Risk Factors for Anabolic-Androgenic Steroid Abuse

描述（由申请人提供）：非法合成代谢雄激素类固醇（AAS）的使用代表了一个重要的公共卫生问题; NIDA最近资助了一项重大的公众教育活动，以对抗AAS的使用，并在英语和西班牙语电视广告。然而，令人惊讶的是，在过去的四个财政年度里，我们没有发现任何由NIDA资助的关于非法AAS使用者的研究（除了一个基于团队的药物滥用预防计划）。由于现有研究有限，对非法使用AAS的风险因素知之甚少。在最近的一项试点研究中，我们发现AAS的使用可能与两组风险因素有关，一组是反社会因素，另一组是身体形象因素。为了验证这些假设，我们提出了一个横断面队列研究-一个有利的和未充分利用的设计，我们表明，这是等同于更传统的病例对照设计的有效性，但特别适合在我们的设置的危险因素的研究。我们将评估300名男子，从经常举重的人群中抽取，并通过我们的试点数据显示，包含约50%的AAS用户。为了尽量减少观察者偏倚，一名访谈者将评估受试者的结局变量（AAS使用史），另一名设盲访谈者将评估受试者的所有暴露变量（可能是AAS使用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以前广泛的AAS研究中开发出来的。我们假设AAS的使用与以下因素显著相关：1）儿童和青少年的反社会特征和相关属性，包括父母物质使用，缺乏父母监督，冒险和同龄人之间的药物使用; 2）儿童和青少年的身体形象问题和相关属性，包括饮食障碍，身体畸形障碍和强迫症谱系中的其他疾病。我们还将检验第二个假设，即反社会集群预测一般药物使用，而身体形象集群预测AAS使用特别。这项研究的结果将导致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）针对风险最大的人群，以确保教育资源的最佳部署，以减少AAS的使用; 3）治疗精神疾病。（如身体形象障碍）的个体在高风险的AAS使用;和4）设计随后的前瞻性干预研究的策略，以防止AAS的使用。

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.