The aetiology and trajectory of anabolic-androgenic steroid use initiation: a systematic review and synthesis of qualitative research

Background: To our knowledge, there has never been a systematic review and synthesis of the qualitative literature on the trajectory and aetiology of nonmedical anabolic-androgenic steroid (AAS) use. Methods: We systematically reviewed and synthesized qualitative literature gathered from searches in PsycINFO, PubMed, ISI Web of Science, Google Scholar, and reference lists of relevant literature to investigate AAS users’ ages of first use and source(s), history prior to use, and motives/drives for initiating use. We adhered to the recommendations of the UK Economic and Social Research Council’s qualitative research synthesis manual and the PRISMA guidelines. Results: A total of 44 studies published between 1980 and 2014 were included in the synthesis. Studies originated from 11 countries: the United States (n =18), England (n =8), Australia (n =4), Sweden (n =4), both England and Wales (n =2), and Scotland (n =2). One study each originated from Brazil, Bulgaria, Canada, France, Great Britain, and Norway. The majority of AAS users initiated use before age 30. Sports participation (particularly power sports), negative body image, and psychological disorders such as depression preceded initiation of AAS use for most users. Sources of first AAS were mainly users’ immediate social networks and the illicit market. Enhanced sports performance, appearance, and muscle/strength were the paramount motives for AAS use initiation. Conclusions: Our findings elucidate the significance of psychosocial factors in AAS use initiation. The proliferation of AAS on the illicit market and social networks demands better ways of dealing with the global public health problem of AAS use

A dialogue worth having: Vocational competence, career identity and a learning environment for 21th century success at work

The cultivation of intrinsic motivation is key in the 21th century, but most students in Dutch vocational education lack this quality. To foster intrinsic motivation, a strong career-learning environment is needed that enables students to develop career competencies and a career identity. However such an environment is absent in much of vocational education in The Netherlands. Research shows that the desired learning must be practice based (real life experiences are key), enable a dialogue (in order to attach personal meaning to real life experiences) and give students more autonomy in making choices in their school careers. Although there has been an increase in the use of portfolios and personal-development plans, these instruments are used mainly for improving success at school but are not in career and work. In addition research on the conversations between student and teachers/work-place mentors shows that the latter talk primarily to (65%), and about (21%), but rarely with (9%) students. The culture in schools is still predominately monological. Most teachers feel uncertain about their abilities to help students in developing career competencies and a career identity, though a growing number of teachers want to be trained in initiating meaningful career dialogues. In order to make such training successful in terms of promoting new guidance behaviours, it is essential that school managers create a strong career-learning environment for teachers. The Standards Era policies (Gatto, 2009) that dominate Dutch vocational education at the moment, however, leaves managers little space to do so. https://doi.org/10.1007/978-3-319-50734-7_7 LinkedIn: https://www.linkedin.com/in/reinekke-lengelle-phd-767a4322