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The mechanism doesn't really matter. Perhaps these drugs simply do make people feel good and consequently they perform better. In the end it still increases their performance on these tasks.

I think it's a significant difference. For example, this would mean it's unlikely to benefit Alzheimer's patients.

You're implying that improved confidence is not a form of cognitive enhancement, when all anecdotal evidence would suggest the opposite.

From the publication:

> We conducted a phase IV, single-center, randomised, double-blind, placebo-controlled 4 x 4 crossover trial.

I assume it means that the control group gets placebo, so it's controlled for confidence boost.

What's the difference if the effect is the same?