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Wang J, Li H. Neural Correlates of the Attentional Bias Towards Subliminal Pornographic Cues in Individuals with Tendencies Toward Problematic Pornography Use: An ERP Study Using a Dot-Probe Task. ARCHIVES OF SEXUAL BEHAVIOR 2024; 53:3365-3378. [PMID: 39134733 DOI: 10.1007/s10508-024-02965-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/26/2023] [Revised: 05/20/2024] [Accepted: 07/19/2024] [Indexed: 09/13/2024]
Abstract
Attentional bias toward addiction-related stimuli has been implicated in the development and maintenance of addiction disorders. Several previous studies have reported an attentional bias toward pornographic cues in individuals with problematic pornography use (PPU). Since attentional bias can occur without conscious awareness, the purpose of this study was to use electroencephalography to examine whether individuals with a high tendency for PPU exhibit attentional bias at the level of the preconscious processing. Event-related potentials (ERPs) were recorded while male participants with high (n = 24) and low (n = 23) levels of subclinical PPU performed a masked version of the dot-probe task measuring attentional bias toward subliminally presented pornographic stimuli. Behavioral data revealed that participants from both groups with high and low tendencies for PPU reacted faster to probes replacing pornographic images than to probes replacing neutral images. ERPs revealed that individuals with a high tendency for PPU exhibited larger probe-locked P1 amplitudes following masked pornographic images (valid condition) compared with masked neutral images (invalid condition). Additionally, PPU symptom severity correlated positively with the P1 amplitude difference between valid and invalid conditions. These results highlight the automaticity of attentional capture by pornographic stimuli and support the hypothesis of an addiction-related attentional bias during preconscious processes. The implication of these findings for understanding the clinical phenomenon of out-of-control addictive behavior are discussed.
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Affiliation(s)
- Jianfeng Wang
- Institute of Brain and Psychological Sciences, Sichuan Normal University, Chengdu, 610066, China
- School of Psychology, Chengdu Medical College, Chengdu, China
| | - Hong Li
- Institute of Brain and Psychological Sciences, Sichuan Normal University, Chengdu, 610066, China.
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2
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Ince C, Albertella L, Liu C, Tiego J, Fontenelle LF, Chamberlain SR, Yücel M, Rotaru K. Problematic pornography use and novel patterns of escalating use: A cross-sectional network analysis with two independent samples. Addict Behav 2024; 156:108048. [PMID: 38761685 PMCID: PMC7616041 DOI: 10.1016/j.addbeh.2024.108048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 04/09/2024] [Accepted: 04/30/2024] [Indexed: 05/20/2024]
Abstract
Modern internet pornography allows users to harness sexual novelty in numerous ways, which can be used to overcome desensitisation through increasing volume of use (quantitative tolerance), progressing to more stimulating genres (qualitative escalation), skipping between stimuli (tab-jumping), delaying orgasm ('edging'), and engaging in pornographic binges. However, existing research has not yet evaluated how these potentially reciprocal consumption patterns relate to problematic pornography use (PPU). To this end, we recruited two independent samples of male pornography users (N1 = 1,356, Mage = 36.86, SD = 11.26; N2 = 944, Mage = 38.69, SD = 12.26) and examined the relationships between these behavioural dimensions and self-reported difficulties in controlling one's pornography use. Data were analysed through the network analysis approach (using Gaussian graphical models). As hypothesised, i) quantitative tolerance was centrally placed within the overall network, and ii) acted as a statistical bridge node between other patterns of pornography use (e.g., pornographic binges), and all measured facets of PPU. Our results are consistent with other emerging literature suggesting that tolerance, pornographic binges, tab-jumping, and edging behaviours as relevant features ofPPU, and that upscaling overall usage may connect broader patterns of use with problematic engagement. Clinical and theoretical implications, as well as future research directions, are discussed.
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Affiliation(s)
- Campbell Ince
- School of Psychological Sciences, Monash University, Australia; Brain Park, Turner Institute for Brain and Mental Health, Monash University, Australia.
| | - Lucy Albertella
- School of Psychological Sciences, Monash University, Australia; Brain Park, Turner Institute for Brain and Mental Health, Monash University, Australia
| | - Chang Liu
- School of Psychological Sciences, Monash University, Australia; Brain Park, Turner Institute for Brain and Mental Health, Monash University, Australia
| | - Jeggan Tiego
- School of Psychological Sciences, Monash University, Australia; Brain Park, Turner Institute for Brain and Mental Health, Monash University, Australia; Monash Biomedical Imaging, Monash University, 770 Blackburn Rd, Clayton, VIC 3800, Australia
| | - Leonardo F Fontenelle
- Brain Park, Turner Institute for Brain and Mental Health, Monash University, Australia; Institute of Psychiatry, Federal University of Rio de Janeiro, Brazil; D'Or Institute for Research and Education (IDOR), Brazil
| | - Samuel R Chamberlain
- Department of Psychiatry, Faculty of Medicine, University of Southampton, UK; Southern Health NHS Foundation Trust, Southampton, UK
| | - Murat Yücel
- School of Psychological Sciences, Monash University, Australia; Brain Park, Turner Institute for Brain and Mental Health, Monash University, Australia; QIMR Berghofer Medical Research Institute, Herston, QLD, Australia
| | - Kristian Rotaru
- School of Psychological Sciences, Monash University, Australia; Brain Park, Turner Institute for Brain and Mental Health, Monash University, Australia; Monash Business School, Monash University, Australia
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3
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Mestre-Bach G, Potenza MN, Granero R, Uríszar JC, Tarragón E, Chiclana Actis C, Testa G, Fernández-Aranda F, Jiménez-Murcia S. Understanding the Co-occurrence of Gambling Disorder and Problematic Pornography Use: Exploring Sociodemographic and Clinical Factors. J Gambl Stud 2024; 40:1295-1314. [PMID: 38151657 DOI: 10.1007/s10899-023-10274-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/25/2023] [Indexed: 12/29/2023]
Abstract
The co-occurrence between gambling disorder (GD) and problematic pornography use (PPU) has not yet been explored. Therefore, the present study compared (a) sociodemographic variables, (b) GD-related factors, (c) substance use, (d) psychopathology, (e) personality features, (f) impulsivity, and (g) emotion regulation between individuals with GD (GD group) and those with co-occurring GD and PPU (GD+PPU group). The sample consisted of 359 treatment-seeking individuals with GD: n = 332 individuals had GD only (GD group) and n = 37 individuals had GD and co-occurring PPU (GD+PPU group). GD severity, impulsivity, psychopathology, personality, emotion regulation, and other sociodemographic and clinical variables were assessed. No between-group differences in sociodemographic measures were observed. The GD+PPU group demonstrated greater GD severity and a higher likelihood of substance use compared to those without PPU. Furthermore, the presence of PPU was associated with worse psychopathology, higher impulsivity (except for lack of premeditation and positive urgency), more difficulties in emotion regulation (except for non-acceptance of emotions and limited access to emotions), and a personality profile characterized by lower levels of self-directedness and cooperativeness. The co-occurrence of GD and PPU seems associated with a more dysfunctional clinical profile.
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Affiliation(s)
- Gemma Mestre-Bach
- Instituto de Investigación, Transferencia e Innovación, Universidad Internacional de La Rioja, Avenida de la Paz, 137, 26006, Logroño, La Rioja, Spain.
| | - Marc N Potenza
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- Child Study Center, Yale University School of Medicine, New Haven, CT, USA
- Connecticut Mental Health Center, New Haven, CT, USA
- Connecticut Council on Problem Gambling, Wethersfield, CT, USA
- Department of Neuroscience, Yale University, New Haven, CT, USA
- Wu Tsai Institute, Yale University, New Haven, CT, USA
| | - Roser Granero
- Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Barcelona, Spain
- Departament de Psicobiologia i Metodologia de les Ciències de la Salut, Universitat Autònoma de Barcelona, Barcelona, Spain
- Psychoneurobiology of Eating and Addictive Behaviors Group, Neuroscience Program, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain
| | - Juan Carlos Uríszar
- Clinical Psychology Unit, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain
- Sub-Directorate General for the Regulation of Gambling, Directorate General for Taxation and Gambling, Secretariat of Finance, Ministry of the Economy and Finance, Generalitat de Catalunya, Barcelona, Spain
| | | | - Carlos Chiclana Actis
- Instituto de Investigación, Transferencia e Innovación, Universidad Internacional de La Rioja, Avenida de la Paz, 137, 26006, Logroño, La Rioja, Spain
- Unidad de Sexología Clínica y Salud Sexual, Consulta Dr. Carlos Chiclana, Madrid, Spain
| | - Giulia Testa
- Instituto de Investigación, Transferencia e Innovación, Universidad Internacional de La Rioja, Avenida de la Paz, 137, 26006, Logroño, La Rioja, Spain
| | - Fernando Fernández-Aranda
- Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Barcelona, Spain
- Psychoneurobiology of Eating and Addictive Behaviors Group, Neuroscience Program, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain
- Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | - Susana Jiménez-Murcia
- Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Barcelona, Spain.
- Psychoneurobiology of Eating and Addictive Behaviors Group, Neuroscience Program, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain.
- Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain.
- Bellvitge University Hospital-IDIBELL and CIBERObn, c/Feixa Llarga s/n, 08907, Hospitalet de Llobregat, Barcelona, Spain.
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Briken P, Bőthe B, Carvalho J, Coleman E, Giraldi A, Kraus SW, Lew-Starowicz M, Pfaus JG. Assessment and treatment of compulsive sexual behavior disorder: a sexual medicine perspective. Sex Med Rev 2024; 12:355-370. [PMID: 38529667 PMCID: PMC11214846 DOI: 10.1093/sxmrev/qeae014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2023] [Revised: 02/02/2024] [Accepted: 02/03/2024] [Indexed: 03/27/2024]
Abstract
INTRODUCTION The addition of compulsive sexual behavior disorder (CSBD) into the ICD-11 chapter on mental, behavioral, or neurodevelopmental disorders has greatly stimulated research and controversy around compulsive sexual behavior, or what has been termed "hypersexual disorder," "sexual addiction," "porn addiction," "sexual compulsivity," and "out-of-control sexual behavior." OBJECTIVES To identify where concerns exist from the perspective of sexual medicine and what can be done to resolve them. METHODS A scientific review committee convened by the International Society for Sexual Medicine reviewed pertinent literature and discussed clinical research and experience related to CSBD diagnoses and misdiagnoses, pathologizing nonheteronormative sexual behavior, basic research on potential underlying causes of CSBD, its relationship to paraphilic disorder, and its potential sexual health consequences. The panel used a modified Delphi method to reach consensus on these issues. RESULTS CSBD was differentiated from other sexual activity on the basis of the ICD-11 diagnostic criteria, and issues regarding sexual medicine and sexual health were identified. Concerns were raised about self-labeling processes, attitudes hostile to sexual pleasure, pathologizing of nonheteronormative sexual behavior and high sexual desire, mixing of normative attitudes with clinical distress, and the belief that masturbation and pornography use represent "unhealthy" sexual behavior. A guide to CSBD case formulation and care/treatment recommendations was proposed. CONCLUSIONS Clinical sexologic and sexual medicine expertise for the diagnosis and treatment of CSBD in the psychiatric-psychotherapeutic context is imperative to differentiate and understand the determinants and impact of CSBD and related "out-of-control sexual behaviors" on mental and sexual well-being, to detect forensically relevant and nonrelevant forms, and to refine best practices in care and treatment. Evidence-based, sexual medicine-informed therapies should be offered to achieve a positive and respectful approach to sexuality and the possibility of having pleasurable and safe sexual experiences.
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Affiliation(s)
- Peer Briken
- Institute for Sex Research, Sexual Medicine, and Forensic Psychiatry, University Medical Center, Hamburg-Eppendorf, Hamburg 20251, Germany
| | - Beáta Bőthe
- Department of Psychology, Université de Montréal, Montréal, QC H3C 3J7, Canada
- Centre de Recherche Interdisciplinaire Sur Les Problèmes Conjugaux Et Les Agressions Sexuelles, Montréal, QC H3C 3J7, Canada
| | - Joana Carvalho
- William James Center for Research, Department of Education and Psychology, University of Aveiro, Aveiro 3810-193, Portugal
| | - Eli Coleman
- Eli Coleman Institute for Sexual and Gender Health, University of Minnesota, Minneapolis, MN 55454, United States
| | - Annamaria Giraldi
- Sexological Clinic, Mental Health Center, Copenhagen University Hospital, Mental Health Services, Copenhagen CPH 2200, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen 2200, Denmark
| | - Shane W Kraus
- Department of Psychology, University of Nevada Las Vegas, Las Vegas, NV 5030, United States
| | - Michał Lew-Starowicz
- Department of Psychiatry, Centre of Postgraduate Medical Education, Warsaw 01-809, Poland
| | - James G Pfaus
- Center for Sexual Health and Intervention, Czech National Institute of Mental Health, Klecany 25067, Czech Republic
- Department of Psychology and Life Sciences, Faculty of Humanities, Charles University, Prague 18200, Czech Republic
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Fournier L, Schimmenti A, Musetti A, Boursier V, Flayelle M, Cataldo I, Starcevic V, Billieux J. Further evidence for the bidimensionality of the components model of addiction: a reply to Amendola (2023). Addict Behav 2024; 150:107914. [PMID: 37995610 DOI: 10.1016/j.addbeh.2023.107914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 11/18/2023] [Indexed: 11/25/2023]
Abstract
In our original research article entitled "Deconstructing the components model of addiction: an illustration through "addictive" use of social media" (Fournier et al., 2023), we showed that the Bergen Social Media Addiction Scale, a six-item psychometric instrument derived from the components model of addiction to assess social media "addiction", did not form a unitary, but a bidimensional construct in which some components (i.e., salience, tolerance) were not associated with psychopathological symptoms, thus conflating central and peripheral features of addiction. Subsequently, in a recent commentary, Amendola (2023) sought to determine whether our findings were driven by the use of data aggregated from multiple independent datasets, i.e., a decision we transparently acknowledged as a limitation in our original research article. Following their re-analysis, Amendola (2023) claimed to have demonstrated that a unidimensional model best fitted the data. However, they only reported results for a partial set of models relevant to this investigation. In the present reply, through a transparent assessment and reporting of all unidimensional and bidimensional models relevant to this investigation, we show that the bidimensionality of the Bergen Social Media Addiction Scale is, in fact, tenable, robust, and consistent across multiple independent datasets. In line with the growing evidence demonstrating that many sets of criteria involved in operationalizing behavioral addictions pathologize involvement in appetitive behaviors, these results highlight the necessity to renew the conceptualization and assessment of behavioral addictions.
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Affiliation(s)
- Loïs Fournier
- Institute of Psychology, University of Lausanne, Quartier UNIL-Mouline, Bâtiment Géopolis, CH-1015 Lausanne, Switzerland.
| | - Adriano Schimmenti
- Faculty of Human and Social Sciences, UKE - Kore University of Enna, Cittadella Universitaria, 94100 Enna, Italy.
| | - Alessandro Musetti
- Department of Humanities, Social Sciences and Cultural Industries, University of Parma, Borgo Carissimi 10, 43121 Parma, Italy.
| | - Valentina Boursier
- Department of Humanities, University of Naples "Federico II", Via Porta di Massa, 1, 80133 Naples, Italy.
| | - Maèva Flayelle
- Institute of Psychology, University of Lausanne, Quartier UNIL-Mouline, Bâtiment Géopolis, CH-1015 Lausanne, Switzerland.
| | - Ilaria Cataldo
- Department of Humanities, Social Sciences and Cultural Industries, University of Parma, Borgo Carissimi 10, 43121 Parma, Italy.
| | - Vladan Starcevic
- Faculty of Medicine and Health, Sydney Medical School, Nepean Clinical School, University of Sydney, Penrith, NSW 2751, Australia.
| | - Joël Billieux
- Institute of Psychology, University of Lausanne, Quartier UNIL-Mouline, Bâtiment Géopolis, CH-1015 Lausanne, Switzerland; Center for Excessive Gambling, Addiction Medicine, Lausanne University Hospital (CHUV), Lausanne, Switzerland.
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Villena-Moya A, Granero R, Chiclana-Actis C, Potenza MN, Blycker GR, Demetrovics Z, Bőthe B, Steward T, Fernández-Aranda F, Jiménez-Murcia S, Mestre-Bach G. Spanish Validation of the Long and Short Versions of the Problematic Pornography Consumption Scale (PPCS and PPCS-6) in Adolescents. ARCHIVES OF SEXUAL BEHAVIOR 2024; 53:673-687. [PMID: 37845419 DOI: 10.1007/s10508-023-02700-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/23/2022] [Revised: 06/26/2023] [Accepted: 09/06/2023] [Indexed: 10/18/2023]
Abstract
Although 1-14% of adolescents may experience problematic pornography use (PPU), psychometrically sound instruments for assessing PPU in Spanish-speaking adolescents are scarce. Given the advantages of the different forms of the Problematic Pornography Consumption Scale (PPCS), the aim of the present study was to assess the psychometric properties of the PPCS and PPCS-6, and to examine associations between PPU and age among boys and girls. Two school-based adolescent samples were recruited in Spain (n = 650; Mage = 16.0 [SD = 1.1]; 50% girls and 50% boys) and Mexico (n1, 160; Mage = 15.8 [SD = 1.1]; 68% girls) to assess the psychometric properties of the PPCS and PPCS-6. Confirmatory factor analysis was applied and convergent and discriminant validity with other measures related to PPU was also tested. The results provided empirical support for the six-factor structure of the PPCS and the one-factor structure of the PPCS-6. Boys with older age showed higher levels of tolerance than girls on the PPCS in both countries. Both the PPCS and the PPCS-6 may be considered valid psychometric instruments for the assessment of PPU in Spanish-speaking adolescents from Spain and Mexico.
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Affiliation(s)
- Alejandro Villena-Moya
- Centro de Investigación, Transferencia e Innovación, Universidad Internacional de la Rioja, La Rioja, 26006, Spain
- Unidad de Sexología Clínica y Salud Sexual de la Consulta Dr. Carlos Chiclana, Madrid, Spain
| | - Roser Granero
- Ciber Fisiopatología Obesidad y Nutrición, Instituto de Salud Carlos III, Barcelona, Spain
- Departament de Psicobiologia i Metodologia de les Ciències de la Salut, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Carlos Chiclana-Actis
- Centro de Investigación, Transferencia e Innovación, Universidad Internacional de la Rioja, La Rioja, 26006, Spain
- Unidad de Sexología Clínica y Salud Sexual de la Consulta Dr. Carlos Chiclana, Madrid, Spain
| | - Marc N Potenza
- Department of Psychiatry and Child Study Center, Yale University School of Medicine, New Haven, CT, USA
- Connecticut Mental Health Center, New Haven, CT, USA
- Connecticut Council on Problem Gambling, Wethersfield, CT, USA
- Department of Neuroscience, Yale University, New Haven, CT, USA
| | - Gretchen R Blycker
- College of Nursing, University of Rhode Island, Kingston, RI, USA
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Zsolt Demetrovics
- Centre of Excellence in Responsible Gaming, University of Gibraltar, Gibraltar, Gibraltar
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
| | - Beáta Bőthe
- Département de Psychologie, Université de Montréal, Montréal, QC, Canada
- Département de Psychologie, Université du Québec á Trois-Rivières, Trois-Rivières, QC, Canada
| | - Trevor Steward
- Melbourne School of Psychological Sciences, University of Melbourne, Parkville, VIC, Australia
| | - Fernando Fernández-Aranda
- Ciber Fisiopatología Obesidad y Nutrición, Instituto de Salud Carlos III, Barcelona, Spain
- Department of Clinical Psychology, Bellvitge University Hospital-IDIBELL, Barcelona, Spain
- Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | - Susana Jiménez-Murcia
- Ciber Fisiopatología Obesidad y Nutrición, Instituto de Salud Carlos III, Barcelona, Spain
- Department of Clinical Psychology, Bellvitge University Hospital-IDIBELL, Barcelona, Spain
- Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | - Gemma Mestre-Bach
- Centro de Investigación, Transferencia e Innovación, Universidad Internacional de la Rioja, La Rioja, 26006, Spain.
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Roza TH, Noronha LT, Shintani AO, Massuda R, Kessler FHP, Passos IC. Withdrawal-like Symptoms in Problematic Pornography Use: A Scoping Review. J Addict Med 2024; 18:19-27. [PMID: 37788127 DOI: 10.1097/adm.0000000000001227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/05/2023]
Abstract
OBJECTIVES There is still debate whether problematic pornography use (PPU) can be understood as an addictive disorder, and little is known about withdrawal-like symptoms in these patients. Therefore, our aim was to summarize the existing scientific literature about this topic in the format of a scoping review. METHODS Potentially eligible references were retrieved from 6 databases (MEDLINE/PubMed, Web of Science, Embase, PsycINFO, LILACS, and SciELO) up to February 7, 2023. Studies were included if they reported original data about withdrawal-like symptoms in individuals with PPU. Studies investigating child pornography use, or in which it was not possible to extract data of interest were excluded. Data extracted from included studies and their quality assessment were described narratively. RESULTS A total of 937 references were retrieved, and 14 studies were included (n = 31,009 participants). According to our results, cravings were intense in most cases and frequent reasons for relapse. The proportion of participants experiencing other withdrawal-like symptoms (mental, sexual, and physical symptoms) reached up to 72.2% in the cross-sectional studies with this information available. Severity of withdrawal symptoms was associated with severity of PPU and frequency of pornography use. In some studies, measures of withdrawal symptoms were considered central symptoms of PPU and were significantly higher in individuals considering treatment. Masturbation was reported to alleviate withdrawal-like symptoms in some cases. CONCLUSIONS There is preliminary evidence for the existence of withdrawal-like symptoms in PPU. Future studies should investigate onset, characteristics, duration, and proportion of withdrawal-like symptoms in PPU with robust methodology, also investigating potential confounding variables.
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Affiliation(s)
- Thiago Henrique Roza
- From the Laboratory of Molecular Psychiatry, Centro de Pesquisa Experimental (CPE) and Centro de Pesquisa Clínica (CPC), Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil (THR, LTN, AOS, ICP); Graduate Program in Psychiatry and Behavioral Sciences, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil (THR, AOS, FHPK, ICP); and Department of Psychiatry, Universidade Federal do Paraná (UFPR), Curitiba, PR, Brazil (THR, RM)
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Pistre N, Schreck B, Grall-Bronnec M, Fatseas M. Should problematic sexual behavior be viewed under the scope of addiction? A systematic review based on DSM-5 substance use disorder criteria. Addict Behav Rep 2023; 18:100510. [PMID: 37519859 PMCID: PMC10374865 DOI: 10.1016/j.abrep.2023.100510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 06/19/2023] [Accepted: 07/15/2023] [Indexed: 08/01/2023] Open
Abstract
Despite similarities between compulsive sexual disorder and substance use disorder, the issue whether problematic sexual behavior should be viewed within an addiction framework continues to be a subject of debate with no consensus regarding its conceptualization and diagnosis criteria. Examining the presence of addiction criteria among clinical and no clinical samples in the existing literature could permit to ascertain clinical validity of sex addiction diagnosis and support its overlapping feature with other addictive disorders. The aim of this systematic review was to examine this issue by assessing DSM-5 criteria of substance use disorder among individuals engaged in problematic sexual activity. Methods: Using PRISMA criteria, three databases were comprehensively searched up to April 2022, in order to identify all candidate studies based on broad key words. Resulting studies were then selected if they examined problematic sexual behavior within the framework of DSM-5 addiction criteria. Results: Twenty articles matched the selection criteria and were included in this review. DSM-5 criteria of addictive disorders were found to be highly prevalent among problematic sex users, particularly craving, loss of control over sex use, and negative consequences related to sexual behavior. Exposition to sexual cues was also shown to trigger craving, with an association to problematic use and symptom severity. Conclusions: More studies should been done to assess homogeneously according to the DSM-5 criteria the addiction-like features of problematic sexual behaviors in clinical and no-clinical populations. Furthermore, this work argues for the need of further research to examine the extent to which anti-craving interventions could be effective in improving clinical outcomes.
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Affiliation(s)
- Natasha Pistre
- Department of Addictology, CHU Bordeaux, F-33000 Bordeaux, France
| | - Benoît Schreck
- Nantes Université, CHU Nantes, UIC Psychiatrie et Santé Mentale, F-44000 Nantes, France
- Nantes Université, Univ Tours, CHU Nantes, INSERM, MethodS in Patient-Centered Outcomes and HEalth ResEarch, SPHERE, F-44000 Nantes, France
| | - Marie Grall-Bronnec
- Nantes Université, CHU Nantes, UIC Psychiatrie et Santé Mentale, F-44000 Nantes, France
- Nantes Université, Univ Tours, CHU Nantes, INSERM, MethodS in Patient-Centered Outcomes and HEalth ResEarch, SPHERE, F-44000 Nantes, France
| | - Melina Fatseas
- Department of Addictology, CHU Bordeaux, F-33000 Bordeaux, France
- Department of Addictology, CH Charles Perrens, F-33000 Bordeaux, France
- Univ. Bordeaux, CNRS, INCIA, UMR 5287, F-33000 Bordeaux, France
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9
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Chen L, Wang D, Wang H, Zhang Y, Jiang X. Moderating Role of Sexual Attitudes in the Association between Online Sexual Activity and Problematic Pornography Use: Evidence from the Chinese Community and Help-Seeking Men. INTERNATIONAL JOURNAL OF SEXUAL HEALTH : OFFICIAL JOURNAL OF THE WORLD ASSOCIATION FOR SEXUAL HEALTH 2023; 35:555-572. [PMID: 38601807 PMCID: PMC10903587 DOI: 10.1080/19317611.2023.2257688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Accepted: 09/05/2023] [Indexed: 04/12/2024]
Abstract
Objectives This study aimed to investigate the moderating role of sexual attitudes in the association between online sexual activity (OSA) and problematic pornography use (PPU) in the Chinese context. Specifically, we examined whether incongruence stemming from attitudes (i.e., disapproval of nonmarital and casual sex but engaging in OSA) amplifies the perception of PPU. Methods We recruited two samples of Chinese men, one from the community (N1 = 525) and the other comprising help-seeking individuals (N2 = 578). Results Sexual attitudes moderate the relationship between OSA and PPU in both samples, with the predictive influence of OSA on PPU weakening among individuals with a relatively permissive attitude (scored one SD above the mean of sexual attitudes), and strengthened among individuals with a relatively conservative attitude (scored one SD below the mean of sexual attitudes). Conclusions In the conservative sexual cultural context of China, a relatively conservative sexual attitude might strengthen the association between OSA and PPU.
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Affiliation(s)
- Lijun Chen
- Department of Psychology, Fuzhou University, Fuzhou, China
| | - Dian Wang
- Department of Psychology, Fuzhou University, Fuzhou, China
| | - Haihua Wang
- Department of Psychology, Fuzhou University, Fuzhou, China
| | - Ying Zhang
- Department of Physical Education, Fuzhou University, 2 Wulongjiangbei Avenue, Fuzhou, Fujian Province, 350108, China
| | - Xiaoliu Jiang
- Department of Social Psychology, Zhou Enlai School of Government, Nankai University, Tianjin, China
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10
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File D, File B, Bőthe B, Griffiths MD, Demetrovics Z. Investigating mental representations of psychoactive substance use and other potentially addictive behaviors using a data driven network-based clustering method. PLoS One 2023; 18:e0287564. [PMID: 37856517 PMCID: PMC10586681 DOI: 10.1371/journal.pone.0287564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 06/07/2023] [Indexed: 10/21/2023] Open
Abstract
BACKGROUND AND AIMS The aim of the present study was to examine the mental representations of the use of different substances and other potentially addictive behaviors in order to explore meaningful similarities and differences that may contribute to a better understanding of behavioral addictions' representations and diagnostic criteria. METHODS The authors mapped the mental and emotional representations of 661 participants (70.5% women; Mage = 35.2 years, SD = 11.7) to the concept "your most disturbing excessive activity" using free-word associations combined with a network-based clustering method. RESULTS The network analyses identified four distinct mental representations, three implicating dominantly negative (Guilt/Shame/Relief, Addiction/Health, and Procrastination/Boredom) and one dominantly positive emotion (Stress/Relaxation). The distribution of Addiction/Health and Procrastination/Boredom representations were different across substance use and problem behaviors, indicating meaningful differences in the underlying cognitive evaluation processes. The Addiction/Health representation was more frequent for substances, while for other addictive behaviors, the Procrastination/Boredom representation was more frequent, and its frequency increased with the self-reported intensity of the behavior. Guilt/Shame/Relief was equally common for both substances and behaviors, but importantly, for substances its' likelihood increased with the intensity of use. CONCLUSION The common part of representations for substance use and other potentially addictive behaviors supports the scientific viewpoint, that real addictions can exist even in the absence of psychoactive drugs. Based on the results, a novel proposition is posited, that a more appropriate indicator of tolerance for problem behaviors might be the perceived amount of time wasted on the activity rather than the actual time spent.
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Affiliation(s)
- Domonkos File
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
| | - Bálint File
- Wigner Research Centre for Physics, Budapest, Hungary
| | - Beáta Bőthe
- Département de Psychologie, Université de Montréal, Montreal, Canada
| | - Mark D. Griffiths
- Psychology Department, International Gaming Research Unit, Nottingham Trent University, Nottingham, United Kingdom
| | - Zsolt Demetrovics
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
- Centre of Excellence in Responsible Gaming, University of Gibraltar, Gibraltar, Gibraltar
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11
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Fernandez DP, Kuss DJ, Justice LV, Fernandez EF, Griffiths MD. Effects of a 7-Day Pornography Abstinence Period on Withdrawal-Related Symptoms in Regular Pornography Users: A Randomized Controlled Study. ARCHIVES OF SEXUAL BEHAVIOR 2023; 52:1819-1840. [PMID: 36652136 PMCID: PMC9847461 DOI: 10.1007/s10508-022-02519-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 11/14/2022] [Accepted: 12/20/2022] [Indexed: 06/17/2023]
Abstract
Little is known about whether withdrawal-like symptoms manifest when regular pornography users attempt to abstain from pornography. The present study used a randomized controlled design to examine whether (1) negative abstinence effects that may be potentially reflective of withdrawal-related symptoms manifest when a non-clinical sample of regular pornography users attempt to abstain from pornography for a 7-day period and (2) these negative abstinence effects would only manifest (or manifest more strongly) for those with higher levels of problematic pornography use (PPU). A total of 176 undergraduate students (64.2% female) who were regular pornography users (defined as having used pornography ≥ three times a week in the past 4 weeks) were randomly assigned to an abstinence group (instructed to attempt abstinence from pornography for 7 days, n = 86) or a control group (free to watch pornography as usual, n = 90). Participants completed measures of craving, positive and negative affect, and withdrawal symptoms at baseline and each night of the 7-day period. Contrary to the confirmatory hypotheses, there were no significant main effects of group (abstinence vs. control) or group × PPU interaction effects on any of the outcome measures, controlling for baseline scores. These findings indicate that no evidence of withdrawal-related symptoms was found for abstaining participants, and this was not dependent on level of PPU. However, exploratory analyses showed a significant three-way interaction (group × PPU × past 4-week frequency of pornography use [FPU]) on craving, where an abstinence effect on craving was found at high levels of PPU only once past 4-week FPU reached the threshold of daily use. While these exploratory findings should be interpreted with caution, they suggest that abstinence effects could potentially manifest when there is a combination of high PPU and high FPU-a hypothesis that warrants investigation in future prospective abstinence studies.
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Affiliation(s)
- David P Fernandez
- Psychology Department, Nottingham Trent University, 50 Shakespeare Street, Nottingham, NG1 4FQ, UK.
| | - Daria J Kuss
- Psychology Department, Nottingham Trent University, 50 Shakespeare Street, Nottingham, NG1 4FQ, UK
| | - Lucy V Justice
- Psychology Department, Nottingham Trent University, 50 Shakespeare Street, Nottingham, NG1 4FQ, UK
| | | | - Mark D Griffiths
- Psychology Department, Nottingham Trent University, 50 Shakespeare Street, Nottingham, NG1 4FQ, UK
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12
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Rodda SN, Luoto S. The Feasibility and Impact of a Brief Internet Intervention for Pornography Reduction. SEXUAL HEALTH & COMPULSIVITY 2022. [DOI: 10.1080/26929953.2022.2153772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- Simone N. Rodda
- Department of Psychology and Neuroscience, Auckland University of Technology, Auckland, New Zealand
- School of Psychology, Deakin University, Geelong, Australia
| | - Severi Luoto
- School of Population Health, University of Auckland, Auckland, New Zealand
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13
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Wood DS, Esplin CR, Hatch SG, Dodini D, Braithwaite SR, Ogles BM. Predicting readiness to change among pornography consumers. SEXUAL AND RELATIONSHIP THERAPY 2022. [DOI: 10.1080/14681994.2022.2126451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- David S. Wood
- Department of Psychology, Brigham Young University, Provo, Utah, USA
| | | | - S. Gabe Hatch
- Department of Psychology, University of Miami, Coral Gables, Florida, USA
| | - David Dodini
- Department of Psychology, Brigham Young University, Provo, Utah, USA
| | | | - Benjamin M. Ogles
- Department of Psychology, Brigham Young University, Provo, Utah, USA
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14
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Jiang X, Wu Y, Zhang K, Bőthe B, Hong Y, Chen L. Symptoms of problematic pornography use among help-seeking male adolescents: Latent profile and network analysis. J Behav Addict 2022; 11:912-927. [PMID: 36067020 PMCID: PMC9872529 DOI: 10.1556/2006.2022.00065] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 08/13/2022] [Accepted: 08/14/2022] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND AND AIMS Little data exist on exploring the subgroups and characteristics of problematic pornography use (PPU) in help-seeking adolescents. The aims of the study were to classify the subgroups among help-seeking male adolescents, explore their similarities and differences, and uncover their core symptoms. METHODS A total of 3,468 Chinese male adolescents (Mage = 16.64 years, SD = 1.24) who were distressed about their pornography use were recruited. The Problematic Pornography Consumption Scale, the Brief Pornography Screen Scale, and Moral Disapproval of Pornography Use were used to classify them. The General Health Questionnaire, the Pornography Craving Questionnaire, and the Sexual Compulsivity Scale were used to investigate participants' negative consequence related to their pornography use; and the Online Sexual Activity Questionnaire (OSAs) and time spent on pornography use every week were considered as quantitative indicators. RESULTS Help-seeking male adolescents could be divided into 3 profiles, namely, self-perceived problematic (SP, n = 755), impaired control (IC, n = 1,656), and problematic use groups (PPU, n = 1,057). Frequency of OSAs was important for the identification of SP individuals, while negative consequences were more effective in identifying individuals with objective dysregulated behavior. Salience and mood modification were shared by all groups; however, in addition to this, the SP and PPU groups also showed withdrawal symptoms. DISCUSSION AND CONCLUSION This study's results provide support for the presence of different profiles of help-seeking individuals and information on potential intervention targets among adolescents which is lacking in the literature.
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Affiliation(s)
- Xiaoliu Jiang
- Department of Psychology, School of Humanities and Social Sciences, Fuzhou University, Fujian, China
| | - Yudi Wu
- Department of Psychology, School of Humanities and Social Sciences, Fuzhou University, Fujian, China
| | - Kuo Zhang
- Department of Social Psychology, Nankai University, Tianjin, China
| | - Beáta Bőthe
- Département de Psychologie, Université du Québec à Trois-Rivières, Trois-Rivières, Canada,Département de Psychologie, Université de Montréal, Montréal, Canada,Corresponding author. E-mail:
| | - Youjuan Hong
- School of Nursing, Fujian Medical University, Fujian, China
| | - Lijun Chen
- Department of Psychology, School of Humanities and Social Sciences, Fuzhou University, Fujian, China,Corresponding author. Tel.: +86-59122866562. E-mail:
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15
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Islam MS, Tasnim R, Sujan MSH, Bőthe B, Ferdous MZ, Sikder MT, Siddique MAB, Toma TY, Kamruzzaman S, Sakib MN, Pinky KN, Islam MR, Anter FS, Hossain A, Hossen I, Kraus SW, Potenza MN. Validation and Evaluation of the Psychometric Properties of the Bangla Version of the Brief Pornography Screen in Men and Women. Int J Ment Health Addict 2022. [DOI: 10.1007/s11469-022-00903-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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16
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Castro-Calvo J, Flayelle M, Perales JC, Brand M, Potenza MN, Billieux J. Compulsive Sexual Behavior Disorder should not be classified by solely relying on component/symptomatic features •. J Behav Addict 2022; 11:210-215. [PMID: 35895452 PMCID: PMC9295252 DOI: 10.1556/2006.2022.00029] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 03/14/2022] [Accepted: 04/15/2022] [Indexed: 01/02/2023] Open
Abstract
The paper by Sassover and Weinstein (2022) contributes to a timely and complex debate related to the classification of Compulsive Sexual Behavior Disorder (CSBD). The recent inclusion of CSBD as an impulse-control disorder in the ICD-11 has generated debate since a competitive view is that CSBD should rather be classified as an addictive disorder. Sassover and Weinstein (2022) reviewed existing evidence and concluded it does not support the conceptualization of CSBD as an addictive disorder. Although we agree regarding the relevance and timely nature of considering the classification of CSBD, we respectfully disagree with the position that relying on the components model of addiction (Griffiths, 2005) is the optimal approach for determining whether or not CSBD is an addictive disorder. In this commentary, we discuss potential pitfalls of relying on the components model to conceptualize CSBD as an addictive disorder and argue that considering a process-based approach is important for advancing this timely debate.
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Affiliation(s)
- Jesús Castro-Calvo
- Department of Personality, Assessment, and Psychological Treatments, University of Valencia, Spain
- Corresponding authors. E-mail: ,
| | - Maèva Flayelle
- Institute of Psychology, University of Lausanne (UNIL), Lausanne, Switzerland
| | - José C. Perales
- Department of Experimental Psychology, Mind, Brain and Behavior Research Center (CIMCYC), Universidad de Granada, Spain
| | - Matthias Brand
- General Psychology: Cognition and Center for Behavioral Addiction Research (CeBAR), University of Duisburg-Essen, Germany
| | - Marc N. Potenza
- Department of Psychiatry and the Child Study Center, Yale School of Medicine, New Haven, CT, USA
- Department of Neuroscience and the Wu Tsai Institute, Yale University, New Haven, CT, USA
- Connecticut Mental Health Center, New Haven, CT, USA
- The Connecticut Council on Problem Gambling, Wethersfield, CT 06109, USA
| | - Joël Billieux
- Institute of Psychology, University of Lausanne (UNIL), Lausanne, Switzerland
- Centre for Excessive Gambling, Addiction Medicine, Lausanne University Hospitals (CHUV), Lausanne, Switzerland
- Corresponding authors. E-mail: ,
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17
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Bőthe B, Koós M, Demetrovics Z. Contradicting classification, nomenclature, and diagnostic criteria of Compulsive Sexual Behavior Disorder (CSBD) and future directions •. J Behav Addict 2022; 11:204-209. [PMID: 35895454 PMCID: PMC9295218 DOI: 10.1556/2006.2022.00030] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 03/20/2022] [Accepted: 04/15/2022] [Indexed: 11/19/2022] Open
Abstract
Building on the conclusions of the debate papers by Gola et al. (2022) and Sassover and Weinstein (2022), the present commentary further addressed the contradictions between the current classification, nomenclature, and diagnostic criteria of Compulsive Sexual Behavior Disorder (CSBD) with elaborating on the potential roles impulsivity and compulsivity may play in CSBD, and how these characteristics may relate to addictive behaviors in particular. Moreover, it briefly discussed how the classification of CSBD might impact research and clinical practice and proposed potential future research directions that may help to reach a consensus on the classification and core symptoms of CSBD.
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Affiliation(s)
- Beáta Bőthe
- Département de Psychologie, Université de Montréal, Montréal, Canada,Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary,Corresponding author. E-mail: ;
| | - Mónika Koós
- Doctoral School of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary,Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
| | - Zsolt Demetrovics
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary,Centre of Excellence in Responsible Gaming, University of Gibraltar, Gibraltar, Gibraltar
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18
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Chen L, Jiang X, Wang Q, Bőthe B, Potenza MN, Wu H. The Association between the Quantity and Severity of Pornography Use: A Meta-analysis. JOURNAL OF SEX RESEARCH 2022; 59:704-719. [PMID: 34723731 DOI: 10.1080/00224499.2021.1988500] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Although the quantity of pornography use (QPU, i.e., frequency/time spent on pornography use) has been positively associated with the severity of pornography use (i.e., problematic pornography use, PPU), the magnitudes of relationships have varied across studies. This meta-analysis aimed to assess the overall relationships and identify potential moderating variables to explain the variation in these associations between QPU and PPU. We performed a literature search for all published and unpublished studies from 1995 to 2020 in major online scientific databases up until December 2020. Sixty-one studies were identified with 82 independent samples involving 74,880 participants. Results indicated that there was a positive, moderate relationship between QPU and PPU (r = 0.34, p < .001). The strength of relationship significantly varied across measures of PPU based on different theoretical frameworks, indicators of QPU, and sexual cultural contexts (conservative vs. permissive sexual values). Frequency was a more robust quantitative indicator of PPU than time spent on pornography use. In conservative countries, QPU showed more robust association with self-perceived PPU. Future studies are encouraged to select the measurement of PPU according to research aims and use multi-item measures with demonstrated content validity to assess pornography use. Cross-cultural (conservative/permissive) comparisons also warrant further research.
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Affiliation(s)
- Lijun Chen
- School of Humanities and Social Sciences, Fuzhou University
| | - Xiaoliu Jiang
- School of Humanities and Social Sciences, Fuzhou University
| | - Qiqi Wang
- School of Humanities and Social Sciences, Fuzhou University
| | - Beáta Bőthe
- Département de Psychologie, Université de Montréal
| | - Marc N Potenza
- Department of Psychiatry, Yale University School of Medicine
- Department of Neuroscience, Yale University School of Medicine
- Department of Child Study Center, Yale University School of Medicine
- Connecticut Mental Health Center
- Connecticut Council on Problem Gambling
| | - Huijuan Wu
- School of Humanities and Social Sciences, Fuzhou University
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19
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Jiang X, Lu Y, Hong Y, Zhang Y, Chen L. A Network Comparison of Motives behind Online Sexual Activities and Problematic Pornography Use during the COVID-19 Outbreak and the Post-Pandemic Period. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19105870. [PMID: 35627407 PMCID: PMC9141011 DOI: 10.3390/ijerph19105870] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 05/05/2022] [Accepted: 05/07/2022] [Indexed: 11/24/2022]
Abstract
Many researchers have considered whether online sexual activities (OSAs) increased over the course of the COVID-19 pandemic and whether these have led to an increase in problematic pornography use (PPU). This study investigated the impact of COVID-19 on PPU through pornography use motivations (PUMs) and OSAs to develop a better understanding of the mechanism and changes affecting PPU. Two groups of Chinese adults were recruited during the initial months of the pandemic (April 2020, n1 = 496) and the post-pandemic period (October 2021, n2 = 504). A network analysis was conducted to compare the structures of PPU symptoms among the two groups. The results showed that PUMs and OSAs were stronger predictors of PPU during the pandemic than post-pandemic (R2pandemic = 57.6% vs. R2post-pandemic = 28.7%). The motives of fantasy, sexual pleasure, stress reduction, and self-exploration were the prominent motivations during these two periods, but we found distinct PPU-related communities. PPU, sexual pleasure, and viewing sexually explicit materials (a type of OSAs) constituted a community during the pandemic but not in the post-pandemic’s network. The present study indicated that the pandemic may not have been the only factor impacting the higher rate of PPU. Instead, the higher frequency of OSAs during the pandemic may have been a strategy to cope with stress and to safely satisfy sexual desire.
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Affiliation(s)
- Xiaoliu Jiang
- School of Humanities and Social Sciences, Fuzhou University, Fuzhou 350108, China; (X.J.); (Y.L.)
| | - Yingfei Lu
- School of Humanities and Social Sciences, Fuzhou University, Fuzhou 350108, China; (X.J.); (Y.L.)
| | - Youjuan Hong
- School of Nursing, Fujian Medical University, Fuzhou 350108, China;
| | - Ying Zhang
- Department of Physical Education, Fuzhou University, Fuzhou 350108, China
- Correspondence: (Y.Z.); (L.C.)
| | - Lijun Chen
- School of Humanities and Social Sciences, Fuzhou University, Fuzhou 350108, China; (X.J.); (Y.L.)
- Correspondence: (Y.Z.); (L.C.)
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20
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Koós M, Demetrovics Z, Griffiths MD, Bőthe B. No Significant Changes in Addictive and Problematic Behaviors During the COVID-19 Pandemic and Related Lockdowns: A Three-Wave Longitudinal Study. Front Psychol 2022; 13:837315. [PMID: 35496258 PMCID: PMC9043320 DOI: 10.3389/fpsyg.2022.837315] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 02/21/2022] [Indexed: 12/24/2022] Open
Abstract
Introduction The COVID-19 outbreak and related lockdowns brought substantial changes in people's lives and led to concerns about possible increases of addictive behaviors at the initial stages of the pandemic. To examine these concerns, the aim of the present study was to assess longitudinal changes in addictive and problematic behaviors (i.e., problematic social media use, Internet gaming disorder, gambling disorder, problematic pornography use, and compulsive sexual behavior disorder) over time during the COVID-19 pandemic. Methods Three waves of data collection took place in different stages of the COVID-19 outbreak in Hungary in a general population, from the first wave of lockdowns to the second and third waves of restrictions (May, 2020; N T1 = 1747; June-August, 2020; N T2 = 656; January, 2021; N T3 = 411). Latent growth curve models were calculated to assess the potential changes in addictive and problematic behaviors over time. Results Latent growth curve models showed that the sample varied in their initial scores, but there were no significant changes over time in any of the examined behaviors, except for compulsive sexual behavior disorder, which demonstrated a small but significant increase (i.e., positive and significant slope factor). However, the rate of this change was negligible. Overall, there were no noteworthy changes over time regarding any of the examined addictive and problematic behaviors. Conclusion Contrary to initial concerns, no substantial changes over time were observed regarding the examined addictive behaviors during the COVID-19 pandemic and related lockdowns. These findings indicate that those who had no previous problem with these addictive behaviors, might have not developed a problem, and those who had problem with either of the behaviors previously, might have not experienced a significant increase in their symptoms.
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Affiliation(s)
- Mónika Koós
- Doctoral School of Psychology, Eötvös Loránd University, Budapest, Hungary
- Institute of Psychology, Eötvös Loránd University (ELTE), Budapest, Hungary
| | - Zsolt Demetrovics
- Institute of Psychology, Eötvös Loránd University (ELTE), Budapest, Hungary
- Centre of Excellence in Responsible Gaming, University of Gibraltar, Gibraltar, Gibraltar
| | - Mark D. Griffiths
- International Gaming Research Unit, Psychology Department, Nottingham Trent University, Nottingham, United Kingdom
| | - Beáta Bőthe
- Département de Psychologie, Université de Montréal, Montreal, QC, Canada
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21
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Bőthe B, Baumgartner C, Schaub MP, Demetrovics Z, Orosz G. Hands-off: Feasibility and preliminary results of a two-armed randomized controlled trial of a web-based self-help tool to reduce problematic pornography use. J Behav Addict 2021; 10:1015-1035. [PMID: 34727088 PMCID: PMC8987418 DOI: 10.1556/2006.2021.00070] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 09/14/2021] [Accepted: 10/04/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND AND AIMS Despite problematic pornography use (PPU) being prevalent, no previous study has examined the effectiveness of evidence-based interventions for PPU, using rigorous methods. Using a two-armed randomized controlled trial study design, we examined the feasibility and initial effectiveness of a six-week online PPU intervention. METHODS We recruited 264 participants (3.8% women, M age = 33.2, SD = 10.6) who were randomized and assigned to either the self-help intervention (n = 123) or waitlist control condition (n = 141), and completed self-report questionnaires at baseline and after the end of the intervention (six-week follow-up). Multivariable linear regression models were generated and tested on a complete case basis to investigate possible treatment effects. Participants provided quantitative and qualitative feedback regarding the intervention's content and appearance. RESULTS Participants evaluated all modules positively in the intervention in general. There were differential dropout rates (89.4% in intervention vs. 44.7% in control group) with an overall follow-up rate of 34.5%. The intervention group reported significantly lower levels of PPU (P < 0.001, d = 1.32) at the six-week follow-up. Moreover, they reported lower pornography use frequency (P < 0.001, d = 1.65), self-perceived pornography addiction (P = 0.01, d = 0.85), pornography craving (P = 0.02, d = 0.40), and higher pornography avoidance self-efficacy (P = 0.001, d = 0.87) at the six-week follow-up. DISCUSSION AND CONCLUSIONS The present study was only a first step in rigorous treatment studies for PPU, but the findings are promising and suggest that online interventions for PPU might help reduce PPU in some cases, even without the guidance of therapists, by reducing treatment barriers.
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Affiliation(s)
- Beáta Bőthe
- Département de Psychologie, Université de Montréal, Montréal, Canada
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
| | - Christian Baumgartner
- Swiss Research Institute for Public Health and Addiction ISGF, Associated to the University of Zurich, Zurich, Switzerland
| | - Michael P. Schaub
- Swiss Research Institute for Public Health and Addiction ISGF, Associated to the University of Zurich, Zurich, Switzerland
| | - Zsolt Demetrovics
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
- Centre of Excellence in Responsible Gaming, University of Gibraltar, Gibraltar, Gibraltar
| | - Gábor Orosz
- Université d’Artois, Université de Lille, Université Littoral Côte d’Opale, ULR 7369 - URePSSS - Unité de Recherche Pluridisciplinaire Sport Santé Société, Atelier Sherpas, F-62800, Liévin, France
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22
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Profile of Treatment-Seeking Gaming Disorder Patients: A Network Perspective. J Gambl Stud 2021; 38:941-965. [PMID: 34625873 DOI: 10.1007/s10899-021-10079-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/22/2021] [Indexed: 01/11/2023]
Abstract
The increasing presence of gaming disorder in recent years has led to major efforts to identify the specific predictors that have a high impact on the profile of people seeking treatment for this mental condition. The purpose of this study was to explore the network structure of the correlates of gaming disorder considering sociodemographic features and other clinical symptoms. Network analysis was applied to a sample of patients who met clinical criteria for gaming disorder (n = 117, of ages ranging from 15 to 70 yrs-old). Variables considered in the network included sex, age, socioeconomic position, global emotional distress, age of onset and duration of the gaming disorder, personality traits and the presence of other addictive behaviors (tobacco, alcohol and behavioral addictions). The central nodes in the network were global psychological distress, chronological age, and age of onset of gaming related problems. Linkage analysis also identified psychopathological status and age as the variables with the most valuable information in the model. The poorest relevance in the analysis was for the duration of gaming problems and socioeconomic levels. Modularity analysis grouped the nodes within four clusters. Identification of the variables with the highest centrality/linkage can be particularly useful for developing precise management plans to prevent and treat gaming disorder related problems.
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23
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Bőthe B, Koós M, Nagy L, Kraus SW, Potenza MN, Demetrovics Z. International Sex Survey: Study protocol of a large, cross-cultural collaborative study in 45 countries. J Behav Addict 2021; 10:632-645. [PMID: 34534102 PMCID: PMC8997233 DOI: 10.1556/2006.2021.00063] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Revised: 07/17/2021] [Accepted: 08/16/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND AND AIMS Limitations of research into sexuality and compulsive sexual behavior disorder (CSBD) include the use of simplistic methodological designs and the absence of quality and unified measurements, empirically supported theoretical models, and large, collaborative studies between laboratories. We aim to fill these gaps with the International Sex Survey (ISS, http://internationalsexsurvey.org/). METHODS The ISS is a large-scale, international, multi-lab, multi-language study using cross-sectional survey methods, involving more than 40 countries. Participants responding to advertisements complete a self-report, anonymous survey on a secure online platform. Collaborators from each country collect a community sample of adults with a minimum sample size of 2,000 participants with a gender ratio of approximately 50-50% men and women, including diverse individuals with respect to sexuality and gender. The ISS includes a wide range of sociodemographic questions and scales assessing a diverse set of sexual behaviors, pornography use, psychological characteristics, and potential comorbid disorders. Analyses are conducted within a structural equation modeling framework, including variable (e.g., measurement invariance tests) and person-centered approaches (e.g., latent profile analysis). DISCUSSION AND CONCLUSIONS The ISS will provide well-validated, publicly available screening tools, helping to eliminate significant measurement issues in the field of sexuality research and health care. It will provide important insights to improve the theoretical understanding of CSBD as well as help to identify empirically supported treatment targets for prevention and intervention programs. Following open-science practices and making study materials open-access, the ISS may serve as a blueprint for future large-scale research in addiction and sexuality research.
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Affiliation(s)
- Beáta Bőthe
- Département de Psychologie, Université de Montréal, Montréal, Canada,Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary,Corresponding author. E-mail: ,
| | - Mónika Koós
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary,Doctoral School of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
| | - Léna Nagy
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary,Doctoral School of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
| | - Shane W. Kraus
- Department of Psychology, University of Nevada, Las Vegas, Las Vegas, NV, USA
| | - Marc N. Potenza
- Yale University School of Medicine, New Haven, CT, USA,Connecticut Council on Problem Gambling, Wethersfield, CT, USA,Connecticut Mental Health Center, New Haven, CT, USA
| | - Zsolt Demetrovics
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary,Centre of Excellence in Responsible Gaming, University of Gibraltar, Gibraltar, Gibraltar
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24
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Sharpe M, Mead D. Problematic Pornography Use: Legal and Health Policy Considerations. CURRENT ADDICTION REPORTS 2021; 8:556-567. [PMID: 34518793 PMCID: PMC8426110 DOI: 10.1007/s40429-021-00390-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/06/2021] [Indexed: 11/30/2022]
Abstract
Purpose of Review Reports of sexual violence, especially towards women and children, are rapidly increasing. At the same time, rates of problematic pornography use (PPU) are accelerating across the world too. The purpose of this review is to consider the recent research on PPU and its contribution to sexual violence. The article offers guidance to governments on possible health policy interventions and legal actions to prevent the development of PPU and to reduce the incidence of sexual violence in society. Recent Findings Working from the consumer’s point of view, we identify PPU and ask how much pornography is needed to cause PPU. We examine how PPU drives sexual offending in children, adolescents and adults. The impact of PPU on some consumers’ behaviour suggests significant links to domestic violence. Sexual strangulation is highlighted as an example. Artificial intelligence algorithms play a key role in the pornography industry and appear to be driving escalation to more violent material, inducing high levels of sexual dysfunction in consumers and creating appetites for viewing child sexual abuse material (CSAM). Summary Easy access to internet pornography has led to an increase in PPU and sexual violence. Diagnoses and treatments for PPU are examined, as are legal transgressions of a civil and criminal nature arising from PPU. Legal remedies and government policy implications are discussed from the point of view of the precautionary principle. Strategies covered include age verification for pornography, public health campaigns and embedded health and legal warnings for users at the start of pornography sessions along with lessons for pupils about pornography’s impact on the brain.
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Affiliation(s)
- Mary Sharpe
- The Reward Foundation, The Melting Pot, 15 Calton Road, Edinburgh, EH8 8DL UK.,Lucy Cavendish College, University of Cambridge, Cambridge, CB3 0BU UK
| | - Darryl Mead
- The Reward Foundation, The Melting Pot, 15 Calton Road, Edinburgh, EH8 8DL UK
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25
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School-Based Prevention of Screen-Related Risk Behaviors during the Long-Term Distant Schooling Caused by COVID-19 Outbreak. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18168561. [PMID: 34444307 PMCID: PMC8392870 DOI: 10.3390/ijerph18168561] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 08/10/2021] [Accepted: 08/12/2021] [Indexed: 12/24/2022]
Abstract
The COVID-19 outbreak and related restrictions meant a higher incidence of screen-related risk behaviors in both children and adolescents. Our goal was to assess the perceived importance and extent of school-based preventions related to these risks during the long-term, nation-wide distant schooling period in the Czech Republic. The online survey was responded to by the school-based prevention specialists (N = 1698). For the analysis, within-subject analysis of variance (ANOVA) and binominal logistic regression were used. At-risk internet use and cyber-bullying were perceived as pressing, but other risks, for example, excessive internet use or the use of cyberpornography, received substantially less priority. The differences in all grades were significant and moderate to large (η2G between 0.156 and 0.288). The proportion of schools which conducted prevention interventions of screen-related risks was low (between 0.7% and 27.8%, depending on the grade and the type of the risk). The probability of delivering prevention intervention was in all grades significantly predicted by the presence of screen-related problems in pupils (OR 3.76–4.88) and the perceived importance of the screen-related risks (OR 1.55–1.97). The limited capacity of schools to deliver prevention interventions during distant schooling as well as the low awareness and impaired ability to recognize the importance of some screen-related risks should be addressed.
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26
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Bőthe B, Vaillancourt-Morel MP, Bergeron S. Hypersexuality in Mixed-Sex Couples: A Dyadic Longitudinal Study. ARCHIVES OF SEXUAL BEHAVIOR 2021; 50:2139-2150. [PMID: 34189627 DOI: 10.1007/s10508-021-01959-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Revised: 02/09/2021] [Accepted: 02/12/2021] [Indexed: 06/13/2023]
Abstract
Emotion dysregulation and intimacy problems are theoretically underpinned correlates of hypersexuality (i.e., uncontrollable sexual urges, fantasies, and behaviors resulting in distress and impairment in different areas of functioning), but the directionality of these associations has not been established, as work in this area has relied on cross-sectional designs. Moreover, although hypersexuality may have significant adverse effects on romantic relationships and approximately half of treatment-seeking individuals are in a relationship, prior studies almost exclusively involved samples of men, regardless of their relationship status. The aim of the present study was to examine the directionality of associations between both partners' emotion dysregulation, physical (i.e., partnered sexual frequency) and relationship intimacy, and hypersexuality using a longitudinal, dyadic framework. Self-reported data of 267 mixed-sex couples (Mage_men = 29.9 years, SD = 8.2; Mage_women = 27.7 years, SD = 6.7) at baseline (T1) and six-month follow-up (T2) were analyzed using a crossed-lagged model within an actor-partner interdependence framework. Prior greater emotion dysregulation (T1) in both men and women was associated with their own later greater hypersexuality (T2). Women's prior greater hypersexuality (T1) was associated with their later lower relationship intimacy (T2). Lower levels of intimacy were not significantly associated with later hypersexuality. No partner effects were found in relation to hypersexuality. Findings suggest that men and women may use sexual behaviors to cope with negative emotions, which could, in turn, lead to hypersexuality. Intimacy problems did not precede hypersexuality, although women's hypersexuality may reduce their own relationship intimacy over time.
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Affiliation(s)
- Beáta Bőthe
- Département de Psychologie, Université de Montréal, C.P. 6128, Succursale Centre-Ville, Montréal, QC, H3C 3J7, Canada.
| | | | - Sophie Bergeron
- Département de Psychologie, Université de Montréal, C.P. 6128, Succursale Centre-Ville, Montréal, QC, H3C 3J7, Canada
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27
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Bőthe B, Tóth-Király I, Griffiths MD, Potenza MN, Orosz G, Demetrovics Z. Are sexual functioning problems associated with frequent pornography use and/or problematic pornography use? Results from a large community survey including males and females. Addict Behav 2021; 112:106603. [PMID: 32810799 DOI: 10.1016/j.addbeh.2020.106603] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 07/05/2020] [Accepted: 08/05/2020] [Indexed: 02/07/2023]
Abstract
There is much debate regarding whether pornography use has positive or negative associations with sexuality-related measures such as sexual functioning problems. The present study aimed to examine differential correlates between quantity (frequency of pornography use-FPU) and severity (problematic pornography use-PPU) of pornography use with respect to sexual functioning problems among both males and females. Multi-group structural equation modeling was conducted to investigate hypothesized associations between PPU, FPU, and sexual functioning problems among males and females (N = 14,581 participants; females = 4,352; 29.8%; Mage=33.6 years, SDage=11.0), controlling for age, sexual orientation, relationship status, and masturbation frequency. The hypothesized model had excellent fit to the data (CFI = 0.962, TLI = 0.961, RMSEA = 0.057 [95% CI = 0.056-0.057]). Similar associations were identified in both genders, with all pathways being statistically significant (p < .001). PPU had positive, moderate associations (βmales=0.37, βfemales=0.38), while FPU had negative, weak associations with sexual functioning problems (βmales=-0.17, βfemales=-0.17). Although FPU and PPU had a positive, moderate association, they should be assessed and discussed separately when examining potential associations with sexuality-related outcomes. Given that PPU was positively and moderately and FPU negatively and weakly associated with problems in sexual functioning, it is important to consider both PPU and FPU in relation to sexual functioning problems.
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28
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Koós M, Bőthe B, Orosz G, Potenza MN, Reid RC, Demetrovics Z. The negative consequences of hypersexuality: Revisiting the factor structure of the Hypersexual Behavior Consequences Scale and its correlates in a large, non-clinical sample. Addict Behav Rep 2020; 13:100321. [PMID: 33364331 PMCID: PMC7750154 DOI: 10.1016/j.abrep.2020.100321] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 11/03/2020] [Accepted: 11/28/2020] [Indexed: 01/06/2023] Open
Abstract
Introduction Despite the growing literature about hypersexuality and its negative consequences, most studies have focused on the risk of sexually transmitted infections (STI’s), resulting in relatively few studies about the nature and the measurement of a broader spectrum of adverse consequences. Methods The aim of the present study was to examine the validity and reliability of the Hypersexual Behavior Consequence Scale (HBCS) in a large, non-clinical population (N = 16,935 participants; females = 5854, 34.6%; Mage = 33.6, SDage = 11.1) and identify its factor structure across genders. The dataset was divided into three independent samples, taking into consideration gender ratio. The validity of the HBCS was investigated in relation to sexuality-related questions (e.g., frequency of pornography use) and the Hypersexual Behavior Inventory (Sample 3). Results Both the exploratory (Sample 1) and confirmatory (Sample 2) factor analyses (CFI = 0.954, TLI = 0.948, RMSEA = 0.061 [90% CI = 0.059–0.062]) suggested a first-order, four-factor structure that included work-related problems, personal problems, relationship problems, and risky behavior as a result of hypersexuality. The HBCS showed adequate reliability and demonstrated reasonable associations with the examined theoretically relevant correlates, corroborating the validity of the HBCS. Conclusion Findings suggest that the HBCS may be used to assess consequences of hypersexuality. It may also be used in clinical settings to assess the severity of hypersexuality and to map potential areas of impairment, and such information may help guide therapeutic interventions.
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Affiliation(s)
- Mónika Koós
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary.,Doctoral School of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
| | - Beáta Bőthe
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary.,Département de Psychologie, Université de Montréal, Montreal, Canada
| | - Gábor Orosz
- Université Artois, Université Lille, Université Littoral Côte d'Opale, ULR 7369 - URePSSS - Unité de Recherche Pluridisciplinaire Sport Santé Société, Atelier Sherpas, F-62800 Liévin, France
| | - Marc N Potenza
- Departments of Psychiatry and Neuroscience and Child Study Center, Yale School of Medicine, New Haven, CT, United States.,Connecticut Council on Problem Gambling, Wethersfield, CT, United States.,Connecticut Mental Health Center, New Haven, CT, United States
| | - Rory C Reid
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, United States
| | - Zsolt Demetrovics
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
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29
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Sexual addiction 25 years on: A systematic and methodological review of empirical literature and an agenda for future research. Clin Psychol Rev 2020; 82:101925. [PMID: 33038740 DOI: 10.1016/j.cpr.2020.101925] [Citation(s) in RCA: 103] [Impact Index Per Article: 25.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 09/17/2020] [Accepted: 09/21/2020] [Indexed: 12/16/2022]
Abstract
In 1998, Gold and Heffner authored a landmark review in Clinical Psychology Review on the topic of sexual addiction that concluded that sexual addiction, though increasingly popular in mental health settings, was largely based on speculation, with virtually no empirical basis. In the more than two decades since that review, empirical research around compulsive sexual behaviors (which subsumes prior research about sexual addiction) has flourished, ultimately culminating in the inclusion of a novel diagnosis of Compulsive Sexual Behavior Disorder in the eleventh edition of the World Health Organization's International Classification of Diseases. The present work details a systematic review of empirical research published between January 1st, 1995 and August 1st, 2020 related to compulsive sexual behaviors, with a specific focus on evaluating the methodologies of that literature. This review yielded 371 papers detailing 415 individual studies. In general, the present review finds that, although research related to compulsive sexual behaviors has proliferated, much of this work is characterized by simplistic methodological designs, a lack of theoretical integration, and an absence of quality measurement. Moreover, the present review finds a virtual absence of high-quality treatment-related research published within this time frame. Implications of these findings for both clinical practice and future research are discussed.
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