United States Sports Academy - "America's Sports University"

Abstract

The purpose of this study was to measure multiple addictive behaviors
in college athletes using the Multiple Addictive Behaviors Questionnaire
(MABQ). The MABQ was developed to measure patterns of addictive behaviors
and to ascertain gender differences as well as to construct an instrument
designed to measure multiple addictive behaviors. The authors assessed
five addictive behaviors: gambling, substance abuse, disordered eating,
addictive exercise and alcohol abuse. Two levels, problematic and diagnostic
were measured as well as gender differences for each variable. The data
revealed a high percentage of athletes meeting the problematic level with
fewer meeting diagnostic criteria for one or more addictive behaviors.

Introduction

Addiction is a complex behavior and a major health problem in America
(American Psychiatric Association, 2000). Schaef (1987) defines addiction
as an insidious process that we are powerless to control, propelling us
to act in ways contrary to our values and beliefs and may progress to
obsession and maladaptive action. Persons with addictive behaviors are
at high risk for affective disorders, criminal behavior, ethical misconduct,
absenteeism, and problematic relationships (American Psychiatric Association,
2000; Weiss, 1999). Collegiate student-athletes are thought to be at an
even higher risk for academic and socially problematic behaviors than
their nonathletic peer cohort (FindLaw, 2002; National Collegiate Association
Drug Education Committee, 2001).

Problematic behaviors such as alcohol abuse, steroid use, pathological
gambling, weight control behavior, and exercise addition are common maladaptive
behaviors within the athletic population at all ages and levels of sport.
The media continues to highlight professional athletes who, as a result
of maladaptive behaviors, have serious health conditions, relationship
problems, or a decline in athletic performance. Ken Caminiti, 1996 MVP
in baseball, career was cut short as a result of extensive steroid use;
Pete Rose's gambling problem; or the deaths of Korey Stringer and Rashida
Wheeler after consuming ephedra are but a few examples. Sadly though,
these athletes serve as role models for youths.

In the most recent NCAA study, 78.3% of the respondents reported using
alcohol within the past year and that for most, the problem began in high
school (2001). The American Psychiatric Association (2000) reports that
60% of males and 30% of females have had one or more negative event(s)
in their lives as a result of alcohol use. The prevalence of eating disorders
is significant among female athletes (Kirk, Singh & Getz, 2001). Although
both men and women do not meet the diagnostic criteria for an eating disorder
as delineated in the DSM-IV-TR, there appears to be a large percentage
of female athletes (Overdoff & Gill, 1994) and a growing number of
males (Pope, Phillips, & Olivardia, 2000) with subclinical eating
problems. Studies report between 15% and 62% of college women engage in
problematic weight control behaviors (Berry & Howe, 2000). The weight
control methods used include: overuse of laxatives and diuretics, excessive
exercise, and self-induced vomiting. (Pope, Phillips, & Olivardia,
2000).

Gambling in athletics is also a major concern. Sports wagering, beginning
in high school and increasing in college is done by 50% of student-athletes
(Engwall, Hunter, & Steinberg, 2003). Lesieur (1991) reported 85%
of college athletes as having participated in betting and 23% surveyed
showed evidence of pathological gambling behavior. Gambling activities
in sport include: playing cards for money, wagering on sporting events,
playing the lottery, and casino betting (Miller, Adams, Kraus, Clayton,
Miller, Anderson, & Ogilvie, 2001).

Not all addictive behaviors involve ingesting a substance. Like gambling,
excessive exercise is a process whereby the individual engages in excessive
activity or series of actions or interactions (Schaef, 1987). Distance
running is a common addiction sometimes referred to as a negative addiction
(Hailey & Bailey, 1982). Process addictions, like gambling and exercise,
meet the basic criteria of an addiction: powerlessness to stop at will,
have harmful consequences, unmanageability in other areas of life, escalation
of use, and withdrawal upon quitting (Kasl, 1989). In addition to the
possibility of having multiple or cross addictions, many athletes meet
the criteria for a dual diagnosis, that is, have a clinical depression
along with a substance abuse or gambling addiction (Miller, Adams, Kraus,
Clayton, Miller, Anderson, & Ogilvie, 2001).

The purpose of this study was to measure five addictive behaviors on
two levels: problematic and clinically diagnostic. The addictive behaviors
targeted for this study included: gambling, drug abuse, disordered eating,
exercise addiction, and alcohol abuse. These five variables were chosen
upon careful review of the literature as to which behaviors would be most
associated with collegiate student-athletes.

Method

Subjects

The study consisted of ninety-nine male and eighty-six female Division
III college athletes (N=185) between 18 and 23 years of age, primarily
Caucasian (92.4%), middle class student-athletes from a mid-size New England
college. Ninety-two percent of the participants lived on or near the campus.
There was a fairly equal distribution of student by year: freshman (34.1%),
sophomore (27.0%), junior (25.9%), and senior (23.0%).

Students reported the following distribution overall out of 4.00 G.P.A.:
2.0-2.49 (35.7%), 2.5-2.99 (33.5%). 3.0-3.49 (23.2%), and 3.5-4.0 (5.9%).
The participants were selected from twelve teams: baseball, football,
field hockey, lacrosse, softball, volleyball, men's and women's soccer,
basketball, and swimming. Participation was voluntary with written consent.
The Committee for Use of Human Subjects approved this study and informed
consent was obtained from all participants.

Testing Procedure

A survey instrument, The Multiple Addictive Behaviors Questionnaire (MABQ)
(Bacon & Lee, 1997) was developed to measure five addictive behaviors:
gambling, substance abuse, disordered eating, exercise, and alcohol abuse.
The MAGS-7 (Shaffer, LaBrie, ScanLan, & Cummings, 1994) was used in
full to assess the student-athletes' gambling behaviors. Benyo's (1990)
Exercise Addiction Questionnaire and Rudy and Estok's (1989) Running Addiction
Scale provided guidance for the development of questions for the exercise
variable. All other questions were derived from the diagnostic criteria
for the remaining variables (substance, alcohol, and eating) as outlined
in the DSM IV-TR (American Psychiatric Association, 2000). The MABQ was
designed to measure both problematic and clinically diagnostic levels
for each of the five addictive behaviors as well as obtain demographic
data. The instrument contained thirty-five questions having both forced
choice and Likert-type scale questions which are cumulative for each of
the five addictive behaviors measured: gambling, substance abuse, disordered
eating, exercise, and alcohol abuse.

Results

The data revealed large numbers of athletes who self-reported as meeting
the problematic or diagnostic criteria for one or more addictive behavior.
Not surprisingly, the data in the problematic category shows that exercise
addiction was the largest category and substance abuse the smallest. In
the diagnostic category, the highest frequency was with gambling, with
15. 1 % of students reported pathological addiction to this activity.
The low incidence of substance use reported might be due in part to NCAA
regulations that prohibit and penalize collegiate student-athletes who
have been found to engage in recreational and/or controlled substances.

To assess the interrelationships among addictive behaviors patterns (i.e.,
multiple addictive behaviors) reported on The MABQ, a principle components
factor analysis with a varimax rotation was done. The analysis revealed
two factors (clusters) of addictive behaviors. The first factor accounted
for 44.54 % of the variance and consisted of substance abuse, gambling
and alcohol. The second factor accounted for 26.74% of the variance and
consisted of eating and exercise. Five T-tests were performed to examine
gender differences among the addictive behavior patterns (Table 3). Females
reported a significantly higher (p=.00l) prevalence of disordered eating;
males reported a significantly higher (p=.02) prevalence of substance
abuse. Although males reported a higher level of gambling behaviors, this
result only approached significance (p=.07) suggesting that problematic
gambling with female college athletes is a notable concern. There were
no significant gender differences on the other subscales.

Discussion

These findings are consistent with other research studies (Shaffer, 1997;
National Collegiate Association Drug Education Committee, 2001) where
investigators have reported growing numbers of college athletes exhibiting
addictive behaviors. When data were examined in light of gender differences,
two patterns emerged: male athletes fell into the substance/gambling/alcohol
cluster and female athletes fell into the eating/exercise cluster. The
cluster patterns were similar to those suggested by Shaffer (1994). The
increase in disordered eating with males is consistent with the findings
of recent research investigating body image disorders with athletes and
physically active males (Pope, Phillips, and Olivardia 2000).

Interestingly, earlier research shows gambling to be found primarily
among male athletes. Gambling appears to be on the rise for female athletes
- although a closer look at individual responses revealed women to be
engaging in different gambling activities (e.g. scratch tickets). It is
well documented in the literature that there is a high correlation between
disordered eating and substance/alcohol abuse (Walsh, & Garner, 1997;
Krahn, 1991). In this study, disordered eating correlated with excessive
exercise, but not with drugs or alcohol, for female athletes. This brings
into question the idea of volitional intent or choice. In one study, Martin
(1998) found significantly less alcohol use in-season than out-of-season
periods among NCAA Division I female basketball, softball, and volleyball
players.

Collegiate student-athletes are unique and face different challenges
than their non-athlete peers (Engwall, Hunter, & Steinberg, 2003;
Weiss, 1999). The sport environment is complex with student-athletes having
to negotiate a unique set of challenges: succeeding at both academics
and athletics, issues related to time management, stress related to the
pressures of their sport, peer pressure regarding recreational activities
including drug and alcohol use, and having to cope with the traditional
developmental tasks typical of their peer group (Etzel, Ferrante, &
Pinkney, 1991). Athletic department staff and Counseling Center practitioners
are faced with developing and implementing appropriate and successful
intervention strategies to address the special needs of this population.
Collegiate athletes report lecture style education programs to be noneffective
(Martin, 1998). Further study is needed to better understand addictive
behaviors and to determine the most effective interventions for college
athletes.

One limitation worth noting is the use of a newly developed instrument
that is currently being tested for validity and reliability (Bacon &
Russell, 2003). All study findings must be reviewed with caution. The
MAGS-7 (Shaffer, LaBrie, Scanlan & Cummings, 1994) has been found
to be both valid and reliable; therefore, the gambling subscale, including
the problematic and clinically diagnostic levels can be given the most
credence. The MABQ (Bacon & Lee, 1994) is undergoing extensive field-testing
to establish concurrent criterion related validity for all five variables
and content validity for the subset of questions that address each behavior.

Acknowledgment

This study was funded by a grant from the Center for the Advancement
of Research and Teaching at Bridgewater State College.

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