The Misuse of Prescription Stimulants: A Test of the Theory of Planned Behavior

Introduction: The misuse of prescription stimulants (MPS) among college undergraduates is a growing social problem as the prevalence of MPS peaks among undergraduate students. The Theory of Planned Behavior (TPB; Ajzen, 1985, 1991; Ajzen & Fishbein, 1980) is a useful framework to understand college students’ intention and MPS. The current study employed a longitudinal study to understand how students’ attitudes, perceived norms, and efficacy were associated with behavioral intent at Time 1 and also actual use at Time 2.

Method: A sample of 137 participants (25 males, 112 females) were recruited from the participant pools in the College of Communication at a large Southwestern university.  Approximately four weeks later, a follow up study launched through the same participant pools. Of the 137 participants who completed the primary study, 89 participants (24 males, 64 females) completed the follow-up study.

Results: Hypothesis 1 suggested that favorable attitudes, perceived norms that others are engaging in MPS, and efficacy positively predict behavioral intentions to engage in MPS. Path analysis with maximum-likelihood estimation was used to analyze the direct influences of attitudes, norms, and efficacy on behavioral intention. Favorable attitudes about MPS was positively associated with behavioral intention (β = .51, z = 8.33, p < .001). Additionally, perceived norms that others were engaging in MPS was positively associated with behavioral intention (β = .33, z = 5.64, p < .001). The variance explained in behavioral intentions was 60.4% (R² = .60, CI: .05, .49, p < .01). Hypothesis 2 posited that intentions at the beginning of the semester to engage in MPS will be positively associated with behavioral use at the end of the semester. A similar path analysis showed that behavioral intention at Time 1 was positively associated with behavioral use at Time 2 (β = .56, z = 5.98, p < .001). The variance explained in behavioral intentions was 56.8% (R² = .57, CI: .42, .68, p = .001), and the variance explained in behavioral use was 29.1% (R² = .29, CI: .11, .46, p = .001).

Conclusion: Because young adults who misuse prescription stimulants are thought to be struggling with the adjustment to college (Custode & Norvilitis, 2012), peer mentors, resident advisors, and academic counselors have an opportunity to play a role throughout the semester by helping students’ transition to the academic and social demands of college life. These resources may ease the adjustment to college and lessen the prevalence of MPS during college, and may have implications for University policy. More specifically, these individuals could be influential in shaping undergraduates attitudes and normative beliefs about MPS.