Challenging expectancies to prevent nonmedical prescription stimulant use: a randomized, controlled trial

College students continue to report nonmedical prescription stimulant use to enhance alertness and concentration. Despite increasing prevalence of this behavior, techniques for preventing or treating it are lacking. An intervention that focuses on challenging positive consequence-oriented beliefs about prescription stimulants may be efficacious in preventing use.

The current study examined the efficacy of a randomized controlled expectancy challenge intervention to prevent nonmedical prescription stimulant use among 96 at-risk, stimulant-naïve college students (i.e., low grade point average, Greek involvement, binge drinking, cannabis use). Forty-seven participants completed a brief expectancy challenge intervention aimed at modifying positive expectancies for prescription stimulants, to consequently deter initiation of use. The remaining participants received no intervention.

The expectancy challenge successfully modified expectancies related to prescription stimulant effects. Nevertheless, this intervention group and a control group showed comparable rates of nonmedical prescription use at 6-month follow-up. However, negative expectancies were significant predictors of reduced odds of future use.

A challenge session appears to modify stimulant-related expectancies, which are related to nonmedical prescription stimulant use. Nevertheless, a more potent challenge or booster sessions might be essential for longer-term changes.