The Role of Impulsivity in Anabolic-Androgenic Steroid Use

Impulsivity is associated with many forms of substance use, but few studies have assessed impulsivity in users of anabolic-androgenic steroids (AAS). Also, if an AAS-impulsivity association exists, it remains unclear whether impulsivity might be a cause of AAS use, an effect of AAS use, or a consequence of confounding variables. We sought to assess the magnitude and nature of this association.

We administered the Barratt Impulsiveness Scale (BIS) to 55 male AAS-using weightlifters (of whom 33 were currently taking AAS and 22 were off-drug at the time of evaluation) and 26 male weightlifters reporting no lifetime AAS use.

AAS users reported significantly higher scores than non-users on the total BIS and its three subscales (especially the Non-Planning subscale). However, current AAS users differed little from off-drug users on these measures. Among AAS users, age of onset of use, lifetime duration of use, and recency of last use (among the off-drug users) showed no significant associations with BIS measures. Causal analysis indicated that impulsivity likely represents a causal factor for AAS use and that the association of impulsivity with AAS use cannot reasonably be explained by confounding variables.

Impulsivity, especially non-planning impulsivity, appears to contribute substantially to the development of AAS use, possibly because impulsive individuals are more prone to seek the reward of rapidly increased muscularity without concern for the potential long-term health consequences of AAS use. Clinicians encountering current or potential AAS users should be sensitive to the possible role of impulsivity.