Psychopathology among anabolic-androgenic steroid using and non-using female athletes in Norway

Morgan Scarth; Marie Lindvik Jørstad; Amund Reierstad; Sandra Klonteig; Svenn Torgersen; Ingunn R Hullstein; Astrid Bjørnebekk

doi:10.1016/j.jpsychires.2022.09.023

Psychopathology among anabolic-androgenic steroid using and non-using female athletes in Norway

J Psychiatr Res. 2022 Nov:155:295-301. doi: 10.1016/j.jpsychires.2022.09.023. Epub 2022 Sep 21.

Authors

Morgan Scarth¹, Marie Lindvik Jørstad², Amund Reierstad³, Sandra Klonteig⁴, Svenn Torgersen⁵, Ingunn R Hullstein⁶, Astrid Bjørnebekk⁴

Affiliations

¹ Anabolic Androgenic Steroid Research Group, Section for Clinical Addiction Research, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway; Department of Psychology, University of Oslo, Oslo, Norway. Electronic address: morsca@ous-hf.no.
² Anabolic Androgenic Steroid Research Group, National Advisory Unit on SUD Treatment, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway.
³ Faculty of Medicine, University of Oslo, Oslo, Norway.
⁴ Anabolic Androgenic Steroid Research Group, Section for Clinical Addiction Research, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway.
⁵ Department of Psychology, University of Oslo, Oslo, Norway.
⁶ Norwegian Doping Control Laboratory, Oslo University Hospital, Oslo, Norway.

PMID: 36170757
DOI: 10.1016/j.jpsychires.2022.09.023

Abstract

Anabolic-androgenic steroids (AAS) are primarily used to improve physical appearance and increase lean muscle mass. Due to their masculinizing properties, the majority of people using AAS are men; however, AAS use among females may increase with changing body ideals trending towards a more muscular appearance. AAS use among males have been associated with risk-taking behavior, and increased prevalence of personality disorders and psychopathology. As a result of low perceived prevalence and stigma among females who use AAS, the relationship between AAS use and psychopathology in this population is not well-known. AAS using women (n = 16) and weight-lifting controls (WLC) (n = 16) completed questionnaires regarding AAS use, health and training information. Psychopathology was evaluated using the Millon Clinical Multiaxial Inventory-III (MCMI-III). Group differences on demographic variables and scores on MCMI-III scales were evaluated with Mann-Whitney U tests. The clinical cut-off was then applied to all MCMI-III scales and groups were compared using Fisher's exact test. AAS consumers demonstrated significantly greater psychopathology than WLC on several scales. Externalizing personality disorder scales were elevated among those who use AAS relative to controls, such as borderline (p < 0.001), antisocial (p = 0.007) and sadistic (p = 0.002), and in addition depressive (p = 0.012), negativistic (p = 0.001) and masochistic (p = 0.029) personality disorders scales. Furthermore, all clinical syndromes were elevated among AAS consumers. AAS consumers thus demonstrated multi-pathology, and 56% (n = 9) of the group met the clinical criteria for six or more disorders. Females who use AAS experience in general increased levels of psychopathology compared to WLC. Clinicians should be aware of these traits and the challenges they present in providing care to this population.

Keywords: Anabolic androgenic steroids; Heavy resistance training; Image and performance enhancing drugs; Personality disorders; Psychopathology.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Anabolic Agents* / adverse effects
Athletes
Female
Humans
Steroids
Substance-Related Disorders* / epidemiology
Testosterone Congeners / adverse effects

Substances

Anabolic Agents
Steroids
Testosterone Congeners