A Multistudy Cross-Sectional and Experimental Examination Into the Interactive Effects of Moral Identity and Moral Disengagement on Doping

20 May 2020

A Multistudy Cross-Sectional and Experimental Examination Into the Interactive Effects of Moral Identity and Moral Disengagement on Doping / Nicholas Stanger, Susan H. Backhouse. - (Journal of Sport and Exercise Psychology 42 (2020) 3; p. 185-200)

  • PMID: 32434146
  • DOI: 10.1123/jsep.2019-0097


Moral identity and moral disengagement have been linked with doping likelihood. However, experiments testing the temporal direction of these relationships are absent. The authors conducted one cross-sectional and two experimental studies investigating the conjunctive effects of moral identity and moral disengagement on doping likelihood (or intention). Dispositional moral identity was inversely (marginally), and doping moral disengagement, positively, associated with doping intention (Study 1). Manipulating situations to amplify opportunities for moral disengagement increased doping likelihood via anticipated guilt (Study 2). Moreover, dispositional moral identity (Study 2) and inducing moral identity (Study 3) were linked with lower doping likelihood and attenuated the relationship between doping moral disengagement and doping likelihood. However, the suppressing effect of moral identity on doping likelihood was overridden when opportunities for moral disengagement were amplified. These findings support multifaceted antidoping efforts, which include simultaneously enhancing athlete moral identity and personal responsibility alongside reducing social opportunities for moral disengagement.

Moral disengagement and doping

7 Feb 2017

Moral disengagement and doping / Maria Kavussanu

  • Published in: The psychology of doping in sport / V. Barkoukis, L. Lazuras, H. Tsorbatzoudis (Eds.). - Routledge/Taylor & Francis Group, 2016. - (Part 3: Ethical aspects and implications in doping use and control; p. 151-164)
  • ISBN 9781138705197


The focus of this chapter is on this construct as applied to doping. The chapter starts by briefly outlining the main tenets of social-cognitive theory as they pertain to moral disengagement and describes the moral disengagement mechanisms. Next, the instruments that measure this construct and have been used in doping research are briefly discussed, followed by a review of quantitative studies examining moral disengagement and doping variables in athletes. Finally, qualitative studies in bodybuilders are reviewed, and the chapter ends with some concluding remarks.

Violent Behaviors, Violent Victimization, and Doping Agents: A Normal Population Study of Adolescents

1 Aug 2001

Violent Behaviors, Violent Victimization, and Doping Agents : A Normal Population Study of Adolescents / Willy Pedersen, Lars Wichstrøm, Morten Blekesaune. - (Journal of Interpersonal Violence 16 (2001) 8 (August); p. 808-832)

  • DOI: 10.1177%2F088626001016008005


The authors investigated the association between doping agents (mostly anabolic-androgenic steroids) and involvement in violence and experience of violent victimization in Oslo, Norway. The sample consisted of 10,828 adolescents aged 14 to 17 years. Of the adolescents, 11.5% had been offered doping agents and 1.8% had used doping agents. When confounding variables were controlled for, there was an association between exposure to doping agents and own violence for both genders, but use of doping agents had no additional effect. The same pattern was found with regard to victimization. However, when only the most serious victimization episodes were considered, increased risk for users of doping among boys but not girls was found. Doping agents may serve as a marker of a violent subculture more than being a causal factor in the etiology of violence. However, use of doping agents may also result in a big appearance in male users, which may make them a target for youth violence.

Performance-Enhancing Drugs in Sport: The Ethical Issue

1 Jan 1984

Performance-Enhancing Drugs in Sport : The Ethical Issue / Warren P. Fraleigh. - (Journal of the Philosophy of Sport 11 (1984) 1; p. 23-29)

  • DOI: 10.1080/00948705.1984.9714410

Predicting intentions for long-term anabolic-androgenic steroid use among men: a covariance structure model

1 Sep 2006

Predicting intentions for long-term anabolic-androgenic steroid use among men : a covariance structure model / Tom Hildebrandt, James Langenbucher, Sasha Carr, Pilar Sanjuan, Steff Park. - (Psychology of Addictive Behaviors 20 (2006) 3 (September); p. 234-240)

  • PMID: 16938061
  • DOI: 10.1037/0893-164X.20.3.234


Long-term use of anabolic-androgenic steroids (AASs) is associated with both positive and negative effects. The authors examined possible mechanisms by which these effects contribute to AAS satisfaction and predict intentions for future AAS use. Five hundred male AAS users completed an interactive Web-based instrument assessing the psychological and physical effects of AAS use. Covariance structure modeling was used to evaluate both direct and indirect effects of AAS consequences on satisfaction with AASs and intentions for future AAS use. Results suggest that gain in muscle mass and psychological benefits from AAS use uniquely contributed to both AAS satisfaction and intentions for future use. Side effects from AAS use also uniquely contributed to AAS satisfaction, but ancillary drug use was found to partially mediate this relationship, suggesting that the satisfaction of experienced AAS users is enhanced by their mastery of side effects through the use of ancillary drugs. The final model explained 29% of the variance in intentions for future AAS use. Mechanisms for sustained AAS use and implications for intervention and prevention strategies are discussed.

Polydrug use and drug market intersections within powerlifting cultures in remote South-West England

21 Jan 2021

Polydrug use and drug market intersections within powerlifting cultures in remote South-West England / Luke A. Turnock. - (Performance Enhancement & Health (2021) 100186 (21 January)

  • DOI: 10.1016/j.peh.2021.100186


With the rising use of Image and Performance Enhancing Drugs (IPEDs), research has increasingly pointed to a need for in-depth understanding of users' consumption behaviours, in order to form effective harm reduction policy. With polydrug use prevalent in IPED-using cultures, both among ‘hardcore’ and non-competitive trainers, it is clear there is a need to understand this use, and its socio-cultural contexts, as well as how drug access and supply occurs within these cultures.

This paper offers an exploration of the motivations and contexts of hardcore powerlifters' polydrug use, as well as their experiences of IPED and other illicit drug market intersections, through findings drawn from 18 qualitative interviews with participants involved in these lifting cultures and gyms in South-West England, supported by ethnographic fieldwork conducted in nine gyms in the region over a four year period, including five ‘hardcore’ powerlifting and bodybuilding gyms, as well as four commercial gym establishments.

Results first demonstrate how cultural narratives around what is drug ‘use’ versus ‘abuse’ influenced powerlifters' consumption and perceptions of polydrugs, with a number of illicit drugs and other medicines used by these sportsmen, despite cultural opposition to other drug consumption considered to be harmful, and associated by powerlifters with ‘gym rats’, or YOLO type trainers. This leads into exploration of where powerlifters' polydrug consumption behaviours present the greatest risk, particularly in relation to the acceptance of benzodiazepine use as a form of ‘steroid accessory drug’ for long periods, as well as the common sharing and use of opioid painkillers to allow continued training through injury, and discussion of where harm reduction policy might therefore be most appropriately targeted for this population.

Findings then turn to an exploration of how polydrug supply occurs within powerlifting culture and gyms, and the intersections between IPED markets and other illicit drug markets perceived to exist in the region. This documents the prevalence of social supply norms of polydrugs following patterns observed for IPEDs in the existing literature, before discussing the extent to which individuals with links to criminal organisations may be ‘pushing out’ culturally-embedded IPED suppliers in the region, and the impacts this is having on risk for IPED buyers. This is followed by further discussion of relevance to policy, and avenues for future research into polydrug use and supply from a harm reduction perspective, as well as the limitations of this study as specific to a remote region of the UK.

Bile cast nephropathy associated with severe liver dysfunction caused by anabolic steroids

3 Feb 2018

Nefropatía por cilindros biliares asociada a disfunción hepática severa causada por esteroides anabolizantes = 
Bile cast nephropathy associated with severe liver dysfunction caused by anabolic steroids  / Mónica Milla Castellanos, Eduardo Gutiérrez Martínez, Ángel Sevillano Prieto, Paola Rodríguez Ramos, Manuel Praga Terente. - (Nefrología 38 (2018) 2 (March-April); p. 221-223)

  • PMID: 29402460
  • DOI: 10.1016/j.nefro.2017.03.017

English text version online

Spanish text version in pdf

Epistane, an anabolic steroid used for recreational purposes, causes cholestasis with elevated levels of cholic acid conjugates, by upregulating bile acid synthesis (CYP8B1) and cross-talking with nuclear receptors in human hepatocytes

1 Jan 2020

Epistane, an anabolic steroid used for recreational purposes, causes cholestasis with elevated levels of cholic acid conjugates, by upregulating bile acid synthesis (CYP8B1) and cross-talking with nuclear receptors in human hepatocytes / Petar D. Petrov, Leonor Fernández-Murga, Isabel Conde, Teresa Martínez-Sena, Carla Guzmán, José Vicente Castell, Ramiro Jover. -  (Archives of Toxicology 94 (2020) 2 (February) p. 589-607)

  • PMID: 31894354
  • DOI: 10.1007/s00204-019-02643-y


Anabolic-androgenic steroids are testosterone derivatives, used by body-builders to increase muscle mass. Epistane (EPI) is an orally administered 17α-alkylated testosterone derivative with 2a-3a epithio ring. We identified four individuals who, after EPI consumption, developed long-lasting cholestasis. The bile acid (BA) profile of three patients was characterized, as well the molecular mechanisms involved in this pathology. The serum BA pool was increased from 14 to 61-fold, basically on account of primary conjugated BA (cholic acid (CA) conjugates), whereas secondary BA were very low. In in vitro experiments with cultured human hepatocytes, EPI caused the accumulation of glycoCA in the medium. Moreover, as low as 0.01 μM EPI upregulated the expression of key BA synthesis genes (CYP7A1, by 65% and CYP8B1, by 67%) and BA transporters (NTCP, OSTA and BSEP), and downregulated FGF19. EPI increased the uptake/accumulation of a fluorescent BA analogue in hepatocytes by 50-70%. Results also evidenced, that 40 μM EPI trans-activated the nuclear receptors LXR and PXR. More importantly, 0.01 μM EPI activated AR in hepatocytes, leading to an increase in the expression of CYP8B1. In samples from a human liver bank, we proved that the expression of AR was positively correlated with that of CYP8B1 in men. Taken together, we conclude that EPI could cause cholestasis by inducing BA synthesis and favouring BA accumulation in hepatocytes, at least in part by AR activation. We anticipate that the large phenotypic variability of BA synthesis enzymes and transport genes in man provide a putative explanation for the idiosyncratic nature of EPI-induced cholestasis.

The actions and side effects of Anabolic Steroids in sport and social abuse

1 Dec 2003

The actions and side effects of Anabolic Steroids in sport and social abuse / Alan James George. - (Andrologie 13 (2003) 4 (December);p. 354-366)

  • DOI: 10.1007/BF03035203

Erratum published in: Andrologie 14 (2004) 1 (March); p. 1

  • DOI: 10.1007/BF03035476


Anabolic steroids (AS) derived from testosterone have both anabolic (muscle and strength enhancing) and androgenic (primary and secondary sexual) effects. Efforts to limit the androgenic while enhancing the anabolic effects have not been successful. Alterations to the structure of testosterone, so as to improve the pharmacokinetics of AS, have resulted in drugs, which are orally active, have a longer plasma half life and may be administered as depot injections. Therapeutic doses of AS produce statistically significant effects on strength and athletic performance in well-controlled scientific and clinical trials. At low, therapeutic doses, diet and an intensive training regime are equally important in producing a statistically significant increase in strength. Higher doses 6–7000mg per week are regularly administered in sport and produce the greatest increases in muscle strength erythropoiesis and lean body mass. Patterns of steroid abuse can be complex, reflecting a desire to minimise side effects, and avoid detection. AS side effects are of many types. AS increase salt and water retention leading to an expansion of the blood volume, but effects of steroids on blood pressure are equivocal and most cardiovascular side effects appear to be reversible.

Abuse of AS causes an increase in blood triglyceride and cholesterol levels and this is associated with a decline in High Density Lipoproteins (HDLs) and an increase in the Low Density (LDL) type. Though these effects are reversible they are associated with an increased risk of both acute and chronic cardiovascular pathology. The most serious irreversible anabolic steroid side effects are associated with carcinomas-mainly of the liver, prostate and kidney. Hepatic carcinomas are strongly associated with abuse of the orally active 17alpha methyl substituted steroids, which also produce a reversible jaundice. In males, anabolic steroid abuse causes suppression of LH and FSH release leading to inhibition of testosterone production often accompanied by testicular atrophy, and azoospermia. High, chronic doses of the drugs may also cause moderate to severe feminising effects in the form of gynaecomastia. Male secondary sexual characteristics are a side effect of AS abuse in women. Increased insulin resistance and elevated fasting blood glucose levels are the commonest non-gonadal endocrine side effects of AS.

AS abuse leads to contradictory, complex, behavioural, and psychiatric changes. Increased frequency of mental illness, in anabolic steroid abusers including paranoid schizophrenia, mania and depression has been reported. Physical and psychological dependency occur amongst some anabolic steroid abusers and severe psychiatric disorders can appear upon withdrawal, leading in a few cases to criminality and even suicide. We need more studies on the long-term effects of AS. The implications of the past 50 years of AS abuse will be discussed in the review.

Disruption and recovery of testicular function during and after androgen abuse: the HAARLEM study

7 Feb 2021

Disruption and recovery of testicular function during and after androgen abuse : the HAARLEM study / D.L. Smit, M.M. Buijs, O. de Hon, M. den Heijer, W. de Ronde. - (Human Reproduction (2021) deaa366; p. 1-11)

  • PMID: 33550376
  • DOI: 10.1093/humrep/deaa366


Study question: What is the speed and extent by which endogenous testosterone production and spermatogenesis recover after androgen abuse?

Summary answer: Testosterone concentrations normalized within 3 months after discontinuation of androgen abuse in most subjects but recovery of spermatogenesis took longer-approximately 1 year.

What is known already: An estimated 4-6% of amateur strength athletes use androgens. Abuse of supraphysiological doses of androgens completely suppresses endogenous testosterone production and spermatogenesis.

Study design, size, duration: Prospective and observational cohort study in which 100 male amateur athletes participated for 1 year.

Participants/materials, setting, methods: Subjects (≥18 years) were included if they had not used androgens for at least 3 months and intended to start an androgen cycle within 2 weeks. Clinic visits took place before (T0), at the end (T1), and 3 months after the end of the cycle (T2), and 1 year after start of the cycle (T3), and included a blood test for gonadotrophins and sex hormones, and semen analysis.

Main results and the role of chance: During androgen abuse, 77% of subjects had a total sperm count (TSC) below 40 million. Three months after the end of the cycle (T2), total (-1.9 nmol/l, CI -12.2 to 8.33, P = 0.71) and free (-38.6 pmol/l, CI -476 to 399, P = 0.86) testosterone concentrations were not different compared to baseline, whereas mean TSC was 61.7 million (CI 33.7 to 90.0; P < 0.01) lower than baseline. At the end of follow-up (T3), there was no statistically significant difference for total (-0.82 nmol/l, CI -11.5 to 9.86, P = 0.88) and free (-25.8 pmol/l, CI -480 to 428, P = 0.91) testosterone compared to baseline, but there was for TSC (-29.7 million, CI -59.1 to -0.39, P = 0.05). In nine (11%) subjects, however, testosterone concentrations were below normal at the end of follow-up (T3), and 25 (34%) subjects still had a TSC below 40 million.

Limitations, reasons for caution: The follow-up period (after the cycle) was relatively short, especially considering the long recovery time of spermatogenesis after discontinuation of androgens.

Wider implications of the findings: Endogenous testosterone production and spermatogenesis recover following androgen abuse in the vast majority of users. Nevertheless, not all users achieve a normalized testicular function. This may especially be the case for athletes with a high past exposure to androgens.

Study funding/competing interest(s): There is no conflict of interest. The study was funded by the Spaarne Gasthuis academy.

Trial registration number: N/A.

Keywords: anabolic steroids; androgens; bodybuilding; post-cycle therapy; semen analysis; testosterone.

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