ADHD symptoms and use of anabolic androgenic steroids among male weightlifters

Kildal, Emilie; Hassel, Bjørnar; Bjørnebekk, Astrid · 2022 · Crossref

DOI: 10.1038/s41598-022-12977-w

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Summary

This study investigates the association between Attention Deficit/Hyperactivity Disorder (ADHD) symptoms and the use of anabolic androgenic steroids (AAS) among male weightlifters. The research was motivated by the high prevalence of ADHD among athletes and its known link to substance abuse, alongside the poorly understood factors predisposing athletes to AAS use, which carries significant health risks. The authors aimed to determine if AAS use correlates with ADHD symptoms and to examine the relationship between these symptoms and cognitive performance. The study recruited 134 male weightlifters from Oslo, Norway, comprising 72 current or previous AAS users (with at least one year of cumulative exposure) and 62 weightlifting controls (WLC) with no history of AAS or other performance-enhancing drug use. Participants completed the Achenbach System of Empirically Based Assessment (ASEBA) to self-report ADHD symptoms and underwent a comprehensive neuropsychological examination covering five cognitive domains: working memory, processing speed, verbal learning and memory, problem solving, and executive functioning. Statistical analyses included Wilcoxon–Mann–Whitney tests for group differences and Spearman’s rank-order correlations to assess relationships between ADHD scores, cognitive performance, and AAS usage parameters. Results indicated that AAS users reported significantly higher ADHD symptom scores than controls, with 16.7% of users scoring in the clinically concerning range compared to 3.3% of controls. The age of onset for AAS use was inversely correlated with ADHD symptom severity, suggesting that individuals with more severe symptoms began using steroids earlier. Furthermore, higher ADHD scores were significantly associated with lower performance in working memory, processing speed, verbal learning and memory, and problem solving, though no correlation was found with executive functioning. AAS users also exhibited higher rates of antidepressant and anxiolytic use compared to controls. The findings suggest that ADHD symptoms are more prevalent among male weightlifters who use AAS and are linked to specific cognitive deficits. The inverse correlation between symptom severity and age of onset, along with the lack of increase in symptoms with duration of use, implies that ADHD may predispose individuals to AAS use rather than AAS causing ADHD-like symptoms. The authors conclude that recognizing this relationship can inform targeted prevention strategies in sports medicine, such as screening for ADHD and implementing motivational interventions to reduce AAS abuse.

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