Sociocultural pressures and appearance ideal internalization are associated with intentions to use anabolic-androgenic steroids among boys and men

Abstract Background Prior research and theory have outlined the strong connection between sociocultural pressures and appearance ideal internalization and muscularity-oriented behaviors, including anabolic-androgenic steroid (AAS) use. This study aimed to investigate the associations between sociocultural pressures and the internalization of appearance ideals and intentions to use AAS. Methods Data from 1,515 boys and men from Canada and the United States who never used AAS were analyzed. Linear regression analyses were used to determine the associations between sociocultural pressures and the internalization of appearance ideals and intentions to use AAS. Results Findings revealed significant associations between the internalization of the thin/low body fat ideal, the muscular ideal, and the general attractiveness appearance ideal, and greater intentions to use AAS. The internalization of the muscular ideal was most strongly associated with greater intentions to use AAS. Additionally, sociocultural pressures from peers, significant others, and media, but not family, were associated with greater intentions to use AAS. Pressure from peers was most strongly associated with greater intentions to use AAS. Conclusions The findings underscore that sociocultural pressures, particularly from peers, and internalization of appearance ideals, specifically the muscular ideal, are critical areas for consideration in prevention and intervention efforts to curtail AAS use initiation.