents. Furthermore, it underscores the importance of future studies using a more diverse and representative sample. Limitations of the present study included limited generalizability and the lack of independent and blind reviewer process. Possible explanations for the lack of inclusion and suggestions on how to address these disparities are discussed.

Willingness to Receive a COVID-19 Vaccine in an Iranian Population: Assessment of Attitudes, Perceived Benefits, and Barriers.

Background: To significantly reduce the disease and mortality from the novel Coronavirus Disease (COVID-19), a safe and effective vaccine must be widely delivered to the community. However, the availability of a vaccine for COVID-19 does not ensure that individuals will want to be vaccinated. The present study investigated the attitudes, perceived barriers, and benefits of the COVID-19 vaccine, as well as vaccination intentions, among a sample of Iranian adults. Methods: Demographic data were categorized in this study based on whether or not participants received the vaccine. Drawn from a multistage sampling protocol in 2021, a descriptive-analytical study was conducted on 1350 adults in Saveh, Iran. A survey with 5 different sections inquired about eligible participants' sociodemographic information, their attitudes, perceived benefits, and barriers, as well as their intentions to get vaccinated for COVID-19. Multiple logistic regression analysis (enter method) was performed to assess factors related to vaccination intent. Results: The mean age of those who intended to receive the COVID-19 vaccine (57.9±19.2) was significantly higher than those who did not intend to receive the vaccine (43.4±16.8) ( p =0.00). Additionally, married individuals were significantly more likely to receive the vaccine than individuals who were single and/or widowed. Additionally, (n=663) substantially more homemakers and retirees received vaccinations than workers and self-employed individuals (n=481) ( p =0.001). Findings revealed that 78% of participants intended to receive the COVID-19 vaccine. Multiple unconditional logistic regression analyses showed that age and marital status, as well as the behavioral variables (attitude odds ratio [OR]=1.73, benefits OR=1.78, and perceived Barriers OR=0.52), had a significant relationship with vaccination intentions ( p =0.001). Conclusion: This study demonstrated that to increase intentions to receive the COVID-19 vaccine, public health campaigns and interventions should focus on promoting the benefits of the vaccine, improving the attitudes toward the vaccine, as well as reducing the perceived barriers.

Factor Structure of the Sexual Risk Survey Among U.S. College Students with and without ADHD: Assessing Clinical Utility with a High-Risk Population.

Young adults, particularly college students, report a higher prevalence of risky sexual behavior than the general population, increasing their likelihood for unplanned pregnancy, sexually transmitted infections (STIs), and negative psychological outcomes. Although sexual risk behavior and its consequences are a major public health concern, current prevention literature is insufficient and relies on sexual risk measures with limited psychometric support. The present study, therefore, examined the psychometric properties of a sexual risk survey (SRS; Turchik, Garske, in Arch Sex Behav 38:936-948, 2009), using data from the first year of a longitudinal study following the outcomes of college students with and without attention-deficit/hyperactivity disorder (ADHD; N = 410). Principal components analyses were conducted to assess the factorial structure of the SRS comparing results from a general college population and a college population considered to be high-risk (ADHD). Results revealed four components across both samples. Internal consistency estimates for component scores and total scores ranged from .627 to 918. Implications of the findings are discussed and suggestions for future studies are advanced.

The association between neurocognition and sexual abuse within a children's psychiatric inpatient program.

Objective: The aim of this study was to understand the detrimental effects of sexual abuse on neuropsychological variables including child's intelligence, executive functioning (EF), and learning/memory within a pediatric inpatient population.Method: This study examined the effect of sexual abuse on children's intelligence, EF, and learning/memory by conducting a retrospective chart review for 144 children (aged 7-12) who completed a neuropsychological assessment during a psychiatric inpatient hospitalization. Of the 144 children, participants were matched two to one by gender and age, with one group (n = 52) categorized by reported sexual abuse and the other group (n = 92) categorized by no reported sexual abuse. The neuropsychological measures included the Wechsler Abbreviated Scale of Intelligence (WASI-I/II) or Wechsler Intelligence Scale for Children-Fourth Edition (WISC-IV), Wide Range Assessment of Memory and Learning - Second Edition (WRAML-2): Story Memory Immediate/Delayed Recall and Delayed Recognition, Trail Making Test-B, Stroop Interference Test: Color-Word Condition, WRAML-2: Sentence Memory and Conners Continuous Performance Test-Second Edition.Results: Statistical analysis showed that participants with reported sexual abuse had significantly (p< .05) lower intelligence, EF, and learning/memory skills than those without reported sexual abuse. Only working memory and cognitive flexibility differences remained after controlling for clinical variables (e.g., PTSD, amount of total abuse types).Conclusions: These findings contributed to the limited research on the detrimental effects of sexual abuse in a pediatric inpatient population. They demonstrated a relationship between early sexual abuse and neuropsychological deficits, specifically executive function and IQ deficits.

Psychosocial Determinants of Teens' Online Engagement in Drug Prevention Social Media Campaigns: Implications for Public Health Organizations.

Social networking sites (SNSs) now serve as a primary form of communication among adolescents. Consequently, drug prevention campaigns delivered through SNSs have the potential to reach a wide network of adolescents if teens are willing to engage in the message diffusion process by commenting on, "liking," following, creating, or sharing prevention messages with their networked peers. However, little is known about the psychosocial factors that influence adolescents' willingness to participate in drug prevention social media campaigns. We use qualitative methods to explore reasons why adolescents may or may not want to engage in the message diffusion process. We conducted four semi-structured focus groups with a total of 33 high school students from various school- and community-based youth programs in Rhode Island. Focus groups were followed by a brief self-administered questionnaire collecting information about participants' social media use to augment qualitative findings. Overall, findings reveal that engaging teens in the message diffusion process can be advantageous but difficult to accomplish due to multiple factors. Most notably, asking adolescents to participate in drug prevention campaigns delivered through SNSs means also asking youth to violate online norms that promote drug use, which could in turn subject them to peer reprisal. We conclude that future studies should begin to investigate strategies addressing the various challenges we identified. Meanwhile, prevention specialists should consider alternative or supplemental evidence-based approaches to drug prevention rather than invest resources into activities that may offer little return on investment.