TitleDoes the prescribing context for ADHD medications suggest cognitive enhancement motivation?
NameBilder, Scott (author), Vitello, Stanley (chair), Penfield, Douglas (internal member), O'Donnell, Angela (internal member), Crystal, Stephen (outside member), Rutgers University, Graduate School - New Brunswick,
Attention-deficit hyperactivity disorder--Treatment,
Attention-deficit disorder in adolescence--Treatment,
High school students--Health and hygiene,
Cognition disorders in adolescence,
DescriptionNumerous scientific studies and media reports point to the widespread use of prescription medications for Attention Deficit Hyperactivity Disorder (ADHD) to improve study performance. The purpose of this study was to determine, among a population of high school-age students, whether (a) there was an increase in the prescribing of these medications in the weeks immediately prior to and during final exams and (b) whether physicians appeared to be more cautious during this period in terms of the patients for whom they wrote prescriptions and the characteristics of the medications prescribed. In addition, to the extent that an exam-related increase in prescribing was observed, this study sought to determine whether its magnitude was related to county level measures of academic performance. These questions were addressed using administrative prescription drug, medical claims, and enrollment records from a database of private health insurance plan beneficiaries. County level measures of performance on the SAT and AP exams, as well as on state-mandated tests, were linked to the health care data for a geographic subset of students. Contrary to expectations, the final exam period appeared to represent the start of an anticipated summer decline in rates of prescribing rather than the occasion for a hypothesized temporary increase. Moreover, there was no evidence of between-county variation that could be explained by the test performance measures. In addition, there was only limited evidence that students who began pharmacotherapy for ADHD in the exam period differed from other treatment initiators in terms of age, sex, diagnosis and treatment history, or characteristics of the medications prescribed. These results, in combination with similar findings concerning summer initiators, suggest that the timing of treatment initiation is more sensitive to clinical need than to short-term academic demand. Nevertheless, the sharp decline in prescribing observed from late spring through late summer suggests that school-related demands do play a role on a larger scale despite clinical recommendations that ADHD be treated as a chronic condition.
NoteIncludes bibliographical references
Noteby Scott M. Bilder
CollectionGraduate School - New Brunswick Electronic Theses and Dissertations
Organization NameRutgers, The State University of New Jersey
RightsThe author owns the copyright to this work.