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Whirled piece: Dancing as an addiction

In previous blogs I have examined various (admittedly extreme) aspects of dancing including people that are sexually aroused by dancing (choreophilia), dancing as a form of frottuerism, people that are addicted to dancing (in this case, the Argentine tango), and people who have developed medical complaints as a result of dancing (‘breaker’s neck’ caused by break dancing). However, over the last few months I have been a co-author on two dance-related research papers with my research colleagues in Hungary (led by Aniko Maraz). The first one (published in the journal PLoS ONE) was about the development and psychometric validation of the ‘Dancing Motives Inventory’ (DMI). The second one (also published in PLoS ONE) was a study of dance addiction (and which I will describe in more detail below).

I’m sure many of you reading this will think that dancing is a somewhat trivial area to be carrying out scientific research. However, research has shown that dancing can have substantial benefits for physical and mental health such as decreased depression and anxiety, and increased physical and psychological wellbeing. After we developed the DMI, we realised that very little known about the psychological underpinnings of excessive dancing, and whether in extreme cases, dancing could be classed as an addictive behaviour. Given the lack of empirical research in dance addiction, we conceptualized dance addiction to be akin to exercise addiction. For example, a study published in the journal Perceptual and Motor Skills led by Dr. Edgar Pierce reported that dancers scored higher on the Exercise Addiction Scale compared to endurance and non-endurance athletes. Added to this, both exercise and dancing require stamina and physical fitness, and for this reason, dance is often classified as a form of exercise.

Over the last 20 years I have published many papers on exercise addiction (see ‘Further reading’ below) so there is no reason why dance addiction couldn’t theoretically exist (in fact, it could be argued that dance addiction – if it exists – is a sub-type of exercise addiction). There are also a handful of studies that have examined excessive dancing and whether it can be addictive to a small minority. A study by Edgar Pierce and Myra Daleng (again in Perceptual and Motor Skills) conducted a study with 10 elite ballet dancers and found that dancers rated thinner bodies as ideal and significantly more desirable than their actual body image despite being in the ‘ideal’ BMI range. The study also found that dancers often continue to dance despite discomfort, “because of the embedded subculture in dance that embraces injury, pain, and tolerance”. In a more recent study in the Journal of Behavioral Addictions (and which I reported at length in a previous blog), Dr. Remi Targhetta and colleagues assessed addiction to the Argentine tango. They found that almost half of their participants (45%) met the DSM-IV criteria of abuse, although a substantially lower prevalence rate (7%) was found when using more conservative criteria.

In our recently published study, we proposed that excessive social dancing would be associated with detriments to mental health. More specifically, we aimed to (i) identify subgroups of dancers regarding addiction tendencies, (ii) explore which factors account for the elevated risk of dance addiction, and (iii) explore the motivations underlying excessive dancing.

Our sample included 447 salsa and ballroom dancers (32% male and 68% female, with an average age of 33 years) who danced recreationally at least once a week. To assess ‘dance addiction’ we created the ‘Dance Addiction Inventory’ modified from the Exercise Addiction Inventory (that I co-developed back in 2004) in which we simply replaced the word ‘exercise’ with the word ‘dance’. We also assessed the dancers’ general mental health, borderline personality disorder, eating disorder symptoms, and dance motives.

As far as we are aware, our study is the first to explore the psychopathology and motivation behind dance addiction. Based on my criteria of addiction, five distinct types of dancers were identified. Only two of these types danced excessively. About one-quarter of our sample reported high values on all criteria of addiction but they reported no conflict with the social environment. However, 11% of dancers (and what we termed the ‘high risk’ group) scored high on all addiction symptoms and experienced conflict in their life as a consequence of their excessive dancing.

Our study also found that dance addiction was associated with mild psychopathology, especially with elevated number of eating disorder symptoms and (to a lesser extent) borderline personality traits (something which has also been found in research examining exercise addiction). Perhaps unsurprisingly, escapism (and to a lesser extent mood enhancement) was an especially strong indicator of dance addiction. I say ‘unsurprisingly’ because escapism has already been much reported in other types of behavioural addiction such as gambling and video gaming (including a lot of my own research). Here, escapism as a motivational factor refers to dancing in order to avoid feeling empty or as a mechanism to deal with everyday problems. Based on our findings, we believe that to a minority of individuals appear to be addicted to dancing and that it may be being used be a maladaptive coping mechanism.

Based on what we know in the exercise addiction literature, we proposed that future studies should also assess whether eating disorder is primary or secondary to dance addiction (i.e., whether the purpose of excessive dancing is weight-control and/or the motivation to perform leads to disturbances in eating patterns). I should also point out that although we found that distress was correlated with dance addiction, the association disappeared when other measures were added to the regression model. This may indicate that distress is not directly associated with problematic dancing and that it may arise from other problematic factors such as having an eating disorder.

Given the lack of research in the field, other studies are needed to confirm or refute the findings of our study. Given that dancing is a social activity, social conflicts may not arise when the person has only fellow dancers as partners or friends – therefore, the risky behaviour may remain somewhat hidden. Another question that could be examined is whether there is any difference between amateur and professional dancers in terms of addiction tendency (although among professional dancers there may be a debate about whether their behaviour is dancing addiction or ‘workaholism’). Also, we don’t know whether our findings can be extended to other dance genres (as we only surveyed ballroom and salsa dancers)

I would just like to end by saying that dancing is very clearly a healthy activity for the majority of individuals. However, our study does seem to suggest that excessive dancing may have problematic and/or harmful effects for a small minority. Although we couldn’t establish causality, dance addiction appears to have the potential to be associated with mild psychopathology.

Dr. Mark Griffiths, Professor of Gambling Studies, International Gaming Research Unit, Nottingham Trent University, Nottingham, UK

Additional input: Aniko Maraz, Róbert Urbán and Zsolt Demetrovics.

Further reading

Allegre, B., Souville, M., Therme, P. & Griffiths, M.D. (2006). Definitions and measures of exercise dependence, Addiction Research and Theory,14, 631-646

Berczik, K., Szabó, A., Griffiths, M.D., Kurimay, T., Kun, B. & Demetrovics, Z. (2012). Exercise addiction: symptoms, diagnosis, epidemiology, and etiology. Substance Use and Misuse, 47, 403-417.

Berczik, K., Szabó, A., Griffiths, M.D., Kurimay, T., Kun, B. & Demetrovics, Z. (2012). Exercise addiction: symptoms, diagnosis, epidemiology, and etiology. Substance Use and Misuse, 47, 403-417.

Griffiths, M.D., Szabo, A. & Terry, A. (2005). The Exercise Addiction Inventory: A quick and easy screening tool for health practitioners. British Journal of Sports Medicine, 39, 30-31.

Griffiths, M.D., Urbán, R., Demetrovics, Z., Lichtenstein, M.B., de la Vega, R., Kun, B., Ruiz-Barquín, R., Youngman, J. & Szabo, A. (2015). A cross-cultural re-evaluation of the Exercise Addiction Inventory (EAI) in five countries. Sports Medicine Open, 1:5.

Kurimay, T., Griffiths, M.D., Berczik, K., & Demetrovics, Z. (2013). Exercise addiction: The dark side of sports and exercise. In Baron, D., Reardon, C. & Baron, S.H., Contemporary Issues in Sports Psychiatry: A Global Perspective (pp.33-43). Chichester: Wiley.

Maraz, A., Király, O., Urbán, R., Griffiths, M.D., Demetrovics, Z. (2015). Why do you dance? Development of the Dance Motivation Inventory (DMI). PLoS ONE, 10(3): e0122866. doi:10.1371/ journal.pone.0122866

Maraz, A., Urbán, R., Griffiths, M.D. & Demetrovics Z. (2015). An empirical investigation of dance addiction. PloS ONE, 10(5): e0125988. doi:10.1371/journal.pone.0125988.

Pierce, E.F. & Daleng, M.L. (1998) Distortion of body image among elite female dancers. Perceptual and Motor Skills, 87, 769-770.

Pierce, E.F., Daleng, M.L. & McGowan, R.W. (1993) Scores on exercise dependence among dancers. Perceptual and Motor Skills, 76, 531-535.

Ramirez, B., Masella, P.A., Fiscina, B., Lala, V.R., & Edwards, M. D. (1984). Breaker’s neck. Journal of the American Medical Association, 252(24), 3366-3367.

Targhetta, R., Nalpas, B. & Perney, P. (2013). Argentine tango: Another behavioral addiction? Journal of Behavioral Addictions, 2, 179-186.

Blame it on the boogie: A brief look at dancing as frotteurism

In a previous blogs I have examined both choreophilia (sexual arousal from dancing) and frotteurism (sexual arousal (sexual arousal from non-consensually rubbing up against other people). However, while researching these previous blogs I came across a number of academic papers on ‘dancing frottuerism’. For instance, in a book chapter on frotteurism by Dr. Richard Krueger and Dr. Meg Kaplan, they outlined four case studies of frotteurs in treatment, one of which was a 58-year old male that had engaged in various types of frotteuristic behaviour over a 40-year period (estimated 20,000 acts of frotteurism). This included “dirty dancing” where he would go to nightclubs and deliberately rub himself up against women while dancing with them. He estimated that he engaged in this type of frotteuristic behaviour on approximately 100 nights of the year (compared to other frotteuristic behaviour such as rubbing himself against women on buses and in train subways approximately 200 days a year).

In a short online article concerning frotteurism on the Anxiety Zone website, the term ‘dry humping’ (aka ‘grinding’) is viewed as a form of modern dancing style. The same article also notes that frotteurism may not always be non-consensual:

“Frotteurism carries a connotation of ‘anonymous and discreet rubbing’ in a public place – like on a crowded train. The contact may be mutual or a one-way perpetration…As with most other sexual practices, frottage with a non-consenting person is regarded as a form of sexual assault in most jurisdictions…Frot is a term used among homosexual men to refer to penis to penis rubbing in a conventional private context. It is also known as ‘phrot’, ‘swordfighting’, ‘cockrub’, ‘penis fencing’, ‘bumping dicks’, ‘frication’ and ‘the Princeton rub’. Advocates of this practice represent it as a safer and more erotic alternative to anal sex. Two people engaging in clothed frottage in a manner that simulates intercourse is known in the vernacular as ‘dry humping’. A modern dancing style which involves partners rubbing their clothed bodies on one another is called grinding”

The online Encyclopedia Dramatica also appears to concur, and notes in its article on frotteurism that sometimes, bump and grind dancing in clubs is also thought of as being frottage”. Frotteurism in the form of dancing appears to be an accepted part of leisure life in the Caribbean. According to a short online article (‘Frottage and Frotteurism in the Caribbean’), dancing frotteurism occurs when couples are dancing (“typically with the man behind the woman. It is something like freak dancing in the US except that nobody is scandalised by it and it is not restricted to teenagers. In Jamaica there are dance events called ‘rubs’ where pelvic thrusting is meant to happen”).

However, some academics do not see this Caribbean practice as socially acceptable. For instance, Dr. Hari Maharajh published a 2010 book chapter entitled ‘Dancing frotteurism or rubbing at the Carnival celebrations in Trinidad’. (Although this appears to be based on an earlier paper published in a 2007 issue of the Journal of Chinese Clinical Medicine). Dr. Maharajh noted that Trinidad and Tobago had been influenced by a variety of cultures that finds its greatest expression during the Carnival season. More specifically, it was reported that:

“During this [Carnival time] a local dance form of wining with suggestible sexual movements is pervasive. It is associated with distortions of normal courtship behavior with paraphilic disturbances. In a case presentation, a young male is presented showing paraphilic disturbances touching, holding, rubbing and coercive sex. This behavior of frotteurism and other paraphilias are common occurrences at carnival in Trinidad and Tobago and are considered to be cultural normative practices”.

The Carnival occurs on many Caribbean islands (not just Trinidad and Tobago) and is celebrated just before Lent. Dr. Maharajh’s case study attempted to identify a number of sexual paraphilias such as “toucherism, frotteurism and preferential rape” during the Trinidad and Tobago Carnival celebration and then looked at some of the legal ramifications of such behaviour. Similar observations were also made in a 2013 paper by Annette George et Darlington Richards in the online journal Études Caribéennes.They noted that two specific behaviors continue to be of concern during the Carnival: (i) the high levels of alcohol consumption during the Carnival’s festivities and, (ii) the erotic dancing and wining expressed by the Carnival participants. They wrote that:

“[In addition to the amount of alcohol consumed during the Carnival, the] second major concern of the celebrations is the dancing or wining. Wining, a term used to describe sensuous pelvic gyrations of the hips and waist, is considered to be suggestive and sexually stimulating not only to the revelers but also to on-lookers (Maharajh & Konings, 2007; Miller, 1991). It is also considered expressions of enjoyment, happiness and freedom…Similarly, Miller (1991) reports that wining between men and women during Carnival, is clearly a sexual expression that encourages rape”.

Maharajh also concurred that excessive alcohol consumption is a key feature of the Carnival and that it is seen as a “time to free up, break away and get on bad” including promiscuity and other “immoral and inexcusable” behaviours. George and Darlington argue that for these reasons, the Trinidadians as a group have a ‘carnival mentality’ that equates to a never-ending all year-round ‘party mentality’. Maharajh claims that in Trinidad, sex is a “comparative performance for both men and women”, and that an activity such as wining “is viewed as either a form of ‘virtual sex’ or as an expression of sexuality”.  Citing the work of Dr. C.L. Green (2007), George and Darlington note that the “Carnival is nothing more than an orgy of sexuality and hedonism appealing to the fetishistic fantasies of the potential tourist”, George and Darlington then go on to claim that:

“This contextual, if tantalizing environment for the ‘carnival spirit’ for the locals have an equal, if not more, tantalizing allure for the tourists. The prevailing environment of social, and cultural permissiveness and intermingling, allows for the indulgent tourist to be part of the rascality and the attendant exposure”.

As a backdrop to any debate concerning whether sexual dancing is a legitimate form of frotteurism, it is clear that appropriate sexual behaviours depend on the surrounding context (cultural and/or social) including the time and the place of where the behaviour occurs. Some sexual behaviours that may be unacceptable under most circumstances (e.g., being nude in public, sexual contact between individual dancers) appears as though they are encouraged during celebrations like Mardi Gras or the Carnival.

Dr Mark Griffiths, Professor of Gambling Studies, International Gaming Research Unit, Nottingham Trent University, Nottingham, UK

Further reading

Anxiety Zone (2013). Frotteurism. Located at: http://www.anxietyzone.com/conditions/frotteurism.html

Encyclopedia Dramatica (2012). Frottage. Located at: https://encyclopediadramatica.es/Frottage

George, A. A., & Richards, D. (2013). Tourism in Trinidad and Tobago: The evolving attitudes and behaviors and its implications in an era of HIV/AIDS epidemic. Études Caribéennes, 19. Located at: http://etudescaribeennes.revues.org/5314

Green, G.L. (2007). ‘Come to life’: Authenticity, value, and the carnival as cultural commodity in Trinidad and Tobago. Identities: Global Studies in Culture and Power, 14, 203-224.

Krueger, R.B., & Kaplan, M. S. (1999). Evaluation and treatment of sexual disorders: frottage. Innovations in Clinical Practice: A Source Book, 18, 185-197.

Maharajh, H.D. (2010). Dancing frotteurism or rubbing at the carnival celebrations in Trinidad. In: Maharajh, H.D., Merrick, J., Social and cultural psychiatry experience from the Caribbean Region. (pp.117-122) New York, Nova Science Publishers Inc.

Maharajh, H. D., & Konings, M. (2007). Dancing frotteurism and courtship disorder in Trinidad and Tobago. Journal of Chinese Clinical Medicine, 2(7), 407-411.

Miller, D. (1991). Absolutely freedom in Trinidad. Royal Anthropological Institute of Great Britain and Ireland. Man, New Series, 26(2), 323-341.