Sports Medicine

, Volume 22, Issue 6, pp 367–390 | Cite as

Psychological and Behavioural Effects of Endogenous Testosterone and Anabolic-Androgenic Steroids

An Update
  • Michael S. Bahrke
  • Charles E. YesalisIII
  • James E. Wright
Review Article


Endogenous testosterone levels have been linked to aggressive behaviour in both animals and humans. Studies administering moderate doses of exogenous testosterone for contraceptive and clinical purposes reveal essentially no adverse effects on male sexual and aggressive behaviour. However, investigations and case reports of athletes, usually involving higher doses, demonstrate an association between anabolic-androgenic steroid use and affective and psychotic syndromes and psychological dependence. Efforts to study the psychological and behavioural effects of anabolic-androgenic steroids are complicated by a variety of methodological limitations. Only 3 prospective, blinded studies demonstrating aggression or adverse overt behaviour resulting from anabolic-androgenic steroid use have been reported. With estimates of over 1 million past or current users in the US, an extremely small percentage of individuals using anabolic-androgenic steroids appear to experience mental disturbances severe enough to result in clinical treatment and medical case reports. Even among those so affected, the roles of previous psychiatric history, genetic susceptibility to addictions or mental disorders, environmental and peer influences, and individual expectations remain unclear.


Testosterone Adis International Limited Anabolic Steroid Steroid User Testosterone Enanthate 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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  1. 1.
    Pearson B, Hansen B. Survey of U.S. Olympians. USA Today 1990 Feb 5; C10Google Scholar
  2. 2.
    Blackwell J. Discourses on drug use: the social construction of a steroid scandal. J Drug Issues 1991; 21(1): 147–64Google Scholar
  3. 3.
    Buckley W, Yesalis C, Friedl K, et al. Estimated prevalence of anabolic steroid use among male high school seniors. JAMA 1988; 260: 3441–5PubMedCrossRefGoogle Scholar
  4. 4.
    Johnson M, Jay M, Shoup B, et al. Anabolic steroid use in adolescent males. Pediatrics 1989; 83: 921–4PubMedGoogle Scholar
  5. 5.
    The insanity of steroid abuse. Newsweek 1988 May 23: 75Google Scholar
  6. 6.
    Pope H, Katz D. Affective and psychotic symptoms associated with anabolic steroid use. Am J Psychiatry 1988; 145(4): 487–90PubMedGoogle Scholar
  7. 7.
    Brower K, Blow F, Beresford T, et al. Anabolic-androgenic steroid dependence. J Clin Psychiatry 1989; 50(1): 31–3PubMedGoogle Scholar
  8. 8.
    Bahrke M, Yesalis C, Wright J. Psychological and behavioural effects of endogenous testosterone levels and anabolic-androgenic steroids among males: a review. Sports Med 1990; 10(5): 303–37PubMedCrossRefGoogle Scholar
  9. 9.
    Kochakian C. Anabolic-androgenic steroids: a historical perspective and definition. In: Yesalis C, editor. Anabolic steroids in sport and exercise. Champaign: Human Kinetics Publishers, 1993: 3–33Google Scholar
  10. 10.
    Kruskemper H. Anabolic steroids. New York: Academic Press, 1968Google Scholar
  11. 11.
    World Health Organization Task Force on Methods for the Regulation of Male Fertility. Contraceptive efficacy of testosterone-induced azoospermia in normal men. Lancet 1990; 336: 955–9CrossRefGoogle Scholar
  12. 12.
    Hoberman J, Yesalis C. The history of synthetic testosterone. Sci Am 1995; 272(2): 60–5CrossRefGoogle Scholar
  13. 13.
    Morley J, Perry H, Kaiser F, et al. Effects of testosterone replacement therapy in old hypogonadal males: a preliminary study. J Am Geriatr Soc 1993; 41: 149–52PubMedGoogle Scholar
  14. 14.
    Wang C, Alexander G, Berman N, et al. Effect of testosterone replacement therapy on mood changes in hypogonadal men [abstract]. Seventy-Seventh Annual Meeting of the Endocrine Society; 1995 Jun 14–17; Washington, DCGoogle Scholar
  15. 15.
    Berger J, Pall L, Winfield D. Effect of anabolic steroids on HIV-related wasting myopathy. South Med J 1993; 86(8): 865–6PubMedCrossRefGoogle Scholar
  16. 16.
    Jekot W, Purdy D. Treating HIV/AIDS patients with anabolic steroids: a retrospective study. AIDS Patient Care 1993; 7(2): 68–74CrossRefGoogle Scholar
  17. 17.
    Smith D. HIV/endocrine update. AIDS Treat News 1992; 150: 6–8Google Scholar
  18. 18.
    Elofson G, Elofson S. Steroids claimed our son’s life. Physician Sports Med 1990; 18(8): 15–6Google Scholar
  19. 19.
    NHL tough guy Kordic dies of lung failure at 27. USA Today 1992 Aug 10; 15CGoogle Scholar
  20. 20.
    Reports link suicide try to steroids test. Wis State J 1991 July 27: 4BGoogle Scholar
  21. 21.
    Orchard J, Best J. Test violent offenders for anabolic steroid use [letter]. Med J Aust 1994; 161(3): 232PubMedGoogle Scholar
  22. 22.
    American College of Sports Medicine. Position stand on the use of anabolic-androgenic steroids in sports. Sports Med Bull 1984; 19(3): 13–8Google Scholar
  23. 23.
    Elashoff J, Jacknow A, Shain S, et al. Effects of anabolic-androgenic steroids on muscular strength. Ann Intern Med 1991; 115(5): 387–93PubMedGoogle Scholar
  24. 24.
    Forbes G, Porta C, Herr B, et al. Sequence of changes in body composition induced by testosterone and reversal of changes after drug is stopped. JAMA 1992; 267(3): 397–9PubMedCrossRefGoogle Scholar
  25. 25.
    Haupt H. Anabolic steroids and growth hormone. Am J Sports Med 1993; 21(3): 468–74PubMedCrossRefGoogle Scholar
  26. 26.
    Wright J. Anabolic steroids and athletics. Exerc Sport Sci Rev 1980; 8: 149–202PubMedCrossRefGoogle Scholar
  27. 27.
    Yesalis C, Bahrke M. Anabolic-androgenic steroids: current issues. Sports Med 1995; 19(5): 326–40PubMedCrossRefGoogle Scholar
  28. 28.
    Celotti F, Cesi P. Anabolic steroids: a review of their effects on the muscles, of their possible mechanisms of action and of their use in athletes. J Steroid Biochem Mol Biol 1992; 43(5): 469–77PubMedCrossRefGoogle Scholar
  29. 29.
    Boone J, Lambert C, Flynn M, et al. Resistance exercise effects on plasma Cortisol, testosterone and creatine kinase activity in anabolic-androgenic steroid users. Int J Sports Med 1990; 11(4): 293–7PubMedCrossRefGoogle Scholar
  30. 30.
    Hakkinen K, Alen M. Training volume, androgen use and serum creatine kinase activity. Br J Sports Med 1989; 23(3): 188–9PubMedCrossRefGoogle Scholar
  31. 31.
    Rozenek R, Rahe C, Kohl H, et al. Physiological responses to resistance-exercise in athletes self-administering anabolic steroids. J Sports Med Phys Fitness 1990; 30(4): 354–60PubMedGoogle Scholar
  32. 32.
    Bahrke M. International conference on abuse and trafficking of anabolic steroids. Int J Drug Policy 1994; 5(1): 23–6Google Scholar
  33. 33.
    Canadian Centre for Drug-free Sport. National school survey on drugs and sport: final report. Gloucester: Canadian Centre for Drug-Free Sport, 1993Google Scholar
  34. 34.
    Chan S, Torok-Both G, Billay D, et al. Drug analysis at the 1988 Olympic Winter Games in Calgary. Clin Chem 1991; 37(7): 1289–96PubMedGoogle Scholar
  35. 35.
    DuRant R, Escobedo L, Heath G. Anabolic-steroid use, strength training, and multiple drug use among adolescents in the United States. Pediatrics 1995; 96(1): 23–8PubMedGoogle Scholar
  36. 36.
    Forman E, Dekker A, Javors J, et al. High-risk behaviors in teenage male athletes. Clin J Sport Med 1995; 5(1): 36–42PubMedCrossRefGoogle Scholar
  37. 37.
    Fusseil S. Muscle: the confessions of an unlikely bodybuilder. New York: Simon and Schuster, 1991Google Scholar
  38. 38.
    Gaa G, Griffith E, Cahill B, et al. Prevalence of anabolic steroid use among Illinois high school students. J Athletic Training 1994; 29(3): 216–22Google Scholar
  39. 39.
    Killip S, Stennett R. Use of performance enhancing substances by London secondary school students. Report 90–03. London: Board of Education for the City of London, 1990Google Scholar
  40. 40.
    Klein A. Little big men. Albany: State University of New York press, 1993Google Scholar
  41. 41.
    Korkia P, Stimson G. Anabolic steroid use in Great Britain: an exploratory investigation. London: Centre for Research on Drugs and Health Behaviour, 1993Google Scholar
  42. 42.
    Meilman P, Crace R, Presley C, et al. Beyond performance enhancement: polypharmacy among college users of steroids. J Am Coll Health 1995; 44(3): 98–104PubMedCrossRefGoogle Scholar
  43. 43.
    Melia P, Pipe A, Greenberg L. The use of anabolic-androgenic steroids by Canadian students. Clin J Sport Med 1996; 6(1): 9–14PubMedCrossRefGoogle Scholar
  44. 44.
    Middleman A, Faulkner A, Woods E, et al. High-risk behaviors among high school students in Massachusetts who use anabolic steroids. Pediatrics 1995; 96(2): 268–72PubMedGoogle Scholar
  45. 45.
    Newman S. Despite warnings, lure of steroids too strong for some young Canadians. Can Med Assoc J 1994; 151(6): 844–6Google Scholar
  46. 46.
    Nilsson S. Androgenic anabolic steroid use among male adolescents in Falkenburg. Eur J Clin Pharmacol 1995; 48(1): 9–11PubMedCrossRefGoogle Scholar
  47. 47.
    Ohaeri J, Ikpeme E, Ikwuagwu U, et al. Use and awareness of effects of anabolic steroids and psychoactive substances among a cohort of Nigerian professional sports men and women. Hum Psychopharmacol 1993; 8: 429–32CrossRefGoogle Scholar
  48. 48.
    Park J. Doping test report of 10th Asian Games in Seoul. J Sports Med Phys Fitness 1991; 31(2): 303–17PubMedGoogle Scholar
  49. 49.
    Park J, Park S, Lho D, et al. Drug testing at the 10th Asian Games and 24th Seoul Olympic Games. J Anal Toxicol 1990; 14: 66–72PubMedGoogle Scholar
  50. 50.
    Plowright S. Harm minimisation and anabolic steroids: results and recommendations of the DRIC injecting steroid user survey. Australian Capital Territory: Assisting Drug Dependants Inc., 1993Google Scholar
  51. 51.
    Radakovich J, Broderick P, Pickell G. Rate of anabolic-androgenic steroid use among students in junior high school. J Am Board Fam Pract 1993; 6(4): 341–5PubMedGoogle Scholar
  52. 52.
    Schwellnus M, Lambert M, Todd M, et al. Androgenic anabolic steroid use in matric pupils. S Afr Med J 1992; 82(3): 154–8PubMedGoogle Scholar
  53. 53.
    Terney M, McLain L. The use of anabolic steroids in high school students. Am J Dis Child 1990; 144: 99–103PubMedGoogle Scholar
  54. 54.
    Van Der Merwe P, Krugar H. Drugs in sport — results of the past 6 years of dope testing in South Africa. S Afr Med J 1992; 82(3): 151–3PubMedGoogle Scholar
  55. 55.
    Whitehead R, Chillag S, Elliot D. Anabolic steroid use among adolescents in a rural state. J Fam Pract 1992; 35(4): 401–5PubMedGoogle Scholar
  56. 56.
    Williamson D. Anabolic steroids: Edinburgh’s lesser known drug problem. Edinb Med 1991; 65: 6–7Google Scholar
  57. 57.
    Williamson D. Anabolic steroid use among students at a British college of technology. Br J Sports Med 1993; 27(3): 200–1PubMedCrossRefGoogle Scholar
  58. 58.
    Yesalis C. Incidence of anabolic steroid use: a discussion of methodological issues. In Yesalis C, editor. Anabolic steroids in sport and exercise. Champaign: Human Kinetics Publishers, 1993: 49–69Google Scholar
  59. 59.
    Yesalis C, Kennedy N, Kopstein A, et al. Anabolic-androgenic steroid use in the United States. JAMA 1993; 270(10): 1217–21PubMedCrossRefGoogle Scholar
  60. 60.
    Kouri E, Pope H, Katz D, et al. Use of anabolic-androgenic steroids: we are talking prevalence rates[letter]. JAMA 1994; 271(5): 347–8PubMedCrossRefGoogle Scholar
  61. 61.
    Elsewhere. USA Today 1995 Apr 26: 13CGoogle Scholar
  62. 62.
    Briefly. USA Today 1992 Sep 9: 2CGoogle Scholar
  63. 63.
    Delbeke F, Desmet N, Debackere M. The abuse of doping agents in competing body builders in Flanders (1988–1993). Int J Sports Med 1995; 16(1): 66–70PubMedCrossRefGoogle Scholar
  64. 64.
    Dart R. Drugs in the workplace: anabolic steroid abuse among law enforcement officers. Police Chief 1991; 58(7): 18Google Scholar
  65. 65.
    Swanson C, Gaines L, Gore B. Abuse of anabolic steroids. FBI Law Enforcement Bulletin 1991; 60(8): 19–23Google Scholar
  66. 66.
    Popping pills and pumping lead. Time 1989 Dec 4: 48Google Scholar
  67. 67.
    Steroids. Washington Post 1994 Apr 6: B–3Google Scholar
  68. 68.
    Title XIX — Anabolic Steroids Control Act of 1990. United States Congressional Record — Senate. 1990 Nov 2; 136: 18301Google Scholar
  69. 69.
    Ham E. Steroids: wrestling with the issues. Trial 1993; 29(8): 36–42Google Scholar
  70. 70.
    Office of Diversion Control. Report of the international conference on the abuse and trafficking of anabolic steroids. Washington, DC: United States Drug Enforcement Administration Conference Report, 1994Google Scholar
  71. 71.
    Rejeski W, Gregg E, Kaplan J, et al. Anabolic steroids: effects on social behavior and baseline heart rate. Health Psychol 1990; 9(6): 774–91PubMedCrossRefGoogle Scholar
  72. 72.
    Minkin D, Meyer M, van Haaren F. Behavioral effects of long-term administration of an anabolic steroid in intact and castrated male Wistar rats. Pharmacol Biochem Behav 1993; 44(4): 959–63PubMedCrossRefGoogle Scholar
  73. 73.
    Lumia A, Thorner K, McGinnis M. Effects of chronically high doses of the anabolic androgenic steroid, testosterone, on intermale aggression and sexual behavior in male rats. Physiol Behav 1994; 55(2): 331–5PubMedCrossRefGoogle Scholar
  74. 74.
    Clark A, Barber D. Anabolic-androgenic steroids and aggression in castrated male rats. Physiol Behav 1994; 56(5): 1107–13PubMedCrossRefGoogle Scholar
  75. 75.
    Martinez-Sanchis S, Brain P, Salvador A, et al. Long-term chronic treatment with stanozolol lacks significant effects on aggression and activity in young and adult male laboratory mice. Gen Pharmacol 1996; 27(2): 293–8PubMedCrossRefGoogle Scholar
  76. 76.
    Bitran D, Kellog C, Hilvers R. Treatment with an anabolic-androgenic steroid affects anxiety-related behavior and alters the sensitivity of cortical GABAA receptors in the rat. Horm Behav 1993; 27(4): 568–83PubMedCrossRefGoogle Scholar
  77. 77.
    Clark A, Lindenfeld R, Gibbons C. Anabolic-androgenic steroids and brain reward. Pharmacol Biochem Behav 1996; 53(3): 741–5PubMedCrossRefGoogle Scholar
  78. 78.
    Bronson F, Nguyen K, De La Rosa J. Effect of anabolic steroids on behavior and physiological characteristics of female mice. Physiol Behav 1996; 59(1): 49–55PubMedCrossRefGoogle Scholar
  79. 79.
    Bronson F. Effects of prolonged exposure to anabolic steroids on the behavior of male and female mice. Pharmacol Biochem Behav 1996; 53(2): 329–34PubMedCrossRefGoogle Scholar
  80. 80.
    Archer J. The influence of testosterone on human aggression. Br J Psychol 1991; 82: 1–28PubMedCrossRefGoogle Scholar
  81. 81.
    Archer J. Testosterone and aggression. J Offender Rehab 1994; 21(3–4): 3–39Google Scholar
  82. 82.
    Bahrke M, Wright J, Strauss R, et al. Psychological moods and subjectively perceived behavioral and somatic changes accompanying anabolic-androgenic steroid usage. Am J Sports Med 1992; 20(6): 717–24PubMedCrossRefGoogle Scholar
  83. 83.
    Gray A, Jackson D, McKinlay J. The relation between dominance, anger, and hormones in normally aging men: results from the Massachusetts Male Aging Study. Psychosom Med 1991; 53: 375–85PubMedGoogle Scholar
  84. 84.
    Gladue B. Qualitative and quantitative sex differences in self-reported aggressive behavioral characteristics. Psychol Rep 1991; 68: 675–84PubMedCrossRefGoogle Scholar
  85. 85.
    Gladue B. Aggressive behavioral characteristics, hormones, and sexual orientation in men and women. Aggressive Behav 1991; 17(6): 313–26CrossRefGoogle Scholar
  86. 86.
    Dabbs J, Morris R. Testosterone, social class, and antisocial behavior in a sample of 4,462 men. Psychol Sci 1990; 1(3): 209–11CrossRefGoogle Scholar
  87. 87.
    Booth A, Dabbs J. Testosterone and men’s marriages. Soc Forces 1993; 72(2): 463–77Google Scholar
  88. 88.
    Dabbs J, Jurkovic G, Frady R. Salivary testosterone and Cortisol among late adolescent male offenders. J Abnorm Child Psychol 1991; 19(4): 469–78PubMedCrossRefGoogle Scholar
  89. 89.
    Dabbs J, Carr T, Frady R, et al. Testosterone, crime, and misbehavior among 692 male prison inmates. Person Individ Diff 1995; 18(5): 627–33CrossRefGoogle Scholar
  90. 90.
    Lindman R, von der Pahlen B, Ost B, et al. Serum testosterone, Cortisol, glucose, and ethanol in males arrested for spouse abuse. Aggressive Behav 1992; 18: 393–400CrossRefGoogle Scholar
  91. 91.
    Halpern C, Udry J, Campbell B, et al. Relationship between aggression and pubertal increases in testosterone: a panel analysis of adolescent males. Soc Biol 1993; 40(1–2): 8–24PubMedGoogle Scholar
  92. 92.
    Berman M, Gladue B, Taylor S. The effects of hormones, Type A behavior pattern, and provocation on aggression in men. Motivation Emotion 1993; 17(2): 125–38CrossRefGoogle Scholar
  93. 93.
    Gladue B, Boechler M, McCaul K. Hormonal responses to competition in human males. Aggressive Behavior 1989; 15: 409–22CrossRefGoogle Scholar
  94. 94.
    McCaul K, Gladue B, Joppa M. Winning, losing, mood, and testosterone. Horm Behav 1992; 26(4): 486–504PubMedCrossRefGoogle Scholar
  95. 95.
    Mazur A, Booth A, Dabbs J. Testosterone and chess competition. Soc Psychol Q 1992; 55(1): 70–7CrossRefGoogle Scholar
  96. 96.
    Simon N, Whalen R. Hormonal regulation of aggression: evidence for a relationship among genotype, receptor binding, and behavioral sensitivity to androgen and estrogen. Aggressive Behav 1986; 12: 255–67CrossRefGoogle Scholar
  97. 97.
    Ogawa S, Luban D, Korach K, et al. Behavioral characteristics of transgenic estrogen receptor knockout male mice: sexual aggressive and open-field behaviors [abstract]. Seventy-Seventh Annual Meeting of the Endocrine Society; 1995 Jun 14–17; Washington DCGoogle Scholar
  98. 98.
    Finkelstein J, Susman E, Chinchilli V, et al. Testosterone (T) or conjugated estrogen (E) cause increases in aggressive behavior in hypogonadal boys or girls [abstract]. Annual Meeting of the American Pediatric Society/Society of Pediatric Research; 1995 May 8–12;San DiegoGoogle Scholar
  99. 99.
    Wu F, Farley T, Peregoudov A, et al. Effects of testosterone enanthate in normal men: experience from a multicenter contraceptive efficacy study. Fertil Steril 1996; 65(3): 626–36PubMedGoogle Scholar
  100. 100.
    World Health Organization Task Force on Methods for the Regulation of Male Fertility. Contraceptive efficacy of testosterone-induced azoospermia and oligozoospermia in normal men. Fertil Steril 1996; 65(4): 821–9Google Scholar
  101. 101.
    Anderson R, Bancroft J, Wu F. The effects of exogenous testosterone on sexuality and mood of normal men. J Clin Endocrinol Metab 1992; 75(6): 1503–7PubMedCrossRefGoogle Scholar
  102. 102.
    Bagatell C, Heiman J, Matsumoto A, et al. Metabolic and behavioral effects of high-dose exogenous testosterone in healthy men. J Clin Endocrinol Metab 1994; 79(2): 561–7PubMedCrossRefGoogle Scholar
  103. 103.
    Leckman J, Scahill L. Possible exacerbation of tics by androgenic steroids[letter]. N Engl J Med 1990; 322(23): 1674PubMedGoogle Scholar
  104. 104.
    Lindstrom M, Nilsson A, Katzman P, et al. Use of anabolic-androgenic steroids among bodybuilders — frequency and attitudes. J Intern Med 1990; 227: 407–11PubMedCrossRefGoogle Scholar
  105. 105.
    Choi P, Parrott A, Cowan D. High-dose anabolic steroids in strength athletes: effects upon hostility and aggression. Hum Psychopharmacol 1990; 5: 349–56CrossRefGoogle Scholar
  106. 106.
    Perry P, Yates W, Anderson K. Psychiatric symptoms associated with anabolic steroids: a controlled, retrospective study. Ann Clin Psychiatry 1990; 2(1): 11–7CrossRefGoogle Scholar
  107. 107.
    Perry P, Andersen K, Yates W. Illicit anabolic steroid use in athletes: a case series analysis. Am J Sports Med 1990; 18(4): 422–8PubMedCrossRefGoogle Scholar
  108. 108.
    Yates W, Perry P, Andersen K. Illicit anabolic steroid use: a controlled personality study. Acta Psychiatr Scand 1990; 81: 548–50PubMedCrossRefGoogle Scholar
  109. 109.
    Pope H, Katz D. Homicide and near-homicide by anabolic steroid users. J Clin Psychiatry 1990; 51(1): 28–31PubMedGoogle Scholar
  110. 110.
    Lefavi R, Reeve T, Newland M. Relationship between anabolic steroid use and selected psychological parameters in male bodybuilders. J Sport Behavior 1990; 13(3): 157–66Google Scholar
  111. 111.
    Hannan C, Friedl K, Zold A, et al. Psychological and serum homovanillic acid changes in men administered androgenic steroids Psychoneuroendocrinology 1991; 16: 335–42PubMedCrossRefGoogle Scholar
  112. 112.
    Bahrke M, Strauss R. Selected psychological characteristics of female anabolic-androgenic steroid (AAS) users[abstract]. Med Sci Sports Exerc 1992; 24(5): S136Google Scholar
  113. 113.
    Yates W, Perry P, Murray S. Aggression and hostility in anabolic steroid users. Biol Psychiatry 1992; 31(12): 1232–4PubMedCrossRefGoogle Scholar
  114. 114.
    Moss H, Panazak G, Tarter R. Personality, mood, and psychiatric symptoms among anabolic steroid users. Am J Addictions 1992; 1(4): 315–24Google Scholar
  115. 115.
    Dalby J. Brief anabolic steroid use and sustained behavioral reaction[letter]. Am J Psychiatry 1992; 149(2): 271–2PubMedGoogle Scholar
  116. 116.
    Su T-P, Pagliaro M, Schmidt P, et al. Neuropsychiatric effects of anabolic steroids in male normal volunteers. JAMA 1993; 269(21): 2760–4PubMedCrossRefGoogle Scholar
  117. 117.
    Pope H, Katz D, Hudson J. Anorexia nervosa and ‘reverse anorexia’ among 108 male bodybuilders. Compr Psychiatry 1993; 34(6): 406–9PubMedCrossRefGoogle Scholar
  118. 118.
    Schulte H, Hall M, Boyer M. Domestic violence associated with anabolic steroid abuse[letter]. Am J Psychiatry 1993; 150(2): 348PubMedGoogle Scholar
  119. 119.
    Burnett K, Kleiman M. Psychological characteristics of adolescent steroid users. Adolescence 1994; 29(113): 81–9PubMedGoogle Scholar
  120. 120.
    Choi P, Pope H. Violence toward women and illicit androgenic-anabolic steroid use. Ann Clin Psychiatry 1994; 6(1): 21–5PubMedCrossRefGoogle Scholar
  121. 121.
    Cooper C, Noakes T. Psychiatric disturbances in users of anabolic steroids. S Afr Med J 1994; 84(8): 509–12PubMedGoogle Scholar
  122. 122.
    Stanley A, Ward M. Anabolic steroids — the drugs that give and take away manhood: a case with an unusual physical sign. Med Sci Law 1994; 34(1): 82–3PubMedGoogle Scholar
  123. 123.
    Wemyss-Holden S, Hamdy F, Hastie K. Steroid abuse in athletes, prostatic enlargement and bladder outflow obstruction — is there a relationship? Br J Urol 1994; 74(4): 476–8PubMedCrossRefGoogle Scholar
  124. 124.
    Pope H, Katz D. Psychiatric and medical effects of anabolic-androgenic steroid use. Arch Gen Psychiatry 1994; 51(5): 373–82CrossRefGoogle Scholar
  125. 125.
    Parrott A, Choi P, Davies M. Anabolic steroid use by amateur athletes: effects upon psychological mood states. J Sports Med Phys Fitness 1994; 34(3): 292–8PubMedGoogle Scholar
  126. 126.
    Bjorkqvist K, Nygren T, Bjorklund A-C, et al. Testosterone intake and aggressiveness: real effect or anticipation. Aggressive Behav 1994; 20: 17–26CrossRefGoogle Scholar
  127. 127.
    Blouin A, Goldfield G. Body image and steroid use in male bodybuilders. Int J Eat Disord 1995; 18(2): 159–65PubMedCrossRefGoogle Scholar
  128. 128.
    Porcerelli J, Sandler B. Narcissism and empathy in steroid users. Am J Psychiatry 1995; 152(11): 1672–4PubMedGoogle Scholar
  129. 129.
    Bond A, Choi P, Pope H. Assessment of attentional bias and mood in users and non-users of anabolic-androgenic steroids. Drug Alcohol Depend 1995; 37(3): 241–5PubMedCrossRefGoogle Scholar
  130. 130.
    Malone D, Dimeff R, Lombardo J, et al. Psychiatric effects and psychoactive substance use in anabolic-androgenic steroid users. Clin J Sports Med 1995; 5(1): 25–31CrossRefGoogle Scholar
  131. 131.
    Silvester L. Self-perceptions of the acute and long-range effects of anabolic-androgenic steroids. J Strength and Conditioning Res 1995; 9(2): 95–8Google Scholar
  132. 132.
    Kouri E, Lukas S, Pope H, et al. Increased aggressive responding in male volunteers following the administration of gradually increasing doses of testosterone cypionate. Drug Alcohol Depend 1995; 40(1): 73–9PubMedCrossRefGoogle Scholar
  133. 133.
    Bhasin S, Storer T, Berman N, et al. The effects of supra-physiologic doses of testosterone on muscle size and strength in normal men. N Engl J Med 1996; 335(1): 1–7PubMedCrossRefGoogle Scholar
  134. 134.
    Choi P. Alarming effects of anabolic steroids. Psychologist 1993 Jun; 258–60Google Scholar
  135. 135.
    Duchaine D. Underground steroid handbook II. Venice (CA): HLR Technical Books, 1989Google Scholar
  136. 136.
    Ariel G, Saville W. Anabolic steroids: the physiological effects of placebos. Med Sci Sports Exerc 1972; 4: 124–6Google Scholar
  137. 137.
    Brower K, Blow F, Young J, et al. Symptoms and correlates of anabolic-androgenic steroid dependence. Br J Addict 1991; 86: 759–68PubMedCrossRefGoogle Scholar
  138. 138.
    Malone D, Dimeff R. The use of fluoxetine in depression associated with anabolic steroid withdrawal: a case series. J Clin Psychiatry 1992; 53(4): 130–2PubMedGoogle Scholar
  139. 139.
    Cooper C. Factors undermining the success of prevention and harm reduction strategies for anabolic-androgenic steroid abuse. In: Adey D, Steyn P, Herman N, et al., editors. State of the art in higher education. Vol. 1. Pretoria, South Africa: University of South Africa, 1994Google Scholar
  140. 140.
    Allnutt S, Chaimowitz G. Anabolic steroid withdrawal depression: a case report[letter]. Can J Psychiatry 1994; 39(5): 317–8PubMedGoogle Scholar
  141. 141.
    Cowan C. Depression in anabolic steroid withdrawal. Ir J Psychol Med 1994; 11(1): 27–8Google Scholar
  142. 142.
    Bahrke M, Yesalis C. Weight training: a potential confounding factor in examining the psychological and behavioural effects of anabolic-androgenic steroids. Sports Med 1994; 18(5): 309–18PubMedCrossRefGoogle Scholar
  143. 143.
    McBride A, Williamson K, Petersen T. Three cases of nalbuphine hydrochloride dependence associated with anabolic steroid use. Br J Sports Med 1996; 30: 69–70PubMedCrossRefGoogle Scholar
  144. 144.
    Newton L, Hunter G, Bammon M, et al. Changes in psychological state and self-reported diet during various phases of training in competitive bodybuilders. J Strength Conditioning Res 1993; 7(3): 153–8Google Scholar
  145. 145.
    Edbauer M, Levine A, Stapleton F. The importance of differentiating between anabolic steroids and glucocorticoids[letter]. NY State J Med 1992; 92(8): 365Google Scholar
  146. 146.
    Research and Forecasts, Inc. The American Asthma Report II. Conducted for Allen & Hanburys, December, 1991Google Scholar
  147. 147.
    Anonymous. Steroidophobia: public misperception of steroid medications. Pharm Times 1993; 59: 42, 44Google Scholar
  148. 148.
    Lee P. The use of anabolic steroids[letter]. Am J Dis Child 1990; 144(9): 954–5PubMedGoogle Scholar
  149. 149.
    Higgins G. Adonis meets Addison: another potential cause of occult adrenal insufficiency. J Emerg Med 1993; 11(6): 761–2PubMedCrossRefGoogle Scholar
  150. 150.
    Perry H, Hughes G. A case of affective disorder associated with the misuse of ‘anabolic steroids’. Br J Sports Med 1992; 26(4): 219–20PubMedCrossRefGoogle Scholar
  151. 151.
    Alcena V, Alexopoulos G. Ulcerative colitis in association with chronic paranoid schizophrenia: a review of steroid-induced psychiatric disorders. J Clin Gastroenterol 1985; 7(5): 400–4PubMedCrossRefGoogle Scholar
  152. 152.
    Lewis D, Smith R. Steroid-induced psychiatric syndromes. J Affect Disord 1983; 5: 319–32PubMedCrossRefGoogle Scholar
  153. 153.
    Ling M, Perry P, Tsuang M. Side effects of corticosteroid therapy: psychiatric aspects. Arch Gen Psychiatry 1981; 38: 471–7PubMedCrossRefGoogle Scholar
  154. 154.
    Walters M, Ayers R, Brown D. Analysis of illegally distributed steroid products by liquid chromatography with identity confirmation by mass spectrometry or infrared spectrophotometry. J Assoc Off Anal Chem 1990; 73(6): 904–26PubMedGoogle Scholar
  155. 155.
    Colman P, A’Hearn E, Taylor R, et al. Anabolic steroids — analysis of dosage forms from selected case studies from the Los Angeles County Sheriff’s Scientific Services Bureau. J Forensic Sci 1991; 36(4): 1079–88Google Scholar
  156. 156.
    Fish M. Steroids: riskier than ever. Atlanta Journal/Constitution 1993 Sep 28: DlGoogle Scholar
  157. 157.
    Kochakian C. The steroids in sports problem. National Steroid Consensus Meeting: 1989 July 30–31: Los AngelesGoogle Scholar

Copyright information

© Adis International Limited 1996

Authors and Affiliations

  • Michael S. Bahrke
    • 1
  • Charles E. YesalisIII
    • 2
  • James E. Wright
    • 3
  1. 1.Human KineticsChampaignUSA
  2. 2.Departments of Health Policy and Administration and KinesiologyPennsylvania State UniversityUniversity ParkUSA
  3. 3.MET-Rx USAIrvineUSA

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