Study Maps Seven Doping Attitude Profiles in Gym Athletes

Published in the Harm Reduction Journal, the cross-sectional study provides preliminary support for a seven-profile structure that characterizes how German gym users approach image- and performance-enhancing drugs (IPEDs). The findings suggest that doping-related orientations are not a single linear continuum of risk but rather a heterogeneous landscape of partially overlapping motivational configurations, which has implications for how harm-reduction messages are tailored to different groups within fitness communities.

The study was designed to re-examine a typology originally identified by René Paasch and colleagues, which had previously shown only preliminary information regarding cluster stability. By using an independent sample and adding robustness analyses, the current research aimed to verify the reproducibility of these profiles. The authors utilized constructs from the Theory of Planned Behavior (TPB) and the Health Belief Model (HBM) to capture both intention-related orientations and health-related risk appraisals. This theoretical combination allows for a more differentiated understanding of how individuals weigh perceived benefits against potential harms in the context of non-medical substance use.

The sample comprised 624 recreational fitness athletes recruited from gyms and online platforms across Germany, with a mean age of 37.1 years. After applying strict data-quality criteria, including attention checks and outlier removal, the final analytical sample consisted of 550 participants. The demographic profile was predominantly male, with 64.1% identifying as male, 34.5% as female, and 1.4% as diverse. Participants reported an average of 3.1 weekly training sessions and 6.1 years of training experience, indicating a population with significant engagement in commercial fitness environments.

Using hierarchical Ward clustering followed by k-means clustering, the researchers identified seven distinct profiles based on four TPB and HBM-related scales: intention, avoidance, risk acceptance, and risk perception. The overall silhouette coefficient was 0.22, indicating moderate profile differentiation, which is typical for multidimensional survey data. Bootstrap-based reproducibility analyses with 200 resamples showed moderate stability, suggesting that while the overall structure is recoverable, individual cluster assignments should be interpreted with caution. The cluster sizes ranged from 60 to 91 participants, with each profile representing approximately 8% to 16% of the sample.

The seven profiles were labeled to reflect their dominant motivational and cognitive characteristics. Cluster 0, the Reflective Avoiders, exhibited low intention and risk acceptance combined with high risk perception and strong avoidance, representing a value-based abstinence orientation. Cluster 1, the Ambivalent Risk-Takers, showed moderate intentions and elevated risk acceptance, reflecting cognitive ambivalence and decisional uncertainty. Cluster 2, the Performance-Oriented Rationalizers, displayed higher intentions and lower risk perception, often framing potential use as a controllable optimization strategy. Cluster 3, the Ambivalent Avoiders, demonstrated situational uncertainty with variable avoidance tendencies, while Cluster 4, the Controlled Abstainers, grounded their abstinence in discipline and self-regulation.

Cluster 5, the Risk-Inclined Performers, was characterized by the lowest risk perception across all groups, despite relatively modest intention levels, indicating a tendency to downplay potential harms. Cluster 6, the Passive Indifferents, showed moderate intentions but low engagement with the topic, suggesting that enhancement issues have limited salience in their decision-making. These profiles illustrate how motivational orientations range from moral conviction to calculated rationalization and indifference, providing a structured framework for understanding the diverse ways athletes evaluate harm and negotiate social cues in gym settings.

Descriptive associations between these profiles and lifetime substance use were examined using chi-square tests. Small but statistically significant associations were observed for the lifetime use of anabolic-androgenic steroids (AAS) and testosterone replacement therapy (TRT), with Cramér’s V values of 0.17 and 0.11, respectively. In contrast, growth hormone (GH) use did not differ significantly across the profiles. The small effect sizes suggest that the typology primarily captures differences in belief structures and motivational orientations rather than strong behavioral differentiation. This pattern is consistent with the notion that cognitive and motivational factors may shape how individuals interpret risks and engage with prevention resources, even if they do not directly predict specific usage behaviors in a cross-sectional design.

To enrich the quantitative findings, the researchers conducted a supplementary qualitative analysis of 52 open-ended responses. This illustrative component provided narrative depth to the statistical profiles, showing how participants articulate their motivations in their own words. For instance, Reflective Avoiders frequently emphasized moral identity and long-term health risks, while Performance-Oriented Rationalizers justified potential use through instrumental reasoning and perceived training benefits. The qualitative accounts highlighted the interplay of moral identity, rationalization, and social context, offering insights into the internal conflicts and justifications that underpin the statistical clusters.

The study acknowledges several limitations that temper the interpretation of its findings. The cross-sectional design precludes causal inference regarding the relationship between motivational constructs and doping behavior, and the reliance on self-report data introduces potential concerns about recall accuracy and social desirability. The moderate stability indices suggest that the seven-cluster solution should be viewed as a probabilistic structure rather than fixed psychological categories. Additionally, the qualitative component was coded by a single rater and was unevenly distributed, limiting its utility as independent triangulation. The cultural and regulatory specificity of the German sample may also restrict the generalizability of the typology to other fitness contexts.

Despite these limitations, the replication provides a valuable conceptual lens for understanding the heterogeneity of IPED-related orientations in recreational fitness. The findings suggest that prevention approaches should move beyond singular deterrence-based messages, which may be ineffective for groups who frame substance use as rational or disciplined. Instead, the typology supports the development of flexible, context-sensitive harm-reduction strategies that account for the specific motivational pathways of different profiles. For example, groups driven by moral identity may respond better to informational or normative prevention, while those with high risk tolerance may require different structural or environmental interventions.

The authors emphasize that the typology is not a diagnostic instrument and should not be used to classify individuals or prescribe specific intervention pathways. Rather, it serves as a heuristic foundation for future hypothesis-driven research. The moderate reproducibility of the clusters underscores the need for longitudinal studies and preregistered replication criteria to build a more cumulative evidence base. By identifying distinct motivational constellations, the study offers multiple entry points for prevention, highlighting how attitudes, norms, and risk appraisals interact to shape doping-related decision-making in gym populations.

Future research should employ longitudinal and multi-wave designs to examine transitions between these motivational orientations and how shifts in risk perception or social context influence them. Cross-cultural replications are needed to test the generalizability of the typology in settings with different regulatory climates. Independent qualitative studies using structured sampling and multiple coders could further clarify how narrative framings shape harm appraisals and prevention engagement. Ultimately, advancing this work will require multi-method designs that strengthen methodological rigor and support precision-oriented harm-reduction and policy strategies in recreational fitness environments.

Subject of Research: Replicating motivational and cognitive-motivational typologies of doping attitudes among recreational fitness athletes: implications for harm reduction and risk communication

Article Title: Replicating motivational and cognitive-motivational typologies of doping attitudes among recreational fitness athletes: implications for harm reduction and risk communication

Article References: Paasch, R., & Mau, G. (2026). Replicating motivational and cognitive-motivational typologies of doping attitudes among recreational fitness athletes: implications for harm reduction and risk communication. Harm Reduction Journal, 23(1), Article 155. https://doi.org/10.1186/s12954-026-01546-3

Image Credits: AI Generated

DOI: 10.1186/s12954-026-01546-3

Keywords: Replicating, motivational, cognitive-motivational, typologies, doping, attitudes, recreational, fitness, athletes, implications, harm, reduction