Eating disorders and anabolic androgenic steroids in males - similarities and differences in self-image and psychiatric symptoms

Substance Abuse Treatment, Prevention, and Policy

Ingemar Engström¹  Kurt Skårberg¹  Tabita Björk² 

[1] School of Health and Medical Sciences, Örebro University, Örebro, Sweden;Department of Clinical Neuroscience, Psychiatry, Karolinska Institute, Stockholm, Sweden

关键词: Psychiatric symptoms;    Self-image;    Anabolic androgenic steroids;    Male eating disorders;   

Others  :  833935
DOI  :  10.1186/1747-597X-8-30

 received in 2013-01-14, accepted in 2013-08-07,  发布年份 2013

【 摘 要 】

Background

Body dissatisfaction is common among both females and males. Dissatisfaction with the body is a risk factor both for onset of eating disorders and for abuse of anabolic androgenic steroids (AAS). Few studies have however investigated if there are other similarities in respect to self-image or psychiatric symptoms between clinical samples of eating disordered males and males in treatment for negative effects of AAS use.

Aim

The aim of this study was to compare two clinical samples, one of males with ED and one of males who used AAS, regarding self-image and psychiatric symptoms.

Methods

This study compared males with eating disorders (n = 13) and males who recently stopped AAS use (n = 29) on self-image and psychiatric symptoms, using The Structural Analysis of Social Behavior self-questionnaire and a shortened version of The Symptom Check List.

Results

The eating disorder group reported significantly lower scores for Self-emancipation and Active self-love and higher scores for Self-blame and Self-hate. Both groups reported serious psychiatric symptoms. The common denominator between groups was serious psychiatric symptomatology rather than negative self-image.

Conclusions

The negative self-image profile, especially self-hate, found among males with Eating Disorders may indicate that the studied groups differ in aetiology of the underlying problems. The serious psychiatric symptoms in both groups call staff to pay attention to any thoughts of suicide due to severe depressive symptoms where by specialized psychiatric treatment may be needed.

【 授权许可】

   
2013 Björk et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

【 参考文献 】

• [1]Runfola CD, Von Holle A, Tracel SE, Brownley KA, Hofmeier SM, Gagne DA, Bulik C: Body dissatisfaction in women across the lifespan: results of the UNC-SELF and Gender and Body Image (GABI) studies. Eur Eat Disorders Rev 2013, 21:52-59.
• [2]Murray SB, Rieger E, Karlov L, Touys SW: Masculinity and femininity in the divergence of male body image concerns. Int J Eat Disord 2013, 1:11. BioMed Central Full Text
• [3]Daniel S, Bridges SK: The drive for muscularity in men: media influences and objectification theory. Body Image 2010, 7(1):32-38.
• [4]Lever J, Frederick DA, Peplau LA: Does size matter? Men’s and women’s views on penis size across the lifespan. Psychol Men Masc 2006, 7(3):129-143.
• [5]Olivardia R, Pope HG Jr, Borowiecki JJ III, Cohane GH: Biceps and body image: The relationship between muscularity and self-esteem, depression, and eating disorder symptoms. Psychol Men Masc 2004, 5(2):112-120.
• [6]Grabe S, Ward LM, Hyde M, Shibley J: The role of the media in body image concerns among women: a meta-analysis of experimental and correlational studies. Psychol Bull 2008, 134(3):460-476.
• [7]Andersen AE, Holman JE: Males with eating disorders: challenges for treatment and research. Psychopharmacol Bull 2007, 33(3):391-397.
• [8]Ferreiro F, Seoane G, Senra C: A prospective study of risk factors for the development of depression and disordered eating in adolescents. J Clin Child Adolesc Psychol 2011, 40:3.
• [9]Leon GR, Fulkerson JA, Perry CL, Keel PK, Klump KL: Three to four year prospective evaluation of personality and behavioral risk factors for later disordered eating in adolescent girls and boys. J Youth Adolesc 1999, 28:181-196.
• [10]Stice E, Marti CN, Durant S: Risk factors for onset of eating disorders: Evidence of multiple risk pathways from an 8-year prospective study. Behav Res Ther 2011, 49(10):622-627.
• [11]Paxton SJ, Neumark-Sztainer D, Hannan PJ, Eisenberg ME: Body dissatisfaction prospectively predicts depressive mood and low self-esteem in adolescent girls and boys. J Clin Child Adolesc Psychol 2006, 35:539-549.
• [12]Freeman AC: Eating disorders in males: a review. S AfrPsychiatr 2005, 8(2):58-64.
• [13]Kanayama G, Barry S, Hudson J, Pope H: Body image and attitudes toward male roles in anabolic-androgenic steroid users. Am J Psychiatry 2006, 163(4):697-703.
• [14]Fairburn CG: Cognitive-behavioral therapy for bulimia nervosa. In: Eating disorders and obesity. A comprehensive handbook. Edited by Fairburn CG, Brownell KD. Guilford Press, New York; 2002.
• [15]Skårberg K: Anabolic-androgenic steroid users in treatment: Social background, drug use patterns, and criminality. Örebro: PhD thesis. Örebro University; 2009.
• [16]Hoek HW, Van Hoeken D: Review of prevalence and incidence of eating disorders. Int J Eat Disord 2003, 34(4):383-396.
• [17]Olivardia R, Pope HG, Mangweth B, Hudson JI: Eating disorders in College men. Am J Psychiatry 1995, 152(9):1279-1285.
• [18]Björk T, Clinton D, Norring C: Reasons for non-participation in follow-up research on eating disorders. Eat Weight Disord 2006, 11:147-153.
• [19]Gustafsson Aila S, Birgegård A: Nationellt kvalitetsregister för ätstörningsbehandling, Opublicerad rapport 2011 – 2012. Sweden: Swedish Quality Registry on Eating Disorders, Unpublished report 2011 – 2012; 2012.
• [20]Keel PK, Brown TA: Update on course and outcome in eating disorders. Int J Eat Disord 2010, 43(3):195-204.
• [21]Crisp AH, Burns T, Bhat AV: Primary Anorexia Nervosa in the male and female: A comparison of clinical features and prognosis. Br J Med Psychol 1986, 59:123-132.
• [22]Divac SM, Guelfi J-D, Crisp A: Anorexia in males: Similarities and differences to anorexia nervosa in females. Eur Eat Disord Rev 2006, 14:3.
• [23]Gueguen J, Godart N, Chambry J, Brun-Eberentz A, Foulon C: Severe anorexia nervosa in men: comparison with severe AN in women and analyses of mortality. Int J Eat Disord 2012, 45(4):537-545.
• [24]Smink FRE, van Hoeken D, Hoek HW: Epidemiology of eating disorders: incidence, prevalence and mortality rates. Curr Psychiatry Rep 2012, 14:406-414.
• [25]Gupta MA, Schork NJ, Dhaliwal JS: Stature, drive for thinness and body dissatisfaction: a study of males and females from a non-clinical sample. Can J Psychiatry 1993, 38(1):59-61.
• [26]Oates-Johnson T, Decourville N: Weight pre occupation, personality and depression in university students: an inter actionist perspective. J Clin Psychol 1999, 55:1157-1166.
• [27]Stanford SC, Lemberg R: A clinical comparison of men and women on the eating disorder inventory-3 (EDI-3) and the eating disorder assessment for men (EDAM). Eat Disord 2012, 20:379-394.
• [28]McCreary DR, Sasse DK: An exploration of the drive for muscularity in adolescent boys and girls. J Am Coll Health 2000, 48:297-304.
• [29]Grieve FG, Wann D, Henson CT, Ford P: Healthy and unhealthy weight management practices in collegiate men and women. J Sport Behav 2006, 29:229-241.
• [30]Streigel-Moore RH, Rosselli R, Perrin N, DeBar L, Wilson GT, May A: Gender differences in the prevalence of eating disorder symptoms. Int J Eat Disord 2009, 42:471-474.
• [31]Button E, Aldridge S, Palmer R: Males assessed by specialized eating disorder service: pattern over time and comparison with females. Int J Eat Disord 2008, 41:758-761.
• [32]Weltzin TE, Weisensel N, Franczyk D, Burnett K, Klitz C, Bean P: Eating disorders in men: update. Men’s Health gend 2005, 2(2):186-193.
• [33]Støving KR, Andreis A, Brixen K, Bilenberg N, Horder K: Gender differences in outcome of eating disorders: a retrospective cohort study. Psychiatry Res 2011, 186:362-366.
• [34]Evans NA: Gym and tonic: a profile of 100 male steroid users. Br J Sports Med 1997, 31(1):54-58.
• [35]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(2):195-197.
• [36]Gruber AJ, Pope HG Jr: Psychiatric and medical effects of anabolic-androgenic steroid use in women. Psychother Psychosom 2000, 69(1):19-26.
• [37]Miller KE, Hoffman JH, Barnes GM, Sabo D, Melnick MJ, Farrell MP: Adolescent anabolic steroid use, gender, physical activity, and other problem behaviors. Subst Use Misuse 2005, 40:1637-1657.
• [38]Skårberg K, Nyberg F, Engström I: Multisubstance use as a feature of addiction to anabolic-androgenic steroids. Eur Addict Res 2009, 15(2):99-106.
• [39]Sjöqvist F, Garle M, Rane M: Use of doping agents, particularly anabolic steroids, in sports and society. Lancet 2008, 371:1872-1882.
• [40]Hakansson A, Mickelsson K, Wallin C, Berglund M: Anabolic androgenic steroids in the general population: user characteristics and associations with substance use. Eur Addict Res 2012, 18:83-90.
• [41]Kanayama G, Boynes M, Hudson JI, Field AE, Pope HG Jr: Anabolic steroid abuse among teenage girls: an illusory problem? Drug Alcohol Depend 2007, 88:156-162.
• [42]Blouin A, Goldfield G: Body image and steroid use in male bodybuilders. Int J Eat Disord 1995, 18(2):159-165.
• [43]Skarberg K, Engstrom I: Troubled social background of male anabolic-androgenic steroid abusers in treatment. Subst Abuse Treat Prev Policy 2007, 2:20. BioMed Central Full Text
• [44]Beaver KM, Waughn MG, DeLisi M, Wright JP: Anabolic-androgenic steroid use and involvement in violent behavior in a nationally representative sample of young adult males in the United States. Am J Public Health 2008, 98:2185-2187.
• [45]Mangweth B, Pope HG Jr, Kemmler G, Ebenbichler C, Hausmann A, De Col C, Kreutner B, Kinzl J, Biebl W: Body image and psychopathology in male bodybuilders. Psychother Psychosom 2001, 70(1):38-43.
• [46]Pope HG, Gruber AJ Jr, Choi PY, Olivardia R, Phillips KA: Muscle dysmorphia: an underrecognized form of body dysmorphic disorder. Psychosomatics 1997, 38(6):548-557.
• [47]Olivardia R, Pope HG Jr, Hudson JI: Muscle dysmorphia in male weightlifters: a case-control study. Am J Psychiatry 2000, 157(8):1291-1296.
• [48]Pope HG, Katz DL, Hudson JI: Anorexia nervosa and “reverse anorexia” among 108 male body builders. Compr Psychiatry 1993, 34(6):406-409.
• [49]American Psychiatric Association: Diagnostic and statistical manual of mental disorders: DSM-IV. 4th edition. Washington, DC: American Psychiatric Association; 1994.
• [50]Skårberg K, Nyberg F, Engström I: Is there an association between use of anabolic-androgenic steroids and criminality. Eur Addict Res 2010, 16:213-219.
• [51]Derogratis LR, Lipman RS: SCL-90: an outpatient psychiatric rating scale preliminary report. Psychopharmacol Bull 1973, 9(1):13-28.
• [52]Benjamin LS: Structural analysis of social behavior. Psychol Rev 1974, 81:392-425.
• [53]Benjamin LS: SASB Intrex user’s manual. Utah: University of Utah; 2000.
• [54]Lorr M, Strack S: A study of Benjamin’s eight-facet structural analysis of social behavior (SASB) model. J Clin Psychol 1999, 55(2):207-215.
• [55]Cohen J: Statistical power analysis for the behavioral sciences. 2nd edition. Hillsdale, NJ: Larence Earlbaum Associates; 1988.
• [56]Björck C, Clinton D, Sohlberg S, Hellström T, Norring C: Interpersonal profiles in eating disorders: ratings of SASB self-image. Psychol Psychother 2003, 76(4):337-349.
• [57]Rohman L: The relationship between anabolic androgenic steroids and muscle dysmorphia: a review. Eat Disord 2009, 17:187-199.
• [58]Kanayama G, Hudson JI, Pope HG Jr: Illicit anabolic-androgenic steroid use. Horm Behav 2010, 58(1):111-121.
• [59]Skårberg K, Nyberg F, Engström I: The development of multiple drug use among anabolic-androgenic steroid users: six subjective case reports. Subst Abuse Treat Prev Policy 2008, 3(1):24. BioMed Central Full Text