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Ince C, Yücel M, Albertella L, Fontenelle LF. Exploring the clinical profile of problematic pornography use. CNS Spectr 2020; 26:1-10. [PMID: 32690117 DOI: 10.1017/s1092852920001686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Although problematic pornography use (PPU) will soon be diagnosable through the International Classification for Diseases, 11th revision, its clinical profile remains contentious. The current study assessed whether PPU may be characterized by various symptoms sometimes observed among online recovery forums that currently lack empirical assessment, such as heightened cognitive-affective issues following pornography use and sexual dysfunction with partners as a result of escalating use. METHOD Cross-sectional surveys were completed by male PPUs (N = 138, mean age = 31.75 years, standard deviation = 10.72) recruited via online recovery communities and Amazon Mechanical Turk. Multiple regression analysis was performed using the Problematic Pornography Use Scale as the dependent variable and variables of interest (Arizona Sexual Experiences Scales modified for partnered sex and pornography use, Brunel Mood Scale, Social Interaction Anxiety Scale, and the Tolerance subscale from the Problematic Pornography Consumption Scale) and potential confounders (eg, comorbid psychopathology) as independent variables. RESULTS Current levels of pornography use, indicators of tolerance and escalation, greater sexual functioning with pornography, and psychological distress were uniquely associated with PPU severity, while cognitive-affective issues after pornography use, impulsivity and compulsivity were not. Although sexual dysfunction did not predict PPU severity, nearly half the sample indicated sexual dysfunction with intimate partners. CONCLUSIONS The present findings suggest that PPU may be characterized by tolerance and escalation (as per substance addiction models), greater sexual responsivity toward pornography, and psychological distress. Meanwhile, the high rate of partnered sexual dysfunction observed suggests that PPU might be somewhat separable from other forms of compulsive sexual behavior.
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Affiliation(s)
- Campbell Ince
- Turner Institute for Brain and Mental Health, Monash University, Melbourne, Australia
| | - Murat Yücel
- Turner Institute for Brain and Mental Health, Monash University, Melbourne, Australia
| | - Lucy Albertella
- Turner Institute for Brain and Mental Health, Monash University, Melbourne, Australia
| | - Leonardo F Fontenelle
- Turner Institute for Brain and Mental Health, Monash University, Melbourne, Australia
- D'Or Institute for Research and Education (IDOR), Rio de Janeiro, Brazil
- Obsessive, Compulsive and Anxiety Spectrum Research Program, Institute of Psychiatry of the Federal University of Rio de Janeiro (IPUB/UFRJ), Rio de Janeiro, Brazil
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Agastya IGN, Siste K, Nasrun MWS, Kusumadewi I. Cybersex addiction: an overview of the development and treatment of a newly emerging disorder. MEDICAL JOURNAL OF INDONESIA 2020. [DOI: 10.13181/mji.rev.203464] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
Cybersex addiction is a non-substance related addiction that involves online sexual activity on the internet. Nowadays, various kinds of things related to sex or pornography are easily accessible through internet media. In Indonesia, sexuality is usually assumed taboo but most young people have been exposed to pornography. It can lead to an addiction with many negative effects on users, such as relationships, money, and psychiatric problems like major depression and anxiety disorders. A few instruments may be used to detect cybersex behavior. This review was aimed to provide a comprehensive discussion about cybersex addiction in Indonesian society and the importance of its screening for this condition to enable its early detection and subsequent management.
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McTavish J. Internet Pornography: Some Medical and Spiritual Perspectives. LINACRE QUARTERLY 2020; 87:451-463. [PMID: 33100393 DOI: 10.1177/0024363920933114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The Internet has made pornography available on a massive scale. Data released by "Pornhub" the world's most popular Internet porn site, reveal that in 2019 alone, there were over 42 billion visits to its website, which in itself is an incredible waste of time and energy, which could be more fruitfully employed. Pornography viewing is poisonous for the conscience and commodifies the human body, reducing it to an object of abusive pleasure. Its negative effects can be broadly seen in three overlapping categories: personal, psychological, and social. The antidote is a renewed call to chastity, that self-mastery that can help direct one's passions in a more fruitful way. Without prayer, we cannot live chastely as "the spirit is willing but the flesh is weak" (Matthew 26:41). There is an urgency for the new evangelization to help recapture the dignity of the body and counter the lie of pornography, and to ensure that in the digital world, the face of Christ needs to be seen and his voice heard. Summary The first part of this essay outlines some personal, psychological, and social dangers of pornography. Viewing of pornography is harmful, as it objectifies the human body and distorts one's vision of sexuality. The second part of the essay gives some practical advice concerning how to ideally halt or reverse the epidemic of porn viewing, emphasizing the dignity of each person as subject, and reminding us of how a chaste gaze helps one rediscover the real beauty and value of the human body.
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Hornor G. Child and Adolescent Pornography Exposure. J Pediatr Health Care 2020; 34:191-199. [PMID: 32063261 DOI: 10.1016/j.pedhc.2019.10.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Revised: 10/09/2019] [Accepted: 10/15/2019] [Indexed: 01/01/2023]
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Nalmefene in the Treatment of Internet Pornography Addiction - A Case Report and Review of Literature. J Addict Med 2020; 14:348-351. [PMID: 31972764 DOI: 10.1097/adm.0000000000000602] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
: The mu-opioid antagonist nalmefene (18 mg per day) was administered in the treatment of a heterosexual male with internet pornography addiction. The patient had no other co-addictions or psychiatric comorbidities, allowing a direct measurement for the effectiveness of nalmefene on internet pornography addiction. Over a period of 72 weeks and an assessment frequency between 1 and 18 weeks, self-monitoring assessments of craving and pornography consumption were collected on different craving and obsessive-compulsive scales. Results indicate that nalmefene impressively decreased addictive symptoms. Importantly, the patient-induced discontinuation of nalmefene led to an immediate increase of craving scores and addictive behavior, which dropped again after restarting the medication. The patient has been in complete remission of symptoms for over a year under our supervision, and for further 2 years after that according to his account. Therefore, nalmefene seems to be a useful adjunction for patients with internet pornography addiction.
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Impaired Recent Verbal Memory in Pornography-Addicted Juvenile Subjects. Neurol Res Int 2019; 2019:2351638. [PMID: 31531240 PMCID: PMC6721264 DOI: 10.1155/2019/2351638] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Accepted: 05/21/2019] [Indexed: 11/17/2022] Open
Abstract
We aimed to find the differences in memory capabilities between pornography-addicted and nonaddicted juveniles. We enrolled 30 juveniles (12-16 y) consisting of 15 pornography addiction and 15 nonaddiction subjects. We used Rey Auditory Verbal Learning Test (RAVLT) to measure verbal memory, Rey-Osterrieth Complex Figure Test (ROCFT) for visual memory, along with Trail Making Test A and B (TMT-A and TMT-B) for attention. We found a significant reduction in the RAVLT A6 result of the addiction group (nonaddiction vs addiction: 13.47 ± 2.00 vs 11.67 ± 2.44, MD = -1.80, p=0.04), but not in ROCFT or attention tests. Analysis in sex subgroups yielded no sex-specific difference. We concluded that pornography addiction may be associated with impaired recent verbal memory in juveniles, regardless of sex and without association to attention.
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Baranowski AM, Vogl R, Stark R. Prevalence and Determinants of Problematic Online Pornography Use in a Sample of German Women. J Sex Med 2019; 16:1274-1282. [PMID: 31277972 DOI: 10.1016/j.jsxm.2019.05.010] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Revised: 05/08/2019] [Accepted: 05/15/2019] [Indexed: 01/05/2023]
Abstract
AIM To investigate problematic online pornography use in women, an issue that has rarely been tackled to date. METHODS We used the data from a comprehensive, cross-sectional survey of a self-referred sample of 485 German women to examine the relationships between problematic online pornography consumption and a range of sexual behaviors, trait sexual motivation, and motives for pornography use. RESULTS Approximately 3% of our sample had problematic pornography use. In multivariate analysis, problematic use was significantly associated with the overall time spent viewing online pornography, greater sexual motivation, and greater emotional avoidance. Our data also indicate that the influence of sexual motivation on problematic pornography use is mediated by the amount of time spent watching online pornography. CLINICAL TRANSLATION Identifying these predictors for problematic use is important for specific prevention programs for women at risk of pathological use. STRENGTHS & LIMITATIONS This study is one of the first to show that women also experience problematic online pornography use and identifies risk factors for problematic behavior. The weakness of this study is that as in all studies on sexuality, people who are interested in the topic and are comfortable talking about it are more likely to participate, thus rendering the sample nonrepresentative. CONCLUSION Based on our findings, approximately 3% of women experience problems associated with engaging in online pornography consumption. Baranowski AM, Vogl R, Stark R. Prevalence and Determinants of Problematic Online Pornography Use in a Sample of German Women. J Sex Med 2019;16:1274-1282.
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Affiliation(s)
| | - Romina Vogl
- Department of Psychology, Justus Liebig University Giessen, Giessen, Germany
| | - Rudolf Stark
- Department of Psychology, Justus Liebig University Giessen, Giessen, Germany
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Sousa AD. Compulsive Pornography Use in Late Life: A Case Report. JOURNAL OF PSYCHOSEXUAL HEALTH 2019. [DOI: 10.1177/2631831819890766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Compulsive pornography use is on the rise and is a common compulsive sexual behavior being seen in the younger age groups between 18 and 30 years of age. The treatment of the same involves a combination of medical and behavioral management. We present herewith a case of a 69-year-old male who developed compulsive pornography usage for the first time and that responded well to psychotherapy and medication.
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Affiliation(s)
- Avinash De Sousa
- Department of Psychiatry, Lokmanya Tilak Municipal Medical College, Mumbai, Maharashtra, India
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The Potential Associations of Pornography Use with Sexual Dysfunctions: An Integrative Literature Review of Observational Studies. J Clin Med 2019; 8:jcm8070914. [PMID: 31247949 PMCID: PMC6679165 DOI: 10.3390/jcm8070914] [Citation(s) in RCA: 53] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Revised: 06/20/2019] [Accepted: 06/24/2019] [Indexed: 12/17/2022] Open
Abstract
This paper reviews the associations between pornography use and sexual dysfunction based on evidence from observational studies. The existing data in this regard mostly derive from cross-sectional investigations and case reports. There is little if no evidence that pornography use may induce delayed ejaculation and erectile dysfunction, although longitudinal studies that control for confounding variables are required for a full assessment. The associations between pornography use and sexual desire may differ between women and men although the existing data is contradictory and causal relationships cannot be established. The strongest evidence is available for the relation of pornography use with decreased sexual satisfaction, although the results of prospective studies are inconsistent. The paper outlines future research prospects beneficial in understanding the nature of associations between pornography use and sexual dysfunctions in men and women.
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Efrati Y, Gola M. The Effect of Early Life Trauma on Compulsive Sexual Behavior among Members of a 12-Step Group. J Sex Med 2019; 16:803-811. [DOI: 10.1016/j.jsxm.2019.03.272] [Citation(s) in RCA: 63] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2018] [Revised: 03/07/2019] [Accepted: 03/21/2019] [Indexed: 11/26/2022]
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Antons S, Mueller SM, Wegmann E, Trotzke P, Schulte MM, Brand M. Facets of impulsivity and related aspects differentiate among recreational and unregulated use of Internet pornography. J Behav Addict 2019; 8:223-233. [PMID: 31120316 PMCID: PMC7044546 DOI: 10.1556/2006.8.2019.22] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND AND AIMS Unregulated Internet pornography (IP) use is discussed as a clinically significant disorder. Because of its primarily rewarding nature, IP is a predestinated target for addictive behaviors. However, not every user develops an unregulated usage pattern. In fact, most users tend to use IP recreationally. Impulsivity-related constructs have been identified as promoters of addictive behaviors. It is unclear whether these impulsivity-related constructs are specific for unregulated IP use or also play a role in recreational but frequent behaviors. In this study, we investigated impulsive tendencies (trait impulsivity, delay discounting, and cognitive style), craving toward IP, attitude regarding IP, and coping styles in individuals with recreational-occasional, recreational-frequent, and unregulated IP use. METHODS A total of 1,498 heterosexual males participated in an online survey. Groups of individuals with recreational-occasional use (n = 333), recreational-frequent use (n = 394), and unregulated use (n = 225) of IP were identified by screening instruments. RESULTS Craving and attitude regarding IP as well as delay discounting and cognitive and coping styles differed between groups. Individuals with unregulated use showed the highest scores for craving, attentional impulsivity, delay discounting, and dysfunctional coping, and lowest scores for functional coping and need for cognition. Recreational-frequent users had the most positive attitude toward IP. Motor and non-planning impulsivity did not differ between groups. DISCUSSION AND CONCLUSIONS The results indicate that some facets of impulsivity and related factors such as craving and a more negative attitude are specific for unregulated IP users. The results are also consistent with models on specific Internet use disorders and addictive behaviors.
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Affiliation(s)
- Stephanie Antons
- General Psychology: Cognition and Center for Behavioral Addiction Research (CeBAR), University of Duisburg-Essen, Duisburg, Germany
| | - Silke M. Mueller
- General Psychology: Cognition and Center for Behavioral Addiction Research (CeBAR), University of Duisburg-Essen, Duisburg, Germany
| | - Elisa Wegmann
- General Psychology: Cognition and Center for Behavioral Addiction Research (CeBAR), University of Duisburg-Essen, Duisburg, Germany
| | - Patrick Trotzke
- General Psychology: Cognition and Center for Behavioral Addiction Research (CeBAR), University of Duisburg-Essen, Duisburg, Germany
| | - Max M. Schulte
- General Psychology: Cognition and Center for Behavioral Addiction Research (CeBAR), University of Duisburg-Essen, Duisburg, Germany
| | - Matthias Brand
- General Psychology: Cognition and Center for Behavioral Addiction Research (CeBAR), University of Duisburg-Essen, Duisburg, Germany,Erwin L. Hahn Institute for Magnetic Resonance Imaging, Essen, Germany,Corresponding author: Prof. Dr. Matthias Brand; General Psychology: Cognition and Center for Behavioral Addiction Research, University of Duisburg-Essen, Forsthausweg 2, 47057 Duisburg, Germany; Phone: +49 203 3792541; Fax: +49 203 3791846; E-mail:
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Prevalence, Patterns and Self-Perceived Effects of Pornography Consumption in Polish University Students: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16101861. [PMID: 31137778 PMCID: PMC6571756 DOI: 10.3390/ijerph16101861] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Revised: 05/22/2019] [Accepted: 05/23/2019] [Indexed: 12/16/2022]
Abstract
This cross-sectional online survey of Polish students (n = 6463) assessed the frequency and patterns of pornography consumption, its self-perceived effects, the prevalence of self-perceived pornography addiction, and opinions on the potential effects of pornography and its legal status. Nearly 80% of students have been exposed to pornography (median age of first exposure: 14 years). Streaming videos were decidedly the most frequent form of use. In the subset of current users (n = 4260), daily use and self-perceived addiction was reported by 10.7% and 15.5%, respectively. The majority of those surveyed did not report any negative effects of pornography use on their sexual function, sexual, and relationship satisfaction. Instead, over one-quarter of students in relationships reported beneficial effects on its quality. The most common self-perceived adverse effects of pornography use included: the need for longer stimulation (12.0%) and more sexual stimuli (17.6%) to reach orgasm, and a decrease in sexual satisfaction (24.5%). Females and males with a Body Mass Index >25 kg/m2 more often reported a self-perceived decrease in relationship quality associated with pornography use. Age of first exposure was significantly associated with reported need for longer stimulation and more sexual stimuli to reach orgasm when using pornography, decrease in sexual satisfaction, and quality of romantic relationship, neglect of basic needs and duties due to pornography use, and self-perceived addiction in both females and males. The highest odds ratios were always observed for age <12 years in reference to exposure at >16 years. In the opinion of most of the surveyed students, pornography may have adverse effects on human health, although access restrictions should not be implemented. The study gives a broad insight into the pornography consumption in young Polish adults.
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Müller KW, Beutel ME, Dreier M, Wölfling K. A clinical evaluation of the DSM-5 criteria for Internet Gaming Disorder and a pilot study on their applicability to further Internet-related disorders. J Behav Addict 2019; 8:16-24. [PMID: 30663331 PMCID: PMC7044592 DOI: 10.1556/2006.7.2018.140] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND AND AIMS Internet Gaming Disorder (IGD) and other Internet-related disorders (IRDs) have become growing health concerns in our today's lives. Based on defined diagnostic criteria, IGD has been recognized as a condition for further research in the DSM-5; however, other IRDs have been excluded. Since the release of the DSM-5, representativeness and appropriateness of the nine diagnostic criteria have been debated. Although some first evidence has been published to evaluate these criteria, our knowledge is still limited. Thus, the purpose of this study was to provide data on the clinical validity of the DSM-5 criteria for IGD and other types of IRD. We were also interested in examining the additional diagnostic validity of craving that is currently not being considered in the DSM-5. METHODS Analyses on a sample of n = 166 treatment seekers for IRDs were performed. The clinician's diagnosis was used as a main reference for determining the DSM criteria's diagnostic performance. Secondary criteria (depression and anxiety) were defined as indicators for the construct validity. RESULTS The overall diagnostic accuracy ranged between 76.6% for deceiving and 92% for loss of control and craving. Considerable differences occurred in the degree of sensitivity and specificity between the single criteria. No particular differences were found for the applicability of the criteria to other forms of IRDs. DISCUSSION AND CONCLUSIONS Our results confirm the validity of the DSM criteria. However, the diagnostic utility of the criterion escaping aversive moods is critically discussed. Considering craving as an additional diagnostic indicator might be recommendable.
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Affiliation(s)
- Kai W. Müller
- Outpatient Clinic for Behavioral Addiction, Department of Psychosomatic Medicine and Psychotherapy, University Medical Center, Johannes Gutenberg University Mainz, Mainz, Germany,Corresponding author: Dr. Kai W. Müller; Outpatient Clinic for Behavioral Addiction, Department of Psychosomatic Medicine and Psychotherapy, University Medical Center, Johannes Gutenberg University Mainz, Untere Zahlbacher Straße 8, 55131 Mainz, Germany; Phone: +49 6131 174039; Fax: +49 6131 4287; E-mail:
| | - Manfred E. Beutel
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Centre, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Michael Dreier
- Outpatient Clinic for Behavioral Addiction, Department of Psychosomatic Medicine and Psychotherapy, University Medical Center, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Klaus Wölfling
- Outpatient Clinic for Behavioral Addiction, Department of Psychosomatic Medicine and Psychotherapy, University Medical Center, Johannes Gutenberg University Mainz, Mainz, Germany
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Rodriguez-Nieto G, Emmerling F, Dewitte M, Sack AT, Schuhmann T. The Role of Inhibitory Control Mechanisms in the Regulation of Sexual Behavior. ARCHIVES OF SEXUAL BEHAVIOR 2019; 48:481-494. [PMID: 30671876 PMCID: PMC6373525 DOI: 10.1007/s10508-018-1283-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/05/2016] [Revised: 07/11/2018] [Accepted: 07/28/2018] [Indexed: 05/31/2023]
Abstract
Sexual behavior is the open manifestation of a complex interplay between psychophysiological mechanisms that either facilitate or inhibit sexual thoughts, desires, and associated behaviors. Whereas sexual excitation has been widely studied, less is known about the impact of inhibitory control mechanisms that enable individuals to refrain from sexual cognition and behavior. The present study examined: (1) the relationship between general and sexual inhibitory mechanisms (as measured through self-reports and computer-based tasks), (2) the relation between sexual inhibitory processes at cognitive and motor-motivational levels and with sexual inhibition as an individual trait, and (3) the predictive value of these parameters on sexual thoughts (cognition) and behavior. We demonstrate that general inhibitory control (i.e., the ability to suppress any preponderant response) and the specific inhibition of sexual responses represent distinct processes that require at least partly different control mechanisms. Similarly, the ability to inhibit sexual visual input and the ability to suppress sexually driven responses seem to be two independent processes. The different inhibitory processes distinctively predicted the frequency of sexual thoughts and sexual behavior. We propose that these different inhibitory mechanisms are at play during different phases of sexual regulation (before and after the generation and unfolding of sexual arousal) and that a specific deficit in one of these processes may underlie the distinctive symptomatology and comorbidity of sexual disorders.
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Affiliation(s)
- Geraldine Rodriguez-Nieto
- Department of Cognitive Neuroscience, Faculty of Psychology and Neuroscience, Maastricht University, Oxfordlaan 55, 6229 EV, Maastricht, The Netherlands.
- Maastricht Brain Imaging Center, Maastricht University, Maastricht, The Netherlands.
| | - Franziska Emmerling
- Department of Cognitive Neuroscience, Faculty of Psychology and Neuroscience, Maastricht University, Oxfordlaan 55, 6229 EV, Maastricht, The Netherlands
- Maastricht Brain Imaging Center, Maastricht University, Maastricht, The Netherlands
- Department of Experimental Psychology, University of Oxford, Oxford, UK
| | - Marieke Dewitte
- Department of Clinical Psychological Science, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Alexander T Sack
- Department of Cognitive Neuroscience, Faculty of Psychology and Neuroscience, Maastricht University, Oxfordlaan 55, 6229 EV, Maastricht, The Netherlands
- Maastricht Brain Imaging Center, Maastricht University, Maastricht, The Netherlands
| | - Teresa Schuhmann
- Department of Cognitive Neuroscience, Faculty of Psychology and Neuroscience, Maastricht University, Oxfordlaan 55, 6229 EV, Maastricht, The Netherlands
- Maastricht Brain Imaging Center, Maastricht University, Maastricht, The Netherlands
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Fisher WA, Montgomery-Graham S, Kohut T. Pornography Problems Due to Moral Incongruence. ARCHIVES OF SEXUAL BEHAVIOR 2019; 48:425-429. [PMID: 30128983 DOI: 10.1007/s10508-018-1291-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Accepted: 08/06/2018] [Indexed: 05/25/2023]
Affiliation(s)
- William A Fisher
- Department of Psychology, Western University, London, ON, N6G 2 V4, Canada
| | | | - Taylor Kohut
- Department of Psychology, Western University, London, ON, N6G 2 V4, Canada
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de Alarcón R, de la Iglesia JI, Casado NM, Montejo AL. Online Porn Addiction: What We Know and What We Don't-A Systematic Review. J Clin Med 2019; 8:E91. [PMID: 30650522 PMCID: PMC6352245 DOI: 10.3390/jcm8010091] [Citation(s) in RCA: 90] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Revised: 12/27/2018] [Accepted: 01/10/2019] [Indexed: 01/09/2023] Open
Abstract
In the last few years, there has been a wave of articles related to behavioral addictions; some of them have a focus on online pornography addiction. However, despite all efforts, we are still unable to profile when engaging in this behavior becomes pathological. Common problems include: sample bias, the search for diagnostic instrumentals, opposing approximations to the matter, and the fact that this entity may be encompassed inside a greater pathology (i.e., sex addiction) that may present itself with very diverse symptomatology. Behavioral addictions form a largely unexplored field of study, and usually exhibit a problematic consumption model: loss of control, impairment, and risky use. Hypersexual disorder fits this model and may be composed of several sexual behaviors, like problematic use of online pornography (POPU). Online pornography use is on the rise, with a potential for addiction considering the "triple A" influence (accessibility, affordability, anonymity). This problematic use might have adverse effects in sexual development and sexual functioning, especially among the young population. We aim to gather existing knowledge on problematic online pornography use as a pathological entity. Here we try to summarize what we know about this entity and outline some areas worthy of further research.
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Affiliation(s)
- Rubén de Alarcón
- Psychiatry Service, Hospital Clínico Universitario de Salamanca, Institute of Biomedical Research of Salamanca (IBSAL), 37007 Salamanca, Spain.
| | - Javier I de la Iglesia
- Psychiatry Service, Hospital Clínico Universitario de Salamanca, Institute of Biomedical Research of Salamanca (IBSAL), 37007 Salamanca, Spain.
| | - Nerea M Casado
- Psychiatry Service, Hospital Clínico Universitario de Salamanca, Institute of Biomedical Research of Salamanca (IBSAL), 37007 Salamanca, Spain.
| | - Angel L Montejo
- Psychiatry Service, Hospital Clínico Universitario de Salamanca, Institute of Biomedical Research of Salamanca (IBSAL), 37007 Salamanca, Spain.
- University of Salamanca, EUEF, 37007 Salamanca, Spain.
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Efrati Y, Gola M. Understanding and predicting profiles of compulsive sexual behavior among adolescents. J Behav Addict 2018; 7:1004-1014. [PMID: 30378458 PMCID: PMC6376392 DOI: 10.1556/2006.7.2018.100] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Revised: 08/16/2018] [Accepted: 09/07/2018] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND AND AIMS This two-study research was designed to define and predict profiles of compulsive sexual behavior (CSB) among non-clinical population of adolescents, and aimed to fill gaps in the current research. METHODS In Study 1 (N = 1,182), we examined the profiles of CSB among adolescents using latent profile analysis. Results revealed the following three clusters: abstainers, sexual fantasizers, and individuals with CSB. In Study 2 (N = 618), we replicated this classification and examined differences between the clusters in Big Five personality traits, locus of control, attachment orientations, loneliness, age, gender, socioeconomic status (SES), residence quality, use of pornography, and sex-related online activities. RESULTS Adolescents classified into different clusters significantly differed in personality traits, loneliness, age, SES, use of pornography, and sex-related online activities. Specifically, individuals with CSB had external locus of control, anxious attachment, greater loneliness, higher frequency of pornography use, and more sex-related online activities than the other groups. DISCUSSION The current research expands the knowledge about CSB by providing a more individualized approach to understanding CSB among adolescence.
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Affiliation(s)
- Yaniv Efrati
- Institute of Psychology, Polish Academy of Sciences, Warsaw, Poland
- Faculty of Education and Society and Culture, Beit-Berl Collage, Kfar Saba, Israel
| | - Mateusz Gola
- Institute of Psychology, Polish Academy of Sciences, Warsaw, Poland
- Swartz Center for Computational Neuroscience, Institute for Neural Computations, University of California San Diego, San Diego, CA, USA
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Stark R, Klucken T, Potenza MN, Brand M, Strahler J. A Current Understanding of the Behavioral Neuroscience of Compulsive Sexual Behavior Disorder and Problematic Pornography Use. Curr Behav Neurosci Rep 2018. [DOI: 10.1007/s40473-018-0162-9] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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Lissak G. Adverse physiological and psychological effects of screen time on children and adolescents: Literature review and case study. ENVIRONMENTAL RESEARCH 2018; 164:149-157. [PMID: 29499467 DOI: 10.1016/j.envres.2018.01.015] [Citation(s) in RCA: 298] [Impact Index Per Article: 49.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/09/2017] [Accepted: 01/16/2018] [Indexed: 05/03/2023]
Abstract
UNLABELLED A growing body of literature is associating excessive and addictive use of digital media with physical, psychological, social and neurological adverse consequences. Research is focusing more on mobile devices use, and studies suggest that duration, content, after-dark-use, media type and the number of devices are key components determining screen time effects. Physical health effects: excessive screen time is associated with poor sleep and risk factors for cardiovascular diseases such as high blood pressure, obesity, low HDL cholesterol, poor stress regulation (high sympathetic arousal and cortisol dysregulation), and Insulin Resistance. Other physical health consequences include impaired vision and reduced bone density. Psychological effects: internalizing and externalizing behavior is related to poor sleep. Depressive symptoms and suicidal are associated to screen time induced poor sleep, digital device night use, and mobile phone dependency. ADHD-related behavior was linked to sleep problems, overall screen time, and violent and fast-paced content which activates dopamine and the reward pathways. Early and prolonged exposure to violent content is also linked to risk for antisocial behavior and decreased prosocial behavior. Psychoneurological effects: addictive screen time use decreases social coping and involves craving behavior which resembles substance dependence behavior. Brain structural changes related to cognitive control and emotional regulation are associated with digital media addictive behavior. A case study of a treatment of an ADHD diagnosed 9-year-old boy suggests screen time induced ADHD-related behavior could be inaccurately diagnosed as ADHD. Screen time reduction is effective in decreasing ADHD-related behavior. CONCLUSIONS Components crucial for psychophysiological resilience are none-wandering mind (typical of ADHD-related behavior), good social coping and attachment, and good physical health. Excessive digital media use by children and adolescents appears as a major factor which may hamper the formation of sound psychophysiological resilience.
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Affiliation(s)
- Gadi Lissak
- Meuhedet Health Services, Jerusalem, Israel.
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71
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Unintended Side Effects of the Digital Transition: European Scientists’ Messages from a Proposition-Based Expert Round Table. SUSTAINABILITY 2018. [DOI: 10.3390/su10062001] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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72
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Abstract
Background and aims Sexuality is natural to human life and inseparable from it, yet some individuals develop compulsive sexual behavior (CSB). Many individuals with CSB seek treatment in free self-support groups based on the twelve-step program. This program was extensively studied in substance abuse disorders (e.g., Alcoholics Anonymous), but little is known about its efficiency in CSB. Methods We "assesed" questionnaire data on sociodemographical-, psychological-, and recovery-related factors from 97 male participants of Sexaholics Anonymous (SA) programs in Israel. Results Our results indicated that advancement in the SA program, measured as a current step of the program, is significantly related to lower levels of sexual-related overall sense of helplessness, avoidant help-seeking, self-control, overall CSB, and sexual suppression. It is also related to the higher well-being. Discussion This is the first study to examine psychological factors of CSB recovery process in twelve-step groups, and future research is needed to replicate our results within a longitudinal study.
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Affiliation(s)
- Yaniv Efrati
- Faculty of Education and Society and Culture, Beit-Berl College, Kfar Saba, Israel,Corresponding author: Yaniv Efrati, PhD; Faculty of Education and Society and Culture, Beit-Berl College, Kfar Saba 4490500, Israel; Phone: +972 545 800 094; E-mail:
| | - Mateusz Gola
- Institute of Psychology, Polish Academy of Sciences, Warsaw, Poland,Swartz Center for Computational Neuroscience, Institute for Neural Computations, University of California San Diego, San Diego, CA, USA
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Kohut T, Štulhofer A. The Role of Religiosity in Adolescents' Compulsive Pornography Use: A Longitudinal Assessment. JOURNAL OF SEX & MARITAL THERAPY 2018; 44:759-775. [PMID: 29676698 DOI: 10.1080/0092623x.2018.1466012] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Despite increasing concerns that adolescent men are vulnerable to developing compulsive pornography use, little research has been done in this area. Given recent theorizing and research concerning moral incongruence, we hypothesized that symptoms of compulsive pornography use should generally be associated with higher levels of pornography use and increased growth in male adolescent pornography use over time, but that this pattern would be attenuated among very religious participants. These hypotheses were tested with mixed effects growth models using two independent panel samples of male Croatian adolescents. As expected, adolescent men who reported features of compulsive pornography use tended to exhibited higher levels of pornography use. However, contrary to expectations, increased growth in pornography use was limited to more religious compulsive users. Compared to nonreligious compulsive users, these adolescents started with lower initial levels of pornography use and their use increased over time at a greater rate of change. This study's results are the first to suggest that some adolescent men who report high levels of pornography use tend to exhibit symptoms of compulsive use, which highlights a need for counseling and therapeutic attention. Our findings also have implications for the emerging theory of moral incongruence.
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Affiliation(s)
- Taylor Kohut
- a Department of Psychology , University of Western Ontario , London , Ontario , Canada
- b Department of Sociology , University of Zagreb , Zagreb , Croatia
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74
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Wright PJ. Sex Education, Public Opinion, and Pornography: A Conditional Process Analysis. JOURNAL OF HEALTH COMMUNICATION 2018; 23:495-502. [PMID: 29746204 DOI: 10.1080/10810730.2018.1472316] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
This study assesses the relationship between pornography consumption and support for sex education in public schools among adults in the United States. Goals were theoretical and applied. At the theoretical level, conditional process analyses are needed to further evaluate the predictions of the primary theory applied to pornography and social influence, the sexual script acquisition, activation, application model (3AM) of sexual media socialization. At the applied level, themes in pornography are most often associated with socialization outcomes that are a threat to the public health. In certain instances, however, pornography may socialize its users in ways that lead to health-promoting attitudes. An increased likelihood of support for sex education among youth may be one such example. Probabilistic national survey data gathered between 1988 and 2016 from 16 unique samples were utilized. A moderated-mediation path analysis indicated that pornography consumption was associated with support for sex education through more acceptance of teenage sex, but that this indirect effect (IE) was moderated by religiosity. Specifically, as religiosity decreased, the magnitude of the IE increased. These results are consistent with 3AM tenets about the role of sexual scripts in mass media socialization and factors that increase the likelihood of sexual scripting effects.
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Affiliation(s)
- Paul J Wright
- a The Media School , Indiana University , Bloomington , IN , USA
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75
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Bina RW, Langevin JP. Closed Loop Deep Brain Stimulation for PTSD, Addiction, and Disorders of Affective Facial Interpretation: Review and Discussion of Potential Biomarkers and Stimulation Paradigms. Front Neurosci 2018; 12:300. [PMID: 29780303 PMCID: PMC5945819 DOI: 10.3389/fnins.2018.00300] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Accepted: 04/18/2018] [Indexed: 01/06/2023] Open
Abstract
The treatment of psychiatric diseases with Deep Brain Stimulation (DBS) is becoming more of a reality as studies proliferate the indications and targets for therapies. Opinions on the initial failures of DBS trials for some psychiatric diseases point to a certain lack of finesse in using an Open Loop DBS (OLDBS) system in these dynamic, cyclical pathologies. OLDBS delivers monomorphic input into dysfunctional brain circuits with modulation of that input via human interface at discrete time points with no interim modulation or adaptation to the changing circuit dynamics. Closed Loop DBS (CLDBS) promises dynamic, intrinsic circuit modulation based on individual physiologic biomarkers of dysfunction. Discussed here are several psychiatric diseases which may be amenable to CLDBS paradigms as the neurophysiologic dysfunction is stochastic and not static. Post-Traumatic Stress Disorder (PTSD) has several peripheral and central physiologic and neurologic changes preceding stereotyped hyper-activation behavioral responses. Biomarkers for CLDBS potentially include skin conductance changes indicating changes in the sympathetic nervous system, changes in serum and central neurotransmitter concentrations, and limbic circuit activation. Chemical dependency and addiction have been demonstrated to be improved with both ablation and DBS of the Nucleus Accumbens and as a serendipitous side effect of movement disorder treatment. Potential peripheral biomarkers are similar to those proposed for PTSD with possible use of environmental and geolocation based cues, peripheral signs of physiologic arousal, and individual changes in central circuit patterns. Non-substance addiction disorders have also been serendipitously treated in patients with OLDBS for movement disorders. As more is learned about these behavioral addictions, DBS targets and effectors will be identified. Finally, discussed is the use of facial recognition software to modulate activation of inappropriate responses for psychiatric diseases in which misinterpretation of social cues feature prominently. These include Autism Spectrum Disorder, PTSD, and Schizophrenia-all of which have a common feature of dysfunctional interpretation of facial affective clues. Technological advances and improvements in circuit-based, individual-specific, real-time adaptable modulation, forecast functional neurosurgery treatments for heretofore treatment-resistant behavioral diseases.
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Affiliation(s)
- Robert W Bina
- Division of Neurosurgery, Banner University Medical Center, Tucson, AZ, United States
| | - Jean-Phillipe Langevin
- Neurosurgery Service, VA Greater Los Angeles Healthcare System, Los Angeles, CA, United States.,Department of Neurosurgery, University of California, Los Angeles, Los Angeles, CA, United States
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77
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Butler MH, Pereyra SA, Draper TW, Leonhardt ND, Skinner KB. Pornography Use and Loneliness: A Bidirectional Recursive Model and Pilot Investigation. JOURNAL OF SEX & MARITAL THERAPY 2018; 44:127-137. [PMID: 28448246 DOI: 10.1080/0092623x.2017.1321601] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
Sexuality is presumptively and observably a powerful core element of the human pair-bond relationship. Technological advances of the last half-century have made media a dominant cultural and developmental presence, including scripting sexual relationship attitudes and behavior. Theoretically and empirically, we examine loneliness as it relates to pornography use in terms of pornography's relational scripting and its addictive potential. Empirically, we examine the associative nature between pornography use and loneliness using a measurement model and two structural equation models where pornography use and loneliness are regressed on each other, respectively. Survey data were collected from a sample of 1,247 participants, who completed an online questionnaire containing questions on pornography use, the University of California-Los Angeles Loneliness Scale (UCLALS), and other demographic variables. Results from our analyses revealed significant and positive associations between pornography use and loneliness for all three models. Findings provide grounds for possible future bidirectional, recursive modeling of the relation between pornography use and loneliness.
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Affiliation(s)
- Mark H Butler
- a School of Family Life , Brigham Young University , Provo , Utah , USA
| | - Samuel A Pereyra
- a School of Family Life , Brigham Young University , Provo , Utah , USA
| | - Thomas W Draper
- a School of Family Life , Brigham Young University , Provo , Utah , USA
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78
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Sniewski L, Farvid P, Carter P. The assessment and treatment of adult heterosexual men with self-perceived problematic pornography use: A review. Addict Behav 2018; 77:217-224. [PMID: 29069616 DOI: 10.1016/j.addbeh.2017.10.010] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2017] [Revised: 08/17/2017] [Accepted: 10/11/2017] [Indexed: 01/27/2023]
Abstract
Self-Perceived Problematic Porn Use (SPPPU) refers to an individual who self-identifies as addicted to porn because they feel they are unable to regulate their porn consumption, and that use interferes with everyday life. Although porn addiction has not been formally classified as its own distinct behavioral addiction, therapists and clinicians are advised to educate themselves on the current state of literature pertaining to pornography consumption given the widespread availability and consumption of sexually explicit material online. This review article begins with a general overview of pornography and porn use so that therapists and researchers can discern between non-intrusive and problematic pornography consumption patterns within their practice and understand the common characteristics of those that most commonly present with SPPPU. Thereafter, an overview and examination of therapeutic interventions for SPPPU will be identified and analysed. Finally, the review concludes with recommendations for therapists, clinicians, and future research.
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79
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George M, Maheshwari S, Chandran S, Rao SS, Shivanand MJ, Sathyanarayana Rao TS. Psychosocial intervention for sexual addiction. Indian J Psychiatry 2018. [PMID: 29540923 PMCID: PMC5844164 DOI: 10.4103/psychiatry.indianjpsychiatry_38_18] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Addiction is the term employed not only for excess consumption of substances, but also for problem behaviours like eating disorders, pathological gambling, computer addiction and pathological preoccupation with video games and sexual acts. No clear diagnostic criterion has been established with validity for behavioral addictions. Sexual addiction, including addiction to pornography is not included as a separate entity because of a lack of strong empirical evidence in this area. Different scales can be used for assessment of sexual addiction. Since there is an absence of established diagnostic criteria, the significance of validity of these scales is doubted. Several of the questions in these scales do not yield information about whether the diagnostic criteria are met or not. Pharmacotherapy, together with psychotherapy proves to have a better outcome in such patients as it helps to synthesize the role of developmental antecedents, reduce current anxiety, depression, guilt and to improve social adjustment.
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Affiliation(s)
- Manju George
- Department of Psychiatry, J.S.S Medical College and Hospital, J.S.S University, Mysore, India
| | - Shreemit Maheshwari
- Department of Psychiatry, J.S.S Medical College and Hospital, J.S.S University, Mysore, India
| | - Suhas Chandran
- Department of Psychiatry, J.S.S Medical College and Hospital, J.S.S University, Mysore, India
| | - Suman S Rao
- Department of Psychiatry, Vydehi Institue of Medical Sciences and Research Centre, Bengaluru, India
| | - Manohar J Shivanand
- Department of Psychiatry, J.S.S Medical College and Hospital, J.S.S University, Mysore, Karnataka, India
| | - T S Sathyanarayana Rao
- Department of Psychiatry, J.S.S Medical College and Hospital, J.S.S University, Mysore, Karnataka, India
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80
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Christensen JF. Pleasure junkies all around! Why it matters and why 'the arts' might be the answer: a biopsychological perspective. Proc Biol Sci 2018; 284:rspb.2016.2837. [PMID: 28469018 DOI: 10.1098/rspb.2016.2837] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2016] [Accepted: 03/10/2017] [Indexed: 01/10/2023] Open
Abstract
Today's society is pleasure seeking. We expect to obtain pleasurable experiences fast and easily. We are used to hyper-palatable foods and drinks, and we can get pornography, games and gadgets whenever we want them. THE PROBLEM with this type of pleasure-maximizing choice behaviour we may be turning ourselves into mindless pleasure junkies, handing over our free will for the next dopamine shoot. Pleasure-only activities are fun. In excess, however, such activities might have negative effects on our biopsychological health: they provoke a change in the neural mechanisms underlying choice behaviour. Choice behaviour becomes biased towards short-term pleasure-maximizing goals, just as in the addicted brain (modulated by the amygdala, posterior ventromedial prefrontal cortex' (VMPFC), striatum, nucleus accumbens; 'A-system') and away from long-term prosperity and general well-being maximizing objectives (normally ensured by the insula, anterior VMPFC, hippocampus, dorsolateral prefrontal cortex (DLPFC), anterior cingulate cortex (ACC); 'I-system'). This paper outlines, first, what 'pleasure' is and what 'pleasure-only' activities are (e.g. social media engagement, hyper-palatable eating). Second, an account is given of the type of action that might aid to maintain the neural systems underlying choice behaviour balanced. Finally, it is proposed that engagement with the arts might be an activity with the potential to foster healthy choice behaviour-and not be just for pleasure. The evidence in this rather new field of research is still piecemeal and inconclusive. This review aims to motivate targeted research in this domain.
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Affiliation(s)
- Julia F Christensen
- Cognitive Neuroscience Research Unit, Department of Psychology, University of London, London, UK .,Autism Research Group, Department of Psychology, University of London, London, UK
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81
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Carnes S, Love T. Separating Models Obscures the Scientific Underpinnings of Sex Addiction as a Disorder. ARCHIVES OF SEXUAL BEHAVIOR 2017; 46:2253-2256. [PMID: 28948394 DOI: 10.1007/s10508-017-1072-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/11/2017] [Accepted: 08/30/2017] [Indexed: 06/07/2023]
Affiliation(s)
- Stefanie Carnes
- American Foundation for Addiction Research, PO Box 3172, Carefree, AZ, 85377, USA.
| | - Todd Love
- Society for the Advancement of Sexual Health, Ardmore, PA, 19003, USA
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82
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Fernandez DP, Tee EYJ, Fernandez EF. Do Cyber Pornography Use Inventory-9 Scores Reflect Actual Compulsivity in Internet Pornography Use? Exploring the Role of Abstinence Effort. ACTA ACUST UNITED AC 2017. [DOI: 10.1080/10720162.2017.1344166] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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83
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Allen A, Kannis-Dymand L, Katsikitis M. Problematic internet pornography use: The role of craving, desire thinking, and metacognition. Addict Behav 2017; 70:65-71. [PMID: 28214738 DOI: 10.1016/j.addbeh.2017.02.001] [Citation(s) in RCA: 73] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2016] [Revised: 01/25/2017] [Accepted: 02/02/2017] [Indexed: 01/05/2023]
Abstract
Defined as sexually explicit material that elicits erotic thoughts, feelings, and behaviours, internet pornography is a prevalent form of media that may facilitate problematic use and craving for engagement. Research suggests that superordinate cognitions and information processing, such as desire thinking and metacognition, are central to the activation and escalation of craving in addictive behaviours. The current study aimed to contribute to the literature by testing the proposed metacognitive model of desire thinking and craving in a sample of problematic pornography users, while revising the model by incorporating negative affect. From a theoretical perspective, environmental cues trigger positive metacognitions about desire thinking that directly influence desire thinking, resulting in the escalation of craving, negative metacognitions, and negative affect. Participants were recruited via an online survey and screened for problematic internet pornography use. Path analyses were used to investigate relationships among the aforementioned constructs in a final sample of 191 participants. Consistent with previous research, results of this study validated the existence of metacognitive processes in the activation of desire thinking and escalation of craving, while indicating that desire thinking has the potential to influence negative affect. Additionally, results supported the role of significant indirect relationships between constructs within the revised model of metacognition, desire thinking, and psychopathology. Collectively, the findings demonstrate the clinical value of a metacognitive conceptualisation of problematic pornography use. Exploring the metacognitive mechanisms that underpin problematic internet pornography use may give rise to the development of new treatment and relapse prevention strategies.
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Affiliation(s)
- Andrew Allen
- Faculty of Arts, Business and Law, University of the Sunshine Coast, 90 Sippy Downs Drive, Sippy Downs, Queensland 4556, Australia
| | - Lee Kannis-Dymand
- Sunshine Coast Mind & Neuroscience - Thompson Institute, School of Social Sciences, FABL, University of the Sunshine Coast, 12 Innovation Parkway, Birtinya, Queensland 4575, Australia.
| | - Mary Katsikitis
- Faculty of Arts, Business and Law, University of the Sunshine Coast, 90 Sippy Downs Drive, Sippy Downs, Queensland 4556, Australia
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84
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Donevan M, Mattebo M. The relationship between frequent pornography consumption, behaviours, and sexual preoccupancy among male adolescents in Sweden. SEXUAL & REPRODUCTIVE HEALTHCARE 2017; 12:82-87. [DOI: 10.1016/j.srhc.2017.03.002] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2016] [Revised: 01/31/2017] [Accepted: 03/08/2017] [Indexed: 11/27/2022]
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85
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Use of Information and Communication Technologies in Clinical Practice Related to the Treatment of Pain. Influence on the Professional Activity and the Doctor-Patient Relationship. J Med Syst 2017; 41:77. [PMID: 28337668 DOI: 10.1007/s10916-017-0724-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2017] [Accepted: 03/10/2017] [Indexed: 12/30/2022]
Abstract
The increasing relevance of Information and Communication Technologies (ICTs) in medical care is indisputable. This evidence makes it necessary to start studies that analyse the scope these new forms of access to information and understanding of medicine have on the professional activity of the physician, on the attitude and on the knowledge of patients or, on the doctor-patient relationship. The purpose of this study is to explore some of these aspects in a group of physicians whose clinical activity is related to one of the greatest social impact health problems which is the treatment of chronic pain. Starting with the completion of a questionnaire, in the study group it is observed that the interaction between social structure, increase of information flows and ICTs generate transformations in social practices and behaviour of the actors of the health system. Internet is confirmed as an information space on the subject, but is shown as an underutilized space of interaction between the doctor and his patient.
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86
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Laier C, Brand M. Mood changes after watching pornography on the Internet are linked to tendencies towards Internet-pornography-viewing disorder. Addict Behav Rep 2016; 5:9-13. [PMID: 29450222 PMCID: PMC5800558 DOI: 10.1016/j.abrep.2016.11.003] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2016] [Revised: 11/28/2016] [Accepted: 11/28/2016] [Indexed: 11/25/2022] Open
Abstract
Internet-pornography-viewing disorder (IPD) is considered one type of Internet-use disorder. For IPD's development, it was assumed theoretically that a dysfunctional use of Internet pornography to cope with depressive mood or stress might be considered to be a risk factor. To address the effect of Internet pornography use on mood, an online study with three measuring points with a sample of male participants was conducted. Participants were investigated regarding their tendencies towards IPD, personal use of Internet pornography, general mood, perceived stress, and their Internet pornography use motivation. Moreover, participants were asked regarding their current mood, sexual arousal, and need to masturbate before and after they watched Internet pornography self-determinedly in a private environment. Data showed that tendencies towards IPD were associated negatively with feeling generally good, awake, and calm and were correlated positively with perceived stress in daily life and using Internet pornography for excitation seeking and emotional avoidance. Self-determined use of Internet pornography in their private environment was accompanied by changes in mood and indicators of sexual arousal. Moreover, tendencies towards IPD were negatively related to mood before and after Internet-pornography use as well as an actual increase of good and calm mood. The results showed effects of watching Internet pornography on mood and sexual arousal which can be considered having reinforcing effects for the user. Thus, the results are in line with theoretical assumptions on IPD's development, in which the positive (and negative) reinforcement received by Internet-pornography use is related to cue-reactivity and craving reactions. Investigation of mood and sexual arousal before and after self-determined Internet pornography use in private environment Watching pornography was associated to changes in mood and indicators of sexual arousal Current mood as well as changes in mood were associated to symptoms of Internet-pornography-viewing-disorder
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Affiliation(s)
- Christian Laier
- General Psychology: Cognition, University of Duisburg-Essen and Center for Behavioral Addiction Research (CeBAR), Germany
- Corresponding author at: General Psychology: Cognition, University of Duisburg-Essen and Center for Behavioral Addiction Research (CeBAR), Forsthausweg 2, 47057 Duisburg, Germany.General Psychology: CognitionUniversity of Duisburg-Essen and Center for Behavioral Addiction Research (CeBAR)Forsthausweg 2Duisburg47057Germany
| | - Matthias Brand
- General Psychology: Cognition, University of Duisburg-Essen and Center for Behavioral Addiction Research (CeBAR), Germany
- Erwin L. Hahn Institute for Magnetic Resonance Imaging, Essen, Germany
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87
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Effects of outcome on the covariance between risk level and brain activity in adolescents with internet gaming disorder. NEUROIMAGE-CLINICAL 2016; 12:845-851. [PMID: 27857886 PMCID: PMC5103101 DOI: 10.1016/j.nicl.2016.10.024] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/15/2016] [Revised: 10/30/2016] [Accepted: 10/31/2016] [Indexed: 12/31/2022]
Abstract
Individuals with internet gaming disorder (IGD) often have impaired risky decision-making abilities, and IGD-related functional changes have been observed during neuroimaging studies of decision-making tasks. However, it is still unclear how feedback (outcomes of decision-making) affects the subsequent risky decision-making in individuals with IGD. In this study, twenty-four adolescents with IGD and 24 healthy controls (HCs) were recruited and underwent functional magnetic resonance imaging while performing the balloon analog risk task (BART) to evaluate the effects of prior outcomes on brain activity during subsequent risky decision-making in adolescents with IGD. The covariance between risk level and activation of the bilateral ventral medial prefrontal cortex, left inferior frontal cortex, right ventral striatum (VS), left hippocampus/parahippocampus, right inferior occipital gyrus/fusiform gyrus and right inferior temporal gyrus demonstrated interaction effects of group by outcome (P < 0.05, AlphaSim correction). The regions with interactive effects were defined as ROI, and ROI-based intergroup comparisons showed that the covariance between risk level and brain activation was significantly greater in adolescents with IGD compared with HCs after a negative outcome occurred (P < 0.05). Our results indicated that negative outcomes affected the covariance between risk level and activation of the brain regions related to value estimation (prefrontal cortex), anticipation of rewards (VS), and emotional-related learning (hippocampus/parahippocampus), which may be one of the underlying neural mechanisms of disadvantageous risky decision-making in adolescents with IGD. Evaluating effects of outcome on subsequent risk decision making in IGDs Negative feedback affects risk decision making related brain activity in IGDs. Altered response to negative feedback contributes to adverse decision making in IGDs.
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88
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Gola M, Wordecha M, Marchewka A, Sescousse G. Visual Sexual Stimuli-Cue or Reward? A Perspective for Interpreting Brain Imaging Findings on Human Sexual Behaviors. Front Hum Neurosci 2016; 10:402. [PMID: 27574507 PMCID: PMC4983547 DOI: 10.3389/fnhum.2016.00402] [Citation(s) in RCA: 86] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2016] [Accepted: 07/26/2016] [Indexed: 11/28/2022] Open
Abstract
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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Affiliation(s)
- Mateusz Gola
- Swartz Center for Computational Neuroscience, Institute for Neural Computations, University of California San DiegoSan Diego, CA, USA; Institute of Psychology, Polish Academy of SciencesWarsaw, Poland
| | - Małgorzata Wordecha
- Institute of Psychology, Polish Academy of SciencesWarsaw, Poland; Laboratory of Brain Imaging, Neurobiology Center, Nencki Institute of Experimental Biology of Polish Academy of SciencesWarsaw, Poland
| | - Artur Marchewka
- Laboratory of Brain Imaging, Neurobiology Center, Nencki Institute of Experimental Biology of Polish Academy of Sciences Warsaw, Poland
| | - Guillaume Sescousse
- Donders Institute for Brain, Cognition and Behavior, Radboud University Nijmegen, Netherlands
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89
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Park BY, Wilson G, Berger J, Christman M, Reina B, Bishop F, Klam WP, Doan AP. Is Internet Pornography Causing Sexual Dysfunctions? A Review with Clinical Reports. Behav Sci (Basel) 2016; 6:E17. [PMID: 27527226 PMCID: PMC5039517 DOI: 10.3390/bs6030017] [Citation(s) in RCA: 67] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2016] [Revised: 07/29/2016] [Accepted: 08/02/2016] [Indexed: 01/07/2023] Open
Abstract
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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Affiliation(s)
- Brian Y Park
- Flight Surgeon, Fleet Logistics Support Squadron 40, Norfolk, VA 34800 Bob Wilson Drive, San Diego, CA 92592, USA.
| | - Gary Wilson
- The Reward Foundation, 5 Rose Street, Edinburgh EH2 2PR, Scotland, UK.
| | - Jonathan Berger
- Department of Urology, Naval Medical Center San Diego, 34800 Bob Wilson Drive, San Diego, CA 92592, USA.
| | - Matthew Christman
- Department of Urology, Naval Medical Center San Diego, 34800 Bob Wilson Drive, San Diego, CA 92592, USA.
| | - Bryn Reina
- Department of Mental Health, Naval Medical Center San Diego, 34800 Bob Wilson Drive, San Diego, CA 92592, USA.
| | - Frank Bishop
- Department of Ophthalmology, Naval Medical Center San Diego, 34800 Bob Wilson Drive, San Diego, CA 92592, USA.
| | - Warren P Klam
- Department of Mental Health, Naval Medical Center San Diego, 34800 Bob Wilson Drive, San Diego, CA 92592, USA.
| | - Andrew P Doan
- Department of Mental Health, Naval Medical Center San Diego, 34800 Bob Wilson Drive, San Diego, CA 92592, USA.
- Department of Ophthalmology, Naval Medical Center San Diego, 34800 Bob Wilson Drive, San Diego, CA 92592, USA.
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90
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Snagowski J, Laier C, Duka T, Brand M. Subjective Craving for Pornography and Associative Learning Predict Tendencies Towards Cybersex Addiction in a Sample of Regular Cybersex Users. ACTA ACUST UNITED AC 2016. [DOI: 10.1080/10720162.2016.1151390] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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91
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Brand M, Snagowski J, Laier C, Maderwald S. Ventral striatum activity when watching preferred pornographic pictures is correlated with symptoms of Internet pornography addiction. Neuroimage 2016; 129:224-232. [DOI: 10.1016/j.neuroimage.2016.01.033] [Citation(s) in RCA: 131] [Impact Index Per Article: 16.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2015] [Revised: 12/18/2015] [Accepted: 01/12/2016] [Indexed: 12/20/2022] Open
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