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Privara M, Bob P. Sexual development in ADHD and internet pornography consumption. Front Psychiatry 2023; 14:1240222. [PMID: 37614646 PMCID: PMC10442643 DOI: 10.3389/fpsyt.2023.1240222] [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] [Received: 06/14/2023] [Accepted: 07/11/2023] [Indexed: 08/25/2023] Open
Abstract
Development of sexual identity during adolescence is a major process of transition in individual life which in cases of ADHD specifically interacts with other ontogenetic, pathological and psychosocial conditions. According to recent findings growing consumption of internet pornography mainly in male ADHD population is closely related to compulsive sexual behavior and hypersexuality. Recent findings also indicate that consumption of internet pornography in ADHD individuals and other sexual activities may serve as a mood-altering "self-medication" which may help to cope with stressful events and decrease depression and anxiety. Taken together recent findings indicate that internet pornography consumption mainly in ADHD individuals is closely related to stressful experiences, anxiety, depression and identity problems in partnerships which significantly increase their vulnerability to the so-called "problematic pornography use" and other forms of addictive sexual behavior. From this developmental perspective "problematic pornography use" in ADHD individuals represents significant epidemiological problem which requires further research mainly with focus on clinical diagnostics and treatment.
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Affiliation(s)
| | - Petr Bob
- Center for Neuropsychiatric Research of Traumatic Stress, Department of Psychiatry and UHSL, First Faculty of Medicine, Department of Psychiatry, Faculty of Medicine Pilsen, Charles University, Prague, Czechia
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Seyedzadeh Dalooyi SI, Aghamohammadian Sharbaaf H, Abdekhodaei MS, Ghanaei Chamanabad A. Biopsychosocial Determinants of Problematic Pornography Use: A Systematic Review. ADDICTION & HEALTH 2023; 15:202-218. [PMID: 38026725 PMCID: PMC10658102 DOI: 10.34172/ahj.2023.1395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Accepted: 10/08/2022] [Indexed: 12/01/2023]
Abstract
Background Although some studies have examined the determinants of problematic pornography use (PPU), few systematic comparisons of risk profiles have been conducted so far. Research on risk profiles can shed a bright light on our knowledge of both the early diagnosis and etiology of such highly prevalent disorders. Accordingly, the present study aimed to provide a comprehensive overview of the determinants of PPU. Methods Scopus, Web of Science, PubMed, and PsycINFO databases were systematically searched, and relevant English articles, including longitudinal and cross-sectional studies on risk factors published from January 2000 to February 2022 were reviewed. Findings The determinants of PPU extracted from the investigated studies (n=66) were summarized and clustered into biological, psychological, and social categories. The findings indicated that ventral striatum activity is a consistent biological factor which plays a key role in the development of PPU, while there were other psychological factors influencing PPU as mentioned in several studies, including craving, low self-esteem, sexual arousal, coping styles, stress, frequent pornography watching, avoidance, negative beliefs, and emotional deficiency. In addition, the social factors affecting PPU have been reported to be male gender, age, religion, moral incompatibility, and loneliness. According to these results, the identified factors could be considered in preventive treatment. Conclusion This systematic review provided a comprehensive overview of the biopsychosocial determinants of PPU by analyzing 66 articles mostly from Europe and North America. Most studies showed that ventral striatum activity, craving, self-esteem, stress, frequent pornography watching, gender, age, and religion are related to PPU.
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Affiliation(s)
| | | | - Mohammad Saeed Abdekhodaei
- Department of Psychology, Faculty of Educational Sciences and Psychology, Ferdowsi University of Mashhad, Mashhad, Iran
| | - Ali Ghanaei Chamanabad
- Department of Psychology, Faculty of Educational Sciences and Psychology, Ferdowsi University of Mashhad, Mashhad, Iran
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Hernández-Mora Ruiz Del Castillo M, Bonnet P, Varescon I. Profiles of Pornography Use Based on Addictive Mechanisms and Psychopathological Features. Int J Ment Health Addict 2023:1-13. [PMID: 37363758 PMCID: PMC10235843 DOI: 10.1007/s11469-023-01087-x] [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] [Accepted: 05/19/2023] [Indexed: 06/28/2023] Open
Abstract
Studies using person-centered approaches to further explore the profiles of pornography users throw their psychiatric features are lacking. This study was designed to examine the different profiles of pornography users based on the addictive dimensions of Problematic Pornography Use (PPU) and to characterize these profiles according to psychopathological variables such as depression, anxiety, attention deficit hyperactivity disorder (ADHD) and obsessive-compulsive disorder (OCD). A sample of 1001 French adults participated to a survey containing scales related to psychopathological variables, cybersexual addiction and PPU. PPU was assessed with the French Version of Problematic Pornography Consumption Scale (Fr-PPCS-18). An Agglomerative Hierarchical Classification was performed on the basis of FR-PPCS-18. A student's t-test was used to observe PPU and psychopathological differences between profiles. Findings revealed three profiles of users: non-problematic users (66.5%), at-risk users (29.9%), and problematic users (3.6%). There were significant differences between the three profiles concerning levels of global PPU, PPU mechanisms, cybersexual addiction symptoms, ADHD symptomatology and depressive symptomatology. Results confirmed the existence of different levels of severity of pornography use corresponding to three different profiles. Also, findings revealed the influence of ADHD symptoms, obsessive-compulsive symptoms and depressive symptoms on PPU.
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Affiliation(s)
- María Hernández-Mora Ruiz Del Castillo
- Laboratoire de Psychopathologie Et Processus de Santé (URP 4057, Université Paris Cité, 92100 Boulogne Billancourt, France
- Laboratoire Vision Action Cognition (URP 7326), Université Paris Cité, 92100 Boulogne Billancourt, France
| | - Philippe Bonnet
- Laboratoire de Psychopathologie et Processus de Santé, Université Paris Cité(URP 4057, Université Paris Cité), 92100 Boulogne Billancourt, France
| | - Isabelle Varescon
- Laboratoire de Psychopathologie Et Processus de Santé (URP 4057, Université Paris Cité, 92100 Boulogne Billancourt, France
- Laboratoire Vision Action Cognition (URP 7326), Université Paris Cité, 92100 Boulogne Billancourt, France
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Jhe GB, Addison J, Lin J, Pluhar E. Pornography use among adolescents and the role of primary care. Fam Med Community Health 2023; 11:fmch-2022-001776. [PMID: 36650009 PMCID: PMC9853222 DOI: 10.1136/fmch-2022-001776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Accepted: 12/27/2022] [Indexed: 01/19/2023] Open
Abstract
Given the increase in pornography use among adolescents over the years, we discuss the impact of its use on sexual health development as well as the role of primary care providers (PCPs) in assessing use and providing sexual health education. While pornography use is often viewed negatively, it is important to develop unbiased understanding of the use in order to provide non-judgemental, adolescent-focused and educational care. As PCPs are often the first point of contact when adolescents experience medical and behavioural health concerns, it is essential for them to be equipped to screen for pornography use effectively, create a confidential and comfortable environment to talk about pornography use and sexuality, and be informed of ways to promote open discussion between youth and parents. In addition to PCP involvement, parental collaboration, knowledge and comfortability with discussing pornography use with their child are powerful tools in understanding and navigating pornography use in this population. This special communication seeks to provide an objective view of adolescents' pornography use, guidelines for screening of pornography use and ways to facilitate conversations about the use between adolescents and caregivers.
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Affiliation(s)
- Grace B Jhe
- Department of Psychiatry and Behavioral Sciences, Boston Children's Hospital, Boston, MA, USA .,Department of Psychiatry, Harvard Medical School, Boston, MA, USA.,Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Jessica Addison
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, Massachusetts, USA,Department of Pediatrics, Harvard Medical School, Boston, MA, USA
| | - Jessica Lin
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, Massachusetts, USA,Division of Adolescent and Transition Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA,Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Emily Pluhar
- Department of Psychiatry and Behavioral Sciences, Boston Children's Hospital, Boston, MA, USA,Department of Psychiatry, Harvard Medical School, Boston, MA, USA,Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, Massachusetts, USA,Division of Sports Medicine, Boston Children’s Hospital, Boston, MA, USA
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Zhang Y, Chen L, Jiang X, Bőthe B. Investigating the Associations of ADHD Symptoms, Impulsivity, Physical Exercise, and Problematic Pornography Use in a Chinese Sample. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15221. [PMID: 36429937 PMCID: PMC9691194 DOI: 10.3390/ijerph192215221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 11/14/2022] [Accepted: 11/15/2022] [Indexed: 06/16/2023]
Abstract
Investigating the relationship between attention-deficit/hyperactivity disorder (ADHD) symptoms and impulsivity will benefit our understanding of the concept of problematic pornography use (PPU), and revealing predisposing and malleable moderators of PPU will be beneficial for its prevention and intervention. The current study not only aimed to observe these relationships, but also explored the potential moderating role of physical exercise in the general population. A total of 600 Chinese adults (Mage = 32.31, SDage = 12.40, 39.8% women) were recruited and completed an online survey. The results showed that participants with regular exercise scored lower than those without exercise on ADHD, impulsivity, and PPU (all ps < 0.001). Using latent moderated structural equations (LMS), the findings revealed that the relationship between ADHD symptoms and PPU was mediated by impulsivity, and physical exercise moderated this relationship (B = -0.14, p = 0.048). Specifically, when individuals' physical exercise was higher than 0.84 standard deviations above the mean, the positive predictive effect of impulsivity on PPU was not significant. These findings indicate the important role of impulsivity in the relationship between ADHD and PPU, and physical exercise could be a meaningful component of interventions among individuals experiencing PPU.
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Affiliation(s)
- Ying Zhang
- Department of Physical Education, Fuzhou University, Fuzhou 350108, China
| | - Lijun Chen
- Department of Psychology, School of Humanities and Social Sciences, Fuzhou University, Fuzhou 350108, China
| | - Xiaoliu Jiang
- Department of Psychology, School of Humanities and Social Sciences, Fuzhou University, Fuzhou 350108, China
| | - Beáta Bőthe
- Département de Psychologie, Université du Québec à Trois-Rivières, Trois-Rivières, QC G8Z 4M3, Canada
- Département de Psychologie, Université de Montréal, Montréal, QC H3T 1J4, Canada
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Hertz PG, Turner D, Barra S, Biedermann L, Retz-Junginger P, Schöttle D, Retz W. Sexuality in Adults With ADHD: Results of an Online Survey. Front Psychiatry 2022; 13:868278. [PMID: 35651826 PMCID: PMC9148957 DOI: 10.3389/fpsyt.2022.868278] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Accepted: 04/25/2022] [Indexed: 12/03/2022] Open
Abstract
Establishing a secure sexual identity is a major developmental goal of an individual's transition from childhood to adolescence and the years that follow. Attention deficit/hyperactivity disorder (ADHD) as a neurodevelopmental disorder defined by the core symptoms of inattention, hyperactivity, and impulsivity, but also with emotional dysregulation, oppositional behaviors, or disorganization appearing early in life, can affect several areas of an individual's personal and social development, including sexual health. Yet, the scientific knowledge about the relationship between ADHD and sexual functioning is still scarce. Using an anonymous online survey, we compared different sexual behaviors including risky sexual behaviors, hypersexual behaviors, and sexual dysfunctions between 206 individuals with (n = 139) and without (n = 76) ADHD. Individuals with ADHD reported significantly more hypersexual behaviors than non-ADHD individuals, whereas no differences were found concerning risky sexual behaviors or sexual dysfunctions. In women with ADHD, hypersexual behaviors, sexual risk-taking as well as sexual dysfunctions were closely related to symptoms of emotional dysregulation, impulsivity, and oppositional symptoms. In men with ADHD, the associations between ADHD symptomatology and the sexuality-related measures were less clear, however, signs of emotional dysregulation seemed to be relevant as well. Since individuals with ADHD seem to be at an increased risk of some peculiarities in sexual behavior, sexuality-related issues should be routinely addressed during clinical consultations to provide more holistic treatment in order to enhance individual well-being and quality of life.
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Affiliation(s)
- Priscilla Gregório Hertz
- Department of Psychiatry and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Daniel Turner
- Department of Psychiatry and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Steffen Barra
- Institute for Forensic Psychology and Psychiatry, University Hospital, Homburg, Germany
| | - Laura Biedermann
- Department of Psychiatry and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Petra Retz-Junginger
- Institute for Forensic Psychology and Psychiatry, University Hospital, Homburg, Germany
| | - Daniel Schöttle
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Wolfgang Retz
- Department of Psychiatry and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
- Institute for Forensic Psychology and Psychiatry, University Hospital, Homburg, Germany
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Werling AM, Kuzhippallil S, Emery S, Walitza S, Drechsler R. Problematic use of digital media in children and adolescents with a diagnosis of attention-deficit/hyperactivity disorder compared to controls. A meta-analysis. J Behav Addict 2022; 11:305-325. [PMID: 35567763 PMCID: PMC9295226 DOI: 10.1556/2006.2022.00007] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 11/05/2021] [Accepted: 03/08/2022] [Indexed: 12/24/2022] Open
Abstract
Objective Problematic use of digital media and problematic use of the internet (PUI) in particular are growing problems in the general population. Moreover, studies have shown links between PUI and symptoms of attention-deficit/hyperactivity disorder (ADHD). This meta-analysis investigated whether children and adolescents with ADHD are more often affected by PUI compared to control groups. Method Multiple databases (EBSCOhost, Pubmed) were reviewed. Studies were eligible if individuals (aged 6-18 years) were diagnosed with ADHD, assessed on PUI-related measures, and compared to non-clinical or/and clinical controls without a diagnosis of ADHD. Out of 3,859 identified studies, 14 studies assessing 2,488 participants met all inclusion criteria. Four meta-analyses examining time-based and scale-based measures, different informants and non-clinical vs. clinical controls using random-effects models were performed. Funnel plots were used to investigate publication bias. Results The analyses revealed significantly more severe PUI in individuals with ADHD compared to controls, both when PUI was assessed via rating scale (scaled-based) and via units for time (time-based measures). Different informants (self- vs. parent-rating) had no impact on results. Differences in PUI between groups with ADHD and non-clinical controls were significant, whereas differences between ADHD and clinical controls were not. Due to the high heterogeneity observed and the small sample sizes, these latter findings should be interpreted cautiously. Conclusion Children and adolescents with ADHD show more severe PUI compared to non-clinical controls without ADHD. However, the small number of studies does not allow for a systematic comparison between ADHD and groups with other psychopathologies.
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Affiliation(s)
- Anna Maria Werling
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital of Psychiatry Zurich, University of Zurich, Switzerland
| | - Sajiv Kuzhippallil
- Department of Forensic Psychiatry, University Hospital of Psychiatry Zurich, University of Zurich, Switzerland
| | - Sophie Emery
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital of Psychiatry Zurich, University of Zurich, Switzerland
| | - Susanne Walitza
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital of Psychiatry Zurich, University of Zurich, Switzerland
- Neuroscience Center Zurich, University of Zurich and ETH Zurich, Switzerland
| | - Renate Drechsler
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital of Psychiatry Zurich, University of Zurich, Switzerland
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Sassover E, Weinstein A. Should compulsive sexual behavior (CSB) be considered as a behavioral addiction? A debate paper presenting the opposing view. J Behav Addict 2020; 11. [PMID: 32997646 PMCID: PMC9295215 DOI: 10.1556/2006.2020.00055] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Revised: 06/18/2020] [Accepted: 08/18/2020] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND AND AIMS Compulsive sexual behavior disorder (CSBD) has been a long debated issue. While formerly the discussion was about whether to regard CSBD as a distinctive disorder, the current debate is dealing with the classification of this phenomenon. One of the prominent voices in this field considers CSBD as a behavioral addiction and proposes CSBD to be called and diagnosed as sexual addiction (SA). This present debate paper will review the existing evidence supporting this view and it will argue against it. RESULTS We have found that a great deal of the current literature is anecdotal while empirical evidence is insufficient. First, the reports about the prevalence of CSBD are contradictory. Additionally, the field mainly suffers from inconsistent defining criteria of CSBD and a consensus which symptoms should be included. As a result, the empirical evidence that does exist is mostly about some symptoms individually and not on the disorder as a whole construct. CONCLUSIONS We conclude that currently, there is not enough data supporting CSBD as a behavioral addiction. Further research has to be done, examining CSBD phenomenology as a whole construct and based on a homogeneous criterion.
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Affiliation(s)
- Eli Sassover
- Department of Behavioral Science, Ariel University, Science Park, Ariel, Israel
- Department of Behavioral Science and Integrative Brain and Cognition Center, Ariel University, Ariel, Israel
| | - Aviv Weinstein
- Department of Behavioral Science, Ariel University, Science Park, Ariel, Israel
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