TITLE PAGE
Why Players Engage in Drug Abuse Substances? A Survey Study
Kumar Neeraj1, Paul Maman2, Sandhu J. S3.
1
Lecturer, Dept of Physiotherapy, Saaii College of Medical Science & Technology, Kanpur, U.P., India
2
Lecturer, Faculty of sports Medicine & Physiotherapy, Guru Nanak Dev University, Amritsar, Punjab, India
3
Professor, Faculty of Sports Medicine & Physiotherapy, Guru Nanak Dev University, Amritsar, Punjab, India
Corresponding Author:
Maman Paul, B.P.T, M.S.P.T, Lecturer, Faculty of Sports Medicine & Physiotherapy, Guru Nanak Dev
University, Amritsar, Punjab, India
Email: physioner@gmail.com
Contact No.: +91-9815459353
ABSTRACT
Purpose of this study was to find out the psychological and social support factor which may possibly lead the
players towards using drug abuse substances. 303 players were surveyed with a battery of questionnaires
consisting questions about performance enhancement attitude, motivation, perfectionism, self confidence, task,
ego and social support. 83 players accepted that they have taken banned substances, significant differences were
found in their performance enhancement attitude (p<0.001), self confidence (p<0.05) and social support
(p<0.001). Result of this study suggested that psychological and social support factors play an important role in
players’ propensity to engage in drug abuse substances. This will be the duty of coaches, sports physiotherapist,
sports psychologists and sports officials to guide athletes towards a positive approach to encounter the pressure
of any competition.
Keywords: Drug abuse, psychology, performance enhancement, social support
INTRODUCTION
Drug abuse is one of the biggest problems in sports. It can also be referred to as substance abuse or doping.
Drug abuse involves the repeated and excessive use of chemical substances to achieve a certain effect. It is an
unacceptable part of sports and it is illegal because of their adverse effects and performance enhancing actions,
moreover, several prohibited drugs may have very high potential for addiction and abuse. These drugs help in
increasing muscle mass, strength, and resistance to fatigue, but the utmost advantage of these drugs is their
effect on the central nervous system, which makes athletes more aggressive in training and in competition [1].
Doping is a divisive and socially undesirable behaviour and it is an enormously secretive behaviour. Athletes
usually do not accept that they are using dope. In the 1998, Tour de France, many of the riders were engage in
doping but they refused to accept it. When they got caught in doping test they reacted strangely about its
presence in their body and shrugged it off by saying, I wonder how this substance get into my body or I had
never taken these drugs [2].
Athletes’ use of illicit substances to excel in performance is a form of cheating behaviour and this could be
dangerous for their health and career. The problem of drug use is very common in competitive sports [3]. In spite
of the complexity of doping, two major problems arise: health problem and unfair performance enhancement.
Both these issues sometimes seen in conflict with the right of autonomy which implies that the athletes can use
their body freely [4,5,6], but for the sake of sports, another major issue need to be addressed while dealing with
doping is ‘spirit of sport’. The prevalence of doping is higher among sports competitors and increases with age
and level of competition [7,8]. There are numerous psychological factors that contribute to a player’s propensity
to engage in drug abuse substances, like performance enhancement, perfection, confidence, motivation, task,
ego, emotional status and low social support.
Unfortunately, much of the research on doping behaviour has so far concentrated on individual differences in
attitudes towards drug use and towards drug testing programs. But it is not well understood, what are the
underlying psychological factors for the use of performance enhancing substances in sports. There is empirical
lack of studies stating the role of psychosocial variables in the use of doping in sports, like, some studies
analyzed the performance enhancement attitude with doping belief and sports orientation [9], while few
researchers studied the social support determinants of the performance enhancing drugs by gym user [10]. Hence,
understanding player’s attitudes and behavioural intentions towards performance enhancement is critical for
anti-doping intervention strategies. The current research work was particularly interested in identifying
psychological & social variables that might have a link to performance enhancing drug use. Additionally, the
present research work will provide useful information for the design of the doping attitudes, which hopefully
will serve both a practical and an academic application in the fight against doping in sports. A deeper
understanding of decision making processes and player’s disposition towards performance enhancement may
point sport managers, officials, policy makers, coaches, sports physiotherapists and even athletes towards a
better-targeted approach and may even point the anti-doping effort towards radically different directions.
METHODOLOGY
A survey study with total of 303 subjects both male and female athletes, aged between 18-35 years, associated
with 17 different team or individual sports participated. Athletes of university or higher level were included,
whereas athletes taking psychotherapy and handicapped athletes were excluded. Athletes were selected from the
various sports centres of Punjab (India). The study was approved by the Institutional Ethics Committee of Guru
Nanak Dev University, Amritsar, India.
Measures:
The test consists of the following battery of questionnaires / documents.
1. Consent form: The form allows the participant to state agreement to participate in the study
anonymously. The subjects were informed about the confidential nature of the study. The participation
was voluntary with no compensation or credit to athletes.
2. Demographic questionnaire: Information on this questionnaire includes personal details, questions
relating to sporting experience and doping-specific questions regarding knowledge and use.
3. Performance Enhancement Attitude Scale (PEA) [9]: The PEA scale is a 17- item, six-point Likert-type
attitude scale. A high score on this scale will denote positive or permissive attitudes to doping.
Cronbach’s alpha coefficient for this scale is 0.85. The score can range from 17 to 102.
4.
5.
6.
7.
8.
Perceived Motivational Climate in Sport Questionnaire (PMCSQ-2) [11]: The PMCSQ is a 33-item, 5point Likert-type motivational scale. It contains two subscales (perceived task involving climates and
perceived ego involving climates). Cronbach’s alpha coefficient for this scale is 0.87. The score can
range from 33 to 165.
Perfectionism in Sport Scale (PSS) [12]: The PSS is a 24-item, 5-point Likert-type scale to measure
attitude and expectations of competitive sport participation. It contains three subscales (coach’s
criticism, concern over mistakes, and personal standard). Cronbach’s alpha coefficient for this scale is
0.80. The score can range from 24 to 120.
Trait Sport Confidence Inventory (TSCI) [13]: The TSCI consists of 13-items in which the participants
rate their confidence on a 9-point Likert-type scale. Cronbach’s alpha coefficient for this scale is 0.93.
The score can range from 13 to 117.
Task and Ego Orientation in Sport Questionnaire (TEOSQ) [14]: The TEOSQ comprises 13-items, 5point Likert-type task and ego scale. It contains two subscales (task orientation, and ego orientation).
Cronbach’s alpha coefficient for this scale is 0.82. The score can range from 13 to 65.
Duke-UNC functional social support questionnaire (FSSQ) [15]: It consists of 10-items social support
scale to be measured on a 5-points Likert-type scale. Cronbach’s alpha coefficient for this scale is 0.81.
The score can range from 10 to 50.
Protocol:
The athletes who volunteered to participate in the study were asked to present on a prescribed date. Only 20
athletes were asked to report at a particular date and time. All participants were assured about the confidential
nature of the study and the results will remain anonymous. The participants first filled up the consent form and
hand it over to the researcher. After filling the consent form, the participants were asked to complete all
questionnaires and give their responses on the response sheet. The participants were then instructed to fold the
response sheet, put it in the given envelope & drop it into the prescribed drop box without making any mark on
it.
Statistical Analysis:
Mean, standard deviation, standard error and percentile were used to prepare summary statistics. Karl Pearson
Correlation Coefficient (r) and student’s t test were used to determine the association between various
questionnaires. The statistical analysis was done on SPSS v 16.00.
RESULTS
A total of 303 athletes with 277(91%) males and 26(9%) females participated in the study. The average age of
the athletes was 24.08 (±4.4) years with 24.46 (±4.3) years of males and 20.12 (±3.1) years of females. Average
experience of total athletes was 8.81 (±5.5) yrs. The study comprised of athletes of 17 different sports with
following distribution: Archery- 22, Athletics- 48, Badminton- 5, Basket Ball- 41, Boxing- 11, Cricket- 10,
Soccer- 40, Gymnastic- 8, Hand Ball-15, Hockey- 23, Judo-13, Swimming- 11, Table Tennis- 1, Taekwondo- 3,
Volley Ball-12, Water Polo-21, & Wrestling-19.
The level of participation of subjects ranged from university level to international level with, International- 40,
National- 181, State- 52, District- 2, & University- 28.
Total 83(27%) athletes accepted that they have taken banned substances in which males and females were 74
(26.71%) and 9 (34.62%) respectively. The average age of athletes who have taken banned substances and who
have not taken banned substances are 23.51 (±4.7) years and 24.3 (±3.3) respectively, as shown in table 1.
The levels of participation of athletes who have taken banned substances are as: International- 15, National- 43,
State- 17, District- 1, and University- 7, as shown in figure 1.
Total 125 (41%) athletes with 114 (41.2%) males and 11 (42.31%) females accepted that they had received
information about banned substances in their sport with 178(59%) did not receive information; distribution is
shown in figure 2.
Total 118(39%) athletes with 102 (36.82%) male and 16 (61.54%) female accepted that they personally know
athletes who are taking banned substances whilst 185(61%) do not know any athlete taking banned substances;
its distribution is shown in figure 3.
The mean scores of each questionnaire in different categories are given in table 2.
Descriptive statistics were calculated in the athletes who have taken banned substances. Descriptive statistics on
measurement level variables are provided in table 3. All the measures viz. Performance Enhancement Attitude
(PEA), Perceived Task Involving Climate (PTIC), Perceived Ego Involving Climate (PEIC), Coach’s Criticism
(CC), Concern over Mistakes (CM), Personal Standard (PS), Task Orientation (TO), Ego Orientation (EO), Trait
Sport Confidence Inventory (TSCI) and Functional social Support (FSSQ) were negatively skewed.
Student’s ‘t’ test were applied in the score of questionnaires between one group of athletes who have taken
banned substances and athletes who have not taken banned substances, the statistically significant differences
were found in performance enhancement attitude scale (p<0.001), trait sport confidence inventory scale
(p<0.05), and functional social support questionnaire (p<0.001), as shown in table 4.
Pearson correlation were applied between PEA Scale and various psychological variables viz. Perceived Task
Involving Climate (PTIC), Perceived Ego Involving Climate (PEIC), Coach’s Criticism (CC), Concern over
Mistakes (CM), Personal Standard (PS), Task Orientation (TO), Ego Orientation (EO), Trait Sport Confidence
Inventory (TSCI) and Functional Social Support (FSSQ) in the group of athletes who have taken banned
substances, as shown in table 5.
DISCUSSION
The aim of the present study was to explore the role of psychological and social support factors which could
influence the use of drug abuse substances in sports. Statistically significant differences were seen in PEA-Scale
(p<0.001), TSCI (p<0.05) and D-UNC FSSQ (p<0.001) questionnaires between the athletes who have taken
banned substances and the athletes who have not taken banned substances.
Athletes who accepted that they have taken banned substances had much higher score (mean) on PEA-Scale
(69.08) as compared to the athletes who have not taken banned substances (49.43), which demonstrates that they
really wanted to enhance their performance, no matter how. This finding is consistent with previous research
which suggests that athletes’ win orientation have an effect on doping attitude [9]. It could also be emphasised
here that economic status might have inkling towards the winning attitude in athletes as stated by economic
theory of doping which mainly assume that athletes act according to economic rationality. Most of the athletes
are likely to see doping as their best option and the only feasible strategy to ensure winning [16].
The athletes who indulged in drug abuse substances were less confident (87.11) in their sporting ability than the
athletes who did not indulge in such abuse of banned substances (92.17). These findings indicate a direct
influence of self confidence over athletes’ attitude to use doping, which is parallel to the findings of
Radovanovic et al. (1998) & Donovan et al. (2002) [17,18].
Further, it is also imperative to mention here that in a study conducted by Skarberg et al. (2007) [19], it was found
that the anabolic androgenic steroid users were having deprived relationship with their parents and half of them
had gone through physical or mental abuse, moreover their childhood was also disturbed and they were socially
dissatisfied. The results of the present study also exhibit a similar trend with athletes with low social support
(27.64) inclined towards drug abuse than the athletes with high social support (34.64).
Another important factor which has emerged from the findings of the present study in curbing the drug menace
in sports is the dissemination of information among the athletes about the harmful effects of drug abuse. The
results of the present study also suggests that only 125 (41%) athletes received information about banned
substances in their sport, whereas out of 83 athletes from the total of 303 who accepted to have taken banned
substances, only 28 (33.73%) athletes received information about these substances and rest 55 (66.27%) athletes
received no information indicating lack of knowledge about banned substances which probably lead athletes
toward engaging in these substances. Education about banned substances in sports is of utmost important as
stated by Hardy et al. (1997) [20] that in the Australian Football League doping is not a problem, most likely
because an education program is being run by the football authority, similarly Ozdemir et al (2005) [6] also
emphasized on education program of doping in sports. In addition, another study by Dvorak et al. (2006) [21]
stated that FIFA’s anti-doping strategy relies on education and prevention.
In the present survey, it was found that 118 (39%) athletes accepted that they personally know athletes who are
taking banned substances. In total of 83 athletes who have taken banned substances, 54 (65.06%) personally
know athletes who were taking banned substances; it suggests influence of peer pressure in athletes attitude
towards engaging in these substances, these results of present study are supported by the findings of Backhouse
et al. (2007) [22], who stated that the appropriate reason for using performance enhancement drugs were own
personal interest, personally knowing of athletes who are using and non-conformity of peer group, and by study
of Wieffernik et al. (2008) [10], who stated that the psychosocial factors which are more susceptible for the use of
performance enhancement drugs are individual norms, to get better performance and noticeable use of others.
The results of the present study reveals statistically significant correlation of PEA Scale with perceived ego
involving climate (0.46), and coach’s criticism (0.48). These findings suggest that an athlete who perceives high
ego involving climate may be at risk for doping. Also, it seems that the criticism made by coach on athletes’
performance creates a negative influence on their perception and could lead them towards doping. Athletes
believe that the coach creates an ego involving atmosphere in their team and this ego climate which is created by
coach has a significant role in athletes’ behaviour [23]. The results of present study also show significant
correlations of PEA Scale with concern over mistakes (0.72) and personal standards (0.43). The behaviour of
athletes to show concern over their mistakes and to gauge high personal standards also play a decisive role in
drug abuse as shown by the findings of the present study, which is in agreement with Sleasman (2009) [24] who
stated that for improving perfection one can move towards the shortcut through artificial stimulants and muscle
building hormones. The study by Petroczi et al. (2008) [16] also suggested that the anticipation of perfection for
progress and improvement or aspiration to win has an influence on the athletes’ behaviour.
Results of the present study show significant correlation of PEA Scale with task orientation (0.24) and ego
orientation (0.43). A high task and ego orientation in sports also has a significant role in attitude toward doping
by athletes, as suggested by Petroczi et al. (2007) [9] who stated that task and ego orientation had a rational
association with doping behaviour. A small negative (but non significant) correlation between PEA Scale and
FSSQ (0.008) was seen in the results of present study which indicates athletes’ willingness to enhance
performance having low social support with the help of drug abuse substances.
The result of the present study also showed that even the university level players (25%) engaged in drug abuse
substances, indicating prevalence of doping at this level also; which is a matter of grave concern. The beginner
level competition should be fair and players should know the importance of fair play. These results of the
present study are consistent with the finding of previous studies, who found that the drug abuse substances are
being used by high school athletes in France [7, 25]. In another study, Tahtamouni et al. (2008) [26] found that
more than half of the collegiate students of Jordan are using AAS, and they gave emphasis to educate and warn
adolescents and mentors about the side effects of AAS abuse.
Therefore, the anti-doping strategies are required to prevent the use of these substances by players rather than
disqualifying them from competition. A proper assessment of player is necessary, including, medical history,
social history and psychological history. An education program for players is essential, as Chan et al. (2005) [27]
investigated the opinion, understanding and practice of doping in the local sporting community of Hong Kong
and found that the local athletes have no clear picture about dope substances. To prevent local athletes from
using these substances, a tailored made education program about doping control is necessary, whereas, Ama et
al. (2003) [28] investigated the use and awareness of lawful and unlawful substances by amateur footballers in
Cameroon and concluded that prevention of doping through awareness is much essential and the study on
prevalence of doping among footballers is urgently needed. In another study, Kayser et al. (2007) [29] reviewed
the recent development of increasingly severe anti-doping control measures and found them based on
questionable ethical grounds and suggested that the main aim of the current anti-doping strategy is to prevent
doping in elite sports by the means of all-out repression, and making it a public discourse. They also suggested
that doping prevention is an unachievable task in sports; therefore, a more realistic approach should aim at
control and safe use of these drugs which may be practicable choice to deal with doping. The current antidoping
policy has received much criticism for its elite focus, sanction-based approach and associated costs [30], apart
from these current anti-doping strategies, a need exist to find the deep rooted causes of doping and the results of
the present study will help to focus and analyse the basic causes of doping. As such, unless we do not know the
basic causes of attitudes towards doping it is very hard to obtain a dope free environment.
CONCLUSION
The present study reveals that several psychological and social support factors may contribute to the athletes’
propensity to engage in drug abuse substances. These factors include, willingness to enhance performance, high
perception of ego involving climate, criticism by coach, much concern of athletes on their own mistakes,
athletes’ personal standard, lack of self confidence, low social support, as well as high task and ego orientations.
Many athletes through self reported measures revealed that they can improve their performance by engaging in
drug abuse in relatively short span of time instead of adapting to advanced techniques. General psychology of
the athletes is that in their sports only performance matters, no matter how they achieve it. Some athletes are of
view that the banned substances should be legalized in the competition. Inadequate knowledge of dope
substances and their adverse effect could also contribute to the use of these substances by athletes.
Since less than 50% of athletes accepted that they received information about banned substances in their sport,
hence sports officials are required to distribute information booklet to each and every player informing them
about the banned substances, because adequate knowledge about these drugs and their adverse effects might
help them to avoid using these substances. Psychological factors are very important in player’s decision towards
using banned substances, so proper counselling of athletes by sports psychologist is much required. During
counselling, social support factors should also be considered. There is no short cut for performance
enhancement, but if athletes take this course of doping they may end up with jeopardizing their health. So to
save athletes from ruining their health and future of sports by using these substances they should be encouraged
to learn new skills and techniques to enhance performance. This will be the duty of coaches, sports
physiotherapist, sports psychologists and sports officials to guide athletes towards a positive approach to
encounter the pressure of any competition. Emphasis should be given on sports participation and coaches should
praise athletes for their effort whether they win or lose, never criticize them for their mistake but try to motivate
them to learn from their mistakes.
Acknowledgement: We would like to thank all our participants to support us in completing this study.
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Tables
Category
No. of
Athletes
Mean
Age
SD
Mean
Experience
Male
Female
277
26
24.46
20.12
4.3
3.1
9.24
32.65
5.5
3.9
Athletes who have taken
Banned Substances
Athletes who have Not taken
Banned Substances
Male who have taken
Banned substances
Female who have taken
Banned substances
Male who have Not taken
Banned Substances
Female who have Not taken
Banned Substances
83
23.51
3.3
8.56
4.6
220
24.3
4.7
8.9
5.8
74
23.75
3.1
8.91
4.4
09
21.44
4.2
5.77
5.3
203
24.71
4.7
9.36
5.8
17
19.41
2.1
3.41
2.9
Table 1: Showing the no. of athletes with mean age and experience in different
categories
SD
Category
Male
Female
Male who have taken
Banned substances
Female who have taken
Banned substances
Male who have Not taken
Banned Substances
Female who have Not
taken
Banned Substances
Athletes who received
information about Banned
Substances
Athletes who did not
receive
Information about Banned
Substances
Participants personally
know Athletes taking
Banned Substances
Participants personally do
not know any Athlete
taking Banned Substances
PEA
PMCSQ
PSS
55.18
(±16.2)
50.81
(±15.9)
69.65
(±17.6)
64.44
(±8.5)
49.92
(±11.9)
43.58
(±14.3)
132.81
(±25.5)
140.23
(±13.1)
136.39
(±18.5)
138.44
(±17.3)
131.51
(±15.3)
141.17
(±10.7)
91.16
(±11.8)
92.31
(±10.3)
93.05
(±13.5)
92.11
(±12.6)
90.47
(±11.1)
92.41
(±9.2)
51.76
(±17.4)
128.73
(±32.1)
56.95
(±14.9)
TSCI
TEOSQ
FSSQ
91.03
(±13.8)
88.19
(±28.2)
89.25
(±15.2)
69.44
(±36.9)
91.67
(±13.3)
98.12
(±15.9)
51.06
(±7.3)
51.04
(±8.1)
52.87
(±7.7)
46.66
(±10.6)
50.41
(±6.9)
53.35
(±5.4)
32.73
(±8.6)
32.65
(±6.9)
27.03
(±9.2)
32.66
(±6.7)
34.81
(±7.4)
32.65
(±7.3)
87.48
(±10.5)
89.32
(±17.1)
50.78
(±7.5)
33.67
(±8.4)
136.76
(±17.1)
93.92
(±12.2)
91.82
(±14.5)
51.26
(±6.9)
32.05
(±7.7)
58.26
(±17.7)
136.92
(±32.9)
93.41
(±10.7)
90.98
(±17.3)
51.85
(±7.4)
29.42
(±8.5)
52.61
(±14.7)
131.24
(±17)
89.89
(±12.1)
90.66
(±14.4)
50.56
(±7.2)
34.83
(±7.7)
Table 2: Scores (Mean±SD) of each questionnaire in different categories
Variables
Min. Max. Mean
Performance
34
92
69.08
Enhancement
Attitude Scale
Perceived Task
44
85
72.49
Involved Climate
Perceived Ego
39
82
64.12
Involved Climate
Coach’s Criticism
14
30
23.08
Concern over
15
35
27.02
Mistakes
Personal Standards
28
55
42.83
Task Orientation
14
35
28.92
Ego Orientation
12
36
23.53
Trait Sport
36
115 87.11
Confidence
Inventory
Functional Social
9
47
27.64
Support
Questionnaire
SE
SD Variance Skewness Kurtosis
1.86 16.92 286.15
-.454
-1.146
1.17 10.68
114.20
-.770
-.379
1.15 10.49
110.21
-.219
-.989
.36
.55
3.31
5.04
10.93
25.41
-.310
-.346
-.291
-1.035
.74 6.78
.48 4.43
.51 4.65
2.13 19.42
46.02
19.66
21.62
377.19
-.363
-1.052
-.413
-1.302
-.664
1.075
-.174
1.187
.99
82.38
-.153
-.747
Table 3: Measurement level descriptive statistics
9.07
Athletes who have
taken Banned
Substances
Athletes who have
not taken Banned
Substances
(Mean±SD)
(Mean±SD)
69.08±16.9
49.43±12.2
9.68***
136.61±18.3
132.25±15.2
1.935NS
PSS
92.95±13.3
90.62±10.9
1.422NS
TSCI
87.11±19.4
92.17±13.6
2.184*
52.2±8.2
50.64±6.9
1.549NS
Questionnaires
PEA-Scale
PMCSQ
TEOSQ
27.64±9.1
34.64±7.4
FSSQ
***Significant p<0.001, *Significant p<0.05, NS-Non Significant
t-Value
6.289***
Table 4: Differences in the questionnaires between athletes who have taken banned
substances and athletes who have not taken banned substances
PEA Scale
r2
Perceived Task Involving Climate
0.07
0.53%
Perceived Ego Involving Climate
0.46**
21.71%
Coach’s Criticism
0.48**
23.14%
Concern over Mistakes
0.72**
51.98%
Personal Standard
0.43**
18.41%
Task Orientation
0.24*
5.63%
Ego orientation
0.43**
18.32%
0.16
2.56%
-0.008
0.006%
Scale
Trait Sport Confidence Inventory
Functional Social Support Questionnaire
** Correlation is significant at the 0.01 level (2-tailed)
* Correlation is significant at the 0.05 level (2-tailed)
Table 5: Correlation between PEA scores & other psychological variables
Figures
Figure 1: Distribution of level of participation of athletes who have taken banned
substances
Figure 2: Distribution of athletes on the basis of receiving information about banned
substances
Figure 3: Distribution on the basis of personally knowing any athlete who is taking
banned substances