Patterns in the situated activity of substance use in the careers of elite doping athletes

Psychology of Sport and Exercise xxx (2013) 1e8

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Patterns in the situated activity of substance use in the careers of elite doping athletes D. Hauw*, S. Mohamed Group of Research of the Institute of Sport Science of the University of Lausanne (GRISSUL), University of Lausanne, Switzerland

a r t i c l e i n f o

a b s t r a c t

Article history: Received 19 December 2012 Received in revised form 11 September 2013 Accepted 15 September 2013 Available online xxx

Objectives: This article presents a psychological approach to substance use in sport using a dynamic and situated activity framework. The aim was to analyze the various relationships between activity and the consumption of substances during the sporting life course of athletes who recognized doping violation. Design: Data were collected from secondary sources and biographical and self-confrontational interviews to build traces of the past activity. Method: Twelve doping athletes or those admitting to having used banned substances volunteered to participate. The data were coded and compared to identify typical activities and their intrinsic dynamics. Results: Six activities were identified: “Agree to use,” “Drop out of a non-viable state,” Return to a former state,” “Prevent a potential deficiency,” “Maintain an acquired state,” and “Balance the sporting life with substance use,” comprising 11 patterns. Conclusions: The athletes’ activity embedded substance use in reciprocal relationships that consisted of freezing, exploring and exploiting fields of possible actions created and offered by the situation dynamics. Recommendations for situated and dynamic prevention are provided. Ó 2013 Elsevier Ltd. All rights reserved.

Keywords: Situated activity Dynamics Meaning Substance use Doping Elite performance

Doping has generally been studied in psychology as a discrete behavior arising from a series of cognitive and decision-making processes (e.g., Donovan, Egger, Kapernick, & Mendoza, 2002; Kleinert & Jüngling, 2007; Strelan & Boeckmann, 2003). This has led to a focus on the transformation of normative behaviors (i.e., safe and clean) into deviant behaviors (e.g., risky and cheating). The influence of such diverse factors as representations, knowledge, attitudes, personality and motivation, has been examined, as well as the mediation by variables like the power of the group, significant others, and the culture of practice (e.g., Lazuras, Barkoukis, Rodafinos, & Tzorbatzoudis, 2010; Lucidi et al., 2008; Mazanov, Petróczi, Bingham, & Holloway, 2008; Petroczi, 2007; Zelli, Mallia, & Lucidi, 2010). The results have shown that doping emerges within a broad and complex set of psychosocial configurations, which has been analyzed in depth by several researchers. Yet despite the growing body of knowledge on the factors that influence this behavior, many researchers are convinced that our understanding of drug use and doping in sports and our capacity to

* Corresponding author. Institut des Sciences du Sport, Faculté des Sciences Sociales et Politiques, Université de Lausanne, Quartier UNIL-Mouline, Bâtiment Géopolis, bureau 5441, 1015 Lausanne, Switzerland. Tel.: þ41 021 692 3605; fax: þ41 021 692 3293. E-mail address: [email protected] (D. Hauw).

implement efficient prevention program remain limited (e.g., Backhouse, McKenna, Robinson, & Atkin, 2007; Hauw & Bilard, 2012; Laure, 1997; Mazanov et al., 2008). The conclusions and practical implications of many studies have indeed remained general, as the focus has been on the intention to dope and not the action of doing so, and this has resulted in tentative attempts at prevention that have been difficult to manage. Several authors have noted that these limitations are in part due to the research paradigms (e.g., Brissonneau, Aubel, & Ohl, 2008; Hardie, Shilbury, Ware, & Bozzi, 2012; Hauw & Bilard, 2012). These criticisms principally point to the psychological analysis of doping as a two-step process, by which athletes are pushed from no substance abuse directly to prohibited substance intake. From these cognitivist and mechanistic perspectives, the investigations have sought to determine the causal agents of this shift in behavior and the deterrent or compliance factors that influence the doping decision (e.g., Clark, 1997; Juarrero, 1999; Varela, 1980; 1989). The practical and paradigmatic criticisms have therefore offered alternative perspectives (Hauw, 2013a). Recently, research programs have emerged that take into account these criticisms and new perspectives. Using a dynamic and autonomous epistemological approach, the studies investigate the transformation in behavior as it occurs over time, rather than as two theoretically discrete steps, and assume that the reasons for doping are not “outside” but “inside” the activity in which it took

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Please cite this article in press as: Hauw, D., & Mohamed, S., Patterns in the situated activity of substance use in the careers of elite doping athletes, Psychology of Sport and Exercise (2013), http://dx.doi.org/10.1016/j.psychsport.2013.09.005

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D. Hauw, S. Mohamed / Psychology of Sport and Exercise xxx (2013) 1e8

place (Hauw, 2013a). Athletes are assumed to be in a continuous process of development, and the focus has been broadened to take into account the progressive emergence of doping behavior (e.g., McGee, 2005a, 2005b, Robbins & Aydede, 2009). Attention is given to the specificity of context (Doris, 2002) in relation to the dynamics of individual life events (Bruner, 1990; Maturana & Varela, 1987), based on the assumption that human activities generate individual experiences that progressively transform meaningful relations into events (Kirshner & Whitson, 1997; Reed, 1993). Hence, a range of results has been provided, as each study focuses on certain aspects of this framework (e.g., Brissonneau et al., 2008; Hauw & Bilard, 2012; Lentillon-Kaestner & Carstairs, 2010). For example, Brissonneau et al. (2008) identified specific periods in cyclists’ careers, over the course of which their identities were transformed as they “learned the trade” and discovered legal substances (e.g., magnesium, iron, vitamin B12) and proceeded to “doing the trade” and “becoming a champion,” which was characterized by their use of the professional pharmacopoeia (i.e., amphetamines, cortisone, anabolic steroids) and, eventually, substances specifically to win (e.g., erythropoietin, growth hormone). They also identified a final step of reconversion associated with the use of substances to overcome the distress associated with the end of the athletic career (e.g., amphetamines, Belgian pot). These results have been confirmed by other studies comparing elite and junior cyclists (Lentillon-Kaestner & Carstairs, 2010). Hauw and Bilard (2012) used the “course of action” framework (e.g., Theureau, 2003) to analyze the dynamics of doping by comparing the courses of action in the sporting careers of doping and non-doping elite track and field athletes. They showed that doping appeared after a specific number of years of sporting activity and when a specific path had been followed: doping athletes had spent a shorter time in an “open focus” state during the development of their careers than non-doping athletes, which corresponds to the “years of specialization” in the model of talent development from FraserThomas, Côté, and Deakin (2005). They also observed that doping athletes had regularly used legal substances for at least two years and had profoundly changed their training regimen. Last, they found that these doping athletes had experienced specific periods of personal distress. Recently, Hauw (2013b) studied elite athletes from a variety of sports who had had positive doping controls or who had admitted to having used banned substances. In this work, the focus was on the athletes’ actions during the doping period and the meaning they attributed to these actions. Four typical activities, all describing autonomous and emergent organizations of activity, were identified: (a) the actions of doping had a dual relationship with other actions composing the sporting activity; (b) the actions of doping occurred within a set of coordinated actions common to a group of athletes and was hierarchically managed; (c) the actions of using banned substances were dissociated from the sport, despite having consequences with regard to doping violations; or (d) the actions of doping were part of a more general activity of drug use, with the consumption of banned substances being unintentional. To summarize these findings, many states and transitions were associated with the act of doping and differentiated non-doping and doping athletes. These investigations thus provide theoretical insight into the multiple, multiphasic, and situated nature of the changes over the sporting life course of athletes. Nevertheless, knowledge is still lacking on the micro-organization of the activity associated with these changes in their substance use. Knowing that doping athletes are also licite substance users, pointing differences between the activities associated to banned or to licite substance would be relevant for a better understanding of doping in context. Rather than searching for the external factors related to doping and isolating the consumption of doping substance from the licite one, our aim was to focus the analysis on situated and dynamic activity

in order to provide a deeper insight into the interactions between athletes, substance and doping. This approach would also offer a developmental view of vulnerability. This might help professionals to build more effective prevention policies and improve the methods of supporting and guiding athletes in relation to specific identified activities. Activity theory provides an umbrella framework that can unify these lines of investigation, as it incorporates psychological analyses of actions, situations, meanings and experiences (e.g., Engeström, Miettinen, & Punamäki, 1999; Kirshner & Whitson, 1997; Sannino & Sutter, 2011; Theureau, 2003). Activity theory and mainly “course of action” analysis have shown their usefulness in ergonomics (e.g., Theureau, 2003), social science (e.g., Durand, 2013) and sport psychology research, with analyses of performance (e.g., Hauw & Durand, 2008; Hauw, Renault, & Durand, 2008), competition (e.g., d’Arripe-Longueville, Saury, Fournier, & Durand, 2001; Hauw & Durand, 2007), training (e.g., Hauw, 2009; Saury & Durand, 1998) and doping (Hauw & Bilard, 2012) in the latter field. These activity approaches analyze how humans build relationships and interact with their own environment by creating fields of promoted actions and fields of free actions (Reed, 1993; Valsiner, 1997, 2001). Starting from the assumption that the degrees of freedom for human activity are much too extensive to allow for the control of each one independently, these studies have sought to identify and explain the patterns of coherence emerging from a range of variations (Lawrence & Valsiner, 2003; Reed, 1993; Valsiner, 1997). Activity is considered as a dynamic stream of actions that coordinates all the elements of a situation into a global form (Theureau, 2003). Regularities are patterns of activity that describe a viable organization of the interactions between humans and their environment. This means that a pattern of activity emerges in relation to the circumstances or the available opportunities that provide functional organization, which may not be completely efficient but is sufficiently satisfying for the given situation. For the case of doping, the viability of consumption should be linked to the entire activity in which it takes place. Research has suggested that this viability would be somewhat constrained by the distinction between legal and illegal substances, based on several observations: (a) athletes still lack knowledge on dietary supplements and the side effects of performance enhancement substance (e.g., Morente-Sánchez & Zabala, 2013), (b) the WADA list of banned substances remains very enigmatic for athletes because it is composed only of the chemical names of substances (LentillonKaestner & Ohl, 2011), and (c) the banalization of doping substances in certain sport cultures is such that it possible to consider a doping substance as normal for an athlete (e.g., Brissonneau et al., 2008). Nevertheless, distinctions can be made between substances for such studies. According to athletes’ experiences as reported by the hotline Ecoute Dopage, a meaningful distinction is made between the use of vitamin C and heavy performanceenhancing nutritional supplements (Ecoute Dopage, 2009, 2010, 2011). Thus, the examination of the viability of using substances in an athlete’s activity should not be conducted only on the basis of an objective distinction between the legal and illegal status of a substance, but also by taking into account three behavioral criteria: the substance use is (a) targeting the effects on performance or training, (b) excluding current, well-known and low-risk substances of everyday life (e.g., vitamin C, magnesium, calcium) and (c) presenting a real risk of including an active substance that could be considered as banned on the WADA list. Using this definition of substance use, we can analyze the viability of using not only illegal substances, but also substances whose status is not widely known and potentially illegal. To summarize, the aim of this study was to refine the analysis of doping in elite athletes by focusing on the shifting relationships

Please cite this article in press as: Hauw, D., & Mohamed, S., Patterns in the situated activity of substance use in the careers of elite doping athletes, Psychology of Sport and Exercise (2013), http://dx.doi.org/10.1016/j.psychsport.2013.09.005

D. Hauw, S. Mohamed / Psychology of Sport and Exercise xxx (2013) 1e8

between athletes and substances (licit or not) over the course of their careers. To do so, we considered the intrinsic dynamics of the activity of elite athletes (what they did, what they promoted, and what experience was associated in the situation). We expected to identify and distinguish various types of self-organized activity that would characterize how substances, including banned substances, were considered as viable in specific situations and used.

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traces of his/her own activity. The athletes were asked to show, tell about, and comment on their experience. In doing so, they revealed how they handled it on-line by building new meanings (re-enactment process) or by activating pre-existing ones (remembering process). Requests for a posteriori interpretations and generalizations were avoided. Data encoding

Method Participants Twelve athletes (2 tennis players, 2 track and field athletes, 2 cyclists, 2 volleyball players, 2 soccer players and 2 rugby players) participated in this study, and all were part of a population that had volunteered to participate to a national study called “The sporting life course related to the doping practices of elite athletes.”1 They were chosen because they represented the sports we were able to investigate, given the difficulty of collecting this type of data. Five of them had had positive doping controls and seven admitted to having used banned substances. All of them had consumed basic substances during their sporting life course. They were also aware of the possibility of doping controls and the existence of antidoping rules. All had more than 20 years of sport practice, and all were on the same high level of performance as international competitors. Informed consent was signed by all participants. Data collection Three types of data were collected to progressively re-build the stream of activity database for each participant: (a) secondary sources on the athletes’ past activity, (b) verbalizations on past activity during biographical interviews, and (b) verbalizations about these traces of past activity during self-confrontation interviews. The secondary sources on past activity included national federation websites, newspapers and books. This information was expected to provide a skeleton of the traces of the general sporting life course (e.g., evolution in performances, selections, results, medals, teams, and so on). The biographical interviews also provided information on past activity, as they were focused on the meaningful sporting life and events for each athlete. The interviews were recorded and lasted for 1.5e2 h. A guide was followed, which included questions related to family, substance use, type of training, performance results, particular events such as injuries, and so on. The secondary sources and biographical interviews provided complementary documentation and ensured a precise description of each athlete’ own meaningful situations and actions during their sporting life. These two types of data were used to build a representation of the meaningful traces of each athlete’s past activity. This representation is presented as a succession of columns, each corresponding to a period in the sporting life course separated into sections related to specific themes (i.e., family and school or professional activity, training, results, nutrition and substances) abstracted from the meaningful elements that constituted the traces of past activity. A self-confrontation interview was then conducted to confront each athlete with this representation of the meaningful traces of his/her past activity. This representation also served to support the interview as it was used to provoke the re-emergence of elements from past experience when the participant was face to face with

1 This research was funded by the French Ministry of Sports between 2008 and 2011.

Data were encoded in four steps: “Identifying changes in substance use,” “Reconstructing the activity around a change,” “Typicalizing these activities by creating patterns,” and “Identifying types of activity in relation to substance use.” Identifying changes in substance use consisted of listing the entry, the increasing dosage, and the modification in substances. The ordinary substances of everyday life were excluded (i.e., vitamins, nutraceuticals). The substances presenting a potential risk of containing a banned component in their composition and aimed at training or performance enhancement were considered (e.g., medications, performance-enhancing nutritional supplements and painkillers). Each change was identified by looking at the traces of past activity. Two researchers reconstructed the activity around these changes by independently breaking down the activity into chains of Units of Meaningful Action (UMA) using traces of past activity and the transcripts from the self-confrontation interviews. The task consisted of cutting, labeling and situating the succession of UMAs around this change using an action verb followed by a direct object, an adverb, or another complement that situated this UMA (e.g., Used substances despite feeling no effects, Looked on a website for a sleeping drug). The label reflected the responses to a number of questions about the athletes’ activity regarding actions, interpretations, and feelings as they appeared in the data: What did he or she do? What was he or she concerned about in this situation? What element of the situation was he or she considering? This activity around the change lasted for a temporal horizon that was delimitated by its coherence. This means that the analysis was focused on the period of activity reorganization linked to the change related to substances, when up to this point a stable state characterizing the new self-organized activity was identified. For example, some periods of beginning to use were rapidly abandoned after one trial but the period was considered to be finished only when the activity (i.e., concerns, questions.) in relation to this try was finished. The typicalization of the activity consisted of comparing these chains in order to build “patterns of activity.” This typicalization of the athletes’ activity was accomplished by examining regularities within chains of identified UMAs (e.g., same starting situation, same chaining, same concerns). When regularity was observed, a pattern was rewritten characterizing the general form of the chaining units that described how the viability of the substance use was considered by elite athletes. The types of activity in relation to substance use were then identified by associating the patterns of the “activity of substance use” with the general concerns in which they were based (e.g., prevent a potential deficiency, balance the sporting life with substance use). Trustworthiness of the data and analysis Several measures were taken to ensure the trustworthiness of the data and analysis. First, the researchers were experienced in conducting qualitative research. Second, the researchers had extensive knowledge on doping to guide them in collecting the data, as they had more than five years of experience with Ecoute

Please cite this article in press as: Hauw, D., & Mohamed, S., Patterns in the situated activity of substance use in the careers of elite doping athletes, Psychology of Sport and Exercise (2013), http://dx.doi.org/10.1016/j.psychsport.2013.09.005

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Dopage, the French hotline, and with issues related to elite performance and training because of involvement with French elite sports teams. They were highly sensitive to the demands of the lifestyle and quite familiar with the subcultural idiosyncrasies, terminology and masking strategies that the athletes were liable to use during the interviews. Third, the data were collected in a succession of steps that offered the possibility of verifying previous assertions while new information was being collected. In addition, the compatibility of the diverse data could be verified in an ongoing process and used as a method of triangulation (Lincoln & Guba, 1985). Fourth, the reconstruction of the activity during periods of change in substance use (i.e., chaining of UMAs) and their typicalization (i.e., patterns) were independently coded by the two researchers. The reliability of the coding procedure was assessed and ranged from 74% to 85% between coders. Results Six types of activity integrating substance use and doping were observed. They were labeled “Agree to use,” “Drop out of a nonviable state,” “Return to a former state,” “Prevent a potential deficiency,” “Maintain an acquired state,” and “Balance the sporting life with substance use.” Each was composed at different periods in the athletes’ careers, reflecting the various activities in relation to substances from the first use of a licit one to the use of a banned one. Agree to use The first type of activity, “Agree to use,” consisted of taking a substance without being actively involved in the decision but simply agreeing to do so. It was observed with the use of drugs and performance-enhancing nutritional supplements. The following case of a soccer player illustrates this activity: a) Listened to the medical staff, who insisted that the entire team take a substance during the pre-competition period: “They told me I should do it, just like my teammates; that it was only vitamins.” b) Used the substance and felt the effects: “I felt like I was sweating a lot and that I wasn’t tired, even if I ended the match exhausted, but I was running fast.” c) Stopped taking the substance after his mother and family physician discouraged the use: “She said ‘I forbid you to use something until I know what it is.’ Then she brought me to our doctor who said it was not OK for someone my age to use it. I didn’t really understand because I knew it was not a prohibited substance. but he said it was not OK, so I didn’t use it again.” This activity was composed of two typical patterns labeled “To experiment with substances in competition,” and “To experiment with substances to be a real athlete.” The pattern “To experiment with substances in competition” corresponded to activity with this typical sequence: (a) Listened to a third party who suggested taking substances for a specific performance, (b) Used the substance and felt an amazing state, and (c) Stopped or decided to renew the experience. The pattern “To experiment with substances to be a real athlete” corresponded to activity with this typical sequence: (a) Listened to a third party who suggested taking a substance to enhance the future sporting career, (b) Used the substance without feeling or expecting any specific state, (c) Encountered a problem during competition, (d) Felt the need to follow a rigorous preparation for competition, and (e) Associated the use of the substance with this need.

Drop out of a non-viable state The second type of activity, “Drop out of a non-viable state,” consisted of using substances in response to a current problem that had only been met with irrelevant responses. It was observed with the use of drugs and banned substances. The following case of a rugby player illustrates this activity: a) Was injured and underwent many inconclusive medical tests: “I’m still waiting for a diagnosis and answers.This can’t last forever. They have to figure out what’s wrong. I need to know if I will need to stop playing so I can heal or if we can solve the problem while I keep on training.” b) Used an anti-inflammatory to cope with painful workouts: “I’m currently training with anti-inflammatories, and I still managed to train 13 times this week.” c) Found the situation uncomfortable and hoped it would not last too much longer: “I don’t like this situation, antiinflammatories are pharmaceuticals. it’s like adding water to a river and then being happy that you caught a fish... it doesn’t deal with the problem.” d) Built a new relationship to substance use: “Before I was just curious about doping, like for cannabisdnow it would be more about the effects I could get from it. Sometimes I think that it would solve a lot of problems.” This activity was composed of four typical patterns labeled “To resolve a health problem,” “To deal with a constraining training program,” “To cope with a typical problematic sport situation” and “To wait for a solution to a current problem with no responses.” The pattern “To resolve a health problem” corresponded to activity with this typical sequence: (a) Experienced a period of distress related to an inexplicable drop in physical well-being or performance, (b) Had a checkup that revealed deficiencies, (c) Associated the identified deficiencies with the general health problem, (d) Used substances previously prescribed by a physician, (e) Felt enhanced physical well-being, and (f) Decided that, from now on, biological indicators should be monitored for training and performance. The pattern “To deal with a constraining training program” corresponded to activity with this typical sequence: (a) Coped with a new method of training that was experienced as too difficult to endure, (b) Tried without success to negotiate the type of training, (c) Sought the effects and legitimacy of using a specific substance, (d) Used the substance and felt immediate facilitating effects on performance, (e) Felt amazing facilitating effects on performance, (f) After not receiving a positive control, maintained both training and substance use, and (g) Became injured, and (i) Continued the substance intake and shifted to a new training method. The pattern “To cope with a typical problematic sport situation” corresponded to activity composed of this typical sequence: (a) Listened to a suggestion about using a substance from a third party in a typical sport situation, (b) Weighed the innocuousness versus the risks for a potential positive control, (c) Without any counter indications, and to cope with this typical problematic sport situation, tried the substance during a cure, and (d) After the cure and without identifiable effects, stopped using the substance. The pattern “To wait for a solution to a current problem with no responses” corresponded to activity with this typical sequence: (a) Coped with an injury without medical explanation, (b) Used a substance that enabled a minimum level of training without increasing the severity of the injury, (c) Experienced feelings of helplessness (powerlessness) about being stuck in the situation linked to the temporary, unsatisfactory, short-term character of this “substance solution,” and (d) Considered doping like a field of possible actions for solving the problem.

Please cite this article in press as: Hauw, D., & Mohamed, S., Patterns in the situated activity of substance use in the careers of elite doping athletes, Psychology of Sport and Exercise (2013), http://dx.doi.org/10.1016/j.psychsport.2013.09.005

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Return to a former state The third type of activity, “Return to a former state,” consisted of using substances related to a past regime of sporting activity in order to make up for lost time. It was observed with the use of performanceenhancing nutritional supplements and banned substances. The following case of a volleyball player illustrates this activity: a) Went back to training at a high intensity after recovery: “I am back from a long period of successive injuries, and I need to get on quickly, to improve my physical state faster.” b) Noticed other athletes in the group taking a specific substance: “During the winter season, I noticed some players were taking it. I had never heard about someone being positively tested for it, and the guys were taking it. We talked about that, but not a lot. I didn’t even check anything, I knew there was no problem with that substance.” c) Got the substance and took it: “I didn’t tell anybody, not even my coach. Actually, we’re not used to talking about that stuff.” d) Did not feel any effects and stopped using it: “I felt the effects at a sexual level, but nothing on my performance.honestly it sucks! I didn’t use it for long. Maybe two cures in 2006.” e) Finding no satisfying solution, changed the whole training system: “At that moment, I had the feeling of doing all I could do for it to work, but it never did, I was stuck. So, I stopped playing for this coach, this club. I changed the whole system, with a new team.” This activity was composed of one typical pattern labeled “To use a substance to speed up the recovery time.” The pattern was composed of this typical sequence: (a) Increased training with belated or late benefits, (b) Used a substance that was taken by other athletes, (c) Did not feel the effects so stopped, and (d) Changed the training system and sought other substances.

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This activity was composed of one typical pattern labeled “To anticipate detrimental effects of training on performance.” This pattern corresponded to activity with this typical sequence: (a) Was convinced that the use of legal substances is needed for performance, (b) Regularly used these substances, (c) Monitored the biological indicators that should balance the elite sport activity, (d) Sometimes forgot to take the substances when the routine in the life course changed, and (e) Was an inflexible rigorous consumer during specific periods of competition or hard training. Maintain an acquired state The activity “Maintain an acquired state” consisted of using substances to maintain the current level of performance quality despite a switch in training method that could potentially reduce it. It was observed with the use of performance-enhancing nutritional supplements. The following case of a rugby player illustrates this activity: a) Joined a new team, with radically different methods: “I knew it would be more intense here, but I was expecting a more gradual transition. It was too hard, I was exhausted.” b) Looked for a substance that could help him to keep some of the qualities he had developed with the former method and didn’t want to lose: “What can I take that is legal, and that would be efficient? I wanted a better recovery and didn’t want to lose volume. I was afraid it because there was no strength training in the plans anymore.” c) Discussed a new substance with a nutritionist he knew: “We talked about the pros and he explained the physiological effects. But he also warned me that I should use a safe product, a brand name..” d) After the nutritionist gave approval, checked the components of the product he was considering to find out whether it was detectable: no problem with this product. e) Used the substance, felt the effects and continued to use it: “It was a good compromise for my problem.”

Prevent a potential deficiency The activity “Prevent a potential deficiency” consisted of using substances to ward off potential physiological or psychological distress due to elite training. It was observed with the use of performance-enhancing nutritional supplements. The following case of a cyclist illustrates this activity: a) Was convinced that he needed supplements of some kind to maintain a proper level of biological indicators, which are considered as a prerequisite for high performance: “These substances have an effect, they work, but not directly. I know that without them, there is no balance possible at an elite level.” b) Used supplements his nutritionist prescribed: “I have a lot of substances to use, I always manage to have a stock at home.” c) Devoted himself to regular blood testing in order to check the biological levels and readjust dosages with the nutritionist: “I see him regularly; he has the results of all my workups, explains to me any deficiencies, and asks me how I’m doing at the moment. Then he adjusts the substances, the dosages.and so on.” d) Sometimes forgot to take his supplements: “This is a really complex protocol, this one at lunch, those two before bed. I sometimes lack the time, need to be careful. It implies making an effort all the time not to forget.” e) Was rigorous in the way he took the supplements at specific moments: “When they are sitting out on my kitchen, before an important competition, after a tough training session.”

This activity was composed of one typical pattern labeled “To maintain acquired qualities.” This pattern corresponded to activity with this typical sequence: (a) Coped with a new and exhausting training program, (b) Sought a substance that would address the problem, (c) Discussed a substance and received approval from a nutritionist/physician, (d) Checked the composition of the product and the possibility to receiving a positive control, and (e) Used the substance, continued using it, or stopped using it. Balance the sporting life with substance use The activity “Balance the sporting life with substance use” consisted of reorganizing substance use in relation to the effects of previous substance use on life, training and performance. It was observed with the use of drugs and banned substances. The following case of a track and field athlete illustrates this activity: a) Coped with insomnia: “We were back from two weeks of intensive training and I couldn’t sleep anymore. It was unbearable, and the training was becoming hard to follow. Worse. not productive.” b) Sought a substance that could solve the problem: “I found DHEA, it was a solution to my problem that did not involve injections.” c) Used the substance and felt the effects: “I was sleeping again, but I did not feel any benefit for performance, except that I was able to train properly again.” d) Stabilized the use: “It works, so I keep using it.”

Please cite this article in press as: Hauw, D., & Mohamed, S., Patterns in the situated activity of substance use in the careers of elite doping athletes, Psychology of Sport and Exercise (2013), http://dx.doi.org/10.1016/j.psychsport.2013.09.005

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This activity was composed of two typical patterns labeled “To thwart a negative effect of a substance” and “To extend the positive expectations for a substance to performance.” The pattern “To thwart a negative effect of a substance” corresponded to activity with this typical sequence: (a) Coped with a daily life problem associated with substance use and performance, (b) Sought a substance that would solve this problem, (c) Used substances and felt the effects, and (d) Stabilized all substance intake. The pattern “To extend the positive expectations for a substance to performance” corresponded to activity with this typical sequence: (a) Coped with a daily life problem associated with substance use and performance, (b) Sought a substance that would solve this problem, (c) During this research, explored other possibilities for performance-enhancing drugs, (d) Used substances that should solve the problem, and (e) Increased the dosage of the current substance to enhance performance without feelings of guilt or fear to becoming trapped. Discussion The aim of this study was to refine the analysis of the doping and substance use of elite athletes by focusing on how they relate to substance consumption (licit or not) during their careers. The results reveal that these doping athletes behaved in ways that embedded the substance use into their entire sporting activity, forming typical and differentiated self-organized activities. From a general point of view, substance use can be considered as the consequence of sporting constraints. Indeed, our results showed that substance use is associated to various sporting activity that are quite representative of the sporting constrains that elite athletes will encounter during their career. Athletes take various substances to cope with injuries or a difficult training program, recover a past physical state, or prepare for specific events (e.g., Mazanov et al., 2008; Petroczi, 2007). Thus, substance use is coordinated with other sporting actions to make up a new activity. Moreover, these results confirmed other research that showed that athletes use substances to protect themselves from potential disease caused by their intense activity (e.g., Bilard, Ninot, & Hauw, 2011) or to respond to specific problems in their current lives that they have not been able to solve (Hauw & Bilard, 2012). Beyond this confirmation, our results illuminate the types of sporting constraints in terms of activity that are more closely associated to the use of doping substance. The following types of activity “Drop out to a non viable state”, “Return to a former state”, “Balance the sporting life with substance use” were characterized by the use of doping and licite substance whereas “Agree to use”, “Prevent a potential deficiency” and “Maintain an acquired state” merely involved legal consumption. A major difference between these two groups of activity appears in the temporality of the situation in which athletes were embedded. The first group of activity gathered sequences of action that corresponded to a way of dealing with an immediate concern. In contrast, the second group was characterized by sequences of action that corresponded to future possible development of the situation that was not current or at stake yet. Another element of distinction between these two groups was the situation pressure that was identified as more or less unbearable. For example, the activity “Drop out of a non viable state” belonging to the first group described a situation where the sporting constraints have reached the athlete in a deadlock. On the other hand, the activity “Agree to use”, belonging to the second group and related also to a form of sporting constraints, corresponded to an open situation that set a potential problem that was not concrete. Rather than claiming that doping is the consequence of sporting constraints, we proposed to characterize the vulnerability to doping in terms of these two properties of the tension e

intensity and temporality of the pressure e expressing these constraints in the activity. In other words, athletes’ activity described the various tensions in which they are involved during their sporting life course and some of them are more enclined to the use of doping substance because they emerged in sequences that do not find an issue and increase the impact of the temporal pressure. We also notice that athletes consumed licite substances in these patterns of activity (drugs, performance enhancing supplements). In this dynamic and situated view, two possible interpretations could be proposed. First, the distinction between licite and banned substances was not the main concern during these sequences. This distinction is part of the background of the activity, but the main and meaningful tension at that moment was to break the deadlock and maintain the viability of the current activity. This could be a reason why we observed both types of consumption in these patterns. By the way, we have to recognize that the distinction between banned and licite substances appeared very tenuous for these athletes. Second, the sequences observed in these types of activity could be more refined in order to discriminate the degree of tension that characterized them. We would have thus the possibility to identify the activity in which the use of banned substances would be unavoidable. Another specific results, showing that substance use can also be the starting event that leads to the emergence of a new activity, should be underlined. In certain respects, it is no longer the sporting constraints that create the need to use substances, but rather the use of substances in a sporting context that creates a new self-organized sporting activity in which consumption also evolves. Thus, when athletes have been engaged in regular consumption that has become associated with an experience of enhanced sporting activity, they rapidly have to face new situations they have never had to consider before. This perturbs the current activity and creates a new coordination among all the actions at stake; that is, a new organization. A good example is the use of stimulants, which soon requires the use of sleeping drugs. This analysis suggests the heuristic character of studying doping in relation to the other actions that compose athletes’ entire scope of activity, with consumption embedded in the situated activity (Robbins & Aydede, 2010). In addition, it also demonstrates that a close examination of the dynamics of athletes’ actions provides a viable alternative to the two-step approach (i.e., non-doping to doping) in the psychological study of doping phenomena. The six identified types of activity could also be characterized as configurations of actions in relation to the possibilities offered to athletes to either consume no substances or to engage in sport with the use of them. These possibilities could be considered as having many degrees of freedom, and activity as consisting of constraining and releasing them, as suggested by the dynamic analysis of human activity and the growing field of promoted actions (Reed, 1993; Valsiner, 1997). By taking these approaches, the meaning of substance use can be seen to change in relation to the circumstances and the state of development of the athlete’s activity. The “Agree to use” activity seemed to operate similarly to the freezing of degrees of freedom observed in motor control and consisted of eliminating other organizations of action in order to reduce the complexity of the problem (Bernstein, 1967; Vereijken, Whiting, & Beck, 1992). The athletes agreed to use substances without examining other possibilities, such as modifying forms of training and nutrition, or merely discussing the substances with significant others. Moreover, at that very moment of agreement, the athletes did not consider the proposal as particularly meaningful in the situation. This activity also revealed that the new possibility for action had been embedded in the field of possible actions without serious deliberation. The impact of significant others in the transformation of the field of meaningful actions appeared to have been

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prominent in this process of freezing the degrees of freedom more than the substance itself. It is also important to notice that the use of licite substances were in this situation. Many types of activity appeared to operate as explorations of degrees of freedom in relation to the circumstances the athletes had to deal with, corresponding to an activity of inquiry (Dewey, 1938). The pattern “To deal with a constraining training program” indicates how the athletes explored different possibilities in the situation of organizing a viable training program/schedule. The athletes tried to negotiate the form of training, discussed it with other athletes, examined the possibility of using substances with them and with the physiotherapist. The examination lasted until the most accessible and affordable solution prompted the activity to shift toward a specific coordination among all the actions, including substance use. A similar process was implicit in the pattern “To cope with a typical problematic sport situation.” The inquiry was nevertheless delayed until the emergence of the specific situation that had been anticipated. After that, the athletes examined the possibilities and effects of substances in relation to the meaningful constraints of the situation they were actually experiencing. The pattern “To resolve a health problem” describes another form of inquiry. The possibilities were examined through medical tests, which led to the need to take substances. This chaining of experiences led up to the reorganization of the field of meaningful activity in which the substance solution was henceforward grounded. The use of licite but also banned substances was observed in all of these patterns and activity. Other types of activity appeared to operate as exploitations of the degrees of freedom, embedding substance use in the larger field of performance activity. Here, performing was oriented toward the substance type, dosages or detectability. This was the case for “Prevent a potential deficiency” and “Maintain an acquired state.” The pattern “To anticipate detrimental effects of training on performance” showed variability in the consumption (i.e., regular consumption with some casual omissions). The field of possibilities remained relatively stable in relation to the stream of experience. The pattern “To maintain acquired qualities” showed another form of performing. Here the possibility of using substances was grounded, and the examination was devoted to the type of substance. This level of examination did not correspond to an exploration of the degrees of freedom but to the exploitation of an already stabilized activity in which the use of doping substances was not observed. A specific analysis should be devoted to the activity “Balance the sporting life with substance use,” as a turning point in the dynamics of activity appeared, as previously suggested. The activity of substance use generated a shift in the field of possibilities by creating a new situation with new degrees of freedom. Previously, the field of possible substance use had been related to a problem generated by the sporting activity. At this level, the field of possible use should be considered in relation to the sporting activity that embodied the substance use. This sporting activity created a new possibility for acting or a field of free actions because the whole activity was changed. Thus, a new step in development appeared and an exploration of the degrees of freedom was again possible in relation to licite and banned substances. In sum, these results showed that the use of banned substances appeared during sequences of activity mainly corresponding to the exploration of degrees of freedom. It corresponded to an instability zone in the athletes’ sporting life course. During these periods of activity, the possibility to shift toward the doping use is very critical and circumstances such as teammates or coaches experience appear to play the role of control parameter for a switch to a doping sporting life course or not. The diverse limitations of the study should be examined. From a methodological point of view, the difficulties and challenges of a

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retrospective design should be underlined. In general, these limitations are due to the process of building new meaning when someone has to explain his or her past history. Nevertheless, in an enactive and situated paradigm, the new method that has been described in this research offers several possibilities to limit the weaknesses of traditional verbal reporting (Hauw & Bilard, 2012). Practical implications These findings suggest many possibilities for implementing educational programs. Three major outcomes should be underlined in this respect. First, specific attention should be given to the organization of athletes’ activity in relation to critical periods, which can be the start for a whole new organization. Second, the meaningful world of athletes’ sporting activity should be examined to assess how deeply substance use is embedded (i.e., fields of promoted and free actions). This could be done with a specific anamnesis that collects details on specific sporting actions, daily life actions, and substance use. This is the competence of sport psychologists, who are qualified to distinguish what in an athlete’s consumption dynamics is viable and what is not, taking into account the anecdotic, controlled, circumstantial, suitable, regulated, public, and legal characteristics. By doing so, they can determine what types of actions are favored and help the athletes to open new alternatives in cases where they are turning onto a risky path. Third, the results showed that prevention based on a series of discrete actions, such as information from physicians or sport psychologists’ explanations about the risks of substance use, are entirely unsatisfactory. Prevention should be organized around those actions that are meaningful for athletes. In addition, it should also take into account the sporting career of individual athletes. By regularly checking indicators of the evolution in an athlete’s sporting actions (e.g., results, problems, negative experience, etc.), the transformation of activity in relation to substance use would be better managed. This approach corresponds to a new form of prevention based on the principle of lifelong education (Hauw, 2013b). All of these recommendations could be carried out by the athletes’ coaches and federation staff, but we think that it would be better to include a third party whose independence is guaranteed. Given the high stakes of elite sport competition, this would ensure the administration of an effective prevention program and reduce the temptation to hide doping activities. To conclude, there are many doping activities and to consider them only as responses to biological limitations or as the expression of the intention to enhance performance is undoubtedly too reductive. Placing the focus on the entire meaningful world of sporting actions and their dynamic properties constitutes a worthy challenge for future research. Acknowledgments The present research was supported by a grant from the French Ministry of Health and Sports. References d’Arripe-Longueville, F., Saury, J., Fournier, J. F., & Durand, M. (2001). Coach-Athlete situated interaction during elite French male archery competitions. Journal of Applied Sport Psychology, 13(3), 275e298. http://dx.doi.org/10.1080/ 104132001753144419. Backhouse, S., McKenna, J., Robinson, S., & Atkin, A. (2007). International literature review: attitude, behaviours, knowledge and education-drugs in sport: past, present and future. Social Science Research Fund, WADA, Carnegie Research Institute, Leeds Metropolitan University. Bernstein, N. A. (1967). The co-ordination and regulation of movement. London: Pergamon Press.

Please cite this article in press as: Hauw, D., & Mohamed, S., Patterns in the situated activity of substance use in the careers of elite doping athletes, Psychology of Sport and Exercise (2013), http://dx.doi.org/10.1016/j.psychsport.2013.09.005

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Bilard, J., Ninot, G., & Hauw, D. (2011). Motives for illicit use of doping substances among athletes calling a national anti-doping phone-help service: an exploratory study. Substance Use and Misuse, 46, 359e367. http://dx.doi.org/10.3109/ 10826084.2010.502553. Brissonneau, C., Aubel, O., & Ohl, F. (2008). L’épreuve du dopage. Paris: PUF. Bruner, J. S. (1990). Acts of meanings. Harvard: Harvard University Press. Clark, A. (1997). Being there. Putting the brain, body and the world together again. Cambridge Mass: MIT Press. Dewey, J. (1938). Logic: the theory of inquiry. Henry Holt & Company. Donovan, R. J., Egger, G., Kapernick, V., & Mendoza, J. (2002). A conceptual framework for achieving performance enhancing drug compliance in sport. Sports Medecine, 32, 269e284. Doris, J. M. (2002). Lack of character. Cambridge: Cambridge University Press. Durand, M. (2013). Special issue: human activity, social practices and lifelong education: francophone perspectives. International Journal of Lifelong Education, 32(1), 1e13. http://dx.doi.org/10.1080/02601370.2012.734495. Ecoute dopage. (2009). Activity report retrieved from Ecoute dopage website. www. ecoutedopage.fr/rapportactivite2009.pdf. Ecoute dopage. (2010). Activity report retrieved from Ecoute dopage website. www. ecoutedopage.fr/rapportactivite2010.pdf. Ecoute dopage. (2012). Activity report retrieved from Ecoute dopage website. www. ecoutedopage.fr/rapportactivite2011.pdf. Engeström, Y., Miettinen, R., & Punamäki, R.-L. (Eds.). (1999). Perspectives on activity theory. Cambridge, UK: Cambridge University Press. Fraser-Thomas, J., Côté, J., & Deakin, J. (2005). Youth sport programs: an avenue to foster positive youth development. Physical Education and Sport Pedagogy, 10, 49e70. Hardie, M., Shilbury, D., Ware, I., & Bozzi, C. (2012). I wish I was twenty one now e Beyond doping in the Australian Peloton. Auskadi Samizdats. Hauw, D. (2009). Reflective practice in the heart of training and competition: the course of experience analysis for enhancing elite acrobatics athletes’ performances. Reflective Practice. Special Issue: Reflective Learning in Sport, 10(3), 341e 352. http://dx.doi.org/10.1080/14623940903034671. Hauw, D. (2013a). Toward a situated and dynamics understanding of doping behaviors. In J. Tolleneer, P. Bonte, & S. Sterckx (Eds.), Athletic enhancement, human nature and ethics. Threats and opportunities of doping technologies (pp. 219e235). Berlin: Springer. Hauw, D. (2013b). How unethical actions can be learned: the analysis of the sporting life courses of doping athletes. International Journal of Lifelong Education, 32(1), 14e25. http://dx.doi.org/10.1080/02601370.2012.734493. Hauw, D., & Bilard, J. (2012). Situated activity analysis of elite track and field athletes’ use of prohibited performance-enhancing substances. The Journal of Substance Use, 17(2), 183e197. http://dx.doi.org/10.3109/ 14659891.2010.545858. Hauw, D., & Durand, M. (2007). Situated analysis of elite trampolinist’s problems in competition using retrospective interviews. The Journal of Sport Sciences, 25(2), 173e183. http://dx.doi.org/10.1080/02640410600624269. Hauw, D., & Durand, M. (2008). Temporal dynamics of acrobatic activity: an approach of elite athletes’ specious present. Journal of Sports Science and Medicine, 7, 8e14. Hauw, D., Renault, G., & Durand, M. (2008). How do aerial freestyler skiers land on their feet? A situated analysis of athletes’ activity related to new forms of acrobatic performance. Journal of Science and Medicine in Sport, 11(5), 481e486. http://dx.doi.org/10.1016/j.jsams.2007.06.005. Juarrero, A. (1999). Dynamics in action. Intentional behavior as a complex system. Cambridge Mass: MIT Press. Kirshner, D., & Whitson, J. A. (1997). Situated cognition. Social, semiotic and psychological perspectives. Mahwah: Lawrence Erlbaum Associates. Kleinert, J., & Jüngling, S. (2007). Factors of doping behaviour: model development and first steps of evaluation. In Y. Theodorakis, M. Goudas, & A. Papaioannou (Eds.), Long papers 12th European congress of sport psychology (pp. 655e659). Halkidiki, Greece. Laure, P. (1997). Les gélules de la performance. Paris: Ellipses. Lawrence, J. A., & Valsiner, J. (2003). Making personal sense: an account of basic internalization and externalization processes. Theory & Psychology, 13(6), 723e 752. http://dx.doi.org/10.1177/0959354303136001.

Lazuras, L., Barkoukis, V., Rodafinos, A., & Tzorbatzoudis, H. (2010). Predictors of doping intentions in elite-level athletes: a social cognition approach. Journal of Sport & Exercise Psychology, 32, 694e710. Lentillon-Kaestner, V., & Carstairs, C. (2010). Doping use among young elite cyclists: a qualitative psychosociological approach. Scandinavian Journal of Medicine and Science in Sports, 200, 336e345. http://dx.doi.org/10.1111/j.16000838.2009.00885.x. Lentillon-Kaestner, V., & Carstairs, C. (2011). Can we measure accurately the prevalence of doping? Scandinavian Journal of Medicine and Science in Sports, 21(6), 132e142. http://dx.doi.org/10.1111/j.1600-0838.2010.01199.x. Lincoln, Y. S., & Guba, E. G. (1985). Naturalistic inquiry. Newbury Park, CA: Sage Publications. Lucidi, F., Zelli, A., Mallia, L., Grano, C., Russo, M., & Violani, C. (2008). The socialcognitive mechanisms regulating adolescents’ use of doping substances. Journal of Sports Sciences, 26(5), 447e456. http://dx.doi.org/10.1080/ 02640410701579370. Maturana, H. R., & Varela, F. (1987). The tree of knowledge. Boston: Shambhala Publications. Mazanov, J., Petróczi, A., Bingham, J., & Holloway, A. (2008). Towards an empirical model of performance enhancing supplement use: a pilot study among high performance UK athletes. Journal of Science Medicine in Sport, 11, 185e190. http://dx.doi.org/10.1016/j.jsams.2007.01.003. McGee, K. (2005a). Enactive cognitive science. Part 1: background and research themes. Constructivist Foundations, 1(1), 19e34. McGee, K. (2005b). Enactive cognitive science. Part 2: methods, insights, and potential. Constructivist Foundations, 1(2), 73e82. Morente-Sánchez, J., & Zabala, M. (2013). Doping in sport: a review of elite athletes’ attitudes, beliefs and knowledge. Sports Medicine. http://dx.doi.org/10.1007/ s40279-013-0037-x. Petroczi, A. (2007). Attitudes and doping: a structural equation analysis of the relationship between athletes’ attitudes, sport orientation and doping behaviour. BMC. Substance Abuse Treatment, Prevention, and Policy, 2, 34. http:// dx.doi.org/10.1186/1747-597X-2-34. Reed, E. S. (1993). The intention to use a specific affordance: a conceptual framework for psychology. In R. H. Wosniak, & K. W. Fischer (Eds.), Development in context. Acting and thinking in specific environments (pp. 45e76). Hillsdale, NJ: LEA. Robbins, P., & Aydede, M. (2009). The Cambridge handbook on situated cognition. Cambridge: Cambridge University Press. Sannino, A., & Sutter, B. (2011). Cultural-historical activity theory and interventionist methodology: classical legacy and contemporary developments. Theory & Psychology, 21, 557e570. http://dx.doi.org/10.1177/0959354311414969. Saury, J., & Durand, M. (1998). Practical knowledge of expert coaches: on-site study of training in sailing. Research Quarterly for Exercise and Sport, 69(3), 254e266. Strelan, P., & Boeckmann, R. J. (2003). A new model for understanding performanceenhancing drug use by elite athletes. Journal of Applied Sports Psychology, 15, 176e183. http://dx.doi.org/10.1080/10413200390213795. Theureau, J. (2003). Course-of-action analysis and course-of-action centered design. In E. Hollnagel (Ed.), Handbook of cognitive task design (pp. 55e81). Mahwah, New Jersey: Lawrence Erlbaum Associates. Valsiner, J. (1997). Culture and the development of children’s actions: A theory of human development. Chichester: John Wiley & Sons. Valsiner, J. (2001). Process structure of semiotic mediation in human development. Human Development, 44, 84e97. http://dx.doi.org/10.1159/000057048. Varela, F. J. (1980). Principles of biological autonomy. New York: Elsiever North Holland. Varela, F. J. (1989). Cognitive science. A cartography of current ideas. Cambridge: MIT Press. Vereijken, B., Whiting, H. T. A., & Beck, W. J. (1992). A dynamical systems approach towards skill acquisition. Quarterly Journal of Experimental Psychology, 45A, 323e344. Zelli, A., Mallia, L., & Lucidi, F. (2010). The contribution of interpersonal appraisals to a social-cognitive analysis of adolescents’ doping use. Psychology of Sport and Exercise, 11, 304e311. http://dx.doi.org/10.1016/j.psychsport.2010.02.008.

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