APPEARANCE AND PERFORMANCE ENHANCING
DRUG USE SCHEDULE
Version 1.1: 1-25-2010
Tom Hildebrandt, PsyD
&
James W. Langenbucher, PhD
1
Background and Definition
Appearance and Performance Enhancing Drug (APED) use is a complex form of
substance use that typically includes muscle building, fat burning/weight loss, and
energy/endurance boosting substances. It is goal-directed, aimed to change physiological or
psychological states relevant to individual appearance and performance related goals, and
typically includes both benefits as well as a number of potential side effects. There are a wide
range of potential substances that may be taken for appearance or performance enhancing
purposes. These substances are usually taken in relatively predictable patterns with several
drug classes being the most frequently encountered. These drug classes include anabolicandrogenic steroids, over-the-counter thermogenics/weight-loss supplements, over-the-counter
muscle building supplements, and illicit ergo/thermogenics.
APED Cycle: An APED cycle is the cornerstone phenomenon of APED use although
few if any users will use the acronym “APED”. The cycle is typical referred to as an “anabolic
cycle” or referenced by the specific goal such as a “bulking cycle” or “cutting cycle”. Many will
refer to distinct periods of time as either “on-cycle” or “off-cycle”. These periods will vary in time
from person to person, but “on-cycle” periods typically span 12-16 weeks and the “off-cycle”
period begins as the APEDs start to leave the body (typically beginning about 2 weeks after the
last dose of an APED. The “off-cycle” time is sometimes associated with what users refer to as
a “post-cycle” crash. In attempts to avoid or prevent this “crash,” male users may use drugs like
human chorionic gonadatropin (HCG) or low doses of testosterone to keep testosterone within
a normal range. In some cases, users may stay on a lose dose of testosterone between cycles,
a phenomenon called “bridging”. When a user stays on a low-dose chronically, he/she may
conceptualize this as a form of hormone replacement therapy (HRT; for males) or an attempt to
maximize health. Despite this practice, a user will still be able to identify alterations from this
bridge or HRT as a cycle. During this period of “on-cycle” drug use, APED users will take a
range of drugs, “stacking” them in specific order, dose, and duration. The types of drugs
(described below) have different properties and functions, but generally they are taken for the
purposes of maximizing lean muscle mass, reducing body fat, or in most cases both increasing
muscle mass and decreasing fat.
AAS: AASs constitute a majority of APEDs used with the most popular forms being
testosterone (“Test”), trenbolone acetate (“Tren”), stanozolol (“Winny” or “Win-V”), nandrolone
decanoate (Deca-Durabolin, "Deca," "Nan"), methandrostenolone (Dianabol, "Dbol"),
methyltestosterone, oxandrolone, and oxymetholone (“Anavar”). All synthetic and endogenous
androgens are four-ringed structures with 19 carbon atoms, but AAS generally consist of
modified testosterone molecules. The chemical structure of these synthetic androgens differs
in several important ways. For example, many AASs represent testosterone molecules
modified by 17α-alkylation, where a methyl group (CH3) is added at the C17α position. This
process slows hepatic inactivation and allows for these AAS to become active through oral
administration. Such modifications are seen in a range of AASs including methyltestosterone,
oxandrolone, oxymetholone, and stanozolol. A second, equally important modification to the
chemical structure of testosterone, is the 17β-estrification of the 17-hydroxy group with a chain
of hydrocarbon molecules. This process allows esters of different lengths to be added to the
testosterone molecule, which slow the metabolism of the molecule to biologically inactive keto
2
steroids. Finally, a third modification includes both esterification and substituting hydrogen for
the methyl group at C19, which further extends the half-life of the molecule. Although these
methods are the most common alterations to the testosterone molecule, more than 100
synthetic steroids have been developed.
Biological Activity. The body naturally produces C19 steroid hormones (known as the
androgens) through a series of biotransformations primarily taking place in the gonads, where
pregnenolone is eventually converted into testosterone and androstenedione through cleavage
of the ethyl group from a progestin precursor at C17. These androgens are produced in the
Leydig cells of the testes, while Sertoli cells produce the androgen-binding proteins that carry
androgens through the blood and able to cross the blood-brain barrier. Endogenous as well as
synthetic androgens exert the majority of their biological activity through androgen receptors,
which are spread widely throughout the mammalian body with the highest concentrations
being in the reproductive tissue (e.g., gonads) and nonreproductive tissues such as the
kidneys, liver, muscles, brain, and bone.
In addition to direct activation of androgen receptors by AASs, these hormones are also
subject to different metabolic processes. Testosterone breaks down into several metabolites
including dihydrotestosterone (DHT) and estradiol (E2). The biotransformation of testosterone
into these molecules is a result of enzymatic activity of 5α-reductase and aromatase
respectively. These enzymes have different concentrations across different areas of the body.
Of most relevance, these enzymes have differential concentrations in relevant brain regions.
These metabolites are also responsible for the effects of AAS. For instance, DHT is
responsible for much of the androgenic or virulizing effects of AAS and is associated with
particularly high concentrations in the prostate. Conversely, E2 is an estrogen with higher
activity found in bone and breast tissues and there is some evidence that this metabolite is
associated with aggression in male mice, although this may be related to amount of E2
receptors in the brain.
Non-Steroidal Anabolics: There are at least three primary non-steroidal anabolics that
are used by APED users, although non-steroidal anabolics are used only by a small
percentage of users. These substances include insulin (“slin”), insulin-like growth hormone
(IGF), and human growth hormone (HGH). All three substances are produced by the human
body and have legitimate medical uses.
Ergo/thermogenics: Ergogenic, thermogenic, and anorexigent compounds are
typically used to increase energy, boost metabolism, raise body temperature, reduce appetite,
and “burn fat.” These substance fall into three basic categories (a) xanthines - caffeine,
theophylline, and theobromine; (b) sympathomimetics - such as ephedrine and ephedra; and
(c) thyroid hormones - mainly Cytomel or T3. All three categories work as central nervous
stimulants (CNS) with the latter category requiring a prescription for legal use. Other
substances that may be used by some APED users include dinitrophenol (DNP) which is a
protein uncoupler and will increase internal body temperatures, and eyrthropotein (EPO) which
stimulates red blood cell production and is used for increased endurance.
Over-the-Counter Ergo/Thermogenics: These substances are typically sold in the
form of fat burning or performance enhancing nutritional supplements. Popular forms of these
supplements will often stack xanthenes with a sympathomimetic (e.g., caffeine + ephedra) in
order to maximize CNS effects. Almost all APED users will include these substances as part of
an APED cycle, although the duration of use may be constant rather than cycled with some
users. The side effects of these drugs are more clearly linked to aggression, irritability, and
3
anger than AASs and are likely to play some significant role in the reported psychological
effects of the APED cycle.
The most common ingredient in OTC ergo/thermogenics (caffeine) acts as a stimulant
by disabling the inhibitory effects of adenosine in the central nervous system. The blockade of
adenosine receptors by caffeine results in increased concentrations of several cerebral
neurotransmitters including serotonin, dopamine, acetylcholine, norepinephrine, and
glutamate, which in turn cause increased spontaneous neuronal firing and also activates the
peripheral nervous system. Thus, an individual taking high amounts of this substance will
achieve a higher overall level of arousal which may lead to increased ability to attend to
different stimuli in the environment and improve cognitive performance. Similarly, the stimulant
properties will allow someone who is otherwise fatigued to continue to train and ultimately
increase the productivity of their physical output. Finally, caffeine and other xanthenes will
also decrease appetite and increase the likelihood of sticking to a restrictive caloric diet.
Sympathomimetic drugs are similar in structure and action (hence being called mimics)
to epinephrine and norepinephrine in the sympathetic nervous system. Ephedrine,
norephedrine, ephedra, Ma Huang, phenylpropanolamine (PPA), and pseudoephedrine are all
substances in this category. Ephedrine, pseudoephedrine, PPA, and herbal preparations
containing ephedra and Ma Huang have until recently been easily available over the counter
and present in a number of herbal supplements. However, in November 2000, after a study
found that the use of PPA caused an increased risk of strokes, the United States Food and
Drug Administration released a health advisory and requested that all manufacturers
discontinue marketing products containing PPA (FDA/Center for Drug Evaluation and
Research, 2000). Although it is still available for some uses, it is no longer easily available
over-the-counter. Ephedra has undergone similar legislative restriction, being placed on the
FDA banned list as an herbal supplement with all legal sales ending in 2004. Similar
substances have been developed to get around these restrictions, which reflects the rapidly
evolving market. Ephedrine’s primary mechanism of action is through activation of the betaandronergic receptors of muscle tissue which increase metabolic output and ultimately
increases the likelihood of burning fat.
Illicit Ergo/Thermogenics: The thyroide hormones (T3 and T4) require a prescription
for legal use. The most common hormone used is triiodothyronine (T3 or liothyronine). It is
available in a synthetic preparation as Cytomel or combined with thyroxine (T4) as Thyrolar. T3
is only available by prescription in the United States. Synthetic thyroxine (T4) by itself is also
available and is more frequently prescribed for thyroid disease. Thyroxine (T4) must be
converted to T3 in order to be metabolically active and so it is often prescribed by itself for
hypothyroidism since it is somewhat safer due to the brain’s ability to autoregulate the
conversion from T4 to T3. The most well known action of thyroid hormones is thermogenesis,
which is believed to result from effects of these hormones either on mitochondrial metabolism
or on transport of sodium and potassium across cellular membranes.
As described earlier, other substances potentially used by APED users include EPO
and DNP, which have their own unique mechanisms of action. EPO is a primary endurance
booster believed to improve performance by increasing the oxygen available in the blood for
muscles. DNP, on the other hand, is an ingredient found in non-nutritive products such as
TNT and pesticides. Taking this substance usually results in increased body temperature and
is thought to reduce body fat through over-production of heat.
4
Prohormones and Nutritional Supplements. APED users will often add other legal
substances to their cycles which can be purchased over the internet or through nutritional
supplement stores. The most common of these substances include protein supplements and
creatine, but these substances can target a wide range of potential biological mechanisms
associated with muscle gain, performance enhancement, or fat reduction (see
ergo/thermogenics above). Prohormones are a particularly relevant supplement as they are
typically pre-cursor hormones that break down into testosterone through natural processes
once injected. In some instances, individuals will inject these substances to maximize their
effects as the prohormones often lose their potency when digested naturally through the
stomach.
APED Phenomenology: The use of APEDs has a range of associated behavioral and
psychological features. Most notably, APEDs are used in the context of some form of
exercise, performance, or competition. These contexts may direct the pattern of APED use as
different disciplines are likely associated with APED patterns designed to maximize success or
goal achievement. This may be obvious for certain types of competition such as powerlifting,
where strength and size are valued over characteristics such as muscle definition or
endurance. Exercise, in some form, will likely occur with all APED users. The nature of this
exercise will vary widely based on idiosyncratic differences in goals, experience, and
knowledge, but several features of APED users’ exercise regimen assessed in the APEDUS.
Specifically, the APEDUS targets the degree to which exercise is aerobic or anerobic, the
amount of time spent in these respective forms of exercise, and the degree to which exercise
is a pleasure seeking process or an affect neutralizing process. A similar common
phenomenological experience shared by most APED users is dietary control. Many APED
users will attempt to control macro and micro nutrient content in efforts to maximize their
appearance or performance related goals. As with exercise, these forms of control are
idiosyncratic and likely influenced by the context in which APEDs are used. For example,
bodybuilders will consume varying amounts of protein, fat, and carbohydrates depending on
where they are in their training plan with typical patterns including acute starvation precompetition to bring out vascularity (visible evidence of veins surrounding the muscle) or
volume associated with subcutaneous fat. The APEDUS contains items assessing several
aspects of dietary control, including the level of investment in a specific dietary plan,
adherence to that plan, and psychological effects of deviating from that plan. As with exercise,
the dietary items also assess the relative function of this dietary control as either producing
pleasure or attempt to neutralize affect.
Appearance is also an integral part of APED phenomenology. In most cases, the use of
these drugs will target specific changes in appearance such as increased muscle mass,
increased leanness or “vascularity”, or the combination of these dimensions. The items of the
APEDUS measure the importance of appearance and the degree to which certain individuals
engage in behaviors or think about appearance that reflects affect neutralization, along with
the degree to which the individual engages in behaviors or thinking that indicates that the body
or appearance is a source of pleasure, novelty, or reward. In particular, the items are
designed to scale the pathological forms of these constructs.
APED use may take on a rather wide range of drug use, exercise, and dietary patterns,
but also has considerable variation in the degree of social regulation of these behaviors and
attitudes. For these reasons, there are specific items within the APEDUS to target the degree
to which APED use exists as part of a larger social context. For instance, APED users are
5
likely to gain advice on a wide range of behavior from individuals perceived to have expertise
in the use of APEDs. In addition, they may use internet discussion boards and postings to
exchange information about use patterns, diets, exercise regimens, etc.
Finally, there are a number of potential risks, physical, psychological, social, and legal,
that is associated with APED use. Many APEDs are illegal and there may be significant risks
involved with the purchase and possession of these substances. Furthermore, some APED
users will take other risks, experimenting with high doses or dangerous patterns of use, or
using homemade APEDs where the quality and safety of the drugs may be questionable. This
risk taking pattern as well as the investment of men/women in taking these substances is
believed to influence future APED use.
Using the APEDUS
The APEDUS is separated into eight modules designed to canvas the most common
phenomena of APEDUS use. These modules may be used separately or in any combination
depending upon the particular research questions being asked. In its full form, the interview
should average approximately 1 hr. The APEDUS also includes a common introduction that
we recommend to be used with any combination of the modules. The structure of the
APEDUS is as follows:
1. Background & Demographics
2. Module I: Training History and Identity
3. Module II: Dietary History and Practices
4. Module III:Body Image and Appearance Control
5. Module IV: Nutritional Supplements and Prohormone Use
6. Module V: First Appearance and Performance Enhancing Drug Cycle
7. Module VI: Current/Most Recent Appearance and Performance Enhancing Drug Cycle
8. Module VII:Usual Appearance and Performance Enhancing Drug Cycle
9. Module VIII:Social Context of Appearance and Performance Enhancing Drug Use
10. Module IX: Risk and Future Use
The APEDUS uses a couple of common interview techniques that the interviewer
should familiarize him/herself with before conducting an interview. First, the APEDUS is a
semi-structured interview so all ratings are made by the clinician taking into account the
information provided in response to the question. If an interviewee reports inconsistent
responses across similar items, then it is up to the interviewer to resolve the inconsistency with
further questioning of the interviewee. If necessary, the interviewer may go back to earlier
parts of the interview to resolve discrepancies.
Second, the interviewer should keep the interviewee on track, redirecting him/her when
digressions to the questions occur while maintaining rapport.
Third, many of the questions refer to the last 28 days or month. This design feature
allows to the interviewer to capture the most recent APED phenomena. All items that lead with
“…” should be read with the beginning statement, “Over the past 28 days…”. When collecting
information on this time period, code the rating that reflects only this time period. If the
interviewee had difficulty making ratings for this time period, ask him/her to list some of the
activities he/she engaged in over the past month and have him/her use these anchors to help
6
approximate to the answer. If the interviewee still has trouble with the time frame, have them
make the best approximation using the scale provided.
When an item is not applicable or impossible to rate based on the interviewers response
or experience, code “-9”.
For several of the sections, the interviewee will be asked to describe a pattern of drug
use or side effects related to that side effect. To increase the efficiency of this process, we
have included the use of drug/side effects lists to be used with the interview. When using
these lists, make sure to hand the list to the interviewee when arriving at the appropriate
section. Have the interviewee list all the substances he or she used for the referent time
period and use the appropriate follow-up questions when necessary. It is possible that the list
of drugs provided does not include a specific substance used by the interviewee. In this case,
have the interviewee provide as much information as possible on the substance (e.g., street
name, true drug name, and typical metric for dosing.
For coding purposes, all codes should be recorded in the grey tinted boxes. For
Likert-type scales, which will have the appropriate item tag to the lower right of the box,
circle the most appropriate number. The codes in the lower right corner are for data
entry purposes and are used to identify the appropriate cell in the corresponding
spreadsheet.
7
BACKGROUND AND
DEMOGRAPHICS
Basic Demographics
1. What is your sex?
male: 0
female: 1
1
2. What is your Age?
# of years
2
# inches
3
# lbs
4
% body fat
5
3. Height
4. Weight
5. Body Fat Percentage
Code “-9” if unknown
Race and Ethnicity
6. How would you
define your racial
background?
White,
Caucasian, or
European
American
Black or
African
American
American
Indian or
Alaskan
Native
Asian
Native
Hawaiian or
Other Pacific
Islander
0
1
2
3
4
Hispanic or Latino
Not Hispanic or Latino
0
1
7. How would you
define your ethnic
background?
Notes:
6
7
Occupational and Living Status
8. What is your Marital
Status?
Never
Married
Widowed
Divorced
Separated
Living as
Married
Married
0
1
2
3
4
5
8
8
9. What is your Sexual
Orientation?
10. What is your
employment status?
11. What is your
Occupation?
Primarily Heterosexual
Bisexual
Primarily
Homosexual
0
1
2
9
Employed
full-time
Employed
part-time
Homemaker
Student
full-time
Retired
Unemployed
Disabled
0
1
2
3
4
5
6
10
Notes.
11
12. What is your
approximate annual
household income?
$
12
13. What is the highest level of education you’ve received?
Calculate the total number of years based on interviewee’s
response.
# years
14. Have you ever served in the military or armed forces?
15. Did you see any combat in the military?
16. Were you injured in combat?
13
No
0
Yes
1
14
N/A
-9
No
0
Yes
1
15
N/A
-9
No
0
Yes
1
16
17. How long did you serve in the military?
years
9
17
Medical History and Status
18. Have you ever been hospitalized for an injury related to
your exercise, training, or athletic competition?
No
Yes
0
1
# of times
19. How many times?
20. Have you ever been knocked unconscious or received
some other sort of injury to your head?
(N/A = -9)
No
Yes
0
1
21. How many times?
19
23. Have you ever been diagnosed with high cholesterol?
24. Has either of your biological parents ever been
diagnosed with a heart problem or high cholesterol?
Code “-9” if unknown.
25. Have you ever been hospitalized for psychiatric or
psychological reasons?
21
No
Yes
0
1
22
No
0
Yes
1
23
N/A
No
Yes
-9
0
1
No
Yes
0
1
26. How many times?
25
# of times
(N/A = -9)
27. Are you currently receiving psychological/psychiatric
treatment of any type?
20
# of times
(N/A = -9)
22. Have you ever been diagnosed with a heart condition?
18
No
Yes
0
1
26
27
10
24
28. What type of treatment?
Notes.
28
29-32. What medications are
you currently taking for a
medical or psychological/
psychiatric reason that are not
related to your APED use?
Nam
e
Get the list as best the interviewee
can recall. For the fourth column
code “0” if the interviewee is taking
the medication without the
supervision of a medical professional
and “1” if the medication was
obtained through a prescription of a
medical professional.
Reason
Dose
Prescription
29a
30a
31a
32a
29b
30b
31b
32b
29c
30c
31c
32c
Notes.
11
TRAINING HISTORY AND IDENTITY
I am now going to ask you some specific questions about your exercise, athletic, and training
practices, what they mean to you, and how they may have changed over time.
1. At what age did you first begin regular exercise?
yrs
1
a)**Was this exercise something you did almost every day?
If no… when did you first exercise more days than not for at least six
months?
b)**How long did you keep it up… was it at least 6 months?
If no… when was the first time you exercised this way for at least six
months?
Exercise must have been regular and occurred for more than a six month period
with exercise occurring more days than not over that period. Examples include
weight training, aerobics, and team sports.
2. In the past month, what has been your primary method of exercise or training?
Be specific to the past month. If there is variation, rate the method that accounted for the majority
of time over the past four weeks.
**What percentage of the time did you spend on cardio or endurance exercise?
**What about power, strength, or mass building exercises?... Which do you rely on more?
Exclusively
cardio/endurance
(e.g., marathon,
distance cycling,
etc.)
Primarily cardio
/endurance (e.g.,
aerobics, dance,
competitive
fitness,
swimming, etc.)
Notable reliance
on cardio/
endurance (e.g.,
soccer,
intermediate
racing, etc.)
Equivalent
reliance on
cardio/endurance
and power, size,
strength (e.g.,
boxing, mountain
climbing, etc.)
Notable reliance
on strength,
power, size (e.g.,
football, sprinter,
decathlon, etc.)
0
1
2
3
4
Exercise where success or
achievement is primarily
related to cardiovascular
fitness or muscular endurance
Exercise where success or
achievement depends on
cardiovascular fitness/muscular
endurance and physical strength,
power, or size.
Primarily
strength, power,
or size (e.g.,
wrestling, combat
sports, etc.)
Exclusively
strength, power,
or size (e.g.,
power lifting,
strong man
competition, etc.)
5
6
Exercise where success
or achievement is
primarily related to
power, size, or
endurance
12
2
3. In the past month, how many days have you exercised?
4. On the days that you have exercised, how much time did
you spend exercising?
5. What has been the longest continuous period of time you
spent exercising at one time over the past month?
# days
3
# hours
4
# min
5
THE REMAINING QUESTIONS WILL REFER TO THIS SPECIFIC TIME PERIOD OF
EXERCISE/TRAINING. EACH QUESTION SHOULD BEGIN “Over the past month…”
6. …did you ever feel like exercise was something you had to do?
If No… skip to “b”
a)**How often did you feel this way?... Did it occur every day?
b)**What about feeling like a burden?... How often did you feel this way?
If No… code “0”
To be rated above a “0” there must be some evidence that the interviewee experienced exercise as
a burden or driven by the avoidance of some degree of negative affect.
0-4
0
5-8
1
9-12
2
13-16
3
17-20
4
21-23
5
24-28
6
13
6
7. …did you exercise because you were feeling bad [anxious, depressed, etc.]? Could you
give an example?
a)**Did you use exercise to control these feelings?
b)**What percentage of the [___days from item #3] did you use exercise for this purpose?
The use of “neutralizing” exercise should be differentiated from “pleasure seeking” exercise. The
goal of neutralizing exercise is to feel “normal” or to reduce anxiety or worry as opposed to a goal of
feeling “better than normal.” Interviewees can have both of these goals over the course of a month,
but we want to scale the percentage of time it was present. Calculate based on #days exercised.
For example, an answer of 3 out of 12 days exercised =25% or code “2”.
Never
Seldom
Occasionally
About Half Time
Sometimes
Frequently
Always
0
0%
1
1-20%
2
21-40%
3
41-60%
4
61%-80%
5
81%-99%
6
100%
7
8. …have you had to make an unwanted change to your exercise routine?
If Yes…a)**How badly did you feel when this happened?... How long did the feeling last?
If No…b)**How badly would you have felt if you had to change your routine or couldn’t
complete all the training you had planned?
There must be notable distress or anxiety expressed by the interviewee to code above a “0”.
None
Very Little
Some
Moderate
Significant
A Great Deal
Extreme
0
1
2
3
4
5
6
Absence or very little distress. When
distress occurs, it has no measurable
impact on daily life.
Clear distress with observable duration and some
measurable impact on daily life. For example, more
irritable around co-workers or with loved ones.
Distress never resolved, only
resolved with compensation, or
results in functional impairment.
14
8
9. …have you found yourself being preoccupied with exercise or thought about exercise
even when you did not want to?
a)**How often does this occur?...How long does it last when it happens?
b)**How much does it bother you or interfere with things you are actively trying to do… for
example, concentrating at work or carrying on a conversation?
Preoccupation must be experienced as intrusive, unwanted or clearly dysfunctional thoughts about
exercise and it must occur in contexts where it is not desirable or functional. For instance, when
carrying on a conversation with a friend, while concentrating on work or school, or when trying to
relax. Preoccupation does not include purposeful thought about exercise.
No impairment
0
No preoccupation
Very Little
Impairment
Some
Impairment
Moderate
Impairment
Significant
Impairment
A Great Deal of
Impairment
1
2
3
4
5
Occurs infrequently or it has little
Occurs frequently or when it
appreciable impact on his/her life occurs it has a strong impact on
his/her life
Extreme
Impairment
6
Frequent
and
Impairing
9
10. …did you fear that your athletic ability or looks would deteriorate if you didn’t keep up
your exercise schedule or intensity?
If No… Would you be anxious if you were unable to keep up with your current exercise
level?
If yes… how intense was that fear?...Did this fear interfere with your life at all?
This question is specific to the fear or anxiety that motivates exercise. For example, someone may
do1 hr of sit-ups or crunches per day to prevent the loss of “six pack abs”. If there is no
acknowledgement of fear, but interviewee attributes this to successful prevention of fear through
exercise code greater than 0.
None
0
No Fear
Very Little
Some
Moderate
Significant
A Great Deal
1
2
3
4
5
Evidence of fear that either occurs
infrequently, is mild in intensity, or has
little impact on life
Evidence of fear that occurs frequently,
is intense, or has strong impact on life
Extreme
6
Frequent,
intense, &
impairing
15
10
11. …did you ever become uncomfortable or upset because an exercise, lift, or athletic drill
didn’t feel right?
a)**…did you have to repeat an exercise, drill, or lift because it didn’t feel right?
b)**How often did this occur over the past month?... that is, what percentage of your
exercise or training did you have to execute until it fell right?
This question measures the compulsive need for exercise or athletic activity to lead to affect
neutralization. This must be evidence that the executing a given exercise, lift, or athletic drill will
neutralize or reduce some internal negative feeling. This may be related to an extreme sense of
perfectionism or superstitious belief about quality of exercise.
Never
Seldom
Occasionally
About Half Time
Sometimes
Frequently
Always
0
0%
1
1-20%
2
21-40%
3
41-60%
4
61%-80%
5
81%-99%
6
100%
11
12. …did you experience a “high” or feeling of intense pleasure while exercising?... could
you give an example?
If No… code “0” for items 12—15.
If yes… a) Did it occur during the actual exercise or shortly after?
b) What percentage of [___#days item 3] that you exercised did you feel this way?
This item scales the experience of pleasure during the actual exercise. This feeling should be
differentiated from positive anticipation pre-exercise.
Never
Seldom
Occasionally
About Half Time
Sometimes
Frequently
Always
0
0%
1
1-20%
2
21-40%
3
41-60%
4
61%-80%
5
81%-99%
6
100%
16
12
13. …[only ask if coded > 0 on item 12] thinking back to the times you felt this way… could
you describe how intense the feeling was?
**Was it intense enough that it blocked the feeling of pain or fatigue?
This item scales the intensity of the pleasure during the actual exercise. Again, differentiate this
from pre-exercise anticipation.
None at all
0
Very little
A little
Somewhat
A lot
Very Much
1
2
3
4
5
A noticeable change from preIntensity of pleasure obscures
exercise, but able to experience
other emotions or sensations
other emotions or sensations (e.g.,
(e.g., pain, fatigue, etc.)
pain, fatigue, etc.)
Extreme
6
Could not
feel other
emotions or
sensations
13
14. …[only ask if coded > 0 on item 12] did these “highs” lead to exercising longer than
intended? Could you give an example?
If yes… a) What percentage of the [___#days from item 3] that you exercised did this occur?
Distinguish this from simple over exercise in that it must have been pleasure driven and lead to
exercise that was unplanned or undesired. For example, planning on running for 2 miles, but
running 5 miles because it felt good.
Never
Seldom
Occasionally
About Half Time
Sometimes
Frequently
Always
0
0%
1
1-20%
2
21-40%
3
41-60%
4
61%-80%
5
81%-99%
6
100%
17
14
15. …have you increased the intensity or duration of your exercise?
If Yes… a)**Has this increase been to achieve a “high” or intense pleasure that you no
longer experienced?
b) How much have you had to increase the intensity or duration of your exercise to get the
same effects?
This question is designed to address the degree of tolerance to exercise effects that have
developed of the past 4 weeks. Do not consider planned increases in exercise intensity or duration
in relation to specific training plan or goal. The exercise must functionally produce some
recognizable pleasure or positive feeling to be rated above a zero.
None at all
0
No change
Very little
A little
Somewhat
A lot
Very Much
1
2
3
4
5
Either time or intensity of
Time and/or intensity increases
exercise increases, but only on a on most days or changes reflect
few days or slight amount
a distinct increase (e.g., twice
as much time to achieve same
high)
Extreme
6
Same
feeling
never
attained
despite
significant
changes
18
15
DIETARY HISTORY AND PRACTICES
I’m now going to ask you some specific questions about your diet or the food that you eat
and how you make decisions about your diet.
Start each relevant question with “Over the past month…”
1. At what age did you first begin watching the amount, type, or
frequency of food you ate?
Dietary control must have been regular and occurred for more than a six month
period with regulation or control occurring more days than not over that period.
This regulation or control may vary from restriction of calories to frequent
attempts to overeat to gain weight. Structured plans for eating will also qualify
as long as the methods were intentional.
yrs
1
2. Could you describe this first attempt to change your eating?
Get a general picture of the types of rules/ guidelines used. Follow up with the following questions
**Was caloric intake important to you?...were you trying to lose or gain weight?
If yes continue to item below. If no code “-9”
**How much did calories influence decisions you made about food? Consider the
interviewee’s perception of the number of calories necessary to maintain energy balance for
activity level, age, and gender. A “3” represents complete energy balance.
N/A
-9
Extreme
restriction of
calories.
(includes
periods of
fasting or eating
non-caloric
food)
Substantial
caloric
restriction.
(caloric intake is
clearly below
that needed to
achieve energy
balance).
0
1
Successful control
requires the intake of no
calories or only enough
for minimal functioning.
Mild caloric
restriction.
(Likely a
negative energy
imbalance, but
not severe)
Energy Balance
(no consistent
restriction or
overeating)
Mild caloric
overconsumption
(Likely a
positive energy
imbalance, but
not severe)
2
3
4
Successful control requires caloric
regulation that approximates energy
balance.
Substantial
caloric overconsumption
(Clear positive
energy
imbalance)
Extreme overconsumption
(intentional and
persistent
overeating)
5
6
Successful control
requires overconsumption of
calories
19
2
3**What about macronutrients… that is, did you base your diet upon the amount of protein,
carbohydrates, or fats?
If yes continue to item below otherwise code -9.
**Were there other important aspects of nutrition that influenced the food you ate?... Please
describe?
**How much did macronutrient content influence the decisions you made about food?
The degree to which one’s eating pattern favored specific macronutrient content. For example a
high protein low fat diet (regardless of calorie consumption) would be scored higher than “0”
because of use of macronutrients to inform dietary decisions.
N/A
-9
No influence of
macro-nutrient
content on
caloric
consumption
Little influence
of macronutrient content
on caloric
consumption.
0
1
Caloric control
independent of macronutrient content.
Some macronutrient control
but other
aspects more
important.
Equivalent
reliance on
macro-nutrient
control vs. other
methods of
control.
Notable macronutrient control
2
3
4
Caloric control depends upon
macronutrient content, but other
aspects or nutrition or regulation has
considerable influence over daily
caloric consumption.
Primarily macronutrient control.
Exclusively
macro-nutrient
control.
5
6
Caloric control
heavily related to
macronutrient
content.
20
3
WE’RE NOW GOING TO FOCUS ON YOUR DIETARY PRACTICES OVER THE PAST MONTH
4. In the past month, were you attempting control your diet? Please explain.
Get a general picture of the types of rules or guidelines used over the past 4 weeks. Follow up
with the following questions: If no… code “-9”
**Did you watch the number of calories you consumed?
If yes continue below. If no, code “-9” and move to next item.
**Did calories influence your decisions about food?
Consider the interviewee’s perception of the number of calories necessary to maintain energy
balance for activity level, age, and gender. A “3” represents complete energy balance.
N/A
-9
Extreme
restriction of
calories.
(includes
periods of
fasting or
consumption of
non-caloric
food)
Substantial
Caloric
restriction.
(Caloric intake
is clearly below
that needed to
achieve energy
balance).
0
1
Successful control
requires the intake of no
calories or only enough
for minimal functioning.
Mild caloric
restriction.
(Likely a
negative energy
imbalance, but
not severe)
Energy Balance
(no consistent
restriction or
overeating)
Mild caloric
overconsumption
(Likely a
positive energy
imbalance, but
not severe)
2
3
4
Successful control requires caloric
regulation that approximates energy
balance.
Substantial
caloric overconsumption
(Clear positive
energy
imbalance)
Extreme overconsumption
(intentional and
persistent
overeating)
5
6
Successful control
requires overconsumption of
calories
4
5. …how about macronutrients… did you keep track of them?
*Did macronutrients influence your decisions about food?
N/A
-9
No influence of
macro-nutrient
content on
caloric
consumption
Little influence
of macronutrient content
on caloric
consumption.
0
1
Caloric control
independent of macronutrient content.
Some macronutrient control
but other
aspects more
important.
Equivalent
reliance on
macro-nutrient
control vs. other
methods of
control.
Notable macronutrient control
2
3
4
Caloric control depends upon
macronutrient content, but other
aspects or nutrition or regulation has
considerable influence over daily
caloric consumption.
Primarily
macro-nutrient
control.
Exclusively
macro-nutrient
control.
5
6
Caloric control
heavily related to
macronutrient
content.
21
5
# days
6. …how many days have you trying to control your diet?
6
7. …how successful have you been at controlling your diet?
Rate interviewee’s perception of success. Code “-9” if no attempt at regulation.
N/A
Never
Seldom
Occasionally
About Half
Time
Sometimes
Usually
Always
-9
0
1
2
3
4
5
6
7
8. …did you feel controlling your diet was something you had to do?
If No… skip to “b”
a)**How often did you feel this way?... Did it occur every day?
b)**What about feeling like a burden?...How often did you feel this way?
To be rated above a “0” there must be some evidence that the interviewee experienced caloric or
macronutrient control as a burden or driven by the avoidance of some degree of negative emotion.
If no evidence of attempt at dietary control, then code “-9”.
N/A
-9
0-4
0
5-8
1
9-12
2
13-16
3
17-20
4
21-23
5
24-28
6
22
8
9. …did you feel bad about the way you looked, your physical health, or your athletic
ability? If No… Ask “a”
*Did controlling your diet reduce these feelings?...What percentage of the time?
a) Did success with your diet prevent you from feeling bad? (Code 6 if “yes”)
The use of “neutralizing/prevention” should be differentiated from “pleasure seeking” eating. The
goal of neutralizing or compensatory caloric/macronutrient control is to feel “normal” or to reduce
anxiety or worry as opposed to a goal of feeling “better than normal.” Interviewees can have both
of these goals over the course of a month, but this item scales the percentage of time dietary
control was used compulsively. Code “-9” if there is no evidence of regulated eating.
N/A
Never
Seldom
Occasionally
About Half
Time
Sometimes
Frequently
Always
-9
0
0%
1
1-20%
2
21-40%
3
41-60%
4
61%-80%
5
81%-99%
6
100%
9
10. …did you deviate from your diet at all?
If No, skip to “c”
If yes…a)**Did you feel bad when this happened? Please describe.
b) How intense was this feeling? …How long did it last?
c)**How would you have felt if you deviated from your diet? Please describe.
If no attempts at regulating eating than code “-9”.
N/A
None at all
-9
0
No
reaction
Very little
A little
Somewhat
A lot
Very Much
Extreme
1
2
3
4
5
6
Some emotional disturbance. Clear distress associated with
Can’t
Low intensity or feeling fades
deviation. High intensity or
tolerate
quickly
persistence of emotion.
associated
distress
23
10
11. …have you found yourself being preoccupied with food, eating, or nutrition or thought
about food, eating, or nutrition even when you did not want to?
a)**How often does this occur?
b)**How much does it bother you or interfere with things you are actively trying to do… for
example, concentrating at work or carrying on a conversation.
Preoccupation must be experienced as intrusive or unwanted thoughts about food, eating, or
calories and it must occur in contexts where it is not desirable or functional. For instance, when
carrying on a conversation with a friend, while concentrating on work or school, or when trying to
relax. Preoccupation does not include purposeful thought about food, eating, or calories.
N/A
Never
Seldom
Occasionally
-9
0
1
2
No preOccurs infrequently or it has little
occupation appreciable impact on his/her life
About Half
Time
Sometimes
Usually
3
4
5
Occurs frequently or when it
occurs it has a strong impact on
his/her life
Always
6
Frequent
and
Impairing
11
12. …were you concerned that your looks, your health, or your athletic ability would
deteriorate if you didn’t control your diet?
**Did sticking to your diet reduce these concerns? What percentage of the time?
This item measures the amount of time which dieting decisions function as harm avoidance or
prevention of undesirable changes in appearance, health status, or athletic ability. When
determining the percentage keep in mind that most interviewees will be eating 3-5 times per day
over a 28 day period.
N/A
Never
Seldom
Occasionally
About Half
Time
Sometimes
Usually
Always
-9
0
0%
1
1-20%
2
21-40%
3
41-60%
4
61%-80%
5
81%-99%
6
100%
24
12
13. …did dietary control lead to a “dieting high” or feeling of intense pleasure?
**Was this in response to caloric restriction?
On how many days did you experience this feeling?
This item scales the experience of pleasure from sticking to or regulating nutritional content or
achieving nutritional goals. This feeling should be differentiated from the feeling of
accomplishment, success, or dominance. It will typically be in response to severe restriction.
N/A
Never
Seldom
Occasionally
About Half
Time
Sometimes
Usually
Always
-9
0
0-4
days
1
5-8
days
2
9-12
days
3
13-16
days
4
17-20
days
5
21-24
days
6
25-28
days
13
14. …did you experience a strong desire or craving for a specific food or type of foods?...
Please give an example.
What about foods you were trying to restrict or cut out of your diet (e.g., chocolate bars,
French fries, etc.)?
Did you avoid cravings by eating the foods that you wanted?
**On how many days did you experience these cravings or end up eating certain foods to
avoid these cravings?
In this context strong desire and craving are experienced as positive anticipation of the actual
effects of eating that food. For interviewees who could not tolerate being unable to eat certain
foods when they desire to eat them code a “6”.
N/A
Never
Seldom
Occasionally
About Half
Time
Sometimes
Usually
Always
-9
0
0-4
days
1
5-8
days
2
9-12
days
3
13-16
days
4
17-20
days
5
21-24
days
6
25-28
days
25
14
15. …did the positive experiences related to food (e.g., taste, etc.) lead to consuming more
than intended?
**On how many days did this happen?
Distinguish this from simple overeating in that it must have been pleasure driven and must have
lead to eating that was unplanned or undesired. For example, planning on having one cookie, but
eating 5 because it felt/tasted good.
N/A
Never
Seldom
Occasionally
About Half
Time
Sometimes
Usually
Always
-9
0
0-4
days
1
5-8
days
2
9-12
days
3
13-16
days
4
17-20
days
5
21-24
days
6
25-28
days
15
16. …did you end up losing control over your eating? (If No, code “0” for items 16 & 17)
Could you give an example?
Were you intending to eat something different or eat less?
How did you feel when you were actually eating?
Was this part of a “cheat day”?
Loss of control is present when control or regulation was attempted or intended, but not executed.
Loss of control is distinguished from simple regret or guilt about eating, which may occur during
loss of control but are not necessary for the experience of loss of control. For example, some
people may plan “cheat days” to manage the experience of loss of control without regret or guilt.
N/A
Never
Seldom
Occasionally
About Half
Time
Sometimes
Usually
Always
-9
0
0-4
days
1
5-8
days
2
9-12
days
3
13-16
days
4
17-20
days
5
21-24
days
6
25-28
days
26
16
17. … did you attempt to compensate for these times you lost of control? For example, did
you cut back on quantity, type, or amount of food?
**Did you get stricter with your diet or increase the intensity of your workouts to eliminate
the effects of losing control? Please describe.
**On how many days did you try to compensate?
A common form of compensation will be increasing restriction (calories or macronutrient content)
to compensate for overeating or breaking a dietary rule. Code “-9” if there was no attempt to
regulate eating.
N/A
Never
Seldom
Occasionally
About Half
Time
Sometimes
Usually
Always
-9
0
0-4
days
1
5-8
days
2
9-12
days
3
13-16
days
4
17-20
days
5
21-24
days
6
25-28
days
17
18. …in general, how successful have your efforts been at controlling your diet?
This item refers to global attitudes or beliefs about the efficacy of the interviewees’ attempts at
dietary control. Consider the interviewee’s perception of success, not actual success. Code “-9” if
the interviewee has had no attempt to regulate eating.
N/A
Very
Unsuccessful
Somewhat
unsuccessful
A little
unsuccessful
Neither
successful or
unsuccessful
A little
successful
Somewhat
successful
Very Successful
-9
0
1
2
3
4
5
6
27
18
19. …How important was your diet… That is how much did eating or its effects matter to
you?
**Was it more important than exercise or athletic performance?
**Was it more important than other areas of your life such as work, school, or
relationships?
Diet includes anything related to the consumption of food or other products designed to provide
nutrition (e.g., calories, macronutrients, micronutrients, etc.).
Not of much
importance
N/A
No importance.
-9
0
1
Little to no recognition
that outward
appearance matters
Recognized
importance, but
not as important
as other areas.
Moderate
Importance.
Other areas of
equal
importance
Clearly a
priority, but
recognizes the
importance of
other areas
2
3
4
Recognized or observable evidence
that outward appearance matters
Primary
importance
The most
important
aspect of life
5
6
Outward appearance is
of primarily importance
28
19
BODY IMAGE AND APPEARANCE
CONTROL
I’m now going to ask you some questions about the way you think about and evaluate your
appearance.
1. …how important was it that your body looked a certain way… that is how much did your
outward appearance matter to you?
**Was it more important than exercise or athletic performance?
**Was it more important than other areas of your life such as work, school, or
relationships?
The importance in appearance can be inter or intrapersonal. This investment should be separated
from functional aspects of the body (e.g., strength, dexterity, etc.).
No Importance
Negligible
Importance
0
1
Little to no recognition that
outward appearance
matters
Some
Importance
Important
Significant
Importance
2
3
4
Recognized or observable evidence that
outward appearance matters
Primary
Importance
Total
Importance
5
6
Outward appearance
is of primarily
importance
1
2. …how important was exercising… That is, how much did your athletic ability matter to
you?
How about in comparison to other areas of your life such as relationships, job performance,
or your health?
The importance of performance is distinct from appearance although an interviewee may be
invested in both.
No Importance
Negligible
Importance
0
1
Little to no recognition that
function or performance
matters.
Some
Importance
Important
Significant
Importance
2
3
4
Recognized or observable
evidence that function or
performance matters.
Primary
Importance
Total Importance
5
6
Function or
performance is of
primary importance
29
2
3. …Did you scrutinize or evaluate the way you look or your athletic performance?
What specifically did you evaluate? How did you go about you doing this?
How often did you find yourself doing this? …did it happen every day?
Get a general picture of the types of evaluation methods used (e.g., weighing, body fat testing,
body checking). Give examples if the interviewee is unclear or denies evaluation. Evaluation
assumes some sort of standard or comparison which may range from direct comparison to others
or internal comparison to personal standard.
Never
Seldom
0
1
No observable attempts to
evaluate appearance or
performance
Occasionally
About Half Time
Sometimes
2
3
4
Recognized or observed attempts to
evaluate appearance or performance.
Occurs > 1/week.
Frequently
Always
5
6
Evaluation takes up a
marked period of time
on a daily basis.
3
4. …were you unsure about the way you looked or your athletic ability?
Critical or negative evaluations should be internal and not originate from a coach, friend, or
partner.
*…did this bother you?... did you find yourself evaluating your appearance or athletic ability
because of this uncertainty?
*How often did this happen?
The item measures the degree to which body checking or scrutiny is used to resolve the
discomfort over uncertainty about appearance.
Never
Seldom
0
1
No observable attempts
to evaluate appearance
or performance
Occasionally
About Half Time
Sometimes
2
3
4
Recognized or observed attempts to
reduce uncertainty with checking or
scrutiny. Occurs > 1/week.
Frequently
Always
5
6
Checking or scrutiny
takes up a marked period
of time on a daily basis.
30
4
5. … did evaluation of your looks or athletic ability lead to positive thoughts or feelings of
confidence? Please give an example.
**What percentage of the times that you evaluated yourself did it lead to feeling good?
As with the above question, evaluations should be internal and lead to noticeable feelings of wellbeing.
Never
Seldom
Occasionally
About Half Time
Sometimes
Frequently
Always
0
0%
1
1-20%
2
21-40%
3
41-60%
4
61%-80%
5
81%-99%
6
100%
5
6. …did you seek positive feedback about your looks or athletic ability from other people?
For example, ask your partner to comment on your muscle definition or strength.
How often did this occur? Was it every day?... More than 1 x per day?
Reassurance in this context is actively pursued and not spontaneously given and may constitute a
wide range of aspects of appearance or performance (e.g. form while lifting weights, presence of
visible musculature, execution of a play or something objective such as scale weight).
Never
Seldom
Occasionally
About Half Time
Sometimes
Frequently
0
1
2
3
4
5
No days
As much as a couple of
times per week
At least 2-3
times per
week
More days than not and/or
multiple times per day
Always
6
Every day
31
6
7. …[If Item 6 = 0, skip to Item 8 and code “0”] did feedback from others, positive or negative,
to reduce doubts or uncertainty about the way you look or your athletic ability?
For example, sometimes people ask others to evaluate their form while executing a certain
lift, or will inquire about the symmetry of their muscles to determine where to focus.
**How often did this occur? Did it happen every day?… More than 1 x per day?
Reassurance in this context is actively pursued and not spontaneously given and may constitute a
wide range of aspects of appearance or performance (e.g. form while lifting weights, presence of
visible musculature, execution of a play or something objective such as scale weight.
Never
Seldom
Occasionally
About Half Time
Sometimes
Frequently
Always
0
1
2
3
4
5
6
No days
As much as a couple of
times per week
At least 2-3
times per
week
More days than not and/or
multiple times per day
7
Every day
8. …did you avoid looking at or evaluating different aspects of your body?
If No… Did you experience discomfort when certain aspects of your body were exposed?
How much did this bother you? Did this avoidance or discomfort interfere with your life
over the past month?
Did you do anything to avoid seeing yourself or to avoid self evaluation or evaluation by
others?
Body avoidance may consist of ignoring reflective surfaces, refusing to look at pictures of oneself,
avoiding the scale, etc. Avoidance may also be identified by the level of discomfort present when
exposure is forced or happens by circumstance (e.g., someone brings a picture to a party, etc.).
No Impairment
0
Very Little
Impairment
A little
Impairment
1
2
Avoidance or distress
occurs but has little
impact on daily activities
Some
Impairment
3
Some
impact, but
functioning
in several
domains
A lot of
Impairment
Very Much
Impairment
4
5
Affects multiple domains
and occurs almost daily
Extreme
Impairment
6
Affects
most
aspects of
life on daily
basis
32
8
9. … have you been preoccupied with the way you look?
**Did you find yourself thinking about the way you look even when you didn’t want to?
**How often did it occur? Was it every day?
**When it did occur, how long did it last?
**How much does it bother you or interfere with things you are actively trying to do… for
example, concentrating at work or carrying on a conversation.
Preoccupation must be experienced as intrusive or unwanted thoughts about appearance or
performance and it must occur in contexts where it is not desirable or functional. For instance,
when carrying on a conversation with a friend, while concentrating on work or school, or when
trying to relax. Preoccupation does not include purposeful thought about bodily appearance or
physical performance.
No Impairment
0
Very Little
Impairment
A little
Impairment
1
2
Preoccupation occurs but
has little impact on daily
activities
Some
Impairment
3
Some
impact, but
functioning
in several
domains
A lot of
Impairment
Very Much
Impairment
4
5
Preoccupation affects
multiple domains and
occurs almost daily
Extreme
Impairment
6
Affects
most
aspects of
life on a
daily basis
9
10. …did you find yourself looking in the mirror because it felt good?
**Did you have difficulty stopping because it felt so good? Please describe.
**On how many days did this happen?
This question taps the experience of pleasure derived from one’s appearance and the experience
of pleasure leading to excess, unwanted, or uncontrolled behavior.
Never
Seldom
Occasionally
0
0-4 days
1
5-8 days
2
9-12 days
About Half Time
Sometimes
Frequently
Always
3
4
5
6
13-16 days 17-20 days 21-24 days 25-28 days
33
10
11. …How often did you impulsively buy clothing, grooming supplies, or workout gear to
enhance your appearance or improve performance?
Impulse requires a lack of consideration for the negative consequences such as costs,
ineffectiveness of the product, or lack of support for workout device. For example, someone who
describes the inability to resist purchasing the newest ab contraption.
Never
Seldom
Occasionally
About Half Time
Sometimes
Frequently
Always
0
1
1-2
times/mo
2
3-5
times/mo
3
5-10
times/mo
4
11-14
times/mo
5
15-20
times/mo
6
>20
times/mo
34
11
NUTRITIONAL SUPPLEMENTS AND
PROHORMONES
“Give me a general sense of what kinds of supplements or you have used… the ones you can
buy over-the-counter”
“Have you ever used a nutritional supplement such as protein powder, vitamins, or amino
acids?”
“Have you ever used prohormones such as androstenedione, androstenediol,
norandrostenedione, norandrostenediol, DHEA, HMB?”
“Have you ever used an over-the-counter fat burner or diet pill… how about a supplement in
increase your energy or endurance?”
What did you use _____ for?
(Get a general sense of what the supplements/prohormones were used for)
If used a Nutritional Supplement other than an OTC ergo/thermogenic.… complete items 1-11
If used a Prohormone… complete items 12-21
If used a OTC ergo/thermogenic complete items 22-33
** If No to all check box and SKIP TO “Module D”
35
1. At what age did you first take a nutritional supplement
other than a prohormone or over-the-counter fat
burner/endurance booster?
years
Who was your primary influence, if anyone, to begin using
nutritional supplements?
If there was more than one primary influence have the
participant choose which source was most influential about the
DECISION to use a nutritional supplement.
2. Coach or athletic trainer
3. Physician or medical personnel.
4. Teammate or other athlete
5. Friend or family member
6. Scout or agent
7. Advertisements
8. Celebrity (famous athlete or coach)
9. Internet advice
10. Independent or self directed?
11. Do you currently use nutritional supplements?
No
Yes
0
1
0
1
0
1
0
1
0
1
0
1
0
1
0
1
0
1
0
1
1
2
3
4
5
6
7
8
9
10
11
36
12. At what age did you first take a prohormone?
Code “-9” if never taken a prohormone.
years
Who was your primary influence, if anyone, to begin using
prohormones?
If there was more than one primary influence have the
participant choose which source was most influential about the
DECISION to use a prohormone.
13. Coach or athletic trainer
14. Physician or medical personnel.
15. Teammate or other athlete
16. Friend or family member
17. Scout or agent
18. Advertisements
19. Celebrity (famous athlete or coach)
20. Internet advice
21. Independent or self-directed
22. Do you currently use prohormones?
No
Yes
0
1
0
1
0
1
0
1
0
1
0
1
0
1
0
1
0
1
0
1
12
13
14
15
16
17
18
19
20
21
22
37
23. At what age did you first take an Over-the Counter fat
burner or endurance booster?
Code “-9” if never taken an OTC ergo/thermogenic.
years
Who was your primary influence, if anyone, to begin using
over-the-counter fat burner/endurance boosters?
If there was more than one primary influence have the
participant choose which source was most influential about the
DECISION to use an OTC ergo/thermogenic
.
24. Coach or athletic trainer
25. Physician or medical personnel.
26. Teammate or other athlete
27. Friend or family member
28. Scout or agent
29. Advertisements
30. Celebrity (famous athlete or coach)
31. Internet advice
32. Independent or self-directed
33. Do you currently use an over-the-counter fat
burner/endurance booster?
No
Yes
0
1
0
1
0
1
0
1
0
1
0
1
0
1
0
1
0
1
0
1
23
24
25
26
27
28
29
30
31
32
33
38
GENERAL INTRODUCTION TO APED MODULES
I would first like to get a general sense of your experience with using substances to
improve your appearance or alter your performance…
Have you ever used hormones such as testosterone or any other anabolic steroids?
In what pattern(s) do you these drugs?
***Do you “cycle” these drugs… if unaware of the terminology, then describe: “A prescribed
period of time in which you take steroids, other hormones, or supplements or increase the amount
of these drugs taken. This period is followed by a period of discontinuation, where you let your
body recover from the drug use.
***Do you bridge between cycles?... if unaware of the terminology, then describe: “A low
dose of testosterone or similar substance to maintain steroid effects between cycles. If the low
dose is just used constantly, it is sometimes referred to as hormone replacement.”
N/A
No
-9
0
Yes
1
1
In the following set of questions, I will refer to these substances as “APEDs” and the
pattern as an “APED cycle.” The term “cycle” includes the increase of APEDs while on a
steady low dose of testosterone or derivative). I will ask you about your experiences while
“on-cycle” as well as the period of discontinuation (or APED reduction), which I will label
“post-cycle”.
How many cycles have you completed in your life? (If less than 3, do not complete “Usual use
Module)
Cycles
2
Has your pattern of APED use changed over time? Are your cycles different than when you
first started using? (If no, skip “Usual use Module”).
….If so, how much has the types and dosages of drugs and duration of your cycles
changed since your first cycle? (If the drugs, dosages, duration are similar to first and last than
skip “Usual use Module”).
39
We’re going to start by focusing on this first time you took APEDs. [Only if starting with first
APED Use]
We’re going to focus on your most recent or current use of APEDs [Only if starting with most
recent or current APED use]
We’re going to focus on the ways you typically use APEDs [Only if starting with usual APED
Use]
40
FIRST APPEARANCE AND
PERFORMANCE ENHANCING DRUG
CYCLE
Think back to the first time you ever took an appearance and performance enhancing
substance.
Do not include creatine, protein supplements, or similar nutritive products. The APED cycle we are
targeting must have included, at some point, an illegal anabolic agent and/or an illegal fat-burner or
endurance booster.
…the following questions will be specific to the first time you cycled these substances.
1. How old were you when you started this first cycle?
Do not consider prohormones or nutritional supplements that make
claims about anabolic activity.
Who, if anyone, influenced your decision to go on this first cycle?
If there was more than one primary influence have the participant choose which source
was most influential about the DECISION to execute an APED cycle.
2. Coach or athletic trainer
3. Physician or medical personnel.
4. Teammate or other athlete
5. Friend or family member
6. Scout or agent
7. Advertisements
8. Celebrity (famous athlete or coach)
9. Internet advice
10. Independent or self directed
years
No
Yes
0
1
0
1
0
1
0
1
0
1
0
1
0
1
0
1
0
1
1
2
3
4
5
6
7
8
9
10
41
Thinking back to this first cycle, which of the following substances did
you use?
**Which of the following substances did you use during your first APED cycle? (Hand
the Interviewee the list of substances. If the interviewee cannot remember exact
information, have him/her make their best approximation or help him/her complete
calculations for dose, duration, etc.)
ASK THE FOLLOWING FOR EACH ENDORSED APED
**For how many days did you use____?
**What was your average weekly dose?
**What was the highest dose you ever took of this substance?
FILL IN THE APED # FROM THE CODE SHEET AS WELL AS THE NAME.
IF THE APED REPORTED IS NOT ON THE CODE SHEET, THEN FILL IN THE
SUBSTANCE IN THE SPACE PROVIDED, CODE “”, AND ASK THE SAME SET OF
FOLLOW-UP QUESTIONS.
42
Duration
Substance #
Dose
Max Dose
11
days
12
/wk
13
15
15
days
16
/wk
17
18
19
days
20
/wk
21
22
23
days
24
/wk
25
26
27
days
28
/wk
29
30
31
days
32
/wk
33
34
35
days
36
/wk
37
38
39
days
40
/wk
41
42
43
Days
44
/wk
45
46
47
days
48
/wk
49
50
51
days
52
/wk
53
54
55
days
56
/wk
57
58
59
days
60
/wk
61
62
63
days
64
/wk
65
66
67
days
68
/wk
69
70
43
71
days
72
/wk
73
74
75
days
76
/wk
77
78
79
days
80
/wk
81
82
83
days
84
/wk
85
86
87
days
88
/wk
89
90
91
days
92
/wk
93
94
95
days
96
/wk
97
98
99
days
100
/wk
101
102
103
days
104
/wk
105
106
107
days
108
/wk
109
110
111
days
112
/wk
113
114
115
days
116
/wk
117
118
119
days
120
/wk
121
122
123
days
124
/wk
125
126
127
days
128
/wk
129
130
131
days
132
/wk
133
134
44
135. What was the total duration of this APED cycle, not
including post-cycle drug use?
days
136. APED cycle average anabolic dose?
Calculate from data after interview.
Mg/wk
135
136
Sometimes people who take these substances will also take other drugs or substances
during their cycle or shortly after to reduce or prevent the side effects of heavy training
or certain drugs. During this first cycle, did you take any of the following ancillary
drugs? [HAND INTERVIEWEE ANCILLARY CODE SHEET]
These substances must have been taken for the purpose of managing side effects (usually
from AAS) or aspects of the training during this period (e.g., pain killers). For this question,
only consider substance use that is part of the cycle or recovery from the cycle. If, for
instance, a pain killer was taken continuously throughout the cycle and was also regularly
used outside of the cycle, consider the use only during the actual cycle or post cycle recovery
in scoring.
Ancillary Drug (Code #)
137
138
139
140
141
142
143
144
145
146
147
148
149
150
151
152
153
45
154. At the peak of this cycle, how much did your strength
increase?
Strength should be comparative to pre-cycle strength. For example,
pre-cycle bench press was 150 lbs and at peak of the cycle could
bench press 200 lbs, this would reflect a 33% increase in strength
(200-150 = 50; 50/150 = .333 = 33.3%.)
%
154
155. How much strength did you retain after post-cycle
recovery?
Strength will usually reduce post-cycle and the reduction plateaus.
Calculate total strength change, from pre-cycle to post-cycle plateau.
%
155
156. What was your lowest body fat percentage during this cycle,
if you kept track?
Ask how the interviewee obtained this information (e.g., educated
guess, body fat calipers, etc.). For those who have no idea code “-9”,
otherwise use the interviewee’s self-rating.
%
156
157. What level of body fat percentage did you maintain postcycle, if you kept track?
Must have kept approximate body fat percentage for at least one
month following on-cycle attempts at reduction. If interviewee was
unable to maintain a specific body fat, or the interviewee was unaware
of changes in body fat levels code “-9”
%
157
158. How much did you spend on your first cycle, including all of
the substances that you just described?
$
158
lbs
159
159. How much weight did you gain during your first cycle?
46
How much did you experience the following benefits during your first
APED cycle?
Use the scaling under each item to determine the extent to which the described benefit
was experienced during the course of the first cycle or as an immediate result of the
cycle. Be sure to note changes from pre-cycle functioning to establish relative change
or experience of benefits. Also ask interviewees to place their ratings in relation to later
cycles.
Increased confidence in one’s abilities?
This item should include non-appearance or
performance enhancement domains as well, but be
differentiated from appearance confidence.
None
Little
Somewhat
Very
Much
A Lot
0
1
2
3
4
160
Increased confidence in one’s appearance?
This item should include appearance domains only.
Improved relationships with others?
The extent to which social interactions with others
were experienced more positively. This should be
coded strictly from the interviewee’s perspective
and is not a rating of the appropriateness of social
behavior (e.g. aggression).
Improved sense of physical health or physical
well-being?
Only consider physical health or how well the
interviewee believed the cycle led to improved
physical health (e.g. less risk for obesity related
disease, etc.).
Reductions in negative feelings or moods such
as irritability, depression, anger, or anxiety?
Consider any reduction in pre-cycle negative affect
state.
Improved sense of accomplishment or ability to
achieve one’s goals?
Target the sense of ability to be goal-directed and
achieve those goals, including non-appearance or
performance goals.
0
1
2
3
4
0
1
2
3
4
161
162
0
1
2
3
4
163
0
1
2
3
4
164
0
1
2
3
4
165
47
Improved job-related functioning or success?
Did APEDs lead to improved status at work,
increased pay, productivity, or success?
Improved sense of control or confidence in
social situations?
Consider only interpersonal interactions that
occurred during the actual on-cycle phase and not
social changes (e.g., finding a romantic partner) that
may be attributed to the drug use, but occurred after
the cycle ended.
Reduction in lethargy, fatigue, physical
weakness, or pain?
This should not be specific to an existing injury (see
next question), but more global somatic experiences
related to possible depression, stress, or excess
physical output (e.g., intense exercise).
Improved recovery from physical injury?
The first cycle may result from pressure to recover
from sport or accident related injury (e.g., shoulder
surgery, etc.) and be intended to speed recovery or
prevent muscle wasting during recovery. Similarly,
it may be used to prevent injuries related to intense
training or contact in sport/activity (e.g., ultimate
fighting, football, etc.)
Improved performance at sport or weight
training?
This targets specific outcomes related to sports or
weight training (e.g., winning more often).
0
1
2
3
4
166
0
1
2
3
4
167
0
1
2
3
4
168
0
1
2
3
4
169
0
1
2
3
4
170
Increased success at attracting romantic
partners?
This can be in the form of flirtation or actual
relationships.
0
1
2
3
4
171
Increased libido?
Desirable increase in sex drive, interest, or
performance.
0
1
2
3
4
172
48
Increased ability to concentrate or make
decisions?
Overall ability to make decisions or concentrate
during cycle.
0
1
2
3
4
173
Greater sense of being driven or motivated?
Keep this to sense of being driven or motivated in
some physical sense, not a social sense.
0
1
2
3
4
174
During this first APED cycle, which of the following side effects did you experience while you were
actively “on-cycle”? (GIVE INTERVIEWEE THE LIST OF ON-CYCLE SIDE EFFECTS).
Take the interviewee’s report for each item and include period of time about approximately 2 weeks after
last administration. If the interviewee does not know whether they experienced this side effect (e.g.,
increased LFT) code “0.” Get a sense for each side effect the amount or frequency of each endorsed
item. Follow-up each scalable endorsed item with:
***How much did this side effect bother you?”
***How often did this side effect occur?”
Based on the answers to these questions, scale each side effect on a severity continuum using the
anchors listed below. If the level of severity is unclear, code based on evidence of functional impairment
over evidence of frequency, particularly for side effects that may be severe but only occur once or twice.
For items that usually just occur just once or may exist but require medical examination to detect, simply
code as “absent = 0” or “present = 1”
0
1
2
3
4
Not Severe
Somewhat Severe
Moderately Severe
Very Severe
Extremely Severe
Side effect not
experienced
Evidence that the side
Some evidence that the side effect occurred effect occurred regularly
and was minimally impairing and occurred and/or was notably
infrequently.
impairing when it did
occur.
Evidence that the side
effect occurred often
and was functionally
impairing when it
occurred.
Evidence that the side effect was
persistent and impairing
49
Physical Side Effects
Water retention?
0
1
2
3
4
Headaches?
0
1
2
3
4
Nosebleeds?
0
1
2
3
4
0
1
2
3
Can’t stop moving or
excessive energy?
0
0
1
1
2
2
3
3
2
3
4
Diarrhea?
0
1
2
3
4
Joint pain?
0
1
2
3
4
Digestive trouble such as
indigestion or excessive
gas?
0
1
2
3
4
0
1
2
3
4
Nausea or vomiting?
0
1
2
3
4
0
1
2
3
4
Flu-like symptoms?
0
1
2
3
4
0
1
2
3
4
Heart palpitations?
0
1
2
3
4
Heart skips a beat?
Heat intolerance?
Night sweats?
0
0
0
1
1
1
2
2
2
3
3
3
0
1
2
3
4
195
180
No
0
0
Yes
1
1
2
196
3
0
1
2
3
0
1
2
3
0
1
2
3
186
0
1
2
3
4
0
1
2
3
4
0
1
203
0
1
204
0
1
0
1
206
207
Medical Consequences?
188
Verified by medical test or evaluation
Increased blood
Pressure
0
189
0
190
Increased liver
function test
Polycystic Ovarian
Syndrome
0
191
Elevated cholesterol
0
4
4
4
1
208
1
209
1
210
1
192
Trouble falling or staying
asleep?
0
1
2
3
4
200
Administrative-Related Side Effects?
Allergic or bad
reaction to injection
or substance
consumed
Scarring from
injections
Extreme pain or
swelling at injection
site
4
199
183
Abscess at injection
site
4
198
182
181
4
197
Difficulty getting an
orgasm?
Infertility or
amenorrhea
187
Dehydration?
Painful prostate?
Decrease in sex
drive?
185
Muscle cramps or
spasms?
1
9
4
179
184
Fatigue easily?
4
Excessive sex drive
Must be unwanted or
undesirable
Difficulty getting an
erection or becoming
aroused?
Testicular shrinkage
or clitoral
Enlargement?
4
1
3
Sexual Side Effects?
4
0
2
176
4
Stomach pain?
1
175
178
Excessive sweating?
0
Muscle or tendon
tear?
177
Tremors or shakiness?
Sleeping too much?
211
Enlarged prostate
4
0
1
193
212
50
201
202
Heart condition?
0
1
213
Affective or Mood related Side Effects?
Increased depression?
0
1
2
3
Difficulty making
decisions?
0
Difficulty
remembering things?
0
1
2
3
4
222
1
2
3
4
223
Unwanted Changes in Appearance?
4
214
Increased number of
mood swings?
0
1
2
3
4
Panic attacks?
0
1
2
3
4
215
216
Increased irritability?
0
1
2
3
4
Lower frustration
tolerance?
0
1
2
3
4
Increased aggression?
0
1
2
3
4
217
218
219
Cognitive Side Effects?
Difficulty focusing or
concentrating?
Thoughts are racing or
moving too quickly?
Any other side effects:
0
1
2
3
4
0
1
2
3
4
220
221
Acne?
0
Intestinal growth?
0
1
225
Bone growth?
0
1
226
Increased hair growth
(body or face)?
Hair loss or
baldness?
Flushed face?
Gynecomastia or
“gyno”? Male only
Loss of breast
tissue? Female only
Change in facial
features?
1
224
0
1
2
3
4
0
1
2
3
4
0
1
2
3
4
0
1
0
1
0
1
230
231
232
233
51
227
228
229
During this first APED cycle, which of the following side effects did you experience after finishing
your cycle or were “off-cycle”? (GIVE INTERVIEWEE LIST OF POST-CYCLE SIDE EFFECTS)
Take the interviewee’s report for each item. If the interviewee does not know whether they experienced
this side effect (e.g., increased LFT) code “-9.” Get a sense for each side effect the amount or frequency of
each endorsed item. Follow-up each scalable endorsed item with:
***How much did this side effect bother you?”
***How much of the time did this side effect occur?”
Based on the answers to these questions, scale each side effect on a severity continuum using the
anchors listed below. If the level of severity is unclear, code based on evidence of functional impairment
over evidence of frequency, particularly for side effects that may be severe but only occur once or twice.
For items that usually just occur just once or may exist but require medical examination to detect, simply
code as “absent = 0” or “present = 1”
0
1
2
4
5
Not Severe
Somewhat Severe
Moderately Severe
Very Severe
Extremely Severe
Side effect not
experienced
Evidence that the side
Some evidence that the side effect occurred effect occurred regularly
and was minimally impairing and occurred and/or was notably
infrequently.
impairing when it did
occur.
Affective or Mood Related Side Effects?
Increased Anxiety, Worry, or Fear?
Increased Depression?
1
2
3
4
0
1
2
3
4
234
235
Increased number of Mood Swings?
1
2
3
4
234
Panic attacks?
Increased Irritability?
Lower frustration tolerance?
Increased Aggression?
Evidence that the side effect was
persistent and impairing
Other Side Effects
0
0
Evidence that the side
effect occurred often
and was functionally
impairing when it
occurred.
0
1
2
3
4
0
1
2
3
4
0
1
2
3
4
0
1
2
3
4
236
237
Trouble falling or
staying asleep?
0
1
2
3
4
Sleeping too much?
0
1
2
3
4
0
1
2
3
4
Difficulty
Concentrating or
Focusing?
Decrease in Sex
Drive?
Suicidal Thoughts?
240
241
242
0
1
0
2
3
4
1
243
244
Any other side effects?
238
239
245
52
244. During this APED cycle, at any point did you seek the help of a health
professional to manage the side effects or consequences of your use?
This item includes non-MD professionals including counselors, nurses, nursepractitioner, etc.
No
Yes
0
1
246
245. What about the help of a non-professional?
Trainers, coaches, or experienced users would qualify as non-professionals. Consider
friends or acquaintances that may have a medical degree, but were not providing
consultation in a professional context would be a “yes” for this question. This includes
internet discussion board posts.
246. What about the internet?
Consider only published information. If questions were posted and answered by other
users through a discussion board, code “0”. Consider only information already
published on a website for this item.
0
1
247
0
1
248
247. What about print materials such as medical journals or books such as
steroid bibles?
This item targets the use of “steroid bibles” and others sources that provide information
relevant to APED cycle and managing side effects.
0
1
249
What was the primary reason you decided to go on this first APED cycle?
Identify only the primary reason for initial use. Code based on interviewee response. Provide
examples from the list if the interviewee can’t remember.
No
Yes
To treat injury or illness?
0
1
To prevent injury, illness, or promote overall health and well
being?
0
1
To improve athletic or job related performance?
0
1
To improve physical appearance or increase level of
attractiveness?
0
1
To intimidate or fight better?
0
1
To improve feelings about oneself?
0
1
250
251
252
253
254
255
53
Other (Specify):
0
1
256
255. During your first cycle, how satisfied with the effects of these substances were you?
Try to keep the satisfaction rating specific to effects the interviewee attributes to the drugs
themselves and not the effects of diet or training during the cycle.
Not at All
Satisfied
A little
Satisfied
Somewhat
Satisfied
Moderately
Satisfied
Notably
Satisfied
Very Satisfied
Extremely
Satisfied
0
1
2
3
4
5
6
257
54
CURRENT OR MOST RECENT
APPEARANCE AND PERFORMANCE
ENHANCING DRUG CYCLE
We will focus now on your current APED cycle or the most recent APED cycle you have
completed.
Do not include creatine, protein supplements, or similar nutritive products. The APED cycle we are
targeting must have included, at some point, an illegal anabolic agent and/or an illegal fat-burner or
endurance booster.
No
Yes
0
1
1. Are you currently on-cycle?
The interviewee must have recently taken an APED and plan on taking an
APED sometime after this interview to be considered on-cycle. If the
interviewee has recently (within 2 weeks) taken their last APED and is
entering the post-cycle phase of their pattern, do NOT code “1”.
2. When did you start this most recent/current cycle?
1
Mo
Day
Yr
Mo
Day
Yr
Mo
Day
Yr
Do not consider prohormones or nutritional supplements that make claims
about anabolic activity.
3. When did this most recent cycle end? Are you bridging?
2
Consider the end of the cycle as when the last dose of an illicit APED was
taken. If the interviewee is currently “bridging” and considers his/her cycle
over but continues to take APEDs (e.g., low dose of testosterone) use the
interviewee’s identification of the last day of the cycle.
3
4. When do you expect your current cycle to end? [Only if on-cycle]
For those currently “on cycle”, record the day they plan on finishing their
current cycle. Do not include “bridging” in the cycle definition. If there is no
planned finish date or it is unknown, code “-9” for Month, Day, and Year.
4
55
Who, if anyone, influenced your decision to go on this current/most
recent cycle?
If there was more than one primary influence have the participant choose
which source was most influential about the DECISION to execute an
APED cycle.
5. Coach or athletic trainer
6. Physician or medical personnel.
7. Teammate or other athlete
8. Friend or family member
9. Scout or agent
10. Advertisements
11. Celebrity (famous athlete or coach)
12. Internet advice
13. Independent or self-directed
No
Yes
0
1
0
1
0
1
0
1
0
1
0
1
0
1
0
1
0
1
5
6
7
8
9
10
11
12
13
Thinking back to this current/most recent cycle, which of the following
substances did you use? (Hand the Interviewee the list of substances. If the
interviewee cannot remember exact information, have him/her make their best
approximation or help him/her complete calculations for dose, duration, etc.)
ASK THE FOLLOWING FOR EACH ENDORSED APED
**For how many days did you use____?
**What was your average weekly dose?
**What was the highest dose of this substance that you used during this cycle?
FOR APEDS THAT ARE NOT USED CODE “-9”
IF THE APED REPORTED IS NOT ON THE LIST HAVE THE INTERVIEWEE FILL
IN THE SUBSTANCE IN THE “OTHER” BOX AND ASK THE SAME SET OF
FOLLOW-UP QUESTIONS.
56
Substance (Code #)
Duration
Dose
Max Dose
14
days
15
/wk
16
17
18
days
19
/wk
20
21
22
days
23
/wk
24
25
26
days
27
/wk
28
29
30
days
31
/wk
32
33
34
days
35
/wk
36
37
38
days
39
/wk
40
41
42
days
43
/wk
44
45
46
Days
47
/wk
48
49
50
days
51
/wk
52
53
54
days
55
/wk
56
57
58
days
59
/wk
60
61
62
days
63
/wk
64
65
66
days
67
/wk
68
69
70
days
71
/wk
72
73
57
74
days
75
/wk
76
77
78
days
79
/wk
80
81
82
days
83
/wk
84
85
86
days
87
/wk
88
89
90
days
91
/wk
92
93
94
days
95
/wk
96
97
98
days
99
/wk
100
101
102
days
103
/wk
104
105
106
days
107
/wk
108
109
110
days
111
/wk
112
113
114
days
115
/wk
116
117
118
days
119
/wk
120
121
122
days
123
/wk
124
125
126
days
127
/wk
128
129
130
days
131
/wk
132
133
134
days
135
/wk
136
137
58
138. What was the total duration of this APED cycle, not including
post-cycle drug use?
days
138
139. APED cycle average anabolic dose?
Mg/wk
139
Sometimes people who take these substances will also take other drugs or substances
during their cycle or shortly after to reduce or prevent the side effects of heavy training or
certain drugs. During this cycle, did you take any of the following ancillary drugs? [HAND
INTERVIEWEE ANCILLARY CODE SHEET]
These substances must have been taken for the purpose of managing side effects (usually from
AAS) or aspects of the training during this period (e.g., pain killers). For this question, only consider
substance use that is part of the cycle or recovery from the cycle. If, for instance, a pain killer was
taken continuously throughout the cycle and was also regularly used outside of the cycle, consider
the use only during the actual cycle or post cycle recovery in scoring.
Ancillary (Code #)
140
141
142
143
144
145
146
147
148
150
150
151
152
153
154
155
156
59
157. At the peak of this cycle, how much did your strength
increase?
Strength should be comparative to pre-cycle strength. For example,
pre-cycle bench press was 150 lbs and at peak of the cycle could
bench press 200 lbs, this would reflect a 33% increase in strength
(200-150 = 50; 50/150 = .333 = 33.3%.) If the cycle is active, get
rating of current strength increase.
%
157
158. How much strength did you retain after post-cycle
recovery?
Strength will usually reduce post-cycle and the reduction plateaus.
Calculate total strength change, from pre-cycle to post-cycle plateau.
Code ‘-9’ if cycle is still active.
%
158
159. What was your lowest body fat percentage during this
cycle?
Ask how the interviewee obtained this information (e.g., educated
guess, body fat calipers, etc.). For those who have no idea code “-9”,
otherwise use the interviewee’s self-rating. Code current body fat if
lowest since cycle started.
%
159
160. What level of body fat percentage did you maintain postcycle?
Must have kept approximate body fat percentage for at least one
month following on-cycle attempts at reduction. If interviewee was
unable to maintain a specific body fat, the interviewee was unaware of
changes in body fat levels, or is still “on-cycle” code “-9”
%
160
161. How much did you spend on the substances we just
described?
$
161
lbs
162
162. How much weight did you gain?
60
To what degree did you experience the following benefits during this
current/most recent cycle?
Use the scaling under each item to determine the extent to which the described benefit was
experienced during the course of the cycle or as an immediate result of the cycle? Be sure to note
changes from pre-cycle functioning to establish relative change or experience of benefits.
Increased confidence in one’s abilities?
This item should include non-appearance or
performance enhancement domains as well, but be
differentiated from appearance confidence.
None
Little
Somewhat
Very
Much
A Lot
0
1
2
3
4
163
Increased confidence in one’s appearance?
This item should include appearance domains only.
Improved relationships with others?
The extent to which social interactions with others
were experienced more positively. This should be
coded strictly from the interviewee’s perspective
and is not a rating of the appropriateness of social
behavior (e.g. aggression).
Improved sense of physical health or physical
well-being?
Only consider physical health or how well the
interviewee believed the cycle led to improved
physical health (e.g., less risk for obesity related
disease, etc.).
Reductions in negative feelings or moods such
as irritability, depression, anger, or anxiety?
Consider any reduction in pre-cycle negative affect
state.
Improved sense of accomplishment or ability to
achieve one’s goals?
Target the sense of ability to be goal-directed and
achieve those goals, including non-appearance or
performance goals.
0
1
2
3
4
0
1
2
3
4
164
165
0
1
2
3
4
166
0
1
2
3
4
167
0
1
2
3
4
168
61
Improved job-related functioning or success?
Did APEDs lead to improved status at work,
increased pay, productivity, or success?
Improved sense of control or confidence in
social situations?
Consider only interpersonal interactions that
occurred during the actual on-cycle phase and not
social changes (e.g., finding a romantic partner) that
may be attributed to the drug use, but occurred after
the cycle ended.
Reduction in fatigue, physical weakness, or
pain?
This should not be specific to an existing injury (see
next question), but more global somatic experiences
related to possible depression, stress, or excess
physical output (e.g., intense exercise).
Improved recovery from physical injury?
The first cycle may result from pressure to recover
from sport or accident related injury (e.g., shoulder
surgery, etc.) and be intended to speed recovery or
prevent muscle wasting during recovery. Similarly,
it may be used to prevent injuries related to intense
training or contact in sport/activity (e.g., ultimate
fighting, football, etc.)
Improved performance at sport or weight
training?
This targets specific outcomes related to sports or
weight training (e.g., winning more often).
0
1
2
3
4
169
0
1
2
3
4
170
0
1
2
3
4
171
0
1
2
3
4
172
0
1
2
3
4
173
Increased success at attracting romantic
partners?
This can be in the form of flirtation or actual
relationships.
0
1
2
3
4
174
62
Increased libido?
Desirable increase in sex drive, interest, or
performance.
0
1
2
3
4
175
Increased ability to concentrate or make
decisions?
Overall ability to make decisions or concentrate
during cycle.
0
1
2
3
4
176
Greater sense of being driven or motivated?
Keep this to sense of being driven or motivated in
some physical sense, not a social sense.
0
1
2
3
4
177
During this current/most recent APED cycle, which of the following side effects did you experience
while you were actively “on-cycle”? [GIVE INTERVIEWEE THE LIST OF ON-CYCLE SIDE EFFECTS].
Take the interviewee’s report for each item and include period of time about approximately 2 weeks after
last administration. If the interviewee does not know whether they experienced this side effect (e.g.,
increased LFT) code “0.” Get a sense for each side effect the amount or frequency of each endorsed
item. Follow-up each scalable endorsed item with:
***How much did this side effect bother you?”
***How much of the time did this side effect occur?”
Based on the answers to these questions, scale each side effect on a severity continuum using the
anchors listed below. If the level of severity is unclear, code based on evidence of functional impairment
over evidence of frequency, particularly for side effects that may be severe but only occur once or twice.
For items that usually just occur just once or may exist but require medical examination to detect, simply
code as “absent = 0” or “present = 1”
0
1
2
4
5
Not Severe
Somewhat Severe
Moderately Severe
Very Severe
Extremely Severe
Side effect not
experienced
Evidence that the side
Some evidence that the side effect occurred effect occurred regularly
and was minimally impairing and occurred and/or was notably
infrequently.
impairing when it did
occur.
Evidence that the side
effect occurred often
and was functionally
impairing when it
occurred.
Evidence that the side effect was
persistent and impairing
63
Physical Side Effects
Water retention?
0
1
2
3
4
Headaches?
0
1
2
3
4
Nosebleeds?
0
1
2
3
4
0
1
2
3
Can’t stop moving or
excessive energy?
0
0
1
1
2
2
3
3
2
3
4
Diarrhea?
0
1
2
3
4
Joint pain?
0
1
2
3
4
Digestive trouble such as
indigestion or excessive
gas?
0
1
2
3
4
Fatigue easily?
0
1
2
3
4
Nausea or vomiting?
0
1
2
3
4
1
2
3
4
Flu-like symptoms?
0
1
2
3
4
0
1
2
3
4
Heart palpitations?
0
1
2
3
4
Heart skips a beat?
Heat intolerance?
Night sweats?
0
0
0
1
1
1
2
2
2
3
3
3
0
1
2
3
4
198
183
No
0
0
Yes
1
1
2
199
3
0
1
2
3
0
1
2
3
0
1
2
3
189
0
1
2
3
4
0
1
2
3
4
0
1
206
0
1
207
0
1
0
1
208
209
Medical Consequences?
191
Verified by medical test or evaluation
Increased blood
Pressure
0
192
0
193
Increased liver
function test
0
194
Polycystic Ovarian
Syndrome
Elevated cholesterol
0
4
4
4
1
210
1
211
1
212
1
195
Trouble falling or staying
asleep?
0
1
2
3
4
203
Administrative-Related Side Effects?
Allergic or bad
reaction to injection
or substance
consumed
Scarring from
injections
Extreme pain or
swelling at injection
site
4
202
186
Abscess at injection
site
4
201
185
184
4
200
Difficulty getting an
orgasm?
Infertility or
amenorrhea
190
Dehydration?
Painful prostate?
Decrease in sex
drive?
188
0
1
9
7
182
187
Muscle cramps or
spasms?
4
Excessive sex drive
Must be unwanted or
undesirable
Difficulty getting an
erection or becoming
aroused?
Testicular shrinkage
or clitoral
Enlargement?
4
1
3
Sexual Side Effects?
4
0
2
179
4
Stomach pain?
1
178
181
Excessive sweating?
0
Muscle or tendon
tear?
180
Tremors or shakiness?
Sleeping too much?
213
Enlarged prostate
4
0
1
196
214
64
204
205
Heart condition?
0
1
215
Affective or Mood related Side Effects?
Increased depression?
0
1
2
3
Difficulty making
decisions?
0
Difficulty
remembering things?
0
1
2
3
4
224
1
2
3
4
225
Unwanted Changes in Appearance?
4
216
Increased number of
mood swings?
0
1
2
3
4
Panic attacks?
0
1
2
3
4
217
218
Increased irritability?
0
1
2
3
4
Lower frustration
tolerance?
0
1
2
3
4
Increased aggression?
0
1
2
3
4
219
220
221
Cognitive Side Effects?
Difficulty focusing or
concentrating?
Thoughts are racing or
moving too quickly?
Any other side effects:
0
1
2
3
4
0
1
2
3
4
222
223
Acne?
0
Intestinal growth?
0
1
227
Bone growth?
0
1
228
Increased hair growth
(body or face)?
Hair loss or
baldness?
Flushed face?
Gynecomastia or
“gyno”? Male only
Loss of breast
tissue? Female only
Change in facial
features?
1
226
0
1
2
3
4
0
1
2
3
4
0
1
2
3
4
0
1
0
1
0
1
232
233
234
235
65
229
230
231
During this current/most recent APED cycle, which of the following side effects did you experience
after finishing your cycle or were “off-cycle”? [GIVE INTERVIEWEE LIST OF POST-CYCLE SIDE
EFFECTS]
Take the interviewee’s report for each item. If the interviewee does not know whether they experienced
this side effect (e.g., increased LFT) code “0.” Get a sense for each side effect the amount or frequency of
each endorsed item. Follow-up each scalable endorsed item with:
***How much did this side effect bother you?”
***How much of the time did this side effect occur?”
Based on the answers to these questions, scale each side effect on a severity continuum using the
anchors listed below. If the level of severity is unclear, code based on evidence of functional impairment
over evidence of frequency, particularly for side effects that may be severe but only occur once or twice.
For items that usually just occur just once or may exist but require medical examination to detect, simply
code as “absent = 0” or “present = 1”
0
1
2
4
5
Not Severe
Somewhat Severe
Moderately Severe
Very Severe
Extremely Severe
Side effect not
experienced
Evidence that the side
Some evidence that the side effect occurred effect occurred regularly
and was minimally impairing and occurred and/or was notably
infrequently.
impairing when it did
occur.
Affective or Mood Related Side Effects?
Increased Anxiety, Worry, or Fear?
Increased Depression?
1
2
3
4
0
1
2
3
4
236
237
Increased number of Mood Swings?
1
2
3
4
238
Panic attacks?
Increased Irritability?
Lower frustration tolerance?
Increased Aggression?
Evidence that the side effect was
persistent and impairing
Other Side Effects
0
0
Evidence that the side
effect occurred often
and was functionally
impairing when it
occurred.
0
1
2
3
4
0
1
2
3
4
0
1
2
3
4
0
1
2
3
4
239
240
Trouble falling or
staying asleep?
0
1
2
3
4
Sleeping too much?
0
1
2
3
4
0
1
2
3
4
Difficulty
Concentrating or
Focusing?
Decrease in Sex
Drive?
Suicidal Thoughts?
243
244
245
0
1
0
2
3
1
4
246
7
247
Any other side effects?
241
242
248
66
246. During this current/most recent APED cycle, at any point did you seek the
help of a health professional to manage the side effects or consequences of your
use?
This item includes non-MD professionals including counselors, nurses, nursepractitioner, etc.
No
Yes
0
1
249
247. What about a non-professional?
Trainers, coaches, or experienced users would qualify as non-professionals. Consider
friends or acquaintances that may have a medical degree, but were not providing
consultation in a professional context would be a “yes” for this question. This includes
internet discussion board posts.
0
1
250
248. What about the internet?
Consider only published information. If questions were posted and answered by other
users through a discussion board, code “0”. Consider only informational already
published on a website for this item.
0
1
251
249. What about print materials such as medical journals, or books such as
“steroid bibles”?
This item targets the use of “steroid bibles” and others sources that provide information
relevant to APED cycle and managing side effects.
0
1
252
67
What was the primary reason you decided to go on this APED cycle?
Identify only the primary reason for initial use. Code based on interviewee response. Provide
examples from the list if the interviewee can’t remember.
No
Yes
To treat injury or illness?
0
1
To prevent injury, illness, or promote overall health and well
being?
0
1
To improve athletic or job related performance?
0
1
To improve physical appearance or increase level of
attractiveness?
0
1
To intimidate or fight better?
0
1
To improve feelings about oneself?
0
1
Other (Specify):
0
1
253
254
255
256
257
258
259
257. During current/most recent cycle, how satisfied with the effects of these substances
were you?
Try to keep the satisfaction rating specific to effects the interviewee attributes to the drugs
themselves and not the effects of diet or training during the cycle.
Not at All
Satisfied
A little
Satisfied
Somewhat
Satisfied
Moderately
Satisfied
Notably
Satisfied
Very Satisfied
Extremely
Satisfied
0
1
2
3
4
5
6
260
68
USUAL APED USE CYCLE
Only enter this section for someone who has completed at least 3 APED cycles.
We will focus now on your usual pattern of APED use and attempt to get a general sense of
your experience with APEDS.
Do not include creatine, protein supplements, or similar nutritive products. The APED cycle we are
targeting must have included, at some point, an illegal anabolic agent and/or an illegal fat-burner or
endurance booster.
1. How many APED cycles have you completed?
Do not consider prohormones or nutritional supplements that make
claims about anabolic activity.
2. What was the average duration between cycles?
Consider the end of the cycle as when the last dose of an illicit APED
was taken. If the interviewee has a history of “bridging” between cycles,
consider the duration between actual cycles
Who, if anyone, typically influences your decision to go on-cycle?
If there was more than one primary influence have the participant choose which source
was most influential about the DECISION to execute an APED cycle.
3. Coach or athletic trainer
4. Physician or medical personnel.
5. Teammate or other athlete
6. Friend or family member
7. Scout or agent
8. Advertisements
9. Celebrity (famous athlete or coach)
10. Internet advice
11. Independent or self-directed
cycles
1
wks
2
No
Yes
0
1
0
1
0
1
0
1
0
1
0
1
0
1
0
1
0
1
3
4
5
6
7
8
9
10
11
69
Thinking back across all of your cycles, which of the following
substances have you used? (Hand the Interviewee the list of substances. If the
interviewee cannot remember exact information, have him/her make their best
approximation as to the substances used. If the list of substances used across all cycles is
particularly long, it may be more helpful to have them just list the assigned number on the
list).
FOR APEDS THAT ARE NOT USED CODE “-9”
IF THE APED REPORTED IS NOT ON THE LIST, WRITE THE SUBSTANCE IN
THE “OTHER” BOX AND ASK THE SAME SET OF FOLLOW-UP QUESTIONS.
70
Substance (Code #) cont
Substance (Code #)
Substance (Code #) cont
1
16
31
2
17
32
3
18
33
4
19
34
5
20
35
6
21
36
7
22
37
8
23
38
9
24
39
10
25
40
11
26
41
12
27
42
13
28
43
14
29
44
15
30
45
71
Sometimes people who take these substances will also take other drugs or substances
during their cycle or shortly after to reduce or prevent the side effects of heavy training or
certain drugs. Which of these substances do you typically use? [HAND INTERVIEWEE
ANCILLARY CODE SHEET]
These substances must have been taken for the purpose of managing side effects (usually from
AAS) or aspects of the training during this period (e.g., pain killers). For this question, only consider
substance use that is part of the cycle or recovery from the cycle. If, for instance, a pain killer was
taken continuously throughout the cycle and was also regularly used outside of the cycle, consider
the use only during the actual cycle or post cycle recovery in scoring.
Ancillary (Code #)
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
72
Social APED Context
The following questions will pertain to your general experience as an APED user and the
degree to which your APED use is connected to a community or culture of APED use.
1. How often do you discuss APED use with people you know well?
This questions targets people who are known by the individual and who he/she may spend time
with outside of drug use (e.g., friends, family members, etc.)
Never
0
Never
Seldom
1
~1x/mo
Sometimes
2
~1x/wk
Frequently
3
~several
times/wk
Always
4
daily
1
2. How often do you discuss APED use with people you only know through the internet or
through your APED use?
This questions targets contact with people who are anonymous or not known well but may share
knowledge, expertise, or common experiences with regard to training, dietary practices, or drug
use.
Never
0
Never
Seldom
1
~1x/mo
Sometimes
2
~1x/wk
Frequently
3
~several
times/wk
Always
4
daily
2
3. How much does your APED use conform to that of others you know who use APEDs?
Consider how much the pattern, types, dose/amt of APEDs is similar to others that they know
who use APEDs. Keep in mind this may be because others follow his/her lead or because
he/she is following the lead of someone else.
Not at all
0
Very little
1
Somewhat
2
Very much
3
Completely
4
73
3
4. How often do you give advice or provide counsel to other APED users regarding their
use patterns, maximizing the effects of a cycle, or managing side effects?
This question targets the degree to which the interviewee is an expert in his/her use and one who
shares this knowledge with others. Consider only the amount of time spent in this mentorship
like role and consider this role both through anonymous contact over the internet as well as in
person contact.
Never
0
No evidence of
providing info to
others about use
Seldom
1
Sometimes
2
Frequently
3
Will on occasion
provide guidance or
information, but
usually avoids these
situations.
Will provide
information on at
least a weekly basis
to others.
Clear mentorship
like roles in APED
use, with frequent
advice or direction
to others.
Always
4
4
Provides
mentorship to a
large number of
users or is directly
advising or
coaching an APED
user in every aspect
of APED use.
5. How often do you share your supply or help others source APEDs?
This question targets the interviewee’s role as a gateway to others’ APED use. Any evidence of
having helped others obtain APEDs or of sharing APEDs of others code > 0.
Never
0
Never
Seldom
1
~1x/mo
Sometimes
2
~1x/wk
Frequently
3
~several
times/wk
Always
4
daily
5
6. How many people do you know who use APEDs?
Report only those people who the interviewee knows well.
6
7. How do you source your APEDs?
.
Friend/
Internet
Source/
Family
Dealer
0
1
2
Prescription
Vet Supply
3
4
Legal
Source
5
74
7
RISK AND FUTURE USE
The following questions will pertain to your intentions for future APED use as well as
circumstances where you are likely to stop or continue to use APEDs.
1. If you were given indisputable evidence that APED use leads to severe long term
consequences, what is the likelihood that you would continue to use APEDs?
Not at all Likely
0
Unlikely
1
Ambivalent
2
Probably
3
Absolutely
4
1
2. In order to reach your training, appearance, or performance
related goals, how many years of your life would you sacrifice?
years
2
3. For how long do you plan on continuing to use APEDs?
Calculate based on interviewee’s best estimate.
Never again
<5 more years
5-10 years
0
1
2
>10 years, but
not forever
3
4. If you drink alcohol, which is more important to you, or which
would you preserve, if you could only preserve one?... APED
use or drinking?
For the rest of
my life
4
N/A
APED
Alcohol
-9
0
1
Code “-9” if individual does not drink or does not plan on ever using
APEDs again.
3
4
75
N/A
APED
Other
Drugs
-9
0
1
5. If you use recreational drugs, which is more important to you,
or which would you preserve, if you could only preserve one?...
APED use or Other Drug Use?
Code “-9” if individual does use other drugs or does not plan on ever
using APEDs again.
5
N/A
No
Yes
-9
0
1
6. Have you ever gotten in trouble with the law for your APED
use?
Code “-9” if individual has only used APEDs in a legal context (e.g. in
a country where these drugs are purchased legally).
6
N/A
No
Yes
-9
0
1
7. Would getting in trouble with the law deter your future use of
APEDs?
Code “-9” if individual does use other drugs or does not plan on ever
using APEDs again.
8. Have you ever used any “underground gear” or homemade
APEDs?
7
N/A
No
Yes
-9
0
1
Code “-9” if the interviewee is unsure.
9. Have you ever gotten in trouble with your spouse or partner
because of your APED use?
8
N/A
No
Yes
-9
0
1
Code “-9” if individual has never had a spouse or partner..
9
N/A
No
Yes
-9
0
1
10. Would getting in trouble with your spouse or partner deter
your future APEDs?
Code “-9” if individual does use other drugs or does not plan on ever
using APEDs again.
11. Have you ever gotten in trouble at work or school because of
your APED use?
10
-9
0
1
Code “-9” if individual is not engaged in work or school.
11
76
N/A
No
Yes
-9
0
1
12. Would getting in trouble at work or school deter your future
use of APEDs?
Code “-9” if individual does use other drugs or does not plan on ever
using APEDs again.
12
N/A
No
Yes
-9
0
1
13. Have you ever used a masking agent or scheduled your
APED doses to evade a drug testing program?
Code “-9” if individual has not ever been in a circumstance where drug
testing was possible.
13
N/A
No
Yes
-9
0
1
14. Do you think that APEDs should be legalized?
Code “-9” if individual has not ever been in a circumstance where drug
testing was possible.
14
N/A
No
Yes
15. What is the youngest age at which an athlete should
consider using APEDs?
Code “-9” if individual believes that there should be no age restriction
at all.
Years
77
15
Steroidal Anabolics
Code #
1
2
3
Primary Trade/Street Name(s)
Anadrol (oral)
Anatrofin
Anavar
Generic Names
Oxymetholone
Stenbolone acetate
Oxandrolone
4
5
Andractim, “DHT”
Andriol
Dihydrotestosterone
Testosterone undecanoate
6
Androderm (patch)
Testosterone
7
8
9
Androgel (gel)
Cheque drops
Deca-Durabolin, “Deca”
Testosterone
Mibolerone
Nandralone decanoate
10
Dianabol, “D-bol”
Methandrostenolone
11
Diandrol
Nandralone deconate + nandrolone
phenylpropionate
Trade Names
Anadrol-50
Anatrofin
Anatrophill, Anavar, Bonavar, Kicker Tab,
Lipidex, Lonavar, Oxafort, Oxanabol,
Oxandrin, Oxandro tabs, Oxandro 10,
Oxandrolone SPA, Oxandrovet, Oxavet QV
Andractim
Andriol, Androxon, Nuvir, Panteston,
Restandol, Sustenan Oral, Undestor, Virigen
Androderm, Andropatch, Atmos, Testoderm,
Testum
Androgel, Androtop Gel, Testogel
Mibolerone, Mibolerone drops, Cheque drops
Anabolicum, Anabolin Forte, Anaboline
Depot, Anaprolina, Androlone-D 200,
Canoate inj, Deca 300, Deca QV 200 or 300,
Decabol, Deca-Dubol-100, Deca-Durabolin,
Deca-Evabolin, Decagic, Decanadrolen,
Decandrol 300, Decaneurabol,
Decaneurophen, Decanofort, Decatron 250,
Dimetabol, Dynabolon, Elpihormon,
Extraboline, Gerabolin, Hybolin Decanoate,
Jebolan, Metadec, Myobolin, Nandraboli
L.A., Nandralone 300 L.A., Nadrosande,
Neo-Durabolic, Norandren, Nurezan,
Retabolil, Retabolin, RWR Deca 50,
Sterobolin, Ziremilon
D-Bol, Dialone, Dianabol, Encephan,
Genabol, Melic, Metaboline, Metanabol,
Mentadienon, Metandiol 60, Mentandrol 10,
Metandrostenolon, Methan Tabs, Methanabol,
Methandienone, Methandon, Naposim, NeoAnabolene, Nerobol, Pronabol-5, Reforvit,
Restauvit, Stenolon, Trinergic
Diandrol
78
12
13
Drive
Durabolin
boldenone + methylandrostenediol
Nandralone phenylpropionate
14
15
Dynabolon
Equilon 100
16
Equipoise “EQ”
Nandralone undecanoate
Boldenone Acetate + Boldenone
Proprionate + Boldenone Undecylenate +
Boldenone Cypionate
Boldenone Undecylenate
17
Equitest 200
18
19
20
Esiclene
Norbolethone
Halotestin
21
22
23
Hydrotestosterone
Laurabolin
Libriol
24
Masteron
Testosterone Acetate + Testosterone
Proprionate + Testosterone
Phenylpropionate + Testosterone Caproate
+ Testosterone enanthate + Testosterone
cypionate + testosterone decanoate
Formebolone
Norbolethone
Fluoxymesterone
Drive
Actovin, Anabolin, Andralone, Daily Reborn,
Dubol-50 100, Durabol, Equibolin-50,
Estigor, Evabolin, Fenobolin, Fherbolico,
Ganekyl, Hybolin, Macrabone, Menablin,
Metabol, Metrobolin, Nandrobolic,
Nandrolin, Nerobolil, Neurabol, Neurophen,
Norabon, Nu-Bolic, Protosin, Rubolin,
Sinbolin, Superanabolon, Turinabol
Dynabolon, Psychobolan
Equilon 100
Ana-Bolde, Anabolic-BD, Bold 200, Bold
QV 200, Boldabol, Boldabol, Boldabol-H,
Boldenol 25, Boldenol R, Boldenon,
Boldenona, Boldenona 50, Boldenone-50,
Cebulin 50, Crecibol, Dynabolin 50, Equifort,
Equi-gan, Equipoise, Ex-pois, Ganabol,
Legacy, Maxigan, Mitgan 50, Porkybol 1%,
Sybolin, Ultragan, Vebonol
Equitest 200
Esiclene, Hubernol
No Commercial Production
Android-F, Baojen, Chinglicosan, Ferona,
Fosteron, Fu Lao Shu, Halotestin, Hysterone,
Lipaw, Long, ODK, Oralsterone, Ora-Testryl,
Sidomon, Stenox, Tealigen, Ton Lin,
Ultandren, Vewon, Vi Jane, Waromom
4-hydrotestosterone
No Commercial Production
Nandrolone laurate
Fortabol, Fortadex, Laudrol LA, Laurabolin
Nandralone phenylpropionate + methandriol Libriol
dipropionate
Drostanolone propionate
Dromostan, Drolban, Mastabol, Masterid,
79
25
Megagrisevit-Mono
Clostebol acetate
26
Mestanolone
Mestanolone
27
Methandriol
Methylandrostenediol
28
29
30
31
Methyl-1-testosterone
Methyldienolone
Methylhydroxnandrolone, “MHN”
Methyltestosterone “Methyl-Test”
Methyl-1-testosterone
Methyldienolone
Methylhydroxnandrolone
Methyltestosterone
32
33
34
35
36
37
Metribolone
Miotolan
Myagen
Neotest 250
Nilevar
Omnadren
38
Orabolin
Methyltrienolone
Furazibol
Bolasterone
Testosterone decanoate
Northandrolone
Testosterone propionate + testosterone
phenylpropionate + testosterone isocaproate
+ testosterone caproate
Ethylestrenol
39
40
41
Oranabol
Parabolan
Primobolan (oral) “Primo”
Oxymesterone
Trenbalone hexahydrobenzylcarbonate
Methenolone acetate
42
43
44
Primobolan Depot (injectible) “Primo”
Protabol
Proviron
Methenolone enanthate
Thiomesterone
Mesterolone
45
46
Sanabolicum
Spectriol
Nandrolone cyclohexylpropionate
Methandriol Dipropionatye + Nandrolone
Masteril, Mastisol, Metormon, Permastril
Steranabol, Trofodermin Crema, Trofodermin
Spray
No Commercial Production
Andris, Methyldiol, Methydiol Aqueous,
Methyladnrostendiol, Novandrol
No Commercial Production
No Commercial Production
No Commercial Production
Afro, Agovirin, Android, Androral,
Arcosterone, Debosteron, Geri Tabs, Giando
Stridox, Hormobin, KangJungBing, Longivol,
Mediatric, Mesteron, Metandren, Metesto,
Metil Testosterone, Neo Aphro, Oreton,
Oreton Methyl, T. Lingvalete, Testo Tab,
Teston, Testopropon, Testormon, Testosteron,
Testred, Virilon
Metribolone
Miotolan
Myagen
Neotest 250
Anaplex, Nilevar
Omandren
Maxibolin, Nandoral, Orabol-H, Orabolin,
Orgabolin, Silabolin
No Commercial Production
Danabolan, Parabolan, Trenabol Depot
Metabolon 25, Menetol QV, Primobolan,
Primo-Plus 50
Primobol, Primo Plus 100, Suprimo 100
Emdabolin
Mesterolon, Mestoranum, Plurviron,
Proviron, Provironum, Restore, Vistamon
Sanabolicum
Spectriol
80
47
Sten
48
Steranabol Ritardo
49
Sustanon ‘100’
50
Sustanon ‘250’
51
52
Synovex
Test 400
53
54
55
56
57
Testolent
Testosterone buciclate
Testosterone butyrate
Testosterone cyclohexylpropionate,
“CHP”
Testosterone cypionate, “cyp,” “TC”
58
Testosterone enanthate, “TE”
phenylpropionate + Testosterone
proprionate + testosterone cypionate +
testosterone hexahydrobenzoate
Testosterone cypionate + Testosterone
propionate
Oxabolone cypionate
Testosterone propionate + testosterone
phenylpropionate + testosterone isocaproate
Testosterone propionate + testosterone
phenylpropionate + testosterone isocaproate
+ testosterone decanoate
Testosterone propionate + estradiol
Testosterone proprionate + testosterone
cypionate + testosterone enanthate
Testosterone phenylpropionate
Testosterone buciclate
Testosterone butyrate
Testosterone cyclohexylpropionate
Testosterone cypionate
Testosterone enanthanate
Sten
Steranabol Ritardo
Sustanon ‘100’
Andropen 275, Durandron, Polysteron,
Sostenon, Sustanon ‘250’, Teston 250, TestoJet LA, Testosteron, Testonon ‘250’,
Sustaretard ‘250’
Synovex
Test 400
Testolent
Testosterone buciclate
Testosterone butyrate
Testosterone CHP, Theramex
Anabolic TL, Andro-Cyp, Andronaq LA,
Anronate, Banrot, Biselmon Depot, CycloTestosterone Depot, Cypionax, Cypiotest 250,
Cypriotest L/A, Dep Andro 100-200, DepotBifuron, Depo TCP, Depotest, Depo
Testermon, Depo-Testosterone, Depot
Hormon MF, Depotrone, Depovirin, D-Test
100-200, Duratest 100-200, Malogen Cyp,
Miro Depo, Nannismon Depot, Ridrot
Testosterone, Sheinpharma Testone-Cyp,
Testabol Depot, Testa-C, Testa-cyp,
Testadiate-Depo, Testex Leo prolongatum,
Testo LA, Testoject, Testoject 50. Teston QV
200, Testerona Ultra Lenta, Testred
Cypionate, Vironate
Neotest ‘250’, Anderone 100/200, Andro 100,
Andro LA, Andropository, Androtardyl,
81
Andryl 200, Delatest, Delatestryl, Depo
Testmon Inj, Dura Testosterone, Durathate200, Enantat QV-250-350, Enatesto 250,
Enamon-250, Everone, Jenasteron Inj,
Malogen, Malogex 250 LA, PrimotestonDepot, Ropel Liquid Testosterone, Sunamon
Inj, Tesone LA, Testanate No 1, Testaval,
Testen-250, Testenan, Testermon, Testen
59
Testosterone propionate, “Prop”, “TP”
Testosterone propionate
60
Testosterone suspension
Testosterone
61
Testoviron
62
63
THG
Trenbolone “Tren-A”, “Fina”
Testosterone propionate + testosterone
enanthate
Tetrahyrdogestrinone
Trenbolone acetate
64
65
Trenbolone “Tren-E”
Tribolin
Trenbolone enanthate
Nandrolone decanoate and Methandriol
dipropionate
Agovirin, Anatest, Androfort-Richter,
Androlan, Ara-Test, Astrapin, AVP Supertest,
Dubol, Facovit, Hybolin Imp, Malogen + Oil,
Nansom Depot, Neo-Hombreol, Oreton,
Propionat QV 100, Propiotest, Tepro Hormone,
Testabol Proprionate Testex Leo, Testo,
Testogan, Testolic, Testone-E, Testopin-100,
Testopro L/A, Testosteron, Testosteron Depot,
Testosterona, Testosterone Jenapharm,
Testosterone Streuli, Testostoviron, Testovis,
Triloandren, Viromone, Implus-H, Progo-H,
VR Testprop, Synovex-H
Anabolic-TS, Androlan Aqueous, Androlin,
Andronaq-50, Aqua Test, Histerone Injection,
Malogen, Malogen Aqueous, Malatrone, RWR
Suspension, Tesamone, Testolin, Testos 100,
Testosus 100, Veto-Test Sus, Agovirin-Depot
Testoprim-D
THG
Acetrenbo 50, ComponentTE-G,
ComponentTE-S, ComponentT-H,
ComponentT-S, Finaject, Finajet, Finaplix-H,
Finaplix-S, Parabolan Tabs, Revalor-200,
Revalor-H, Revalor-IH, Revalor-S, Synovex
plus, Trembolone QV 75, Trenbo 75, Trenol 50
Trenbolone enanthate
Tribolin
82
66
Trinabol 150
67
Triolandren
68
69
Turinabol (oral)
Winstrol (oral) “winny”, “Win-V”
Trenbolone acetate + Trenbolone
hexahydrobenzylcarbonate + Trenbalone
enanthate
Testosterone propionate + Testosterone-nvalerianate + Testosterone Undecylenate
4-chlorodehydromethyltestosterone
Stanozolol
70
Winstrol (injectible) “winny”, “Win-V”
Stanozolol
Trinabol 150
Triolandren
Turinabol, T-bol
Anazol, Apetil, Cetabon, Estano-Pet’s,
Menabol, Neurabol, Seidon, Stan QV 10, Stan
Tabs, Stanabol, Stanazolic, Stanol, Stanol 10,
Stanol V, Stanozodon, Stanozolol, Stanzol,
Stromba, Terabon, Winstrol, Winstrol V
Anabolic ST, Anabolico Produvet, Estanozolol,
Estrombol, Nabolic, Nabolic Strong, Stan 50,
Stan QV 50-100, Stanabolic, Stanazol,
Stanazolic, Stanol 50, Stanol-V, Stanosus,
Stromba, Strombaject, Tanoxol, Vitabolic,
Winstrol Depot, Winstrol V
Non-Steroidal Anabolics
Code #
71
72
73
Generic Names
Clonidine hydrochloride
Metformin Hcl
Sermorelin acetate
Trade Names
Catapres
Glucaphage
74
Primary Trade/Street Name(s)
Catapres
Glucaphage
Growth Hormone-Releasing Hormone
“GH-RH”
Human Growth Hormone “HGH”
Somatropin
75
Insulin, “Slin”
Insulin
76
77
78
Insulin Like Growth Factor, “IGF-1”
Protropin
Kynoselen
79
80
Lutalyse
Rezulin
Insulin Like Growth Factor 1
Sontrem
Heptaminol + Adenosine monophosphate
+ Vitamin B-12 + Sodium selenite +
magnesium aspirate + potassium aspartate
Prostaglandin F2Alpha, diniprost
Troglitazone
Humatrobe, Jin Tropin rHGH, Nutropin AQ,
Saizen, Serostim, Nutropin Depot
Humalin, Humalog, Humalin-N, NPH,
Humalin-L, Humalin-U
IGtropin
Fitropin
Kynoselen
Code #
Primary Trade/Street Name(s)
Generic Names
Lutalyse
Rezulin
Fat Loss Agents—Stimulants
Trade Names
83
81
82
83
Adipex
Albuterol
Clenbuterol
Phentermine hydrochloride
Albuterol sulfate
Clenbuterol hydrochloride
84
Ephedrine
85
86
87
HELIOS
Meridia
Over-the-counter Fat Loss Stack
88
Other over-the-counter Fat Loss
Supplement
89
90
Yohimbine
Zaditen
Ephedrine hydrochloride or
Ephedrine sulfate
Clenbuterol hydrochloride + yohimbine
Sibutramine HCL
Caffeine + ephedrine (Mau Huang) +
aspirin
Caffeine, ephedrine, yohimbine, hoodia,
chromium picolinate, guarana, bitter
orange, synphrine
Yohimibine hydrochloride
Ketotifen
Adipex-P
Proventil, Ventolil
Spirpent, Broncoterol, Clenasma, Monores,
Novegam, Oxyflux, Contraspasmin, Ventolase
Hyper Thermal Lipolytic System
Meridia
ECA Stack,
Zaditor
Fat Loss Agents—Thyroid
Code #
91
92
93
Primary Trade/Street Name(s)
Cytomel “T-3”
Synthroid “T-4”
Triacana
Generic Names
Liothyronine sodium
Levothyroxine sodium
Tiatricol
Code #
94
Primary Trade/Street Name(s)
Dinitrophenol, “DNP”, “Nitro”
Generic Names
2,4-Dinitrophenol
95
96
97
Capoten
Parlodel
Thiomucase
Captopril
Bromocriptine mesylate
Mucopolysaccharidase
Trade Names
Cytomel
Synthroid
Triacana
Fat Loss Agents—Other
Trade Names
Dinitriso, Nitromet, Dinitrenal,
Alpha Dintrophenol
Capoten
Parlodel
Thiomucase
Endurance & Erythropoietic Agents
Code #
98
99
100
Primary Trade/Street Name(s)
Aranesp
Epogen, “EPO”
Provigil
Generic Names
Darbapoetin alfa
Epoietin alfa
Modafinil
Trade Names
Erythropoietin, r-HuEPO
Modiodal, Vigil, Alertec,
Modasomil
Other Anabolic
101
Other
84
Ancillary Agents—Anti Estrogens
Code #
1
2
3
4
5
6
7
8
9
10
11
12
Primary Trade/Street Name(s)
Arimidex
Aromasin
Clomid
Cyclofenil
Cytadren
Evista
Fareston
Faslodex
Femara
Lentaron
Nolvadex, “Nolva”
Teslac
Generic Names
Anastrozole
Exemestane
Clomiphene citrate
Cyclofenil
Aminoglutethimide
Raloxifene
Tormifene citrate
Fluvestrant
Letrozole
Formestane
Tamoxifen citrate
Testolactone
Trade Names
Arimidex, Liquidex
Aromasin
Clomid
Cyclofenil
Cytadren
Evista
Fareston
Faslodex
Femara
Lenatron
Nolvadex
Teslac
Ancillary Agents—Diuretics
13
14
15
16
17
18
Aldactazide
Aldactone
Dyazide
Hydrodiuril
Lasix
Lasilactone
19
20
21
22
23
Ativan
Klonopin
Valium
Xanax
Other Benzodiazepine
24
25
26
27
28
29
30
31
Aldactone
Aldactizide
Anandron
Cyproterone Acetate
D-Trytophan- 6
Fentamide
Luteinizing Hormone
Nizoral
Spironolactone + hydrochlorthiazide
Spironolactone
Triamterene + hydrochlorothiazide
Hydrochlorthiazide
Furosemide
Spironolactone + furosemide
Adlactazide
Aldactone
Dyazide
Hydrodiuril
Lasix
Lasilactone
Ancillary Agents—Anti Anxiety
Lorazepam
Clonazepam
Diazepam
Alprazolam
Ativan, Temesta
Klonopin, Rivotril
Valium
Xanax, Niravam
Ancillary Agents—Androgen Blocker
85
32
33
34
Provera
Spironolactone
Other Androgen Blocker
Ancillary Agents—Anti Hypertensive
35
36
Prescription anti-hypertensive
Over-the-counter anti-hypertensive
Ancillary Agents—Anti Depression
37
38
Prescription anti-depressant
Over-the-counter anti-depressant
Prozac, Paxil, Zoloft
St. John’s Wart, etc.
Ancillary Agents—Sleeping Pills
39
40
Prescription sleeping pills
Over-the-counter sleeping pills
Ambien, Sunesta, etc.
Melatonin, Unisom, etc.
41
42
43
44
Prescription pain killer
Over-the-counter pain killer
Prescription anti-inflammatory
Over-the-counter anti-inflammatory
Ancillary Agents—Pain Killer/Anti-inflammatory
Nubian, oxycodon, Vicodine
Aspirin, Tylenol, etc.
Celebrex, Vioxx, etc.
Ibprofen, Aleve, etc.
Ancillary Agents—Hair Loss Prevention
45
46
Prescription hair loss
Over-the-counter hair loss
47
Human Chorionic Gonadatropin
Propecia
Rogaine
Ancillary Agent—Hormone Stimulator
Ancillary Agents—Anti-impotence/Performance Enhancer
48
49
Prescription anti-impotence/performance
enhancer
Over-the-counter antiimpotence/performance enhancer
Viagra, Cialis
Ancillary Agents—Other
50
51
Other Prescription Ancillary
Other Over-the-counter Ancillary
86
On‐CycleSideEffects
Physical Side Effects?
Water retention?
Headaches?
Nosebleeds?
Tremors or shakiness?
Excessive Sweating?
Can’t stop moving or excessive energy?
Stomach Pain?
Diarrhea?
Joint pain?
Digestive trouble such as indigestion or excessive gas?
Fatigue easily?
Nausea or vomiting?
Muscle cramps or spasms?
Flu-like symptoms?
Dehydration?
Heart palpitations?
Heart skips a beat?
Heat intolerance?
Night sweats?
Trouble falling or staying asleep?
Sleeping too much?
87
On‐CycleSideEffects
Painful prostate?
Muscle or Tendon tear?
Sexual Side Effects?
Excessive Sex Drive?
Difficulty getting an erection or becoming aroused?
Testicular Shrinkage or Clitoral Enlargement?
Decrease in Sex Drive?
Difficulty having an orgasm?
Infertility or Amenhorrea?
Administration Related Side Effects?
Abscess at injection site
Allergic or bad reaction to injection or substance consumed
Scarring from injections
Extreme pain or swelling at injection site
Medical Consequences?
Increased Blood Pressure?
Increased liver function test?
Polycystic Ovarian Syndrome?
Elevated Cholesterol?
Enlarged Prostate?
Heart condition?
Affective or Mood Related Side Effects?
88
On‐CycleSideEffects
Increased Anxiety, Worry, or Fear?
Increased Depression?
Increased number of Mood Swings?
Panic attacks?
Increased Irritability?
Lower frustration tolerance?
Increased Aggression?
Cognitive Side Effects?
Difficulty Concentrating or Focusing?
Thoughts are racing or moving too quickly?
Difficulty making decisions?
Difficulty remembering things?
Unwanted Changes in Appearance?
Acne?
Intestinal growth?
Bone growth?
Increased hair growth (body or face)?
Hair loss or baldness?
Flushed face?
Gynecomastia or “gyno”?
Loss of breast tissue?
Change in facial features?
89
Post‐CycleSideEffects
Affective or Mood Related Side Effects?
Increased Anxiety, Worry, or Fear?
Increased Depression?
Increased number of Mood Swings?
Panic attacks?
Increased Irritability?
Lower frustration tolerance?
Increased Aggression?
Physical Side Effects?
Trouble falling or staying asleep?
Sleeping too much?
Difficulty Concentrating or Focusing?
Decrease in Sex Drive?
Suicidal Thoughts