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Decreased LPP for sexual images in problematic pornography users may be consistent with addiction models. Everything depends on the model. (Commentary on Prause, Steele, Staley, Sabatinelli, & Hajcak, 2015)

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  • University of California, San Diego / Polish Academy of Sciences, Warsaw
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... text, picture, audio, video, animation, etc.). pornography being causative to men committing sexual violence (Allen, D'alessio, & Brezgel, 1995;Fisher, & Barak 1991;McKee, 2007a;Malamuth, Addison, & Koss, 2000), or being problematically "used" to excess because of an obsession, compulsion, or a drug-like dependence (Gola, 2016;Prause, Steele, & Staley, 2015;Kafka, 2010;Short, Black, Smith, Wetterneck & Wells 2012;Twohig, Crosby, & Cox, 2009; for criticism see Clarkson & Kopaczewski, 2013). As such, it is worth noting that pornography addiction is not a new conception of pornography being harmful to its audience, but is instead a new theoretical outcropping built upon an enduring substrate of research. ...
... Put simply, whether pornography can discretely "effect" its audience (beyond sexual arousal) remains a site of contentious debate (for example see Gola, 2016;Prause et al. 2015Prause et al. , 2016, with addiction offering a new twist on an old recipe. As discussed further below, instead of representing a new conceptual venture in pornography scholarship, the "addiction" conception of pornography's harm makes for a superficially alluring proposition. ...
... Indeed, the usefulness of the addiction framework for problematic pornography viewing has recently been described in a therapeutic context as "a simplification of a complex individual's psychological functioning with limited clinical relevance" (Wéry et al. 2019, p. 124 7 ). Finally, even when choosing whether or not to describe pornography as addictive, as Gola (2016) suggests in his defence of an addiction approach to problematic pornography viewing, the applicability of the addiction concept further depends upon which model of addiction a researcher chooses (Gola cites Incentive Salience Theory and Reward Deficiency Syndrome for example; see also Walters & Gilbert 2000). Even at a purely semantic level of consideration, the question must be asked as to how Internet, sex, cybersex, pornography, and any other number of addictions are supposed to relate: what is the addictive aspect? ...
Thesis
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Over the last five decades the landscape of pornography as a medium, and the way that pornography is researched and discussed, have shifted. In the first instance, the migration of pornography to more powerful delivery networks has created predictable waves of anxiety about pornography’s ubiquity, content, and consequences. However, in the second instance, the focus of these concerns have changed over time, from protests against pornography on political and sociocultural grounds, to become a battle of the pathological individual. In this thesis, I argue first that this shift represents a convergence of discourses, as old political agitation has given way to a sterile language of expertise and medicalisation. At the same time the unease which underpinned protests against pornography have remained, giving rise to an oxymoronic contemporary tension between pornography as both risky yet ubiquitous and largely unmoderated. Hereafter I argue that the concept of pornography addiction serves a reconciliatory function, as a way of delineating between acceptable and unacceptable pornography viewing. In turn, I argue that pornography addiction offers individuals – and society at large – a scapegoat upon which the excesses of pornography can be divested, while a widespread tolerance for pornography viewing remains intact. As I will explore, the actual experiences of viewing pornography rarely fit into the neat formula of addictive or not, leaving pornography viewers suspended in a discursive gulf between the promise of pleasure and the threat of pathology. Indeed, while viewers of pornography present a peculiar cohort – contradictorily stereotyped as both perverts and sexually adventurous – the experience of pornography viewing as complex, challenging, and ambiguous is rarely considered or investigated. Utilizing media and social media analyses, survey responses, and interview data, this thesis drills down into the ways that pornography, addiction, pornography viewing, and “Pornography Addiction” are made sense of by its viewership. Here I argue, not only that vague understandings of pornography as addictive have created a confusing environment for researchers and pornography viewers alike, but that such pervasive sense-making is fertile ground for the contemporary flourishing of the very pathology being described.
... En la última década, el uso de la pornografía en la internet se ha convertido en algo popular (Mayer, 2011). Para la mayoría de las personas, el uso de pornografía es algo entretenido, para otros se convierte en un hábito que genera dependencia y comportamientos fuera de control (Gola, 2016). Estudios previos han sugerido que el uso de la pornografía puede influir en los comportamientos sexuales (Gola, 2016). ...
... Para la mayoría de las personas, el uso de pornografía es algo entretenido, para otros se convierte en un hábito que genera dependencia y comportamientos fuera de control (Gola, 2016). Estudios previos han sugerido que el uso de la pornografía puede influir en los comportamientos sexuales (Gola, 2016). Según Joyce (2008), la regulación de la pornografía en la web ha demostrado ser una tarea especialmente difícil para los legisladores y la comunidad internacional, debido en gran parte a su naturaleza voluble y al medio electrónico en el que reside. ...
Article
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p>La pornografía puede definirse como el material audiovisual que presenta de forma explícita actividades sexuales y genitales de manera inocultable, con el objetivo de excitar al espectador. El objetivo de este trabajo es identificar las principales causas y consecuencias de la adicción a la pornografía en hombres y mujeres. Se empleó la metodología de la revisión sistemática de literatura (RSL), tomando como referencia investigaciones previas publicadas en bases de datos científicas y publicaciones web especializadas. Este trabajo concluye que la adicción a la pornografía puede generar problemas físicos, mentales, psicológicos y sociales, que son equiparables con los que genera la adicción al consumo de sustancias psicoactivas. Establecer estrategias de autocontrol, incrementar la actividad física y la participación en actividades sociales son algunas de las alternativas que pueden ayudar a combatir y prevenir la adicción.</p
... 11, N. 19, pp.24-45, Disponible en https://doi.org/10.25057/issn.2145-2776 36 considerando la gran apertura hacia experiencias en la realidad virtual que puede favorecer al desarrollo de este tipo de adicción (Love, Laier, Brand, Hatch, Hajela, 2015: Gola, 2016. En cuanto a la ludopatía son 12.68 % de los participantes mostraron actitud favorable hacia conductas de ludopatía, al igual como 12,19 % son indiferentes. ...
Article
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La filosofía consumista de la sociedad contemporánea sumada a una proliferación de medios tecnológicos virtuales que hacen más fácil la obtención de objetivos deseados, conduce a un aumento de conductas adictivas que trascenden al espectro de adiciones clásicas a sustancias psicoactivas químicas. Actualmente, se observan cada vez con mayor frecuencia las conductas adictivas relacionadas con aspectos de la vida cotidiana como medios tecnológicos, compras, cuidado corporal, trabajo, entre otros. En este orden de ideas, las actitudes que presentan los niños y adolescentes en relación a conductas adictivas son de gran importancia ya que constituyen un factor de riesgo que sumado a cierto tipo de circunstancias, podrá llevar al desarrollo de conductas adictivas en el futuro. El artículo expone resultados de un estudio orientado a indagar por las actitudes de favorabilidad hacia conductas adictivas, prevalentes en una muestra de adolescentes entre 12 y 18 años de algunas instituciones educativas de Medellín y Riosocio. El estudio de corte cuantitativo, nivel descriptivo, contó con una muestra de 92 estudiantes en edades entre 12 y 19 años, se empleo una escala Likert diseñada para el presente estudio, Alfa de Cronbach de 0.96. Los resultados muestran porcentajes bastante elevados de actitudes favorables hacia las conductas adictivas relacionadas con el consumo de sustancias químicas, sexo, ludopatía, desordendes alimenticios, tecnologia, compras, vigorexia y ergomanía, lo cual indica la necesidad de intervenciones psicoeducativas orientadas al fomento de consciencia critico-reflexiva en la poblacion estudiantil al respecto de muchos aspectos relacionados con los valores imperantes en la sociedad contemporanea, con el fin de evitar un posible surgimiento de futuros comportamientos adicitvos en estas áreas de sus vidas.
... While most view pornography without problems, some view compulsively and seek treatment (Gola, Lewczuk, & Skorko, 2016;. How best to conceptualize problematic pornography use (PPU) and intervene most effectively remain debated, with obsessivecompulsive-disorder (OCD) and addiction frameworks discussed (Gola, 2016;Kor, Fogel, Reid, & Potenza, 2013;Kraus, Voon, & Potenza, 2016;Prause, 2016). Paroxetine, due to its efficacy in OCD and anxiety disorders (Stein, Andersen, Tonnoir, & Fineberg, 2007) and negative impact on libido (Abler et al., 2011), has been used in PPU treatment. ...
Article
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Background How best to conceptualize problematic pornography use (PPU) and intervene most effectively remain debated, with obsessive–compulsive disorder (OCD) and addiction frameworks. We investigated the efficacy of the serotonin-reuptake inhibitor paroxetine in combination with cognitive-behavioral therapy in the treatment of problematic pornography use (PPU). Case presentation Three heterosexual males with PPU were treated with cognitive-behavioral therapy and paroxetine. Frequency of pornography use, other sexual behaviors, and anxiety were assessed during treatment. Discussion Paroxetine treatment, although seemingly initially effective in reducing pornography use and anxiety, appeared related to new compulsive sexual behaviors after 3 months. Conclusions Paroxetine may hold promise for short-term reduction of PPU and related anxiety, but new potentially distressing sexual behaviors may emerge. The cases suggest that PPU may arise from multiple domains. We propose an explanation of the effects based on recent neuroscientific research on sexual behaviors and alcohol use.
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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.
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Traditional factors that once explained men's sexual difficulties appear insufficient to account for the sharp rise in erectile dysfunction, delayed ejaculation, decreased sexual satisfaction, and diminished libido during partnered sex in men under 40. This review (1) considers data from multiple domains, e.g., clinical, biological (addiction/urology), psychological (sexual conditioning), sociological; and (2) presents a series of clinical reports, all with the aim of proposing a possible direction for future research of this phenomenon. Alterations to the brain's motivational system are explored as a possible etiology underlying pornography-related sexual dysfunctions. This review also considers evidence that Internet pornography's unique properties (limitless novelty, potential for easy escalation to more extreme material, video format, etc.) may be potent enough to condition sexual arousal to aspects of Internet pornography use that do not readily transition to real-life partners, such that sex with desired partners may not register as meeting expectations and arousal declines. Clinical reports suggest that terminating Internet pornography use is sometimes sufficient to reverse negative effects, underscoring the need for extensive investigation using methodologies that have subjects remove the variable of Internet pornography use. In the interim, a simple diagnostic protocol for assessing patients with porn-induced sexual dysfunction is put forth.
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There is an increasing number of neuroimaging studies using visual sexual stimuli (VSS), especially within the emerging field of research on compulsive sexual behaviors (CSB). A central question in this field is whether behaviors such as excessive pornography consumption share common brain mechanisms with widely studied substance and behavioral addictions. Depending on how VSS are conceptualized, different predictions can be formulated within the frameworks of Reinforcement Learning or Incentive Salience Theory, where a crucial distinction is made between conditioned and unconditioned stimuli (related to reward anticipation vs. reward consumption, respectively). Surveying 40 recent human neuroimaging studies we show existing ambiguity about the conceptualization of VSS. Therefore, we feel that it is important to address the question of whether VSS should be considered as conditioned stimuli (cue) or unconditioned stimuli (reward). Here we present our own perspective, which is that in most laboratory settings VSS play a role of reward, as evidenced by: (1) experience of pleasure while watching VSS, possibly accompanied by genital reaction; (2) reward-related brain activity correlated with these pleasurable feelings in response to VSS; (3) a willingness to exert effort to view VSS similarly as for other rewarding stimuli such as money; and (4) conditioning for cues predictive of VSS. We hope that this perspective article will initiate a scientific discussion on this important and overlooked topic and increase attention for appropriate interpretations of results of human neuroimaging studies using VSS.
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Hypersexuality has been defined as abnormally increased sexual activity. Epidemiological and clinical studies have shown that this non-paraphilic condition consists of "excessive" sexual behaviors and disorders accompanied by personal distress and social and medical morbidity. It is a very controversial and political topic in terms of how best to categorize it as similar or not similar to addictive behaviors including substance abuse. Hypersexual disorder is conceptualized as a non-paraphilic sexual desire disorder with impulsivity. Pathophysiological perspectives include dysregulation of sexual arousal and desire, sexual impulsivity, and sexual compulsivity. The nucleus accumbens, situated within the ventral striatum, mediates the reinforcing effects of drugs of abuse, such as cocaine, alcohol, nicotine, and food as well as music. Indeed, it is believed that this structure mandates behaviors elicited by incentive stimuli. These behaviors include natural rewards like feeding, drinking, sexual behavior, and exploratory locomotion. An essential rule of positive reinforcement is that motor responses will increase in magnitude and vigor if followed by a rewarding event. Here, we are hypothesizing that there is a common mechanism of action (MOA) for the powerful effects drugs, music, food, and sex have on human motivation. The human drive for the three necessary motivational behaviors "hunger, thirst, and sex" may all have common molecular genetic antecedents that, if impaired, lead to aberrant behaviors. We hypothesize that based on a plethora of scientific support hypersexual activity is indeed like drugs, food, and music that activate brain mesolimbic reward circuitry. Moreover, dopaminergic gene and possibly other candidate neurotransmitter-related gene polymorphisms affect both hedonic and anhedonic behavioral outcomes. There is little known about both the genetics and epigenetics of hypersexuality in the current literature. However, we anticipate that future studies based on assessments with clinical instruments combined with genotyping of sex addicts will provide evidence for specific clustering of sexual typologies with polymorphic associations. There have been some studies using electrophysiological techniques that do not support the view that hypersexuality is indeed similar to substance abuse and other behavioral addictions. The authors are also encouraging both clinical and academic scientists to embark on research using neuroimaging tools to examine natural dopaminergic agonistic agents targeting specific gene polymorphisms to "normalize" hypersexual behavior.
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Background How best to conceptualize problematic pornography use (PPU) and intervene most effectively remain debated, with obsessive–compulsive disorder (OCD) and addiction frameworks. We investigated the efficacy of the serotonin-reuptake inhibitor paroxetine in combination with cognitive-behavioral therapy in the treatment of problematic pornography use (PPU). Case presentation Three heterosexual males with PPU were treated with cognitive-behavioral therapy and paroxetine. Frequency of pornography use, other sexual behaviors, and anxiety were assessed during treatment. Discussion Paroxetine treatment, although seemingly initially effective in reducing pornography use and anxiety, appeared related to new compulsive sexual behaviors after 3 months. Conclusions Paroxetine may hold promise for short-term reduction of PPU and related anxiety, but new potentially distressing sexual behaviors may emerge. The cases suggest that PPU may arise from multiple domains. We propose an explanation of the effects based on recent neuroscientific research on sexual behaviors and alcohol use.
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Introduction: Pornography has become popular with Internet technology. For most people, pornography use (PU) is entertainment; for some, it can result in seeking treatment for out-of-control behavior. Previous studies have suggested that PU can influence sexual behaviors, but the direct relation between frequency of PU and treatment-seeking behaviors has not been examined. Aims: To investigate whether individuals seeking treatment as a consequence of their problematic PU do so because of their quantity of pornography consumption or because of more complex psychological and behavioral factors related to PU, such as the severity of negative symptoms associated with PU and/or subjective feeling of loss of control over one's behavior. Methods: A survey study was conducted of 569 heterosexual Caucasian men 18 to 68 years old, including 132 seeking treatment for problematic PU (referred by psychotherapists after their initial visit). Main outcomes measures: The main outcome measures were self-reported PU, its negative symptoms, and actual treatment-seeking behavior. Results: We tested models explaining sources of seeking treatment for problematic PU with negative symptoms associated with PU and additional factors (eg, onset and number of years of PU, religiosity, age, dyadic sexual activity, and relationship status). Seeking treatment was significantly, yet weakly, correlated solely with the frequency of PU (r = 0.21, P < .05) and this relation was significantly mediated by negative symptoms associated with PU (strong, nearly full mediation effect size; k(2) = 0.266). The relation between PU and negative symptoms was significant and mediated by self-reported subjective religiosity (weak, partial mediation; k(2) = 0.066) in those not seeking treatment. Onset of PU and age appeared to be insignificant. Our model was fairly fitted (comparative fit index = 0.989; root mean square error of approximation = 0.06; standardized root mean square residual = 0.035) and explained 43% of the variance in treatment-seeking behavior (1% was explained by frequency of PU and 42% was explained by negative symptoms associated with PU). Conclusion: Negative symptoms associated with PU more strongly predict seeking treatment than mere quantity of pornography consumption. Thus, treatment of problematic PU should address qualitative factors, rather than merely mitigating the frequency of the behavior, because frequency of PU might not be a core issue for all patients. Future diagnostic criteria for problematic PU should consider the complexity of this issue.
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To investigate consumption of and attitudes toward pornography in relation to demographic factors and relationships to parents among third-year high school students. A random sample of 718 students with a mean age 18 years (range 17-21) completed a classroom questionnaire consisting of 89 questions. More students in practical than in theoretical study programmes had parents with a practical profession (p < 0.001). More parents to students attending theoretical programmes owned their housing (p < 0.001). More men than women had ever consumed pornography (98% vs. 72%; p < 0.001). More practical than theoretical students were influenced by watching pornographic films, fantasizing about (p < 0.05) or having performed acts inspired by pornography (p < 0.05). Both theoretical and practical male students had more favourable attitudes toward pornography than either group of female students (p < 0.001; p = 0.037). More female, than male students, were of the opinion that pornography could create uncertainty and demands. Students' high school programme choices partly reflect their social background. Pornography was consumed mainly by male students, who also had the most favourable attitudes, while females mainly had negative attitudes. To promote sexual health these differences between genders and study programmes should be taken into consideration in counselling, and in sex- and relationships education.
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This article explores how the concepts of cybersex and sexual addiction overlap. Sexual addiction is explained briefly to provide the reader with the necessary information to understand how this overlap may occur. Examination of data from recent studies in cybersex are presented. In addition, several cybersex case examples are provided to illuminate numerical findings with real-life clinical examples. Recommendations for future research are presented along with the Internet Sex Screening Test to help assess whether someone may need help with their cybersexual addiction.
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We examined exposure to Internet pornography before the age of 18, as reported by college students (n = 563), via an online survey. Ninety-three percent of boys and 62% of girls were exposed to online pornography during adolescence. Exposure prior to age 13 was relatively uncommon. Boys were more likely to be exposed at an earlier age, to see more images, to see more extreme images (e.g., rape, child pornography), and to view pornography more often, while girls reported more involuntary exposure. If participants in this study are typical of young people, exposure to pornography on the Internet can be described as a normative experience, and more study of its impact is clearly warranted.
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The aims of the study were (1) to investigate gender differences in pornography consumption among Danish adults aged 18-30 and (2) to examine gender differences in situational, interpersonal, and behavioral characteristics of pornography consumption. A national survey study was conducted using a representative sample of 688 young heterosexual Danish adult men and women. The study found large gender differences in prevalence rates of pornography consumption and consumption patterns. Compared to women, men were exposed to pornography at a younger age, consumed more pornography as measured by time and frequency, and used pornography more often during sexual activity on their own. Gender differences in the interpersonal context of use were also evident, with women using pornography more often with a regular sexual partner than men. In turn, men were found to use pornography more often on their own or with friends (non-sexual partners) than women. For both men and women, the usual place of use was home and no significant gender difference was found in this regard. Men and women were found to vary in their preferences in pornographic materials, with men both preferring a wider range of hardcore pornography and less softcore pornography than women. Gender differences in sexual behavioral factors were limited to masturbation patterns with men masturbating more than women. Male gender, higher frequency of masturbation, lower age at first exposure, and younger age were found to account for 48.8% of the total variance of pornography consumption. The results were discussed in relation to the sociocultural environment and evolutionary theory. It is argued that gender differences in social acceptability, adherence to gender stereotypes, traditions of gender sexuality, gender norms, and mating strategies are key factors in understanding gender differences in pornography consumption.
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In the present study, the authors explored the reproductive consequences of fetishistic behavior in a previously developed animal model of sexual fetishism (F. Köksal et al., 2004). Male domesticated quail (Coturnix japonica) received sexual conditioning trials in which a terrycloth object (the conditioned stimulus [CS]) was paired with the opportunity to copulate with a female quail (the unconditioned stimulus). Approximately half of the male quail came to copulate with the CS object and were considered to have developed fetishistic behavior. Each of the male quail was then tested with a female quail, whose eggs were incubated to determine rates of fertilization. The CS object was present for 30 s before and during the copulation test. Fetishistic male quail were slower to achieve cloacal contact with the female quail and showed less efficient copulatory behavior. However, they fertilized a greater proportion of eggs than nonfetishistic male quail. These results are unexpected from previous studies of the relationship between reproductive success and copulatory behavior and are discussed in terms of how fetishistic behavior directed toward an inanimate object may modify male-female interactions.
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Recent human functional imaging studies have linked the processing of pleasant visual stimuli to activity in mesolimbic reward structures. However, whether the activation is driven specifically by the pleasantness of the stimulus, or by its salience, is unresolved. Here we find in two studies that free viewing of pleasant images of erotic and romantic couples prompts clear, reliable increases in nucleus accumbens (NAc) and medial prefrontal cortex (mPFC) activity, whereas equally arousing (salient) unpleasant images, and neutral pictures, do not. These data suggest that in visual perception, the human NAc and mPFC are specifically reactive to pleasant, rewarding stimuli and are not engaged by unpleasant stimuli, despite high stimulus salience.
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The motivation to seek out and consume rewards has evolutionarily been driven by the urge to fulfill physiological needs. However in a modern society dominated more by plenty than scarcity, we tend to think of motivation as fueled by the search for pleasure. Here, we argue that two separate but interconnected sub-cortical and unconscious processes direct motivation: " wanting " and " liking. " These two psychological and neuronal processes and their related brain structures typically work together, but can become dissociated, particularly in cases of addiction. In drug addiction, for example, repeated consumption of addictive drugs sensitizes the mesolimbic dopamine system, the primary component of the " wanting " system, resulting in excessive " wanting " for drugs and their cues. This sensitizing process is long-lasting and occurs independently of the " liking " system, which typically remains unchanged or may develop a blunted pleasure response to the drug. The result is excessive drug-taking despite minimal pleasure and intense cue-triggered craving that may promote relapse long after detoxification. Here, we describe the roles of " liking " and " wanting " in general motivation and review recent evidence for a dissociation of " liking " and " wanting " in drug addiction, known as the incentive sensitization theory (Robinson and Berridge 1993). We also make the case that sensitization of the " wanting " system and the resulting disso-ciation of " liking " and " wanting " occurs in both gambling disorder and food addiction.
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This paper presents a biopsychological theory of drug addiction, the 'Incentive-Sensitization Theory'. The theory addresses three fundamental questions. The first is: why do addicts crave drugs? That is, what is the psychological and neurobiological basis of drug craving? The second is: why does drug craving persist even after long periods of abstinence? The third is whether 'wanting' drugs (drug craving) is attributable to 'liking' drugs (to the subjective pleasurable effects of drugs)? The theory posits the following. (1) Addictive drugs share the ability to enhance mesotelencephalic dopamine neurotransmission. (2) One psychological function of this neural system is to attribute 'incentive salience' to the perception and mental representation of events associated with activation of the system. Incentive salience is a psychological process that transforms the perception of stimuli, imbuing them with salience, making them attractive, 'wanted', incentive stimuli. (3) In some individuals the repeated use of addictive drugs produces incremental neuroadaptations in this neural system, rendering it increasingly and perhaps permanently, hypersensitive ('sensitized') to drugs and drug-associated stimuli. The sensitization of dopamine systems is gated by associative learning, which causes excessive incentive salience to be attributed to the act of drug taking and to stimuli associated with drug taking. It is specifically the sensitization of incentive salience, therefore, that transforms ordinary 'wanting' into excessive drug craving. (4) It is further proposed that sensitization of the neural systems responsible for incentive salience ('for wanting') can occur independently of changes in neural systems that mediate the subjective pleasurable effects of drugs (drug 'liking') and of neural systems that mediate withdrawal. Thus, sensitization of incentive salience can produce addictive behavior (compulsive drug seeking and drug taking) even if the expectation of drug pleasure or the aversive properties of withdrawal are diminished and even in the face of strong disincentives, including the loss of reputation, job, home and family. We review evidence for this view of addiction and discuss its implications for understanding the psychology and neurobiology of addiction.
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Objective: The current study evaluated several psychometric properties of the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) [1] adapted for compulsive sexual behavior (CSB) in a sample of 103 men seeking treatment at a private and a public university clinic in the United States. Method: Measures of mental health functioning were collected from patients on two separate appointments: the initial screening and the follow-up appointment. Results: All patients reported using pornography compulsively, and approximately half of the sample also reported a history of having frequent anonymous sex with strangers. Results found that the adapted Y-BOCS had good internal consistency reliability, moderate mean inter-item correlations, and good test-retest reliability. Results from a multiple regression analysis also found that affect dysregulation (depression and anxiety), particularly among single, impaired men, was significantly associated with more severe sexual obsessive and compulsive features. Approximately 94% of the sample met criteria for at least one psychiatric disorder, and 57% of men met criteria for two or more psychiatric disorders. Conclusions: Findings from the current study suggest the CSB-Y-BOCS is a reliable measure of obsessive and compulsive symptoms associated with CSB, and clinicians and researchers could use this scale to aid in the assessment and treatment of problematic sexual behaviors.
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Information about the pornography-viewing habits of urban, low-income youth of color in the United States is lacking. This study was designed to answer the following using a sample of 16- to 18-year-old urban-residing, low-income Black or Hispanic youth: (1) What types of pornography do youth report watching; where and for what purpose? (2) Do youth feel that pornography exposure has an impact on their own sexual behaviors? and (3) How do parents react to their pornography use? The following themes emerged from interviews with 23 youth: (1) Youth primarily reported watching pornography that featured one-on-one sexual intercourse but also reported having seen extreme pornography (e.g., public humiliation, incest); (2) youth reported watching pornography on home computers or smartphones, and that pornography was frequently watched in school; (3) youth reported watching for entertainment, for sexual stimulation, instructional purposes, and to alleviate boredom; many copied what they saw in pornography during their own sexual encounters; (4) pressure to make or to imitate pornography was an element of some unhealthy dating relationships; and (5) parents were generally described as unsupportive of youth's use of pornography but underequipped to discuss it. Approximately one-fifth expressed a preference for pornography featuring actors of their same race/ethnicity.
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Introduction: Studies investigating the neural responses toward sexual stimuli can provide an important basis for further understanding disorders of sexual functioning. Although our knowledge of the neural correlates of sexual stimulus processing has increased considerably in the last decade, the stability of the observed effects in studies on neural sexual responses has been rather neglected. Aims: The current study aimed to test the stability of behavioral and neural responses to visual sexual stimuli in men and women over a time span of 1 to 1.5 years. To disentangle valence and arousal-related aspects of sexual stimulus processing, we employed not only sexual and neutral, but also positive and negative emotional stimuli. Methods: A sample of 56 subjects (24 women) was assessed twice, with an interval of 1 to 1.5 years between assessments. During a functional magnetic resonance imaging (fMRI) session, participants passively viewed sexual, neutral, positive, and negative emotional pictures. Pictures were presented in 24 blocks of five pictures each. Every block was rated immediately after its presentation with respect to valence, arousal, and sexual arousal. Main outcome measures: Blood oxygen level dependent (BOLD) responses measured by fMRI and stimulus ratings. Results: fMRI analyses revealed a distributed network involved in the processing of sexual stimuli, with large parts of this network being consistently activated at both assessment points. Nucleus accumbens, anterior cingulate, occipital and parietal cortex showed the most robust results with respect to group stability. Responses of anterior cingulate, orbitofrontal, parietal and occipital cortex showed interindividual stability. Gender differences were restricted to a few regions of interest. Conclusions: Our data indicate stability of neural responses toward sexual stimuli not only on the group but also on the individual level. Activation of parietal and occipital cortex might reflect a trait like character of attention related responses toward sexual stimuli.
Article
Importance Since pornography appeared on the Internet, the accessibility, affordability, and anonymity of consuming visual sexual stimuli have increased and attracted millions of users. Based on the assumption that pornography consumption bears resemblance with reward-seeking behavior, novelty-seeking behavior, and addictive behavior, we hypothesized alterations of the frontostriatal network in frequent users.Objective To determine whether frequent pornography consumption is associated with the frontostriatal network.Design, Setting, and Participants In a study conducted at the Max Planck Institute for Human Development in Berlin, Germany, 64 healthy male adults covering a wide range of pornography consumption reported hours of pornography consumption per week. Pornography consumption was associated with neural structure, task-related activation, and functional resting-state connectivity.Main Outcomes and Measures Gray matter volume of the brain was measured by voxel-based morphometry and resting state functional connectivity was measured on 3-T magnetic resonance imaging scans.Results We found a significant negative association between reported pornography hours per week and gray matter volume in the right caudate (P < .001, corrected for multiple comparisons) as well as with functional activity during a sexual cue–reactivity paradigm in the left putamen (P < .001). Functional connectivity of the right caudate to the left dorsolateral prefrontal cortex was negatively associated with hours of pornography consumption.Conclusions and Relevance The negative association of self-reported pornography consumption with the right striatum (caudate) volume, left striatum (putamen) activation during cue reactivity, and lower functional connectivity of the right caudate to the left dorsolateral prefrontal cortex could reflect change in neural plasticity as a consequence of an intense stimulation of the reward system, together with a lower top-down modulation of prefrontal cortical areas. Alternatively, it could be a precondition that makes pornography consumption more rewarding.
Article
Modulation of sexual desires is, in some cases, necessary to avoid inappropriate or illegal sexual behavior (downregulation of sexual desire) or to engage with a romantic partner (upregulation of sexual desire). Some have suggested that those who have difficulty downregulating their sexual desires be diagnosed as having a sexual 'addiction'. This diagnosis is thought to be associated with sexual urges that feel out of control, high-frequency sexual behavior, consequences due to those behaviors, and poor ability to reduce those behaviors. However, such symptoms also may be better understood as a non-pathological variation of high sexual desire. Hypersexuals are thought to be relatively sexual reward sensitized, but also to have high exposure to visual sexual stimuli. Thus, the direction of neural responsivity to sexual stimuli expected was unclear. If these individuals exhibit habituation, their P300 amplitude to sexual stimuli should be diminished; if they merely have high sexual desire, their P300 amplitude to sexual stimuli should be increased. Neural responsivity to sexual stimuli in a sample of hypersexuals could differentiate these two competing explanations of symptoms. Fifty-two (13 female) individuals who self-identified as having problems regulating their viewing of visual sexual stimuli viewed emotional (pleasant sexual, pleasant-non-sexual, neutral, and unpleasant) photographs while electroencephalography was collected. Larger P300 amplitude differences to pleasant sexual stimuli, relative to neutral stimuli, was negatively related to measures of sexual desire, but not related to measures of hypersexuality. Implications for understanding hypersexuality as high desire, rather than disordered, are discussed.
Article
This paper highlights a few of the ways that the Internet is having a profound effect on sexuality. For the sake of simplicity, and to better elucidate the points, the Internet's effect on sexuality is divided into the three broad categories: negative patterns, positive connections, and commercial aspects. In addition, three of the key factors that combine to give the Internet its power are delineated. They include Access, Affordability, and Anonymity or as they are called here the "Triple A". Finally, suggestions for how the field should deal with this phenomena are offered.
Article
Background: Learned cues for pleasant reward often elicit desire, which, in addicts, may become compulsive. According to the dominant view in addiction neuroscience and reinforcement modeling, such desires are the simple products of learning, coming from a past association with reward outcome. Results: We demonstrate that cravings are more than merely the products of accumulated pleasure memories-even a repulsive learned cue for unpleasantness can become suddenly desired via the activation of mesocorticolimbic circuitry. Rats learned repulsion toward a Pavlovian cue (a briefly-inserted metal lever) that always predicted an unpleasant Dead Sea saltiness sensation. Yet, upon first reencounter in a novel sodium-depletion state to promote mesocorticolimbic reactivity (reflected by elevated Fos activation in ventral tegmentum, nucleus accumbens, ventral pallidum, and the orbitofrontal prefrontal cortex), the learned cue was instantly transformed into an attractive and powerful motivational magnet. Rats jumped and gnawed on the suddenly attractive Pavlovian lever cue, despite never having tasted intense saltiness as anything other than disgusting. Conclusions: Instant desire transformation of a learned cue contradicts views that Pavlovian desires are essentially based on previously learned values (e.g., prediction error or temporal difference models). Instead desire is recomputed at reencounter by integrating Pavlovian information with the current brain/physiological state. This powerful brain transformation reverses strong learned revulsion into avid attraction. When applied to addiction, related mesocorticolimbic transformations (e.g., drugs or neural sensitization) of cues for already-pleasant drug experiences could create even more intense cravings. This cue/state transformation helps define what it means to say that addiction hijacks brain limbic circuits of natural reward.
Article
A growing number of clients are presenting in therapy with problems related to their on-line sexual habits. Adults who had used the Internet for sexual pursuits at least once ( N = 9,177) completed a 59-item on-line survey. Men and women generally behaved differently, and most (92%) indicated their on-line sexual behaviors were not problematic. Heavy users (8%) reported significant problems typically associated with compulsive disorders. Problems were highly correlated with time spent on-line for sex. Results are discussed in terms of their research and practice implications, including diagnosis and treatment. Recommendations are made for outreach prevention programs and future policies. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Article
Reward contains separable psychological components of learning, incentive motivation and pleasure. Most computational models have focused only on the learning component of reward, but the motivational component is equally important in reward circuitry, and even more directly controls behavior. Modeling the motivational component requires recognition of additional control factors besides learning. Here I discuss how mesocorticolimbic mechanisms generate the motivation component of incentive salience. Incentive salience takes Pavlovian learning and memory as one input and as an equally important input takes neurobiological state factors (e.g. drug states, appetite states, satiety states) that can vary independently of learning. Neurobiological state changes can produce unlearned fluctuations or even reversals in the ability of a previously learned reward cue to trigger motivation. Such fluctuations in cue-triggered motivation can dramatically depart from all previously learned values about the associated reward outcome. Thus, one consequence of the difference between incentive salience and learning can be to decouple cue-triggered motivation of the moment from previously learned values of how good the associated reward has been in the past. Another consequence can be to produce irrationally strong motivation urges that are not justified by any memories of previous reward values (and without distorting associative predictions of future reward value). Such irrationally strong motivation may be especially problematic in addiction. To understand these phenomena, future models of mesocorticolimbic reward function should address the neurobiological state factors that participate to control generation of incentive salience.
Article
This paper presents a biopsychological theory of drug addiction, the ‘Incentive-Sensitization Theory’. The theory addresses three fundamental questions. The first is: why do addicts crave drugs? That is, what is the psychological and neurobiological basis of drug craving? The second is: why does drug craving persist even after long periods of abstinence? The third is whether ‘wanting’ drugs (drug craving) is attributable to ‘liking’ drugs (to the subjective pleasurable effects of drugs)? The theory posits the following.
Article
In recent research similarities between pathological gambling and drug addiction have been identified, suggesting excessive gambling to constitute an addiction. So far, we have insufficient knowledge concerning the psychophysiological mechanisms underlying this kind of non-substance-related addiction. The objective of the study was to investigate emotional processing of gambling-relevant and -irrelevant stimuli in pathological gamblers and non-gambling controls using an EEG cue-reactivity paradigm. Whereas gambling-irrelevant stimuli were processed similarly in non-gambling controls (HC) and pathological gamblers (PG), PG showed significantly stronger gambling-relevant stimulus-induced psychophysiological cue-reactivity (larger gambling stimulus-induced late positive potential, LPP, higher arousal and more positively toned valence ratings as well as higher stimulus-induced craving for gambling cues compared to HC--but not the expectable increase of general craving over time and after stimulus presentation). Our findings suggest enhanced cue-reactivity in pathological gamblers indicative of learned motivated attention that may induce subjective craving and relapse.
Article
The aim of this fMRI study was to explore brain structures that are involved in the processing of erotic and disgust-inducing pictures. The stimuli were chosen to trigger approach and withdrawal tendencies, respectively. By adding sadomasochistic (SM) scenes to the design and examining 12 subjects with and 12 subjects without sadomasochistic preferences, we introduced a picture category that induced erotic pleasure in one sample and disgust in the other sample. Since we also presented neutral pictures, all subjects viewed pictures of four different categories: neutral, disgust-inducing, erotic, and SM erotic pictures. The analysis indicated that several brain structures are commonly involved in the processing of disgust-inducing and erotic pictures (occipital cortex, hippocampus, thalamus, and the amygdala). The ventral striatum was specifically activated when subjects saw highly sexually arousing pictures. This indicates the involvement of the human reward system during the processing of visual erotica.
Porn is not as harmful as other addictions, study claims
  • Prause
Examples of titles of popular science articles about Prause et al., (2015): "Porn is not as harmful as other addictions, study claims" (http://metro.co.uk/2015/07/04/porn-is-not-as-harmful-as-other-addictions-study-claims-5279530/), "Your Porn Addiction Isn't Real"( http://www.thedailybeast.com/articles/2015/06/26/your-porn-addiction-isn-t-real.html), "Porn 'Addiction' Isn't Really Addiction, Neuroscientists Say" (http://www.huffingtonpost.com/2015/06/30/porn-addiction-_n_7696448.html)
  • M Gola
  • M Miyakoshi
  • G Sescousse
Gola, M., Miyakoshi, M., & Sescousse, G. (2015). Sex, Impulsivity, and Anxiety: Interplay between Ventral Striatum and Amygdala Reactivity in Sexual Behaviors. The Journal of Neuroscience, 35(46), 15227-15229.