Drug abuse in sport: how to build a drug free team

The social-psychological profile of athletes at risk of doping and some expert tips on building a ‘clean’ team.

As the incidence of doping continues to rise, coaches and policy makers struggle to pull in the reins on this increasing practice. Alicia Filley explains the social-psychological profile of athletes at risk of doping and provides some expert tips on building a ‘clean’ team.

Social and psychological determinants

Whether or not you agree, the rules concerning doping, put forth by the World Anti-Doping Agency (WADA), speak loudly and clearly – doping in sport will not be tolerated. Despite the effort by WADA’s educational and testing programs, the incidence of doping use did not decrease as expected(1). To understand why an athlete would risk his health, future, and reputation by doping, social scientists are now studying the psychology of an athlete’s decision-making process.
To determine which social and psychological factors played a greater role in the decision to use performance-enhancing drugs (PED), investigators in the Netherlands surveyed 144 adult gym users (2). Attitudes, personal norms, self-efficacy and social influences, were compared with background characteristics to determine which factor had the greatest influence on intention to use PED. Respondents were divided into three groups: current users (15% of population), former users (18% of population) and non-PED users. Of the total number of respondents, 29% acknowledged intention to use PED in the future.

The results showed that previous use of PED was the strongest predictor of intention to use PED in the future. Personal norms that supported winning – no matter the cost – also influenced an athlete toward considering using PED. In addition, current and former PED users displayed overly optimistic attitudes about how PED would enhance their performance and overestimated the number of colleagues and competitors also using PED.

The end game

British researchers highlighted the distinction between doping behaviour and substance abuse(3).  Doping behaviour is a means to an end. Therefore, models developed to analyse doping behaviour should also include evaluation of attitudes toward the end goal.

Attitudes toward competitiveness, winning, and achievement of goals, as they relate to doping behaviour, were measured through questionnaires completed by 174 US collegiate-level, male athletes (see figure 1). Surprisingly, none of the sports orientation measures correlated positively with doping behaviour. Winning orientation was the only variable with a significant relationship to doping attitude. In other words, attitudes toward winning may influence what an athlete thinks about doping, but it does not translate into using PED.

Figure 1

Researchers were also surprised that attitudes toward doping did not significantly influence doping behaviour. The only variable with a strong and significant relationship to doping behaviour was doping beliefs. Respondents who believed that the use of PED should be allowed for athletes were more likely to use them. Therefore, it seems that an athlete does not have to be highly driven to win in order to have a predisposition toward doping.

Sports orientation can also be defined in terms of prevailing attitudes toward goal achievement. Polish researchers defined goal achievement in terms of task orientation (perceiving success in self-referenced terms, such as doing one’s best) or ego orientation (viewing success in comparison to the performance of others, such as beating the competition)(4). When 830 athletes were surveyed, researchers found that the more ego-oriented an athlete is, the more positive his attitude toward doping.

Athletes can have varying degrees of each orientation. According to this study, a high ‘task orientation’ can over-ride any degree of ego orientation and produce negative attitudes toward doping. The environment in which athletes compete influences their goal orientation. A ‘mastery climate’ creates an environment that fosters ‘being the best you can be’. A ‘performance climate’ fosters an orientation toward ‘winning at any cost’.

Beyond beliefs

In psychology, it is generally accepted that beliefs influence attitudes, and attitudes influence behaviour. Puzzled by their previous study where doping beliefs had an effect on doping behaviour, while doping attitude did not, investigators at Kingston University, UK, developed a model evaluation tool to get beyond expressed beliefs and attitudes and measure unconscious attitudes toward doping(3,6).

They borrowed the idea of ‘implicit attitudes’ from social psychology. Implicit attitudes are automatic unconscious responses a person has about a topic that may differ from the attitudes a person expresses about that topic. Implicit attitudes that continue to exist and play a role in decision making, despite new explicit attitudes being acquired, could explain the discrepancy discovered in their previous work.

Researchers adapted the Implicit Associations Test (IAT) to compare implicit doping attitudes to those measured via a self-reported questionnaire. One advantage of the IAT is that it is immune to the response bias inherent in questionnaires. In this pilot study of 78 sports and exercise students (of whom 61.2% were involved in competitive sports), the positive correlation between attitudes about PED expressed in the explicit and implicit tests were strong, but not significant. However, when looking at hypothetical doping scenarios where respondents estimated the likelihood of their using PED, the correlation between the implicit and explicit attitudes was weaker for those students who were also athletes. This suggests a discrepancy between what they say and what they implicitly believe about their behaviour.
The authors acknowledge that the choice to engage in the use of banned substances is not an automatic response. However, despite what they may profess, those athletes with preferentially implicit attitudes toward doping may be inclined to use PED when they encounter doping opportunities. According to the iterative reprocessing model, decision-making is a cyclical process between automatic responses and expressed attitudes(7). The decision comes as the discrepancy between the implicit and explicit attitudes are resolved.

The life-cycle model

Seeking a way to influence that decision-making process, the same researchers collaborated with the School of Psychology at the University of Adelaide in Australia, and developed the life-cycle model of performance enhancement(8). This model is based upon the ‘expectancy theory’. Expectancy theory proposes that behaviour is driven by expected positive outcomes while at the same time, made less likely by expected negative outcomes. Therefore, the authors hypothesised that the balance of positive and negative expectancies associated with doping governs doping behaviour.

The life-cycle model is based upon the assumption that doping behaviour is a natural progression of habitual participation in acceptable means of performance enhancement. This model also assumes that doping is a ‘functional’ use of drugs to achieve a desired outcome and differs from recreational and social drug abuse. Therefore, this model implies that doping is a rational, intentional behaviour and as such, offers intervention points to influence the decision making process (see figure 2). 

Figure 2

The first stage of the life-cycle model is ‘choice’. A performance target is set and a strategy to achieve that target is chosen. Intervention at this stage can modify doping expectancy by providing acceptable alternatives to PED as well as reinforcing the negative aspects of them. ‘Goal commitment’ is the second stage and addresses the question of desirability of the goal. Motivation becomes an important intervention strategy at this stage, as an athlete may be looking for a ‘quick fix’ to substitute for hard work.

The third stage is ‘execution’. Here is where intentions are put into practice. At this stage, an athlete may wonder what he has gotten himself into and look for an easy way out. Support from significant others in both the athletic environment and at home is important to prevent the choice of PED as a means to decrease personal commitment to the training protocol. ‘Goal attainment feedback’ follows, as achieved results are compared to the original goal. At this stage, performance enhancing expectancies are compared with actual results.

Whether or not the performance enhancement plan worked is examined in the ‘goal evaluation and adjustment’ phase. Intervention at this stage is geared toward emphasising shortcomings or negative experiences from the strategy. If an athlete is not entirely satisfied with the outcome of their choice, they are likely to be more open to safe alternatives. The athlete is then left with the choice to repeat the previous performance enhancement cycle, repeat that cycle with modifications, or abandon that effort entirely.

This model completely bypasses the complexity of attitudes and beliefs and focuses on the decision-making process involved in choosing any method of performance enhancement. This model also offers a way to bring the decision making out of the realm of psychological introspection and into the locker room. Coaches, trainers, medical personnel and significant others can participate in this cycle at various stages with the intention to influence doping expectancies in such a way that the negative expectancies outweigh the positive performance enhancing possibilities.

The fact that individuals who intend to use PED are overly optimistic about their benefits is consistent throughout the studies. Is this expectation alone enough to influence performance? Researchers at the Scottish Institute of Sport answered that question using a research design that specifically tests for placebo effect. After being divided into one of four experimental groups, 16 endurance athletes completed a 1,000m time trial (see figure 3) (9).

Figure 3

Those athletes who believed they took a performance enhancing substance (sodium bicarbonate and placebo additives) but actually did not (DN), performed nearly as well as those who believed they took the drug and actually did (DD). In addition, the rate of perceived exertion for the DN group was the lowest of all the groups. Those athletes who were told they did not take the drug, but actually did (ND), showed no significant improvement in their performance. This study not only casts doubt on the actual pharmacological benefit of PED, but also challenges coaches and policy makers. Perhaps the way to decrease doping use is to shift focus and expectations away from them entirely and emphasise acceptable means of building a better athlete.

Advice from an expert

Jonathan Vaughters, former pro-cyclist and founder, CEO, and director sportif of the Garmin-Slipstream pro-cycling team, is leading the charge to change cycling. Vaughters founded Slipstream on the principles of racing hard and racing clean. Now, he is showing the world that racing clean also means winning. He shared how an amateur team can imitate his success.  

Be professional – There is nothing romantic about Vaughters’ view of what it takes to make athletes winners. Vaughters says, ‘If you can’t win clean at the amateur level, than you have absolutely no hope of being any kind of a good professional. Ever.’ Training like a professional means being detailed, task oriented, and focused. It means maximising what you are and pushing your body as far as it can go. If you’re not getting the results you want, you need to look at your preparation.

‘Perfect the process’ – Coaches can model Vaughters approach by providing athletes with the tools and preparation to win clean. Take advantage of every training technique and resource at your disposal. Keep current with the research in your field. Put your heart into providing the athletes with the maximum (legal) possibilities to win. Vaughters suggests that often something simple and inexpensive, like surface testing cyclists, will improve an athlete’s performance and demonstrate your commitment to them. If your athlete’s performance would benefit from better nutrition, go grocery shopping with them or cook for them. What this level of preparation requires is time and commitment. ‘Once the athletes know you are personally invested in them becoming the best they can be, they realise they can’t let you down by doping,’ Vaughters says.

Avoid hypocrisy – Vaughters cautions coaches who may be talking out of both sides of their mouth. ‘You have to make sure your message is consistent. You can’t say your team is all about clean competition, come up short on what you personally invest in the preparation, and then pressure your athletes at the start line to win “or else”. I provide every possible tool for them to prepare for competition so by the time they reach the starting line, it’s just sport.’
 Culture shock – The Slipstream team creates a ‘task oriented’ culture where the implicit and explicit messages are aligned with their mission. Vaughters advises coaches to be wary of cliques forming within a team. Strive to create a mastery climate where everyone achieves his personal best and encourages others. Shift the focus from concern about competitors’ doping behaviour to emphasis on your team’s preparation. Vaughters agrees with the research, ‘ Those athletes most concerned about competitors’ doping are the ones most obsessed with whether or not they themselves are going to do it.’ Slipstream has so eradicated the option of doping from their culture, the subject of others doing it doesn’t even come up.

Incentives – Vaughters uses his resources to reward his team for their success. He challenges coaches to do the same to motivate their athletes to go the extra mile in training and attitude. Find things that work within your budget and rewards that drive your athletes. Designate a ‘sportsman of the week’ and reward those who put forth extra effort with a premier parking spot, a profile in the local or school paper, a pro-shop gift card, a chance to be entered into a drawing for a sports massage donated by a local business, or be first in the locker room, etc. Vaughters advises coaches, ‘ Stay on top of the reasons athletes dope, and incentivise them not to.’

Alicia Filley, PT, MS, PCS, lives in Houston, Texas and is vice president of Eubiotics: The Science of Healthy Living, which provides counselling for those seeking to improve their health, fitness or athletic performance through exercise and nutrition

References

1. Br. Med Bull. 2008;86:95-107
2. Health Educ Res. 2008 Feb;23(1):70-80
3. Subst Abuse Treat Prev Policy. 2007 Nov 9;2:34
4. Int J Sports Med. 2008 Jul;29(7):607-12
5. Int J Sports Med. 2006 Oct:27(10):842-6
6. Subst Abuse Treat Prev Policy. 2008 April 21;3:9
7. Trends Cogn Sci. 2006;11(3):97-104
8. Subst Abuse Treat Prev Policy. 2008 March 10;3:7
9. J Sport Exerc Psychol. 2007 Jun;29(3):382-94
 

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