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September 12, 2007

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Gay men likelier to gamble addictively, study suggests

Nov. 9, 2006
Special to World Science  

Gay and bi­sex­u­al men may be un­u­su­al­ly prone to com­pul­sive gam­bling, a small study has found, adding to grow­ing ev­i­dence link­ing ho­mo­sex­u­al­ity to var­i­ous ad­dic­t­ions and men­tal ill­nesses.

Many com­pul­sive gam­blers say they are look­ing to get a rush of ex­cite­ment out of the ac­tiv­i­ty. (Im­age cour­te­sy Con­gres­sio­n­al Gam­ing Cau­cus)
The results re­quire con­fir­ma­tion by fu­ture stud­ies, re­search­ers say, but un­der­score con­cerns that gays and les­bi­ans might re­quire spe­cial at­ten­tion and care for a range of men­tal dis­or­ders. 

The find­ings could al­so fu­el a charged de­bate over whe­th­er these con­di­tions stem from ho­mo­sex­u­al­ity it­self, or rath­er from the stress of suf­fer­ing anti-gay dis­crim­i­na­tion. 

“Gay and bi­sex­u­al male path­o­log­i­cal gam­b­lers may re­quire more in­ten­sive or spe­cial­ized treat­ment” than oth­er ones, wrote the au­thors of the stu­dy, pub­lished in the No­v­em­ber-De­c­em­ber is­sue of the re­search jour­nal Com­p­re­hen­sive Psy­chi­a­try.

Such ther­a­pies may al­so “need to ad­dress a wide range of im­pul­sive be­ha­v­iors,” added the re­search­ers, Jon Grant of the Uni­ver­si­ty of Min­ne­so­ta Med­i­cal School in Min­ne­ap­o­lis, Minn., and Marc Po­ten­za of Yale Uni­ver­si­ty Med­i­cal School in New Hav­en, Conn.

Com­pul­sive gam­b­ling—also called path­o­log­i­cal or ad­dic­t­ive gam­b­ling—is ha­bi­t­u­al, ex­ces­sive bet­ting with se­vere per­son­al, so­cial or le­gal con­se­quenc­es. A brain dis­ease, it ap­pears si­m­i­lar to dis­or­ders such as al­co­hol­ism and drug ad­dic­tion, ac­cord­ing to the U.S. Na­tion­al In­sti­tutes of Health. 

These ill­nesses tend to in­volve prob­lems in a brain re­gion tied to be­hav­iors such as eat­ing and sex, some­times called the “plea­sure cen­ter,” and strongly as­so­ci­at­ed with a chem­i­cal mes­sen­ger called dopamine. Path­o­log­i­cal gam­blers, pre­dom­i­nantly men, of­ten say they’re look­ing for “ac­tion” or ex­cite­ment in the ac­t­i­vi­ty.

Grant and Potenza stud­ied 105 men who had sought treat­ment for path­o­log­ical gam­bling and had re­sponded to ads or re­fer­rals to join the re­search. Twen­ty-two of these men—21 per­cent—i­den­ti­fied them­selves as gay or bi­sex­u­al, they found. That’s four to sev­en times high­er than the per­cent­age that these groups re­pre­sent of the whole pop­u­la­tion, by most mid­dling es­ti­mates.

Gays and bi­sex­u­als al­so tended to be am­ong the most ad­dict­ed gam­b­lers, the re­search­ers re­port­ed; these pa­tients were al­so like­li­er to suf­fer ad­di­tion­al impulse-control or sub­stance-a­buse con­di­tions, and to be sin­gle. The group con­sis­ted of 15 gays and se­v­en bi­sex­uals.

Lim­i­ta­tions of the stu­dy, the sci­en­tists wrote, were its small size and its in­clu­sion of on­ly treat­ment-seeking men, who might be un­rep­re­sent­a­tive of the wid­er pop­u­la­tion.

The results fit with a trend, though. 

There’s a “grow­ing con­cern that ho­mo­sex­u­al­ly ac­tive in­di­vid­u­als are at in­creased risk for psy­chi­at­ric mor­bid­i­ty,” or ill­ness, wrote an­oth­er group of sci­en­t­ists in the June 2001 is­sue of the Amer­i­can Jour­nal of Pub­lic Health. “Sev­eral sur­veys have found el­e­vat­ed rates of some anx­i­e­ty dis­or­ders, mood dis­or­ders, and sub­stance use dis­or­ders among ho­mo­sex­u­als.”

The rea­sons are un­clear, wrote the au­thors, with Har­vard Med­i­cal School in Bos­ton and oth­er in­sti­tu­tions. One pos­si­bil­i­ty, they added, is that gays and les­bians are more fre­quent vic­tims of early-life abuse.

A sec­ond, they con­tin­ued, is that “les­bians and gay men simp­ly lead risk­i­er lives.” 

Yet anoth­er ex­pla­na­tion, for which they cit­ed sub­s­tan­tial­ly more ev­i­dence, was that “stig­ma­ti­za­tion and ex­po­sure to dis­crim­i­na­tory be­hav­ior lead to higher rates of men­tal dis­or­ders. This hy­poth­e­sis is con­sist­ent with the find­ing that les­bians and gay men ex­pe­ri­ence dis­crim­i­na­tion in mul­ti­ple do­mains of life,” which in turn is tied to psy­cho­log­ical dis­tress. Oth­er dis­ad­van­taged groups al­so face high­er-than-av­er­age risk for psy­cho­log­ical prob­lems, they wrote.

The alternative ex­pla­na­tions are linked to deep­ly, even bit­ter­ly op­posed po­l­i­ti­cal views. The idea that un­healthy risk-taking is in­her­ent in ho­mo­sex­u­al­i­ty tends to sat­is­fy gay-rights op­po­nents, most of whom see same-sex ori­en­ta­tion as ab­nor­mal. The stig­ma­ti­za­tion hyp­o­the­sis pleases gay-rights sup­port­ers, who view dis­crim­i­na­tion, not ho­mo­sex­u­al­ity, as the prob­lem.

The ques­tion of what ex­plains the ho­mo­sex­ua­li­ty-ad­dic­tion sta­t­is­tics is “the big one,” wrote Grant in an e­mail. “I don’t think there’s ei­ther an easy an­swer or, based on our lim­it­ed sci­en­tif­ic knowl­edge cur­rent­ly, an an­swer that does­n’t have some sort of so­ci­o­po­li­ti­cal over­tones. I think of this re­search as a very small piece of the big­ger puz­zle.”

* * *

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Gay and bisexual men may be unusually prone to compulsive gambling, a small study has found, adding to growing evidence linking homosexuality to various impulse-control disorders and other mental illnesses. The findings require confirmation by future studies, researchers say, but for now they underscore concerns that gay people might require special attention and treatments for a range of mental disorders. The results could also fuel a debate over whether these conditions stem from homosexuality itself, or rather from the stress created by anti-gay discrimination. “Gay and bisexual male pathologic gamblers may require more intensive or specialized treatment” than other ones, wrote the authors of the study, which appeared in the November-December issue of the research journal Comprehensive Psychiatry. These therapies may also “need to address a wide range of impulsive behaviors,” added the researchers, Jon Grant of the University of Minnesota Medical School in Minneapolis, Minn., and Marc Potenza of Yale University Medical School in New Haven, Conn. Compulsive or pathological gambling is habitual, excessive gambling with severe personal, social or legal consequences. A brain disease, it seems similar to disorders such as alcoholism and drug addiction, according to the U.S. National Institutes of Health. These illnesses tend to involve problems with a brain region associated with behaviors such as eating and sex, sometimes called the “pleasure center,” and strongly reliant on a chemical messenger called dopamine. Pathological gamblers, who are predominantly men, often say they’re looking for “action” or excitement. Grant and Potenza studied 105 men who had sought treatment for pathological gambling and had responded to ads or referrals to participate in the research. Twenty-two of these men—21 percent—identified themselves as gay or bisexual, they found. That’s four to seven higher than most middling estimates of the percentage of gays populationwide. The gays and bisexuals also tended to be more severely addicted, the researchers found; these patients were also likelier to suffer additional impulse-control or substance-abuse conditions, and to be single. Limitations of the study, the scientists said, are the small size and its inclusion of only treatment-seeking men, who might be unrepresentative of the wider population. The findings are part of a growing trend, though. There’s a “growing concern that homosexually active individuals are at increased risk for psychiatric morbidity,” or illness, wrote researchers in the June 2001 issue of the American Journal of Public Health. “Several surveys have found elevated rates of some anxiety disorders, mood disorders, and substance use disorders among homosexuals.” The reasons are unclear, wrote the authors, with Harvard Medical School in Boston and other institutions. One possibility, they added, is that gays and lesbians are more frequent victims of early-life abuse. A second, they continued, is that “lesbians and gay men simply lead riskier lives.” Yet another explanation, for which they cited considerably more evidence, was that “stigmatization and exposure to discriminatory behavior lead to higher rates of mental disorders. This hypothesis is consistent with the finding that lesbians and gay men experience discrimination in multiple domains of life” and that such discrimination is tied to psychologic distress. Other disadvantaged groups also face higher-than-average risk for psychological problems, they wrote. The latter two explanations in particular are linked to deeply, even bitterly opposed world views. The idea that unhealthy risk-taking is inherent in homosexuality tends to satisfy opponents of gay rights, who tend to view same-sex orientation as abnormal. The notion that psychiatric disorders flow from stigmatization is more pleasing to gay-rights supporters, who view discrimination, not homosexuality, as the problem. The question of what explains the statistics on gays and impulse-control disorders is “the big one,” wrote Grant in an email. “I don’t think there’s either an easy answer or, based on our limited scientific knowledge currently, an answer that doesn’t have some sort of sociopolitical overtones. I think of this research as a very small piece of the bigger puzzle.”