Illicit anabolic-androgenic steroid (AAS) use represents an important public health problem; NIDA has recently funded a major public education campaign to counter AAS use, with television advertising in English and Spanish. Surprisingly, however, we are not aware of any NIDA-funded studies of illicit AAS users (aside from a team-based substance abuse prevention program) in the last four fiscal years. Because of the limited available research, risk factors for illicit AAS use are poorly understood. In a recent pilot study, we found that AAS use may be associated with two clusters of risk factors, an antisocial cluster and a body image cluster. To test these hypotheses, we propose a cross-sectional cohort study- an advantageous and underutilized design, which we show is equal in validity to the more traditional case control design, but particularly suited for the study of risk factors in our setting. We will assess 300 men, drawn from a population of regular weightlifters, and shown by our pilot data to contain approximately 50% of AAS users. To minimize observer bias, one interviewer will assess subjects for the outcome variable (history of AAS use), and a separate blinded interviewer will assess subjects for all exposure variables (childhood and adolescent attributes that may be risk factors for AAS use). These assessments will use a battery of structured personal interviews and self-report measures, developed from our pilot study and extensive previous AAS research. We hypothesize that AAS use will be significantly associated with 1) childhood and adolescent antisocial traits and associated attributes, including parental substance use, lack of parental supervision, risk-taking, and drug use among peers; and 2) childhood and adolescent body image concerns and associated attributes, including eating disorders, body dysmorphic disorder, and other disorders in the obsessive-compulsive spectrum. We will also test the secondary hypothesis that the antisocial cluster predicts drug use in general, whereas the body image cluster predicts AAS use in particular. Findings from this study will lead to more focused and efficient strategies for 1) identifying boys and young men most likely to use AAS; 2) targeting populations at greatest risk, to ensure optimum deployment of educational resources for reducing AAS use; 3) treating psychiatric disorders (such as body image disorders) in individuals at high risk for AAS use; and 4) designing subsequent prospective intervention studies of strategies to prevent AAS use.

Agency
National Institute of Health (NIH)
Institute
National Institute on Drug Abuse (NIDA)
Type
Research Project (R01)
Project #
5R01DA016744-04
Application #
7379970
Study Section
Special Emphasis Panel (ZRG1-HOP-C (02))
Program Officer
Obrien, Moira
Project Start
2005-03-01
Project End
2010-02-28
Budget Start
2008-03-01
Budget End
2009-02-28
Support Year
4
Fiscal Year
2008
Total Cost
$329,129
Indirect Cost
Name
Mclean Hospital
Department
Type
DUNS #
046514535
City
Belmont
State
MA
Country
United States
Zip Code
02478
Pope Jr, Harrison G; Kanayama, Gen; Hudson, James I (2012) Risk factors for illicit anabolic-androgenic steroid use in male weightlifters: a cross-sectional cohort study. Biol Psychiatry 71:254-61
Brennan, Brian P; Kanayama, Gen; Hudson, James I et al. (2011) Human growth hormone abuse in male weightlifters. Am J Addict 20:9-13
Kanayama, Gen; Hudson, James I; Pope Jr, Harrison G (2010) Illicit anabolic-androgenic steroid use. Horm Behav 58:111-21
Baggish, Aaron L; Weiner, Rory B; Kanayama, Gen et al. (2010) Long-term anabolic-androgenic steroid use is associated with left ventricular dysfunction. Circ Heart Fail 3:472-6
Kanayama, Gen; Brower, Kirk J; Wood, Ruth I et al. (2010) Treatment of anabolic-androgenic steroid dependence: Emerging evidence and its implications. Drug Alcohol Depend 109:6-13
Pope, Harrison G; Kean, Joseph; Nash, Adam et al. (2010) A diagnostic interview module for anabolic-androgenic steroid dependence: preliminary evidence of reliability and validity. Exp Clin Psychopharmacol 18:203-13
Kanayama, Gen; Hudson, James I; Pope Jr, Harrison G (2009) Features of men with anabolic-androgenic steroid dependence: A comparison with nondependent AAS users and with AAS nonusers. Drug Alcohol Depend 102:130-7
Kanayama, Gen; Brower, Kirk J; Wood, Ruth I et al. (2009) Anabolic-androgenic steroid dependence: an emerging disorder. Addiction 104:1966-78
Kanayama, Gen; Brower, Kirk J; Wood, Ruth I et al. (2009) Issues for DSM-V: clarifying the diagnostic criteria for anabolic-androgenic steroid dependence. Am J Psychiatry 166:642-5
Kanayama, Gen; Hudson, James I; Pope Jr, Harrison G (2008) Long-term psychiatric and medical consequences of anabolic-androgenic steroid abuse: a looming public health concern? Drug Alcohol Depend 98:1-12

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