Stimulant medications affect arousal and reward, not attention

The dominant paradigm is the attention-network model of stimulant action. This model suggests that stimulants primarily improve attention by directly modulating attention networks in the brain.

This preprint challenges the prevailing paradigm by presenting evidence suggesting that the primary effect of stimulants is on arousal and reward processing, rather than directly on attention. The large sample size of the ABCD study and the inclusion of a controlled drug trial provide strong support for this alternative view. While the preprint acknowledges prior studies supporting the attention-network model, it argues that these studies may have been limited by methodological constraints and smaller sample sizes. The findings related to sleep duration further reinforce the arousal hypothesis, and the correlation with receptor density maps supports the involvement of norepinephrine and dopamine in stimulant-driven brain changes. While not a complete paradigm shift, the preprint's findings represent a significant drift away from the current model, suggesting a need to re-evaluate our understanding of how stimulants affect the brain and behavior. I was uncertain between Model Drift and Model Crisis because of the strong evidence presented, but ultimately chose Model Drift because the preprint doesn't fully resolve all the inconsistencies or offer a complete alternative model to replace the existing one. I believe further research is needed to solidify these findings and potentially push the field into a Model Crisis.
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