Psychosocial factors facilitating anabolic-androgenic steroid dependence

Zoob Carter, Barnaby ORCID: 0000-0003-0387-4849 (2023). Psychosocial factors facilitating anabolic-androgenic steroid dependence. University of Birmingham. Ph.D.

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Abstract

The development of anabolic-androgenic steroid (AAS) dependence within the AAS using community is of some concern, due to the plethora of adverse health consequences it coincides with. To date, little is known about the factors aiding in the development of this condition. Utilising the current theory of AAS dependence and Bandura’s (1991) theory of moral thought and action, this thesis aimed to investigate the psychosocial factors that facilitate the development of AAS dependence amongst recreational strength athletes.

Study 1 quantitatively explored the longitudinal relationship between AAS dependence and the experience of undesired physical and psychological effects via moral disengagement (MD); in a population of male (n = 118) AAS users across three time points over a 12-month period. Mediation analysis revealed significant direct effects between AAS dependence, undesired physical effects (β = 0.08, 95% CI = 0.05 to 0.15), undesired psychological effects (β = 0.10, 95% CI = 0.07 to 0.13), and MD (β = 0.10, 95% CI = 0.07 - 0.13). However, no indirect effects were identified for the longitudinal relationship between AAS dependence on undesired physical and psychological effects via MD.

Attributed to the poor performance of AAS measures in Study 1, and the dearth of multidimensional AAS specific measures in the extant literature. Study 2 sought to develop and provide evidence of validity for measures of AAS dependence and AAS craving with two samples of male and female strength athletes who use AAS (n\(_{sample 1}\) = 206; n\(_{sample 2}\) = 224). Exploratory and Confirmatory Factor Analyses (CFA) with Sample 1 data were used to finalise the item sets for both measures and determine the factorial structures of the 15-item AAS Dependence Scale (AASDS) and the 16-item AAS Craving Scale (AASCS). Evidence supporting the concurrent, convergent and discriminant validity of scores obtained with both scales was provided through their associations with the theoretically related variables. CFA with the data from Sample 2 confirmed the factor structures for both scales.

Study 3 aimed to observe the patterns in levels and trends of AAS craving, anticipated guilt, self-regulatory efficacy (SRE), and affect across AAS administration; to determine if the observations were consistent with extant theory of craving. Through a naturalistic single case experimental investigation collating data across three independent 12-day periods from six participants, visual analysis identified patterns in level and trend for some, but not all, participants in particular phases of AAS use. However, no observed patterns in levels or trends were consistent across all participants. The absence of findings consistent with the current literature was attributed to the blast and cruise nature of AAS administration observed in each participant.

The findings of this thesis demonstrated the concerning longitudinal health effects attributed to AAS dependence, the requirement for appropriate measures to further explore the underlying dimensions of AAS dependence and craving amongst those who use AAS; and a degree of temporal patterns in craving across AAS administration. The findings from this thesis indicate that despite three decades of research in this area, there is still a need for a deeper understanding of the psychosocial factors that facilitate both AAS dependence and craving. By improving our knowledge and understanding, novel findings may aid in the development of harm reduction practices and interventions specific to the needs of AAS dependent individuals.

Type of Work:

Thesis (Doctorates > Ph.D.)

Award Type:

Doctorates > Ph.D.

Supervisor(s):