Steroids in the Spotlight:

A Comparative Study of Psychological and Epidemiological Research Approaches

Shriaan Alshriaan

Perm Number: 7055684

Writing 2

Feb. 21, 2024

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In the complex world of modern sports and fitness, Anabolic-Androgenic Steroids (AAS)

– or simply steroids – cast a significant shadow. These substances, capable of enhancing strength

and physique, have transformed the nature of athletic performance and deeply influenced health

and societal beliefs. This dual nature of steroids has naturally attracted research from multiple

disciplines, most notably psychology and epidemiology. Psychology with its interest in the

human mind, explores how steroid use affects behavior and social interactions. Conversely,

epidemiology, concerned with public health, examines the prevalence and patterns of steroid use

within populations. Exploring the nuanced methodologies of both disciplines, the analysis of two

academic articles on AAS use highlights the distinct approaches of the two in terms of data

analysis, article structure, and citation styles, while acknowledging their shared pursuit of

objective scientific.

Both articles discuss the topic of steroid use, but they adopt distinctly different

approaches, reflective of their respective disciplines' objectives. The first article “Prevalence and

Predictors of Anabolic-Androgenic Steroid Use among Gym Users in Kuwait: A Preliminary

Study” adopts a simple quantitative, epidemiological perspective. Motivated by the absence of

research on steroid usage in Kuwait, it examines the “lifetime prevalence of AAS use among”

Kuwaiti gym users.1 Furthermore, the study identifies potential predictors of steroid use using

logistic regression, a simple statistical method. It finds that 35% of the surveyed population

reported steroid use, with factors such as “[l]ower age, being Kuwaiti, smoking, and placing high

importance on muscle tone … [being] significant predictors of “ steroid use.1 Given that

Epidemiology is the “study of distribution and determinants of health-related states among

1
S. Khullar, et al., "Prevalence and Predictors of Anabolic-Androgenic Steroid Use among Gym Users in
Kuwait: A Preliminary Study," Journal of Health Research, 30 (2016): 144-156.
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specified populations…” it is only natural for that article to look at the prevalence of steroid use

in percentages and the possible predictors of it.2

By contrast, the second article “Aggression and Psychological Distress in Male and

Female Anabolic-Androgenic Steroid Users: A Multigroup Latent Class Analysis” employs a

complex qualitative multi-model approach, typical of psychological research. This is evident in

the complexity of the question at hand. The authors studied the potential relationships between

steroid use and the different psychological patterns of aggression and distress. They found that

under steroids, males are more likely to show higher levels of aggression than females.3

Additionally, as evident in the title, they were looking for qualitative patterns, and multiple

groupings between users. This detailed approach of psychological research, focusing on

individual differences and behaviors, contrasts with epidemiology's broader, quantitative

analysis. In essence, psychological research prioritizes depth and a tighter focus, whereas

epidemiology takes on a broader, more general scope. This distinction becomes clearer when we

contrast their methods of analysis.

The articles differ in the complexity and methods of analysis. The first article uses

straightforward statistical methods when analyzing its data. Utilizing the Statistical Package for

Social Sciences (SPSS), the authors performed a logistic regression on the data to determine

steroid usage prevalence.4 The findings are presented as clear-cut percentages, reflecting the

simplicity of the statistical methods required for epidemiological research. For instance, they

report that the prevalence of use stands at 35%, whereas it increases to 58.6% when the analysis

was narrowed to “Kuwaiti males between the ages of 18 and 30”.4 Because the discipline relies

2
Centers for Disease Control and Prevention, "Introduction to Epidemiology | Public Health 101 Series," accessed
February 21, 2024, https://www.cdc.gov/training/publichealth101/epidemiology.html.
3
R. Chegeni, et al., "Aggression and Psychological Distress in Male and Female Anabolic-Androgenic
Steroid Users: A Multigroup Latent Class Analysis," Journal of Behavioral Medicine, 44 (2021): 1.
4
Khullar et al., "Prevalence and Predictors," 150.
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heavily on spread and simple quantitative variables, only basic binary analysis is needed. In this

case, individuals either use or do not use steroids, no other categories exist. The authors mention

this under the ‘Measures’ sub-section, “Lifetime AAS use was measured as a dichotomous

outcome variable by grouping … as…users and….as non-users.”5 As for the psychology article,

much more complex analyses are performed. Multigroup Latent Class Analysis (MLCA) is used

to analyze the collected data, and as you can tell it isn’t a common method, nor does it sound

simple. As the authors describe, “A multigroup latent class analysis… is superior to traditional

categorization of subgroups…Hence, we conducted an MLCA.”6 This reflects the complexity of

psychological research and the qualitative nature of its results and data, which ask for more

complex methods that can handle that nature. This is evident when the authors state that “a

homogenous five-class solution was the best model…” indicating that they tried other methods,

possibly even simpler ones, and found that a more complex 5-class model provided the best fit,

as opposed to fewer class models.7 As we shift focus from the methodologies employed to the

nature of citations, the contrasting academic approaches of these disciplines become even more

apparent.

The disparity in citation volume between the two articles further emphasizes the

divergent research methodologies of psychology and epidemiology. In the second article, the

authors cite many sources throughout the text. The number of citations used alone is much

greater than those used in the epidemiological article, with 74 references8 as opposed to 549,

respectively. That is around 40% more sources, which is certainly not an insignificant figure.

This simple difference alone reflects a fundamental difference between the two disciplines; the

5
Khullar et al., "Prevalence and Predictors," 148.
6
Chegeni, et al., "Aggression and Psychological Distress," 2.
7
Ibid., 1.
8
Khullar, et al., "Prevalence and Predictors," 153-156.
9
Chegeni, et al., "Aggression and Psychological Distress," 7-9.
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nature of inquiry differs. Psychological research often involves exploring complex behaviors and

mental processes, which might require extensive referencing to establish theoretical and

empirical context. As a result, the authors are obliged to reference a lot of past research to justify

and build upon their claims. On the other hand, the first article focuses more on empirical

findings and less on theoretical discourse, requiring fewer references. This is typical of

epidemiological research and is evident in both the title and the goals that the authors set at the

beginning of the paper.10 As we transition from the quantitative differences in citations, we

uncover the qualitative distinctions in the thematic content of each field.

Analyzing the selection of references in each study, we see a clear boundary between the

research interests of psychology and epidemiology. For example, after looking through the

reference list of the psychology article and randomly choosing 4 entries, it is clear that the

sources are generally about depression, aggression, violence, and other related subjects:

● “The global epidemiology of anabolic-androgenic steroid use: a meta-analysis and

meta-regression analysis,”

● “Anabolic-androgenic steroid administration increases self-reported aggression in healthy

males: a systematic review and meta-analysis of experimental studies,”

● “A study of the psychometric properties of the Beck Depression Inventory-II, the

Montgomery and Åsberg Depression Rating Scale, and the Hospital Anxiety and

Depression Scale in a sample from a healthy population.”11

Conversely, the first article's references cover a broader range of topics:

● “Handbook of women’s sexual and reproductive health,”

● “Eating disorder symptoms and body image concerns in Iran: Comparisons between

10
Khullar, et al., "Prevalence and Predictors," 144.
11
Chegeni, et al., "Aggression and Psychological Distress," 7-9.
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Iranian women in Iran and in America,”

● “His biceps become him: A test of objectification theory’s application to drive for

muscularity and propensity for steroid use in college men.”12

From women’s body image to eating disorders, to objectification theory, we see that

epidemiology has a more diverted, multidisciplinary scope. As mentioned earlier, these

differences in the ranges of sources, reflect the nature of these two disciplines; psychology

usually researches subjects deeply and in a focused manner, while epidemiology takes on a

broader, more holistic approach that focuses on societal impacts. Having observed these thematic

differences, we now turn to the citation styles, which further reveal the distinct academic natures

of psychology and epidemiology.

Each article's citation style reflects its discipline's specific needs. The psychological

article uses an interesting style of citation: the Vancouver style. The following sentence

illustrates this: “However, considering the inconsistency of results across studies (13–22) it is not

clear whether there are unobserved patterns of aggression and psychological distress among AAS

users.”13 This style of citing is very different from other styles like Chicago, or MLA. The in-text

citations do not state the author and date, but rather a number between parentheses. These are

very similar to footnotes, but instead of being expanded upon at the bottom of the page, they

correspond to the same number in the reference list, where the actual information is found. This

style is often preferred in the scientific communities. Disciplines like Psychology, which

emphasize empirical data and qualitative analysis, often cite numerous sources. To streamline the

reading experience, they use concise numerical citations rather than extensive author-date

references. This can be beneficial in presenting complex research findings and methodologies

12
Khullar, et al., "Prevalence and Predictors," 153-156.
13
Chegeni, et al., "Aggression and Psychological Distress," 2.
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typically found in psychological research. In contrast, the Chicago style used in the first article is

found in a variety of disciplines, including social sciences and humanities. This versatility

reflects the interdisciplinary nature of public health/epidemiological research. After considering

the differences in citation styles, the next aspect that illustrates the disciplines' distinct

approaches is the layout of the articles.

Beyond citations, the structural layout of these articles also mirrors their disciplinary

needs. The second article uses a two-column format, commonly seen in scientific and technical

publications. This format efficiently utilizes space and aids in the readability of complex data,

formulas, and statistical analyses. It is particularly suitable for articles with numerous graphs,

tables, and equations. Seeing that the psychology article has 3 large tables that are a page long

each, 2 large complex graphs, and 1 more table for a total of 6 figures, this convention makes

sense.14 In contrast, the first article adopts a full-page format, typical of humanities and social

sciences publications, including public health. This format favors a narrative style of writing and

is reader-friendly for text-heavy articles, focusing on comprehensive descriptions, discussions,

and qualitative analyses rather than technical data presentations. This is not to say that there

aren’t similarities between the two disciplines.

Despite the aforementioned differences, both disciplines exhibit notable similarities in

their scholarly tone and methodological caution. Take a look at the following two quotes:

“Further research using longitudinal designs may elucidate transitions between latent

classes.”15

“It may also be the case that AAS are easily obtainable in Kuwait though this is an area in

need of additional research.”16

14
Chegeni, et al., "Aggression and Psychological Distress," 2-7.
15
Ibid., 7.
16
Khullar, et al., "Prevalence and Predictors," 152.
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Both quotes use a similar tone. One that uses the third-person extensively and which states facts

as ‘likely being the case’, instead of declaring them to be the truth. These similar characteristics

are understandable since both articles fall under a common greater genre: academic articles.

Academic writing developed these features to separate the research findings from the researcher's

personal views, aiming to minimize bias and enhance objectivity. This reflects the objectivity

and skepticism of scientific research and scholarship.

In summary, the exploration of Anabolic-Androgenic Steroids through the lenses of

epidemiology and psychology underscores their distinct focuses. While epidemiology quantifies

steroid use's societal spread, psychology investigates its behavioral impacts. Variations in

structure, citation styles, and references further highlight the unique characteristics of each

discipline. Yet, both fields share a commitment to objective and cautious academic inquiry,

reflecting the broader principles of scientific research.

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Reference List

Khullar, Neha, Nicholas C. Scull, Maureen C. Deeny, and Elham Hamdan. “Prevalence and

Predictors of Anabolic-Androgenic Steroid Use among Gym Users in Kuwait: A

Preliminary Study.” International Journal of Men’s Health 15, no. 2 (July 1, 2016): 144.

https://www.questia.com/library/journal/1P3-4321282151/prevalence-and-predictors-of-an

abolic-androgenic-steroid.

Centers for Disease Control and Prevention. "Introduction to Epidemiology | Public Health 101

Series." Accessed February 21, 2024.

https://www.cdc.gov/training/publichealth101/epidemiology.html.

Chegeni, Razieh, Guy Notelaers, Ståle Pallesen, and Dominic Sagoe. “Aggression and

Psychological Distress in Male and Female Anabolic-Androgenic Steroid Users: A

Multigroup Latent Class Analysis.” Frontiers in Psychiatry 12 (June 4, 2021).

https://doi.org/10.3389/fpsyt.2021.629428.