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Thinking About Thinking

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Recently, the news has been littered with stories of kids popping or snorting off-label amphetamines to get a cognitive boost of alertness and focus, including drugs such as Adderall (prescribed for attention deficit hyperactivity disorder, ADHD). In some affluent high schools, where these drugs are as prevalent as SAT prep, students with Ivy-league dreams take them to stay at the top of the academic heap. In less-advantaged neighborhoods, a few doctors and parents now say the drugs are the only way to keep struggling students from falling farther behind.

There are lots of issues swirling around these stories -- how dangerous are these drugs? Are those who use them cheating? Does the real fault lie with the kids, the schools, or the parents? And is the case against chemical brain boosters completely undermined by double standards (he types while sipping his second cup of morning coffee)? I want to sidestep most of those important questions, however, and instead ask why it is that when it comes to optimizing brain function, we tend to trust everything except the brain itself?

The articles I've read on the rampant off-label use of Adderall and other drugs almost never mention studies that have repeatedly shown how placebo cognitive enhancers can deliver similar boosts in memory, focus, and attention, including a mix of lime-flavored baking soda that researchers pretended was an experimental brain booster dubbed R273.

The mechanism of these effects isn't entirely mapped out, but when it comes to better brain performance, sometimes it's not what's added, but what's taken away that matters. Specifically, anxiety -- pressure to succeed, fear of failure -- can be a real drag on cognitive performance. For some, taking that pre-test pill may be like rubbing a rabbit's foot or wearing lucky socks, boosting performance partly by easing anxiety and keeping worries from cluttering up their working memory.

There's a parallel line of research about steroids and other athletic performance enhancing drugs, with fake pills pushing athletes to new feats of strength, speed, and endurance. Indeed, some of the scientists who do this work suggest that their findings could be used as an anti-doping message: See, you don't need those chemicals, with their addictive potential, and their side effects! The problem, of course, is that we have faith in the power of those chemicals, and no such faith in the power of our own minds.

About a decade ago, researchers gave nationally competitive weightlifters an experimental muscle builder (actually a placebo) to use during training. After a week, the subjects were lifting about 3 to 5 percent more weight than they did at baseline, which is a pretty impressive considering the caliber of these athletes. But then, before a second round of test lifts, half of the subjects were told the truth -- that the supposed muscle builder they'd been taking was a placebo -- and their strength gains evaporated. These athletes had faith in performance-boosting drugs, but no faith in their mind's ability to conjure similar effects, even though they'd just experienced the latter, first hand.

Assumptions are powerful. For instance, returning to cognitive performance, it's commonly expected that mental stamina and memory degrade in old age. This past summer, at the first International Conference on Social Identity and Health, a group of British researchers showed the self-fulfilling potential of this assumption. In their study, several dozen subjects between 60 and 70 years-old were given a battery of tests, including a standard screening for dementia, after reading a mock scientific article about aging and cognitive decline. However, one group of test takers had been told that the study enrolled people 40 to 70 years-old, with the unspoken message that they were among the "older" subjects. The rest were told that subjects ranged in age from 60 to 90, which meant they were among the "younger" crowd. In the end, the scores of 70 percent of the "older' subjects indicated likely dementia, compared to just 14 percent of the others.

What happened? Once again anxiety is a suspect. It's possible that thinking of yourself as "older" automatically triggers stereotypes associated with aging, which clog up your brain with worry and distraction. This is a proposed mechanism for "stereotype threat" -- in which stereotypical expectations of poor performance become self-fulfilling prophecies in members of the stereotyped group. It's not necessary to believe the stereotype, being aware that others believe it, and that any sub-par performance may confirm it, is enough. In one oft-cited study, female Asian college students who took a math test after subtle pre-test reminders of their gender scored significantly below a control group of test takers, while those subjects reminded of their Asian background scored significantly better.

How can brain-clogging anxiety be thwarted? The approaches that have shown promise all tap cognitive resources that we already have on board. One strategy is to acknowledge and externalize the anxiety, to try and clear it from the mental books. In a 2011 study, high school students who spent 10 minutes writing about their test-taking fears before a high-stakes math exam did better than they had on a low-stakes pretest, whereas students who wrote nothing or wrote on unrelated emotional topics did much worse under pressure.

A second possibility is to interpret pre-test, or pre-competition, jitters as getting psyched up rather than psyched out. Studies of both students and athletes show that performance can go up or down with increased arousal levels (the sweaty palms and racing heart, etc.) based on how researchers manipulate these interpretations.

Pressure and anxiety. They ooze from the stories of people sneaking pre-test pills. These students aren't looking for a high, or to fit in (not in the usual, adolescent sense). Typically, they aren't even taking cognitive boosters with a mind to cheat -- the sort of mindset that leads one to write the answers on a palm or hire somebody to take the SAT in one's place. The people taking these drugs are worried about not keeping up. They reach for a quick fix, and in doing so they are certainly not alone. But, it's not just a lack of fortitude that leads these students to rely on chemicals for help. It's a lack of faith.

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