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Argentine Tango: Another Behavioral Addiction?

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Argentine Tango: Another Behavioral Addiction? Journal of Behavioral Addictions 2(3), pp. 179–186 (2013) JournalDOI: of10.1556/JBA.2.2013.007 Behavioral Addictions First publishedDOI: 10.1556/JBA.2.2013.007 online June 14, 2013 Argentine tango: Another behavioral addiction? REMI TARGHETTA1#, BERTRAND NALPAS1,2*# and PASCAL PERNEY1 1Service d’Addictologie, CHU Caremeau, Nîmes, France 2Inserm U1016, Nîmes, France (Received: December 14, 2012; revision received: February 22, 2013; second revision received: April 8, 2013; accepted: April 9, 2013) Background: Behavioral addiction is an emerging concept based on the resemblance between symptoms or feelings provided by drugs and those obtained with various behaviors such as gambling, etc. Following an observational study of a tango dancer exhibiting criteria of dependence on this dance, we performed a survey to assess whether this case was unique or frequently encountered in the tango dancing community. Methods: We designed an online survey based on both the DSM-IV and Goodman’s criteria of dependence; we added questions relative to the positive and negative effects of tango dancing and a self-evaluation of the degree of addiction to tango. The questionnaire was sent via Internet to all the tango dancers subscribing to “ToutTango”, an electronic monthly journal. The prevalence of dependence was analyzed using DSM-IV, Goodman’s criteria and self-rating scores separately. Results: 1,129 tango dancers answered the questionnaire. Dependence rates were 45.1, 6.9 and 35.9%, respectively, according to the DSM-IV, Goodman’s criteria and self-rating scores. Physical symptoms of withdrawal were reported by 20% of the entire sample and one-third described a strong craving for dancing. Positive effects were high both in dependent and non-dependent groups and were markedly greater than negative effects. Long practice of tango dancing did not modify the dependence rate or reduce the level of positive effects. Conclusions: Tango dancing could lead to depend- ence as currently defined. However, this dependence is associated with marked and sustained positive effects whilst the negative are few. Identifying the precise substratum of this dependence needs further investigation. Keywords: addiction, tango, behavior, dependence INTRODUCTION practice more and more tango as he wanted; then he moved to Argentina for 2 years to improve and intensify his prac- tice; in Buenos Aires he danced every day from 11 PM to For the World Health Organization, addiction is now consid- 4 AM and moreover spent 2 hours at least for preparation; he ered to be a neurobiological disease (World Health Organi- has never considered to reduce or stop dancing and, con- zation, 2004) defined as a compulsion to use a drug and the versely, he started liking dancing more and more because he onset of withdrawal symptoms when consumption stops. At was feeling growing pleasure. He claimed that this practice first restricted to drug and alcohol misuse, the concept of ad- presented no drawback, and on the contrary, there have been diction has been subsequently extended to “pathological” advantages such as well-being and self-confidence. Finally, behaviors such as exercise addiction (Allegre, Souville, the only time he did not dance was during a holiday week, he Therme & Griffiths, 2006), compulsive buying, sexual hy- developed symptoms looking like those observed during peractivity (Duarte Garcia & Thibaut, 2010), com- withdrawal such as sadness, feeling uncomfortable and leg puter/video playing and gambling, this list being still open prickling. RT concluded that the relationship of this dancer for debate (Holden, 2010). with tango could correspond to an addiction which substan- Tango is a popular dance for two, which originated in tially differed from exercise dependence on sports such as Rio de la Plata, Argentina, in the mid-19th century. Al- running (Sachs & Pargman, 1979; Thornton & Scott, 1995) though several styles exist, tango is mostly danced in either or body-building (Smith & Hale, 2005), since tango dancing open or close embrace, with long elegant steps and complex requires usually smooth physical effort, it is always per- figures often with sensual connotation. Dancers, men and formed in an arousing senses environment, while embracing women, wearing specific clothes and shoes, are perfumed consecutively different partners. This unpublished observa- and very elegant. tion became the supporting argument of the thesis that RT The first author of this article (RT) is a physician special- defended for his addiction certification in 2009. ized in addiction and an experienced tango dancer. At the Tango dancing has been reported to be an alternative end of a 10-day tango festival, he noticed a dancer presented therapy for balance, turning and moving improvement, par- by the tango teacher as the only dancer who attended the ticularly in patients with Parkinson’s disease (Duncan & milonga (place for tango dancing) every night from the Earhart, 2012; Hackney & Earhart, 2009) and an efficient opening to the end of the session. RT developed a friendly relationship with this dancer and throughout their discus- sions RT suspected this dancer could be “addicted” to tango. * Corresponding author: Bertrand Nalpas, MD, PhD, Inserm Therefore, RT proposed to the dancer to conduct a complete U1016, Service d’Addictologie, CHU Caremeau, Place du Pr. interview, aiming to verify this hypothesis: He was a white Robert Debré, 30900 Nîmes, France; Phone: +33 (0)466 687 214; collar in an insurance firm and has a very good income; he E-mail: [email protected] suddenly stopped working at 52 years of age in order to # Both authors contributed equally to the study. ISSN 2062-5871 © 2013 Akadémiai Kiadó, Budapest Targhetta et al. adjunct for the treatment of depression (Pinniger, Brown, Measures Thorsteinsson & McKinley, 2012) but no study describing a possible addiction to tango has been published as stated by Several screening questionnaires of addictive behaviors did an extensive research in PubMed, Web of Science, using the exist, however, all are specific of a given behavior such as keywords “tango, Argentine tango, addiction, dependence”. exercise (Exercise Dependence Scale [Downs, Hausenblas Taking into account the case observed, the question was & Nigg, 2004]; Exercise Addiction Inventory [Terry, Szabo to assess whether tango dancing could lead to addictive be- & Griffiths, 2004]), gambling (South Oaks Gambling havior or was the dancer a highly specific and unique exam- Screen [Lesieur & Blume, 1987]); DSM IV-TR diagnostic ple. We therefore conducted a survey in the community of criteria of pathological gambling (Stinchfield, Govoni & tango dancers in France. Frisch, 2005), body building (Bodybuilding Dependency Scale [Smith, Hale & Collins, 1998]), Internet (Internet Ad- diction Test [Young, 1998]; Compulsive Internet Use Scale METHODS [Meerkerk, Van Den Eijnden, Vermulst & Garretsen, 2009]) and so on, but none of them specifically fits with dancing. Participants Moreover, as it was presumed that tango addiction did not fit well with exercise dependence, the corresponding diagnos- The targeted sample was made up of all the subscribers to tic questionnaires did not appear to be appropriate for this the journal “ToutTango”, an electronic and printed monthly study. As all these tools are derived from DSM-IV (Ameri- newspaper devoted to tango dancing. At time of the study, can Psychiatric Association, 2000) criteria for substance de- about 15,000 persons were registered in the database of the pendence (tolerance, withdrawal, relapse, conflicts, etc.) we journal. In the November 2011 issue, an advertisement was built a questionnaire based upon DSM-IV by re-writing each posted in the journal explaining that a survey aiming to eval- criterion to adapt them to tango, but without modifying their uate whether tango dancing could be an addictive behavior actual meaning; to complete our evaluation toolbox, we also was to be conducted the following month; this advertise- adapted the Goodman’s diagnostic criteria for addictive dis- ment also explained the reason for such a study and its mo- orders (Goodman, 1990) (Table 1) and, secondly, we added dalities; it requested all tango dancers to participate in the a Likert scale from 0 to 5 for self-evaluation of the degree of survey, even those only practicing occasionally or novices. addiction to tango. All items from DSM-IV and Goodman The survey was entitled “Are you tango addicted?” could be included except that corresponding to the “repeated Table 1. Tango dancing questionnaire according to DSM-IV and Goodman’s criteria Correspondence to 2 Goodman1 criteria DSM-IV Effects Questions A Q1. It’s difficult for me not to dance E1, E6 6 Q2. I organize my vacation in relation to tango dancing E7 7 Q3. I dance even if I am injured or ill 2b Q4. After several days without dancing, I have to dance to feel good E7 7 Negative Q5. Tango dancing has persistent negative effects on my life (familial, social, professional or psychological) Positive Q6. The more I dance, the more pleasure I have E5 6 Q7. I go dancing although I have other things to do Positive Q8. Tango dancing benefits my physical health (weight, cardio-vascular system, etc.) 2b Q9. I dance to avoid withdrawal symptoms 4 Q10. I would like to dance more E6 6 Q11. I have given up or reduced other important activities (familial, social, occupational, recreational) because of dancing C Q12. I feel reassured, my nervous tension goes down when I dance E8 1a Q13. At the beginning of tango dancing, I needed to increase my time of dancing (excepted that devoted to learning) E7 Q14. A large part of my income is devoted to tango B Q15. I feel an increasing sense of tension immediately prior to dancing D-E2 3 Q16. I dance longer than intended Positive Q17. Tango dancing benefits my life (familial, social, professional or psychological) E1 Q18. All the clothes, shoes, music that I buy are in relation with tango E9 2a Q19. I have withdrawal symptoms (feel bad, impatience, irritability, frustration, restlessness) if I cannot dance for several days E1-E4 5 Q20.
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