A call for policy guidance on psychometric testing in doping control in sport

Abstract

One of the fundamental challenges in anti-doping is identifying athletes who use, or are at risk of using, prohibited performance enhancing substances. The growing trend to employ a forensic approach to doping control aims to integrate information from social sciences (e.g., psychology of doping) into organised intelligence to protect clean sport. Beyond the foreseeable consequences of a positive identification as a doping user, this task is further complicated by the discrepancy between what constitutes a doping offence in the World Anti-Doping Code and operationalized in doping research. Whilst psychology plays an important role in developing our understanding of doping behaviour in order to inform intervention and prevention, its contribution to the array of doping diagnostic tools is still in its infancy. In both research and forensic settings, we must acknowledge that (1) socially desirable responding confounds self-reported psychometric test results and (2) that the cognitive complexity surrounding test performance means that the response–time based measures and the lie detector tests for revealing concealed life-events (e.g., doping use) are prone to produce false or non-interpretable outcomes in field settings. Differences in social-cognitive characteristics of doping behaviour that are tested at group level (doping users vs. non-users) cannot be extrapolated to individuals; nor these psychometric measures used for individual diagnostics. In this paper, we present a position statement calling for policy guidance on appropriate use of psychometric assessments in the pursuit of clean sport. We argue that, to date, both self-reported and response-time based psychometric tests for doping have been designed, tested and validated to explore how athletes feel and think about doping in order to develop a better understanding of doping behaviour, not to establish evidence for doping. A false ‘positive’ psychological profile for doping affects not only the individual ‘clean’ athlete but also their entourage, their organisation and sport itself. The proposed policy guidance aims to protect the global athletic community against social, ethical and legal consequences from potential misuse of psychological tests, including erroneous or incompetent applications as forensic diagnostic tools in both practice and research.

Introduction

Owing to the recurring doping scandals, a degree of suspicion always falls upon competitive sport and its stakeholders. In a bid to assure the general public, athletes are looking for ways to pre-emptively prove their noble standing as ‘clean athletes’. In recent years, athletes have made public pledges of support for global and national anti-doping campaigns such as the World Anti-Doping Agency's Say NO to doping! and UK Anti-Doping's 100% me. Individually, athletes are also taking ownership of the ‘clean sport’ heuristic, as exemplified by athlete Dee Dee Trotter who is using social networks to promote the assertion ‘Test me, I am clean!’. Beyond anti-doping organisations, the independent not-for-profit organisation Bike Pure aims to promote clean cycling and has amassed a significant following.

However, high profile cases of prolonged and systematic doping, that have been retrospectively admitted or proven, cast a pall over any athlete's self-declared innocence. In a legal sense, one is innocent until proven guilty but in the public eye and the anti-doping sphere, this is not so much the case. Doping control builds on detection-based deterrence through doping testing, combined with education-based prevention. Whilst the latter encompasses all athletes under the auspices of the national/international anti-doping organisations and sport federations, the costs and logistics of drug testing prohibits the detection net to be cast far and wide. Consequently, routine measures to evidence clean status for a large number of athletes are not readily available. Periodically repeated analytical testing of all athletes’ biological samples to continuously provide evidence for the clean status is not feasible for many reasons: (1) as argued above, it is not possible to evidence ‘clean’ status directly, only by the tacit assumption that all non-clean athletes are detected and removed; (2) the recently observed expansion of the prohibited substances, particularly with endogenous hormones and noble gases (e.g., xenon and argon) poses an increasing challenge to detection-based doping control; (3) the cost is prohibitively high at an average of 300 US dollars for each routine test, with specialist tests being much more costly (personal communication, Olivier Rabin, January 18, 2013) and (4) management of such a system is not only resource intensive and inconvenient (Elbe, Melzer, & Brand, 2012) or inherently paradoxical (Pitsch, 2013), but mandating such a system is also an infringement on athletes’ human rights (Hanstad & Loland, 2009). The question is then how can one pre-emptively prove non-guilt?

Entrepreneurial initiatives appear to emerge as alternatives to analytical testing, reaching for cost effective psychometric methods readily available in the anti-doping researcher's tool-box. These tests are widely available (published or otherwise accessible), relatively inexpensive and non-invasive, with results easily stored and analysed if compared to any form of analytical tests based on bodily fluids and tissues. Although authoritative voices, such as WADA's former Chairman John Fahey, advocate education – and thus social science approaches – over increased analytical testing effectiveness and capacity (Lane, 2014), financial investment has not followed such advocacy. The funding balance is still heavily weighted towards supporting the development of more sophisticated analytical techniques, rather than evidence-based prevention programmes (Backhouse, Patterson, & McKenna, 2012). Despite this imbalance, recent years witnessed the emergence of new researchers and teams in the landscape of social science doping research. On the one hand, this expansion has had a positive effect on doping research by bringing diversity, variety and international flavours. On the other hand, it increases the risk of potential misuse of these psychometric tests and consequently, misinterpretation of the outcomes.

Our current concerns about the potential misuse of psychometric measures arose from a recent privately funded anti-doping initiative the Clean Protocol (http://cleanprotocol.org/), which aims to issue athletes with a ‘clean’ certificate upon a successful pass of a battery of psychometric assessments, including a lie detector test. Despite that anti-doping organisations with sanctioning power distanced themselves from this initiative, some testing already took place on a voluntary basis (Cornwall, 2014). With indications for further testing mandated for teams, we felt the urgent need for informing end-users (athletes, entrepreneurs, anti-doping officials and researchers) about the limitations inherent in direct- and indirect psychometric measurements and issue a caution against employing these psychometric measures outside their intended use. Although the Clean Protocol is propagated as a positive approach by offering a ‘clean’ badge to those who can ‘prove’ that they do not use prohibited methods and substances (rather than identifying athletes who have doped), diagnostics do not work on this principle. It is the exact opposite. Because we cannot prove that something is absent, the initial assumption in any diagnostic procedure or statistical testing is that ‘something is not present’. This assumption then – if there is enough evidence to the contrary – is proven to be incorrect and thus rejected. Applying this position to sport, diagnostics tests (Clean Protocol included, along with any form of analytical doping testing) are unable to generate proof that an athlete is ‘clean’. Put simply, no test is perfect. The lack of evidence does not mean with absolute certainty that there is no evidence; and equally if evidence is found, it may have a legitimate explanation other than doping. Owing to the potential consequences from a false positive, any testing protocol must err on the side of caution and its diagnostic tests must guarantee a low risk of falsely accusing honest athletes with doping.

Developments around anti-doping, which focus on ‘the bad athletes’, signal a change in directions toward non-analytical forensic approaches – either in lieu of or to inform the resource-intensive analytical testing. In 2011, the World Anti-Doping Agency bestowed the Young Investigator's Award for the development of the attitude-based “Forensic Anti-Doping Interview, or FADI, as a standardised diagnostic assessment tool that can be used to identify athletes who may be using banned substances” (James Cook University News and Media, 2010, The Profiler, 2011). Even though implementation has not been attempted, anti-doping organisations have had a natural interest in methods – analytical, forensic or psychological – that are capable of identifying doping users. In the past 5 years, anti-doping agencies funded research into exploring the usefulness of indirect approaches to detect doping behaviour, such as the false consensus effect (Petróczi et al., 2008b, Uvacsek et al., 2011) and the implicit association concept (Brand et al., 2014a, Brand et al., 2014b, Petróczi et al., 2008a, Petróczi et al., 2011a, Petróczi et al., 2011b). Whilst these attempts did not fulfil the need of producing a diagnostic tool, the results offered valuable insights into athletes’ doping mindsets and highlighted the complexity that surrounds the detection of doping behaviour with psychometric testing.

Doping research includes exploratory work in personality profiling of doping users and of athletes who are susceptible for doping (e.g., Barkoukis et al., 2011, Gucciardi et al., 2011); along with identifying the ingredients of a doper prototype (Whitaker, Long, Petróczi, & Backhouse, 2013), but mainly without validated psychometric measures. Although not involving psychometrics, ‘muscle profiling’ (identifying suspects based on having unusually large muscles) is an accepted practice of some police units and national anti-doping organisations (Mulrooney & van de Ven, 2015).

Taken all together, it is vital that anti-doping organisations engaging in doping control, prevention and/or education – and their customers – are cognisant and cautious about the limitations inherent in direct and indirect psychometric measurements. Recent developments in anti-doping – with informed, intelligence-led approaches and targeted testing within the anti-doping programme – further underscore the need for a global guidance on psychometric testing.

In this commentary, as a group of leading European experts in psychological research of doping in sport, we present a position statement calling for policy guidance on appropriate use of psychometric assessments in anti-doping. We argue that (1) these measurements have been designed, tested and validated to explore how groups of athletes feel and think about doping, not to determine whether an individual athlete engages in prohibited performance enhancing practices, (2) the psychometric properties established for the athletic groups in controlled research settings under anonymous conditions should not be interpreted as ecological validity for individual diagnostics and (3) the unique characteristics of athletic populations at different levels of involvement and doping-control (e.g., elite, sub-elite, amateur competitive and recreational) must be taken into consideration when interpreting psychometric test differences. It is imperative that we look at these psychometric tests with critical eyes and set clear boundaries for what each can and cannot be used for. In order to inform and protect athletes, anti-doping officials and policy makers from the consequences of potential misuse of the existing psychometric tests, we provide a succinct critical evaluation of the direct and indirect methodologies used in the context of doping prevention. We then make recommendations for the key ingredients of a global policy guide on the use of psychometric testing in social science doping research and anti-doping.