Defining the Construct of Synthetic Androgen Intoxication: An Application of General Brain Arousal.

Synthetic androgens (i. e., anabolic-androgenic steroids) are the primary component to the majority of problematic appearance and performance enhancing drug (APED) use. Despite evidence that these substances are associated with increased risk for aggression, violence, body image disturbances, and polypharmacy and can develop a pattern of chronic use consistent with drug dependence, there are no formal definitions of androgen intoxication. Consequently, the purpose of this paper is to establish a testable theory of androgen intoxication. We present evidence and theorize that synthetic androgen intoxication can be defined by a pattern of poor self-regulation characterized by increased propensity for a range of behaviors (e.g., aggression, sex, drug seeking, exercise, etc.) via androgen mediated effects on general brain arousal. This theory posits that androgens reduce threshold for emotional reactivity, motor response, and alertness to sensory stimuli and disrupt inhibitory control over the behaviors associated with synthetic androgen use. These changes result from alteration to basic neurocircuitry that amplifies limbic activation and reduces top-down cortical control. The implications for this definition are to inform APED specific hypotheses about the behavioral and psychological effects of APED use and provide a basis for establishing clinical, legal, and public health guidelines to address the use and misuse of these substances.

合成雄激素（即蛋白同化雄性类固醇）是大多数有问题的外貌和体能增强药物（APED）使用的主要成分。尽管有证据表明这些物质与攻击性、暴力行为、身体意象障碍和多种药物合用的风险增加有关，并且可能形成一种符合药物依赖的慢性使用模式，但雄激素中毒并没有正式的定义。因此，本文的目的是建立一个可检验的雄激素中毒理论。我们提供证据并提出理论，即合成雄激素中毒可通过雄激素对大脑整体唤醒的介导作用，以一系列行为（例如攻击性、性行为、寻求药物、运动等）倾向增加为特征的自我调节不良模式来定义。该理论假定雄激素降低了情绪反应、运动反应和对感官刺激的警觉性的阈值，并破坏了对与合成雄激素使用相关行为的抑制控制。这些变化源于基本神经回路的改变，这种改变放大了边缘系统的激活并减少了自上而下的皮质控制。这一定义的意义在于为有关APED使用的行为和心理影响的特定假设提供信息，并为制定临床、法律和公共卫生指南以解决这些物质的使用和滥用问题提供基础。