High dose anabolic steroid use and facial emotion recognition, the hormonal influence on social cognition.

The use of anabolic androgenic steroids (AAS) is effective in increasing muscle mass, but may bring adverse medical and psychological effects. Prolonged, high-dose AAS use causes large alterations to the hormonal environment that have been linked to alterations in mood and social cognitive abilities, such as reduced empathy while using AAS. We tested whether prolonged high-dose AAS use is associated with altered emotion recognition abilities, and the potential role of hormonal status for performance.

The Emotion Recognition Task (ERT) was used to measure the ability to identify basic emotions in facial expressions. Participants include male strength athletes who either used AAS in the test period (AAS on-cycle, n =61), had quit or were not using AAS at the period of testing (AAS off-cycle, n=32), and a non-using weightlifting comparison group (WLC, n =79). Serum levels of sex steroid hormones was measured from blood. Group differences in ERT performance were tested using general linear models, and the relationships among ERT performance and hormones were assessed with Spearman’s correlations.

Multivariate analysis of variance showed between-group differences on several facial emotions including disgust [F (2, 171) = 7.01, p = .001, ηp² = 0.08], anger p < .05, ηp² = 0.05, fear p < .05, ηp² = 0.04, and overall emotion recognition p < .001, ηp² = 0.10]. Post hoc test showed that on-cycle users performance stood out, with lower score than WLC for all emotions, and lower than off-cycle users for disgust and overall performance. Overall performance and disgust were negatively associated with the free androgen index, which are elevated on-cycle, and positively with luteinizing and follicle-stimulating hormones that are suppressed upon AAS use.

The findings suggest temporary effects of AAS use on emotional processing, where hormonal perturbations caused by high-dose AAS use impair the ability to recognize emotional faces.