Context
The mission of WADA is to “promote, co‐ordinate and monitor, on an international basis, the fight against doping in sport in all its forms” (WADA, 2009; p. 2). To further WADA’s anti‐doping initiatives, a Social Sciences Research Grant Program was created to “encourage research in the social sciences and to obtain information, which will enable more efficient doping‐prevention strategies” (p.2).

The present study was funded by the WADA Social Sciences Research Grant Program. The general aims of this project were to:

1. Identify factors that motivate young athletes to use performance enhancing drugs (PEDs)
2. Identify factors that deter young athletes from using PEDs.

Conclusions
The findings of the present research show that there is a clear link between moral functioning, as originally conceptualized by Rest (1984) and attitudes towards PEDs. There is also a clear link
between moral disengagement, as originally conceptualised by Bandura (1991) and attitudes towards PEDs. In short, morality, however it is theoretically conceptualised and operationalised, predicts attitudes to doping.
It is necessary to develop training programs that aim to educate young athletes and thus deter future drug use. However, there are some conceptual issues that should be addressed before embarking on any such efforts. While the current study shows a strong link between morality and attitudes to PEDs, when asked to identify the ‘top of mind’ disadvantages of PED use, the respondents overwhelmingly identified health related problems.
Future research employing measures of morality based on both Rest’s and Bandura’s may be warranted, particularly if placed in a broader framework aiming to develop a reliable and valid measure of morality in sporting contexts. This should clearly include contexts such as PED use.

This study examined intermediate and high school students’ attitudes toward and behavior regarding steroids and sports supplements use with a sample of junior high school and high school students from Nassau and Suffolk Counties on Long Island, New York. Behavior was measured by questions about respondents’ future steroid use, and current sports supplements use. Attitudes were measured through respondents’ reactions to whether it was appropriate for their peers and themselves to use steroids and sports supplements in a variety of corporeal situations, and the degree to which use of these substances impacted fairness and health issues. Respondents’ also decided whether the use of steroids and sports supplements was legitimate in three specific scenarios involving fictitious male and female high school students, and gave reasons for their decisions. The respondents’ answers and choices were described and assessed for the effect of gender and level of school (junior high school and senior high school). The effect of their clique identity on steroids and sports supplements attitudes and behavior was also assessed. The potential relationship between sports supplements and steroid use was described, and finally a profile presented of the respondents who predicted that they would be very likely to use steroids in the future.

The most consistent finding in the descriptive phase of the results was the negative reaction to steroid use by the great majority of respondents. Steroid use was perceived as inappropriate across all the descriptive measures, for respondents’ own behavior, the behavior of their peers, for specific fairness and health issues, and in the fictitious athletic and fitness scenarios. This rejection of steroid use was made independent of gender and level of school, although a small but statistically significant age effect was found. While some statistically significant male and female differences were found, these were differences of degree not differences in direction. Specifically, male and female participants never differed in their endorsement of steroid use (i.e., one group in favor and the other group against), only in the degree to which they felt that steroid use was wrong. Differences of degree also characterized the few differences between junior high school and high school participants. The negative attitudes about steroid use were also reflected in the clique analysis. This analysis showed some clique effects but no differences in direction. Members of the “jock” and “regular’ cliques expressed the most negative views about steroid use, while members of the “troublemakers” group expressed the least negative views.

The psychological and social factors of risk and protection vis-a-vis doping. A study among callers using a national anti-doping hotline "Ecoute dopage" = Les enquêtes épidémiologiques montrent que le dopage sportif est un phénomène massif en constante augmentation dans nos sociétés / Jean Bilard, J. Birouste, Gregory Ninot, A. Pastor, P. Salas

Nous avons vu qu’une politique de prévention du dopage doit s’attacher à connaître les raisons, les motivations, les comportements, les besoins, les attentes des acteurs et que pour cela, nous devions utiliser toutes les ressources disponibles.

Dans ce but, nous nous sommes proposé d’étudier les facteurs de protection psychosociaux vis-à-vis du dopage dans un corpus de données particulier constitué par les fiches d’entretiens téléphoniques du service « écoute dopage ». Nous avons choisi d’étudier les fiches des appelants adultes hommes non dopés et pratiquant les trois sports les plus représentés dans notre corpus: la musculation, le cyclisme et le football. Le contenu de chaque fiche a été interprété par deux chercheurs afin de dégager le ou  les facteurs de protection sous jacents référés dans la grille de cotation établie à partir des facteurs de protection psychosociaux vis-à-vis du dopage relevés dans la littérature et d’une pré-analyse des fiches d'écoute. Nous avons établi les occurrences de chaque
facteur en fonction de la population globale étudiée et pour les trois types de sports. Parcette recherche exploratoire quantitative et qualitative, nous espérions aboutir à des résultats originaux par rapport à ceux des études épidémiologiques.

Or nos résultats soulignent plutôt la prédominance de facteurs de protection classiques considérés par certains comme peu inefficaces. Notre étude confirme la prévalence du facteur « préoccupation pour la santé » comme protecteur vis-à-vis du dopage et donc l'importance de la prévention par ce canal. Les facteurs « respecter la loi », versant internalisé et «existence de contrôle par l’environnement », apparaissent comme bien plus importants que ne le décrit la littérature. Ils engagent les pouvoirs publics à poursuivre une attitude ferme (sanctions) et répressive (contrôles et investigations de la police). Nos travaux montrent par ailleurs que la "loi" sportive et sociale est un appui fort pour cadrer les conduites de santé même dans les milieux considérés comme peu sensibles (bodybuilders; cyclistes). Nous avons souligné quelques facteurs importants peu mentionnés dans la littérature comme l'attitude dubitative des sportifs vis-à-vis de la connaissance des médecins. Nous avons montré qu'il fallait développer la réflexion critique sur l'efficacité des produits et sur les conduites dopantes (balance risques / effets). Ce dernier point ouvre sur des actions de prévention telles que l'éducation à la santé, la mise en place de groupes de parole mais aussi sur des messages très spécifiques en fonction des sports pratiqués. Nous avons pu ainsi souligner le paradoxe des messages de prévention vis-à-vis des cyclistes axés sur les effets néfastes pour la santé des médicaments (corticoïdes) alors qu'ils en prennent pour rester en bonne santé. De la même manière nous avons vu de quelle façon les 33 anabolisants apparaissent pour les bodybuilders un excellent moyen de se donner une bonne image d'eux mêmes et donc de contribuer à leur santé mentale!

Notre recherche a surtout permis de distinguer des dynamiques différentes autour de la thématique du dopage et d'orienter les actions de prévention à partir du vécu et des représentations de la population sportive. Nous espérons enfin avoir ouvert des pistes de recherche pour des études cliniques complémentaires.

The Development and Validation of a Doping Attitudes and Behaviour Scale / S. Guerin, K. Kirby, A.Moran

Athletes’ use of prohibited ergogenic substances for performance enhancement is a form of cheating behaviour which can jeopardise both their health and their careers. Given such importance, it is not surprising that the problem of drug-use in competitive sport has been widely studied. Unfortunately, research in this field has at least three obvious limitations. First, few studies have attempted to explain why athletes are willing to use these substances, given the risks involved (Anshel, 2005). Second, little effort has been made to understand the theoretical mechanisms underlying cheating/doping behaviour in athletes. Finally, there is a paucity of research on elite athletes’ attitudes to, and beliefs about, doping in sport. These oversights are unfortunate because antidoping measures cannot be fully effective unless they are based on solid evidence about why athletes (especially elite performers) engage in drug-taking in the first place. To address these gaps in the literature, the first phase of the present study examines the psychological variables underlying attitudes to drug use in sport.
To date, 375 high performance (HP) athletes have been surveyed on their attitudes to doping, and a number of relevant psychological variables have also been measured. Interesting findings have emerged on the perceived and reported incidence of doping in sport, athletes’ knowledge of doping substances and differences in attitudes between various demographic groups. Statistical results also show some significant relationships emerging between doping attitudes and psychological characteristics, including perfectionist tendencies and motivational variables. This is the first time an empirical investigation has examined such a multitude of relationships, and the results have guided the next stage of the research; a qualitative focus on the views of athletes
who have direct experience of doping.

Phase 2 of the study involved exhaustive searches of media reports, seeking athletes who publicly admitted to engaging in doping practices. Over a 30-month period, this list extended to almost 80 elite athletes who were identified as potential interview candidates for this qualitative phase of the research. Following the compilation of the list, efforts were made to contact these athletes through their national governing bodies, national anti-doping agencies, and journalists with whom they had spoken in the past.
However, this proved much more difficult than originally anticipated for two reasons:
(a) because it was not possible to obtain contact details for high profile athletes and
(b) because those who were contacted were not willing to partake in the research, despite assurances of anonymity and confidentiality. The sample size totals 4 athletes who have
admitted doping offences, but in light of the very limited number of potential participants and the sensitive nature of the research topic, this was a reasonable number from which to extract a thematic analysis. Interesting explorations of both the internal and external sources of influence on athletes’ doping practices emerged, along with more in-depth analysis of the psychological variables which may guide doping decisions.

The final stage of the research, the development and validation of a doping attitudes and behaviour scale (DABS) will be informed by findings from both the aforementioned quantitative and qualitative research studies.

The main aim of this project is to explore how social media platforms can be harnessed to promote anti-doping behaviour among young people and applied in various localities by anti-doping organisations worldwide.

More specific aims of the research contributing to the development of this guidance were to explore:
- How social media can be used to influence attitudes and behaviours of people toward social issues comparable to doping:

• The pros and cons of social marketing as compared to other approaches;
• When social marketing should be used and when alternatives should be considered;
• Specific methods of communicating online which are particularly successful in aiding behavioural/attitudinal change;
• Guiding principles which underpin successful or innovative social media campaigns.

Many activities focusing on Dutch elite sport have been transferred to the elite sport campaign, 100% Dope Free. In addition to providing information, this campaign focuses also on changing attitudes and behaviour.

Objectives of this program are:
- Increasing the awareness of athletes that it is their responsibility to keep the sport healthy and clean.
- To show that Dutch athletes actively support clean sport.
- To show a new generation that sport without doping is very well possible.
- To be a source of inspiration for the new generation.

Attitudes, Behaviours, Knowledge and Education – Drugs in Sport: Past, Present and Future / Susan Backhouse, Jim McKenna, Simon Robinson, Andrew Atkin

Based upon the need identified by WADA, the review provides an extensive annotated bibliography of peer reviewed publications in the social sciences regarding (a) predictors and precipitating factors in doping; (b) attitudes and behaviours towards doping and (c) anti-doping education or prevention programs. The database created during this review should be maintained so that future research in this area can be centrally documented and recorded.

The Findings
One hundred and three articles met the inclusion criteria and were considered in this review. Of these, 69 articles considered the attitudes of various target groups, 18 studies sought to examine the precipitating factors and correlates of performance enhancing drug use and 16 articles presented the findings of education intervention studies or model development in relation to doping in sport.

Conclusion
The evidence presented in this review leads to a simple conclusion: the weak evidence base undermines strategic planning and limits the capacity to target appropriate and efficacious education programmes to abate doping in sport.

Recommendations
This review has highlighted a number of key priorities in the social science research field. For example, adopting a Behavioural Epidemiological Framework would direct research efforts. Employing a variety of research designs from the upper echelons of the evidence hierarchy would facilitate the examination of causality and developing psychometrically sound measurement tools would enhance the validity and reliability of findings. Finally, the collaborative networks between practitioner and researcher need to be established so that evidence based findings inform the strategic planning of interventions and enable effective monitoring and evaluation.

Long-term psychiatric and medical consequences of anabolic-androgenic steroid abuse : a looming public health concern? Gen Kanayama, James I. Hudson, Harrison G Pope Jr. - (Drug and Alcohol Dependence 98 (2008) 1-2 (1 November); p 1-12

• PMID: 18599224
• PMCID: PMC2646607
• DOI: 10.1016/j.drugalcdep.2008.05.004

Abstract

Background: The problem of anabolic-androgenic steroid (AAS) abuse has recently generated widespread public and media attention. Most AAS abusers, however, are not elite athletes like those portrayed in the media, and many are not competitive athletes at all. This larger but less visible population of ordinary AAS users began to emerge in about 1980. The senior members of this population are now entering middle age; they represent the leading wave of a new type of aging former substance abusers, with specific medical and psychiatric risks.

Methods: We reviewed the evolving literature on long-term psychiatric and medical consequences of AAS abuse.

Results: Long-term use of supraphysiologic doses of AAS may cause irreversible cardiovascular toxicity, especially atherosclerotic effects and cardiomyopathy. In other organ systems, evidence of persistent toxicity is more modest, and interestingly, there is little evidence for an increased risk of prostate cancer. High concentrations of AAS, comparable to those likely sustained by many AAS abusers, produce apoptotic effects on various cell types, including neuronal cells--raising the specter of possibly irreversible neuropsychiatric toxicity. Finally, AAS abuse appears to be associated with a range of potentially prolonged psychiatric effects, including dependence syndromes, mood syndromes, and progression to other forms of substance abuse. However, the prevalence and severity of these various effects remains poorly understood.

Conclusions: As the first large wave of former AAS users now moves into middle age, it will be important to obtain more systematic data on the long-term psychiatric and medical consequences of this form of substance abuse.