Pub Date : 2025-09-05DOI: 10.1016/j.peh.2025.100365
Dimitrios Liokaftos
The vast array of methods promoted in a deeply commodified US bodybuilding and fitness culture includes the use of various substances. From nutritional supplements to anabolic steroids, the use of such substances has been shown to be primarily practiced not in the contained world of elite sport competition but amongst the general population. Ranging from gym-goers to clients of anti-ageing clinics, ordinary citizens have increasingly come to understand their use of such substances in terms of enhanced well-being, an indispensable technology for achieving higher standards of fitness, ability, and health. As a consequence, lobbying against State attempts to regulate such substances is put forth precisely as a defence of the right to self-govern one's own body, health, and life more generally. Focusing on the US context of the 1990s-2000s, the present paper looks at high-profile cases of regulation of such substances and the corresponding reactions inside bodybuilding culture. The latter I draw on in its capacity as an extreme yet symbolically crucial faction of the broader fitness culture that relentlessly emphasises individual responsibility and self-discipline. Ultimately, I will attempt to show how the very definition of health is not a static given but rather a core stake in these debates, as well as how the discourse of self-management is implicated in negotiating individual and group identities.
{"title":"From supplements to steroids: Substance use and the discourse of self-management in dominant bodybuilding culture","authors":"Dimitrios Liokaftos","doi":"10.1016/j.peh.2025.100365","DOIUrl":"10.1016/j.peh.2025.100365","url":null,"abstract":"<div><div>The vast array of methods promoted in a deeply commodified US bodybuilding and fitness culture includes the use of various substances. From nutritional supplements to anabolic steroids, the use of such substances has been shown to be primarily practiced not in the contained world of elite sport competition but amongst the general population. Ranging from gym-goers to clients of anti-ageing clinics, ordinary citizens have increasingly come to understand their use of such substances in terms of enhanced well-being, an indispensable technology for achieving higher standards of fitness, ability, and health. As a consequence, lobbying against State attempts to regulate such substances is put forth precisely as a defence of the right to self-govern one's own body, health, and life more generally. Focusing on the US context of the 1990s-2000s, the present paper looks at high-profile cases of regulation of such substances and the corresponding reactions inside bodybuilding culture. The latter I draw on in its capacity as an extreme yet symbolically crucial faction of the broader fitness culture that relentlessly emphasises individual responsibility and self-discipline. Ultimately, I will attempt to show how the very definition of health is not a static given but rather a core stake in these debates, as well as how the discourse of self-management is implicated in negotiating individual and group identities.</div></div>","PeriodicalId":19886,"journal":{"name":"Performance enhancement and health","volume":"13 4","pages":"Article 100365"},"PeriodicalIF":3.7,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144996884","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-09-05DOI: 10.1016/j.peh.2025.100378
Usva Friman, Matilda Ståhl
In this study, we will approach gender equality in esports as an organisational question, focusing specifically on gender discrimination as an integrity and governance issue in (inter)national esports federations in a specific geographical and cultural context. We will explore how esports federations in the Nordic countries (Finland, Sweden, Norway, Denmark, and Iceland) aim to promote gender equality in their operations – and the tensions and challenges involved in this process. Our material consists of seven thematic semi-structured interviews with representatives of national esports federations in the Nordic countries.
Our analysis focuses on three research questions:
RQ1: How do representatives of the Nordic esports federations understand their current gender equality situation?
RQ2: What steps are these organisations taking to promote gender equality in Nordic esports?
RQ3: What kind of tensions and challenges relate to these conceptions and goals?
To answer these questions, we will explore our interview material reflected against the gendered structures in esports organisations and governance as well as the idea of gender equality as part of the ‘Nordic brand.’ Our findings will demonstrate that while gender equality is described as a central goal and value shared amongst the Nordic esports federations, there are also some tensions and challenges in the way of pursuing this goal, including a lack of clear value definitions, goals, and strategies, a limited and uncertain perspective of the target group of gender equality actions, the contested question of gender segregation as an inclusion tool, and financial constraints. Without specific strategies and matching tangible practices for improving gender equality, there is also a significant risk that the perceived shared goal to pursue gender equality will remain at the level of brand talk instead of creating real change.
{"title":"‘Much better than the rest of the world, but there is still a lot to do’: Promoting gender equality in Nordic esports","authors":"Usva Friman, Matilda Ståhl","doi":"10.1016/j.peh.2025.100378","DOIUrl":"10.1016/j.peh.2025.100378","url":null,"abstract":"<div><div>In this study, we will approach gender equality in esports as an organisational question, focusing specifically on gender discrimination as an integrity and governance issue in (inter)national esports federations in a specific geographical and cultural context. We will explore how esports federations in the Nordic countries (Finland, Sweden, Norway, Denmark, and Iceland) aim to promote gender equality in their operations – and the tensions and challenges involved in this process. Our material consists of seven thematic semi-structured interviews with representatives of national esports federations in the Nordic countries.</div><div>Our analysis focuses on three research questions:</div><div>RQ1: How do representatives of the Nordic esports federations understand their current gender equality situation?</div><div>RQ2: What steps are these organisations taking to promote gender equality in Nordic esports?</div><div>RQ3: What kind of tensions and challenges relate to these conceptions and goals?</div><div>To answer these questions, we will explore our interview material reflected against the gendered structures in esports organisations and governance as well as the idea of gender equality as part of the ‘Nordic brand.’ Our findings will demonstrate that while gender equality is described as a central goal and value shared amongst the Nordic esports federations, there are also some tensions and challenges in the way of pursuing this goal, including a lack of clear value definitions, goals, and strategies, a limited and uncertain perspective of the target group of gender equality actions, the contested question of gender segregation as an inclusion tool, and financial constraints. Without specific strategies and matching tangible practices for improving gender equality, there is also a significant risk that the perceived shared goal to pursue gender equality will remain at the level of brand talk instead of creating real change.</div></div>","PeriodicalId":19886,"journal":{"name":"Performance enhancement and health","volume":"13 4","pages":"Article 100378"},"PeriodicalIF":3.7,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144996886","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-09-05DOI: 10.1016/j.peh.2025.100369
Helen Ruud, Julius Jooste
Objective
This study explored the interrelatedness between athletes’ performance beliefs, coping ability, and mental health, and evaluated a four-week Rational Emotive Behaviour Therapy (REBT) mobile app intervention targeting these factors
Design and Methods
A multiphase randomised comparative design was used where 155 athletes (Mage = 26.93, SD = 11.32) completed an online survey. A subset of 23 athletes (Mage = 33.70, SD = 14.15) participated in a four-week mobile-app intervention of which the experimental group received eight micro-learning sessions focused on REBT principles and self-help activities to challenge and replace irrational thinking in sport, while the control group received conventional psychological skills training
Results
Correlation analyses revealed significant associations between the factors. Further analyses using Hayes’ PROCESS macro revealed that both coping ability and irrational beliefs mediated the relationship between them and mental health, with coping ability showing a stronger mediation effect. Furthermore, independent samples t-tests analyses confirmed significant improvements in participants’ exhibition of irrational performance beliefs upon completion of the RBT-inspired mobile app intervention, with thematic analyses of qualitative feedback highlighting the mobile app’s utility as a tool for self-management of cognitions and emotions in sport
Conclusion
The incorporation of psychological skills training to enhance coping ability should remain integral to REBT approaches aimed at improving athletes’ mental health in sport. Additionally, mobile web-based interventions hold potential as a valuable and easily accessible tool to support athletes’ psychological needs.
{"title":"Investigating the interconnectedness of athletes’ performance beliefs, coping ability, and mental health, and the efficacy of a REBT-inspired mobile app intervention","authors":"Helen Ruud, Julius Jooste","doi":"10.1016/j.peh.2025.100369","DOIUrl":"10.1016/j.peh.2025.100369","url":null,"abstract":"<div><h3>Objective</h3><div>This study explored the interrelatedness between athletes’ performance beliefs, coping ability, and mental health, and evaluated a four-week Rational Emotive Behaviour Therapy (REBT) mobile app intervention targeting these factors</div></div><div><h3>Design and Methods</h3><div>A multiphase randomised comparative design was used where 155 athletes (<em>M</em>age = 26.93, <em>SD</em> = 11.32) completed an online survey. A subset of 23 athletes (<em>M</em>age = 33.70, <em>SD</em> = 14.15) participated in a four-week mobile-app intervention of which the experimental group received eight micro-learning sessions focused on REBT principles and self-help activities to challenge and replace irrational thinking in sport, while the control group received conventional psychological skills training</div></div><div><h3>Results</h3><div>Correlation analyses revealed significant associations between the factors. Further analyses using Hayes’ PROCESS macro revealed that both coping ability and irrational beliefs mediated the relationship between them and mental health, with coping ability showing a stronger mediation effect. Furthermore, independent samples <em>t</em>-tests analyses confirmed significant improvements in participants’ exhibition of irrational performance beliefs upon completion of the RBT-inspired mobile app intervention, with thematic analyses of qualitative feedback highlighting the mobile app’s utility as a tool for self-management of cognitions and emotions in sport</div></div><div><h3>Conclusion</h3><div>The incorporation of psychological skills training to enhance coping ability should remain integral to REBT approaches aimed at improving athletes’ mental health in sport. Additionally, mobile web-based interventions hold potential as a valuable and easily accessible tool to support athletes’ psychological needs.</div></div>","PeriodicalId":19886,"journal":{"name":"Performance enhancement and health","volume":"13 4","pages":"Article 100369"},"PeriodicalIF":3.7,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144996885","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-09-05DOI: 10.1016/j.peh.2025.100379
Stuart C. Carrington , Martin J. Turner , Jamie S. North , Abbe Brady , Emily A. Martin
This study presents a single case study that assessed the effectiveness of a rational-emotive behaviour therapy (REBT) intervention in reducing irrational beliefs, decreasing negative, unhealthy emotions, and improving performance with a sports official. Following initial assessment, a 43-year-old male football referee participated in a 5-week REBT intervention programme. Irrational beliefs and anxiety were measured using the Irrational Beliefs Scale for Sports Officials and the Sport Anxiety Scale respectively. Following the 5-week intervention, measures of irrational beliefs and anxiety were collected at three follow-up points, taken every 6-weeks, throughout the 2023/24 football season, and again eight weeks after the conclusion of the season. Performance was assessed using observer marks from Football Association Referee Observers, and Club Marks, collected from representatives of teams refereed by the participant. Results showed a medium (d = 2.34) decrease (-43.28 %) in irrational beliefs between pre- and post-intervention stages, and a small (d= 0.67) decrease (21.97 %) in irrational beliefs between the post-intervention and retention stages. A large (d = 5.36) decrease (-31.12 %) in anxiety was reported between pre- and post-intervention stages, and a small (d = 0.18) increase (2.19 %) in anxiety was also reported between the post-intervention and retention stage. Performance enhancement was seen via a small (d= 0.26) increase (1.18 %) in Club Marks, and a medium (d= 2.09) increase (1.05 %) in observer marks. Alongside social validation interviews held with the participant, referee coach and observer, the study provides evidence to inform applied practice and supports the potential value of REBT with sports officials.
{"title":"Exploring the efficacy of a rational emotive behaviour therapy intervention on football referees: A single case study approach","authors":"Stuart C. Carrington , Martin J. Turner , Jamie S. North , Abbe Brady , Emily A. Martin","doi":"10.1016/j.peh.2025.100379","DOIUrl":"10.1016/j.peh.2025.100379","url":null,"abstract":"<div><div>This study presents a single case study that assessed the effectiveness of a rational-emotive behaviour therapy (REBT) intervention in reducing irrational beliefs, decreasing negative, unhealthy emotions, and improving performance with a sports official. Following initial assessment, a 43-year-old male football referee participated in a 5-week REBT intervention programme. Irrational beliefs and anxiety were measured using the Irrational Beliefs Scale for Sports Officials and the Sport Anxiety Scale respectively. Following the 5-week intervention, measures of irrational beliefs and anxiety were collected at three follow-up points, taken every 6-weeks, throughout the 2023/24 football season, and again eight weeks after the conclusion of the season. Performance was assessed using observer marks from Football Association Referee Observers, and Club Marks, collected from representatives of teams refereed by the participant. Results showed a medium (<em>d</em> = 2.34) decrease (-43.28 %) in irrational beliefs between pre- and post-intervention stages, and a small (<em>d</em> <em>=</em> 0.67) decrease (21.97 %) in irrational beliefs between the post-intervention and retention stages. A large (<em>d</em> = 5.36) decrease (-31.12 %) in anxiety was reported between pre- and post-intervention stages, and a small (<em>d</em> = 0.18) increase (2.19 %) in anxiety was also reported between the post-intervention and retention stage. Performance enhancement was seen via a small (<em>d</em> <em>=</em> 0.26) increase (1.18 %) in Club Marks, and a medium (<em>d</em> <em>=</em> 2.09) increase (1.05 %) in observer marks. Alongside social validation interviews held with the participant, referee coach and observer, the study provides evidence to inform applied practice and supports the potential value of REBT with sports officials.</div></div>","PeriodicalId":19886,"journal":{"name":"Performance enhancement and health","volume":"13 4","pages":"Article 100379"},"PeriodicalIF":3.7,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144996887","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-09-04DOI: 10.1016/j.peh.2025.100367
Parth Aphale, Shashank Dokania, Himanshu Shekhar
This commentary presents a scholarly critique of the article titled “Protein powders, painkillers, and pleasure: Reasons for exercise and the use of dietary supplements and analgesics among recreational half-marathoners” by Havermans et al. While the original study provides valuable insights into the motivations for supplement and analgesic use among recreational runners, several conceptual and methodological limitations merit further discussion. Key concerns include the reliance on self-reported data without biochemical validation, potential seasonal bias due to timing of data collection, and an oversimplified framework for understanding exercise motivation. Additionally, the underexplored role of peer influence and health literacy in shaping supplement and analgesic use behaviors is highlighted. This commentary advocates for more nuanced, multi-dimensional research designs incorporating psychosocial variables, risk perception, and longitudinal assessment to better capture the complex factors influencing health-related behaviors in recreational athletes.
{"title":"Commentary on “Protein powders, painkillers, and pleasure: Reasons for exercise and the use of dietary supplements and analgesics among recreational half-marathoners”","authors":"Parth Aphale, Shashank Dokania, Himanshu Shekhar","doi":"10.1016/j.peh.2025.100367","DOIUrl":"10.1016/j.peh.2025.100367","url":null,"abstract":"<div><div>This commentary presents a scholarly critique of the article titled <em>“Protein powders, painkillers, and pleasure: Reasons for exercise and the use of dietary supplements and analgesics among recreational half-marathoners”</em> by Havermans et al. While the original study provides valuable insights into the motivations for supplement and analgesic use among recreational runners, several conceptual and methodological limitations merit further discussion. Key concerns include the reliance on self-reported data without biochemical validation, potential seasonal bias due to timing of data collection, and an oversimplified framework for understanding exercise motivation. Additionally, the underexplored role of peer influence and health literacy in shaping supplement and analgesic use behaviors is highlighted. This commentary advocates for more nuanced, multi-dimensional research designs incorporating psychosocial variables, risk perception, and longitudinal assessment to better capture the complex factors influencing health-related behaviors in recreational athletes.</div></div>","PeriodicalId":19886,"journal":{"name":"Performance enhancement and health","volume":"13 4","pages":"Article 100367"},"PeriodicalIF":3.7,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144988245","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-09-04DOI: 10.1016/j.peh.2025.100373
Verner Møller
In the wake of the 1998 Festina affair, which exposed widespread doping in professional cycling, sports organizations, led by the International Olympic Committee, established a global anti-doping program. This initiative aimed to combat doping, which was seen as a threat to both the integrity and economic viability of sports. The alternative approach—legalizing performance-enhancing drugs—was dismissed as unrealistic and unworthy of serious consideration. Its advocates, if not outright ignored, were criticized as irresponsible attention-seekers who would turn sports into a spectacle.
Today, a quarter of a century after the founding of the World Anti-Doping Agency, a group of wealthy investors has begun efforts to turn this once-dismissed idea into reality by organizing a competition where drug use is permitted. This paper critically examines the proposed Enhanced Games, evaluating whether a sporting event that allows performance-enhancing drugs can be ethically and practically justified. It explores arguments both in favor of and against this model, addressing issues related to technological and biomedical enhancement, fairness, athlete health, and regulatory feasibility. The objective is to assess whether such a competition can be defended within the broader ethical and institutional framework of sports and, ultimately, to determine if it makes sense at all.
{"title":"Can the enhanced games be defended, and are they a good idea?","authors":"Verner Møller","doi":"10.1016/j.peh.2025.100373","DOIUrl":"10.1016/j.peh.2025.100373","url":null,"abstract":"<div><div>In the wake of the 1998 Festina affair, which exposed widespread doping in professional cycling, sports organizations, led by the International Olympic Committee, established a global anti-doping program. This initiative aimed to combat doping, which was seen as a threat to both the integrity and economic viability of sports. The alternative approach—legalizing performance-enhancing drugs—was dismissed as unrealistic and unworthy of serious consideration. Its advocates, if not outright ignored, were criticized as irresponsible attention-seekers who would turn sports into a spectacle.</div><div>Today, a quarter of a century after the founding of the World Anti-Doping Agency, a group of wealthy investors has begun efforts to turn this once-dismissed idea into reality by organizing a competition where drug use is permitted. This paper critically examines the proposed Enhanced Games, evaluating whether a sporting event that allows performance-enhancing drugs can be ethically and practically justified. It explores arguments both in favor of and against this model, addressing issues related to technological and biomedical enhancement, fairness, athlete health, and regulatory feasibility. The objective is to assess whether such a competition can be defended within the broader ethical and institutional framework of sports and, ultimately, to determine if it makes sense at all.</div></div>","PeriodicalId":19886,"journal":{"name":"Performance enhancement and health","volume":"13 4","pages":"Article 100373"},"PeriodicalIF":3.7,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144988243","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-09-04DOI: 10.1016/j.peh.2025.100382
Evelyn Hearne , Amanda Atkinson , Jim McVeigh , Ian Boardley , Vivian D. Hope , Marie Claire Van Hout
UK research in the past decade has indicated the emergence of a cohort older men who use anabolic androgenic steroids (OMAAS), with studies suggesting OMAAS are motivated to use for aesthetics, performance enhancement, to combat the effects of ageing, and for perceived testosterone replacement therapy associated with wellbeing. Currently, there is a lack of information on the experiences and perspectives of harm reduction workers who support OMAAS at needle and syringe programmes in the UK. Semi-structured in-depth interviews (N = 13) with harm reduction workers were conducted to explore their experiences of engagement with OMAAS and how they view their healthcare and support needs.
The analysis generated four key themes with subthemes: 1) AAS Use Patterns of Older Men Accessing Healthcare Services; 2) Motivations for AAS Use; 3) Adverse Health Effects; 4) and Healthcare Responses to OMAAS. Two higher levels of abstraction centred on ‘risk neutralization’ and ‘masculinity’ were identified above the theme level and were described by all harm reduction workers in distinct ways throughout the findings. They focused on scapegoating, self-confidence, and risk comparison as strategies to uphold masculine values and identity through AAS use.
The findings are useful in informing AAS specific training for harm reduction workers, medical and healthcare professionals, and age-appropriate healthcare and treatment pathways specific to the needs of OMAAS who engage in risk neutralization techniques to conform to traditional masculine norms. There is a need for accessible, adequate, non-judgemental AAS-specific treatment and care pathways for OMAAS. Needle and syringe programmes should be developed to implement and evaluate interventions such as blood testing, cardiac monitoring, substance testing, and rapid access and referral pathways for medical support. Medical professionals and harm reduction workers at needle and syringe programmes are urged to address issues with OMAAS’ perceptions of masculinity to help prevent and encourage safer use.
{"title":"“Big-blast, little-blast”: Risk neutralization strategies for sustaining masculinity by older men who use anabolic androgenic steroids (OMAAS)","authors":"Evelyn Hearne , Amanda Atkinson , Jim McVeigh , Ian Boardley , Vivian D. Hope , Marie Claire Van Hout","doi":"10.1016/j.peh.2025.100382","DOIUrl":"10.1016/j.peh.2025.100382","url":null,"abstract":"<div><div>UK research in the past decade has indicated the emergence of a cohort older men who use anabolic androgenic steroids (OMAAS), with studies suggesting OMAAS are motivated to use for aesthetics, performance enhancement, to combat the effects of ageing, and for perceived testosterone replacement therapy associated with wellbeing. Currently, there is a lack of information on the experiences and perspectives of harm reduction workers who support OMAAS at needle and syringe programmes in the UK. Semi-structured in-depth interviews (<em>N</em> = 13) with harm reduction workers were conducted to explore their experiences of engagement with OMAAS and how they view their healthcare and support needs.</div><div>The analysis generated four key themes with subthemes: 1) AAS Use Patterns of Older Men Accessing Healthcare Services; 2) Motivations for AAS Use; 3) Adverse Health Effects; 4) and Healthcare Responses to OMAAS. Two higher levels of abstraction centred on ‘<em>risk neutralization’</em> and <em>‘masculinity’</em> were identified above the theme level and were described by all harm reduction workers in distinct ways throughout the findings. They focused on scapegoating, self-confidence, and risk comparison as strategies to uphold masculine values and identity through AAS use.</div><div>The findings are useful in informing AAS specific training for harm reduction workers, medical and healthcare professionals, and age-appropriate healthcare and treatment pathways specific to the needs of OMAAS who engage in risk neutralization techniques to conform to traditional masculine norms. There is a need for accessible, adequate, non-judgemental AAS-specific treatment and care pathways for OMAAS. Needle and syringe programmes should be developed to implement and evaluate interventions such as blood testing, cardiac monitoring, substance testing, and rapid access and referral pathways for medical support. Medical professionals and harm reduction workers at needle and syringe programmes are urged to address issues with OMAAS’ perceptions of masculinity to help prevent and encourage safer use.</div></div>","PeriodicalId":19886,"journal":{"name":"Performance enhancement and health","volume":"13 4","pages":"Article 100382"},"PeriodicalIF":3.7,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144996668","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-09-04DOI: 10.1016/j.peh.2025.100368
Sidney V. Irwin, Anjum Naweed, Michele Lastella
This article addresses growing concerns of jet lag and its potential impact on esports performance in the Counter-Strike scene. Pre-COVID, this esports scene experienced an oversaturation of tournaments, leading to frequent travel and sleep disruption for players. However, recent developments in 2025 may pave the way for a return of this oversaturation to affect player health and competition outcomes. Research in conventional sports has a long tradition of examining the impacts of transmeridian travel, yet data remains virtually non-existent in esports literature. Given the demand for unique cognitions in professional esports such as intense focus, rapid decision-making, and high mental acuity, players could be severely impacted by disrupted sleep. This article calls for research on how jet lag affects esports athletes and urges the industry to consider players’ mental and physical well-being as they navigate the pressures of international competition.
{"title":"Jet lag and player wellbeing in esports: A call for research in the counter-strike scene","authors":"Sidney V. Irwin, Anjum Naweed, Michele Lastella","doi":"10.1016/j.peh.2025.100368","DOIUrl":"10.1016/j.peh.2025.100368","url":null,"abstract":"<div><div>This article addresses growing concerns of jet lag and its potential impact on esports performance in the Counter-Strike scene. Pre-COVID, this esports scene experienced an oversaturation of tournaments, leading to frequent travel and sleep disruption for players. However, recent developments in 2025 may pave the way for a return of this oversaturation to affect player health and competition outcomes. Research in conventional sports has a long tradition of examining the impacts of transmeridian travel, yet data remains virtually non-existent in esports literature. Given the demand for unique cognitions in professional esports such as intense focus, rapid decision-making, and high mental acuity, players could be severely impacted by disrupted sleep. This article calls for research on how jet lag affects esports athletes and urges the industry to consider players’ mental and physical well-being as they navigate the pressures of international competition.</div></div>","PeriodicalId":19886,"journal":{"name":"Performance enhancement and health","volume":"13 4","pages":"Article 100368"},"PeriodicalIF":3.7,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144988242","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-09-04DOI: 10.1016/j.peh.2025.100377
Diederik L. Smit , Tijs Verdegaal , Peter Bond
Men with low-normal testosterone often present with symptoms such as low energy, reduced libido, and mood disturbances. However, guidelines restrict testosterone therapy (TTh) to men with confirmed hypogonadism, leaving this subgroup without clear treatment options. Frustrated, some turn to illicit testosterone, often at supraphysiological doses, risking long-term endocrine disruption, infertility, and cardiovascular disease. This perspective explores aromatase inhibitors (AIs) as a harm reduction strategy for such men. By inhibiting estrogen-mediated feedback, AIs stimulate endogenous testosterone production while preserving hypothalamic-pituitary-gonadal (HPG) axis integrity. In addition to potential symptom relief, AIs can be used diagnostically to assess HPG responsiveness and the relationship between testosterone levels and symptoms. They may also serve an educational role, helping patients better understand the hormonal contribution to their complaints and avoid premature self-treatment. The response to AIs is variable, and their long-term safety in men remains uncertain. In addition, the use of AIs is off-label and lacks robust clinical evidence. Well-designed trials are needed to determine whether AIs are truly a viable harm reduction strategy and eventually reduce the incidence of self-initiated TTh. Until then, a cautious, individualized approach is essential—yet in selected cases, AIs may offer a supervised alternative that prevents progression to unregulated testosterone use.
{"title":"Aromatase inhibitors as a potential harm reduction strategy for men with low-normal testosterone at risk of non-prescribed androgen use","authors":"Diederik L. Smit , Tijs Verdegaal , Peter Bond","doi":"10.1016/j.peh.2025.100377","DOIUrl":"10.1016/j.peh.2025.100377","url":null,"abstract":"<div><div>Men with low-normal testosterone often present with symptoms such as low energy, reduced libido, and mood disturbances. However, guidelines restrict testosterone therapy (TTh) to men with confirmed hypogonadism, leaving this subgroup without clear treatment options. Frustrated, some turn to illicit testosterone, often at supraphysiological doses, risking long-term endocrine disruption, infertility, and cardiovascular disease. This perspective explores aromatase inhibitors (AIs) as a harm reduction strategy for such men. By inhibiting estrogen-mediated feedback, AIs stimulate endogenous testosterone production while preserving hypothalamic-pituitary-gonadal (HPG) axis integrity. In addition to potential symptom relief, AIs can be used diagnostically to assess HPG responsiveness and the relationship between testosterone levels and symptoms. They may also serve an educational role, helping patients better understand the hormonal contribution to their complaints and avoid premature self-treatment. The response to AIs is variable, and their long-term safety in men remains uncertain. In addition, the use of AIs is off-label and lacks robust clinical evidence. Well-designed trials are needed to determine whether AIs are truly a viable harm reduction strategy and eventually reduce the incidence of self-initiated TTh. Until then, a cautious, individualized approach is essential—yet in selected cases, AIs may offer a supervised alternative that prevents progression to unregulated testosterone use.</div></div>","PeriodicalId":19886,"journal":{"name":"Performance enhancement and health","volume":"13 4","pages":"Article 100377"},"PeriodicalIF":3.7,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144988246","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-09-04DOI: 10.1016/j.peh.2025.100374
Dr. Hannah Plaschkes , Dr. Tom Price , Dr. James L. Findon
Purpose
Higher education institutions (HEIs) are increasingly turning to preventative measures to improve student mental health outcomes. However, previous research has identified sports participation (especially lean sports) as a risk factor for eating disorders. Therefore, the purpose of this cross-sectional observational study was to investigate the association between sports club membership, disordered eating cognitions and vulnerability to mental health problems in a population of university students at UK HEIs.
Methods
Participants were UK students (77% female, average age = 21.66) who reported being a member of a university sports club (n=295) or not (n=242). Sports club members were further divided into lean (n=103) v non-lean sports (n=185). Participants completed an online survey including the Eating Attitudes Test (EAT-26), Strengths and Difficulties Questionnaire (SDQ), Figure Rating Scale (FRS) and Body Appreciation Scale-2 (BAS-2).
Results
In sports club members, EAT-26 and the emotional problems subscale of the SDQ were significantly lower than non-sports club members. Sports club members also had significantly lower body dissatisfaction and higher body appreciation than non-sports club members. The lean-sports group had the lowest EAT-26 scores and the lowest levels of body dissatisfaction and highest levels of body appreciation.
Conclusions
Overall, the results indicate that university sports club membership is associated with better mental health outcomes. Contrary to previous studies, lean sports participation was associated with the lowest levels of eating disorder attitudes.
{"title":"Disordered Eating and Mental Health Across Lean and Non-Lean Sports: A Cross-Sectional Study of UK University Sports Club Members","authors":"Dr. Hannah Plaschkes , Dr. Tom Price , Dr. James L. Findon","doi":"10.1016/j.peh.2025.100374","DOIUrl":"10.1016/j.peh.2025.100374","url":null,"abstract":"<div><h3>Purpose</h3><div>Higher education institutions (HEIs) are increasingly turning to preventative measures to improve student mental health outcomes. However, previous research has identified sports participation (especially lean sports) as a risk factor for eating disorders. Therefore, the purpose of this cross-sectional observational study was to investigate the association between sports club membership, disordered eating cognitions and vulnerability to mental health problems in a population of university students at UK HEIs.</div></div><div><h3>Methods</h3><div>Participants were UK students (77% female, average age = 21.66) who reported being a member of a university sports club (n=295) or not (n=242). Sports club members were further divided into lean (n=103) v non-lean sports (n=185). Participants completed an online survey including the Eating Attitudes Test (EAT-26), Strengths and Difficulties Questionnaire (SDQ), Figure Rating Scale (FRS) and Body Appreciation Scale-2 (BAS-2).</div></div><div><h3>Results</h3><div>In sports club members, EAT-26 and the emotional problems subscale of the SDQ were significantly lower than non-sports club members. Sports club members also had significantly lower body dissatisfaction and higher body appreciation than non-sports club members. The lean-sports group had the lowest EAT-26 scores and the lowest levels of body dissatisfaction and highest levels of body appreciation.</div></div><div><h3>Conclusions</h3><div>Overall, the results indicate that university sports club membership is associated with better mental health outcomes. Contrary to previous studies, lean sports participation was associated with the lowest levels of eating disorder attitudes.</div></div>","PeriodicalId":19886,"journal":{"name":"Performance enhancement and health","volume":"13 4","pages":"Article 100374"},"PeriodicalIF":3.7,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144996880","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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