Karin Helmersson Bergmark

GENDER ROLES, FAMILY, AND DRINKING: WOMEN AT THE CROSSROAD OF DRINKING CULTURES

During the postwar era, extensive changes in family structure and gender roles have occurred in Western countries. The aim for this study was to see if processes of change and convergence in gender roles have led to new drinking patterns among Swedish women. Data were collected from a survey conducted in 1979 and replicated in 2003. For this study, data on aspects of drinking patterns and problems were combined with demographics and indicators of social situation. For one of the drinking pattern indicators, the assumption of convergence between the sexes was confirmed. Generally, though, differences in drinking patterns are at hand among both women and men in the same direction. Also, social background factors and demographics have weaker explanatory power today compared to the late 1970s.

Scholars’ open debate paper on the World Health Organization ICD-11 Gaming Disorder proposal

Concerns about problematic gaming behaviors deserve our full attention. However, we claim that it is far from clear that these problems can or should be attributed to a new disorder. The empirical basis for a Gaming Disorder proposal, such as in the new ICD-11, suffers from fundamental issues. Our main concerns are the low quality of the research base, the fact that the current operationalization leans too heavily on substance use and gambling criteria, and the lack of consensus on symptomatology and assessment of problematic gaming. The act of formalizing this disorder, even as a proposal, has negative medical, scientific, public-health, societal, and human rights fallout that should be considered. Of particular concern are moral panics around the harm of video gaming. They might result in premature application of diagnosis in the medical community and the treatment of abundant false-positive cases, especially for children and adolescents. Second, research will be locked into a confirmatory approach, rather than an exploration of the boundaries of normal versus pathological. Third, the healthy majority of gamers will be affected negatively. We expect that the premature inclusion of Gaming Disorder as a diagnosis in ICD-11 will cause significant stigma to the millions of children who play video games as a part of a normal, healthy life. At this point, suggesting formal diagnoses and categories is premature: the ICD-11 proposal for Gaming Disorder should be removed to avoid a waste of public health resources as well as to avoid causing harm to healthy video gamers around the world.

Extensive internet involvement--addiction or emerging lifestyle?

In the discussions for the future DSM-5, the Substance-Related Disorders Work Group has been addressing “addiction-like” behavioral disorders such as “Internet addiction” to possibly be considered as potential additions for the diagnostic system. Most research aiming to specify and define the concept of Internet addiction (or: Excessive/Compulsive/Problematic Internet Use—PIU), takes its point of departure in conventional terminology for addiction, based in established DSM indicators. Still, it is obvious that the divide between characteristics of addiction and dimensions of new lifestyles built on technological progress is problematic and far from unambiguous. Some of these research areas are developing from the neurobiological doctrine of addiction as not being tied to specific substances. The concept of “behavioral addictions”, based on biological mechanisms such as the reward systems of the brain, has been launched. The problems connected to this development are in this study discussed and reflected with data from a Swedish survey on Internet use (n = 1,147). Most Swedes (85%) do use the Internet to some degree. The prevalence of excessive use parallels other similar countries. Respondents in our study spend (mean value) 9.8 hours per week online at home, only 5 percent spend more than 30 hours per week. There are both positive and negative social effects at hand. Many respondents have more social contacts due to the use of Internet, but there is a decline in face-to-face contacts. About 40% of the respondents indicate some experience of at least one problem related to Internet use, but only 1.8% marked the presence of all problems addressed. Most significant predictors for problem indicators, except for age, relate to “time” and time consuming activities such as gaming, other activities online or computer skills.

Drinking in the Swedish gay and lesbian community

Drinking patterns among Swedish gay men and lesbians (n = 1720) are compared to two nationally representative survey groups. Findings point at elevated levels of drinking among lesbians, but not among gay men. Gay men and lesbians do not, as in the general population, reduce their drinking with increasing age and there are very few gay and lesbian abstainers. Experiences of consequences of drinking are more frequent, particularly among lesbians. The study reveals that alcohol plays a more substantial role at the core of the gay and lesbian community, at least, than in many other subgroups of the Swedish society.

The Development of Advanced Drinking Habits in Adolescence : - A Longitudinal Study

This paper aims at exploring the relations between early risk factors and the development of advanced drinking habits in adolescence. Data were derived from the longitudinal research program Individual Development and Adjustment. Results confirm earlier findings from longitudinal studies in this field. Three important factors have been identified: significant others, general sociability, and personality/conduct. More important, though, is that results indicate that knowledge about one or two background characteristics is not enough to make predictions of adolescent drinking habits. Rather, it is the ensemble of circumstances that together lead to an increased risk for advanced drinking habits in adolescence.

A weak scientific basis for gaming disorder: Let us err on the side of caution

We greatly appreciate the care and thought that is evident in the 10 commentaries that discuss our debate paper, the majority of which argued in favor of a formalized ICD-11 gaming disorder. We agree that there are some people whose play of video games is related to life problems. We believe that understanding this population and the nature and severity of the problems they experience should be a focus area for future research. However, moving from research construct to formal disorder requires a much stronger evidence base than we currently have. The burden of evidence and the clinical utility should be extremely high, because there is a genuine risk of abuse of diagnoses. We provide suggestions about the level of evidence that might be required: transparent and preregistered studies, a better demarcation of the subject area that includes a rationale for focusing on gaming particularly versus a more general behavioral addictions concept, the exploration of non-addiction approaches, and the unbiased exploration of clinical approaches that treat potentially underlying issues, such as depressive mood or social anxiety first. We acknowledge there could be benefits to formalizing gaming disorder, many of which were highlighted by colleagues in their commentaries, but we think they do not yet outweigh the wider societal and public health risks involved. Given the gravity of diagnostic classification and its wider societal impact, we urge our colleagues at the WHO to err on the side of caution for now and postpone the formalization.

Pleasures of Drinking: A Cross-Cultural Perspective

ABSTRACT The purpose of this study was to evaluate how drinking is related to positive expectations of the effects of drinking. Data emanates from Gender, Alcohol and Culture - An International Study (GENACIS), a collaborative project in which surveys from all included countries utilized the same core questionnaire. Three indicators for positive expectations were used, representing a social, relational, and intimate dimension. Cross-country comparisons of positive expectancy reports were conducted, as well as exploratory multiple regression analyses of the relationships between expectations and drinking. Volume and binge drinking were used as two indicators for drinking pattern. The share of current drinkers varied between countries and genders. In all countries, men reported on expectancies more often than women. Regression model results are variable and not directly interpretable into cultural patterns, across countries and continents.