ABSTRACT
Background: Nonmedical prescription stimulant (NPS) use for academic reasons (e.g., to improve concentration) is a growing problem among college students. However, there is limited theory-driven research that attempts to identify risk cognitions underpinning decisions to use and NPS use for academic purposes. Furthermore, it is unclear if academic NPS use is characterized by deliberative and/or socially reactive processing and what health decision-making model or combination of models best predicts NPS use decisions and use. Identifying cognitions associated with NPS use decisions is essential to develop interventions aimed at preventing and reducing NPS use. Objective: The present study tested the Theory of Reasoned Action (TRA), Prototype/Willingness Model (PWM), and a combined TRA/PWM model to identify which model best predicts academic NPS use decisions (willingness and intentions) and past 2-month use among college students. Method: Undergraduates (N = 344) participated in a two-wave study assessing T1 constructs from the TRA and PWM as predictors of T2 (2 months later) academic NPS use decisions and use. Results: In the combined TRA/PWM, all T1 constructs were associated with T2 NPS willingness, intentions, and use except for injunctive norms. The integrated model also explained greater variance in T2 use, willingness, and intentions than each model alone. Conclusions/Importance: The combination of cognitions from the TRA/PWM was superior to each individual model and improved the prediction of future NPS use willingness, intentions, and use. The overall results derived from all three models suggest that both deliberative and socially reactive processing influence and characterize academic NPS use decisions and use.