Exploring the Psychological and Social Dynamics of Steroid and Performance-Enhancing Drug (PED) Use Among Late Adolescents and Emerging Adults (16-22): A Thematic Analysis

Abstract

Background: Performance-enhancing drug (PED) use has become increasingly prevalent among adolescents and emerging adults, not solely for athletic advantage but as a psychological and sociocultural coping mechanism. In T & uuml;rkiye, where Westernized body ideals intersect with traditional values, the emotional and symbolic meanings of PED use among youth remain underexplored. Methods: This qualitative study employed semi-structured interviews and reflexive thematic analysis to examine the subjective experiences of 26 Turkish adolescents and emerging adults (19 males, 7 females; ages 16-22) in Istanbul who reported non-medical use of steroids or other PEDs. Participants were recruited through snowball sampling in gym-adjacent communities across six urban districts. Interviews were conducted online, recorded, transcribed, and analyzed to identify emergent psychological themes. Results: Six interconnected themes were identified: (1) body-based insecurity and the fantasy of reinvention; (2) emotional regulation through bodily control; (3) secrecy as autonomy; (4) compulsive enhancement and dissatisfaction; (5) psychological dependency and regret; and (6) PED use as agency and protest. While male and female participants differed in aesthetic goals and social narratives, both groups framed PED use as a means of identity construction, emotional survival, and social validation. Participants did not perceive themselves as deviant but as strategic actors navigating a performance-driven culture. Conclusions: PED use among youth in urban T & uuml;rkiye emerges as a psychologically embedded coping mechanism rooted in emotional regulation, self-concept, and perceived control. Rather than a deviant behavior, it reflects an adaptive but precarious strategy for managing insecurity and achieving recognition during a critical developmental stage.