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Background Schizophrenia and related disorders are highly disabling and create substantial burdens for families, communities, and health care systems. Although pharmacological treatments can often lessen the psychotic symptoms that are a hallmark of schizophrenia, they do not lessen the social and cognitive deficits that create the greatest impediments to community engagement and functional recovery. This study builds on prior research on psychosocial rehabilitation by comparing the effectiveness of two treatments demonstrated as efficacious in improving social and community functioning, Cognitive Enhancement Therapy (CET) and a version of Social Skills Training (HOPES/SST). Methods The study uses a randomized cluster design in which a pair of clinicians at community- and hospital-based mental service centers deliver either CET or HOPES to at least one group of 6-8 eligible clients for 12 months. Clinicians are trained and then supervised weekly, with ongoing process measurement of treatment fidelity, attendance, satisfaction, and retention, and use of other services. Measures administered at baseline and at 6 and 12 months while in treatment, and then at 18 and 24 months after treatment include social adjustment, quality of life, social skills, positive and negative symptoms, and neuro- and social cognition. We hypothesize that CET will be associated with greater improvements than SST in both the primary outcome of community functioning and the secondary outcomes of neuro- and social cognition and social skills. Secondarily, we hypothesize that more cognitive impairment at baseline and younger age will predict more benefit from CET compared to HOPES. Discussion Resource shortages endemic in mental health services and exacerbated by the pandemic highlight the importance of identifying the most effective approach to improving social and community functioning. We aim to improve understanding of the impact of two efficacious psychosocial treatments and to improve clinicians’ ability to refer to both treatments the individuals who are most likely to benefit from them. We expect the result to be programmatic improvements that improve the magnitude and durability of gains in community functioning. Trial registration ClinicalTrial.gov NCT04321759 , registered March 25, 2020.

While developing traffic-based cognitive enhancement technology (CET), such as bike accident prevention systems, it can be challenging to test and evaluate them properly. After all, the real-world scenario could endanger the subjects’ health and safety. Therefore, a simulator is needed, preferably one that is realistic yet low cost. This paper introduces a way to use the video game Grand Theft Auto V (GTA V) and its sophisticated traffic system as a base to create such a simulator, allowing for the safe and realistic testing of dangerous traffic situations involving cyclists, cars, and trucks. The open world of GTA V, which can be explored on foot and via various vehicles, serves as an immersive stand-in for the real world. Custom modification scripts of the game give the researchers control over the experiment scenario and the output data to be evaluated. An off-the-shelf bicycle equipped with three sensors serves as a realistic input device for the subject’s movement direction and speed. The simulator was used to test two early-stage CET concepts enabling cyclists to sense dangerous traffic situations, such as trucks approaching from behind the cyclist. Thus, this paper also presents the user evaluation of the cycling simulator and the CET used by the subjects to sense dangerous traffic situations. With the knowledge of the first iteration of the user-centered design (UCD) process, this paper concludes by naming improvements for the cycling simulator and discussing further research directions for CET that enable users to sense dangerous situations better.

Understanding the psychological and social benefits associated with university students' use of campus green spaces is essential for promoting student well-being and enhancing the learning environment in higher education institutions. This study explored the key factors influencing students' perceived mood elevation resulting from campus green space use. Adopting a quantitative approach and a correlational cross-sectional design, data were collected from 995 undergraduate students across four colleges in a public university through structured questionnaires and analysed using Partial Least Squares Structural Equation Modelling (PLS-SEM). The analysis identified two major predictors of students' perceived mood elevation: perceived social interaction improvement (PSII) and perceived stress alleviation (PSA). Specifically, PSII significantly predicted perceived mood elevation, perceived cognitive function enhancement (PCFE), and perceived stress alleviation, while PSA also significantly predicted both perceived cognitive function enhancement and perceived mood elevation. Notably, the model explained 40.9% of the variance in perceived mood elevation, with PSA emerging as the most important predictor and PSII demonstrating the strongest performance in predicting students' mood elevation from campus green space use. Based on these findings, practical recommendations are proposed to promote university students' use of campus green spaces to foster social interaction, alleviate stress, enhance cognitive functioning, and ultimately elevate their mood.

Background Some university students consume pharmaceutical stimulants without a medical prescription with the goal of improving their academic performance. The prevalence of this practice has been well documented in the US, but less so in other countries. The potential harms of using prescription stimulants require a better understanding of the prevalence of this practice within Australian universities. Methods An internet survey of 1136 Australian students was conducted in 2015 in three large Australian universities. Students were asked about their personal use of prescription stimulants, attitudes and experiences with prescription stimulants. They were also asked about their use of caffeine, energy drinks and illicit drugs to enhance their academic performance. Results Lifetime self-reported use of stimulant medication to improve academic performance was 6.5, and 4.4% in the past year. Students were far more likely to report using coffee and energy drinks (41.4 and 23.6% respectively, lifetime use) than prescription stimulants to help them study and complete university assessments. Non-medical use of prescription stimulants was strongly associated with a history of illicit drug use. Conclusion The prevalence of nonmedical prescription stimulant use to improve academic performance is low among university students in Australia, especially when compared with their use of coffee and energy drinks.

How have advances in the use of biomedical and cognitive enhancement affected our understanding of human resilience? At what point does enhancement facilitate recovery and growth after exposure to adversity, and when is enhancement a manipulation of human potential, causing a redefinition of resilience as something more than a return to normal functioning? In this article we juxtapose theories of enhancement and resilience, exploring how biomedical and cognitive enhancement technologies are influencing our understanding of the limits of human wellbeing in contexts of exposure to atypical stress or challenge. Specifically, we discuss 3 different ways biomedical enhancement can influence psychological and physical resilience: (a) enhancement that builds latent capacity and resources to deal effectively with atypical stressors before exposure to risk, (b) enhancement as intervention which adds to an individual's existing psychological and social resources after exposure to risk, and (c) transhumanism as a means to make individuals even more resilient than they would be without intervention. These 3 areas of focus distinguish enhancement typologies by their temporality and ontological suppositions of what it means to be fully functioning before, during and after exposure to adversity. The article concludes with a discussion of the potential within the biomedical and cognitive enhancement fields to bolster resilience through interventions that exert a positive influence on human biology. En quoi les progrès dans l'usage de l'amélioration biomédicale et cognitive ont-ils influé sur notre compréhension de la résilience humaine ? À quel point l'amélioration facilite-t-elle le rétablissement et la croissance après une exposition à l'adversité, et à quel moment l'amélioration devient-elle une manipulation du potentiel humain, occasionnant une redéfinition de la résilience en tant qu'un état autre qu'un retour au fonctionnement normal ? Dans cet article, on juxtapose des théories de l'amélioration et de la résilience pour explorer les façons dont les technologies d'amélioration biomédicale et cognitive influent sur notre compréhension des limites de l'être humain dans des contextes d'exposition atypique au stress ou à des difficultés. On s'attarde en particulier sur 3 façons différentes dont l'amélioration biomédicale peut influer sur la résilience psychologique et physique : a) l'amélioration qui accroît la capacité latente et les ressources pour traiter efficacement les facteurs de stress atypiques avant l'exposition au risque; b) l'amélioration en tant qu'intervention qui augmente les ressources psychologiques et sociales d'un individu après une exposition au risque; c) le transhumanisme en tant que moyen de rendre les individus plus résilients que s'il n'y avait pas intervention. Ces 3 domaines d'intérêt font la distinction entre les typologies d'amélioration par leur temporalité et leurs hypothèses ontologiques sur ce que signifie être pleinement fonctionnel avant, durant et après l'exposition à l'adversité. L'article se termine par une discussion du potentiel dans les domaines de l'amélioration biomédicale et cognitive sur le plan de l'accroissement de la résilience au moyen d'interventions qui exercent une influence positive sur la biologie humaine. Public Significance Statement Resilience, defined broadly, is the capacity to recover from difficulties. An individual's recovery is dependent on the contextual resources. We propose that average individuals, as well as disabled, can benefit from human enhancement techniques in order to be more resilient.

Objective The aim of this study was to assess medical students’ perception of pharmacological cognitive enhancement (PCE) with methylphenidate and to determine whether this perception differs between junior and senior medical students. Methods The second and fifth year medical student groups of 2017 at a specific university completed self-administered questionnaires in order to investigate if there were a difference in their attitudes towards methylphenidate use for PCE. Results A total of 353 students were included as follows: 135 second year and 218 fifth year students. Fifth year students were more aware of PCE with methylphenidate than second year students (94% versus 87%; p value = 0.02). Many students (second year = 86%; fifth year = 71%; p value = 0.2469) were of the opinion that methylphenidate could enhance academic performance. Sixty-six percent of all the students were concerned about the fairness of PCE; 93% were concerned about the harmfulness of methylphenidate. There were no statistical significant differences in the attitudes towards methylphenidate use for PCE between the two groups of junior and senior students. Conclusion In both groups, the majority of students were against the use of methylphenidate for PCE in students without attention deficit and hyperactivity disorder. Their attitudes regarding the use of methylphenidate for non-medical purposes did not differ significantly. Addressing the topic of PCE with medical students is essential, and the impact on their practice can be an important direction for future research.

In an effort for better memory, greater motivation, and concentration, otherwise healthy individuals use pharmaceutical cognitive enhancers (PCEs), medicines for the treatment of cognitive deficits of patients with various disorders and health problems, to achieve greater productivity, efficiency, and performance. We examined the use of PCEs among 289 students at the Slovenian Faculty of Electrical Engineering and Computer Science in the behavioral and psychosocial context (students’ attitudes towards study, parents, health, leisure time, and work). Furthermore, we also addressed the immediate reasons, or the hypothesized connections of behavioral and psychosocial aspects, related to PCE misuse. The study consisted of a structured questionnaire, and chi-squared tests were used. An analysis of student statements revealed differences in students’ and parents’ attitudes toward good academic grades. In addition, students chose among 17 values related to relationships with parents, friends, partners, careers, study obligations, leisure, hobbies, material goods, appearance, and the future, and assessed their importance. Regardless of the group they belonged to, young people cited the same values among the most important. Good grades and parental opinions have proven to be key factors in the context of PCE abuse. This research was the first study to examine the relation between PCE misuse and the role of different behavioral and psychosocial factors.

The article investigates the sociocultural implications of the changing modern workplace and of pharmacological cognitive enhancement (PCE) as a potential adaptive tool from the viewpoint of social niche construction. We will attempt to elucidate some of the sociocultural and technological trends that drive and influence the characteristics of this specific niche, and especially to identify the kind of capabilities and adaptations that are being promoted, and to ascertain the capabilities and potentialities that might become diminished as a result. In this context, we will examine what PCE is, and how and why it might be desirable as a tool for adaptation within the workplace. As human beings are, or at least should be allowed to be, more than merely productive, able-bodied and able-minded workers, we will further examine how adaptation to the workplace niche could result in problems in other domains of modern societal life that require the same or other cognitive capabilities. In this context we will also focus on the concept of responsibility and how it pertains to PCE and the modern workplace niche. This will shed some light on the kind of trends related to workplace niche construction, PCE and capability promotion that we can expect in the future, and on the contexts in which this might be either beneficial or detrimental to the individual as a well-rounded human being, and to other members of society.

Intake of dietary supplements has increased, despite evidence that some of these have adverse side effects and uncertainty about their effectiveness. This systematic review examined the evidence for the cognitive benefits of a wide range of dietary supplements in healthy young adult samples; the aim was to identify if any might be useful for optimising cognitive performance during deployment in military personnel. Searches were conducted in 9 databases and 13 grey literature repositories for relevant studies published between January 2000 and June 2017. Eligible studies recruited healthy young adults (18–35 years), administered a legal dietary supplement, included a comparison control group, and assessed cognitive outcome(s). Thirty-seven of 394 identified studies met inclusion criteria and were included for synthesis. Most research was deemed of low quality (72.97%; SIGN50 guidelines), highlighting the need for sound empirical research in this area. Nonetheless, we suggest that tyrosine or caffeine could be used in healthy young adults in a military context to enhance cognitive performance when personnel are sleep-deprived. Caffeine also has the potential benefit of improving vigilance and attention during sustained operations offering little opportunity for sleep. Inconsistent findings and methodological limitations preclude firm recommendations about the use of other specific dietary supplements.

Since it is now broadly acknowledged that ethics should receive early consideration in discourse on emerging technologies, ethical debates tend to flourish even while new fields of technology are still in their infancy. Such debates often liberally mix existing applications with technologies in the pipeline and far-reaching visions. This paper analyses the problems associated with this use of ethics as preparatory research, taking discourse on human enhancement in general and on pharmaceutical cognitive enhancement in particular as an example. The paper will outline and discuss the gap between the scientific and technological state of the art and the ethical debates, pointing out epistemic problems in this context. Furthermore, it will discuss the future role of genuine ethical reflection in discourse on human enhancement, arguing also that such discourse needs to include a technology assessment - in the broad sense of the term - which encompasses, inter alia, anthropological perspectives and aspects of social theory.[PUBLICATION ABSTRACT]