Muscle Dysmorphia and Anabolic‑Androgenic Steroids Use: A Systematic Review
DOI:
https://doi.org/10.51338/rppsm.2020.v6.i1.97Keywords:
Anabolic Agents, Body Dysmorphic Disorder, Body Image, Testosterone CongenersAbstract
Introduction: Muscular dysmorphia (DM) is a subtype of body dysmorphic disorder, which occurs in individuals who, despite having a muscularly developed physique, consider themselves thin and weak. Currently, it is assumed that the use of androgen‑anabolic steroids (AAS) may be a perpetuating factor in this disorder, but also that DM may predispose to the use of AAS, drugs frequently used for their effects on body composition, namely the increase in muscle mass body composition, but with vast side effects. This systematic review aimed to explore the current evidence about the association between DM and the use of AAS.
Methods: Systematic review of recent literature, including articles published between June 2009 and January 2019.
Results: Twelve articles were included, with the majority of studies establishing an association between these two variables, the results oscillating between the absence of statistically significant differences and a strong association, the latter being the most frequently found.
Conclusion: The existing evidence of the association between DM and the use of AAS is still not very consistent, which may be due to the heterogeneity of the tools used to compare the same variables. Thus, it is important to establish an optimal model for collecting more sensitive information, and to establish better validated DM assessment scales, so that data collection and analysis can be as accurate as possible.
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References
American Psychiatric Association. Obsessive compulsive and related disorders. In Diagnostic and Statistical Manual of Mental Disorders.5th ed. Chicago: APA; 2013.
Pope HG, Katz DL, Hudson JI. Anorexia nervosa and “reverse anorexia” among 108 male bodybuilders. Compr Psychiatry. 1993; 34:406‑9.
Pope HG, Gruber AJ, Choi P, Olivardia R, Phillips KA. Muscle dysmorphia: An underrecognized form of body dysmorphic disorder. Psychosomatics. 1997; 38:548‑57.
Murray SB, Nagata JM, Griffiths S, Calzo JP, Brown TA, Mitchison D, et al. The enigma of male eating disorders: A critical review and synthesis. Clin Psychol Rev. 2017; 57:1‑11.
Santos Filho CA dos, Tirico PP, Stefano SC, Touyz SW, Claudino AM. Systematic review of the diagnostic category muscle dysmorphia. Aust N Z J Psychiatry. 2016; 50:322‑33.
Foster A, Shorter G, Griffiths M. Muscle dysmorphia: could it be classified as an addiction to body image? J Behav Addict. 2015; 4:1–5.
Nye S. The Muscular Ideal: Psychological, Social and Medical Perspectives. Eat Disord. 2008; 17:95‑96.
McCreary DR, Hildebrandt TB, Heinberg LJ, Boroughs M, Thompson JK. A review of body image influences on men’s fitness goals and supplement use. Am J Mens Health. 2007; 1:307‑16.
Dawes J, Mankin T. Muscle dysmorphia. Strength Condit J. 2004; 26:24‑5.
Andersen A. The Adonis Complex: The Secret Crisis of Male Body Obsession. Am J Psychiatry. 2001; 158:1947‑8.
Hildebrandt T, Schlundt D, Langenbucher J, Chung T. Presence of muscle dysmorphia symptomology among male weightlifters. Compr Psychiatry. 2006; 47:127‑35.
Seleri S, Assunção M. Dismorfia muscular. Muscle Dysmorphia. 2002; 24(Supl III):80‑4.
Massada M, Ribeiro S, Ferreira V. Consumo de substâncias dopantes no desporto recreativo português
– um estudo em praticantes de musculação. Rev Med Desportiva Inf. 2011; 2:19‑21.
Anton M. Anabolic drugs consumption by adolescent students of physical education degree in Spain, Portugal and Italy: A survey. African J Pharm Pharmacol. 2014; 5: 654‑7.
Moher D, Liberati A, Tetzlaff J, Altman DG. Preferred reporting items for systematic reviews and meta‑analyses:
the PRISMA statement. J Clin Epidemiol. 2009; 62:1006‑12.
Baghurst T, Lirgg C. Characteristics of muscle dysmorphia in male football, weight training, and competitive natural and non‑natural bodybuilding samples. Body Image. 2009; 6:221‑7.
Catherine Walker D, Anderson DA, Hildebrandt T. Body checking behaviors in men. Body Image. 2009; 6:164‑70.
Longobardi C, Prino LE, Fabris MA, Settanni M. Muscle dysmorphia and psychopathology: Findings from an Italian sample of male bodybuilders. Psychiatry Res. 2017; 256:231‑6.
Griffiths S, Murray SB, Dunn M, Blashill AJ. Anabolic steroid use among gay and bisexual men living in Australia and New Zealand: Associations with demographics, body dissatisfaction, eating disorder psychopathology, and quality of life. Drug Alcohol Depend. 2017; 181:170‑6.
Hildebrandt T, Alfano L, Langenbucher JW. Body image disturbance in 1000 male appearance and performance enhancing drug users. J Psychiatr Res. 2010; 44:841‑6.
García CS, Ammendolia A, Procopio L, Papaianni MC, Sinopoli F, Bianco C, et al. Body uneasiness, eating disorders, and muscle dysmorphia in individuals who overexercise. J Strength Cond Res. 2010; 24:3098‑104.
Pope HG, Kanayama G, Hudson JI. Risk factors for illicit anabolic‑androgenic steroid use in male weightlifters:
A cross‑sectional cohort study. Biol Psychiatry. 2012; 71:254‑61.
Babusa B, Túry F. Muscle dysmorphia in Hungarian non‑competitive male bodybuilders. Eat Weight Disord. 2012; 17:e49‑53.
Hildebrandt T, Harty S, Langenbucher JW. Fitness supplements as a gateway substance for anabolic‑androgenic
steroid use. Psychol Addict Behav. 2012; 26:10.1037/a00227877.
Angoorani H, Halabchi F. The misuse of anabolic‑androgenic steroids among iranian recreational male body‑builders
and their related psycho‑socio‑demographic factors. Iran J Public Health. 2015; 44:1662‑9.
Murray SB, Griffiths S, Mond JM, Kean J, Blashill AJ. Anabolic steroid use and body image psychopathology in men: Delineating between appearance‑versus performance‑driven motivations. Drug Alcohol Depend. 2016; 165:198‑202.
Gonzalez‑Marti I, Fernández‑Bustos J, Onofre R, Contreras J, Sokolova M. Muscle dysmorphia: detection of the use‑abuse of anabolic androgenic steroids in a Spanish sample. Addiciones. 2017; 30:243–50.
Mayville SB, Williamson DA, White MA, Netemeyer RG, Drab DL. Development of the muscle appearance satisfaction scale: A self‑report measure for the assessment of muscle dysmorphia symptoms. Assessment. 2002; 9351‑60.
Rogol AD, Yesalis CE. Anabolic‑Androgenic Steroids and the Adolescent. Pediatr Ann. 2014; 21:175, 183, 186‑188.
Pope HG, Kanayama G, Athey A, Ryan E, Hudson JI, Baggish A. The lifetime prevalence of anabolic‑androgenic steroid use and dependence in Americans: Current best estimates. American Journal on Addictions. 2014. 23:371‑7.
Baker JS, Graham MR, Davies B. Steroid and prescription medicine abuse in the health and fitness community: A regional study. Eur J Intern Med. 2006; 17:479‑84.
Nilsson S, Baigi A, Marklund B, Fridlund B. The prevalence of the use of androgenic anabolic steroids by adolescents in a county of Sweden. Eur J Public Health. 2001; 11:195‑7.
Rachoń D, Pokrywka L, Suchecka‑Rachoń K. Prevalence and risk factors of anabolic‑androgenic steroids (AAS) abuse among adolescents and young adults in Poland. Soz Praventivmed. 2006; 51:392.
Melia P, Pipe A, Greenberg L. The use of anabolic‑androgenic steroids by Canadian students. Clin J Sport Med. 1996; 6:9‑14.
Handelsman DJ, Gupta L. Prevalence and risk factors for anabolic‑androgenic steroid abuse in Australian high school students. Int J Androl. 1997; 20:159‑64.
Galduróz JCF, Noto AR, Nappo SA, Carlini EA. Household survey on drug abuse in Brazil: Study involving the 107 major cities of the country ‑ 2001. Addict Behav. 2005; 30:545‑56.
