The diagnostic dilemma of pathological appearance and performance enhancing drug use

The diagnostic dilemma of pathological appearance and performance enhancing drug use / Tom Hildebrandt, Justine K. Lai, James W. Langenbucher, Melanie Schneider, Rachel Yehuda, Donald W. Pfaff. - (Drug and Alcohol Dependence 114 (2011) 1 (1 March); p. 1-11)

  • PMID: 21115306
  • PMCID: PMC3039045
  • DOI: 10.1016/j.drugalcdep.2010.09.018


Abstract

Appearance and performance enhancing drug (APED) use includes the use of a range of pharmacologically distinct substances and concurrent investment in outward appearance or achievement, dietary control, and frequent exercise. A number of existing reviews and conceptual papers have defined pathological forms of APED use within the APED class of anabolic-androgenic steroids (AASs) and using the framework of AAS dependence. We review published data on APED use including human studies of AAS users and identified three defining phenomenological features associated with increased health risk and pathology. These features included (1) polypharmacy or the concurrent use of several pharmacologically distinct substances used to change outward appearance or increase likelihood of personal achievement; (2) significant body image disturbance; (3) rigid practices and preoccupations with diet and exercise. Investigations into the latent structure of APED use suggest these features cluster together in a homogenous group of APED users who have the highest health risk and most psychopathology. These features are discussed in the context of AAS dependence and problems with defining classic tolerance-withdrawal symptoms among APED users. Suggestions for a resolution and outline for future research needed to determine the best system for identifying and diagnosing pathological APED use are discussed.

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Science
Review
Date
5 November 2010
People
Hildebrandt, Tom
Lai, Justin K.
Langenbucher, James W.
Pfaff, Donald W.
Schneider, Melanie
Yehuda, Rachel
Country
United States of America
Language
English
Other organisations
Icahn School of Medicine at Mount Sinai (ISMMS)
James J. Peters VA Medical Center
Rockefeller University
Rutgers University
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S1. Anabolic Agents
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Body image
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Muscle dysmorphia
Substance use research
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Scientific article
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15 October 2020
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20 October 2020
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