Table 2 Characteristics of qualitative studies presenting data on AAS use initiation
First author, year, reference | Initiation age(s) | History prior to use | Source(s) | Motive(s)/drive(s) for use |
|---|---|---|---|---|
Annitto 1980 [19] | 16 years | Weightlifting | Illicit market | Appearance |
Bardick 2006 [20] | Not specified | Weight training | Not specified | Appearance, confidence, media, personal security, psychological well-being, sports |
Bilard 2011 [21] | Not specified | Bodybuilding | Friends, dealers, others, relatives, teammates | Appearance, muscle, physiological recovery, psychological, sports, sports norm, other |
Boyadjiev 2000 [22] | 19 years | Bodybuilding, cycling | Not specified | Sports |
14 to 46 years; mean 25 years | Not specified | Coaches/trainers, dealers, doctors, friends, gym employees, other, pharmacists, mail order relatives, veterinarians | Appearance, muscle, other, physiological recovery/injury prevention, sports | |
Cornford 2014 [9] | ≤ 30 years (n = 14) | Not specified | Not specified | Muscle, personal security, physiological recovery, sports |
Fudala 2003 [25] | ≤ 26 years | Negative body image, poor self-esteem, psychological disorders, troubled background | Not specified | Appearance, psychological |
Fudala 2003 [25] | ≤ 31 years | Negative body image, low self-efficacy, troubled background | Not specified | Appearance, muscle |
Fudala 2003 [25] | 17 years | Football | Relative | Appearance, muscle, sports |
Fudala 2003 [25] | 26 years | Troubled background | Not specified | Appearance, muscle |
Fudala 2003 [25] | 21 years | Binge eating, psychological disorders, troubled background | Not specified | Not specified |
Fudala 2003 [25] | 27 years | Troubled background, weightlifting | Friend | Sports |
Fudala 2003 [25] | 24 years | Bodybuilding | Not specified | Sports |
Grogan 2006 [26] | 15 years, 16 years, 18 years, 19 years, 20 years, 21 years, 23 years, 29 years | Bodybuilding | Not specified | Appearance, media, occupational, sports, sport/social norm |
Gruber 1999 [27] | Not specified | Polydrug use, psychological disorders, troubled background | Trainer | Appearance, muscle, personal security |
Hegazy 2013 [28] | 22 years | Polydrug use, psychological disorders, troubled background | Friends | Appearance, muscle, recovery |
Joubert 2014 [7] | 16 to 24 years | Low self-esteem, negative body image, troubled background | Not specified | Appearance, confidence, family influence, muscle, peer influence, personal security, psychological well-being, self-esteem, social pressure |
Katz 1990 [29] | 21 years | Bodybuilding | Not specified | Sports |
Khorrami 2002 [30] | Not specified | Football, negative body image, weightlifting | Gym employee | Appearance, family influence, muscle, sports |
16 years; mean age 25 years | Not specified | Not specified | Appearance, muscle, occupational, sports | |
Klötz 2010 [31] | Not specified | Not specified | Not specified | Aggression, appearance, muscle, other, psychological, sports, sport/social norm |
Korkia 1993 [12] | 16 years, 18 years, 32 years, 54 years | Weight training | Coach, dealers, doctors, friends/teammates, gym owner/employee | Muscle, physiological recovery, sports |
Korkia 1996 [13] | 19 years, 23 years | Not specified | Friends, gym owners/employees, husbands/boyfriends | Muscle, sports |
Kusserow 1990 [32] | 14 years, 15 years, 17 years, 18 years, ≤ 25 years† | Football, bodybuilding, negative body image, polydrug use | Coach/team doctor, dealers, doctors, friends/teammates, gym employees, pharmacists, veterinarians | Aggression, sports scholarship, appearance, coaches’ approval, famous athletes, media influence, parental approval, peer influence, sexual attraction, sports |
Malone 1995 [33] | 24 years | Weightlifting | Not specified | Appearance, muscle, injury prevention/recovery, sports, sport norm |
24 years, 25 years | Complacent trainers, negative body image, weight training | Dealers | Appearance, aggression, coaches’ approval, peer influence, sexual attraction, sports | |
McKillop 1987 [36] | Not specified | Not specified | Not specified | Aggression, injury prevention/recovery, muscle, sports |
Midgley 1999 [37] | Not specified | Not specified | Not specified | Appearance, injury prevention/recovery, psychological well-being, muscle, peer influence, sports, sexual attraction |
Nøkleby 2013 [38] | Not specified | Other drug use, sports/exercise | Friend | Appearance, muscle, psychological well-being, sports |
O’Sullivan 2000 [39] | Not specified | Not specified | Friends, gym dealers, medical practitioners | Appearance, muscle |
Olrich 1999 [40] | 23 years | Bodybuilding | Not specified | Appearance, curiosity, occupational, peer influence, psychological well-being, social/sexual attraction, sports, sport/social norm |
Pappa 2012 [41] | Not specified | Athletics | Not specified | Appearance, concentration, curiosity, muscle, social influence, sports, sport norm |
Petrocelli 2008 [42] | Not specified | Long-term exposure to muscle magazines, negative body image, weight training | Dealer, friend, external internet, gym dealer | appearance, confidence, muscle, psychological well-being, sexual attraction |
Pope 1990 [43] | 30 years | Weightlifting | Not specified | Not specified |
Pope 1990 [43] | 21 years | Weightlifting | Not specified | Sports |
Pope 1990 [43] | 20 years | Weightlifting | Not specified | Sports |
Pope 1993 [44] | 19 years | Anorexia nervosa, negative body image, psychological disorders, weightlifting | Not specified | Appearance |
Pope 1993 [44] | 18 years | Anorexia nervosa, negative body image, weightlifting | Not specified | Appearance |
Pope 1993 [44] | 24 years | Anorexia nervosa, negative body image, weightlifting | Not specified | Appearance |
Pope 1996 [45] | 14 years | Psychological disorders, weightlifting | Not specified | Appearance, confidence, muscle, psychological |
Rashid 2000 [14] | 38 years | Psychological disorders, other drug use, troubled background | Not specified | Appearance, confidence, muscle, psychological |
Schwingel 2012 [46] | Not specified | Not specified | Friends, illicit market | Appearance, muscle, occupational, sport |
Scull 2013 [47] | 18 years | Male stripping | Not specified | Appearance, muscle, occupational |
Skårberg 2008 [49] | 20 years | Troubled background, weight training | Friend | Appearance, muscle |
Skårberg 2008 [49] | 21 years | Troubled background, weight training | Friend | Muscle |
Skårberg 2008 [49] | 16 years | Irritability, troubled background, weight training | Not specified | Curiosity, muscle |
Skårberg 2008 [49] | 20 years | Bodybuilding, other sports | Not specified | Appearance, sports, sport norm |
Skårberg 2008 [49] | 20 years | Bodybuilding, troubled background, | Not specified | Sports, sport norm |
Skårberg 2008 [49] | 21 years | Other sports, troubled background, weight training | Intimate partner | Appearance, muscle |
15 to 28 years | Troubled background | Not specified | Appearance, muscle, sports | |
Tallon 2007 [11] | 18 to 43 years | Weight training, other sports | Friends/training partners | Appearance, confidence, injury/illness prevention, muscle, psychological, sexual attraction |
Todd 1987 [51] | Not specified | Powerlifting | Dealer | Sports, sport norm |
Vassalo 2010 [52] | Not specified | Football | Not specified | Sports scholarship |
Walker 2011 [10] | 20 to 30 years† | Not specified | Gym dealer | Appearance, muscle |
Wilson-Fearon 1999 [53] | Not specified | Bodybuilding | Not specified | Sports |