From Zero to Hero, with the Man in the Mirror: Engagement of Performance Enhancing Drugs (PEDs) in Young Males

This thesis investigates the phenomenon of young men's body image, mental health, and use of potentially dangerous anabolic steroids, muscle-building supplements, and other similar substances. This is an extremely timely and understudied issue of high public health importance, as evidence suggests body image concerns of young men are worsening and use of muscle-building supplements and similar dangerous products increases in prevalence. The thesis is comprised of 3 main empirical chapters, each study building on the previous, then integrated into an Octagonal Model in the final chapter. These are as follows: 1. A Systematic Review and Narrative Synthesis of the link between body image and performance enhancing drugs (PED) in young men This systematic review identified two overarching theories of why young men would use PEDs: Self Determination Theory and the Gateway Theory. Additionally, four major themes emerged surrounding factors that influence the likelihood of uptake of PEDs: pressure, moral disengagement, perfectionism, and bonding and belonging. 2. Framework Analysis of national anti-doping regulations in three countries across three continents. Three anti-doping guidelines in Ireland, Malaysia, and Australia were identified and reviewed. The analysis showed that the guidelines were extensive and accessible. 3a. A focus group study investigating how young men view their body. Focus groups were conducted investigating how young men view their body. Participants were young men from the student population in University College Dublin (UCD), Ireland. Three major themes of behaviour, perfectionism and influences emerged from the thematic analysis. 3b. A case study using semi-structured interviews examining physical health and mental health support in an organisational structure. Seven in-depth semi-structured interviews were conducted with the aim of exploring the structure and strategies in place to manage and support the physical and mental health of their students. Three major themes of communication, regulation and responsibility emerged from the thematic analysis. The above chapters were consolidated and modelled into 'The Octagonal Model of PED Engagement in Young Men' in the final chapter.