Severity of anabolic steroid dependence, executive function, and personality traits in substance use disorder patients in Norway

Scarth, Morgan; Havnes, Ingrid Amalia; Jørstad, Marie Lindvik; McVeigh, Jim; Hout, Marie Claire Van; Torgersen, Svenn; Bjørnebekk, Astrid

doi:10.1016/j.drugalcdep.2022.109275

Cited by 19 publications

(27 citation statements)

References 67 publications

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“…AAS have a 30% dependence rate among long-term users, higher than many other prescription or illicit drugs such as cocaine and have been linked to medical issues such as liver and kidney damage, cardiovascular problems, testicular atrophy, infertility, hair loss, and gynecomastia 2 , 3 , 7 – 10 . AAS use is strongly associated with other substance abuse 8 , 9 , 11 , 12 , and users often exhibit negative, although idiosyncratic, psychological issues 8 , 13 – 17 . Some users report delusions of grandeur and invincibility, while others experience depression and various mood disturbances 8 , 18 – 20 .…”

Section: Introductionmentioning

confidence: 99%

Anabolic–androgenic steroid use is associated with psychopathy, risk-taking, anger, and physical problems

Nelson

Hildebrandt

Wallisch

2022

Sci Rep

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Previous research has uncovered medical and psychological effects of anabolic–androgenic steroid (AAS) use, but the specific relationship between AAS use and risk-taking behaviors as well as between AAS use and psychopathic tendencies remains understudied. To explore these potential relationships, we anonymously recruited 492 biologically male, self-identified bodybuilders (median age 22; range 18–47 years) from online bodybuilding fora to complete an online survey on Appearance and Performance Enhancing Drug (APED) use, psychological traits, lifestyle choices, and health behaviors. We computed odds ratios and 95% confidence intervals using logistic regression, adjusting for age, race, education, exercise frequency, caloric intake, and lean BMI. Bodybuilders with a prior history of AAS use exhibited heightened odds of psychopathic traits, sexual and substance use risk-taking behaviors, anger problems, and physical problems compared to those with no prior history of AAS use. This study is among the first to directly assess psychopathy within AAS users. Our results on risk-taking, anger problems, and physical problems are consistent with prior AAS research as well as with existing frameworks of AAS use as a risk behavior. Future research should focus on ascertaining causality, specifically whether psychopathy is a risk associated with or a result of AAS use.

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Section: Introductionmentioning

confidence: 99%

Anabolic–androgenic steroid use is associated with psychopathy, risk-taking, anger, and physical problems

Nelson

Hildebrandt

Wallisch

2022

Sci Rep

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“…This suggests that MD for AAS consumers consists of particularly strong connections among symptoms that involve taking action to change ones appearance (diets, supplements, training), whereas the WLC network demonstrates greater in uence of nodes representative of internalized thoughts and feelings such as wanting to conceal their physiques. AAS consumers have previously demonstrated elevated levels of impulsivity and neuroticism, which may contribute to using more extreme practices and willingness to accept increased risk to achieve their desired results compared to those who do not use AAS (59,68).…”

Section: Discussionmentioning

confidence: 99%

Investigating anabolic-androgenic steroid dependence and muscle dysmorphia with network analysis

Scarth

Havnes

Bjørnebekk

2023

Preprint

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Background Anabolic-androgenic steroid (AAS) dependence has numerous adverse health consequences, and may be driven in part by body image concerns, primarily muscle dysmorphia. This study aims to further understanding and identify potential clinical targets using network analyses of AAS dependence and muscle dysmorphia symptoms in males who used AAS and weightlifting controls. Methods A sample of 153 men who had used AAS and 88 weight-lifting controls were recruited through social media and relevant online forums, and via posters and flyers distributed in select gyms in Oslo, Norway. Symptoms of AAS dependence and muscle dysmorphia were assessed using clinical interviews and standardized questionnaires. Severity of muscle dysmorphia symptoms were compared between the groups using independent samples t-tests. The following symptom networks were computed using Gaussian graphical modeling or mixed graphical modeling: 1) AAS dependence symptoms among men who has used AAS 2) muscle dysmorphia symptoms among men who had used AAS and weight-lifting controls in two separate networks, which were compared using a network comparison test, and 3) AAS dependence and muscle dysmorphia symptoms among men who had used AAS. Results In a network of AAS dependence symptoms, continuing use despite physical and mental problems, using longer than planned, tolerance, and work/life interference were the most central symptoms. When comparing symptom structures of muscle dysmorphia between those who used AAS and controls, the most central symptoms in each group were exercise dependence and size/symmetry concerns, respectively. Men who had used AAS demonstrated elevated muscle dysmorphia symptoms compared to controls, indicating that both the severity and structure of symptoms differ between these groups. In a network including both AAS dependence and muscle dysmorphia symptoms among men who had used, no significant connections between symptom groups were identified. Conclusions AAS dependence is complex, with correlated somatic and psychological challenges driving the symptom network, indicating that alleviating physical and mental health concerns during both AAS use and cessation is an important clinical target.

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“…Although speculative, this similarity may be partially explained by shared reward mechanisms for opioid and AAS dependence involving opioid receptors in the dopamine system of the ventral tegmental area, which is often implicated in substance use and addiction (Bontempi & Bonci, 2020;Johansson et al, 1997;Morales & Margolis, 2017). In addition, common personality traits and cognitive dysfunctions have been identified in both AAS and opioid users (Baldacchino et al, 2012;Hauger et al, 2020;Scarth et al, 2022). Furthermore, some of the strong edges in the AAS dependence network may be explained by similarly worded or clearly related items.…”

Section: Discussionmentioning

confidence: 99%

“…This suggests that MD for AAS users consists of particularly strong connections among symptoms that involve taking action to change ones appearance (diets, supplements, training), whereas the WLC network demonstrates greater influence of nodes representative of internalized thoughts and feelings such as wanting to conceal their physiques. AAS users have previously demonstrated elevated levels of impulsivity and neuroticism, which may contribute to using more extreme practices and willingness to accept increased risk to achieve their desired results compared to those who do not use AAS (Garcia-Argibay, 2019;Scarth et al, 2022).…”

Section: Discussionmentioning

confidence: 99%

Investigating anabolic-androgenic steroid dependence and muscle dysmorphia with network analysis

Scarth¹,

Westlye²,

Havnes³

et al. 2022

Preprint

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Background: Anabolic-androgenic steroid (AAS) dependence has adverse psychological and health consequences, and may be driven in part by muscle dysmorphia. This study aims to identify possible targets for clinical care, and further understanding of symptom structures using network analyses of AAS dependence and muscle dysmorphia symptoms in male AAS users and weightlifting controls.Methods: Symptoms of AAS dependence and muscle dysmorphia were assessed using clinical interviews and standardized questionnaires. The following symptom networks were computed 1) AAS dependence symptoms among users (n=120), 2) muscle dysmorphia symptoms in AAS users and weight-lifting controls (n=88) in two separate networks, which were compared using a network comparison test, and 3) AAS dependence and muscle dysmorphia symptoms in AAS users. Results: AAS users scored significantly higher on all muscle dysmorphia measures compared to controls. In the dependence network, continuing use despite physical and mental problems, interference with work/life, using more or for longer than planned, and tolerance were the most central symptoms, while time spent was the least central. The symptom structure of muscle dysmorphia differed in controls and AAS users, with physique concealment and exercise dependence as the most central symptoms in the two groups, respectively. The correlation stability coefficients indicated acceptable stability of all networks. Conclusion: Side effects and tolerance were the key constituents of AAS dependence, suggesting alleviating discomfort when ceasing use as a target for treatment. Additional studies are needed to assess the value of symptom network analysis for clinical decision-making, and the role of body image problems in AAS dependence.

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Severity of anabolic steroid dependence, executive function, and personality traits in substance use disorder patients in Norway

Cited by 19 publications

References 67 publications

Anabolic–androgenic steroid use is associated with psychopathy, risk-taking, anger, and physical problems

Anabolic–androgenic steroid use is associated with psychopathy, risk-taking, anger, and physical problems

Investigating anabolic-androgenic steroid dependence and muscle dysmorphia with network analysis

Investigating anabolic-androgenic steroid dependence and muscle dysmorphia with network analysis

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