[NOT] Anabolic Androgenic Steroids and Violent Offending [Roid Rage]

Michael Scally MD

Doctor of Medicine
10+ Year Member
[That so many believe the 'roid rage myth is just more evidence of AAS politicization. It makes me sick. Anyone, and I mean ANYONE, that believes this CRAP is on an agenda.]

Lundholm L, Frisell T, Lichtenstein P, Langstrom N. Anabolic androgenic steroids and violent offending: Confounding by polysubstance abuse among 10,365 general population men. Addiction. http://onlinelibrary.wiley.com/doi/10.1111/add.12715/abstract

BACKGROUND AND AIMS: Anabolic androgenic steroid (AAS) use is associated with aggressive and violent behavior, but it remains uncertain if this relationship is causal in humans. We examined the link between AAS use and violent crime while controlling for polysubstance abuse and additional suggested risk factors for violence.

DESIGN: Cross-sectional study of a population-based sample.

SETTING: In 2005, all Swedish-born male twins aged 20-47 years were invited to participate in the Swedish Twin Adults: Genes and Environment (STAGE) survey of the Swedish Twin Register (response rate=60%).

PARTICIPANTS: 10,365 male survey participants with information on AAS use.

MEASUREMENT: Data on self-reported use of AAS, alcohol and other substances, attention deficit hyperactivity disorder (ADHD) and personality disorder symptoms were linked to nationwide, longitudinal register information on criminal convictions, IQ, psychological functioning and childhood socioeconomic status (SES) covariates.

FINDINGS: Any lifetime use of AAS was strongly associated with conviction for a violent crime (2.7% vs. 0.6% in convicted and non-convicted men, respectively; OR=5.0, 95% CI 2.7-9.3). However, this link was substantially reduced and no longer significant when controlling for other substance abuse (OR=1.6, 95% CI 0.8-3.3). Controlling for IQ, psychological functioning, ADHD, personality disorder symptoms and childhood SES did not reduce the risk further.

CONCLUSION: In the general population, co-occurring polysubstance abuse, but not IQ, other neuropsychological risks or socioeconomic status, explains most of the relatively strong association between any anabolic androgenic steroid use and conviction for a violent crime.
 
Bull Shit Studies

Morrison TR, Ricci LA, Melloni RH, Jr. gamma-Aminobutyric acid neural signaling in the lateroanterior hypothalamus modulates aggressive behavior in adolescent anabolic/androgenic steroid-treated hamsters. Behav Pharmacol 2014;25(7):673-83. http://www.ncbi.nlm.nih.gov/pubmed/25171080

Male Syrian hamsters (Mesocricetus auratus) treated with anabolic/androgenic steroids (AAS) during adolescence (P27-P56) display highly escalated and mature forms of offensive aggression correlated with increased gamma-aminobutyric acid (GABA) afferent development as well as decreased GABAA receptors in the lateroanterior hypothalamus (LAH) - an area of convergence for developmental and neuroplastic changes that underlie offensive aggressive behaviors in hamsters.

This study investigated whether microinfusion of a GABAA receptor agonist (muscimol; 0.01-1.0 pmol/l) or antagonist (bicuculline; 0.04-4.0 pmol/l) directly into the LAH modulate adolescent AAS-induced offensive aggression.

Activation of LAH GABAA receptors enhanced adolescent AAS-induced offensive aggression, beginning at the 0.1 pmol/l dose, when compared with AAS-treated animals injected with saline into the LAH. Importantly, GABAA receptor agonism within the LAH significantly increased the frequency of belly/rear attacks, while simultaneously decreasing the frequency of frontal attacks.

These data identify a neuroanatomical locus where GABAA receptor activation functions to enhance aggression in adolescent AAS-treated animals, while also promoting the display of mature forms of aggression and suppressing juvenile play behaviors.
 
What Came First, The Steroids Or The Violence?


Dunn M. Commentary on Lundholm et al. (2015): What came first, the steroids or the violence? Addiction 2015;110(1):109-10. http://onlinelibrary.wiley.com/doi/10.1111/add.12752/full

One of the oft-cited side effects from the non-medical use of anabolic–androgenic steroids (AAS) is an increase in aggression and violence. Since the mid-1980s, the idea that AAS use led to aggressive or violent behaviour became widespread, such that ‘roid rage’, a term to denote AAS-related aggression, has become entrenched in popular parlance.

Studies from the early 1990s with small samples of AAS users began to report an association between AAS use and violent behaviour (e.g. [1]), and since then a number of larger studies have attempted to analyse this relationship further (e.g. [2]).

Adding to more recent literature, including previous studies from Scandinavia [3, 4], the study by Lundholm and colleagues [5] is the latest to examine the relationship between AAS use and violent behaviour. Among a sample of more than 10 000 males in Sweden, the authors found the life-time prevalence of AAS use to be 0.7% and that 4.9% had been convicted for a violent crime.

Those who had been convicted of a violent crime more often reported AAS use; however, this association was no longer significant once controlling for other substance use.

While the findings from this and other studies from the general population, or more targeted studies, such as treatment [6] or prisoner [4]populations, provide a picture they may not be providing the most relevant picture. As the authors note, AAS use in the general population is low, with life-time AAS use roughly 1% in countries such as the United States [7] and Australia [8].

As these substances are typically used to increase muscle size and muscle size, as well as to increase body strength, it could be argued that if understanding the relationship between AAS use and aggression and violence is important, then we should be exploring it within groups where AAS use has a higher prevalence, such as body builders and the average gym attendee. It is in these groups where harms, both physical and psychological, will be more prevalent, and interventions may be targeted.

All this is predicated on the notion that increased feelings of aggression and violence are an experienced and undesirable effect by those who use these substances.

Sizeable proportions of AAS users report increased aggression; for instance, 42% of AAS users in Copeland, Peters & Dillon's study reported more aggression [11], as did 44% in the study by Larance et al [10].

Notably, however, sizeable proportions do not, with some believing that ‘roid rage’ is more related to the characteristics of the person using AAS rather than AAS use itself [10].

Furthermore, for occupational users such as bouncers and doormen, for whom motivations such as increased size and strength may be related to their work in the night-time economy [11], heightened feelings of aggression may be a welcome effect. Indeed, there may be a relationship between this form of employment, AAS use and aggression, as Midgley, Heather & Davies [12] found that AAS users showed heightened levels of aggression compared to non-AAS users, but that this was related more to irritability and bad temper and that more AAS users worked as doormen/bouncers.

While the study by Kundholm and colleagues and those similar are a welcome addition to the literature, we are still no closer to answering the more important question (if, indeed, it is an important question): which comes first?

Does AAS use lead to aggression and violence, or does a tendency towards these behaviours lead to AAS use?

Knowing the temporal order may not seem important, but it is in knowing the answer that we can begin to make real use of the findings from this literature.

For instance, knowing whether cannabis use causes schizophrenia allows us to target those at risk. Similarly, knowing who may be at risk for engaging in aggressive and violent acts may allow us to provide targeted information within AAS-using populations.

Allowing those who choose to use these substances to have better control over their health, both physically and psychologically, may reduce the harm not only to the individual but to others.


1 Choi P. Y., Pope H. G. Jr. Violence toward women and illicit androgenic-anabolic steroid use. Ann Clin Psychiatry 1994; 6: 21–25. http://www.crossref.org/iPage?doi=10.3109/10401239409148835

2 Beaver K. M., Vaughn M. G., DeLisi M., Wright J. P. 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: 2185–2186. http://ajph.aphapublications.org/doi/abs/10.2105/AJPH.2008.137018

3 Lundholm L., Kall K., Wallin S., Thiblin I. Use of anabolic androgenic steroids in substance abusers arrested for crime. Drug Alcohol Depend 2010; 111: 222–226. http://www.drugandalcoholdependence.com/article/S0376-8716(10)00176-6/abstract

4 Klotz F., Petersson A., Hoffman O., Thiblin I. The significance of anabolic androgenic steroids in a Swedish prison population. Compr Psychiatry 2010; 51: 312–318. https://www.sciencedirect.com/science/article/pii/S0010440X09000704

5 Lundholm L., Frisell T., Lichtenstein P., Langstrom N. Anabolic androgenic steroids and violent offending: confounding by polysubstance abuse among 10 365 general population men. Addiction 2015; 110: 100–108. http://onlinelibrary.wiley.com/doi/10.1111/add.12715/abstract

6 Petersson A., Benqtsson J., Voltaire-Carlsson A., Thiblin I. Substance abusers' motives for using anabolic androgenic steroids. Drug Alcohol Depend 2010; 111: 170–172. http://www.drugandalcoholdependence.com/article/S0376-8716(10)00135-3/abstract

7 Pope H. G. Jr, Kanayama G., Athey A., Ryan E., Hudson J. I., Baggish A. The lifetime prevalence of anabolic–androgenic steroid use and dependence in Americans: current best estimates. Am J Addict 2014; 23: 371–377. http://onlinelibrary.wiley.com/doi/10.1111/j.1521-0391.2013.12118.x/abstract

8 Dunn M. The non-medical use of steroids in Australia: findings from a general population survey. Aust NZ J Public Health 2010; 34:531–532. http://onlinelibrary.wiley.com/doi/10.1111/j.1753-6405.2010.00603.x/abstract

9 Copeland J., Peters R., Dillon P. A study of 100 anabolic–androgenic steroid users. Med J Aust 1998; 168: 311–312. http://www.ncbi.nlm.nih.gov/pubmed/9549549

10 Larance B., Degenhardt L., Dillon P., Copeland J. Rapid Assessment of Performance and Image Enhancing Drugs (Pieds) in New South Wales: Feasibility Study 2005. National Drug and Alcohol Research Centre. Sydney: National Drug and Alcohol Research Centre, University of New South Wales; 2005.

11 Monaghan L. F. Hard men, shop boys and others: embodying competence in a masculinist occupation. Sociol Rev 2002; 50: 334–355. http://onlinelibrary.wiley.com/doi/10.1111/1467-954X.00386/abstract

12 Midgley S. J., Heather N., Davies J. B. Levels of aggression among a group of anabolic–androgenic steroid users. Med Sci Law 2001; 41:309–314. http://www.ncbi.nlm.nih.gov/pubmed/11693226
 
I'll slap a mfr quick on some good tren....but i know not to, its called self control. But sometimes i slip :)
 
Yeah my aggression gos way up will on but you have to be a man and think is this person a threat to mine or my loved ones safety. But this is one reason of many why I think young guys shouldnt juice.
 
I'm an aggressive person naturally, so when I'm on cycle of course I'm worse so I try to avoid situations that may cause me to snap.
 
Værøy H. Aggression questionnaire scores in extremely violent male prisoners, male bodybuilders, and healthy non-violent men. Open Journal of Psychiatry, 2013;3:293-300. http://file.scirp.org/Html/4-1420178_33670.htm

Two aggression questionnaires, the Revised Swedish Version (AQ-RSV) of the Buss-Perry Aggression Questionnaire (AQ) and the shortened and refined version by Bryant and Smith (BS-AQ) were compared.

Both questionnaires identified subscore levels of aggression and there were significant differences between the groups.

On the AQ-RSV subscales, the violent inmates showed statistically significantly more aggression for Hostility (p = 0.000), Anger (p = 0.000), Physical Aggression (p = 0.000) and Verbal Aggression (p = 0.01) than the healthy (non-violent) men.

The bodybuilders, all “on” performance-enhancing substances, scored significantly higher on the Physical Aggression subscale than the healthy men (p = 0.000). Compared to the bodybuilders, the violent inmates scored significantly higher on the Anger (p = 0.02) and Hostility (p = 0.002) subscales.

For the BS-AQ, where general variance was higher than for the original AQ, some of the above mentioned relationships were different.

The violent inmates still scored significantly higher than the healthy men for Hostility (p = 0.000), Anger (p = 0.006) and Physical Aggression (p = 0.000), but not for Verbal Aggression.

The inmates scored significantly higher than the bodybuilders for Anger (p = 0.006) and Verbal Aggression (p = 0.006), and the bodybuilders scored higher than the healthy men on the Physical Aggression (p = 0.002) subscale only.

These and other more complex relationships are discussed in the light of previous findings. Thus the BS-AQ resulted in more sharply defined relationships and, at the same time, showed some important differences between the groups studied.

Verbal Aggression does not seem to distinguish violent inmates from healthy men. Angry bodybuilders tend to express their aggression through Physical Aggression.
 
Ima nice guy off cycle & ima nice guy on cycle. I think alot of people who seriously workout are naturally aggressive hence that hardcore drive to be better. I also think some people use aas as a reason to justify being a dick. I live by the theory that this world has more than enough assholes in it & I don't wanna add to that number ;)
 
Dr Scally how come all these studies are from Sweden/Scandinavia? From personal experience they are one of the worst countries against steroids. I know that from personal experience, the cops can test you for steroids if you are "too buff." Also, it is very hard to get steroids into Sweden, it is people into heavy crime that have access to steroids in Sweden. It would make sense that they skew the studies to show how bad they are because of how tightly they regulate steroids.
 
Highlights
  • Sustained AAS use has adverse behavioral consequences, including aggression, violence and impulsivity.
  • We obtained r-fMRI data from 50 male users testing positive for AAS and 16 previous users and 59 controls testing negative.
  • We used ICA and dual regression, and defined connectivity matrices as the between-node temporal partial correlations.
  • Current users showed significantly reduced connectivity between amygdala and DMN and between DAN and a SFG/IFG/ACC node.

Westlye LT, Kaufmann T, Alnaes D, Hullstein IR, Bjornebekk A. Brain connectivity aberrations in anabolic-androgenic steroid users. Neuroimage Clin 2016;13:62-9. ScienceDirect

Sustained anabolic-androgenic steroid (AAS) use has adverse behavioral consequences, including aggression, violence and impulsivity.

Candidate mechanisms include disruptions of brain networks with high concentrations of androgen receptors and critically involved in emotional and cognitive regulation.

Here, we tested the effects of AAS on resting-state functional brain connectivity in the largest sample of AAS-users to date.

We collected resting-state functional magnetic resonance imaging (fMRI) data from 151 males engaged in heavy resistance strength training.

50 users tested positive for AAS based on the testosterone to epitestosterone (T/E) ratio and doping substances in urine. 16 previous users and 59 controls tested negative.

We estimated brain network nodes and their time-series using ICA and dual regression and defined connectivity matrices as the between-node partial correlations.

In line with the emotional and behavioral consequences of AAS, current users exhibited reduced functional connectivity between key nodes involved in emotional and cognitive regulation, in particular reduced connectivity between the amygdala and default-mode network (DMN) and between the dorsal attention network (DAN) and a frontal node encompassing the superior and inferior frontal gyri (SFG/IFG) and the anterior cingulate cortex (ACC), with further reductions as a function of dependency, lifetime exposure, and cycle state (on/off).


 
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