Psychosocial Factors Facilitating Dependence On Anabolic Steroids

Investigating psychosocial factors influencing dependency on image and performance enhancing drugs (IPED) in sport and exercise, with a particular focus on moral disengagement (MD; a series of six psychosocial mechanisms drawn from Bandura's [1991] Social Cognitive Theory of Moral Thought and Action).

The project includes three studies. Across all three participants will be recruited through gyms, sport clubs, online forums and existing contacts. All participants will have used Anabolic Steroids (AS; the most used IPED amongst sport and exercise participants) during the last 12 months and will be 18 years of age or older. 100-150 participants will be recruited for Study 1, 200-300 for Study 2, and 20-30 for Study 3.

Study 1: Longitudinal study aimed at determining whether changes in AS dependence and MD mediate a positive association between changes in AS use and AS harm, or whether changes in AS dependence and MD prelude changes in AS use. Psychometric data on MD and AS dependence will be collected at four time points over an 18-month period, along with data on AS use and AS harm. An anonymous online questionnaire will be created to collect data at each time point. The questionnaire will be disseminated through gyms, sport clubs, and online forums, as well as through known gatekeepers established during past research. Temporal associations among the study variables will be examined using multilevel structural equation modelling (see Stenling et al., 2017).
Study 2: Validation study developing and validating new measures for AS dependence and AS craving. Definitions and item pools for each construct will be created and sent to an expert panel to identify the best items to capture each construct, to assess content validity. The finalised item sets will be combined with measures of theoretically associated variables to assess the convergent and discriminant validity of the new measures. Questionnaire packs containing these measures will be completed by two samples of AS users, recruited via online forums, gyms, sports clubs and established gatekeepers. A sub-sample of AS users will be used to assess the final measures of both AS dependence and AS craving over two time points spread 4 weeks apart to examine test-retest reliability. Exploratory and confirmatory factor analysis will be used alongside correlational analyses to determine the final item set and its factor structure (see Boardley and Kavussanu, 2007).

Study 3: Longitudinal study investigating associations between changes in MD, mood, AS dependence, and thoughts about AS use (e.g., worries about next dose, loss of size, cravings) during and outside of AS-use cycles. Ecological momentary assessment will be used to collect data three times per day across three 12-day periods; once immediately prior to an AS cycle, once in the middle of an AS cycle, and once immediately following an AS cycle (see Huhn et al., 2016 for an example with opioid dependence). Data will be collected using a bespoke smartphone application, with participants receiving smartphone notifications to complete relevant psychometric instruments via the application. Temporal associations among the study variables will be examined using latent growth-curve modelling (see Stenling et al., 2017).