The use of anabolic androgenic steroids (AAS) can have negative health effects and the factors that predispose people toward AAS use are not well understood. New research published in Scientific Reports found that ADHD symptoms are more prevalent in male weightlifters who use or have used AAS in the past compared to those who have never used them.
AAS use can have serious negative health consequences such as mood syndromes, cardiovascular disease, and disruptions to cognitive and behavioral processes. Studies have linked AAS use to aggressiveness, hostility, and mood swings. Despite these findings, AAS are still used by some professional and recreational athletes.
“The factors that predispose to AAS use are poorly understood. However, attention deficit/hyperactivity disorder (ADHD) occurs among athletes at different levels, from any organized sport to the elite, with a prevalence between 7 and 11%, higher than in the general population,” explained study author Emilie Kildal and colleagues. “Persons with ADHD have increased risk of substance use, which, theoretically, could include AAS use.”
The researchers aimed to study whether AAS use in male weightlifters is associated with ADHD symptoms. To do this, researchers recruited a final sample of 134 weightlifters over 18 years old from the Department of Physical Medicine and Rehabilitation at Oslo University Hospital. One group of weightlifters reported current or previous use of AAS (with at least one year of cumulative use) and the other reported no previous or current use of AAS or similar drugs.
Participants completed a cognitive assessment that consisted of 8 neuropsychological tests covering a broad range of cognitive domains such as working memory, verbal learning and memory, processing speed, problem solving, and executive functioning. They also completed a self-report assessment of ADHD symptoms that assesses emotional and behavioral problems.
The researchers found that ADHD symptom scores were higher in AAS users compared to non-users. A higher percentage of AAS users demonstrated symptoms in the borderline or clinical range than in the non-user group. Although years of AAS use was not associated with ADHD scores, earlier onset use of AAS was associated with more ADHD symptoms.
Increased ADHD symptoms was also associated with lower cognitive performance scores on working memory, processing speed, verbal learning and memory, and problem solving. On the other hand, no association was found between ADHD symptoms and executive functioning.
The authors note some limitations to this work, including the inability to draw causal inferences from this data. In other words, we cannot know from this work alone whether ADHD symptoms increase the risk of AAS usage to increase, or vice versa. Further, the authors mention the all-male sample prohibits this from generalizing to women weightlifters.
“Our findings suggest that ADHD symptoms are more common among weightlifters who use AAS,” the researchers concluded. “Correspondence between ADHD symptoms and cognitive test performance substantiated this finding. Recognising a relationship between ADHD symptoms and AAS use may guide prevention strategies against AAS use in sports.”
The study, “ADHD symptoms and use of anabolic androgenic steroids among male weightlifters“, was authored by Emilie Kildal, Bjørnar Hassel, and Astrid Bjørnebekk.