Geoffrey L. Ream

Suicide Attempts Among Sexual-Minority Male Youth

The purpose of this study was to provide data addressing Diamonds (this issue) 4 problem areas in sexual orientation research by comparing gay, bisexual, and questioning male youth who report attempting suicide with those who do not. Secondary analyses were conducted with 2 datasets, 1 with a gay support group (n = 51) and the other with online youth (n = 681). Reported suicide attempts ranged from 39% among support-group youth, to 25% among Internet gay support group youth, to 9% among Internet non-support group youth. Sexual orientation, behavior, and identity did not predict suicidal attempt status, but suicide attempters experienced higher levels of both generic life stressors (low self-esteem, substance use, victimization) and gay-related stressors, particularly those directly related to visible (femininity) and behavioral (gay sex) aspects of their sexual identity. Support-group attendance was related to higher levels of suicidality and life stressors, as well as certain resiliency factors. Results suggest that there exists a minority of sexual-minority youth who are at risk but that it would be inappropriate to characterize the entire population as such.

Sex variations in the disclosure to parents of same-sex attractions

The decision whether to disclose same-sex attractions to parents was explored through in-depth interviews with 164 young women and men. Participants were more likely to disclose to mothers than fathers, usually around age 19 years and in a face-to-face encounter. Mothers were told before fathers, largely because mothers asked or because youth wanted to share their life with them; fathers were told by someone other than their child or by the youth because it was time. The reason participants did not disclose to mothers was because it was not the right developmental time; the reason they did not disclose to fathers was because they were not close to them. Sons, more than daughters, feared the negative reactions of parents, who generally reacted in the same manner--supportive or slightly negative. Relationships with parents since disclosure generally had not changed or had improved. Sex of parent mattered more than sex of child on most domains.

Intimate Partner Violence and HIV Sexual Risk Behavior Among Latino Gay and Bisexual Men

This study examined the relationship between intimate partner violence (IPV) and HIV sexual risk behavior using a probability sample of 912 Latino gay and bisexual men from three U.S. cities. Prevalence estimates of psychological, physical, and sexual abuse are higher in our sample than usually found in the general population of gay and bisexual or heterosexual men, with 52% reporting some type of abuse. IPV also was associated with being HIV positive. Controlling for HIV status, age, and immigrant status, all three dimensions of IPV--psychological, [RR = 2.42; 95% CI = 1.02, 5.78], physical, [RR = 2.86; 95% CI = 1.21, 6.74], and sexual abuse [RR = 4.63; 95% CI = 1.63, 13.18]--were, overall, associated with significantly greater likelihood of unprotected receptive anal intercourse with a non-monogamous partner. Sexual abuse [RR = 3.22; 95% CI = 1.00, 10.37], emerged as significant even while controlling for the other two dimensions of IPV.

Intimate Partner Violence and HIV Sexual Risk Behavior Among Latino Gay and Bisexual Men: The Role of Situational Factors

Using a probability sample of 912 Latino gay and bisexual men at bars in 3 U.S. cities (Los Angeles, Miami, New York), this study examines how participation in difficult sexual situations with interpersonal (e.g., wanting to please partner) and circumstantial constraints (e.g., sex in partners home) may explain associations between dimensions of intimate partner violence (IPV) and HIV sexual risk behavior (unprotected anal intercourse with nonmonogamous partner). Findings suggest that all IPV types contribute to greater participation in sexual situations with circumstantial constraints, and that psychological and sexual IPV are also associated with higher likelihood of unprotected receptive anal intercourse with a nonmonogamous partner. Circumstantial constraints fully mediate the difference attributable to psychological IPV and partially mediate the difference attributable to sexual IPV. Intimacy concerns were unrelated to either IPV or HIV risk behavior. Results suggest HIV prevention and research should investigate immediate circumstances of the sexual encounter that may make engaging in HIV sexual risk behavior more likely.

The Contribution of Game Genre and Other Use Patterns to Problem Video Game Play among Adult Video Gamers

A nationally representative online survey (n = 3,380) was used to assess the contribution of patterns of video game play to problem video game play (PVGP) symptomatology. Game genre, enjoyment, consumer involvement, time spent gaming (gaming days in the past month and hours on days used), and demographic variables were all examined. The study confirms game genre’s contribution to problem use as well as demographic variation in play patterns that underlie problem video game play vulnerability. Identification of a small group of game types positively correlated with problem use suggests new directions for research into the specific design elements and reward mechanics of “addictive” video games. Unique vulnerabilities to problem use among certain groups demonstrate the need for ongoing investigation of health disparities related to contextual dimensions of video game play.

Patterns of and Motivations for Concurrent Use of Video Games and Substances

“Behavioral addictions” share biological mechanisms with substance dependence, and “drug interactions” have been observed between certain substances and self-reinforcing behaviors. This study examines correlates of patterns of and motivations for playing video games while using or feeling the effects of a substance (concurrent use). Data were drawn from a nationally-representative survey of adult Americans who “regularly” or “occasionally” played video games and had played for at least one hour in the past seven days (n = 3,380). Only recent concurrent users’ data were included in analyses (n = 1,196). Independent variables included demographics, substance use frequency and problems, game genre of concurrent use (identified by looking titles up in an industry database), and general game playing variables including problem video game play (PVP), consumer involvement, enjoyment, duration, and frequency of play. Exploratory factor analysis identified the following dimensions underlying patterns of and motivations for concurrent use: pass time or regulate negative emotion, enhance an already enjoyable or positive experience, and use of video games and substances to remediate each other’s undesirable effects. Multivariate regression analyses indicated PVP and hours/day of video game play were associated with most patterns/motivations, as were caffeine, tobacco, alcohol, marijuana, and painkiller use problems. This suggests that concurrent use with some regular situational pattern or effect-seeking motivation is part of the addictive process underlying both PVP and substance dependence. Various demographic, game playing, game genre of concurrent use, and substance use variables were associated with specific motivations/patterns, indicating that all are important in understanding concurrent use.

Playing Video Games While Using or Feeling the Effects of Substances: Associations with Substance Use Problems

This study tested the hypothesis that playing video games while using or feeling the effects of a substance—referred to herein as “concurrent use”—is related to substance use problems after controlling for substance use frequency, video gaming as an enthusiastic hobby, and demographic factors. Data were drawn from a nationally representative online survey of adult video gamers conducted by Knowledge Networks, valid n = 2,885. Problem video game playing behavior was operationalized using Tejeiro Salguero and Bersabé Morán’s 2002 problem video game play (PVP) measure, and measures for substance use problems were taken from the National Survey of Drug Use and Health (NSDUH). Separate structural equation modeling analyses were conducted for users of caffeine, tobacco, alcohol, and marijuana. In all four models, concurrent use was directly associated with substance use problems, but not with PVP. Video gaming as an enthusiastic hobby was associated with substance use problems via two indirect paths: through PVP for all substances, and through concurrent use for caffeine, tobacco, and alcohol only. Results illustrate the potential for “drug interaction” between self-reinforcing behaviors and addictive substances, with implications for the development of problem use.

Trends in Video Game Play through Childhood, Adolescence, and Emerging Adulthood

This study explored the relationship between video gaming and age during childhood, adolescence, and emerging adulthood. It also examined whether “role incompatibility,” the theory that normative levels of substance use decrease through young adulthood as newly acquired adult roles create competing demands, generalizes to video gaming. Emerging adult video gamers (n = 702) recruited from video gaming contexts in New York City completed a computer-assisted personal interview and life-history calendar. All four video gaming indicators—days/week played, school/work day play, nonschool/work day play, and problem play—had significant curvilinear relationships with age. The “shape” of video gamings relationship with age is, therefore, similar to that of substance use, but video gaming appears to peak earlier in life than substance use, that is, in late adolescence rather than emerging adulthood. Of the four video gaming indicators, role incompatibility only significantly affected school/work day play, the dimension with the clearest potential to interfere with life obligations.

Civic Norms and Etiquettes Regarding Marijuana Use in Public Settings in New York City

This paper shows that active police enforcement of civic norms against marijuana smoking in public settings has influenced the locations where marijuana is smoked. It has subtly influenced the various marijuana etiquettes observed in both public and private settings. The ethnographic data reveal the importance of informal sanctions; most marijuana consumers report compliance with etiquettes mainly to avoid stigma from nonusing family, friends, and associates—they express limited concern about police and arrest.

The provider perception inventory: psychometrics of a scale designed to measure provider stigma about HIV, substance abuse, and MSM behavior.

Abstract Nongay identified men who have sex with men and women (NGI MSMW) and who use alcohol and other drugs are a vulnerable, understudied, and undertreated population. Little is known about the stigma faced by this population or about the way that health service providers view and serve these stigmatized clients. The provider perception inventory (PPI) is a 39-item scale that measures health services providers’ stigma about HIV/AIDS, substance use, and MSM behavior. The PPI is unique in that it was developed to include service provider stigma targeted at NGI MSMW individuals. PPI was developed through a mixed methods approach. Items were developed based on existing measures and findings from focus groups with 18 HIV and substance abuse treatment providers. Exploratory factor analysis using data from 212 health service providers yielded a two dimensional scale: (1) individual attitudes (19 items) and (2) agency environment (11 items). Structural equation modeling analysis supported the scales predictive validity (N=190 sufficiently complete cases). Overall findings indicate initial support for the psychometrics of the PPI as a measure of service provider stigma pertaining to the intersection of HIV/AIDS, substance use, and MSM behavior. Limitations and implications to future research are discussed.