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Social Psychology of Doping in Sport: a Mixed-Studies Narrative Synthesis

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Social Psychology of Doping in Sport: a Mixed-Studies Narrative Synthesis Social psychology of doping in sport: a mixed-studies narrative synthesis Prepared for the World Anti-Doping Agency By the Institute for Sport, Physical Activity and Leisure Review Team The review team comprised members of the Carnegie Research Institute at Leeds Beckett University, UK. Specifically the team included: Professor Susan Backhouse, Dr Lisa Whitaker, Dr Laurie Patterson, Dr Kelsey Erickson and Professor Jim McKenna. We would like to acknowledge and express our thanks to Dr Suzanne McGregor and Miss Alexandra Potts (both Leeds Beckett University) for their assistance with this review. Address for correspondence: Professor Susan Backhouse Institute for Sport, Physical Activity and Leisure Leeds Beckett University, Headingly Campus Leeds, LS6 3QS UK Email: [email protected] Web: www.leedsbeckett.ac.uk/ISPAL Disclaimer: The authors undertook a thorough search of the literature but it is possible that the review missed important empirical studies/theoretical frameworks that should be included. Also, judgement is inevitably involved in categorising papers into sample groups and there are different ways of representing the research landscape. We are not suggesting that the approach presented here is optimal, but we hope it allows the reader to appreciate the breadth and depth of research currently available on the social psychology of doping in sport. October 2015 2 Table of Contents Executive Summary .................................................................................................................. 6 Introduction ............................................................................................................................... 9 Athlete Support Personnel .................................................................................................... 13 Adolescent Athletes ............................................................................................................... 35 Competitive Athletes ............................................................................................................. 60 Elite Athletes ........................................................................................................................... 98 Gym users .............................................................................................................................. 141 General Public ....................................................................................................................... 160 Intervention Studies ............................................................................................................. 171 Theoretical Perspectives on Doping Behaviours .............................................................. 185 The Wider Science of Behaviour Change .......................................................................... 210 Synthesis and Future Focus ................................................................................................. 219 References ............................................................................................................................. 233 Appendix: Search Strategy .................................................................................................. 261 3 List of Figures Table Title 1 Modified sport drug control model. 2 The life-cycle model of performance enhancement. 3 Incremental model of doping behaviour. 4 Factors influencing PED use in sport. 5 Conceptual model of contextual variables and attitudes towards substances in sport. 6 Determinants of performance enhancing substances and methods use. 7 Systemic model of doping behaviour. 8 A conceptualisation of the relationship among the person, the environment and doping. 9 A hypothesised integrative model of doping intentions. 10 Prototype willingness model applied to doping behaviours. 11 Doping and anti-doping correlates 4 List of Tables Table Title 1 Overview of descriptive studies examining the doping knowledge, attitudes and beliefs of athlete support personnel. 2 Overview of studies that employed regression analysis to identify variables that were predictive of AAS use in adolescent athletes. Overview of studies that employed regression analysis to identify variables 3 that were predictive of doping intentions/doping use in adolescent athletes. 4 Overview of descriptive studies examining the doping knowledge, attitudes and beliefs of adolescent athletes. 5 Overview of descriptive studies examining the knowledge, attitudes and beliefs of competitive athletes. 6 Overview of studies employing inferential statistics to identify variables that were predictive of doping intentions/doping use in competitive athletes. 7 Overview of descriptive studies examining the doping knowledge, attitudes and beliefs of elite athletes. 8 Overview of studies that employed regression analysis to identify variables that were predictive of doping intentions/doping use in elite athletes. 9 Overview of descriptive studies examining the doping knowledge, attitudes and beliefs of gym users. 10 Overview of descriptive studies examining the correlates, reasons and motives for AAS use in gym users. 11 Overview of studies that employed regression analysis to identify variables that were predictive of doping intentions/doping use in gym users. 12 Overview of descriptive studies examining the doping knowledge, attitudes and beliefs of the general public. 13 Overview of studies employing regression analysis to identify sport/training specific predictors of AAS use in the general public. 14 Overview of studies investigating doping prevention programmes. 5 Executive Summary Introduction: Even though the concept of doping in sport first penetrated the broader public consciousness on a global scale nearly three decades ago, the social sciences have been slow to enter the debate. However, a vision for prevention is emerging. In recent years the World Anti-Doping Agency (WADA) has made a growing investment in social science research, recognising the need to move beyond detection-deterrence approaches. Concerns about systematic doping, an era of austerity and the acceptance of an ever-growing scientific basis for intervention, demand the use of robust and cost- effective strategies to prevent sport doping. Now, social scientists are more involved and the research landscape is developing rapidly. Social science is, in its broadest sense, the study of society and the manner in which people behave and influence the world around us. It tells us about the world beyond our immediate experience, and can help explain how our own society works. In the context of doping in sport, social science helps us to examine how and why athletes dope. The work of these researchers provides vital information for governments and policymakers, local authorities, non-governmental organisations and others. Insofar as doping in sport can be seen as having many human facets, this update to our 2007 review explores the contribution of social psychology to our understanding of doping in sport and considers recent empirical research alongside prevention programming. Commissioned by the WADA, the review aims to build on the findings of our previous review by summarising the current evidence. The review focuses on (i) psychosocial correlates and predictors of doping in sport, (ii) knowledge, attitudes, beliefs and behaviours towards (anti-) doping, (iii) efficacy and effectiveness of anti-doping education programmes, and (iv) doping specific models and theories. The new mixed- studies synthesis provides researchers, policymakers and practitioners with a comprehensive summary of current progress in the field. Method: The review was conducted in line with guidelines devised by the UK National Health Service Centre for Reviews and Dissemination. An extensive search of the literature was conducted using electronic resources, including PubMed, Ingenta, EBSCO (Academic Search Complete, Business Source Premier, CINAHL, Hospitality and Tourism Complete, LISTA, Medline, psycARTICLES, psycINFO, SportDiscus). The search strategy employed keywords for drug use in sport: ‘doping’, ‘performance-enhancing drugs’, ‘performance-enhancing substances’ and ‘drugs AND sport’ combined with selected terms relating to specific areas of interest, such as: 1) ‘attitudes’, ‘beliefs’, ‘knowledge’, ‘perspectives’, ‘perceptions’, ‘opinions’, 2) ‘correlates’, ‘determinants’, ‘risk factors’, ‘predictors’ ‘precipitating factors’, and 3) ‘education’, ‘intervention’, ‘model’, ‘prevention’. The review was limited to peer-reviewed articles written in the English language and published from 1st January 2007 to 1st May 2015. Findings: Using our inclusion criteria 212 peer-reviewed articles were considered. This equates to an annual average of 26 papers published each year, far exceeding the annual average of six papers per year in 2007. Thus the field has seen a rapid increase 6 in the quantity and quality of studies examining the social psychology of doping. The majority of studies examined doping correlates, as well as the knowledge, attitudes and beliefs of athlete support personnel, athletes (adolescent, elite and competitive), gym users, and the general public. Signalling the emerging nature of this area of work, only a handful of studies have progressed to present either the outcomes of anti-doping education programmes or to develop specific anti-doping theory/models. The review identified multiple forms of deductively and inductively derived evidence. However, the heterogeneity of the studies
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