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Thread: Anabolic androgenic steroids and violence

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    Post Anabolic androgenic steroids and violence

    Acta Psychiatrica Scandinavica
    Volume 106 Issue s412 Page 125 - June 2002
    doi:10.1034/j.1600-0447.106.s412.27.x


    Anabolic androgenic steroids and violence
    I. Thiblin1, T. Pärlklo2
    Objective: To scrutinize the criminal career among users of anabolic androgenic steroids (AAS) with focus on a possible relationship between use of AAS and violent offences.

    Method: Prospective longitudinal follow-up of police records concerning known users of AAS.

    Results: The present study describes five young men who started to use AAS with the primary motive of gaining muscle mass and strength and who subsequently got involved in criminal activities, including violent offences. One person showed deviant behaviour suggestive of conduct disorder at an early age. The other persons appeared to have low self-confidence, but had not been acting out during early adolescence.

    Conclusion: Use of AAS may constitute an increased risk of developing an antisocial life style with involvement in criminal violence.

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    Post Re: Anabolic androgenic steroids and violence

    Introduction


    The use of anabolic androgenic steroids (AAS) has been associated with a variety of psychiatric complications and deviant behaviour. According to case reports and survey studies among AAS using populations (e.g. body builders), affective disorders - usually hypomania, mania or major depression and aggressiveness with feelings of anger, irritability and hostility - are the most frequently reported symptoms (1-8). Occasionally, the increased aggressiveness may take the proportion of outwardly directed violence towards persons, sometimes to the extent of homicide (8-10). The potential of AAS to cause psychiatric symptoms has been confirmed in three prospective studies in healthy volunteers (11-13). In the present study we describe a series of cases in which the use of AAS among young men is associated with violent offences.



    Material and methods


    All data derive from police records. Each person has been monitored prospectively for several years. The study as a whole extends over a period of 9 years, 1993-2001. All persons lived in the same rural district, which has 152 000 inhabitants with approximately 30% of the population between 19 and 44 years of age.

    For a person to be included, use of AAS should be the first illegal activity reported to the police. Information of use of AAS should be complemented either by confiscation of AAS found in the person's clothes or at his home or by observations of marked muscular growth with a temporal connection to the claimed AAS use. Confession of AAS use was not regarded as mandatory for inclusion.

    In the case vignettes, details of little relevance for the general impression and interpretation of the possible association between use of AAS and behavioural changes have been changed to ensure the anonymity of the subjects


    Case vignettes

    Person A

    A 24-year-old male, 168 cm tall and weighing approximately 60 kg before starting to use doping agents, and approximately 70-75 kg after intake of doping agents.

    Social status.
    He was brought up in a populated area. His parents were separated when he was a few years old and he had no further contact with his father. He was regarded as having low self-esteem and was probably harassed in school. He displayed a complex for his smallness and started to work out in gyms and practised martial arts sporadically.

    Tips/information.
    1995: Tip about acts of violence and illicit threats. Information regarding possible use of doping agents.

    1997: Persistent tips regarding use of doping agents.

    1998: Information about various criminal activities, mainly theft.

    1999: Convicted for assault and battery, illicit threat, violent resistance and sexual harassment. Wrote a perverted slave contract with his girlfriend. Tips kept coming in regarding use of doping agents.

    2000: Person A is small but quite well trained. Prosecuted for a very cruel assault and robbery of an old man. Metabolites of nandrolone had been detected in a urine sample taken in custody. AAS ampoules (nandrolone) were found during a house search. Admitted to using AAS.

    2001: Arrested for a serious weapons offence, carrying a non-licensed shotgun in a public place. At the same time an investigation regarding narcotic offence and driving under the influence of drugs was in progress. He was suspected of using amphetamine and ecstasy.

    Person B

    A 26-year-old male, 191 cm tall and weighing approximately 85 kg before starting to use doping agents, and approximately 100-110 kg after intake of doping agents.

    Social status.
    Came from a good family situation. He had been taking an active part in hockey when he was a boy and later in junior teams, but was injured.

    In 1994 his parents contacted the police regarding their son's abuse of AAS, describing that he was 'flipping out', showing marked mental instability.

    Tips/information.
    1994: The police made a bust and due to his own information, he was convicted of a doping crime. The tips regarding doping kept coming in about his own use and dealing. A new contact was made with the person in question but he firmly denied any use of AAS. People close to him testified that he was showing an extraordinary increase in weight and strength. Tips were coming in regarding his involvement in fights and physical abuse. However, no one took responsibility for this information.

    1998: The police confiscated a letter containing doping agents. During a house search they found ampoules (15 sustanon and three genotropin), tablets (40 winstrol) and syringes. When questioned he denied use. When he was confronted with the ampoules that were found in his trash can, he confessed to the abuse of AAS tablets and injectables. He was convicted of a doping crime and an offence against the alcohol law for large-scaled manufacturing of home-brewed alcohol.

    1999: Convicted of assault. Tips regarding abuse of amphetamine. The same year he was arrested at a customs check with a small amount of cocaine. He was severely assaulted in a dispute with criminal persons, probably about a drug deal.

    2000: He started using both amphetamine and anabolic steroids again.

    August 2000: He was prosecuted for assault and violence towards an officer.

    Person C

    A 26-year-old male, 183 cm tall and weighing approximately 82 kg before starting to use doping agents, and approximately 92 kg after intake of doping agents.

    Social status.
    He came from a medium-sized county in the south of Sweden and now lives in a big city. He was a second-generation immigrant in Sweden. His parents were separated during his early years but it seems like he has had a fairly propitious childhood. He became interested in weight training when he was 16-17 years old.

    Tips/information.
    1995: Tips regarding use of anabolic steroids. It was also noted that he had been involved in some fights. However, this could not be confirmed. The tip flow was increasing and people close to him reacted against his aggressive behaviour.

    1996: The police made a bust, confiscating money, price lists and AAS (methandrostenolone). The investigation strongly indicated abuse of AAS, but he denied criminal activity and, according to the prosecutor, no legal actions could be taken. The prosecutor closed the case.

    1997/98: Tips regarding involvement in acts of violence, and he was associating with persons that were highly criminal. These suspicions could not be confirmed but the case was quite clear to the police.

    1998: Tips regarding trading with illicit drugs.

    1999: Convicted for illegal threat.

    2000: He received a restraining order regarding a certain person and was later arrested, suspected of breaking the doping law. A great amount of anabolic steroids was apprehended.

    Person D

    A 28-year-old male, weighing approximately 78 kg before starting to use doping agents, and approximately 88-90 kg after intake of doping agents.

    Social status.
    The subject was from a medium-sized county in the south of Sweden. He appears to have had good upbringing, but his parents were divorced when he was around 10 years of age. He did well in school and was later quite successful in the construction business. Despite this he was regarded as having low self-esteem, which he seemingly compensated for by 'getting bigger'.

    Tips/information.
    1993: Tips regarding the use of AAS. When confronted with these suspicions the subject's denial was 'hard as nails'. The tips regarding doping continued and he was also suspected of an unprovoked assault on a person unknown to him. Due to lack of other witnesses, the case was dropped.

    1998: Information regarding illegal threats and dealing with illegal alcohol on a large scale. He was now associating with known criminals and was strongly suspected of involvement in other criminal activities, like theft, receiving stolen goods, etc. However, he could not be held to these crimes.

    2000: Information that he was now using and selling amphetamine. The suspicions could be confirmed and he was convicted for drunk driving and minor narcotic crimes. By the end of the year, he was stuck in an advanced abuse of amphetamine, cannabis and pharmaceuticals classed as narcotics. The AAS abuse seemed to have ceased and he was only taking other illicit drugs. He lost his job and was convicted of a narcotic crime.

    Person E

    A 28-year-old male with a height of 184 cm. No information regarding weight could be found in the investigations. He was described as 'heavily built'.

    Social status.
    The subject came from a medium-sized county in the middle of Sweden and has lived in many different places. He has two under-age children and is divorced. An assumed low self-esteem was considered as the probable reason for his starting to work out and the use AAS. During the periods of AAS abuse, it was noted that his common wife did not accept this, which led to problems in their relationship.

    Tips/information.
    1996: Tips regarding the use of AAS. He was working out with people presumed to be users of doping agents.

    1997: Convicted of assault. When he was checked, convictions for property damage in 1989 and assault in 1991 appeared.

    1998: A new tip on violence. There was also information alleging that he dealt in drugs.

    1999: The suspicions regarding trading with AAS were confirmed. At the same time, information regarding intake of amphetamine and smoking cannabis on a smaller scale was noted. Despite a confession to smaller amount of doping agents and narcotics in the past, the prosecutor dropped the charges against him. The investigation showed that he had started to use AAS, both ampoules and pills, in 1989, when he was barely 20 years of age. Since then the use of AAS had been going on and off in periods until 1994. Thereafter, the abuse was more advanced, with intake of large quantities of testosterone and synthetic AAS. The aggravation of AAS use coincided with a more avid attitude to weight training.

    2000: An investigation showed that he was dealing in narcotics and doping agents. People close to him were convicted of serious narcotic offences. However, the evidence was not enough to press charges against him.



    Discussion



    Antisocial behaviour is likely to be caused by a number of factors, such as socio-economic conditions, personality traits and disorders, organic brain lesions and psychosocial stress (14). The present study does not provide a comprehensive evaluation of such risk factors, for instance psychiatric evaluations and medical records were not scrutinized. Furthermore, the case series represent selected cases. Thus the study is marred by several limitations. On the other hand, data concerning the use of illicit drugs and violent crimes are extremely hard to come by due to the illegal character of such activities. Furthermore, the study presents a longitudinal perspective that is rather unique and also some consistencies between the cases that may allow for cautious interpretation.

    Earlier observations have emphasized a strong temporal relationship between the use of AAS and violent offences among persons without known previous violent behaviour (8-10). In contrast to many of the earlier studies that describe severe violent acts, usually violent outbursts, among users of AAS without a criminal background, the present study describes a recurrent pattern of a criminal career that starts with abuse of doping agents and subsequently develops into an antisocial life style with violent behaviour. It appears as if the reason for taking AAS was primarily to gain strength and muscle mass and that psychological/psychiatric side-effects of AAS as well as contacts with a criminal environment may have contributed to the development of criminal behaviour. In other words, it does not seem as if the persons in this study were established criminals prior to AAS use, who used AAS for the sole purpose of gaining confidence, hostility or aggressiveness in the mental preparation of a planned criminal act. This 'strategic' use of AAS has been reported earlier (10), and has also been recognized in violent crimes committed by persons intoxicated by bensodiazepins (15). In conclusion, the present case series suggest that the use of AAS may involve changes in personality and life style that in turn may be linked to an increased risk for criminal behaviour.


    References

    1. Pope H, Katz D. Affective and psychotic symptoms associated with anabolic steroid use. Am J Psychiatry 1988;145:487-490.

    2. Pope HJ, Katz D. Psychiatric and medical effects of anabolic-androgenic steroid use. A controlled study of 160 athletes. Arch General Psychiatry 1994;51:375-382.

    3. Choi P, Parrot A, Cowan D. High-dose anabolic steroids in strength atheletes. Effects upon hostility and aggression. Human Psychopharm 1990;5:349-356.

    4. Perry P, William R, Yates M, Andersson K. Psychiatric symptoms associated with anabolic steroids: a controlled retrospective study. Ann Clin Psychiatry 1990;2:11-17.

    5. Malone DJ, Dimeff R, Lombardo J. Psychiatric effects and psychoactive substance use in anabolic-androgenic steroid users. Clin J Sport Med 1995;5:25-31.

    6. Conacher G, Workman D. Violent crime possibly associated with anabolic steroid use. Am J Psychiatry 1989;146:679.

    7. Yates W, Perry P, Murray S. Aggression and hostility in anabolic steroid users. Biol Psychiatry 1992;31: 1232-1234.

    8. Corrigan B. Anabolic steroids and the mind. Med J Aust 1996;165:222-226.

    9. Pope H, Katz D. Homicide and near-homicide by anabolic steroid users. J Clin Psychiatry 1990;51:28-31.

    10. Thiblin I, Kristiansson M, Rajs J. Anabolic androgenic steroids and behavioural patterns among violent offenders. J Forensic Psychiatry 1997;8:299-310.

    11. Su T, Pagliaro M, Schmidt P, Pickar D, Wolkowitz O, Rubinow D. Neuropsychiatric effects of anabolic steroids in male normal volounters. JAMA 1993;131:2760-2764.

    12. Pope H, Kouri E, Hudson J. Effects of supraphysiologic doses of testosterone on mood and aggression in normal men. Arch General Psychiatry 2000;57:133-140.

    13. Yates W, Perry P, Macindoe J, Holman T, Ellingrad V. Psychosexual effects of three doses of testosterone cycling in normal men. Biol Psychiatry 1999;45:254-260.

    14. Holmes S, Slaughter J, Kashani J. Risk factors in childhood that lead to the development of conduct disorder and antisocial personality disorder. Child Psychiatry Hum Dev 2001;31:183-193.

    15. Daderman A, Lidberg L. Flunitrazepam (Rohypnol) abuse in combination with alcohol causes premeditated, grievous violence in male juvenile offenders. J Am Acad Psychiatry Law 1999;27:83-99.



    Acta Psychiatrica Scandinavica
    Volume 106 Issue s412 Page 125 - June 2002

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    Re: Anabolic androgenic steroids and violence

    Without going into detail suffice it to say that I have years of experience with both pro-steriods and steroids , some have side effects of aggression , some do not .

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    Re: Anabolic androgenic steroids and violence

    Anabolic Steroids are derivatives of testosterone


    That reverse after stopping with steroid administration.

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