Can Extensive Use of Adderall Trigger Mental Health Issues Such as Psychosis?
Andrew Sahadeo
Adelphi University
Introduction
The misuse of prescription drugs among the youth is becoming a concerning health problem among the stakeholders. Recent studies show that approximately 17% of college students misuse attention deficit hyperactivity disorder (ADHD) stimulant drugs such as Adderall (Erickson, 2016). Drug-taking culture influences individuals to self-diagnose and self-prescribe, contributing to the misuse of drugs. Erickson (2016) states that Adderall is one of the commonly abused stimulants by college students. Likewise, one of the most pressing professional obligations is reducing the misuse of prescription drugs. The students use Adderall to stay awake or improve academic performance while in reality, the medication is prescribed for a reason. Stevens, Wilens, and Stern (2013) state that ADHD is also common in children, youth, and adults. Therefore, even though the college students are at high risk, misuse of the stimulant is a threat to the entire society regardless of the age.
The adverse effects of Adderall include bipolar illnesses, aggressive behavior, hostility, and thought problems (Weyandt et al., 2018). Psychotic symptoms in children include manic symptoms, hearing voices, and believing things that are not true. Reducing the use of Adderall can improve the quality of life in society. Also, non-medical use of the stimulant does not vary by gender among the students. Therefore, both male and female youth are at high risk of illicit use of the stimulant. The literature shows that professionals have to save the whole community from the misuse of the stimulant by creating awareness and providing the correct prescription.
Additionally, ADHD coexists with other medical and mental disorders, leading to further complications. Stevens, Wilens, and Stern (2013) argue that untreated ADHD has adverse effects on the society, productivity, families, relationships, and increase the risk for new disorders, such as antisocial behaviors, mood disorders, and substance abuse disorders. Also, Adderall is among the controlled substances by the Drug Enforcement Agency. Therefore, the distribution or possession of the drug without a legitimate prescription is against the law (Erickson, 2016). However, there is no scientific literature to support that Adderall is overprescribed in the treatment of ADHD. Adderall affects chemicals in the nerves and brain, which contribute to impulse control and hyperactivity. Weyandt et al. (2018) argue that past studies do not provide adequate information on the cognitive effects of Adderall when taken without a prescription.
The study examines if extensive use of Adderall triggers mental health issues. The previous studies indicate that Adderall causes psychological problems. However, the results do not show whether the ADHD is over-diagnosed and over-treated using Adderall. The research evaluates the impact of the prescription of Adderall on mental health issues such as psychosis. The results help to determine the importance of using other options treatments to minimize the effects of Adderall on patients.
The study explores the effects of different level of Adderall on mental problems such as psychosis. The independent variables are the number of days the participants have used Adderall while the dependent variable is a psychotic symptom. The psychotic symptoms include personality disorders, such as antisocial, paranoid, sadistic, self-defeating, borderline, avoidant. Other independent variables are gender, age, and ethnicity. The independent variables influence the psychosis symptoms reported by the participants.
The purpose of the research was to find out how extensive or prolonged use of Adderall triggers mental problems. The results indicate that ADHD is over-diagnosed and over-treated leading to an increase in health risk. Indeed, the study helps individuals and policymakers to make informed decisions relating to the use of Adderall in treating ADHD (Abelman, 2017). Likewise, the results provide opportunities to improve the quality of life. The research aims to contribute to the information on the impact of the extensive use of Adderall on psychosis. Many college students and adolescents refer to Adderall as a “study drug,†and the outcome of the study can help to run campaigns to reduce the consumption and determine if there is an over-prescription. I hypothesize that extensive use of Adderall does not trigger mental health problems. The null hypothesis assumes that the independent variables have no impact on the mental health. On the other hand, the alternative hypothesis implies that the use of Adderall triggers psychological disorders.
Method
Study design: The research applies longitudinal and cross-sectional studies to assess the effect of Adderall on the mental health of the participants over time without interfering with the subjects. The longitudinal study design examines the impact of the drug on participants over a one year period. In this case, the cross-sectional study design was conducted during the first three months to establish whether there is any relationship between Adderall and mental health problems. Psychosis Screening Questionnaire (PSQ) and Self-Report Disability Questionnaire (SRDQ) were used to examine if Adderall triggers psychosis symptoms. Kemenade and Hosman (2015) state that SRDQ examines the actual disability each participant experience in the different environment.
Additionally, SRDQ is employed to measure social disability, leisure time, family life, psychological disability to evaluate the impact of the drug on mental health. The score is in the range of 0 to 9 or 0 to 27 for each domain in the questionnaire. A domain score greater than 1 is categorized as moderate to severe disability. Besides, a positive correlation between the scores of SRDQ and the PSQ confirms the construct validity of the PSQ. The participants completed cross-sectional studies during the first three months of the study, and the results were positive, indicating the cause and effect relationship between the independent and dependent variables. The researcher applied longitudinal study design for the remaining nine months to monitor the changes in the variables under study. Longitudinal studies provided the results on the changes in the mental health over time. Also, the study design enhanced focus and validity to examine how the use of Adderall triggers mental health problems over the period. The longitudinal study provides results that are more accurate by observing changes and offers flexibility in data collection.
Participants
College Students: A sample of 120 students from the first year to the fourth year, 65 male and 55 female, ranging in age from 18 to 22 (M=20, SD=1.8) was used in the study. Out of the 120 students, 70 participants were using Adderall to treat ADHD either prescribed or self-subscribed while 50 students had never used the drug. Most of the students using the drug (75%) were in the third and fourth year, while only 25% were in their first and second year of study. The sample comprised 80% whites, 10% Latinos, 5% Asian, 3% blacks, and 2% other ethnic groups. The researcher conducted a pretest to examine their mental health to enable the researcher to track the difference over time.
There was no control group and the 50 students who had never used the drug were free to accept the prescription for ADHD treatment. The pretest results indicate that 65% of people using Adderall drugs had psychotic symptoms while only 20% of the students who had never used the drug were diagnosed with the symptoms. The longitudinal study was conducted monthly to track any changes in the patients’ mental health.
The demographic factors taken into account are the participant’s age and gender, and ethnic group. Also, the sample was obtained from the college students because they represent the highest number of ADHD patients and users of Adderall either prescribed or self-prescribed to improve academic performance. Also, the college students are more likely to use the drug due to peer pressure from other students.
The exclusion criteria during the study included participants under psychological problems treatment and students under substance use disorder. The exclusion procedure isolated the participants that may reflect psychotic symptoms from other causes. Besides, the study excluded students less than 18 years and those above 22 years.
Procedures: The participants are college students from the first year to the fourth year of study. First, the researcher conducted a thorough intake process to reduce errors. The researcher tested all the participants for substance abuse and other mental health problems. The second procedure involved identifying individuals under Adderall prescription and those under self-prescription. In other words, the researcher minimized errors by ensuring the participants did not have other conditions that may affect their cognitive process.
SRDQ is a 32-item questionnaire developed to examine people with mild mental disorders. The response to the questionnaire includes “I feel sad†and “I am not good,†and the response indicates the frequency, which the participants experienced during the last one month. Reports of psychometric properties for the questionnaire are adequate and reliable. SRDQ has an internal consistency (90%), criterion validity (r=65%), and item-total correlations have a mean of 0.46 (Esbensen et al., 2005). The results indicate that the questionnaire is reliable and valid to conduct the study.
The researcher respects the participants’ confidentiality; the individuals’ results were used only for the study. Personal details were not recorded on the questionnaire to protect the students’ details. The students signed the consent form after reading and understanding the objective of the research. The reliability of the data was tested by comparing the questions to minimize errors. Likewise, the ethics committee board reviewed the study to ensure that the study met all the standards to protect the participants. Also, the participants were free to withdraw from the study at any given time.
Measures: The psychometrics used in the study include agreeableness or sensation seeking. The scores were measured using the scale that evaluates the participants’ expression to different questions in the questionnaire. SRDQ tested the frequency of the listed items happening. SRDQ evaluated three levels: “rarely,†“sometimes,†and “frequently.†According to Tsakanikos and McCarthy (2013), SRDQ provides good psychometrics for evaluating the mental health of the participants. If the participant was experiencing psychosocial difficulties, the researcher examined if there was a possibility of psychotic disorder. The psychosis screening questions examined thought disorder, delusions, paranoia, and hallucinations. Also, the study examined the presence of psychotic symptoms, frequency, intensity, duration, and associated distress. The researcher also measured the psychometrics in the PSQ (antisocial, paranoid, sadistic, self-defeating, borderline, and avoidant) using a scale to access the information on the participant's mental health.
References
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Erickson, A. K. (2016). ADHD drugs: Perceptions and reality on college campuses. OnetoOne. Retrieved from https://www.pharmacytoday.org/article/S1042-0991(16)00252-8/pdf
Esbensen, A. J. et al. (2005). Psychometric Evaluation of a Self-Report Measure. American Journal Retardation, 110(6), 469–481. Retrieved from https://pdfs.semanticscholar.org/ba28/10233bb4d7b81c8620d6d8a88542bb51cbdb.pdf
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