Motivation and emotion/Book/2016/Performance enhancing drug usage motivation in elite athletes

Overview
In 2013, seven-time Tour de France winner, Lance Armstrong, a respected, loved, and inspiring elite cyclist, admitted to using performance-enhancing drugs throughout his sporting career. Why would a man who was believed to have had an amazing talent that was admired around the world, cheat the system? What would drive someone with so much sporting ability and media spotlight, to use a banned substance in order to outperform his competitors? Not only does it risk a person’s physical and psychological health and well-being, but using these drugs is also a huge violation of the rules of sport. This situation displayed the toxic extent to which athletes will go to, to be successful.

WATCH: Lance Armstrong Doping Confession

The growing trend and culture of doping is one of the most significant problems facing elite sports today. 2015 data gathered from drug test results estimated 14 to 39% of elite athletes intentionally used performance enhancing drugs in major sporting events (de Hon, Kuipers, & van Bottenburg, 2015). The prevalence of doping in elite sports affects all those involved and prompts the need for effective evaluation of anti-doping policies (de Hon et al., 2015). Psychological theories and research can be useful in understanding the underlying doping motives in athletes. These can provide information to anti-doping agencies for addressing the prevalence of doping, and preventing future occurrence of this behaviour.

What motivates elite athletes to use performance- enhancing drugs? What factors contribute to this motivation? From achievement driven desires to underlying risk-taking personalities, what motivates doping? The current book chapter aims to answer these questions in discussing the primary motives of elite athletes to use performance-enhancing drugs or substances, and the factors that influence these motivations.

What is motivation?
Motivation refers to the forces that influence the initiation, direction, intensity, persistence, and quality of goal-directed behaviour (Maehr & Zusho, 2009). In relation to sport these goals could include, improving skills, enjoyment, making friends, developing fitness and ability, or winning and achieving success. For the purpose of understanding this book chapter, refer to Table 1, for key terms and definitions.

Table 1. Key Terms and Definitions

Theories
There a number of theories that help explain the motivations of elite athletes to use PED. In particular, the Self-Determination Theory, Achievement Goal Theory, and the Theory of Planned Behaviour. These are relevant because they emphasise not only the role of social influences and pressure on individual belief systems and subsequent behaviour motivation, but the individual attitudes and intrinsic desires that affect behaviour intention.

Self-determination theory


Self-determination theory constructs can help explain performance-enhancing drug use motives. According to the Self-determination theory, as proposed by Ryan and Deci (2000), motivation occurs along a continuum across two broad categories: Intrinsic and Extrinsic motivation (Hodge, Hargreaves, Gerrard, & Lonsdale, 2013). Extrinsic motivation is driven and regulated by a desire to achieve an outcome based on self-imposed pressures (e.g pride), or external pressures and controls (e.g rewards, or avoid punishments) (Hodge et al, 2013). Conversely, intrinsic motivation characterises behaviour that is driven by personal desires such as enjoyment (Hodge et al, 2013). For this particular motivation to develop the psychological needs of the individual need to be established and satisfied. These include autonomy (sense of independence), competence (ability to perform behavior), and relatedness (forming connected relationships with others).

Hodge and colleagues (2013) argue that athletes with strong extrinsic motivations and the outcome of ‘winning’ in sport are more susceptible to using PED. An athlete’s attitude that emphasises a willingness to do anything in order to achieve their goal of success and fame, suggests they are more likely to engage in morally wrong and illegal behaviour to reach these goals (Hodge et al, 2013). Results of the study largely supported this, finding that there was a significant positive relationship between an extrinsically controlled motivation climate and PED use among competitive and elite athletes (Hodge et al., 2013). Additionally, athletes in ‘high’ PED susceptibility reported greater levels of controlling coach atmosphere compared to those athletes with ‘low’ PED susceptibility (Hodge et al., 2013).

Donahue et al (2006) found that elite athletes primarily motivated by intrinsic desires were less likely to use PED compared to extrinsically motivated athletes. A similar study by Vallerand, and Losier (1994) also revealed a positive relationship between self-determined motivation and athlete ‘sportspersonship’ orientations. Such orientations could include congratulating the opponent following a loss, non-aggressive behaviour, and playing clean and fair (Vallerand & Losier, 1994). This relationship demonstrates that athletes who are more intrinsically motivated, focus more on autonomy, relatedness, and competence in sport as opposed to winning, and are more likely to be good sports, showing respect for themselves, other athletes, and the rules of the competition, thus do not engage in PED use (Donahue et al., 2006).

Achievement goal theory
According to Achievement Goal Theory (AGT), how individuals define competence and success (goal orientation), and how the social context is shaped (motivational climate) influences behaviour motivation (Allen et al., 2015). Achievement goals are about why the person is putting effort into achieving something (Reeve, 2014). The two achievement goals in the AGT are referred to as ‘task oriented or mastery’ goals and ‘ego oriented or performance’ goals (Reeve, 2014).

Task-oriented (mastery) goals
Task-oriented goals are the desire to master a skill, task, or ability. These mastery goals are about when a person is facing a certain standard of achievement and seeks to develop more competence, make progress, improve the self, overcoming challenges and pursue the goal in the face of setbacks (Reeve, 2014). When people adopt mastery goals they tend to:
 * 1) define success in terms of improving and making progress,
 * 2) place value on effort,
 * 3) view errors and challenges as a part of learning,
 * 4) focus attention on the learning process, and
 * 5) are satisfied by hard work toward the goal (Reeve, 2014).

Ego-oriented (performance) goals
Ego-oriented goals focus on performance and reflect when a person is facing a certain standard of achievement and seeks to display high ability, prove competence, outperform competitors and succeed with little effort or drive (Reeve, 2014). Achieving a performance goal simply means being better than others. When these goals are adopted people tend to:
 * 1) define success by winning or high performance results,
 * 2) place value on high ability,
 * 3) experience anxiety from errors or challenges,
 * 4) focus attention on ones own performance relative to others’, and
 * 5) are satisfied by outperforming others’ (Reeve, 2014).

Initial support for the AGT in the study of PED used among athletes has been demonstrated. Barkoukis, Lazuras, and Tsorbatzoudis,l (2011) investigated the relationship between intrinsic and extrinsic motivation and achievement goal orientation, with athletes’ self-reported PED use. The study found that athletes in the mastery achievement goal group showed significantly lower scores on past substance use and intentions to use PED in the future, compared to those in the performance achievement goal group. Additionally, Sas-Nowoseilski and Swiatkowska (2008) investigated the relationship between athletes doping attitudes and goal orientation. They found that task orientated goals were significantly related to attitudes towards doping, such that an increase in mastery goal orientation was associated with more favourable attitudes towards anti-doping. Contrary, athletes reporting more ego oriented goals declared more unfavourable attitudes towards anti-doping (Sas-Nowoseilski and Swiatkowska, 2008).

Whilst these studies empirically support the understanding that goal orientations influence doping behaviour and intentions, they fail to recognise the importance of the motivational climate in determining athletes PED use motivation.

Motivational climate


Motivational climate describes the importance of the social psychological context in determining motivated behaviour (Reeve, 2014). It is formed by the achievement expectations from significant others in an athlete’s life including their coach, parents, supporters, and teammates (Petroczi & Aidman, 2008). Similar to goal orientation, motivational climate has both a mastery and performance subdivision (Reeve, 2014). Petroczi and Aidman (2008) found that motivational climate contributes to an athlete's behaviour orientation. Self-reported reasons for athletes taking PED are mostly related to the inner desire to win, improving appearance, external pressures and a fear surrounding their competitors having an unfair advantage (Petroczi & Aidman, 2008). The athlete’s recognition of external standards as either an ongoing improvement process (mastery climate), or a constant competition and winning desire (performance climate), influences their subsequent decisions and behaviours (Petroczi & Aidman, 2008). The culture of a sport, in particular the performance enhancement views, may prompt an athlete to take drugs in order to prove their solidarity and identity with fellow athletes who agree with this behaviour (Petroczi & Aidman, 2008).

Allen and colleagues (2008) studied elite Scottish athletes to determine their attitudes towards PED use based on contributions from the goal orientations and motivational climate. In the study, a strong mastery motivational climate suggested an environment that fostered individual effort, persistence, progress and learning. Whereas, a strong performance motivational climate suggested an environment that placed emphasis on winning, punishing mistakes, and fosters inter-individual rivalry (Allen et al., 2008).The study found that athletes with a mastery climate had a negative attitude toward PED use, suggesting that an immediate social context that emphasises moral behaviour, is a significant motivator to not use PED. This suggests there is a cultural norm and social motivation for athletes’ to use PED. It is important to note that a lot of this research has used athletes who had existing negative attitudes towards doping, therefore bias was an issue.

Theory of planned behaviour
The Theory of Planned Behaviour put forward by Ajzen (1991), has become one of the most influential theories to explain human action. According to the theory, human behaviour is driven by three main constructs: behavioural beliefs (beliefs about the consequences or attributes of behaviour), normative beliefs (beliefs about the expectations of others), and control beliefs (beliefs about what factors may increase or decrease the behaviour) (Ajzen, 1991). These beliefs then elicit predictive intentions based on, the Attitudes towards behaviour, Subjective norms, and Perceived Behavioural Control (PBC). Behavioural beliefs elicit either a favourable or unfavourable attitude toward the behavior; the normative beliefs brings out a perceived subjective norm or social pressure from others, and control beliefs produce PBC, which relates to the individual’s belief that they have control over successful execution of the behaviour (Ajzen, 1991).



Research guided by the TPB has reported that variables such as doping attitudes and norms surrounding doping, can predict athlete’s intentions to use PED (Barkoukis et al., 2015) Athletes’ positive intentions to dope are directly predicted by pro-doping attitudes and biased subjective norms that overestimate the social acceptability of using PED (Ntoumanis et al., 2014). Self-efficacy or PBC was also a significant predictor of PED use motivation, suggesting that athletes who believe they have the competence to win without PED, are more likely to refrain from using them compared to athletes who do not possess these beliefs (Ntoumanis et al., 2014).

Findings from meta-analyses emphasise the effect of social (normative) influences on doping (Ntoumanis et al., 2014). Such influences can range from simple peer pressure and apparent acceptability by teammates or fellow athletes, to more powerful internal and external pressures associated with outcomes and enhanced performance (Ntuoumanis et al., 2014). Therefore, the athletes’ social support and perceptions about the use of PED within their sporting context, are strong determinants of the decision to dope in sport (Ntoumanis et al., 2014).

However, it is important to note that the perceived social acceptability of PED may not be an accurate measure of its influence on athletes’ doping intentions. This questions the reliability of these findings, and it is recommended that future researchers explore the cognitive processes that underpin biased normative beliefs in order to increase the predictive power of this TPB construct.

Motivation theory quiz
{According to the SDT, elite athletes who use PED are more likely? + Extrinsically motivated - Intrinsically motivated - Amotivated
 * type=""}

{Mastery motivated goals... - Focus on winning and getting better at the sport + Focus on improving skill, and making consistent progress - Focus on winning, beating the competition, and on the outcome of performance
 * type=""}

{What role does perceived subjective norm play in athletes PED use?| - It does not play a role + It increases the likelihood of using PED because athletes believe others are using too - It decreases the likelihood of PED use
 * type=""}

Risk taking
Using PED is a huge risk for elite athletes. It jeopardises their future in the sport, destroys the sports’ image, and creates significant medical risks for the athletes’ health. Due to these potential dangers, doping is referred to as ‘risk-taking behaviour’ (Johnson, 2012). Risk taking is defined as ones purposive participation in behaviour that involves potential negative consequences and perceived positive consequences (Ben-Zur & Zeider, 2009). Once an individual has decided to a risk, previous variables such as a supportive environment may not be enough to protect them from injury (Johnson, 2012). Before using PED, athletes need to consider two main risks: the risk of negative health effects and the risk of being caught by sporting authorities (Ehrnborg & Rosen, 2009). These risks are weighed against the potential benefits achieved by PED including, increased performance and maximum body strength. According to the risk-taking approach to doping, athletes’ acceptance of the risks associated with PED and analysis that they do not outweigh the advantages of using them, increases the likelihood of the athletes’ intention to dope (Ehrnborg & Rosen, 2009). In order for the decision to dope to be made accurately and rationally, effective PED test methods and procedures need to be available. These must convince the athletes that the risk of being caught is equal to that of their opponents risk (Ehrnborg & Rosen, 2009). This creates a sense of ‘fairness’ and results in one of the strongest motives for an athlete to avoid using doping agents (Ehrnborg & Rosen, 2009).



Additionally, risk taking as a psychological personality variable, is a predicting factor of PED use motivation (Petroczi & Aidman, 2007). From this perspective, athletes with risk taking dispositions are more likely to be involved in prohibited PED use as they place greater emphasis on gaining improved performance, than they do on analysing the risks associated with this behaviour (Petroczi & Aidman, 2007). In particular, sensation seeking, which includes desire to seek adventure, thrill, and experience, is a major risk taking personality trait that has been related to substance use in athletes (Ewald, 2011). Rosenbloom (2003) found a positive correlation between risk taking and sensation seeking, in that those individuals high in sensation seeking had an increased likelihood of taking risks. This is relevant in the sporting context as research also emphasises a relationship between athlete’s sensation seeking and their self-reported PED and other substance use (Ewald, 2011). Rockafellow and Saules (2006) found that sensation seeking athletic personalities were significantly related to substance use. In addition, results from another study showed a clear association between sensation seeking and risk of PED use, indicated by a positive correlation (Elwald, 2011).

Despite well-documented research on the relationship between risk-taking behaviour and PED use, much of the data is collected from elite athletes’ self-reported recall of their doping attitudes and behaviour. Although it is the ideal way to create a clear picture of an athlete’s cognitions and beliefs, self-reported data is limited by its subjective view points, so must be verified to manage potential self-serving bias responses.

Attitudes, beliefs, and knowledge
It has also been found that athlete’s attitudes, beliefs, and knowledge of doping act as motives to use PED (Morente-Sanchez & Zabala, 2013).

Beliefs
Firstly, athlete’s belief about the prevalence of PED use among other competitors and beliefs about the effectiveness of PED use on athletic performance, greatly influences their motivation to dope (Morente-Sanchez & Zabala, 2013). Dunn, Thomas, Shift, and Burns (2012) explored the concept of the ‘false consensus effect’ to understand the use of illicit substances among athletes. False Consensus Effect is the tendency for people to overestimate the extent to which other people share the same attitudes and behaviours as them (Dunn et al., 2012). In this study, participants (who were elite Australian athletes) were asked to indicate the proportion of athletes in their sport and those in other sports, that they felt used illicit performance substances (Dunn et al., 2012). This survey revealed a trend, that participants more likely reported illicit drug use among athletes more generally than did for those in their sport (Dunn et al., 2012). Additionally, athletes in the groups labelled ‘lifetime users’ and ‘recent users’ of illicit drugs, were more likely to believe other athletes in their sport were using these drugs too (Dunn et al., 2012). This suggests that athletes who believe others in their sport are taking PED, they are more motivated to do so, or more likely to report experimenting in the past (Dunn et al., 2012). This false consensus effect was supported by Tangen and Breivik (2001), (as cited in Morente-Sanchez & Zabala, 2013), who found that the decision to take banned substances among athletes is influenced by their assumptions that competitors are also taking drugs.



Therefore, it seems that athletes’ beliefs regarding the commonality among other athletes of using drugs, greatly influences their willingness to take PED. Streigel et al (2002) described athletic success, financial gain, increasing self-confidence, and social recognition as the most frequently reported reasons for drug use among elite athletes. It can be suggested based on the ‘false consensus effect’ that if athletes believe other athletes are using, these motives are emphasised as the means of achieving become more competitive and thus, the drive to use PED is strengthened by the false consensus of drug use among other athletes.

Attitudes
With regards to predicting behaviour outcome, attitudes usually positively correlate with doping behaviour (Petroczi & Aidman, 2008). Personal dispositions including, being overly competitive and winning-oriented, are often used as lay explanations for motives to use PED. However, new research suggests athletes’ attitudes are more responsible for this deviant behaviour (Petroczi, 2007). ‘The Drugs in Sport Deterrence Model’ considers attitudes as well as cost and benefits of athletes doping behaviour in determining doping motives (Petroczi, 2007). The common ground of this model with other theories including the TPB and SDT, is the recognised influence of subjective norm. When individual’s attitudes reflect that of what they perceive to be socially acceptable, it is a strong predictor of their behaviour. Hence, when athletes’ attitudes toward doping behaviour are encouraged by social norms, these attitudes act as motivates to dope (Petroczi, 2007). Despite this, there has been little research support for this idea. Petroczi (2007) designed a study aimed at empirically testing doping attitude and related dispositions of competitive athletes. Interestingly, the study found that winning orientation (desire to win) had a significant relationship with doping behaviour, such that the importance of winning influenced what athletes thought about doping. However, the study also found that doping specific attitudes did not have a significant path to predicting behaviour (Petroczi, 2007). This suggests that, although they are an integral part of doping behaviour, it is not clear whether doping attitudes are consequences or reasons of other related dispositions, attitudes, and personal experiences (Petroczi, 2007). More research is needed that expands beyond studying just attitudes to explain doping motivations, and incorporates other influencing behavioural factors.

Knowledge
Although most athletes acknowledge that using PED is cheating, unhealthy, and a risk-taking behaviour, the extent to which their knowledge about anti-doping programs, and the consequences of PED use is still lacking (Morente-Sanchez & Zabala, 2013). Petroczi and Aidman (2007) recognised that increasing awareness and knowledge of the risk factors of doping, should be the highest priority for anti-doping associations. Maughan, Depiesse, and Geyer (2007) evaluated the influence of knowledge about risk factors associated with PED, on athletes’ decisions to use them. They reported that supplements and drugs are often used among athletes without evaluating the potential costs and benefits associated with them (Maughan et al., 2007). Individuals with greater ‘doping knowledge’ (regarding side effects and potential risks) have been found to have higher prevalence of PED abuse (Johnson, Sacks, & Edmonds, 2010). Therefore, it can be implied that despite knowing the risks and social disapproval of using banned substances, when athletes reap the rewards of improved performance, this motivation is more likely to overshadow the knowledge of doping consequences.

This idea is supported by research finding that among athletes who have full knowledge of the negative effects, both physically and psychologically, of doping, it has little to no impact on their self-selected decision to use PED (Johnson et al., 2010). Despite this, it needs to be acknowledged that many athletes report being under educated and informed on the negative effects of using PED (Morente-Sanchez & Zabala, 2013). This is something on which future anti-doping programs need to focus. Despite it being common that athletes act contrary to their doping knowledge, increasing awareness, education and understanding is still important to deter doping behaviour and continue encouraging to maintain correct attitudes and behaviours among athletes (Morente-Sanchez & Zabala, 2013).

Conclusion


With the ever-mounting pressure placed upon elite athletes, it is not surprising that drug use exists (Reardon & Creado, 2014). The main motivations to use PED are to enhance performance, be successful, and outperform competitors. These motivations and the decision to use banned substances in sport, is based on underlying individual beliefs and values, some of which are about simply improving appearance and performance, and others involving satisfying the expectations of peers, coaches, and competitors (Wiefferink et al., 2008). The take home message from this book chapter is that there are a number of factors that contribute to, and motivate elite athlete’s PED use. Research emphasises that performance oriented goals, extrinsic motivation, risk-taking personalities, false consensus beliefs, social acceptability bias, and history of behaviour, are the main motivators that influence PED use. Understanding these motivations is the first step to establishing effective prevention programs and deterring elite athletes from initiating or continuing drug abuse.