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The importance of stress in the understanding of adolescent health and well-being is widely documented. The measurement of adolescent stress has however been subjected to sufficient methodological and conceptual criticism in recent times to warrant a concerted re-evaluation of the exercise. This study sought information on the nature of adolescent stressors, building on a previous instrument developed by the first author to ask adolescents themselves to inform the development of a pool of new items reflecting stressor experience and to advise on the wording of these items to comprehensively assess that experience. This pool of items was then administered as a self-reported questionnaire to a large sample of school-age adolescents (N greater than 1000) together with a scale to assess the intensity of distress arising from stressor occurrence. Principal components analysis of the questionnaire yielded 10 internally reliable dimensions of adolescent stress, the nature of which were consistent with the available literature on adolescent stressor experience. Scales constructed from this PCA related positively to measures of anxiety and depression, and negatively to a measure of self-esteem, suggesting that they were valid measures of adolescent stress. Test-retest reliability was good for all scales. The resultant Adolescent Stress Questionnaire (ASQ) is therefore suggested to have potential for the measurement of adolescent stress in both research and clinical contexts.

In the 1980s and 1990s, Goldman’s eponymous ‘Dilemma’ asked if athletes would take a substance that guaranteed sporting glory but killed them in 5 years. The 50% acceptance rate was widely reported as evidence supporting the need for anti-doping policy. Evidence from athletes surveyed in 2011 showed only 1% acceptance. To explore why such striking variation exists, and its implications for policy, this study investigated both the validity and reliability of the original Dilemma and how early twenty-first century elite athletes interpret and understand the Dilemma. The reporting of the original Dilemma demonstrated a lack of scientific rigour, which raises questions about the Dilemma’s status as valid and reliable evidence to inform sports drug control policy. Cognitive interviews with a sample of 30 athletes (30 athletes; 14 female; 19 international; age 22.17 ± 2.13) revealed the death outcome made the Dilemma implausible; it was too absolute an outcome given athletes’ non-sporting aspirations (e.g. marriage and parenthood). The idea that a substance could be undetectable and guarantee sporting success was also considered implausible. Athlete conflation of performance enhancement with illegality, immorality and negative health outcomes further undermined perceived plausibility. Thus, the athletes in the sample considered the Dilemma largely implausible. As a consequence of the questionable scientific basis of the original, and the implausibility of the Dilemma to early twenty-first century athletes, the oft-cited 50% acceptance rate is of historical interest only and no longer relevant to drug control policy debate in sport. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To explore how current substance use, including the use of sports supplements and illicit drugs, may impact upon a person's future intentions to use anabolic-androgenic steroids (AAS). DESIGN: Web-based survey. PARTICIPANTS: Two hundred fourteen exercising males (mean age, 30 years; range, 17-61 years) recruited from 5 gymnasia in Sydney, Australia, completed a web-based survey. The survey contained questions relating to sport supplement use, illicit substance use, reasons for currently not using AAS, and reasons for intending to use AAS in the future. INTERVENTIONS: Participants completed a structured interview schedule that included questions regarding licit and illicit substance use, reasons for non-AAS use, and, where appropriate, reasons for intended future AAS use. MAIN OUTCOME MEASURES: The planned main outcome measure was positive intention to use AAS. RESULTS: Sixteen percent of the sample indicated that they would use AAS in the future. Reasons for future AAS use included increasing muscle size (80%), improving appearance (74%), and increasing strength (57%). Four-fifths (80%) of the sample reported use of sports supplements, with vitamins and protein supplements commonly reported (83% and 67%, respectively); more than one-third (36%) reported use of creatine in the past 6 months. Half (52%) of the sample reported use of illicit substances in the preceding 6 months, with amphetamines and cannabis commonly reported (66% and 62%, respectively). Significant predictors of intending to use AAS included past 6-month use of creatine and knowing AAS users. CONCLUSIONS: The use of sport supplements and/or illicit substances may remove barriers for the future use of such drugs as AAS. Future research is necessary to explore in depth whether such substances may act as a 'gateway' to future AAS use. [ABSTRACT FROM AUTHOR]

Objective : The onset of smoking in adolescence leads to significant health problems in later life and so adolescent smoking prevention is a crucial concern of health psychology. Yet the evidence on smoking prevention in adolescence is not encouraging. The objective of this study was to examine the relative long‐term efficacy of three specifically focussed prevention strategies (health‐oriented, fitness‐oriented and social skills/stress management‐oriented) directed at the onset of adolescent smoking. Design : A longitudinal intervention study. Method : A large sample of adolescents aged 11–17 years was assessed for smoking behaviour and then assigned through group randomization to one of the three intervention programmes listed above. Following intervention, based on four standard classroom sessions, smoking behaviour was then reassessed immediately after intervention. Final follow‐up of smoking behaviour at 12 months after intake yielded completed data for n = 1,694 (62.3%) of the intake cohort. Data on smoking behaviour were then compared both across intervention strategies and with another large “control” cohort of adolescents who had been identically assessed in a previous study by DGB. Results : Application of a health‐oriented strategy was significantly better than the other two strategies in controlling smoking behaviour immediately following intervention. The intervention strategy emphasizing social skills and stress management in the face of peer pressure to smoke was, however, superior to either the health‐ or fitness‐oriented strategies, or to the “control” group in controlling smoking behaviour at 12‐month follow‐up. Conclusions : While the health message cannot be dismissed as a focus for adolescent smoking prevention, a strategy that assists young people to resist the effects of peer pressure through social skills and stress management seems to provide the most enduring means of controlling smoking behaviour in adolescence. [ABSTRACT FROM AUTHOR]

Adolescent stress is an emerging area of importance in considerations of the health of young people. Exposure to stress predicts a range of both physical and mental health problems in adolescents and relates, as well, to the initiation of important health risk behaviours. Yet the measurement of stress in adolescents has been as fraught with methodological difficulty as it has been for adults. This paper examines the Adolescent Stress Questionnaire (ASQ) which was developed specifically to address the domain of stressors specific to adolescent experience and looks at three cohorts of responses to this questionnaire over time (1995, 1998 and 2001). It assesses the stability of the original 7-factor structure of the ASQ over time, and while confirmatory factor analysis indicates that stability to be acceptable, it also suggests that either adolescent stressors themselves, or the language by which they are reported, vary sufficiently over time to warrant the refinement of the instrument. Copyright © 2002 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

This paper explores one possible operationalization of smoking intention to assist development of adolescent smoking intervention programmes. Such programmes usually focus on predictors of current smoking, ignoring predictors of intentions to smoke, or how intentions relate to actual future smoking. Respondents took part in two stages of a repeated measures national survey on Australian adolescent smoking behaviour (12-month interval between administrations). A total of N=1419 adolescents provided matched data, measuring personal smoking habits, intentions of smoking behaviour, stress (seven subscales), self-esteem and response to the General Health Questionnaire (GHQ-12). A comparison of discriminant function predictors showed similarity between the current smoking and intention to smoke, with only one predictor differing between the functions. Non-smokers were more behaviourally consistent with their stated non-smoking intention over 12 months (i.e. remain non-smokers) than smokers (i.e. intention seemed unrelated to actual behaviour). While the predictors give no general indication of whether the processes behind the intention to smoke differ from current smoking, the intention to smoke may be a better focus for intervention with smokers given the apparent inconsistency with stated intention. Intervention for non-smokers may be usefully focused on maintaining non-smoking rather than preventing smoking. [ABSTRACT FROM AUTHOR]

Both high stress and low self-esteem have been consistently, though independently, reported to relate to aspects of adolescent smoking behaviour. Recent work on self-esteem, however, suggests that adequate provision of this attribute may protect the individual adolescent from unpleasant dysphoric or harmful behavioural states. In line with this suggestion, the present study sought to extend this to the area of adolescent smoking behaviour. While independent associations were confirmed there was not strong support for a protective effect of self-esteem on adolescent smoking in the face of stressor exposure. A modest sex effect was evident but not of sufficient magnitude to allow firm conclusions. Nonetheless, the results were tempting enough to indicate further investigation. Copyright © 2001 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Stress is an established correlate of smoking behaviour in regular adult smokers and has been related to the use of alcohol and other drugs as well. Empirical data supporting these assertions are entirely consistent with theoretical conceptions of both smoking and other substance use behaviours. Despite both supportive theory and empirical evidence with adults, however, little work has been done to extend such views to adolescent smoking and the use of other substances, where the evolution of these health risk behaviours is still plastic and potentially amenable to intervention. The present study reports associations between sources of adolescent stress assessed by an instrument purposely constructed for that exercise and both smoking behaviour and the use of alcohol and other substances. Some sources of stress in the self-reported experience of adolescents statistically related both to current smoking and to the use of alcohol and other drugs. Associations were generally stronger for smoking than for other substances and both stronger and broader for girls than for boys. Stress arising from compulsory school attendance was broadly associated with substance use for both boys and girls and this was in line with past evidence; for girls, however, associations extended to stressors arising from other sources and particularly those to do with the family. The theoretical bases for these findings are discussed in the context of the stress reduction properties of smoking and other substance use, and the implications for intervention through targeted stress management are raised. [ABSTRACT FROM AUTHOR]

Abstract Background Despite the growing body of literature and putative links between the use of ergogenic nutritional supplements, doping and illicit drugs, it remains unclear whether, in athletes' minds, doping aligns with illicit behaviour or with functional use of chemical or natural preparations. To date, no attempt has been made to quantitatively explore athletes' mental representation of doping in relation to illegality and functionality. Methods A convenience sample of student athletes from a large South-Eastern Australian university responded to an on-line survey. Competitive athletes (n = 46) were grouped based on self-reported use as follows: i) none used (30%), ii) supplement only (22%), iii) illicit only (26%) and iv) both supplements and illicit drug use (22%). Whereas no athlete reported doping, data provided on projected supplement-, doping- and drug use by the four user groups allowed evaluation of doping-related cognition in the context of self-reported supplement- and illicit drug taking behaviour; and comparison between these substances. Results A significantly higher prevalence estimation was found for illicit drug use and a trend towards a biased social projection emerged for supplement use. Doping estimates by user groups showed mixed results, suggesting that doping had more in common with the ergogenic nutritional supplement domain than the illicit drug domain. Conclusions Assessing the behavioural domain to which doping belongs to in athletes' mind would greatly advance doping behaviour research toward prevention and intervention. Further investigation refining the peculiarity of the mental representation of doping with a larger study sample, controlling for knowledge of doping and other factors, is warranted.

Abstract Background The 'False Consensus Effect' (FCE), by which people perceive their own actions as relatively common behaviour, might be exploited to gauge whether a person engages in controversial behaviour, such as performance enhancing drug (PED) use. Hypothesis It is assumed that people's own behaviour, owing to the FCE, affects their estimation of the prevalence of that behaviour. It is further hypothesised that a person's estimate of PED population use is a reliable indicator of the doping behaviour of that person, in lieu of self-reports. Testing the hypothesis Over- or underestimation is calculated from investigating known groups (i.e. users vs. non-users), using a short questionnaire, and a known prevalence rate from official reports or sample evidence. It is proposed that sample evidence from self-reported behaviour should be verified using objective biochemical analyses. In order to find proofs of concept for the existence of false consensus, a pilot study was conducted. Data were collected among competitive UK student-athletes (n = 124) using a web-based anonymous questionnaire. User (n = 9) vs. non-user (n = 76) groups were established using self-reported information on doping use and intention to use PEDs in hypothetical situations. Observed differences in the mean estimation of doping made by the user group exceeded the estimation made by the non-user group (35.11% vs. 15.34% for general doping and 34.25% vs. 26.30% in hypothetical situations, respectively), thus providing preliminary evidence in support of the FCE concept in relation to doping. Implications of the hypothesis The presence of the FCE in estimating doping prevalence or behaviour in others suggests that the FCE based approach may be an avenue for developing an indirect self-report mechanism for PED use behaviour. The method may be successfully adapted to the estimation of prevalence of behaviours where direct self-reports are assumed to be distorted by socially desirable responding. Thus this method can enhance available information on socially undesirable, health compromising behaviour (i.e. PED use) for policy makers and healthcare professionals. The importance of the method lies in its usefulness in epidemiological studies, not in individual assessments.

Abstract Background Athletes are expected to consider multiple factors when making informed decision about nutritional supplement use. Besides rules, regulations and potential health hazards, the efficacy of different nutritional supplements in performance enhancement is a key issue. The aim of this paper was to find evidence for informed decision making by investigating the relationship between specific performance-related reasons for supplement use and the reported use of nutritional supplements. Methods The 'UK Sport 2005 Drug Free Survey' data (n = 874) were re-analysed using association [χ2] and 'strength of association' tests [ϕ] to show the proportion of informed choices and to unveil incongruencies between self-reported supplement use and the underlying motives. Results Participants (n = 520) reported supplement use in the pattern of: vitamin C (70.4%), creatine (36.1%), whey protein (30.6%), iron (29.8%), caffeine (23.8%), and ginseng (8.3%) for the following reasons: strength maintenance (38.1%), doctors' advice (24.2%), enhancing endurance (20.0%), ability to train longer (13.3%), and provided by the governing body (3.8%). Of thirty possible associations between the above supplements and reasons, 11 were predictable from literature precedents and only 8 were evidenced and these were not strong (ϕ < .7). The best associations were for the ability to train longer with creatine (reported by 73.9%, χ2 = 49.14, p < .001; ϕ = .307, p < .001), and maintaining strength with creatine (reported by 62.6%, χ2 = 97.08, p < .001; ϕ = .432, p < .001) and whey protein (reported by 56.1%, χ2 = 97.82, p < .001; ϕ = .434, p < .001). Conclusion This study provided a platform for assessing congruence between athletes' reasons for supplement use and their actual use. These results suggest that a lack of understanding exists in supplement use. There is an urgent need to provide accurate information which will help athletes make informed choices about the use of supplements.

Abstract Background The widespread use of nutritional supplements among athletes is poorly understood. The prevalence of supplement intake and users' knowledge have been researched independently leading to useful, but disconnected, information on supplement use. Methods The 'UK Sport 2005 Drug Free Survey' data (n = 874) were re-analysed using association [χ2] and 'strength of association' tests [φ], to discover observed incongruencies between self-reported supplement use and the underlying motives. Results are given for test pairs between 'motive for use' [doctor's advice, avoiding sickness, overcoming injuries and enhancement of diet] and each supplement used and these were categorized as strong (φ > .7), intermediate (7 < φ > .3) and weak (φ < .3). Results The use of selected supplements varied widely as follows: multivitamin (72.7%), vitamin C (70.4%), echinacea (30.8%), iron (29.8%), magnesium (11.0%) and ginseng (8.3%). Associations with motive were found in 8 of the 10 test pairs which were expected from literature precedents, however only weak associations exist. Of these, four were associated with avoidance of sickness [iron (χ2 = 11.94, p < .001; φ = .15, p = .001), multivitamin (χ2 = 6.43, p < .001; φ = .11, p = .011), vitamin C (χ2 = 54.67, p < .001; φ = .32, p < .001) and echinacea (χ2 = 40.34, p < .001; φ = .28, p < .001)]. The remaining 4 associations were: no time to prepare meals with ginseng (χ2 = 7.64, p = .006; φ = .12, p = .006) and multivitamin (χ2 = 9.103, p = .003; φ = .13, p = .003); overcoming injuries with magnesium (χ2 = 6.99, p = .008; φ = .11, p = .008); doctors' advice and iron (χ2 = 35.00, p < .001; φ = .25, p = .001). Conclusion These results suggest a lack of understanding regarding supplements and health maintenance, except for vitamin C and echinacea. Furthermore, supplement use is apparently independent of physicians/dieticians' advice, except for iron. This may suggest a widespread circumvention of expert advice in the growing area of supplement use and therefore should be addressed to underscore potential health risks.

Debate about the ethics of drug control in sport has largely focused on arguing the relative merits of the existing antidoping policy or the adoption of a health-based harm minimisation approach. A number of ethical challenges arising from antidoping have been identified, and a number of, as yet, unanswered questions remain for the maturing ethics of applying harm minimisation principles to drug control for sport. This paper introduces a 'third approach' to the debate, examining some implications of applying a stakeholder theory of corporate social responsibility (CSR) to the issue of doping in sport. The introduction of the stakeholder-CSR model creates an opportunity to challenge the two dominant schools by enabling a different perspective to contribute to the development of an ethically robust drug control for sport., (Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/)

Background/aim: Discussions of doping often report Goldman's sensational results that half of the elite athletes asked would take a drug that guaranteed sporting success which would also result in their death in 5 years' time. There has never been any effort to assess the properties of the 'Goldman dilemma' or replicate the results in the post World Anti-Doping Agency context. This research evaluated the dilemma with contemporary elite athletes., Methods: Participants at an elite-level track and field meet in North America were segregated into an interview or online response. After basic demographics, participants were presented with three variant 'Goldman' dilemmas counter-balanced for presentation order., Results: Only 2 out of 212 samples  (119 men, 93 women, mean age 20.89) reported that they would take the Faustian bargain offered by the original Goldman dilemma. However, if there were no consequences to the (illegal) drug use, then 25/212 indicated that they would take the substance (no death condition). Legality also changes the acceptance rate to 13/212 even with death as a consequence. Regression modelling showed that no other variable was significant (gender, competitive level, type of sport) and there was no statistical difference between the interview and online collection method., Conclusions: Goldman's results do not match our sample. A subset of athletes is willing to dope and another subset is willing to sacrifice their life to achieve success, although to a much lesser degree than that observed by Goldman. A larger scale online survey is now viable to answer important questions such as variation across sports.

Objectives: There is debate concerning whether the guiding paradigm for anti-doping policy should be the current legalistic approach or a "harm minimisation" approach prioritising athlete health. This study sought to determine whether a representative sample of Australians prioritises health above other concerns using the World Anti-Doping Code's Spirit of Sport statement which lists the 11 attributes that define the moral basis for anti-doping., Design: A Best-Worst Scaling (BWS) Balanced Incomplete Block Design experiment using 11 choice sets of five Spirit attributes from the set of 11, with the attributes within each choice set in a random order., Methods: A representative sample of n=168 Australians responded to an on-line survey. The BWS scores defined the relative ranking of each attribute to define an aggregate model and demographically defined models (gender, education, sports participation and sports following)., Results: Health was ranked as 7/11 in the aggregate model. Only those who did not follow sport prioritised health (2/11), with other demographic models failing to show a meaningful departure from the aggregate model., Conclusions: Australians ranked health below other attributes in the Spirit of Sport, appearing to prioritise "rule following" consistent with the legalistic approach. This challenges the harm minimisation approach to managing the role of drugs in sport and suggests that rule-following and legalistic approaches to drug use should take precedence over health messages., (Copyright © 2012 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.)

Anti-doping activities in sport have shifted from secondary prevention (intervening after athletes have used) to educational strategies focused on primary prevention through promoting abstinence. There is no empirical evidence to guide targeting of anti-doping education initiatives. In this paper, a heuristic to guide education initiatives was derived by re-analysing a series of interviews (n=20) with athletes, coaches, sports managers, physiotherapists and sports nutritionists. The findings indicate primary prevention of doping may be enhanced by timing it around periods of career instability where athlete vulnerability to doping may increase as a function of winning or losing sponsorship. Sponsorship is broadly defined as financial (e.g. salary stipend) and non-financial support (e.g. training facilities). This provides a basis for targeting education interventions to promote abstinence. Two options are offered to mitigate the need to time prevention activity around career instability by lessening the effect of sponsorship on athlete doping. The first is liberalising access to legitimate performance enhancing technologies (e.g. training techniques or nutritional supplements). The second is to delay access to financial sponsorship (beyond living expenses) until retirement, with monetary gains (e.g. prize money) deposited into an account where penalties are debited if the athlete is caught doping., (Copyright © 2010 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.)

Behavioural intention was advanced as an alternative bifurcation variable to peer pressure in the context of a cusp catastrophe model of changes in adolescent substance use (Clair, 1998; Byrne, Mazanov & Gregson, 2001). Three sets of models were tested using data from a 12 month longitudinal study of adolescent smoking in Australia: the first with peer pressure only as the bifurcation term, the second with behavioural intention only and the third with both. In isolation both bifurcation variables performed similarly (adjusted-R2 and beta). In the third model, peer pressure edged out behavioural intention as an indicator of catastrophic change. Post hoc analysis revealed the polynomial and simple terms of initial conditions were more important than the bifurcation variable to explain change in smoking behaviour. This provoked a call for more work on finding an appropriately complex (non-straight line), theoretically justifiable mathematical model of adolescent substance use. Overall, behavioural intention was considered equivalent to peer pressure as a bifurcation variable although further research is needed to confirm this result.