Ethics, Integrity and Well-Being in Elite Sport: A Systematic Review

Authors: Deborah Agnew, Philippa Henderson and Carl Woods

Corresponding Author:
Deb Agnew, PhD
GPO Box 2100
Adelaide, South Australia, Australia 5001
deb.agnew@flinders.edu.au
+61 8 8201 3456

Dr. Deborah Agnew: is a lecturer in the School of Education at Flinders University in South Australia. Her research interests include Australian football, masculinity, sports retirement and men’s health. She is a member of the Flinders SHAPE (Sport, Health and Physical Education) Research Centre and teaches in the Bachelor of Sport, Health and Physical Activity.

Ms. Philippa Henderson: has a Masters degree in public health and teaches across a wide variety of health topics in the School of Education and the School of Health Sciences at Flinders University in South Australia. Her research interests include sport, physical activity and well-being as well as the health and well-being of children.

Dr. Carl Woods: is a lecturer of Skill Acquisition and Motor Learning in the Discipline of Sport and Exercise Science at James Cook University. His research primarily focuses on talent identification, talent development and coaching in junior team sports; with a particular interest in Australian football. He currently provides research support to Australian football State Academy programs; with this being oriented around different aspects of performance analysis, skill acquisition and coach education.

Ethics, integrity and well-being in elite sport: A systematic review

ABSTRACT
Background: Athletes are expected to be good role models, compete fairly and allow the public insight into their personal lives away from sport.
Objective: The purpose of this paper was to conduct a systematic review on integrity, ethics and well-being in elite level sport.
Methods: A systematic search of SPORTDiscus, ScienceDirect, Taylor & Francis and Informit was conducted. The selection criteria were; published between 2006-2016, full-text availability, peer reviewed and English language. Twenty-three articles met the criteria for inclusion in this review and were analysed through an inductive thematic synthesis approach.
Results: Three themes emerged through the inductive thematic synthesis approach; sportspersonship and ethics, scandal and well-being. The concept of sportspersonship extends beyond the rules of sport and is strongly linked to the character of athletes. Sports environments are a key factor in the well-being of athletes and contribute to the expectations placed on athletes, particularly with regard to winning.
Conclusions: Ethics, integrity, sportspersonship and well-being are interrelated concepts in elite sport. Expectations placed on athletes may be unrealistic and may have negative consequences on well-being. It is important to understand the factors contributing to athlete well-being in order to develop strategies to minimize the adversities faced by athletes.

Keywords: Ethics, Integrity, Elite Sport, Systematic Review, Well-being

INTRODUCTION
Sports integrity can be defined as “manifestations of the ethics and values which promote community confidence in sports” (Australian Government, 2016). It includes the positive conduct of athletes, coaches, administrators, officials and stakeholders both on and off the field as well as sports performances that are fair and honest (Australian Government, 2016). The integrity of sport may be questioned by those involved in sport, or the general public, when the rules of sport are broken, athletes are not perceived to be playing ‘in the spirit’ of the game, the image of a particular sport is compromised by commercialism, or when cheating occurs either before or during a game (Crocker, 2014).

Integrity is also often linked to the concept of ‘sportspersonship’ (Tregas, Cover & Beasley, 2011). Sportspersonship is argued to have four components; equity; fairness; good form of honour and in the sporting context, the will to win (Abad, 2010). It has also been described as a moral concept given it necessitates the conduct of certain behaviour by sportspeople towards others. Thus, one of its key constituents is that it requires more than one person to be involved, as it is difficult to be unsportpersonlike to oneself (Abad, 2010). Being unsporting includes breaking the rules of sport to gain an unacceptable advantage, as well as displaying behaviours that are perceived as being dishonourable. Summers (2007) states that one of the most unsportsmanlike behaviours is “trash-talking” (negatively taunting comments directed towards ones opponent), as sportspersonship is about fair play and conducting one’s behaviours in a way that is considered within the acceptable bounds of the spirit of the game. Therefore, sportspersonship is not just how an athlete conducts themselves during the competition, but also includes their attitude towards sport (Abad, 2010). For example, not shaking hands after the competition, criticising the sport, being a poor winner or loser and not giving one’s all during the competition are examples of behaviours that would be considered dishonourable, therefore unsporting (Abad 2010).

Sportpersonship, and indeed integrity in sport, are complex concepts in that the four suggested components (equity, fairness, good form of honour and in the sporting context, the will to win) can each be at odds with the other components (Abad, 2010). Connor (2009) contends that sport itself is not fair or equitable because the broader social context in which sport exists creates disparities that affect the ability of prospective athletes to be successful. The will to win requires giving one’s all in the competitive environment, however, this can lead to an athlete going to extreme performance enhancement measures to gain a competitive advantage. Connor (2009) argues that modern sport is not natural, and is a ‘cultural activity within a social context’ (p. 331). Further, he argues that the will to win is influenced by the profitability of being successful which can lead to an athlete engaging in unsporting behaviours. In order to be continually offered contracts and sponsorships, an athlete must win, or there are a plethora of other athletes who will take their place (Connor, 2009). The pressure this puts on athletes can lead towards doing anything to keep winning. Martens (2013) suggests that due to many athletes scoring highly on measures of sensation seeking, they may be predisposed to engaging in risky behaviours. One of the fundamental characteristics of sportspersonship is fair play (Abad, 2010), therefore the use of performance enhancing substances by athletes incurs ethical considerations regarding fairness (Martens, 2013). Connor (2009) argues that the use of performance enhancing substances should not be perceived as an individual act by an athlete but must be considered within the broader social context which has a significant influence. The use of performance enhancing substances by an individual therefore occurs as a result of the social forces placed upon the athlete and is not necessarily purely a result of the athlete having questionable ethical attitudes (Connor, 2009).

Doty (2006) argues that traits associated with having a ‘good character’ include showing respect and integrity, which suggests that a person’s character can be demonstrated through actions and behaviours. In the highly variable sporting context, athletes’ actions are often immediate and instinctive and may not be a reflection of the person’s beliefs, rather a product of the stressful and emotional environment in which they are participating. How they act, however, regardless of whether it is perceived to be positively or negatively, becomes a reflection of their overall character (Doty, 2006). Lines (2001) states that sports stars are often portrayed as being the epitome of social values and are therefore constructed in a heroic manner. However, alternative constructions through the media see sports ‘heroes’ being perceived as damaged if they are caught engaging in behaviours that are considered reflections of the problems in society such as adultery, gambling, drugs, drunken exploits and intimate partner violence (Lines, 2001). An analysis of Australian media highlighted that there is a high amount of attention attributed to athlete off-field transgressions (Osborne, Sherry & Nicholson, 2016). The transgressions that were most frequently reported included recreational drug use, assault, and professional misconduct. Other transgressions included gambling, racism, criminal damage and possession of illegal goods (Osborne et al., 2016). The relationship between an athlete’s behaviours, both on and off the field, and the perception of their ‘character’ and therefore overall sporting profile is complex. It is not just their performance in the sporting context that leads to a determination of their character, but their behaviours off the field as well. Athletic performance includes competition style, sportspersonship and rivalry, however the overall ‘character’ of an athlete can have implications for their perceived suitability to advertise products and market their own athlete brand (Arai, Ko, & Ross, 2014). Poor performances in the sporting arena further magnify the perceived severity of the off-field transgression, therefore have the potential to increase the scandal risk and damage the athlete’s reputation (Osborne et al., 2016).

Athlete well-being is recognised as an important component of sports performance (Dunn, 2014). Reinboth and Duda (2006) state that well-being is generally defined in terms of the presence of positive feelings and the absence of negative feelings. The concept of athlete well-being encompasses all aspects of an athlete’s life, including those that are not sport related (Dunn, 2014). Over the life course of elite sports careers, athletes face multiple pressures. Dubuc-Charbonneau and Durand-Bush (2015) found that student athletes experience high levels of burnout and stress which can impact on subjective well-being. This same study argued that in order to manage the challenges they face, athletes adopt various task and social behaviours so they can achieve a more balanced situation. Well-being is highlighted as a key determinant in enabling individuals to cope with daily stressors (World Health Organization 2004). Given that athletes may face additional daily challenges such as poor coach-athlete relationships, injury, poor performance, and stress, it is worthwhile to investigate athlete well-being in the context of elite sport.

Participation in sport is recognised as being an avenue through which to develop “self-esteem, promote sportspersonship, encourage a valuing of physical activity and provide a sense of enjoyment and well-being” (Amorose, Anderson-Butcher & Cooper, 2009, p. 386). Autonomy, competence and relatedness can also be encouraged through sport and can lead to increased well-being (Reinboth & Duda, 2006). In addition, hope and social support appear to be protective factors specifically with regard to injured athletes’ subjective well-being Lu and Hsu, 2013). However, participation in sport alone does not guarantee well-being and the adverse effects of elite sport in particular are also well documented (Bartholomew, Ntoumanis, Ryan & Thøgersen-Ntoumani, 2011; Gould & Carson, 2008; Hellison & Cutforth, 1997). It is important to understand how well-being may change over the course of an athlete’s season and overall career as this may have an impact on their needs, satisfaction with sport and overall experience which may be either positive or negative (Amorose et al., 2009).

The commercialisation of sport has led to a need for athletes to protect their brand image. Athletes are also requires to demonstrate integrity, sportspersonship and ‘good’ character. Further, inherent in the role of the sportsperson is to be an appropriate role model in society (Smith & Stewart, 2008). Therefore, the complex environment in which sport operates requires athletes to consider more than just their sports performance. Increasingly, off-field events are being recognised as a key factor in on-field performance (Dunn, 2014). However, ultimately the focus of athlete well-being programs is on getting the athlete to peak sports performance. Therefore, this shapes the well-being initiatives sports organisations put in place for athletes. Dunn (2014) argues that in some sports, well-being programs are engrained but for others this is still an emerging area. In order to continue the advancement of well-being programs in sport, it is important to first understand what the well-being issues for athletes are.

The aim of this review was to investigate ethics, integrity and well-being in elite level sport. The research questions for this review were:

  • How are issues of ethics and integrity manifested in the sporting context?
  • What are the factors that impact on the well-being of elite athletes?

METHODS
Search Strategy
This systematic review utilised an electronic search in the following four databases: (i) SPORTDiscus; (ii) ScienceDirect; (iii) Taylor & Francis; and (iv) Informit. The Boolean logic was adopted within the databases. The following combinations were used to search for articles: athlete* AND “well-being;” athlete* AND “wellbeing;” athlete* AND “well being;” athlete* AND integrity; athlete* AND scandal;* athlete* AND ethics; athlete* AND sportspersonship OR sportsmanship. Phrase searching was utilised through the use of inverted commas around the terms “well-being,” “wellbeing,” and “well being” to ensure that articles were found on well-being as opposed to all articles that included the terms “well” and “being.” The references lists of retrieved articles were also scanned for suitable articles. The search was undertaken in July and August 2016. Two of the research team (DA and PH) independently conducted the search according to the above search strategy.

Eligibility Criteria
Articles were screened independently by two authors (DA, PH). The inclusion criteria required articles to be focussed on elite athletes, published between 2006-2016, full text availability, peer reviewed and the English language. Elite was considered to be division one or higher, professional sports and competing at the national, international, Olympic or Paralympic level. Articles which focussed on junior or amateur athletes, coaches, fitness and not sport, were a clinical trial, exercise trial or included medical, psychometric tests and literature reviews were excluded. Articles with a nutrition, tourism, or school focus were also excluded. Specifically with regard to the athlete* and ethics search, articles which did not focus on the personal ethical values of elite athletes were excluded. A consensus meeting was held to discuss differences in article selection and where necessary the third author (CW) was consulted to make the final decision.

Data Extraction
Two authors (DA, PH) independently extracted data from all selected articles. Both authors used a standardised data extraction form which included the following components: authors; year; title; study design; study aims; study participants; main findings (Table 1).

Table 1: Athlete integrity and ethical issues and the impact of transgressions on athlete well-being
Table 1a
Table 1b
Table 1c
Table 1d
Table 1e
Table 1f

Data Analysis
Data were analysed according to the method outlined by Thomas and Harden (2008). A thematic synthesis approach was undertaken to not only inductively analyse the results of the review into themes but also synthesise the results in order to ‘go beyond’ the findings of the primary studies so that further understanding can be gained (Thomas & Harden, 2008, p. 54). According to Thomas and Harden (2008), thematic synthesis has three stages; the coding of text line by line; the development of descriptive themes and; the generation of analytical themes. Two of the authors (DA, PH) manually analysed the included primary studies individually line-by-line to generate the initial codes. The two sets of codes were then compared and merged to form one set of codes. The third author (CW) was consulted to make the final decision on the names of codes where necessary. Conducting line-by-line coding allowed the authors to translate the concepts from one study to another, which is considered to be a key component of qualitative thematic synthesis (Thomas & Harden, 2008; Britten, et al., 2002). Following the line-by-line coding of the primary studies, the codes were then analysed to search for similarities and difference in order to generate descriptive themes (Thomas & Harden, 2008). This process generated four themes. A draft summary of themes was written by the first author (DA) with the other two authors (PH, CW) commenting on the draft until a final version was agreed. In order to complete the thematic synthesis of the data, the themes were analysed in accordance with the review research questions (Thomas & Harden, 2008). This process enabled the analysis to go beyond a description of the themes and create a more in depth understanding of ethics, integrity and well-being in elite sport. Two of the original four themes were merged, which provided a more complete overview and resulted in a final data set of three themes to be compiled.

RESULTS
Search results
The search criteria resulted in a total of 1276 articles. Of these articles, 73 were excluded as duplicates, and a further 940 were excluded after two authors (DA, PH) screened the titles and abstracts for suitability. Thirty-three articles were excluded as the authors were unable to access the full text. The remaining 230 full-text articles were examined independently by two authors (DA, PH) according to the inclusion and exclusion criteria outlined in section 2.2. In total, 23 articles met the inclusion criteria. Figure 1 presents the study selection flow chart.

Figure 1: study selection flow chart
Figure 1

Types of articles
Of the 23 articles, nine were quantitative studies, six were qualitative studies utilising interviews as the data collection method, three were qualitative case studies, four were commentaries, and one was a mixed method design (table 1). The inductive thematic analysis generated three themes; 1) Sportspersonship and Ethics; 2) Scandal, and 3) Well-Being. Each of these themes had at least two sub-themes, being elaborated upon in the following sections.

Sportspersonship and Ethics
The findings of this review confirm the strong link between sportspersonship and ethics, with ten articles relating to sportspersonship and ethics of elite athletes. Through the thematic analysis three key sub-themes emerged; ‘spirit of the game’; ‘expectations’ and; ‘will to win’.

Spirit of the Game
The spirit of the game component of sportspersonship was evident in four articles (Sezen-Balcikanli & Yildiran, 2012; Jonson, Lynch & Adair, 2013; Martínková & Parry, 2015; McNamee, 2009). A ‘good’ sportsperson is perceived as adhering to the spirit of the game and does not deviate from the appropriate virtues (Sezen-Balcikanli & Yildiran, 2012). One article (Jonson et al., 2013) questioned what is meant by ‘responsible conduct’ or ‘inappropriate behaviour’ and argued that elite athletes are required to operate within a system that violates their civil and human rights through the ability of the sports organisation to discipline players for ‘bringing the game into disrepute’ (p. 61). Two articles (Martínková & Parry, 2015; McNamee, 2009) considered actions by sportspeople that were not necessarily against the rules, but resulted in sanctions because the acts were considered to be against the spirit of the game. Martínková and Parry (2015) contended that in contact sports in particular the rules specifically outline what forms of contact would be considered against the rules but that for many sports this does not include biting. The authors suggest this is because biting is not a likely strategy in most sports, therefore negating the need to prohibit it. However, this does not mean that biting is permissible and athletes who employ this strategy may be sanctioned, despite it not being formally against the rules. Similarly, McNamee (2009) highlighted that crashing one’s car during a Formula 1 race to allow a teammate to win is not technically against the rules but has been described as being ‘probably on the wrong side of cheating’ (p. 284). Sezen-Balcikanli and Yildiran’s (2012) used the sportspersonship orientation scale to determine what characteristics elite athletes should have in order to act in a manner consistent with the acceptable parameters of fair play. They found that athletes who are more empathetic are more likely to have respect for social conventions such as shaking the opponents’ hands at the completion of a game and respect for the losing side because they tried their best. Thus, being more empathetic appears to strongly coincide with performances in sport which are perceived as being in the ‘spirit of the game’.

Expectations
Jonson et al. (2013) question the expectations placed on elite athletes to be appropriate role models, suggesting that the standards to which athletes are held accountable go far beyond those of employees in other professions. It was acknowledged through two articles that athletes are representing themselves, their sport, organisation, key stakeholders and even the fans (Jonson et al., 2013; Meng & Pan, 2013). However, one article (Scarf, 2008) questioned the use of athletes as role models given they have not been asked whether they want to be or not. Scarf (2008) argued that the assumption they should be is made on their behalf due to the popularity of sport in society. The assigning of role model status for elite athletes is furthered by Jonson et al., (2013) who suggest the role of the sportsperson has evolved to include entertaining and celebrity components. Central to the role model status are the expectations of the sports organisation who may include certain contractual requirements regarding this area, and the influence of the media and public expectations (Jonson et al., 2013). Questions were also raised through two articles (Jonson et al., 2013; Scarf, 2008) as to whether athletes fully understand the consequences of the role model status with regard to player contracts since the obligations are likely to include both on and off field behaviours.

Will to win
Seven articles focussed on the implications of athletes’ will to win (Scarf, 2008; Donahue et al., 2006; Barkoukis, Lazuras, Tsorbatzoudis & Rodafinos, 2011; 2013; Hauw & Mohamed, 2015; Whitaker, Backhouse & Long, 2014; Dunn & Thomas, 2012). While the authors acknowledge unsportspersonlike behaviours include more than doping, much of the literature gained from this search focussed on performance enhancing substances. Donahue et al. (2006) suggests that athletes who display unsportsmanlike behaviours may be more likely to engage in other unethical behaviours such as using performance enhancing substances. However, Barkoukis et al.(2011) found that success can be a significant influence on the decision to use performance enhancing substances because the athlete perceives doping as being an inevitable consequence to avoid failure. Further, Barkoukis et al. (2013) suggested that external pressures from coaching staff or expectations to win may heighten the intention of athletes to dope. Therefore, the decision to dope is not made in isolation (Dunn & Thomas 2012). Male athletes who are older and know other athletes who dope have been found to be at a higher risk of doping (Dunn & Thomas, 2011). In addition, Whitaker et al., (2014) suggested there is a “community of silence” (p. e518) with regard to reporting doping in other athletes, therefore the culture of sport may be an implicit part of individual doping acts. It is important to note that due to the controversial nature of this topic, there are possible limitations to the studies meaning that there might be missing detail regarding the likelihood to dope reasons. Athletes in Whitaker et al.’s research (2014) revealed the tension between wanting to participate in a ‘clean’ sport, and the consequences for the sport if they did report any knowledge of athletes doping. A community of silence may result from the perceived negative consequences for both the athletes who are doping and those who are not as the sport could lose vital sponsorship and the reputation of the sport tarnished if doping in the sport is revealed. However, this same research noted that the willingness to report doping may be influenced by the nature of the sport with individual athletes possibly being more willing to be a whistle blower than those involved in a team sport.

Scandal
When athletes are reported to deviate from the behaviours expected of them there is potential for a scandal to emerge. Four articles addressed scandals in elite sport. Two sub-themes emerged in relation to scandals: ‘the parameters of transgressions’ and; ‘the cost of transgressions’.

Parameters of transgressions
The popularity of sports in society leads to athletes being exemplified in the media, by sports administrators and general society, therefore their behaviour is constantly being scrutinised (Scarf, 2008). Sports scandals occur as a result of athletes transgressing from the expectations placed upon them (Storm & Wagner, 2015). With the increase in media for sports, and the increased availability of information through social media, sports fans are engrossed in more than the sports performance and are increasingly seeking information on athlete’s off-field life (Meng & Pan, 2013). It is arguable with the increased intrusion into the personal lives of athletes, the potential for scandals to result has also increased. Scandals generally have four phases; the prescandal phase, the phase of the scandal proper, the phase of culmination, and the aftermath (Storm & Wagner, 2015, p. 296). One of the key factors in an incident being labelled a scandal is the involvement of the media as this is where scandals are usually exposed and commented on (Burroughs & Vogan, 2015). Athletes are judged for the performance both on and off the sporting field. Burroughs and Vogan (2015) state that athletes are judged according to sporting norms and the sport environment in which these norms are constructed. Athletes who deviate from the norms and societal expectations can be both judged and punished (Burroughs and Vogan, 2015). Three articles (Meng & Pan, 2013; Storm & Wagner, 2015; Burroughs & Vogan, 2015) discussed the behaviours by athletes that are likely to be perceived as transgressions. Behaviours that are likely to be perceived by society as deviant and therefore scandalous can be linked to those that are also seen as being immoral or unethical. Extramarital affairs, doping violations and being untruthful about an event emerged as behaviours resulting in scandals (Meng & Pan, 2013; Storm & Wagner, 2015; Burroughs & Vogan, 2015).

Cost of transgressions
Three articles (Meng & Pan, 2013; Storm & Wagner, 2015; Burroughs & Vogan, 2015), highlighted the issues pertaining to the cost of athlete transgressions for sporting codes. Given that athletes may represent more than their own individual brand, involvement in a scandal has the potential to impact on more than just the individual athlete (Meng & Pan, 2013). The transgression by the athlete may not be related to the rules of the sport, however the expectations of the sport environment can influence the impact of the act. For example, Storm and Wagner (2015) argue that golf is a gentleman’s game, thus an extramarital affair could be very costly for the individual athlete’s own brand in terms of sponsorship, and the sport through being associated with an athlete who has deviated from the ‘norms’ of the sport, despite an affair not being related to the rules of golf. Similarly, the cost of alleged transgressions can be equally as high, regardless of whether the incident actually occurred. Two articles (Storm & Wagner, 2015; Burroughs & Vogan, 2015) detailed scandals which resulted in the athletes being involved in alleged transgressions and regardless of the alleged involvement in the act being proven, the athletes still suffered financially through loss of sponsorship and their reputations being tarnished. Athletes can also be suspended for not adhering to the sport’s policy on personal conduct, despite no criminal charges ever being filed. Therefore this study concludes that both committing a transgression and being linked to a transgression are equally as damaging to athletes.

The cost of transgressions can extend beyond the athlete to sponsors and sport governing bodies. Meng and Pan (2013) argue that sponsors are key influences in the brand image athletes are able to build. Popular athletes can also be profitable for the sponsors as fans may be more influenced to purchase certain products depending on the athletes who are used to market them. However, when athletes transgress from the expected behaviours fans may be deterred from purchasing products advertised by the deviant athlete and from watching or attending sport. Therefore the cost of the transgression to the brand image of sponsors and the overall sport could be substantial (Meng & Pan, 2013; Storm & Wagner, 2015). The pressure that extends to sponsors and sports organisations to deal with the incident culminates in an institutional solution which can see overall sports as well as individual athletes losing sponsorship, or in athlete contract changes to minimise the chance of the transgression occurring again (Storm & Wagner, 2015; Burroughs & Vogan, 2015). However, should the solution not be adequate the potential for scandals to continually reoccur is significant (Storm & Wagner, 2015).

Well-being
The search criteria resulted in nine articles relating to the well-being of elite athletes. Sport can positively affect well-being, however there are elements of the sport culture that can have negative consequences for athletes (Bačanac, Milićević-Marinković, Kasum, & Marinković, 2014). Two sub-themes emerged from the literature regarding well-being; ‘sports environment’ and; ‘adversity’.

Sports environment
The sports environment can be both beneficial and detrimental to the well-being of athletes. Participating in sport appears to provide athletes with a means to engage in culture as well as providing a meaningful experience. However, total immersion in the sport environment can lead to lower reported levels of well-being (Verkooijen, Van Hoye & Dik, 2012). Interestingly, Verkooijen et al. (2012) found that athletes who live in a sports institute had lower psychological well-being than those who did not. In addition, the higher athletes scored on the sense of accomplishment scale the lower their psychological well-being. It is plausible that athletes living in a sports institute experience higher expectations that those who do not and so may perceive the level of pressure to succeed to also be higher. Smith et al. (2015) determined athletes with high scores of neurotic traits have higher levels of homesickness when moving to live at a sports institute. Further, higher levels of homesickness were predicted in athletes who had low self-esteem. It is arguable that higher levels of neurotic traits may also results in higher expectations, therefore higher levels of psychological distress. While the need for sport life balance it apparent (Verkooijen, et al., 2012; Macdougall, O’Halloran, Sherry & Shields, 2016) athletic identity and measures of subjective well-being do not seem to be strongly linked (Verkooijen et al., 2012).

Being immersed in a sports institute environment emerged as a key area through which the well-being of athletes is influenced. In one sense, living at a sports institute can provide a higher level of support for athletes are they are living with others who are going through the same experiences. However, athletes may also be competing with each other for positions on the team and for sponsorship contracts therefore this could lead to higher levels of perceived stress (Smith, Hanrahan, Anderson & Abbott, 2015). The work ethic of athletes can also have an impact on well-being, particularly those living in a sports institute as it can divide athletes and hinder the prospect to develop close friendships (Schinke, Blodgett, McGannon & Ge, 2016).

Adversity
Elite athletes face different types of adversity in order to compete at the highest level (Tamminen, Holt, & Neely, 2013). Some of the negative aspects of participating in elite sport include burnout, external and internal pressures, lack of support, not being able to find balance, isolation, withdrawal, lack of confidence, poor performances and injury (Verkooijen et al., 2012; Smith et al., 2015; Macdougall et al., 2016; Schinke et al., 2016; Tamminen et al., 2013; Theberge, 2008; Gulliver, Griffiths, Mackinnon, Batterham & Stanimirovic, 2015). In addition, Gulliver et al. (2015) found that approximately one in five elite Australian athletes experience depression. The well-being of athletes can be affected based on the level of perceived control the athlete has. Athletes who perceive their level of control over their situation to be low are more likely to experience negative consequences with regard to well-being (Macdougall et al., 2016; Schinke et al., 2016).

Three articles discussed the importance of self-confidence to overall well-being (Bačanac et al., 2014; Tamminen et al., 2013; Sar and Isiklar, 2012). Interestingly facing adversity can be a means through which self-confidence is gained as when facing challenges athletes are able to determine what they are capable of (Tamminen et al., 2013). Further, facing adversity can provide opportunities for personal growth which can include a period of self-reflection on the meaning of sport in the athlete’s lives (Tamminen et al., 2013). High levels of self-esteem and self-confidence are deemed to be significant factors in athletic success (Bačanac et al., 2014; Sar & Isilkar 2012). In addition, Sar and Isilkar (2012) determined that there is a significant correlation between sport confidence and subjective well-being. A key factor in predicting sport confidence is the locus of control. An internal locus of control correlates with sport confidence because athletes’ belief in their ability to be successful and their overall confidence in their own psychological resilience is high (Bačanac et al., 2014; Sar & Isilkar, 2012).

Three articles focussed on athletic burnout which can negatively affect well-being (Verkooijen et al., 2012; Macdougall et al., 2016; Schinke et al., 2016). External pressures to succeed along with not being able to find a balance between on field and off field interests can lead to athlete burnout (Schinke et al., 2016). A reduced sense of accomplishment is also linked to athlete burnout and is related to the sports environment. Athletes living in an elite sport centre have been found to have higher reduced sense of accomplishment and lower psychological well-being (Verkooijen et al., 2012). This may be due to higher expectations being placed on athletes living in an elite sports centre. Living location can also lead to feelings of isolation, uncertainty and perceived low levels of control over their situation (Macdougall et al., 2016; Schinke et al., 2016). Not being able to switch off from sport can also contribute to negative consequences such as a lack of life balance, burnout and lack of direction Macdougall et al., 2016; Schinke et al., 2016) .

Elite athletes compete in an environment where they are exposed to social experiences (Sar and Isiklar, 2012). However, participating in elite sport can be a potentially isolating experience (Smith et al., 2015; Schinke et al., 2016; Tamminen et al., 2013). Isolation can be particularly significance for those who have moved locations to further their sports careers (Smith et al., 2015; Schinke et al., 2016). Under-performing in sport can further lead to isolation as athletes self-withdraw from teammates (Tamminen et al., 2013). More positively, Gulliver et al. (2015) found that moving away from home for sport is not necessarily correlated with depressive symptoms in elite athletes. Elevated levels of social anxiety are also common in elite athletes (Gulliver et al., 2015). However, this same study found that the levels of symptoms for mental health in elite athletes were similar to those observed in the general community (Gulliver et al., 2015).

Despite the many challenges elite athletes face which can significantly affect overall well-being, adversity exists alongside the positive aspects of sport which can promote well-being (Theberge, 2008). Therefore, while sport contains risk factors with regard to well-being, it also provides protective factors for athletes. The protective factors sport can provide for well-being include mental strength, increased health knowledge, providing athletes with an overall philosophy for life and the opportunity for personal growth (Tamminen et al., 2013; Theberge, 2008).

DISCUSSION
The aim of this study was to investigate ethics, integrity and well-being in the context of elite sport. While the search criteria did not elicit any articles which considered all three of these aspects together, through the process of data synthesis, this discussion brings together the results of the combined articles to draw some logical conclusions.

This review confirmed that sportspersonship, integrity and ethics are interrelated. Primarily with regard to athletes, ethics and integrity in elite sport are manifested through how an athlete adheres to the four components of sportspersonship; equity, fairness, good form of honour and the will to win. Athletes are expected to conduct themselves on and off the sporting arena in a manner which ensures fair play for all athletes. However, this study raises questions as to whether athletes are performing in a fair environment to begin with. Athletes are continually seeking to improve their performance and will manipulate diet, training regimes, have pain-killing injections and even surgery to achieve maximal sports performance (Scarf, 2008). However, they also face harsh sanctions and loss of reputation if they are found to be using performance enhancing substances that are banned by the World Doping Authority (Scarf, 2008). In addition, there is an implied consent on behalf of athletes that they are willing to be role models in society (Scarf, 2008). Therefore, it is not only their sports performance that is consistently under review. Growing social media technologies provides even more intrusion into the off-field lives of athletes and any behaviour which is perceived as not being appropriate has the potential to escalate to a scandal, regardless of whether it is related to sports performance or not (Meng & Pan, 2013; Storm & Wagner, 2015; Burroughs & Vogan, 2015). Whether an act is perceived as being scandalous is largely determined by the media and the expectations society places on elite athletes to be role models. This review found that sports organisations are able to sanction athletes for non-sports performance related behaviours such as extramarital affairs under policies of personal conduct. These penalties can be enforced even if the athlete is not charged with an offence. Therefore both committing a transgression and being alleged to have committed a transgression are equally as damaging for elite athletes. This review confirms Scarf’s assertion (2008) that the expectations placed on elite athletes are far beyond those of employees in other professions. It is arguable that the expectations placed on athletes to be role models may cause heightened levels of stress which could result in poorer performances in sport.

While sport can provide avenues for personal growth, elite athletes are faced with a variety of risk factors with regard to their overall well-being. The adversity faced by athletes includes risk of injury, high levels of psychological distress, perceived pressure, and isolation amongst others (Verkooijen et al., 2012; Smith et al., 2015; Macdougall et al., 2016; Schinke et al., 2016; Tamminen et al., 2013). These adversities may cause a high level of perceived pressure which could in turn lead to athletes engaging in behaviours which would be considered unsporting. While athletes may feel isolated, it is important to recognise that they are participating within a complex environment. Pressures from coaches, other athletes, family members, the media and broader society to succeed combined with the athlete’s will to win appear to be strong predictors of the intent to dope (Barkoukis et al., 2013; Dunn & Thomas, 2012). It can be concluded through this study that the environment in which athletes perform is a strong factor in their well-being. Athletes do not train or perform in isolation therefore, transgressions or unsportspersonship behaviours are more than just a reflection of the athlete’s personal characteristics; they are a reflection of the culture in which the athlete is performing. Athletes are most likely to display intentions to dope according to situational pressures, including the suggestion that they should from coaches or high perceived expectations to win (Barkoukis et al., 2013).

Limitations
This review has a number of limitations. The use of the key search term ‘athlete’ has the potential to exclude articles which use sportsperson, sportsman or sportswoman rather than athlete and may have impacted on the results. However, the authors determined that if the aforementioned terms were used we would also need to consider articles which refer to athletes by the sport such as footballer or basketballer, thus athlete was chosen as the single key search term to keep the results consistent.

The search terms regarding ethics largely elicited articles on performance enhancing drugs and doping. It is recognised the ethics, morals and values of elite athletes encompasses more than just their attitudes towards illicit substances. Therefore future research needs to include search terms which have the potential to generate articles on other areas pertaining to the ethical and moral judgements of elite athletes.

It appears as though there are differences between the national competitions and what constitutes an elite athlete that makes comparisons between countries difficult. For example, inter-collegiate may be considered elite in the United States of America but it is difficult to compare this level of competition with university college athletes in Australia or Taiwan. Through the search criteria for this systematic review a significant number of articles pertaining to college, intercollegiate and varsity athletes emerged. Therefore, recommendations for future research include conducting a second systematic review to ascertain whether the same issues are experienced by elite athletes are also experienced by college athletes.

CONCLUSION
Given the implied consent of elite athletes to be role models, it would be of interest to investigate the impact of elite ethical issues and transgressions on lower leagues of sport (such as junior and amateur levels) to determine whether perceived unsportspersonship issues at the elite levels influences behaviours of participants in other competitions.

A key question raised through this review was whether athletes are performing in a fair environment. The expectation to be ‘good’ role models for society arguably places additional pressure on athletes, which could lead to increased stress and therefore impact on sports performance. Given none of the articles in this review asked elite athletes their perception on being a role model, further research should investigate how athletes themselves feel about being role models and the impact of this imposed role on their overall well-being.

APPLICATIONS IN SPORT
Ethics and integrity issues are manifested in sport through athletes’ adherence to the components of sportspersonship. Society places high expectations on athletes to be appropriate role models which are unrealistic and far beyond those of other occupations. The sports environment is a key factor in the expectations placed on athletes and has a significant influence on athlete well-being. Athletes face many adversities during their careers and while these can provide opportunities for personal growth they can have negative consequences. Understanding the factors that can contribute to athlete well-being, either positive or negative is important as this will enable strategies to be developed to minimise the negative consequences of being involved in elite sport.

ACKNOWLEDGEMENTS
none

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