Project

Towards the understanding of neuronal mechanisms of compulsive sexual behaviors (National Science Centre of Poland, 2015-2018)

Goal: In the recent years there was an increase in the number of people suffering from the loss of control over sexual behavior (time spent on pornography, masturbation or use of paid sexual services). There is ongoing discussion among therapists and researchers, about how to conceptualize such compulsive sexual behaviors (CSB) and perform efficient psychotherapeutic intervention. The aim of the project is to: 1) identify the key neural mechanisms underlying CSB, and 2.) verify the causal role of identified neural mechanisms for CSB symptoms.

Methods: Questionnaire-Based Surveys, Clinical Interview, fMRI Analysis, Behavioral Experiment, Behavioral Sampling

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Project log

Ewelina Kowalewska
added a research item
Introduction Human sexuality is a multidimensional phenomenon related to several factors, such as self-esteem, awareness of sexual needs, and ability to communicate them to others. Aim To examine the sexual characteristics of patients seeking treatment for compulsive sexual behavior disorder (CSBD)—a clinical diagnosis recently included in the 11th edition of the International Classification of Diseases classification. Methods We have investigated the sexual characteristics of 72 Polish men seeking treatment for CSBD compared with 208 men from the Polish general population. Main Outcome Measures The Multidimensional Sexual Questionnaire–PL was used to examine 12 sexual aspects of human sexuality. The severity of CSBD symptoms was assessed using Sexual Addiction Screening Test–PL, and the severity of problematic pornography use was measured by Brief Pornography Screener. Results Results show that CSBD patients (when compared with the general population) exhibit higher sexual anxiety, sexual depression, external sexual control, and fear of sexual relationship. Furthermore, CSBD severity is negatively related to sexual esteem, internal sexual control, sexual consciousness, sexual assertiveness, and sexual satisfaction. Clinical Implications Our findings suggest that the impairment of the abovementioned dimensions warrant attention during clinical work and future studies on CSBD. Strengths & Limitations This study was limited to men, most of whom self-identified as heterosexual. Future research should include women and non-heterosexual identified individuals. Conclusion Sexual esteem, consciousness, assertiveness, satisfaction and internal sexual control are commonly affected among CSBD individuals and should be properly addressed during the clinical interview and treatment intervention.
Karolina Golec
added a research item
Za źródło objawów Kompulsywnych Zachowań Seksualnych (CSB) uznaje się zakłócenie przebiegu procesu przetwarzania nagród, u którego podstaw leży aktywność dopaminergicznych struktur mózgowego Układu Nagrody. Pacjentów cechuje nadmierna wrażliwość na wskazówki, zapowiadające możliwość wystąpienia nagrody i informujące o jej właściwościach. Spostrzeżenie wskazówki powoduje nadmierne pragnienie zdobycia nagrody, nieproporcjonalne do czerpanej z niej satysfakcji. Przedstawione w tej pracy badanie miało na celu pogłębienie rozumienia wpływu parametrów statystycznych nagrody, takich jak prawdopodobieństwo i niepewność, na proces przetwarzania nagrody w CSB. Wykazano, że zwiększona reaktywność na konkretny rodzaj nagród w stopniu większym niż prawdopodobieństwo nagrody wyjaśnia dezadaptacyjne zachowanie osób poszukujących profesjonalnej pomocy z powodu utraty kontroli nad zachowaniami seksualnymi.
Mateusz Gola
added a research item
The letter by Kraus et al. (2018) published recently in World Psychiatry presents diagnostic criteria for compulsive sexual behaviors (CSBs). Here, we discuss the potential impact of including CSB disorder in ICD-11 for four areas: educational efforts related to CSB (for both clinicians and patients), investigation of underlying mechanisms and subtypes, development of personalized treatment frameworks, and answering socially important questions and advancing important prevention efforts and effective policies. Each of these four areas has their own challenges that should be addressed, and we briefly describe and discuss them. We hope that this information will help continue a dialog and provide a framework for moving forward in this area.
Mateusz Gola
added a research item
Background and aims Compulsive sexual behaviors (CSBs) are an important clinical and social issue. Despite the increasing number of studies, some of CSB’s aspects remain under-investigated. Here, we explore the nature of CSB, such as binge pornography use and masturbation (PuM), and verify the correspondence between self-perceived factors leading to such behavior with its measures obtained in a diary assessment. Methods Semi-structuralized interviews with nine treatment-seeking males aged 22–37 years (M = 31.7, SD = 4.85) were followed by a questionnaire and a 10-week-long diary assessment, allowing us to acquire real-life daily patterns of CSB. Results Six out of nine subjects experienced binge (multiple hours or times a day) PuM. All subjects presented a high level of anxiety and perceived PuM as a way to regulate mood and stress. Data collected in the diary assessment uncovered a high diversity in the patterns of sexual behaviors (such as frequency of regular and binge PuM) and its correlates. Binge PuM was related to decreased mood and/or increased stress or anxiety. The causal relation between these correlates remains undetermined. Discussion and conclusions Binge PuM seems to be one of the most characteristic behavior among males who are seeking treatment for CSB and is related to the feeling of losing control over one’s sexual activity. CSB individuals indicate a variety of binge triggers. Also, diary assessment data indicate that specific correlates of binge PuM (decreased mood, increased stress, and anxiety) differ between subjects. It suggests the existence of significant individual differences in binge PuM behaviors, and a need to study these differences, as it may help guide personalized treatment.
Mateusz Gola
added 2 research items
Pornography consumption is highly prevalent, particularly among young adult males. For some individuals, problematic pornography use (PPU) is a reason for seeking treatment. Despite the pervasiveness of pornography, PPU appears under-investigated, including with respect to the underlying neural mechanisms. Using functional magnetic resonance imaging (fMRI), we examined ventral striatal responses to erotic and monetary stimuli, disentangling cue-related ‘wanting’ from reward-related ‘liking’ among 28 heterosexual males seeking treatment for PPU and 24 heterosexual males without PPU. Subjects engaged in an incentive delay task in the scanner, in which they received erotic or monetary rewards preceded by predictive cues. BOLD responses to erotic and monetary cues were analyzed and examined with respect to self-reported data on sexual activity collected over the 2 preceding months. Men with and without PPU differed in their striatal responses to cues predicting erotic pictures, but not in their responses to erotic pictures. PPU subjects when compared to control subjects showed increased activation of ventral striatum specifically for cues predicting erotic pictures but not for cues predicting monetary gains. Relative sensitivity to cues predicting erotic pictures versus monetary gains was significantly related to the increased behavioral motivation to view erotic images (suggestive of higher ‘wanting’), severity of PPU, amount of pornography use per week and number of weekly masturbations. Our findings suggest that, similar to what is observed in substance and gambling addictions, the neural and behavioral mechanisms associated with the anticipatory processing of cues specifically predicting erotic rewards relate importantly to clinically relevant features of PPU. These findings suggest that PPU may represent a behavioral addiction and that interventions helpful in targeting behavioral and substance addictions warrant consideration for adaptation and use in helping men with PPU.
Mateusz Gola
added a research item
Pornography consumption is highly prevalent, particularly among young adult males. For some individuals, problematic pornography use (PPU) is a reason for seeking treatment. Despite the pervasiveness of pornography, PPU appears under-investigated, including with respect to the underlying neural mechanisms. Using functional magnetic resonance imaging (fMRI), we examined ventral striatal responses to erotic and monetary stimuli, disentangling cue-related ‘wanting’ from reward-related ‘liking’ among 28 heterosexual males seeking treatment for PPU and 24 heterosexual males without PPU. Subjects engaged in an incentive delay task in the scanner, in which they received erotic or monetary rewards preceded by predictive cues. BOLD responses to erotic and monetary cues were analyzed and examined with respect to self-reported data on sexual activity collected over the 2 preceding months. Men with and without PPU differed in their striatal responses to cues predicting erotic pictures, but not in their responses to erotic pictures. PPU subjects when compared to control subjects showed increased activation of ventral striatum specifically for cues predicting erotic pictures but not for cues predicting monetary gains. Relative sensitivity to cues predicting erotic pictures versus monetary gains was significantly related to the increased behavioral motivation to view erotic images (suggestive of higher ‘wanting’), severity of PPU, amount of pornography use per week and number of weekly masturbations. Our findings suggest that, similar to what is observed in substance and gambling addictions, the neural and behavioral mechanisms associated with the anticipatory processing of cues specifically predicting erotic rewards relate importantly to clinically relevant features of PPU. These findings suggest that PPU may represent a behavioral addiction and that interventions helpful in targeting behavioral and substance addictions warrant consideration for adaptation and use in helping men with PPU.
Mateusz Gola
added 16 research items
Introduction: Sexual arousability is defined as an ability to react with sexual arousal in response to external and internal stimuli. Sexual arousablity measuring is important for research purposes and for diagnostics of sexual dysfunctions. Self-Assessment techniques can be used for such measurement. Due to absence of Polish-language psychometric tools dedicated for sexual arousability measuring we adapted Sexual Arousability Inventory. Material and methods: Psychometrical characteristic of Polish version of SAI (SAI-PL) was examined in the study with 132 participants (42 females, 90 males) and validation with behavioral factors was performed on the group of 39 heterosexual males consuming pornography on the weekly basis. Results: SAI-PL has almost identical characteristics as original SAI (high internal consistency, the same factorial structure and high reliability). Conclusions: Polish version of SAI can be successfully used for research purposes as well as in clinical setups.
Mateusz Gola
added a project goal
In the recent years there was an increase in the number of people suffering from the loss of control over sexual behavior (time spent on pornography, masturbation or use of paid sexual services). There is ongoing discussion among therapists and researchers, about how to conceptualize such compulsive sexual behaviors (CSB) and perform efficient psychotherapeutic intervention. The aim of the project is to: 1) identify the key neural mechanisms underlying CSB, and 2.) verify the causal role of identified neural mechanisms for CSB symptoms.