Moral disengagement and associated processes in performance-enhancing drug use: a national qualitative investigation

Morality- and Norm-Based Subgroups of Disability-Sport Athletes Differ on Their Anticipated Guilt and Intentions Toward Doping

The purpose of this study was to examine whether subgroups of disability-sport athletes exist on morality- and norm-based doping cognitions and whether these groups differ in anticipated guilt or doping intentions. A survey was completed by 186 athletes (Mage = 37.5 years, 78.0% male, 45.1% wheelchair basketball) assessing norms, doping moral disengagement, anticipated guilt, and intentions to dope. Cluster analysis revealed four distinct subgroups of athletes, including one potentially high-risk subgroup characterized by relatively high scores on doping moral disengagement, subjective norms, and descriptive norms. One-way analysis of variance revealed significantly lower anticipated guilt in two athlete subgroups characterized by relatively higher doping moral disengagement than the other two subgroups. Moreover, the potentially high-risk group had a greater proportion of athletes showing some presence of intention to dope. This study suggests there is a small subgroup of disability-sport athletes at elevated risk of doping who might benefit from targeted antidoping interventions.

Context matters: athletes' perception of dopers' values, actions and vulnerabilities

Background

Although athletes seem to hold uniform views towards non-dopers, their perception of dopers is more nuanced, reflecting positive and negative attributes. Research also indicates that rarely a single factor can explain doping, but a host of reasons that intertwine. A holistic understanding of how values play a role in decisions in anti-doping and the elements that influence athletes' doping vulnerability is timely and warranted.

Methods

We recruited elite athletes from 13 countries representing 27 sports at a national or international level (N = 60) to participate as part of a larger research project. Data were collected via focus group interviews focusing on values, value priorities and perceptions about the role of values in doping as a phenomenon and in dopers' actions. Data were analysed using iterative thematic analysis.

Results

Three themes were identified: (1) athletes' personal stance on doping, (2) dopers in the eyes of the anti-doping-compliant athletes, and (3) doping vulnerability is a balance. Athletes in this study strongly opposed doping but showed empathy and understanding toward athletes who doped under certain circumstances. Furthermore, athletes believed that "clean" and "doping" athletes are not always distinguished by the values they hold, leading to the realisation that all athletes can be vulnerable to doping at some point. This vulnerability is a balance between risks and protective factors in a complex interaction between environmental, personal, and situational influences. Each element (e.g., values, environment) can be a motivator or a barrier. Consequently, doping vulnerability is highly idiosyncratic and dynamic.

Conclusion

If doping is not due to a lack of moral values but the consequences of combined risk factors that override the guiding function of values, then doping can happen to anyone, "good" athletes included. Developers and facilitators of anti-doping education programmes are advised to embrace this important aspect. The results also contribute to developing the doping vulnerability concept as a balance between risks and protective factors and draw attention to the clean athlete vulnerability, which is rooted in the combination of strategic performance enhancement via non-prohibited means, their exposure to anti-doping requirements and the constant high level of suspicion that surrounds them.

The Meaning of "Clean" in Anti-doping Education and Decision Making: Moving Toward Integrity and Conceptual Clarity

With the World Anti-Doping Agency's International Standard for Education (ISE) coming into effect in 2021, the clean-sport movement is at a pivotal stage. Through this conceptual paper we juxtapose the sector-wide anti-doping education as set out in the ISE on the decision-making process at the individual level. We discuss three critical issues for the clean-sport movement. First, we make the case for doping being a "wicked" problem and outline the possible implications of this for prevention and detection. Second, we consider why we need to address regulative, normative, and cognitive components of clean sport if we are to maximize its legitimacy. Third, we critically expose the fluidity with which clean sport is defined, and the implications of defining clean sport in substance- vs. rule-based terms, which, respectively, lead to theorizing clean sport as "drug-free" vs. "cheating-free" sport. Finally, we consider the role and key components of anti-doping education and how the relevance of certain components may be dependent on the way clean sport is defined. Conceptualizing doping as a sport integrity issue, we move away from the archaic and delimiting view of clean sport as drug-free sport and conclude with recommendations on how to reconcile values-based education, awareness raising, information provision and anti-doping education within the broader scope of integrity, to support informed decision making and personal agency. To connect anti-doping education to individual-level decision making, we recommend a staggered approach in which specific education content is linked to different influences in the decision-making process, to different stages of athlete development, and to different educational goals. Emphasizing and encouraging sensemaking in anti-doping decision making offers a pragmatic approach for anti-doping education. Conceptual clarity and precise mapping of the educational goal, content, and delivery is vital for valid and meaningful evaluation of the effectiveness of anti-doping education.

Moral Disengagement in Youth Athletes: A Narrative Review

The sports environment can be considered as a context characterized by interactions typical of social groups, where children have the chance to learn good values. Positive and negative behaviours in sports, also called prosocial and antisocial behaviours, have been studied according to a moral perspective, as has doping behaviour, taking into consideration the concept of moral disengagement. Moral disengagement in children has been associated with maladaptive behaviours later in life, even though it should disappear with growth. Concerning the sports environment, previous reviews on the topic have extensively illustrated the role of moral variables in sport and their relation to antisocial behaviour and doping, positing some research questions that should be investigated in the future. Starting from these questions, the current narrative review aims to update literature about the effects of moral disengagement on youth athletes. Therefore, new studies about the predictors of moral disengagement are introduced, followed by contributions concerning the relationship between moral disengagement and doping and between moral disengagement and antisocial behaviour. Finally, the review summarizes which research questions have been solved in the last decade and which should be researched further on.

Racing Clean in a Tainted World: A Qualitative Exploration of the Experiences and Views of Clean British Elite Distance Runners on Doping and Anti-Doping

Background: Doping has been a prominent issue for the sport of athletics in recent years. The endurance disciplines, which currently account for 56% of the global anti-doping rule violations in athletics, appear to be particularly high risk for doping. Objective: Using this high-risk, high-pressure context, the main purpose of this study was to investigate the human impact of doping and anti-doping on "clean" athletes. The secondary aim of the study was to better understand the reasons for, and barriers to, competing "clean" among this group of athletes. Method: Semi-structured interviews were conducted with 11 elite distance runners from the UK to explore: (1) the reasons and motivations for competing clean. (2) Perceptions of the anti-doping system, and experiences of being part of that system. (3) Views on the prevalence and causes of doping and the impact of doping on the lives of clean athletes. The interviews were audio-recorded, transcribed verbatim, and analysed using Reflexive Thematic Analysis. Results: Four major themes were identified: (1) The participants in this study have not been tempted to use prohibited substances or methods; they compete in their sport for the personal satisfaction of seeing how good they can be, rather than in pursuit of winning at all costs. (2) Anti-doping does not currently prevent doping effectively and is not implemented evenly across the globe. (3) Doping was perceived as a major issue and was felt to be borne out of certain sporting cultures in which doping is enabled. (4) Doping has impacted the careers of clean athletes in irreversible ways and presents a continuing challenge to the psychological preparation for competition. Conclusions: Clean athletes suffer negative consequences from both doping and anti-doping. ADOs must collaborate across borders to ensure a more even implementation of anti-doping activities, to facilitate a more level playing field on the global stage. ADOs must also acknowledge the existence of a large group of athletes who would never consider deliberately doping and make anti-doping work for these athletes too.

Perceived Motivational Climates and Doping Intention in Adolescent Athletes: The Mediating Role of Moral Disengagement and Sportspersonship

Doping is an important issue in competitive sports and poses potentially irreversible consequences to athletes. Understanding the psychological process underlying antecedents and doping intention will inform policy and prevention. This study aimed to test the psychosocial mechanisms of doping in adolescent athletes using an integrated model. In this model, we examined the associations of perceived motivational climate (i.e., task-involving and ego-involving), moral variables (i.e., moral disengagement and sportspersonship), and attitudinal variables (i.e., perceived pros/cons of doping and perceived cons of not doping) with doping intention. We further investigated whether the moral variables mediated the relationship between perceived motivational climate and doping intention. A cross-sectional survey was employed in the present study. Six hundred and fifteen Chinese adolescent athletes (mean age = 15.68 ± 1.67 years) completed questionnaires measuring demographic information and the variables mentioned previously. Structural equation modeling showed that the hypothesized model had a good fit and explained 64.1% of the variance in doping intention. Task-involving motivational climate indicated both directly and indirectly negative associations with doping intention via sportspersonship. The ego-involving motivational climate was positively associated with doping intention via moral disengagement. Among perceived pros/cons of doping and perceived cons of not doping, both perceived cons of doping and cons of not doping were positively associated with doping intention with a small effect size. This study confirmed the roles of tasking- and ego-involving motivational climates, moral variables, and attitudinal variables on doping intention. These research findings may provide new insights for the future of intention-based doping prevention programmes.

Validierung einer Skala zur Erfassung der kollektiv-moralischen Einstellung in Sportgruppen (KMES)

Zusammenfassung. Der vorliegende Beitrag stellt eine Skala zur Erhebung der kollektiv-moralischen Einstellung einer Gruppe für den deutschsprachigen Sport- und insbesondere Dopingkontext vor und überprüft sie hinsichtlich ihrer Testgütekriterien. Die KMES wurde auf der Grundlage der Collective Moral Motivation Scale aus der englischsprachigen Arbeits- und Organisationspsychologie entwickelt und anschließend anhand einer Gesamtstichprobe von 545 Personen (Substichprobe 1 und 3: Nachwuchsleistungsathlet_innen; Substichprobe 2: Sportstudierende) validiert. Eine konfirmatorische Faktorenanalyse bestätigt das postulierte eindimensionale Konstrukt, welches eine exzellente interne Konsistenz und eine akzeptable Retest-Reliabilität aufweist. Darüber hinaus zeigt die KMES Kriteriumsvalidität, indem sie die Außenkriterien antisoziales Verhalten und Dopingabsichten vorhersagen kann sowie erwartungskonforme Zusammenhänge zum motivationalen Trainingsklima abbildet. Die Ergebnisse deuten darauf hin, dass die KMES zur Erfassung von Werten auf kollektiver Ebene eingesetzt werden kann. Dies könnte vor allem in Anti-Doping-Studien neue Einblicke generieren.

Antisocial Personality Disorder as a Risk Factor for Opioid Use: The Dual Mediating Roles of Antisocial Attitudes and Self-Control

Antisocial personality disorder is a risk factor for opioid use. There is a dearth of research which examines self-control and moral disengagement as potential mediators of this relationship. This study utilized data from the Pathways to Desistance study in analyses. Generalized structural equation modeling was utilized to test for mediation of the relationship between antisocial personality disorder and opioid use. Bootstrapped standard errors were computed so that a Clogg Z test could be estimated to determine if identified mediation effects significantly differed. Results indicated that a likely diagnosis of antisocial personality disorder increased risk for opioid use. Inclusion of moral disengagement and self-control into the model resulted in attenuation of this effect to non-significance and reduced the magnitude of the effect by around 45%. The contribution of both constructs to the total indirect effect did not significantly differ and only the total indirect effect was significant.

A Multistudy Cross-Sectional and Experimental Examination Into the Interactive Effects of Moral Identity and Moral Disengagement on Doping

Moral identity and moral disengagement have been linked with doping likelihood. However, experiments testing the temporal direction of these relationships are absent. The authors conducted one cross-sectional and two experimental studies investigating the conjunctive effects of moral identity and moral disengagement on doping likelihood (or intention). Dispositional moral identity was inversely (marginally), and doping moral disengagement, positively, associated with doping intention (Study 1). Manipulating situations to amplify opportunities for moral disengagement increased doping likelihood via anticipated guilt (Study 2). Moreover, dispositional moral identity (Study 2) and inducing moral identity (Study 3) were linked with lower doping likelihood and attenuated the relationship between doping moral disengagement and doping likelihood. However, the suppressing effect of moral identity on doping likelihood was overridden when opportunities for moral disengagement were amplified. These findings support multifaceted antidoping efforts, which include simultaneously enhancing athlete moral identity and personal responsibility alongside reducing social opportunities for moral disengagement.

Testing the validity and reliability of the doping willingness in sport scale

Although research investigating doping in sport is burgeoning, there is still a lack of proxy measures of doping behavior that have undergone extensive psychometric testing. To address this issue, we modified a previously used measure of doping willingness in sport and tested aspects of validity and reliability across four studies. In Study 1, we provided support for the face and content validity of the items, and then found support for the factor structure of the scale in a sample of athletes (N = 205) using confirmatory factor analysis. In Study 2, we collected data from an independent sample of athletes (N = 236) to provide further evidence for the factor structure of the scale using confirmatory factor analysis as well as provided evidence for concurrent and discriminant validity. In Study 3, a further independent sample of athletes (N = 144) completed the scale and provided support for discriminant and predictive validity of the scale. In Study 4, we collected data from a further independent sample (N = 74) to provide support for the test-retest reliability, and stability of items. Lastly, a confirmatory factor analysis was conducted on the samples across Studies 3 and 4, and the composite sample across all four studies which provided further support for the factor structure of the final 8-item scale. Taken together, these findings provide psychometric support for the scale to be used to measure the willingness of athletes to use banned substances to help facilitate future research investigating doping in sport.

Empathic and Self-Regulatory Processes Governing Doping Behavior

Evidence associating doping behavior with moral disengagement (MD) has accumulated over recent years. However, to date, research examining links between MD and doping has not considered key theoretically grounded influences and outcomes of MD. As such, there is a need for quantitative research in relevant populations that purposefully examines the explanatory pathways through which MD is thought to operate. Toward this end, the current study examined a conceptually grounded model of doping behavior that incorporated empathy, doping self-regulatory efficacy (SRE), doping MD, anticipated guilt and self-reported doping/doping susceptibility. Participants were specifically recruited to represent four key physical-activity contexts and consisted of team- (n = 195) and individual- (n = 169) sport athletes and hardcore- (n = 125) and corporate- (n = 121) gym exercisers representing both genders (n_male = 371; n_female = 239); self-reported lifetime prevalence of doping across the sample was 13.6%. Each participant completed questionnaires assessing the aforementioned variables. Structural equation modeling indicated strong support for all study hypotheses. Specifically, we established: (a) empathy and doping SRE negatively predicted reported doping; (b) the predictive effects of empathy and doping SRE on reported doping were mediated by doping MD and anticipated guilt; (c) doping MD positively predicted reported doping; (d) the predictive effects of doping MD on reported doping were partially mediated by anticipated guilt. Substituting self-reported doping for doping susceptibility, multisample analyses then demonstrated these predictive effects were largely invariant between males and females and across the four physical-activity contexts represented. These findings extend current knowledge on a number of levels, and in doing so aid our understanding of key psychosocial processes that may govern doping behavior across key physical-activity contexts.

The psychology of doping

Doping is increasingly becoming a problem in both elite and recreational sports. It is therefore important to understand the psychological factors which can explain doping behavior in order to prevent it. The present paper briefly presents evidence on the prevalence of doping use in competitive sports and the measurement approaches to assess doping behavior and doping-related variables. Furthermore, the integrative theoretical approaches used to describe the psychological processes underlying doping use are discussed. Finally, the paper provides suggestions for appropriate measurement of doping behavior and doping-related variables, key preventive efforts against doping as well as avenues for future research.

Russian roulette with unlicensed fat-burner drug 2,4-dinitrophenol (DNP): evidence from a multidisciplinary study of the internet, bodybuilding supplements and DNP users

Background

2,4-Dinitrophenol (DNP) poses serious health-risks to humans. The aims of this three-stage multidisciplinary project were, for the first time, to assess the risks to the general public from fraudulent sale of or adulteration/contamination with DNP; and to investigate motives, reasons and risk-management among DNP-user bodybuilders and avid exercisers.

Methods

Using multiple search-engines and guidance for Internet research, online retailers and bodybuilding forums/blogs were systematically explored for availability of DNP, advice offered on DNP use and user profiles. Ninety-eight pre-workout and weight-loss supplements were purchased and analysed for DNP using liquid-chromatography-mass-spectrometry. Psychosocial variables were captured in an international sample of 35 DNP users (26.06 ± 6.10 years, 94.3 % male) with an anonymous, semi-qualitative self-reported survey.

Results

Although an industrial chemical, evidence from the Internet showed that DNP is sold ‘as is’, in capsules or tablets to suit human consumption, and is used ‘uncut’. Analytical results confirmed that DNP is not on the supplement market disguised under fictitious supplement names, but infrequently was present as contaminant in some supplements (14/98) at low concentration (<100mcg/kg). Users make conscious and ‘informed’ decisions about DNP; are well-prepared for the side-effects and show nonchalant attitude toward self-experimentation with DNP. Steps are often taken to ensure that DNP is genuine. Personal experience with performance- and appearance enhancing substances appears to be a gateway to DNP. Advice on DNP and experiences are shared online. The significant discrepancy between the normative perception and the actual visibility suggests that DNP use is-contrary to the Internet accounts-a highly concealed and lonesome activity in real life. Positive experiences with the expected weight-loss prevail over the negative experiences from side effects (all but two users considered using DNP again) and help with using DNP safely is considered preferable over scare-tactics.

Conclusion

Legislation banning DNP sale for human consumption protects the general public but DNP is sold ‘as is’ and used ‘uncut’ by determined users who are not dissuaded from experimenting with DNP based on health threats. Further research with stakeholders’ active participation is imperative for targeted, proactive public health policies and harm-reduction measures for DNP, and other illicit supplements.

Electronic supplementary material

The online version of this article (doi:10.1186/s13011-015-0034-1) contains supplementary material, which is available to authorized users.

An exploratory study of image and performance enhancement drug use in a male British South Asian community

BACKGROUND

Consumerism of image and performance enhancement drugs (IPEDs) is a world-wide public health concern. Given anecdotal reporting of increased normalisation of IPED use and uptake of British South Asian male IPED users at UK needle and syringe exchange services, the study aimed to explore use of IPEDs among this under-researched ethnic group.

METHODS

20 in depth interviews were conducted with a purposive sample of British South Asian males attending harm reduction outreach in the North East of England. The interviews explored motives for use of IPEDs, sourcing routes, information seeking, injecting behaviours and cultural and community sensitivities around IPED use among this group. The data was collected and analysed using the Interpretative Phenomenological Analysis approach (IPA).

RESULTS

Motives for use centred on the achievement of enhanced definition and density of muscle, and improved recovery from training and injuries. All participants reported initial stimulation of interest and triggers to seek information on IPEDs due to social media, community and peer messages. Diverse forms of IPED use were described, with rational and moderated use common among older participants. In contrast younger participants adopted more excessive use in seeking short cuts to attaining muscle size. Sourcing of androgenic-anabolic steroids (AAS) and growth hormones from originating countries (Pakistan, India) was reported, along with diversification of entrepreneurial activity into IPED dealing networks. Sellers were generally reported to provide effective and reliable products and mentoring to inexperienced users. Group injecting practices were common. IPED use was observed by some as health promotion medium within religious contexts. Crime deterrence and drug abstinence occurred for some while involved in AAS cycles.

CONCLUSIONS

The study is intended to contribute to health policy and practice debate around the targeting of dedicated education, outreach and harm reduction for ethnic groups engaged in IPED use.

Environments, risk and health harms: a qualitative investigation into the illicit use of anabolic steroids among people using harm reduction services in the UK

OBJECTIVES

The illicit use of anabolic steroids among the gym population continues to rise, along with the number of steroid using clients attending harm reduction services in the UK. This presents serious challenges to public health. Study objectives were to account for the experiences of anabolic steroid users and investigate how 'risk environments' produce harm.

METHODS

Qualitative face-to-face interviews with 24 users of anabolic steroids engaged with harm reduction services in the UK.

RESULTS

Body satisfaction was an important factor when deciding to start the use of anabolic steroids. Many users were unaware of the potential dangers of using drugs from the illicit market, whereas some had adopted a range of strategies to negotiate the hazards relating to the use of adulterated products, including self-experimentation to gauge the perceived efficacy and unwanted effects of these drugs. Viewpoints, first-hand anecdotes, norms and practices among groups of steroid users created boundaries of 'sensible' drug use, but also promoted practices that may increase the chance of harms occurring. Established users encouraged young users to go to harm reduction services but, at the same time, promoted risky injecting practices in the belief that this would enhance the efficacy of anabolic steroids.

CONCLUSIONS

Current steroid-related viewpoints and practices contribute to the risk environment surrounding the use of these drugs and may undermine the goal of current public health strategies including harm reduction interventions. The level of harms among anabolic steroid users are determined by multiple and intertwining factors, in addition to the harms caused by the pharmacological action or injury and illness associated with incorrect injecting techniques.