Virtue or pretense? Looking behind self-declared innocence in doping

'Clean athlete status' cannot be certified: Calling for caution, evidence and transparency in 'alternative' anti-doping systems

Athletes, sponsors and sport organisations all have a vested interest in upholding the values of clean sport. Despite the considerable and concerted efforts of the global anti-doping system over two decades, the present system is imperfect. Capitalising upon consequent frustrations of athletes, event organisers and sponsors, alternative anti-doping systems have emerged outside the global regulatory framework. The operating principles of these systems raise several concerns, notably including accountability, legitimacy and fairness to athletes. In this paper, we scrutinise the Clean Protocol™, which is the most comprehensive alternative system, for its shortcomings through detailed analysis of its alleged logical and scientific merits. Specifically, we draw the attention of the anti-doping community - including researchers and practitioners - to the potential pitfalls of using assessment tools beyond the scope for which they have been validated, and implementing new approaches without validation. Further, we argue that whilst protecting clean sport is critically important to all stakeholders, protocols that put athletes in disadvantageous positions and/or pose risks to their professional and personal lives lack legitimacy. We criticise the use of anti-doping data and scientific research out of context, and highlight unintended harms that are likely to arise from the widespread implementation of such protocols in parallel with - or in place of - the existing global anti-doping framework.

Analysis of doping control test results in individual and team sports from 2003 to 2015

BACKGROUND

Determining the prevalence of doping in sport might be useful for anti-doping authorities to gauge the effectiveness of anti-doping policies implemented to prevent positive attitudes toward doping. Using questionnaires and personal interviews, previous investigations have found that the prevalence of doping might be different among different sports disciplines; however, there is no sport-specific information about the proportion of adverse and atypical findings (AAF) in samples used for doping control. The aim of the present investigation was to assess the differences in the frequency of adverse analytical and atypical findings among sports using the data made available by the World Anti-Doping Agency.

METHODS

The data included in this investigation were gathered from the Testing Figures Reports made available annually from 2003 to 2015 by the World Anti-Doping Agency. These Testing Figures Reports include information about the number of samples analyzed, the number of AAFs reported, and the most commonly found drugs in the urine and blood samples analyzed. A total of 1,347,213 samples were analyzed from the individual sports selected for this investigation, and 698,371 samples were analyzed for disciplines catalogued as team sports.

RESULTS

In individual sports, the highest proportions of AAF were 3.3% ± 1.0% in cycling, 3.0% ± 0.6% in weightlifting, and 2.9% ± 0.6% in boxing. In team sports, the highest proportions of AAF were 2.2% ± 0.5% in ice hockey, 2.0% ± 0.5% in rugby, and 2.0% ± 0.5% in basketball. Gymnastics and skating had the lowest proportions at (≤1.0%) for individual sports, and field hockey, volleyball and football had the lowest proportions for team sports (≤1.4%).

CONCLUSION

As suggested by the analysis, the incidence of AAF was not uniform across all sports disciplines, with the different proportions pointing to an uneven use of banned substances depending on the sport. This information might be useful for increasing the strength and efficacy of anti-doping policies in those sports with the highest prevalence in the use of banned substances.

Doping among high school students: findings from the French ESPAD survey

BACKGROUND

The increasing use of doping by youth is a growing public health concern. The present study aimed to calculate robust estimates of the prevalence of doping among French high school students and study factors related to the use of licit vs. banned agents.

METHODS

The European School Project on Alcohol and other Drugs (ESPAD), a nationally representative school-based survey, was distributed across France from April to May 2015, generating a final sample size of 6642 students. Multilevel modelling was used to examine covariates of doping to enhance athletic performance in sport in this population.

RESULTS

Overall, 2.3% of students used banned agents, and 6.1% used licit and banned substances to improve athletic performance. Significant gender differences existed for both, with males more prone to doping than females. Our findings provide support for the existing gateway hypothesis that nutritional supplementation leads to doping banned agents. Multilevel modelling revealed the presence of both school and class-level influences on individual use of licit substances, vs. solely class-level factors impacting the use of banned agents, suggesting a strong peer-effect.

CONCLUSIONS

These findings support the need to engage in early doping prevention through high schools. Programmes should draw attention to the role of licit substances, including nutritional supplementation, in the progression to using banned agents and encompass the continuum of adolescent risk taking through a behaviour-based approach to doping prevention.

Sport motivation and doping in adolescent athletes

Background

Although performance-enhancing drugs appear to be prevalent in adolescent sports, relatively little attention has been paid to why adolescent athletes decide to use these drugs. In this study, we examine doping among adolescents from a motivational perspective and explore how motivational variables, such as achievement goal orientations and the perceived self-determination of sports activities, may be related to moral attitudes, doping intentions and doping behavior in adolescents who participate in competitive sports.

Methodology

The study included 1035 adolescents participating in competitive sports from all regions of the Czech Republic (mean age = 16.3 years). The respondents completed a battery of questionnaires assessing their achievement goal orientations (task, ego), sports motivation at various levels of self-determination (intrinsic motivation, external regulation, amotivation), moral attitudes toward sport competition (acceptance of cheating, keeping winning in proportion, attitudes toward doping), doping intentions and doping behavior. A structural equation model was used to test the relations among motivational variables, attitudes, intentions and doping behavior.

Principal results

Our analyses indicated a good fit with the proposed model, which explained 59% of the variance in doping intentions and 17.6% of the variance in doping behavior. Within the model, task orientation was positively associated with intrinsic motivation and lower amotivation, whereas ego orientation was positively associated with extrinsic regulation and amotivation. Furthermore, intrinsic motivation was positively associated with keeping winning in proportion and negatively associated with acceptance of cheating and attitudes toward doping; the less self-determined forms of motivation showed opposite relationships. However, only the acceptance of cheating and attitudes toward doping were related to doping intention, which subsequently predicted doping behavior.

Conclusions/Significance

The results provide further evidence that sports motivation represents a psychological variable that should be considered in anti-doping policies, programs, and interventions aimed at the adolescent population because motivation was linked to the doping-related attitudinal variables and also partially mediated the effect of achievement goal orientations in this regard. On the basis of these results, we may argue that the focus on intrinsic enjoyment, self-referenced criteria of success and self-improvement may be related to more negative attitudes toward doping and cheating, lower doping intentions and less frequent doping behavior, whereas the emphasis on competition, comparison with others and external motivation appear to be related to the opposite outcomes.

The Brief Death Implicit Association Test: Scoring recommendations, reliability, validity, and comparisons with the Death Implicit Association Test

Assessing suicidal thoughts and behaviors is difficult because at-risk individuals often fail to provide honest or accurate accounts of their suicidal thoughts or intentions. Research has shown that the Death Implicit Association Test (D-IAT), a behavioral test that measures implicit (i.e., outside of conscious control) associations between oneself and death concepts, can differentiate among people with different suicidal histories, such as those with different severity or recency of suicidal behaviors. We report here on the development and evaluation of a shorter and simpler version of the D-IAT called the Death Brief Implicit Association Test (D-BIAT). We recruited large (ns > 1,500) samples of participants to complete the original D-IAT and shorter D-BIAT via a public web-based platform and evaluated different scoring approaches, assessed the reliability and validity of the D-BIAT and compared it with the D-IAT. We found that the D-BIAT was reliable, provided significant group differences with effect sizes on par with the D-IAT, as well as similarly sized classification metrics (i.e., receiver operator characteristics). Although the D-IAT was nonsignificantly better on most outcomes, the D-BIAT is 1-1[1/2] minutes shorter and provided larger effect sizes for distinguishing between past year and lifetime attempters. Thus, there is a trade-off between administration time and improved outcomes associated with increased data. The D-BIAT should be considered for use where time or participant burden needs to be minimized, such as in clinical settings. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Implicit versus explicit attitude to doping: Which better predicts athletes' vigilance towards unintentional doping?

OBJECTIVES

This preliminary study examined whether implicit doping attitude, explicit doping attitude, or both, predicted athletes' vigilance towards unintentional doping.

DESIGN

A cross-sectional correlational design.

METHODS

Australian athletes (N=143;M_age=18.13, SD=4.63) completed measures of implicit doping attitude (brief single-category implicit association test), explicit doping attitude (Performance Enhancement Attitude Scale), avoidance of unintentional doping (Self-Reported Treatment Adherence Scale), and behavioural vigilance task of unintentional doping (reading the ingredients of an unfamiliar food product).

RESULTS

Positive implicit doping attitude and explicit doping attitude were negatively related to athletes' likelihood of reading the ingredients table of an unfamiliar food product, and positively related to athletes' vigilance towards unintentional doping. Neither attitude measures predicted avoidance of unintentional doping. Overall, the magnitude of associations by implicit doping attitude appeared to be stronger than that of explicit doping attitude.

CONCLUSIONS

Athletes with positive implicit and explicit doping attitudes were less likely to read the ingredients table of an unknown food product, but were more likely to be aware of the possible presence of banned substances in a certain food product. Implicit doping attitude appeared to explain athletes' behavioural response to the avoidance of unintentional doping beyond variance explained by explicit doping attitude.

"I Want It All, and I Want It Now": Lifetime Prevalence and Reasons for Using and Abstaining from Controlled Performance and Appearance Enhancing Substances (PAES) among Young Exercisers and Amateur Athletes in Five European Countries

Doping use in recreational sports is an emerging issue that has received limited attention so far in the psychological literature. The present study assessed the lifetime prevalence of controlled performance and appearance enhancing substances (PAES), and used behavioral reasoning theory to identify the reasons for using and for avoiding using controlled PAES in young exercisers across five European countries, in the context of the “SAFE YOU” Project. Participants were 800 young amateur athletes and exercisers (M = 21.56; SD = 2.69) from Cyprus, Germany, Greece, Italy, and UK who completed an anonymous questionnaire that included measures of self-reported use of controlled PAES, as well as reasons for using and not using controlled PAES. The results of the descriptive analyses demonstrated that almost one out five exercisers in the sample had a previous experience with controlled PAES. Higher prevalence rates were found in Greece and Cyprus and lower in Italy. The most frequently reported reasons for using controlled PAES included achieving the desired results faster; pushing the self to the (physical) limits; and recovering faster after exercise/training. Furthermore, the most frequently reported reasons for not using controlled PAES involved worry about any possible adverse health effects; not feeling the need for using them; and wanting to see what can be achieved naturally without using any controlled PAES. The findings of the present study indicate that the use of controlled PAES is fast becoming a crisis in amateur sports and exercise settings and highlight the need for preventive action and concerted anti-doping education efforts.

Korean national athletes' knowledge, practices, and attitudes of doping: a cross-sectional study

Background

Despite the efforts of the World Anti-Doping Agency and national anti-doping agencies at the international level, a relatively low and steady rate of positive doping tests still persists all over the world. Evidence on adolescents using doping substances exists, and the proportion of adolescents engaging in doping practices is small but significant. In relation to the international research trends on anti-doping, this study aims to evaluate doping knowledge, practices, and attitudes among Korean adult and adolescent elite athletes to provide effective information on anti-doping policies and education programs.

Methods

This study was a cross-sectional study of 454 Korean elite athletes (249 adults in 23 events and 205 adolescents in 22 events). Data were collected by an interviewer-administered questionnaire containing items regarding doping practices and knowledge, brief definitions of performance-enhancing substances/methods and recreational substances, and the Performance Enhancement Attitude Scale (PEAS).

Results

Adolescent (47.3%) and adult (57.0%) athletes received information on banned substances of their respective sports from the Korea Anti-Doping Agency, and 39.0 and 53.4% of adolescents and adults, respectively, had knowledge of banned substances and had permissive attitudes toward doping compared to those who were unaware. Adolescent and adult athletes have inadvertently (1.5 and 3.6%, respectively) or knowingly (1.0 and 2.8%, respectively) taken banned performance-enhancing substances, and 2.4 and 3.2%, respectively, knew someone who had taken banned substances. And the adolescent athletes in motor skill category (PEAS: 40.24 ± 10.91) were more permissive toward doping than those in team category (PEAS: 35.08 ± 10.21).

Conclusion

An in-depth anti-doping education for Korean athletes should be more widely implemented, and effective anti-doping policy should meet the athletes’ demographic characteristics, personalities, and values.

Understanding and using the brief Implicit Association Test: recommended scoring procedures

A brief version of the Implicit Association Test (BIAT) has been introduced. The present research identified analytical best practices for overall psychometric performance of the BIAT. In 7 studies and multiple replications, we investigated analytic practices with several evaluation criteria: sensitivity to detecting known effects and group differences, internal consistency, relations with implicit measures of the same topic, relations with explicit measures of the same topic and other criterion variables, and resistance to an extraneous influence of average response time. The data transformation algorithms D outperformed other approaches. This replicates and extends the strong prior performance of D compared to conventional analytic techniques. We conclude with recommended analytic practices for standard use of the BIAT.

Using response-time latencies to measure athletes' doping attitudes: the brief implicit attitude test identifies substance abuse in bodybuilders

Background

Knowing and, if necessary, altering competitive athletes’ real attitudes towards the use of banned performance-enhancing substances is an important goal of worldwide doping prevention efforts. However athletes will not always be willing to reporting their real opinions. Reaction time-based attitude tests help conceal the ultimate goal of measurement from the participant and impede strategic answering. This study investigated how well a reaction time-based attitude test discriminated between athletes who were doping and those who were not. We investigated whether athletes whose urine samples were positive for at least one banned substance (dopers) evaluated doping more favorably than clean athletes (non-dopers).

Methods

We approached a group of 61 male competitive bodybuilders and collected urine samples for biochemical testing. The pictorial doping Brief Implicit Association Test (BIAT) was used for attitude measurement. This test quantifies the difference in response latencies (in milliseconds) to stimuli representing related concepts (i.e. doping–dislike/like–[health food]).

Results

Prohibited substances were found in 43% of all tested urine samples. Dopers had more lenient attitudes to doping than non-dopers (Hedges’s g = -0.76). D-scores greater than -0.57 (CI95 = -0.72 to -0.46) might be indicative of a rather lenient attitude to doping. In urine samples evidence of administration of combinations of substances, complementary administration of substances to treat side effects and use of stimulants to promote loss of body fat was common.

Conclusion

This study demonstrates that athletes’ attitudes to doping can be assessed indirectly with a reaction time-based test, and that their attitudes are related to their behavior. Although bodybuilders may be more willing to reveal their attitude to doping than other athletes, these results still provide evidence that the pictorial doping BIAT may be useful in athletes from other sports, perhaps as a complementary measure in evaluations of the effectiveness of doping prevention interventions.

Beliefs about the causes of success in sports and susceptibility for doping use in adolescent athletes

The present study set out to assess the impact of attributional beliefs about success on the susceptibility for doping use in adolescent athletes. The sample consisted of 309 adolescent athletes participating in both team and individual sports. Participants completed a battery of questionnaires including Beliefs about the Causes of Success in Sport Questionnaire (BACSSQ), current and past doping use, and measures of attitudes, norms, situational temptation and social desirability. Variance reduction rate analysis revealed that social desirability did not act as a confounder in the relationship between doping susceptibility and its predictors. With regard to beliefs about the causes of success dimensions, only deception emerged as a significant predictor of doping use susceptibility over and above the effects of well-established social-cognitive predictors of doping intentions and use. These findings imply that beliefs about the causes of success in youth sports may comprise another dimension of risk factors for doping susceptibility and use.

Prevalence of use of performance enhancing drugs by fitness centre members

Studies on the use of performance enhancing drugs (PED) in fitness centres rely predominately on conventional survey methods using direct questioning. However, research indicates that direct questioning of sensitive information is characterized by under-reporting. The aim of the present study was to contrast direct questioning of different types of PED use by Dutch fitness centre members with results obtained with the Randomized Response Technique (RRT). Questionnaires were conducted among members of fitness centres. PED were classified into the following categories: anabolic steroids, prohormones, substances to counteract side-effects, growth hormone and/or insulin, stimulants (to reduce weight), and miscellaneous substances. A total of 718 athletes from 92 fitness centres completed the questionnaire. The conventional method resulted in prevalences varying between 0% and 0.4% for the different types of PED with an overall prevalence of 0.4%. RRT resulted in prevalences varying between 0.8% and 4.8% for the different types of PED with an overall prevalence of 8.2%. The overall prevalence of the two survey methods differed significantly. The current study showed that the conventional survey method using direct questioning led to an underestimation of the prevalence. Based on the RRT results, the percentage of users of PED among members of fitness centres is approximately 8.2%. Stimulants to lose weight had the highest prevalence, even higher than anabolic steroids. The key task for future preventive health work is to not only focus on anabolic steroid use, but also include interventions focusing on the use of stimulants to lose weight.

The autobiographical IAT: a review

The autobiographical Implicit Association Test (aIAT; Sartori et al., 2008) is a variant of the Implicit Association Test (IAT; Greenwald et al., 1998) that is used to establish whether an autobiographical memory is encoded in the respondent's mind/brain. More specifically, with the aIAT, it is possible to evaluate which one of two autobiographical events is true. The method consists of a computerized categorization task. The aIAT includes stimuli belonging to four categories, two of them are logical categories and are represented by sentences that are always true (e.g., I am in front of a computer) or always false (e.g., I am climbing a mountain) for the respondent; two other categories are represented by alternative versions of an autobiographical event (e.g., I went to Paris for Christmas, or I went to New York for Christmas), only one of which is true. The true autobiographical event is identified because, in a combined block, it gives rise to faster reaction times when it shares the same motor response with true sentences. Here, we reviewed all the validation experiments and found more than 90% accuracy in detecting the true memory. We show that agreement in identifying the true autobiographical memory of the same aIAT repeated twice is, on average, more than 90%, and we report a technique for estimating accuracy associated with a single classification based on the D-IAT value, which may be used in single subject's investigations. We show that the aIAT might be used to identify also true intentions and reasons and conclude with a series of guidelines for building an effective aIAT.

Attitudes Toward Anabolic-Androgenic Steroids Among Non-competing Athletes in Various Types of Sports – A Cross-sectional Study –

Aims: This study investigated the association between attitudes and intentions to use of anabolic - androgenic - steroids (AAS) between participants in various sports and within sports. Data were derived through a cross - sectional population based survey on 5,010 men and women aged 15 to 60 years. Response - rate was 34%. A combination of postal and web-based questionnaire was used. Data for the present study was restricted to 1,045 males. Results: Prevalence of AAS use was 23 (1.8 %), and 104 (5.3 %) of the respondents had considered AAS - use. On average, respondents that had considered using AAS held more positive attitudes toward AAS - use, compared to respondents without experienced within all types of sports. The biggest difference between considered and non - experienced was observed for Aerobics (1.09 CI, 0.76 - 1.41, R2 = 0.23, p = 0.000). No difference in attitudes to AAS - use between types of sports were observed. Conclusions: Attitudes toward AAS did not vary between types of sports and the level of acceptance was consistently higher among non - competing athletes with intentions to use AAS, regardless of the type of sport. The implication of the observations suggests that preventive actions against AAS use should revolve around individuals suggesting interest in AAS regardless of type of sport.

Potential and limitations of alternative specimens in doping control

Alternative specimens (e.g., hair and saliva) are well established in forensic toxicology and provide significant benefits as noninvasive, inexpensive alternatives to blood with access to improved long-term retrospection. Based on these experiences, the question of potential applications and limitations of alternative specimens in doping control arose. Compounds prohibited at all times (e.g., clenbuterol, β2 agonists, estrogen-receptor modulators) may be successfully tested and clearly interpreted in alternative specimens. In contrast, prohibition of certain compounds in sport are limited to time ranges (e.g., stimulants are only prohibited in-competition), dosages or administration routes (e.g., systemic uptake of glucocorticosteroids). This cannot be properly differentiated by semiquantitative tests (e.g., hair analyses), but may be distinguished in saliva. Similarly, proof of external administration of endogenous steroids (e.g., testosterone) only seems to be achievable by quantitative analysis of saliva. Moreover, the retrospective monitoring of the relevance of social drugs or upcoming (unapproved) substances represents promising applications of hair tests in doping control.

Detection of testosterone and epitestosterone in human hair using liquid chromatography-tandem mass spectrometry

The feasibility of using hair analysis as a complimentary test in doping control has received increased attention in the scientific community. The aim of the study was to take a step forward to this goal and develop a method that, for the first time, is able to detect testosterone (T) and epitestosterone (E) in human hair, using liquid chromatography-tandem mass spectrometry (LC-MS/MS) and alkali digestion followed by extraction using pentane. The method was linear within the quantification range of 0.25-100 pg/mg for T and 0.5-100 pg/mg for E, with determination coefficient (r²) values >0.9987. The limits of detection for T and E were 0.1 pg/mg and 0.25 pg/mg respectively. The accuracy, precision and extraction recovery of the assay were satisfactory for the detection of T and E when ca. 50 mg hair was processed. The validated method was successfully applied for the analysis of 75 hair samples collected from healthy volunteers (65.3% males), with the concentration of T between 0.7-11.81 pg/mg and 0.33-6.05 pg/mg and the concentration of E between 0.63-8.27 pg/mg and 0.52-3.88 pg/mg in males and in females respectively. In males, the T levels were significantly higher (p=0.020) but there was no difference in the E levels (p=0.359). However, E was not detectable in 34 samples (of which 19 were females). The T and E levels showed linear correlation (r=0.698, p<0.001) with average T/E ratio of 1.32±0.7. The newly developed analytical method was rapid, facile, sensitive, selective, reproducible and reliable for determining the levels of T and E in hair and thus for calculating the T/E ratio in hair.

Enzymatic digestion and selective quantification of underivatised delta-9-tetrahydrocannabinol and cocaine in human hair using gas chromatography-mass spectrometry

Gas chromatography-mass spectrometric (GC-MS) methods for drug analysis routinely employ derivatising reagents. The aim of this paper was to develop a method for the analysis of two recreational drugs, delta-9-tetrahydrocannabinol (Δ(9)-THC) and cocaine in hair samples using GC-MS, without prior derivatisation, thus allowing the sample to be reanalysed in its original form. An enzymatic digestion technique was also developed. Ten hair samples, that were known positive for either Δ(9)-THC and/or cocaine, were enzymatically digested, extracted, and then analysed by GC-MS. All samples measured contained Δ(9)-THC and one sample contained cocaine. The limits of detection (LOD) and quantification (LOQ) were 0.02 ng/mg and 0.05 ng/mg, respectively, for cocaine and 0.015 ng/mg and 0.02 ng/mg, respectively, for Δ(9)-THC. The wide detection window, ease of direct analysis by GC-MS, lower detection limits of underivatised samples, and the stability of drugs using this technique may offer an improved method of analysis.

Detection of stanozolol in environmental waters using liquid chromatography tandem mass spectrometry

Background

Owing to frequent administration of a wide range of pharmaceutical products, various environmental waters have been found to be contaminated with pharmacologically active substances. For example, stanozolol, a synthetic anabolic steroid, is frequently misused for performance enhancement as well as for illegal growth promoting purposes in veterinary practice. Previously we reported stanozolol in hair samples collected from subjects living in Budapest. For this reason we initiated this study to explore possible environmental sources of steroid contamination. The aim of this study was to develop a method to monitor stanozolol in aqueous matrices using liquid chromatography tandem mass spectrometry (LC-MS/MS).

Results

Liquid-liquid extraction using pentane was found to be an efficient method for the extraction of stanozolol from water samples. This was followed by direct detection using LC-MS/MS. The method was capable of detecting 0.25 pg/mL stanozolol when only 5 mL water was processed in the presence of stanozolol D3 as internal standard. Fifteen bottled waters analysed were found to be negative for stanozolol. However, three out of six samples from the Danube river, collected from December '09 to November '10, were found to contain stanozolol at concentrations up to 1.82 pg/mL. In contrast, only one sample (out of six) of urban tap water from Budapest city was found to contain stanozolol, at a concentration of 1.19 pg/mL.

Conclusion

The method developed is efficient, rapid, reproducible, sensitive and robust for the detection of stanozolol in aqueous matrices.

New non-randomised model to assess the prevalence of discriminating behaviour: a pilot study on mephedrone

Background

An advantage of randomised response and non-randomised models investigating sensitive issues arises from the characteristic that individual answers about discriminating behaviour cannot be linked to the individuals. This study proposed a new fuzzy response model coined 'Single Sample Count' (SSC) to estimate prevalence of discriminating or embarrassing behaviour in epidemiologic studies.

Methods

The SSC was tested and compared to the established Forced Response (FR) model estimating Mephedrone use. Estimations from both SSC and FR were then corroborated with qualitative hair screening data. Volunteers (n = 318, mean age = 22.69 ± 5.87, 59.1% male) in a rural area in north Wales and a metropolitan area in England completed a questionnaire containing the SSC and FR in alternating order, and four questions canvassing opinions and beliefs regarding Mephedrone. Hair samples were screened for Mephedrone using a qualitative Liquid Chromatography-Mass Spectrometry method.

Results

The SSC algorithm improves upon the existing item count techniques by utilizing known population distributions and embeds the sensitive question among four unrelated innocuous questions with binomial distribution. Respondents are only asked to indicate how many without revealing which ones are true. The two probability models yielded similar estimates with the FR being between 2.6% - 15.0%; whereas the new SSC ranged between 0% - 10%. The six positive hair samples indicated that the prevalence rate in the sample was at least 4%. The close proximity of these estimates provides evidence to support the validity of the new SSC model. Using simulations, the recommended sample sizes as the function of the statistical power and expected prevalence rate were calculated.

Conclusion

The main advantages of the SSC over other indirect methods are: simple administration, completion and calculation, maximum use of the data and good face validity for all respondents. Owing to the key feature that respondents are not required to answer the sensitive question directly, coupled with the absence of forced response or obvious self-protective response strategy, the SSC has the potential to cut across self-protective barriers more effectively than other estimation models. This elegantly simple, quick and effective method can be successfully employed in public health research investigating compromising behaviours.

Inside athletes' minds: preliminary results from a pilot study on mental representation of doping and potential implications for anti-doping

BACKGROUND

Despite the growing body of literature and putative links between the use of ergogenic nutritional supplements, doping and illicit drugs, it remains unclear whether, in athletes' minds, doping aligns with illicit behaviour or with functional use of chemical or natural preparations. To date, no attempt has been made to quantitatively explore athletes' mental representation of doping in relation to illegality and functionality.

METHODS

A convenience sample of student athletes from a large South-Eastern Australian university responded to an on-line survey. Competitive athletes (n = 46) were grouped based on self-reported use as follows: i) none used (30%), ii) supplement only (22%), iii) illicit only (26%) and iv) both supplements and illicit drug use (22%). Whereas no athlete reported doping, data provided on projected supplement-, doping- and drug use by the four user groups allowed evaluation of doping-related cognition in the context of self-reported supplement- and illicit drug taking behaviour; and comparison between these substances.

RESULTS

A significantly higher prevalence estimation was found for illicit drug use and a trend towards a biased social projection emerged for supplement use. Doping estimates by user groups showed mixed results, suggesting that doping had more in common with the ergogenic nutritional supplement domain than the illicit drug domain.

CONCLUSIONS

Assessing the behavioural domain to which doping belongs to in athletes' mind would greatly advance doping behaviour research toward prevention and intervention. Further investigation refining the peculiarity of the mental representation of doping with a larger study sample, controlling for knowledge of doping and other factors, is warranted.

Incongruence in doping related attitudes, beliefs and opinions in the context of discordant behavioural data: in which measure do we trust?

Background

Social psychology research on doping and outcome based evaluation of primary anti-doping prevention and intervention programmes have been dominated by self-reports. Having confidence in the validity and reliability of such data is vital.

Methodology/Principal Findings

The sample of 82 athletes from 30 sports (52.4% female, mean age: 21.48±2.86 years) was split into quasi-experimental groups based on i) self-admitted previous experience with prohibited performance enhancing drugs (PED) and ii) the presence of at least one prohibited PED in hair covering up to 6 months prior to data collection. Participants responded to questionnaires assessing a range of social cognitive determinants of doping via self-reports; and completed a modified version of the Brief Implicit Association Test (BIAT) assessing implicit attitudes to doping relative to the acceptable nutritional supplements (NS). Social projection regarding NS was used as control.

PEDs were detected in hair samples from 10 athletes (12% prevalence), none of whom admitted doping use. This group of ‘deniers’ was characterised by a dissociation between explicit (verbal declarations) and implicit (BIAT) responding, while convergence was observed in the ‘clean’ athlete group. This dissociation, if replicated, may act as a cognitive marker of the denier group, with promising applications of the combined explicit-implicit cognitive protocol as a proxy in lieu of biochemical detection methods in social science research. Overall, discrepancies in the relationship between declared doping-related opinion and implicit doping attitudes were observed between the groups, with control measures remaining unaffected. Questionnaire responses showed a pattern consistent with self-reported doping use.

Conclusions/Significance

Following our preliminary work, this study provides further evidence that both self-reports on behaviour and social cognitive measures could be affected by some form of response bias. This can question the validity of self-reports, with reliability remaining unaffected. Triangulation of various assessment methods is recommended.

Methodological considerations regarding response bias effect in substance use research: is correlation between the measured variables sufficient?

Efforts for drug free sport include developing a better understanding of the behavioural determinants that underline doping with an increased interest in developing anti-doping prevention and intervention programmes. Empirical testing of both is dominated by self-report questionnaires, which is the most widely used method in psychological assessments and sociology polls. Disturbingly, the potential distorting effect of socially desirable responding (SD) is seldom considered in doping research, or dismissed based on weak correlation between some SD measure and the variables of interest. The aim of this report is to draw attention to i) the potential distorting effect of SD and ii) the limitation of using correlation analysis between a SD measure and the individual measures. Models of doping opinion as a potentially contentious issue was tested using structural equation modeling technique (SEM) with and without the SD variable, on a dataset of 278 athletes, assessing the SD effect both at the i) indicator and ii) construct levels, as well as iii) testing SD as an independent variable affecting expressed doping opinion. Participants were categorised by their SD score into high- and low SD groups. Based on low correlation coefficients (<|0.22|) observed in the overall sample, SD effect on the indicator variables could be disregarded. Regression weights between predictors and the outcome variable varied between groups with high and low SD but despite the practically non-existing relationship between SD and predictors (<|0.11|) in the low SD group, both groups showed improved model fit with SD, independently. The results of this study clearly demonstrate the presence of SD effect and the inadequacy of the commonly used pairwise correlation to assess social desirability at model level. In the absence of direct observation of the target behaviour (i.e. doping use), evaluation of the effectiveness of future anti-doping campaign, along with empirical testing of refined doping behavioural models, will likely to continue to rely on self-reported information. Over and above controlling the effect of socially desirable responding in research that makes inferences based on self-reported information on social cognitive and behavioural measures, it is recommended that SD effect is appropriately assessed during data analysis.

Promoting functional foods as acceptable alternatives to doping: potential for information-based social marketing approach

Background

Substances with performance enhancing properties appear on a continuum, ranging from prohibited performance enhancing drugs (PED) through dietary supplements to functional foods (FF). Anti-doping messages designed to dissuade athletes from using PEDs have been typically based on moralising sport competition and/or employing scare campaigns with focus on the negative consequences. Campaigns offering comparable and acceptable alternatives are nonexistent, nor are athletes helped in finding these for themselves. It is timely that social marketing strategies for anti-doping prevention and intervention incorporate media messages that complement the existing approaches by promoting comparable and acceptable alternatives to doping. To facilitate this process, the aim of this study was to ascertain whether a single exposure knowledge-based information intervention led to increased knowledge and subsequently result in changes in beliefs and automatic associations regarding performance enhancements.

Methods

In a repeated measure design, 115 male recreational gym users were recruited and provided with a brief information pamphlet on nitrite/nitrate and erythropoietin as a comparison. Measures of knowledge, beliefs and automatic associations were taken before and after the intervention with at least 24 hours between the two assessments. The psychological tests included explicit measures of beliefs and cognitive attitudes toward FF and PED using a self-reported questionnaire and computerised assessments of automatic associations using the modified and shortened version of the Implicit Association Test.

Results

The information based intervention significantly increased knowledge (p < 0.001), changed explicit beliefs in specific FF (p < 0.001) and shifted the automatic association of FF with health to performance (p < 0.001). Explicitly expressed beliefs and automatic associations appear to be independent.

Conclusion

Evidence was found that even a single exposure to a persuasive positive message can lead to belief change and can create new or alter existing associations - but only in the specific domain. Interventions to change outcome expectations in a positive way could be a rewarding avenue for anti-doping. Effective social marketing campaigns for drug free sport should follow appropriate market segmentation and use targeted messages via promoting the natural form as opposed to the purified form of the main active ingredient.