Abstract: Identifying Normative Processes in Non-Prescription Stimulant Use Among College-Aged Individuals

◆ Emily Biery, University of Dayton
◆ Angeline Sangalang, University of Dayton
◆ Stefanie K. Gratale, University of Pennsylvania

It is estimated that 5 to 35 percent of college-aged individuals engage in nonmedical prescription stimulant (NMPS; e.g., using medications like Adderall without a prescription) use each year. Students perceive improved academic work and outcomes (e.g., greater concentration, better grade performance; Bennett & Holloway, 2017; Wilens et al., 2008), though these claims have minimal medical support. In fact, NMPS use is related to more absences and lower GPAs (Arria et al., 2008; Lakhan & Kirchgessner, 2012). Though some recent efforts have been made to uncover and address such misinformation through campus-based campaigns (e.g., LaBelle, Weber, White, & Hendry, 2019), few campaigns have addressed and successfully reduced normative perceptions surrounding NMPS.

At present, little is known about the normative influences on NMPS beyond the Reasoned Action framework – descriptive (who performs) and injunctive (who approves/disapproves) norms (Fishbein & Ajzen, 2010). For example, college students over-estimate peers’ use by six-times the actual use rate (McCabe, 2008), and perceive that their peers and parents approve of NMPS, particularly for improving academics (Schultz, Silvestri, & Correia, 2017). This investigation employed Rimal and Real’s (2005) Theory of Normative Social Behavior (TNSB) to investigate more nuanced normative elements, specifically, outcome expectations (benefits to self/others, anticipatory socialization) and group identity (similarity and aspirational).

A national sample of 439 young adults (n = 265 college students) completed an open-ended elicitation survey regarding NMPS perceptions. Elicitation surveys generate the greatest potential range of beliefs (Fishbein & Ajzen, 2010) and participants were prompted to identify the outcomes of use, describe “typical” users, and articulate perceptions of groups that endorse both NMPS use generally and specifically to alter academic performance.

Belief statements were examined thematically with respect to the framework of TNSB and applied to each of its components. In addition to responses consistent with previous studies’ conceptions of descriptive norms (e.g., Blevins, Stephens, & Abrantes, 2017) and benefits to oneself (e.g., academic performance as cited in Aikins, 2011), some novel normative processes were uncovered, including benefits to others, group identity and anticipatory socialization. A portion of these findings are discussed here. Insights into anticipatory socialization included feeling peer pressured, helping to make friends, or use for rebellion, suggesting that individuals may perceive a potential facilitation in peer socialization and dissociation from other groups (e.g., parental, authority figures) as a benefit of NMPS use. For similar and aspirational groups, many contradictions and discrepancies were illuminated in group perceptions. For example, top responses concerning those most likely to use NMPS included “straight A students,” ''average” and ''low-performing students,” as well as “partiers.” This may represent varying perceptions among the contexts in which the drugs are perceived to be used which warrants further exploration.

This exploratory study provides insight into some foundational normative processes associated with NMPS that go beyond our current understanding in previously explored reasoned action frameworks. With others identifying the challenge of altering NMPS norms (e.g., Labelle et al., 2019), such an investigation provides some initial nuanced guidance to norm-specific influences and contexts of use.