Risk Factors for Anabolic-Androgenic Steroid Abuse

合成代谢雄激素类固醇滥用的危险因素

• 批准号: 7022918
• 负责人: HARRISON G POPE
• 金额: $ 34.59万
• 依托单位: MCLEAN HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-03-01 至 2010-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7022918
• 关键词: androgen analog; antisocial personality; behavior prediction; behavioral /social science research tag; body image; child mental disorders; clinical research; comorbidity; developmental psychology; disease /disorder proneness /risk; eating disorders; high risk behavior /lifestyle; human subject; interview; male; mental disorder diagnosis; obsessive compulsive disorder; parent offspring interaction; peer group; psychopathology; socioenvironment; sports medicine; substance abuse epidemiology; substance abuse related behavior; substance abuse related disorder; young adult human (21-34)

DESCRIPTION (provided by applicant): 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.

描述(申请人提供)：非法使用合成代谢-雄激素类固醇(AAS)是一个重要的公共卫生问题；NIDA最近资助了一项大规模的公共教育运动，以反对AAS的使用，并用英语和西班牙语做电视广告。然而，令人惊讶的是，我们不知道在过去的四个财政年度中，有任何由NIDA资助的关于非法AAS使用者的研究(除了基于团队的药物滥用预防计划)。由于可用的研究有限，人们对非法使用原子吸收的风险因素知之甚少。在最近的一项初步研究中，我们发现AAS的使用可能与两组风险因素有关，一组反社会因素和一组身体形象因素。为了验证这些假设，我们提出了一项横断面队列研究--一种有利且未得到充分利用的设计，我们证明该设计与更传统的病例对照设计具有同等的有效性，但特别适合于我们所处环境中的风险因素研究。我们将评估300名男性，他们是从定期举重运动员中挑选出来的，我们的试点数据显示，他们包含了大约50%的AAS用户。为了尽量减少观察者的偏见，一名面试者将评估受试者的结果变量(AAS的使用历史)，另一名盲人面试者将评估所有暴露变量的受试者(可能是AAS使用的风险因素的儿童和青少年属性)。这些评估将使用一系列结构化的个人访谈和自我报告措施，这些措施是从我们的试点研究和之前广泛的AAS研究中发展出来的。我们假设，AAS的使用将与1)儿童和青少年的反社会特征和相关属性显著相关，包括父母使用药物、缺乏父母监督、冒险和同伴之间的药物使用；以及2)儿童和青少年的身体形象担忧和相关属性，包括进食障碍、身体变形障碍和强迫症谱系中的其他障碍。我们还将检验第二个假设，即反社会群体总体上预测药物使用，而身体形象群体预测AAS的具体使用。这项研究的结果将导致以下方面的更有针对性和更有效的战略：1)确定最有可能使用AAS的男孩和年轻男子；2)以最高风险人群为目标，确保教育资源的最佳配置，以减少AAS的使用；3)治疗AAS使用的高危个人的精神障碍(如身体形象障碍)；以及4)设计后续前瞻性干预研究，以防止AAS的使用策略。