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Janssen E, Bancroft J. The Dual Control Model of Sexual Response: A Scoping Review, 2009-2022. JOURNAL OF SEX RESEARCH 2023; 60:948-968. [PMID: 37267113 DOI: 10.1080/00224499.2023.2219247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
The Dual Control Model proposes that sexual arousal and related processes are dependent on the balance between sexual excitation and sexual inhibition, and that individuals vary in their propensity for these processes. This scoping review provides an overview and discussion of the questionnaires used to measure the propensities for sexual excitation and inhibition, their translation and validation in other languages, and their application in empirical research on topics ranging from sexual desire and arousal, sexual (dys)function, sexual risk taking, asexuality, hypersexuality, and sexual aggression. A total of 152 papers, published between 2009 and 2022 and identified using online databases, were included in this review. The findings, consistent with those reviewed by Bancroft et al. (2009), suggest that sexual excitation is particularly relevant to sexual desire and responsivity and predictive of asexuality and hypersexuality. Sexual inhibition plays a role in sexual dysfunction. sexual risk taking, and sexual aggression, although often in interaction with sexual excitation. Suggestions for the further development of the model and for future studies are discussed.
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Affiliation(s)
- Erick Janssen
- Institute for Family and Sexuality Studies, Department of Neurosciences, KU Leuven, Belgium
- The Kinsey Institute, Indiana University, Bloomington, IN, USA
| | - John Bancroft
- Horspath, Oxfordshire, UK
- The Kinsey Institute, Indiana University, Bloomington, IN, USA
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Bibi K, Fatima A, Amin R, Rowland DL. Understanding Serial Mediators of Problematic Pornography Use in Pakistani Men and Women. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph192114336. [PMID: 36361229 PMCID: PMC9654840 DOI: 10.3390/ijerph192114336] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 10/17/2022] [Accepted: 10/27/2022] [Indexed: 05/17/2023]
Abstract
UNLABELLED In the current digital environment, satisfying sexual needs via Internet pornography use has the potential to develop into a problem that affects one's psychological health and daily functioning. The aim of this study was to examine potential cognitive and affective factors that could help explain the maintenance and exacerbation of self-defined problematic internet pornography use. METHODS 280 Pakistani men and women (mean age = 25.40; SD = 5.271, range 18-50) who were current pornography users were recruited through social networking sites (Facebook, Instagram, LinkedIn, WhatsApp groups) to participate in an online study about pathways to problematic pornography use (PPU). Structural equation modeling was used to estimate path analysis coefficients extending from predisposing variables (depression, anxiety, self-esteem, and loneliness) to PPU via the mediating variables of craving, dysfunctional sexual coping, and stimulus-specific inhibitory control. RESULTS Craving mediated the relationship between three predisposing variables (depression, anxiety, and self-esteem) and PPU, though not the fourth, namely loneliness. Indirect effects of depression, anxiety, and self-esteem were significantly linked to PPU through two serial mediation pathways: (a) craving and stimulus-specific inhibitory control, and (b) craving and dysfunctional sexual coping. CONCLUSION These findings demonstrate that craving, stimulus-specific inhibitory control, and dysfunctional coping serve as important mediators in maintaining and exacerbating the cycle between negative predisposing variables and PPU. These results are interpreted within the general framework of therapeutic interventions that can help develop positive coping skills in individuals seeking to alter self-perceived bothersome or unwanted habits related to pornography use.
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Affiliation(s)
- Khifza Bibi
- Department of Professional Psychology, Bahria University, Islamabad 44000, Pakistan
| | - Ambreen Fatima
- Department of Professional Psychology, Bahria University, Islamabad 44000, Pakistan
| | - Rizwana Amin
- Department of Professional Psychology, Bahria University, Islamabad 44000, Pakistan
| | - David L. Rowland
- Department of Psychology, Valparaiso University, Valparaiso, IN 46383, USA
- Correspondence:
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Flayelle M, Elhai JD, Maurage P, Vögele C, Brevers D, Baggio S, Billieux J. Identifying the psychological processes delineating non-harmful from problematic binge-watching: A machine learning analytical approach. TELEMATICS AND INFORMATICS 2022. [DOI: 10.1016/j.tele.2022.101880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Fineberg NA, Menchón JM, Hall N, Dell'Osso B, Brand M, Potenza MN, Chamberlain SR, Cirnigliaro G, Lochner C, Billieux J, Demetrovics Z, Rumpf HJ, Müller A, Castro-Calvo J, Hollander E, Burkauskas J, Grünblatt E, Walitza S, Corazza O, King DL, Stein DJ, Grant JE, Pallanti S, Bowden-Jones H, Ameringen MV, Ioannidis K, Carmi L, Goudriaan AE, Martinotti G, Sales CMD, Jones J, Gjoneska B, Király O, Benatti B, Vismara M, Pellegrini L, Conti D, Cataldo I, Riva GM, Yücel M, Flayelle M, Hall T, Griffiths M, Zohar J. Advances in problematic usage of the internet research - A narrative review by experts from the European network for problematic usage of the internet. Compr Psychiatry 2022; 118:152346. [PMID: 36029549 DOI: 10.1016/j.comppsych.2022.152346] [Citation(s) in RCA: 33] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 06/29/2022] [Accepted: 08/09/2022] [Indexed: 01/05/2023] Open
Abstract
Global concern about problematic usage of the internet (PUI), and its public health and societal costs, continues to grow, sharpened in focus under the privations of the COVID-19 pandemic. This narrative review reports the expert opinions of members of the largest international network of researchers on PUI in the framework of the European Cooperation in Science and Technology (COST) Action (CA 16207), on the scientific progress made and the critical knowledge gaps remaining to be filled as the term of the Action reaches its conclusion. A key advance has been achieving consensus on the clinical definition of various forms of PUI. Based on the overarching public health principles of protecting individuals and the public from harm and promoting the highest attainable standard of health, the World Health Organisation has introduced several new structured diagnoses into the ICD-11, including gambling disorder, gaming disorder, compulsive sexual behaviour disorder, and other unspecified or specified disorders due to addictive behaviours, alongside naming online activity as a diagnostic specifier. These definitions provide for the first time a sound platform for developing systematic networked research into various forms of PUI at global scale. Progress has also been made in areas such as refining and simplifying some of the available assessment instruments, clarifying the underpinning brain-based and social determinants, and building more empirically based etiological models, as a basis for therapeutic intervention, alongside public engagement initiatives. However, important gaps in our knowledge remain to be tackled. Principal among these include a better understanding of the course and evolution of the PUI-related problems, across different age groups, genders and other specific vulnerable groups, reliable methods for early identification of individuals at risk (before PUI becomes disordered), efficacious preventative and therapeutic interventions and ethical health and social policy changes that adequately safeguard human digital rights. The paper concludes with recommendations for achievable research goals, based on longitudinal analysis of a large multinational cohort co-designed with public stakeholders.
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Affiliation(s)
- Naomi A Fineberg
- Hertfordshire Partnership University NHS Foundation Trust, Hertfordshire, UK; School of Life and Medical Sciences, University of Hertfordshire, Hatfield, UK; School of Clinical Medicine, University of Cambridge, Cambridge, UK.
| | - José M Menchón
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, University of Barcelona, Cibersam, Barcelona, Spain
| | - Natalie Hall
- Centre for Health Services and Clinical Research, University of Hertfordshire, Hatfield, UK
| | - Bernardo Dell'Osso
- Luigi Sacco University Hospital, Psychiatry 2 Unit, University of Milan, Milan, Italy; "Aldo Ravelli" Center for Nanotechnology and Neurostimulation, University of Milan, Milan, Italy; Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA; Centro per lo studio dei meccanismi molecolari alla base delle patologie neuro-psico-geriatriche", University of Milan, Milan, Italy
| | - Matthias Brand
- General Psychology: Cognition and Center for Behavioral Addiction Research (CeBAR), University of Duisburg-Essen, Germany; Erwin L. Hahn Institute for Magnetic Resonance Imaging, Essen, Germany
| | - Marc N Potenza
- Departments of Psychiatry, Neuroscience and Child Study, Yale University School of Medicine, and Wu Tsai Institute, Yale University, New Haven, USA, New Haven, USA; Connecticut Council on Problem Gambling, Wethersfield, USA; Connecticut Mental Health Center, New Haven, USA
| | - Samuel R Chamberlain
- Department of Psychiatry, Faculty of Medicine, University of Southampton, UK; Southern Health NHS Foundation Trust, Southampton, UK
| | - Giovanna Cirnigliaro
- Luigi Sacco University Hospital, Psychiatry 2 Unit, University of Milan, Milan, Italy
| | - Christine Lochner
- SAMRC Unit on Risk and Resilience in Mental Disorders, Department of Psychiatry, Stellenbosch University, South Africa
| | - Joël Billieux
- Institute of Psychology, University of Lausanne (UNIL), Lausanne, Switzerland
| | - Zsolt Demetrovics
- Centre of Excellence in Responsible Gaming, University of Gibraltar, Gibraltar, Gibraltar; Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
| | - Hans Jürgen Rumpf
- Department of Psychiatry and Psychotherapy, Translational Psychiatry Unit, Research Group S:TEP (Substance use and related disorders: Treatment, Epidemiology and Prevention) University of Lübeck, Lübeck, Germany
| | - Astrid Müller
- Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, Hanover, Germany
| | - Jesús Castro-Calvo
- Department of Personality, Assessment, and Psychological Treatments, University of Valencia, Spain
| | - Eric Hollander
- Autism and Obsessive Compulsive Spectrum Program, Psychiatric Research Institute at Montefiore-Einstein, Albert Einstein College of Medicine
| | - Julius Burkauskas
- Laboratory of Behavioral Medicine, Neuroscience Institute, Lithuanian University of Health Sciences, Vyduno al. 4, 00135 Palanga, Lithuania
| | - Edna Grünblatt
- Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric University Hospital Zurich, University of Zurich, Zurich, Switzerland; Neuroscience Center Zurich, University of Zurich and ETH Zurich, Zurich, Switzerland; Zurich Center for Integrative Human Physiology, University of Zurich, Zurich, Switzerland
| | - Susanne Walitza
- Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric University Hospital Zurich, University of Zurich, Zurich, Switzerland; Neuroscience Center Zurich, University of Zurich and ETH Zurich, Zurich, Switzerland; Zurich Center for Integrative Human Physiology, University of Zurich, Zurich, Switzerland
| | - Ornella Corazza
- Department of Clinical Pharmacological and Biological Science, University of Hertfordshire
| | - Daniel L King
- College of Education, Psychology, & Social Work, Flinders University, Adelaide, Australia
| | - Dan J Stein
- SAMRC Unit on Risk & Resilience in Mental Disorders, Dept of Psychiatry & Neuroscience Institute, University of Cape Town
| | - Jon E Grant
- Department of Psychiatry & Behavioral Neuroscience, University of Chicago
| | - Stefano Pallanti
- Albert Einstein College of Medicine and Montefiore Medical Center, New York, USA; INS Istituto di Neuroscienze, Florence, Italy
| | | | - Michael Van Ameringen
- Deptartment of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Canada
| | - Konstantinos Ioannidis
- Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK; Department of International Health, Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands
| | - Lior Carmi
- Post-Trauma Center, Sheba Medical Center, Tel Aviv University, Israel; Reichman University, The Data Science Institution, Herzliya, Israel
| | - Anna E Goudriaan
- Amsterdam UMC, Department of Psychiatry, University of Amsterdam, Amsterdam, the Netherlands; Amsterdam Institute for Addiction Research & Arkin, the Netherlands
| | - Giovanni Martinotti
- Department of Neuroscience, Imaging and Clinical Sciences, G. D'Annunzio University, Chieti, Italy
| | - Célia M D Sales
- Faculty of Psychology and Education Sciences, University of Porto, Porto, Portugal; Center for Psychology at University of Porto (CPUP), University of Porto, Porto, Portugal
| | - Julia Jones
- School of Health and Social Work, University of Hertfordshire, Hatfield, UK
| | | | - Orsolya Király
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
| | - Beatrice Benatti
- Luigi Sacco University Hospital, Psychiatry 2 Unit, University of Milan, Milan, Italy; "Aldo Ravelli" Center for Nanotechnology and Neurostimulation, University of Milan, Milan, Italy
| | - Matteo Vismara
- Luigi Sacco University Hospital, Psychiatry 2 Unit, University of Milan, Milan, Italy; "Aldo Ravelli" Center for Nanotechnology and Neurostimulation, University of Milan, Milan, Italy
| | - Luca Pellegrini
- Hertfordshire Partnership University NHS Foundation Trust, Hertfordshire, UK; School of Life and Medical Sciences, University of Hertfordshire, Hatfield, UK
| | - Dario Conti
- Hertfordshire Partnership University NHS Foundation Trust, Hertfordshire, UK; Luigi Sacco University Hospital, Psychiatry 2 Unit, University of Milan, Milan, Italy
| | - Ilaria Cataldo
- Department of Psychology and Cognitive Science, University of Trento, Trento, Italy
| | - Gianluigi M Riva
- School of Information and Communication Studies, University College Dublin
| | - Murat Yücel
- Brain Park, Turner Institute for Brain and Mental Health, School of Psychological Sciences, and Monash Biomedical Imaging Facility, Monash University, Melbourne, Victoria, Australia
| | - Maèva Flayelle
- Institute of Psychology, University of Lausanne, Lausanne, Switzerland
| | | | | | - Joseph Zohar
- Post-Trauma Center, Sheba Medical Center, Tel Aviv University, Israel
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Klein S, Krikova K, Antons S, Brand M, Klucken T, Stark R. Reward Responsiveness, Learning, and Valuation Implicated in Problematic Pornography Use — a Research Domain Criteria Perspective. CURRENT ADDICTION REPORTS 2022. [DOI: 10.1007/s40429-022-00423-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Abstract
Purpose of Review
Problematic pornography use (PPU) describes a pattern of behavior characterized by excessive time spent using or thinking about pornography and continued use despite negative consequences. To help advance the understanding of transdiagnostic underlying psychological and neurobiological mechanisms in PPU, we aim to review existing evidence on these mechanisms focusing on positive valence systems within the transdiagnostic Research Domain Criteria (RDoC) framework.
Recent Findings
Reward anticipation processes seem to be increased in individuals with PPU symptoms when they anticipate sexual stimuli compared with other rewards. Studies further suggest that the initial neural and attentional responses to sexual rewards compared with different control stimuli are also increased in individuals with PPU symptoms, as are conditioned responses in sexual reward learning paradigms. Sexual reward valuation studies point towards an increased neural value differentiation with increasing PPU symptoms.
Summary
The current state of evidence indicates that positive valence systems are altered in persons with PPU. This framework of organizing evidence may aid in elucidating PPU development and maintenance as well as planning future studies.
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Mennig M, Tennie S, Barke A. Self-Perceived Problematic Use of Online Pornography Is Linked to Clinically Relevant Levels of Psychological Distress and Psychopathological Symptoms. ARCHIVES OF SEXUAL BEHAVIOR 2022; 51:1313-1321. [PMID: 34791580 PMCID: PMC8888508 DOI: 10.1007/s10508-021-02101-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Revised: 07/01/2021] [Accepted: 07/03/2021] [Indexed: 06/13/2023]
Abstract
Online pornography is a widespread Internet application. As with other Internet applications, in some cases its use can become problematic. First indications point to a link between problematic use of online pornography and psychological distress and general functional impairment. However, to date, there are no standardized criteria for assessing problematic use of online pornography. In this study, we used the Online Pornography Disorder Questionnaire (OPDQ)-an instrument which adapted the official criteria for Internet Gaming Disorder to online pornography-to measure problematic use and investigated to what extent consumers with a self-perceived problematic use of online pornography differed from casual users with regard to their psychological distress. An online sample of German adult visitors to a popular casual dating site completed the OPDQ, the Brief Symptom Inventory (BSI), and provided information on their online pornography use (n = 1539; 72.6% male; 31.43 ± 11.96 years). T-scores for the BSI were calculated and independent t-tests were conducted to compare casual users with consumers with a self-perceived problematic use of online pornography. Of the users, 5.9% fulfilled the criteria for problematic use. This group consumed online pornography for longer amounts of time and showed higher levels of psychological distress (Hedges' g from 0.75 to 1.21). The T-scores of users with self-perceived problematic online pornography use reached clinically relevant levels on all subscales. Overall, the results of the study indicate that self-perceived problematic use of online pornography seems to be linked to severe psychological distress that may warrant clinical attention.
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Affiliation(s)
- Manuel Mennig
- Department of Clinical Psychology and Psychotherapy, Philipps-Universität Marburg, Gutenbergstrasse 18, 35032, Marburg, Germany.
| | - Sophia Tennie
- Department of Clinical Psychology and Psychotherapy, Philipps-Universität Marburg, Gutenbergstrasse 18, 35032, Marburg, Germany
| | - Antonia Barke
- Department of Clinical and Biological Psychology, Catholic University of Eichstaett-Ingolstadt, Ingolstadt, Germany
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Musetti A, Gori A, Alessandra A, Topino E, Terrone G, Plazzi G, Cacioppo M, Franceschini C. The Interplay Between Problematic Online Pornography Use, Psychological Stress, Emotion Dysregulation and Insomnia Symptoms During the COVID-19 Pandemic: A Mediation Analysis. Nat Sci Sleep 2022; 14:83-92. [PMID: 35082545 PMCID: PMC8786338 DOI: 10.2147/nss.s348242] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2021] [Accepted: 01/13/2022] [Indexed: 12/16/2022] Open
Abstract
PURPOSE Although a link between problematic online pornographic use (POPU) and insomnia symptoms has been established, psychological and psychopathological mechanisms underlying this relationship are still not clear. Psychological stress and emotion dysregulation have been pointed out as relevant in the development and maintenance of insomnia. This study aims to explore the associations between POPU, psychological stress, emotion dysregulation and insomnia symptoms and to understand the mediating role of psychological stress and emotion dysregulation in the relationship between POPU and insomnia symptoms. PARTICIPANTS AND METHODS A sample of 776 Italian adults aged 19-48 years (51.4% female; M age = 28.49; SD = 7.33) completed questionnaires regarding demographics, COVID-19-related variables, POPU, psychological stress, emotion dysregulation, and insomnia symptoms. RESULTS After controlling for demographic covariates and COVID-19-related variables, multiple mediation model showed that higher psychological stress and emotion dysregulation fully mediated the link between POPU and insomnia. CONCLUSION The findings underscore the significance of the negative consequences of POPU and underline the importance of working on this and its effects on psychological stress and emotion dysregulation to limit insomnia.
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Affiliation(s)
- Alessandro Musetti
- Department of Humanities, Social Sciences and Cultural Industries, University of Parma, Parma, Italy
| | - Alessio Gori
- Department of Health Sciences, University of Florence, Florence, Italy
| | | | - Eleonora Topino
- Department of Human Sciences, Lumsa University of Rome, Rome, Italy
| | - Grazia Terrone
- Department of History, Cultural Heritage, Education and Society, University of Rome Tor Vergata, Rome, Italy
| | - Giuseppe Plazzi
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy.,IRCCS Institute of Neurological Sciences of Bologna (ISNB), Bologna, Italy
| | - Marco Cacioppo
- Department of Human Sciences, Lumsa University of Rome, Rome, Italy
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Döring N, Krämer N, Mikhailova V, Brand M, Krüger THC, Vowe G. Sexual Interaction in Digital Contexts and Its Implications for Sexual Health: A Conceptual Analysis. Front Psychol 2021; 12:769732. [PMID: 34916999 PMCID: PMC8669394 DOI: 10.3389/fpsyg.2021.769732] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Accepted: 11/09/2021] [Indexed: 12/27/2022] Open
Abstract
Based on its prevalence, there is an urgent need to better understand the mechanisms, opportunities and risks of sexual interaction in digital contexts (SIDC) that are related with sexual arousal. While there is a growing body of literature on SIDC, there is also a lack of conceptual clarity and classification. Therefore, based on a conceptual analysis, we propose to distinguish between sexual interaction (1) through, (2) via, and (3) with digital technologies. (1) Sexual interactions through digital technologies are face-to-face sexual interactions that (a) have been started digitally (e.g., people initiating face-to-face sexual encounters through adult dating apps) or (b) are accompanied by digital technology (e.g., couples augmenting their face-to-face sexual encounters through filming themselves during the act and publishing the amateur pornography online). (2) Sexual interactions via digital technology are technology-mediated interpersonal sexual interactions (e.g., via text chat: cybersex; via smartphone: sexting; via webcam: webcam sex/camming). (3) Sexual interactions with digital technology occur when the technology itself has the role of an interaction partner (e.g., sexual interaction with a sex robot or with a media persona in pornography). The three types of SIDC and their respective subtypes are explained and backed up with empirical studies that are grouped according to two major mediators: consent and commerce. Regarding the causes and consequences of the three types of SIDC we suggest a classification that entails biological, psychological, social, economic, and technological factors. Regarding implications of SIDC we suggest to focus on both opportunities and risks for sexual health. The proposed conceptual framework of SIDC is meant to inform future research.
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Affiliation(s)
- Nicola Döring
- Media Psychology and Media Design, Institute of Media and Communication Science, Department of Economic Sciences and Media, Technische Universität Ilmenau, Ilmenau, Germany
| | - Nicole Krämer
- Social Psychology: Media and Communication, Department of Computer Science and Applied Cognitive Science, Faculty of Engineering, University of Duisburg-Essen, Duisburg, Germany
| | - Veronika Mikhailova
- Media Psychology and Media Design, Institute of Media and Communication Science, Department of Economic Sciences and Media, Technische Universität Ilmenau, Ilmenau, Germany
| | - Matthias Brand
- General Psychology: Cognition and Center for Behavioral Addiction Research (CeBAR), Department of Computer Science and Applied Cognitive Science, Faculty of Engineering, University of Duisburg-Essen, Duisburg, Germany
| | - Tillmann H C Krüger
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Section of Clinical Psychology and Sexual Medicine, Hannover Medical School, Hannover, Germany
| | - Gerhard Vowe
- Communication and Media Studies, Center for Advanced Internet Studies (CAIS), Bochum, Germany
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Andrie EK, Sakou II, Tzavela EC, Richardson C, Tsitsika AK. Adolescents' Online Pornography Exposure and Its Relationship to Sociodemographic and Psychopathological Correlates: A Cross-Sectional Study in Six European Countries. CHILDREN (BASEL, SWITZERLAND) 2021; 8:children8100925. [PMID: 34682190 PMCID: PMC8534324 DOI: 10.3390/children8100925] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 10/08/2021] [Accepted: 10/10/2021] [Indexed: 01/08/2023]
Abstract
The aim of the study was to assess the prevalence of online exposure to pornography in European adolescents and its relationship to sociodemographic and psychopathological correlates. A cross-sectional school-based survey of 10,930 adolescents (5211 males/5719 females), aged 14-17 years old (mean age 15.8 ± 0.7) was carried out in six European countries (Greece, Spain, Poland, Romania, the Netherlands, and Iceland). Anonymous self-completed questionnaires covered exposure to pornography, internet use and dysfunctional internet behavior, and psychopathological syndromes (measured by Achenbach's Youth Self-Report). The prevalence of any online exposure to pornography was 59% overall and 24% for exposure at least once a week. The likelihood of online exposure to pornography was greater in male adolescents, heavier internet users, and those who displayed dysfunctional internet behavior. Country-specific analyses confirmed that the gender effect existed in every country, although its strength varied, from an odds ratio of 1.88 in Poland to 14.9 in Greece. Online exposure to pornography was shown to be associated with externalizing problem scale scores, especially rule-breaking and aggressive behavior, but also associated with higher scores in competences, namely activities and social competence. Exposure to pornography is ubiquitous, more relevant to boys, and is associated with both positive qualities/competences and externalizing behavioral problems.
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Affiliation(s)
- Elisabeth K. Andrie
- Adolescent Health Unit, Second Department of Pediatrics, P. & A. Kyriakou Children’s Hospital, School of Medicine, National and Kapodistrian University of Athens, 11527 Athens, Greece; (I.I.S.); (E.C.T.); (A.K.T.)
- Correspondence: ; Tel.: +30-210-771-0824
| | - Irene Ikbale Sakou
- Adolescent Health Unit, Second Department of Pediatrics, P. & A. Kyriakou Children’s Hospital, School of Medicine, National and Kapodistrian University of Athens, 11527 Athens, Greece; (I.I.S.); (E.C.T.); (A.K.T.)
| | - Eleni C. Tzavela
- Adolescent Health Unit, Second Department of Pediatrics, P. & A. Kyriakou Children’s Hospital, School of Medicine, National and Kapodistrian University of Athens, 11527 Athens, Greece; (I.I.S.); (E.C.T.); (A.K.T.)
| | - Clive Richardson
- Department of Economic and Regional Development, Panteion University of Social and Political Sciences, 17671 Athens, Greece;
| | - Artemis K. Tsitsika
- Adolescent Health Unit, Second Department of Pediatrics, P. & A. Kyriakou Children’s Hospital, School of Medicine, National and Kapodistrian University of Athens, 11527 Athens, Greece; (I.I.S.); (E.C.T.); (A.K.T.)
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Eljawad MA, Se'eda H, Ghozy S, El-Qushayri AE, Elsherif A, Elkassar AH, Atta-Allah MH, Ibrahim W, Elmahdy MA, Islam SMS. Pornography Use Prevalence and Associated Factors in Arab Countries: A Multinational Cross-Sectional Study of 15,027 Individuals. J Sex Med 2021; 18:539-548. [PMID: 33526399 DOI: 10.1016/j.jsxm.2020.12.011] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 11/06/2020] [Accepted: 12/17/2020] [Indexed: 11/20/2022]
Abstract
BACKGROUND There has been a tangible increase in pornography consumption during the past decade, with the absence of a large-scale study of Arab countries. AIM The present study aimed to assess the prevalence of pornography viewing and its associated risk factors in Arab countries. METHODS A large cross-sectional online survey was carried out recruiting participants without restrictions on the age, socioeconomic level, job, or educational level. Multivariable logistic regression analysis was performed to identify possible risk factors for viewing porn and results were expressed as odds ratios (ORs) and 95% confidence interval (95% CI). OUTCOMES Main outcomes were pornography viewing (first exposure and frequency), the perceptions of this act, use of spare time, physical activity (exercising), and frequency of psychiatrist visits. RESULTS The final number of participants included in the study was 15027 participants with a mean age ± standard deviation of 23.82 years ± 24.99. Most of the participants were men (84.56%), living with parents (81.71%), and 60.51% university graduates. There were statistically significant differences (P < .001) in the attitude and practice of men compared with women throughout all tested variables. Frequent pornography viewing was associated with male gender (OR [95% CI] = 7.08 [6.43 to 7.81]; P < .001) and age group ≤15 years (OR [95% CI] = 1.33 [1.01 to 1.75]; P = .044). By contrast, higher education was inversely associated with viewing rates reaching the lowest level in PhD awardees (OR [95% CI] = 0.36 [0.26 to 0.51]; P = .003). It was also noted that regular exercising (OR [95% CI] = 0.66 [0.58 to 0.74]; P < .001) was associated with a reduction in pornography viewing rates. CLINICAL IMPLICATIONS Young age, male gender, and lower educational level are all predictors for higher pornography viewing and should be considered when designing public health intervention in a related context. STRENGTHS AND LIMITATIONS This is the first large-scale multi-national survey to be conducted in Arab countries to investigate pornography viewing. The main limitations were the cross-sectional design (cannot indicate causality) and the self-report nature (liable to social desirability and recall bias). CONCLUSION Pornography viewing is common in Arab countries and associated with some personal and behavioral factors. Eljawad MA, Se'eda H, Ghozy S, et al. Pornography Use Prevalence and Associated Factors in Arab Countries: A Multinational Cross-Sectional Study of 15,027 Individuals. J Sex Med 2021;18:539-548.
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Affiliation(s)
- Mohamed Abd Eljawad
- Internal Medicine Department, Jazan Armed Forces Hospital, Jazan, Saudi Arabia; Academic Research Division, The Aware Academy, Cairo, Egypt
| | - Hussien Se'eda
- Academic Research Division, The Aware Academy, Cairo, Egypt; Faculty of Medicine, Minia University, Minia, Egypt
| | - Sherief Ghozy
- Faculty of Medicine, Mansoura University, Mansoura, Egypt.
| | | | - Ahmed Elsherif
- Academic Research Division, The Aware Academy, Cairo, Egypt; Faculty of Medicine, Al-Azhar University, Cairo, Egypt
| | - Ahmed Hussein Elkassar
- Academic Research Division, The Aware Academy, Cairo, Egypt; Faculty of Medicine, Minia University, Minia, Egypt
| | - Mohammed H Atta-Allah
- Academic Research Division, The Aware Academy, Cairo, Egypt; Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Wael Ibrahim
- Academic Research Division, The Aware Academy, Cairo, Egypt; Student Counselor, Australian Islamic College, Kewdale, Australia
| | - Mohamed A Elmahdy
- Psychiatry Department, Damietta Faculty of Medicine, Al-Azhar- University, Damietta, Egypt
| | - Sheikh Mohammed Shariful Islam
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Melbourne, Australia
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11
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Wang J, Dai B. Event-related potentials in a two-choice oddball task of impaired behavioral inhibitory control among males with tendencies towards cybersex addiction. J Behav Addict 2020; 9:785-796. [PMID: 32903206 PMCID: PMC8943673 DOI: 10.1556/jba-9-785] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 06/09/2020] [Accepted: 08/21/2020] [Indexed: 03/14/2024] Open
Abstract
BACKGROUND AND AIMS Impaired behavioral inhibitory control (BIC) is known to play a crucial role in addictive behavior. However, research has been inconclusive as to whether this is also the case for cybersex addiction. This study aimed to investigate the time course of BIC in male individuals with tendencies towards cybersex addiction (TCA) using event-related potentials (ERPs) and to provide neurophysiological evidence of their deficient BIC. METHODS Thirty-six individuals with TCA and 36 healthy controls (HCs) were given a Two-Choice Oddball task that required them to respond differently to frequent standard stimuli (images of people) and infrequent deviant stimuli (pornographic images) within 1,000 ms. Electroencephalography (EEG) was recorded as the participants performed the task. RESULTS Despite the similarity of standard stimuli between the groups in terms of reaction times (RTs), the RTs of the TCA group to deviant stimuli were much slower than those of the HC group. The behavioral difference was accompanied by group differences in the averaged amplitudes of N2 (200-300 ms) and P3 (300-500 ms) components in the deviant-standard difference wave. More specifically, compared to the HC group, the TCA group demonstrated smaller N2 and P3 amplitude differences for deviant than standard stimuli. DISCUSSION AND CONCLUSIONS Individuals with TCA were more impulsive than HC participants and shared neuropsychological and ERP characteristics of substance use disorder or behavioral addictions, which supports the view that cybersex addiction can be conceptualized as a behavioral addiction.
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Affiliation(s)
- Jianfeng Wang
- School of Psychology, Chengdu Medical College, Chengdu, 610500, China
| | - Bing Dai
- School of Psychology, Chengdu Medical College, Chengdu, 610500, China
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12
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Wang J, Dai B. Event-related potentials in a two-choice oddball task of impaired behavioral inhibitory control among males with tendencies towards cybersex addiction. J Behav Addict 2020; 9:785-796. [PMID: 32903206 PMCID: PMC8943673 DOI: 10.1556/2006.2020.00059] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 06/09/2020] [Accepted: 08/21/2020] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND AND AIMS Impaired behavioral inhibitory control (BIC) is known to play a crucial role in addictive behavior. However, research has been inconclusive as to whether this is also the case for cybersex addiction. This study aimed to investigate the time course of BIC in male individuals with tendencies towards cybersex addiction (TCA) using event-related potentials (ERPs) and to provide neurophysiological evidence of their deficient BIC. METHODS Thirty-six individuals with TCA and 36 healthy controls (HCs) were given a Two-Choice Oddball task that required them to respond differently to frequent standard stimuli (images of people) and infrequent deviant stimuli (pornographic images) within 1,000 ms. Electroencephalography (EEG) was recorded as the participants performed the task. RESULTS Despite the similarity of standard stimuli between the groups in terms of reaction times (RTs), the RTs of the TCA group to deviant stimuli were much slower than those of the HC group. The behavioral difference was accompanied by group differences in the averaged amplitudes of N2 (200-300 ms) and P3 (300-500 ms) components in the deviant-standard difference wave. More specifically, compared to the HC group, the TCA group demonstrated smaller N2 and P3 amplitude differences for deviant than standard stimuli. DISCUSSION AND CONCLUSIONS Individuals with TCA were more impulsive than HC participants and shared neuropsychological and ERP characteristics of substance use disorder or behavioral addictions, which supports the view that cybersex addiction can be conceptualized as a behavioral addiction.
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Affiliation(s)
| | - Bing Dai
- Corresponding authors. E-mail: E-mail:
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13
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Klein S, Kruse O, Markert C, Tapia León I, Strahler J, Stark R. Subjective reward value of visual sexual stimuli is coded in human striatum and orbitofrontal cortex. Behav Brain Res 2020; 393:112792. [PMID: 32598998 DOI: 10.1016/j.bbr.2020.112792] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Revised: 06/23/2020] [Accepted: 06/24/2020] [Indexed: 10/24/2022]
Abstract
Human neuroimaging research suggests the existence of one core network for the subjective valuation of rewards, including the striatum and orbitofrontal cortex. However, there is little research on the neural representation of subjective reward values of visual sexual stimuli (VSS) and on the role of these subjective valuations in the development of related addictive behaviors. Here, we investigate how neural reactivity to VSS is connected to individual preference using functional magnetic resonance imaging (fMRI). During the fMRI scan, 72 men viewed different VSS film clips. Ratings regarding valence and sexual arousal were collected and used as parametric modulators in the fMRI analysis. Subjects also filled out questionnaires on self-reported symptoms of problematic pornography use (PPU). Firstly, we found that neural reactivity towards VSS clips in the nucleus accumbens, caudate nucleus and orbitofrontal cortex was positively correlated with individual ratings of the respective VSS in all subjects. Second, the strength of the association between neural activity and sexual arousal ratings was positively correlated with self-reported symptoms of PPU. The first result suggests a precise appraisal of VSS according to individual preferences in established reward valuation regions. Secondly, stronger neural differentiation based on preference in participants with more PPU symptoms indicates an increased importance of VSS/preference fit in these individuals. This heightened correspondence between individual liking and neural activity may facilitate PPU development by increased signaling of incentive salience, thus boosting motivation to seek out and respond to these preferred stimuli.
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Affiliation(s)
- Sanja Klein
- Department of Psychotherapy and Systems Neuroscience, Justus Liebig University, 35394 Giessen, Germany; Bender Institute for Neuroimaging (BION), Justus Liebig University, 35394 Giessen, Germany; Center of Mind, Brain and Behavior, Universities of Marburg and Giessen, 35032 Marburg, Germany.
| | - Onno Kruse
- Department of Psychotherapy and Systems Neuroscience, Justus Liebig University, 35394 Giessen, Germany; Bender Institute for Neuroimaging (BION), Justus Liebig University, 35394 Giessen, Germany; Clinical Psychology, University Siegen, 57076 Siegen, Germany
| | - Charlotte Markert
- Department of Psychotherapy and Systems Neuroscience, Justus Liebig University, 35394 Giessen, Germany; Bender Institute for Neuroimaging (BION), Justus Liebig University, 35394 Giessen, Germany; Center of Mind, Brain and Behavior, Universities of Marburg and Giessen, 35032 Marburg, Germany
| | - Isabell Tapia León
- Department of Psychotherapy and Systems Neuroscience, Justus Liebig University, 35394 Giessen, Germany; Bender Institute for Neuroimaging (BION), Justus Liebig University, 35394 Giessen, Germany; Clinical Psychology, University Siegen, 57076 Siegen, Germany
| | - Jana Strahler
- Department of Psychotherapy and Systems Neuroscience, Justus Liebig University, 35394 Giessen, Germany; Bender Institute for Neuroimaging (BION), Justus Liebig University, 35394 Giessen, Germany
| | - Rudolf Stark
- Department of Psychotherapy and Systems Neuroscience, Justus Liebig University, 35394 Giessen, Germany; Bender Institute for Neuroimaging (BION), Justus Liebig University, 35394 Giessen, Germany; Center of Mind, Brain and Behavior, Universities of Marburg and Giessen, 35032 Marburg, Germany
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14
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Rochat L, Bianchi-Demicheli F, Aboujaoude E, Khazaal Y. The psychology of "swiping": A cluster analysis of the mobile dating app Tinder. J Behav Addict 2019; 8:804-813. [PMID: 31663372 PMCID: PMC7044584 DOI: 10.1556/2006.8.2019.58] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND AND AIMS The use of the smartphone dating application Tinder is increasingly popular and has received much media attention. However, no empirical study to date has investigated the psychological characteristics driving its adaptive or problematic use. The aim of this study is to determine whether reliable subtypes of users can be identified via a cluster analysis approach. METHODS A total of 1,159 Tinder users were recruited. Survey questions investigated user characteristics, including: motives for app use, sexual desire, attachment styles, impulsivity traits, self-esteem, problematic use, depressive mood, and patterns of use. RESULTS Four reliable clusters were identified: two with low levels of problematic use ("regulated" and "regulated with low sexual desire"), one with an intermediate level of problematic use ("unregulated-avoidants"), and one with a high level of problematic use ("unregulated-highly motivated"). The clusters differed on gender, marital status, depressive mood, and use patterns. CONCLUSION The findings provide insight into the dynamic relationships among key use-related factors and shed light on the mechanisms underlying the self-regulation difficulties that appear to characterize problematic Tinder use.
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Affiliation(s)
- Lucien Rochat
- Faculty of Psychology and Educational Sciences, University of Geneva, Geneva, Switzerland
| | - Francesco Bianchi-Demicheli
- Faculty of Psychology and Educational Sciences, University of Geneva, Geneva, Switzerland,Faculty of Medicine, University of Geneva, Geneva, Switzerland,Department of Obstetrics and Gynecology, University Hospitals of Geneva, Geneva, Switzerland
| | - Elias Aboujaoude
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
| | - Yasser Khazaal
- Addiction Medicine, Department of Psychiatry, Lausanne University Hospital, Lausanne, Switzerland,Research Centre, University Institute of Mental Health at Montreal, Montreal, Canada,Faculty of Biology and Medicine, Lausanne University, Lausanne, Switzerland
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15
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Studer J, Marmet S, Wicki M, Gmel G. Cybersex use and problematic cybersex use among young Swiss men: Associations with sociodemographic, sexual, and psychological factors. J Behav Addict 2019; 8:794-803. [PMID: 31868514 PMCID: PMC7044587 DOI: 10.1556/2006.8.2019.69] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Revised: 10/21/2019] [Accepted: 12/02/2019] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND AND AIMS Cybersex use (CU) is highly prevalent in Switzerland's population, particularly among young men. CU may have negative consequences if it gets out of control. This study estimated prevalence of CU, frequency of CU (FCU), and problematic CU (PCU) and their correlates. METHODS A non-selective sample of young Swiss men (N = 5,332, mean age = 25.45) completed a questionnaire assessing FCU and PCU, sociodemographics (age, linguistic region, and education), sexuality (being in a relationship, number of sexual partners, and sexual orientation), dysfunctional coping (denial, self-distraction, behavioral disengagement, and self-blame), and personality traits (aggression/hostility, sociability, anxiety/neuroticism, and sensation seeking). Associations were tested using hurdle and negative binomial regression models. RESULTS At least monthly CU was reported by 78.6% of participants. CU was associated positively with post-secondary schooling (vs. primary schooling), German-speaking (vs. French-speaking), homosexuality, bisexuality (vs. heterosexuality), more than one sexual partner (vs. one), dysfunctional coping (except denial), and all personality traits except sociability, but negatively with being in a relationship (vs. not), age, and sociability. FCU was associated positively with homosexuality, bisexuality, no or more than one sexual partner, dysfunctional coping (except denial), and all personality traits except sociability, but negatively with age, being in a relationship, and sociability. PCU was associated positively with bisexuality, four or more sexual partners, dysfunctional coping, and all personality traits except sociability, but negatively with German-speaking and sociability. DISCUSSION AND CONCLUSIONS CU should be viewed in light of its associations with sociodemographic, sexual, and psychological factors. Healthcare professionals should consider these aspects to adapt their interventions to patients' needs.
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Affiliation(s)
- Joseph Studer
- Addiction Medicine, Department of Psychiatry, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
| | - Simon Marmet
- Addiction Medicine, Department of Psychiatry, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
| | - Matthias Wicki
- Addiction Medicine, Department of Psychiatry, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
| | - Gerhard Gmel
- Addiction Medicine, Department of Psychiatry, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
- Research Department, Addiction Switzerland, Lausanne, Switzerland
- Centre for Addiction and Mental Health, Institute for Mental Health Policy Research, Toronto, Ontario, Canada
- Department of Health and Social Sciences, University of the West of England, Bristol, UK
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16
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Brahim FB, Rothen S, Bianchi-Demicheli F, Courtois R, Khazaal Y. Contribution of sexual desire and motives to the compulsive use of cybersex. J Behav Addict 2019; 8:442-450. [PMID: 31505968 PMCID: PMC7044618 DOI: 10.1556/2006.8.2019.47] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND AND AIMS Cybersex is increasingly associated with concerns about compulsive use. The aim of this study was to assess the roles of motives and sexual desire in the compulsive use of cybersex. METHODS The sample consisted of 306 cybersex users (150 men and 156 women). The participants were assessed using the Compulsive Internet Use Scale (CIUS) adapted for cybersex, the Cybersex Motives Questionnaire (enhancement, coping, and social motives), and the Sexual Desire Inventory-2 (dyadic and solitary sexual desire). RESULTS For both genders, coping motive was associated with CIUS score. For women, an additional association with social motives was found whereas an association with sexual desire was found for men. CONCLUSION The study showed gender differences in the contributors to sex-related CIUS scores.
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Affiliation(s)
| | - Stephane Rothen
- Research Center for Statistics, University of Geneva, Geneva, Switzerland,Department of Mental Health and Psychiatry, Geneva University Hospitals, Geneva, Switzerland
| | | | - Robert Courtois
- Department of Psychology, University of Tours, Tours, France,Psychiatric University Clinic, University Hospital of Tours (CHRU), Tours, France
| | - Yasser Khazaal
- Addiction Medicine, Department of Psychiatry, Lausanne University Hospital and Lausanne University, Lausanne, Switzerland,Research Centre, University Institute of Mental Health at Montreal, Montreal, Canada,Corresponding author: Yasser Khazaal; Addiction Medicine, Department of Psychiatry, Lausanne University Hospital and Lausanne University, Bugnon 23, Lausanne 1011, Switzerland; Phone: +41 21 314 84 00; Fax: +41 21 314 73 51; E-mail:
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17
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Baranowski AM, Vogl R, Stark R. Prevalence and Determinants of Problematic Online Pornography Use in a Sample of German Women. J Sex Med 2019; 16:1274-1282. [PMID: 31277972 DOI: 10.1016/j.jsxm.2019.05.010] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Revised: 05/08/2019] [Accepted: 05/15/2019] [Indexed: 01/05/2023]
Abstract
AIM To investigate problematic online pornography use in women, an issue that has rarely been tackled to date. METHODS We used the data from a comprehensive, cross-sectional survey of a self-referred sample of 485 German women to examine the relationships between problematic online pornography consumption and a range of sexual behaviors, trait sexual motivation, and motives for pornography use. RESULTS Approximately 3% of our sample had problematic pornography use. In multivariate analysis, problematic use was significantly associated with the overall time spent viewing online pornography, greater sexual motivation, and greater emotional avoidance. Our data also indicate that the influence of sexual motivation on problematic pornography use is mediated by the amount of time spent watching online pornography. CLINICAL TRANSLATION Identifying these predictors for problematic use is important for specific prevention programs for women at risk of pathological use. STRENGTHS & LIMITATIONS This study is one of the first to show that women also experience problematic online pornography use and identifies risk factors for problematic behavior. The weakness of this study is that as in all studies on sexuality, people who are interested in the topic and are comfortable talking about it are more likely to participate, thus rendering the sample nonrepresentative. CONCLUSION Based on our findings, approximately 3% of women experience problems associated with engaging in online pornography consumption. Baranowski AM, Vogl R, Stark R. Prevalence and Determinants of Problematic Online Pornography Use in a Sample of German Women. J Sex Med 2019;16:1274-1282.
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Affiliation(s)
| | - Romina Vogl
- Department of Psychology, Justus Liebig University Giessen, Giessen, Germany
| | - Rudolf Stark
- Department of Psychology, Justus Liebig University Giessen, Giessen, Germany
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18
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Brand M, Antons S, Wegmann E, Potenza MN. Theoretical Assumptions on Pornography Problems Due to Moral Incongruence and Mechanisms of Addictive or Compulsive Use of Pornography: Are the Two "Conditions" as Theoretically Distinct as Suggested? ARCHIVES OF SEXUAL BEHAVIOR 2019; 48:417-423. [PMID: 30120612 DOI: 10.1007/s10508-018-1293-5] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Accepted: 08/06/2018] [Indexed: 05/25/2023]
Affiliation(s)
- Matthias Brand
- General Psychology: Cognition and Center for Behavioral Addiction Research (CeBAR), University of Duisburg-Essen, Forsthausweg 2, 47057, Duisburg, Germany.
- Erwin L. Hahn Institute for Magnetic Resonance Imaging, Essen, Germany.
| | - Stephanie Antons
- General Psychology: Cognition and Center for Behavioral Addiction Research (CeBAR), University of Duisburg-Essen, Forsthausweg 2, 47057, Duisburg, Germany
| | - Elisa Wegmann
- General Psychology: Cognition and Center for Behavioral Addiction Research (CeBAR), University of Duisburg-Essen, Forsthausweg 2, 47057, Duisburg, Germany
| | - Marc N Potenza
- Departments of Psychiatry, Neuroscience and Child Study Center, 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
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19
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de Alarcón R, de la Iglesia JI, Casado NM, Montejo AL. Online Porn Addiction: What We Know and What We Don't-A Systematic Review. J Clin Med 2019; 8:E91. [PMID: 30650522 PMCID: PMC6352245 DOI: 10.3390/jcm8010091] [Citation(s) in RCA: 90] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Revised: 12/27/2018] [Accepted: 01/10/2019] [Indexed: 01/09/2023] Open
Abstract
In the last few years, there has been a wave of articles related to behavioral addictions; some of them have a focus on online pornography addiction. However, despite all efforts, we are still unable to profile when engaging in this behavior becomes pathological. Common problems include: sample bias, the search for diagnostic instrumentals, opposing approximations to the matter, and the fact that this entity may be encompassed inside a greater pathology (i.e., sex addiction) that may present itself with very diverse symptomatology. Behavioral addictions form a largely unexplored field of study, and usually exhibit a problematic consumption model: loss of control, impairment, and risky use. Hypersexual disorder fits this model and may be composed of several sexual behaviors, like problematic use of online pornography (POPU). Online pornography use is on the rise, with a potential for addiction considering the "triple A" influence (accessibility, affordability, anonymity). This problematic use might have adverse effects in sexual development and sexual functioning, especially among the young population. We aim to gather existing knowledge on problematic online pornography use as a pathological entity. Here we try to summarize what we know about this entity and outline some areas worthy of further research.
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Affiliation(s)
- Rubén de Alarcón
- Psychiatry Service, Hospital Clínico Universitario de Salamanca, Institute of Biomedical Research of Salamanca (IBSAL), 37007 Salamanca, Spain.
| | - Javier I de la Iglesia
- Psychiatry Service, Hospital Clínico Universitario de Salamanca, Institute of Biomedical Research of Salamanca (IBSAL), 37007 Salamanca, Spain.
| | - Nerea M Casado
- Psychiatry Service, Hospital Clínico Universitario de Salamanca, Institute of Biomedical Research of Salamanca (IBSAL), 37007 Salamanca, Spain.
| | - Angel L Montejo
- Psychiatry Service, Hospital Clínico Universitario de Salamanca, Institute of Biomedical Research of Salamanca (IBSAL), 37007 Salamanca, Spain.
- University of Salamanca, EUEF, 37007 Salamanca, Spain.
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20
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Flayelle M, Canale N, Vögele C, Karila L, Maurage P, Billieux J. Assessing binge-watching behaviors: Development and validation of the “Watching TV Series Motives” and “Binge-watching Engagement and Symptoms” questionnaires. COMPUTERS IN HUMAN BEHAVIOR 2019. [DOI: 10.1016/j.chb.2018.08.022] [Citation(s) in RCA: 58] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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21
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Wéry A, Schimmenti A, Karila L, Billieux J. Where the Mind Cannot Dare: A Case of Addictive Use of Online Pornography and Its Relationship With Childhood Trauma. JOURNAL OF SEX & MARITAL THERAPY 2018; 45:114-127. [PMID: 30015567 DOI: 10.1080/0092623x.2018.1488324] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Revised: 05/29/2018] [Accepted: 06/09/2018] [Indexed: 06/08/2023]
Abstract
Dysfunctional use of cybersex has often been conceptualized as a "behavioral addiction" sharing common traits with substance addiction. We describe the case of a treatment-seeking man, who displayed addictive use of pornography. The case is presented from two perspectives: (1) a symptom-based approach inspired by the addiction model of excessive sexual behaviors and (2) a process-based approach aimed to identify the psychological processes and risk factors that may foster the development of addiction-like symptoms. This article shows how case conceptualization according to a process-based approach is likely to result in psychological intervention that targets the specific processes and risk factors involved in addictive cybersex use.
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Affiliation(s)
- Aline Wéry
- a Psychological Sciences Research Institute, Catholic University of Louvain , Louvain-la-Neuve , Belgium
| | - Adriano Schimmenti
- b Faculty of Human and Social Sciences , UKE-Kore of Enna , Enna , Italy
| | - Laurent Karila
- c Addiction Research and Treatment Center, Paul Brousse Hospital, Paris Sud-11 University , Villejuif , France
| | - Joel Billieux
- a Psychological Sciences Research Institute, Catholic University of Louvain , Louvain-la-Neuve , Belgium
- d Addictive and Compulsive Behaviours Lab , Institute for Health and Behaviour, University of Luxembourg , Esch-sur-Alzette , Luxembourg
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22
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Franc E, Khazaal Y, Jasiowka K, Lepers T, Bianchi-Demicheli F, Rothen S. Factor structure of the Cybersex Motives Questionnaire. J Behav Addict 2018; 7:601-609. [PMID: 30156118 PMCID: PMC6426379 DOI: 10.1556/2006.7.2018.67] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND AND AIMS The Internet is widely used for sexual activities and pornography. Little is known, however, about why people look for meetings and sexual interactions through the Internet and about the correlates of cybersex addiction. The goal of this study was to construct a questionnaire for cybersex motives [Cybersex Motives Questionnaire (CysexMQ)] by adapting the Gambling Motives Questionnaire to cybersex use and validating its structure. METHODS Two online samples of 191 and 204 cybersex users were collected to conduct a principal component analysis (PCA) on the first sample and a confirmatory factor analysis (CFA) on the second. Cronbach's α and composite reliability were computed to assess internal consistency. Correlations between the CysexMQ and the Sexual Desire Inventory (SDI) were also evaluated. RESULTS Two competing models were retained from the PCA, one with two factors and the other with three factors. The CFA showed better fit for the three-factor solution. After three cross-loading items were removed, the results showed that a final 14-item three-factor solution (enhancement, coping, and social motives) was valid (adjusted goodness-of-fit index: 0.993; normed-fit index: 0.978; Tucker-Lewis index: 0.985; comparative fit index: 0.988; root mean square error of approximation: 0.076). Positive correlations were found between the different motives and the subscales of the SDI. DISCUSSION The results suggest that the CysexMQ is adequate for the assessment of cybersex motives.
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Affiliation(s)
- Elisabeth Franc
- Department of Psychiatry, University of Geneva, Geneva, Switzerland
| | - Yasser Khazaal
- Department of Psychiatry, University of Geneva, Geneva, Switzerland,Department of Mental Health and Psychiatry, Geneva University Hospital, Geneva, Switzerland,Research Centre, University Institute of Mental Health at Montreal, Montreal, Canada,Corresponding author: Yasser Khazaal; Geneva University Hospital, Grand-Pré 70C, Geneva 1206, Switzerland; Phone: +41 22 372 55 50; Fax: +41 22 320 28 40; E-mail:
| | - Katarzyna Jasiowka
- Department of Mental Health and Psychiatry, Geneva University Hospital, Geneva, Switzerland
| | - Thibault Lepers
- Department of Mental Health and Psychiatry, Geneva University Hospital, Geneva, Switzerland
| | - Francesco Bianchi-Demicheli
- Department of Psychiatry, University of Geneva, Geneva, Switzerland,Department of Mental Health and Psychiatry, Geneva University Hospital, Geneva, Switzerland
| | - Stéphane Rothen
- Department of Psychiatry, University of Geneva, Geneva, Switzerland,Department of Mental Health and Psychiatry, Geneva University Hospital, Geneva, Switzerland
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23
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Pekal J, Laier C, Snagowski J, Stark R, Brand M. Tendencies toward Internet-pornography-use disorder: Differences in men and women regarding attentional biases to pornographic stimuli. J Behav Addict 2018; 7:574-583. [PMID: 30203692 PMCID: PMC6426393 DOI: 10.1556/2006.7.2018.70] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND AND AIMS Several authors consider Internet-pornography-use disorder (IPD) as addictive disorder. One of the mechanisms that has been intensively studied in substance- and non-substance-use disorders is an enhanced attentional bias toward addiction-related cues. Attentional biases are described as cognitive processes of individual's perception affected by the addiction-related cues caused by the conditioned incentive salience of the cue itself. It is assumed in the I-PACE model that in individuals prone to develop IPD symptoms implicit cognitions as well as cue-reactivity and craving arise and increase within the addiction process. METHODS To investigate the role of attentional biases in the development of IPD, we investigated a sample of 174 male and female participants. Attentional bias was measured with the Visual Probe Task, in which participants had to react on arrows appearing after pornographic or neutral pictures. In addition, participants had to indicate their sexual arousal induced by pornographic pictures. Furthermore, tendencies toward IPD were measured using the short-Internetsex Addiction Test. RESULTS The results of this study showed a relationship between attentional bias and symptom severity of IPD partially mediated by indicators for cue-reactivity and craving. While men and women generally differ in reaction times due to pornographic pictures, a moderated regression analysis revealed that attentional biases occur independently of sex in the context of IPD symptoms. DISCUSSION The results support theoretical assumptions of the I-PACE model regarding the incentive salience of addiction-related cues and are consistent with studies addressing cue-reactivity and craving in substance-use disorders.
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Affiliation(s)
- Jaro Pekal
- Department of General Psychology: Cognition and Center for Behavioral Addiction Research (CeBAR), University of Duisburg-Essen, Duisburg, Germany
| | - Christian Laier
- Department of General Psychology: Cognition and Center for Behavioral Addiction Research (CeBAR), University of Duisburg-Essen, Duisburg, Germany
| | - Jan Snagowski
- Department of General Psychology: Cognition and Center for Behavioral Addiction Research (CeBAR), University of Duisburg-Essen, Duisburg, Germany
| | - Rudolf Stark
- Department of Psychology and Systems Neuroscience, Justus Liebig University Giessen, Giessen, Germany,Bender Institute of Neuroimaging, Justus Liebig University Giessen, Giessen, Germany
| | - Matthias Brand
- Department of General Psychology: Cognition and Center for Behavioral Addiction Research (CeBAR), University of Duisburg-Essen, Duisburg, Germany,Erwin L. Hahn Institute for Magnetic Resonance Imaging, Essen, Germany,Corresponding author: Matthias Brand; Department of General Psychology: Cognition and Center for Behavioral Addiction Research (CeBAR), University of Duisburg-Essen, Forsthausweg 2, 47057 Duisburg, Germany; Phone: +49 203 379 2541; Fax: +49 203 379 1846; E-mail:
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Laier C, Wegmann E, Brand M. Personality and Cognition in Gamers: Avoidance Expectancies Mediate the Relationship Between Maladaptive Personality Traits and Symptoms of Internet-Gaming Disorder. Front Psychiatry 2018; 9:304. [PMID: 30042702 PMCID: PMC6048288 DOI: 10.3389/fpsyt.2018.00304] [Citation(s) in RCA: 84] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Accepted: 06/19/2018] [Indexed: 12/03/2022] Open
Abstract
Internet-gaming disorder (IGD) has become a clinically relevant phenomenon worth investigating with respect to its mechanisms of development and maintenance. Considering theoretical models of specific Internet-use disorders, we assumed an interaction of maladaptive personality traits as unspecific predisposing factors and experience-based, gaming-related Internet-use expectancies in predicting symptoms of IGD. Therefore, 103 male and female regular Internet gamers were investigated with questionnaires assessing maladaptive personality traits in accordance to DSM-5, gaming-related positive and avoidance Internet-use expectancies, and symptoms of IGD. The results demonstrated that negative affectivity, detachment, antagonism, disinhibition, psychoticism as well as gaming-related positive and avoidance expectancies were related to symptoms of IGD. Moreover, the relationship between maladaptive personality traits as represented by negative affectivity, detachment, and psychoticism with symptoms of IGD was mediated by avoidance expectancies. Positive gaming-related use expectancies were related to detachment, and were not a significant mediator in the hypothesized model. The findings give reason to assume that maladaptive personality traits in combination with gaming-related positive expectancies and avoidance expectancies are important factors for the development of IGD, but that positive expectancies and avoidance expectancies play a differential role regarding there mediating role between personality characteristics and symptoms of IGD.
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Affiliation(s)
- Christian Laier
- General Psychology, Cognition and Center for Behavioral Addiction Research, Universität Duisburg-Essen, Duisburg, Germany
| | - Elisa Wegmann
- General Psychology, Cognition and Center for Behavioral Addiction Research, Universität Duisburg-Essen, Duisburg, Germany
| | - Matthias Brand
- General Psychology, Cognition and Center for Behavioral Addiction Research, Universität Duisburg-Essen, Duisburg, Germany
- Erwin L. Hahn Institut für Magnetresonanztomographie, Essen, Germany
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Leonhardt ND, Willoughby BJ, Young-Petersen B. Damaged Goods: Perception of Pornography Addiction as a Mediator Between Religiosity and Relationship Anxiety Surrounding Pornography Use. JOURNAL OF SEX RESEARCH 2018; 55:357-368. [PMID: 28287845 DOI: 10.1080/00224499.2017.1295013] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
Recent research on pornography suggests that perception of addiction predicts negative outcomes above and beyond pornography use. Research has also suggested that religious individuals are more likely to perceive themselves to be addicted to pornography, regardless of how often they are actually using pornography. Using a sample of 686 unmarried adults, this study reconciles and expands on previous research by testing perceived addiction to pornography as a mediator between religiosity and relationship anxiety surrounding pornography. Results revealed that pornography use and religiosity were weakly associated with higher relationship anxiety surrounding pornography use, whereas perception of pornography addiction was highly associated with relationship anxiety surrounding pornography use. However, when perception of pornography addiction was inserted as a mediator in a structural equation model, pornography use had a small indirect effect on relationship anxiety surrounding pornography use, and perception of pornography addiction partially mediated the association between religiosity and relationship anxiety surrounding pornography use. By understanding how pornography use, religiosity, and perceived pornography addiction connect to relationship anxiety surrounding pornography use in the early relationship formation stages, we hope to improve the chances of couples successfully addressing the subject of pornography and mitigate difficulties in romantic relationships.
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Wéry A, Deleuze J, Canale N, Billieux J. Emotionally laden impulsivity interacts with affect in predicting addictive use of online sexual activity in men. Compr Psychiatry 2018; 80:192-201. [PMID: 29128857 DOI: 10.1016/j.comppsych.2017.10.004] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2017] [Revised: 09/25/2017] [Accepted: 10/11/2017] [Indexed: 12/13/2022] Open
Abstract
The interest in studying addictive use of online sexual activities (OSA) has grown sharply over the last decade. Despite the burgeoning number of studies conceptualizing the excessive use of OSA as an addictive disorder, few have tested its relations to impulsivity, which is known to constitute a hallmark of addictive behaviors. To address this missing gap in the literature, we tested the relationships between addictive OSA use, impulsivity traits, and affect among a convenience sample of men (N=182; age, M=29.17, SD = 9.34), building upon a theoretically driven model that distinguishes the various facets of impulsivity. Results showed that negative urgency (an impulsivity trait reflecting the tendency to act rashly in negative emotional states) and negative affect interact in predicting addictive OSA use. These results highlight the pivotal role played by negative urgency and negative affect in addictive OSA use, supporting the relevance of psychological interventions that focus on improving emotional regulation (e.g., to reduce negative affect and learn healthier coping strategies) to mitigate excessive use of OSA.
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Affiliation(s)
- Aline Wéry
- Laboratory for Experimental Psychopathology, Psychological Sciences Research Institute, Université catholique de Louvain, Louvain-la-Neuve, Belgium; Internet and Gambling Disorders Clinic, Department of Adult Psychiatry, Cliniques Universitaires Saint-Luc, Brussels, Belgium.
| | - Jory Deleuze
- Laboratory for Experimental Psychopathology, Psychological Sciences Research Institute, Université catholique de Louvain, Louvain-la-Neuve, Belgium
| | - Natale Canale
- Department of Developmental and Social Psychology, University of Padova, Padova, Italy
| | - Joël Billieux
- Laboratory for Experimental Psychopathology, Psychological Sciences Research Institute, Université catholique de Louvain, Louvain-la-Neuve, Belgium; Internet and Gambling Disorders Clinic, Department of Adult Psychiatry, Cliniques Universitaires Saint-Luc, Brussels, Belgium; Addictive and Compulsive Behaviours Lab (ACB-lab), Institute for Health and Behaviour, University of Luxembourg, Esch-sur-Alzette, Luxembourg
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Young KS, Brand M. Merging Theoretical Models and Therapy Approaches in the Context of Internet Gaming Disorder: A Personal Perspective. Front Psychol 2017; 8:1853. [PMID: 29104555 PMCID: PMC5655004 DOI: 10.3389/fpsyg.2017.01853] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2017] [Accepted: 10/04/2017] [Indexed: 01/12/2023] Open
Abstract
Although, it is not yet officially recognized as a clinical entity which is diagnosable, Internet Gaming Disorder (IGD) has been included in section III for further study in the DSM-5 by the American Psychiatric Association (APA, 2013). This is important because there is increasing evidence that people of all ages, in particular teens and young adults, are facing very real and sometimes very severe consequences in daily life resulting from an addictive use of online games. This article summarizes general aspects of IGD including diagnostic criteria and arguments for the classification as an addictive disorder including evidence from neurobiological studies. Based on previous theoretical considerations and empirical findings, this paper examines the use of one recently proposed model, the Interaction of Person-Affect-Cognition-Execution (I-PACE) model, for inspiring future research and for developing new treatment protocols for IGD. The I-PACE model is a theoretical framework that explains symptoms of Internet addiction by looking at interactions between predisposing factors, moderators, and mediators in combination with reduced executive functioning and diminished decision making. Finally, the paper discusses how current treatment protocols focusing on Cognitive-Behavioral Therapy for Internet addiction (CBT-IA) fit with the processes hypothesized in the I-PACE model.
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Affiliation(s)
- Kimberly S Young
- Center for Internet Addiction, Russell J. Jandoli School of Journalism and Mass Communication, St. Bonaventure University, Olean, NY, United States
| | - Matthias Brand
- General Psychology: Cognition and Center for Behavioral Addiction Research, University of Duisburg-Essen, Essen, Germany.,Erwin L. Hahn Institute for Magnetic Resonance Imaging, Essen, Germany
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Nolet K, Larouche Wilson A, Rouleau JL. Using the dual control model to understand problematic sexual behaviors in men. SEXOLOGIES 2017. [DOI: 10.1016/j.sexol.2017.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Nolet K, Larouche Wilson A, Rouleau JL. Le modèle du double contrôle dans la compréhension des comportements sexuels problématiques chez les hommes. SEXOLOGIES 2017. [DOI: 10.1016/j.sexol.2017.09.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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Abstract
With Internet connectivity and technological advancement increasing dramatically in recent years, “Internet addiction” (IA) is emerging as a global concern. However, the use of the term ‘addiction’ has been considered controversial, with debate surfacing as to whether IA merits classification as a psychiatric disorder as its own entity, or whether IA occurs in relation to specific online activities through manifestation of other underlying disorders. Additionally, the changing landscape of Internet mobility and the contextual variations Internet access can hold has further implications towards its conceptualisation and measurement. Without official recognition and agreement on the concept of IA, this can lead to difficulties in efficacy of diagnosis and treatment. This paper therefore provides a critical commentary on the numerous issues of the concept of “Internet addiction”, with implications for the efficacy of its measurement and diagnosticity.
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The role of emotional inhibitory control in specific internet addiction – an fMRI study. Behav Brain Res 2017; 324:1-14. [DOI: 10.1016/j.bbr.2017.01.046] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2016] [Revised: 01/21/2017] [Accepted: 01/27/2017] [Indexed: 01/30/2023]
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Wéry A, Billieux J. Problematic cybersex: Conceptualization, assessment, and treatment. Addict Behav 2017; 64:238-246. [PMID: 26646983 DOI: 10.1016/j.addbeh.2015.11.007] [Citation(s) in RCA: 98] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2015] [Revised: 10/26/2015] [Accepted: 11/18/2015] [Indexed: 01/21/2023]
Abstract
Problematic involvement in cybersex is generally considered to be an excessive and uncontrolled use of online sexual activities associated with tangible negative outcomes and functional impairment. To date, there is no consensus in the literature regarding the conceptualization and labeling of this disorder, or of its diagnosis and assessment (e.g., screening questionnaires and diagnostic criteria). Through a systematic examination of the literature, we emphasize that problematic cybersex is an umbrella construct that regroups various types of distinct dysfunctional online behaviors. Despite a considerable increase in studies on problematic cybersex, no clear diagnostic guidelines exist for clinicians and researchers. Moreover, the factors involved in the development and maintenance of the disorder remain poorly examined, and the evidence regarding valid assessment and treatment are lacking.
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Laier C, Brand M. Mood changes after watching pornography on the Internet are linked to tendencies towards Internet-pornography-viewing disorder. Addict Behav Rep 2016; 5:9-13. [PMID: 29450222 PMCID: PMC5800558 DOI: 10.1016/j.abrep.2016.11.003] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2016] [Revised: 11/28/2016] [Accepted: 11/28/2016] [Indexed: 11/25/2022] Open
Abstract
Internet-pornography-viewing disorder (IPD) is considered one type of Internet-use disorder. For IPD's development, it was assumed theoretically that a dysfunctional use of Internet pornography to cope with depressive mood or stress might be considered to be a risk factor. To address the effect of Internet pornography use on mood, an online study with three measuring points with a sample of male participants was conducted. Participants were investigated regarding their tendencies towards IPD, personal use of Internet pornography, general mood, perceived stress, and their Internet pornography use motivation. Moreover, participants were asked regarding their current mood, sexual arousal, and need to masturbate before and after they watched Internet pornography self-determinedly in a private environment. Data showed that tendencies towards IPD were associated negatively with feeling generally good, awake, and calm and were correlated positively with perceived stress in daily life and using Internet pornography for excitation seeking and emotional avoidance. Self-determined use of Internet pornography in their private environment was accompanied by changes in mood and indicators of sexual arousal. Moreover, tendencies towards IPD were negatively related to mood before and after Internet-pornography use as well as an actual increase of good and calm mood. The results showed effects of watching Internet pornography on mood and sexual arousal which can be considered having reinforcing effects for the user. Thus, the results are in line with theoretical assumptions on IPD's development, in which the positive (and negative) reinforcement received by Internet-pornography use is related to cue-reactivity and craving reactions. Investigation of mood and sexual arousal before and after self-determined Internet pornography use in private environment Watching pornography was associated to changes in mood and indicators of sexual arousal Current mood as well as changes in mood were associated to symptoms of Internet-pornography-viewing-disorder
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Affiliation(s)
- Christian Laier
- General Psychology: Cognition, University of Duisburg-Essen and Center for Behavioral Addiction Research (CeBAR), Germany
- Corresponding author at: General Psychology: Cognition, University of Duisburg-Essen and Center for Behavioral Addiction Research (CeBAR), Forsthausweg 2, 47057 Duisburg, Germany.General Psychology: CognitionUniversity of Duisburg-Essen and Center for Behavioral Addiction Research (CeBAR)Forsthausweg 2Duisburg47057Germany
| | - Matthias Brand
- General Psychology: Cognition, University of Duisburg-Essen and Center for Behavioral Addiction Research (CeBAR), Germany
- Erwin L. Hahn Institute for Magnetic Resonance Imaging, Essen, Germany
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Wéry A, Vogelaere K, Challet-Bouju G, Poudat FX, Caillon J, Lever D, Billieux J, Grall-Bronnec M. Characteristics of self-identified sexual addicts in a behavioral addiction outpatient clinic. J Behav Addict 2016; 5:623-630. [PMID: 27774812 PMCID: PMC5370367 DOI: 10.1556/2006.5.2016.071] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
Background and aims Research on sexual addiction flourished during the last decade, promoted by the development of an increased number of online sexual activities. Despite the accumulation of studies, however, evidence collected in clinical samples of treatment-seeking people remains scarce. The aim of this study was to describe the characteristics (socio-demographics, sexual habits, and comorbidities) of self-identified "sexual addicts." Methods The sample was composed of 72 patients who consulted an outpatient treatment center regarding their sexual behaviors. Data were collected through a combination of structured interviewing and self-report measures. Results Most patients were males (94.4%) aged 20-76 years (mean 40.3 ± 10.9). Endorsement of sexual addiction diagnosis varied from 56.9% to 95.8% depending on the criteria used. The sexual behaviors reported to have the highest degree of functional impairment were having multiple sexual partners (56%), having unprotected sexual intercourse (51.9%), and using cybersex (43.6%). Ninety percent of patients endorsed a comorbid psychiatric diagnosis, and 60.6% presented at least one paraphilia. Conclusions Results showed highly different profiles in terms of sexual preferences and behaviors, as well as comorbidities involved. These findings highlight the need to develop tailored psychotherapeutic interventions by taking into account the complexity and heterogeneity of the disorder.
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Affiliation(s)
- Aline Wéry
- Laboratory for Experimental Psychopathology, Psychological Sciences Research Institute, Université catholique de Louvain, Louvain-la-Neuve, Belgium,Internet and Gambling Disorders Clinic, Department of Adult Psychiatry, Cliniques Universitaires Saint-Luc, Brussels, Belgium,Corresponding authors: Aline Wéry; Laboratory for Experimental Psychopathology, Psychological Sciences Research Institute, Université catholique de Louvain, Place du Cardinal Mercier, 10, B-1348 Louvain-la-Neuve, Belgium; Phone: +32 (0)10 47 45 46; Fax: +32 (0)10 47 37 74; E-mail: ; Marie Grall-Bronnec; CHU de Nantes, Department of Addictology and Psychiatry, Hôpital Saint-Jacques, 85, rue Saint-Jacques, 44093 Nantes cedex 1, France; Phone: +33 (0)2 40 84 61 16; Fax: +33 (0)2 40 84 61 18; E-mail:
| | - Kim Vogelaere
- Laboratory for Experimental Psychopathology, Psychological Sciences Research Institute, Université catholique de Louvain, Louvain-la-Neuve, Belgium
| | - Gaëlle Challet-Bouju
- CHU de Nantes, Clinical Investigation Unit “Behavioral Addictions and Complex Mood Disorders,” Department of Addictology and Psychiatry, Nantes, France,Université de Nantes, EA 4275 SPHERE “MethodS for Patients-centered outcomes and HEalth Research,” Nantes, France
| | - François-Xavier Poudat
- CHU de Nantes, Clinical Investigation Unit “Behavioral Addictions and Complex Mood Disorders,” Department of Addictology and Psychiatry, Nantes, France
| | - Julie Caillon
- CHU de Nantes, Clinical Investigation Unit “Behavioral Addictions and Complex Mood Disorders,” Department of Addictology and Psychiatry, Nantes, France,Université de Nantes, EA 4275 SPHERE “MethodS for Patients-centered outcomes and HEalth Research,” Nantes, France
| | - Delphine Lever
- CHU de Nantes, Clinical Investigation Unit “Behavioral Addictions and Complex Mood Disorders,” Department of Addictology and Psychiatry, Nantes, France
| | - Joël Billieux
- Laboratory for Experimental Psychopathology, Psychological Sciences Research Institute, Université catholique de Louvain, Louvain-la-Neuve, Belgium,Internet and Gambling Disorders Clinic, Department of Adult Psychiatry, Cliniques Universitaires Saint-Luc, Brussels, Belgium
| | - Marie Grall-Bronnec
- CHU de Nantes, Clinical Investigation Unit “Behavioral Addictions and Complex Mood Disorders,” Department of Addictology and Psychiatry, Nantes, France,Université de Nantes, EA 4275 SPHERE “MethodS for Patients-centered outcomes and HEalth Research,” Nantes, France,Corresponding authors: Aline Wéry; Laboratory for Experimental Psychopathology, Psychological Sciences Research Institute, Université catholique de Louvain, Place du Cardinal Mercier, 10, B-1348 Louvain-la-Neuve, Belgium; Phone: +32 (0)10 47 45 46; Fax: +32 (0)10 47 37 74; E-mail: ; Marie Grall-Bronnec; CHU de Nantes, Department of Addictology and Psychiatry, Hôpital Saint-Jacques, 85, rue Saint-Jacques, 44093 Nantes cedex 1, France; Phone: +33 (0)2 40 84 61 16; Fax: +33 (0)2 40 84 61 18; E-mail:
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Wegmann E, Brand M. Internet-Communication Disorder: It's a Matter of Social Aspects, Coping, and Internet-Use Expectancies. Front Psychol 2016; 7:1747. [PMID: 27891107 PMCID: PMC5102883 DOI: 10.3389/fpsyg.2016.01747] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2016] [Accepted: 10/24/2016] [Indexed: 02/04/2023] Open
Abstract
Online communication applications such as Facebook, WhatsApp, and Twitter are some of the most frequently used Internet applications. There is a growing amount of individuals suffering diminished control over their use of online communication applications which leads to diverse negative consequences in offline life. This could be referred to as Internet-communication disorder (ICD). The current study investigates the role of individual characteristics (e.g., psychopathological symptoms, feelings of loneliness) and specific cognitions. In a sample of 485 participants a structural equation model was tested to investigate predictors and mediators which may predict an excessive use. The results emphasize that a higher level of social loneliness and less perceived social support enhance the risk of a pathological use. The effects of psychopathological symptoms (depression and social anxiety) as well as individual characteristics (self-esteem, self-efficacy, and stress vulnerability) on ICD symptoms are mediated by Internet-use expectancies and dysfunctional coping mechanisms. The results illustrate mediation effects which are in line with the theoretical model by Brand et al. (2016). As suggested in the model social aspects seem to be key predictors of ICD symptoms. Further research should investigate convergent and divergent factors of other types of specific Internet-use disorders.
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Affiliation(s)
- Elisa Wegmann
- Department of General Psychology: Cognition and Center for Behavioral Addiction Research (CeBAR), University of Duisburg-Essen Duisburg, Germany
| | - Matthias Brand
- Department of General Psychology: Cognition and Center for Behavioral Addiction Research (CeBAR), University of Duisburg-EssenDuisburg, Germany; Erwin L. Hahn Institute for Magnetic Resonance ImagingEssen, Germany
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Brand M, Young KS, Laier C, Wölfling K, Potenza MN. Integrating psychological and neurobiological considerations regarding the development and maintenance of specific Internet-use disorders: An Interaction of Person-Affect-Cognition-Execution (I-PACE) model. Neurosci Biobehav Rev 2016; 71:252-266. [PMID: 27590829 DOI: 10.1016/j.neubiorev.2016.08.033] [Citation(s) in RCA: 797] [Impact Index Per Article: 99.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2016] [Revised: 08/11/2016] [Accepted: 08/27/2016] [Indexed: 01/16/2023]
Abstract
Within the last two decades, many studies have addressed the clinical phenomenon of Internet-use disorders, with a particular focus on Internet-gaming disorder. Based on previous theoretical considerations and empirical findings, we suggest an Interaction of Person-Affect-Cognition-Execution (I-PACE) model of specific Internet-use disorders. The I-PACE model is a theoretical framework for the processes underlying the development and maintenance of an addictive use of certain Internet applications or sites promoting gaming, gambling, pornography viewing, shopping, or communication. The model is composed as a process model. Specific Internet-use disorders are considered to be the consequence of interactions between predisposing factors, such as neurobiological and psychological constitutions, moderators, such as coping styles and Internet-related cognitive biases, and mediators, such as affective and cognitive responses to situational triggers in combination with reduced executive functioning. Conditioning processes may strengthen these associations within an addiction process. Although the hypotheses regarding the mechanisms underlying the development and maintenance of specific Internet-use disorders, summarized in the I-PACE model, must be further tested empirically, implications for treatment interventions are suggested.
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Affiliation(s)
- Matthias Brand
- General Psychology: Cognition and Center for Behavioral Addiction Research (CeBAR), University of Duisburg-Essen, Germany; Erwin L. Hahn Institute for Magnetic Resonance Imaging, Essen, Germany.
| | - Kimberly S Young
- Center for Internet Addiction, Russell J. Jandoli School of Journalism and Mass Communication, St. Bonaventure University, Olean, USA
| | - Christian Laier
- General Psychology: Cognition and Center for Behavioral Addiction Research (CeBAR), University of Duisburg-Essen, Germany
| | - Klaus Wölfling
- Outpatient Clinic for Behavioral Addiction, Department of Psychosomatic Medicine and Psychotherapy, University Medical Center, Johannes Gutenberg University Mainz, Germany
| | - Marc N Potenza
- Departments of Psychiatry, Neuroscience and Child Study, Yale University School of Medicine, New Haven, USA; National Center on Addiction and Substance Abuse, Yale University School of Medicine, New Haven, USA; Connecticut Mental Health Center, New Haven, USA
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Snagowski J, Laier C, Duka T, Brand M. Subjective Craving for Pornography and Associative Learning Predict Tendencies Towards Cybersex Addiction in a Sample of Regular Cybersex Users. ACTA ACUST UNITED AC 2016. [DOI: 10.1080/10720162.2016.1151390] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Wéry A, Burnay J, Karila L, Billieux J. The Short French Internet Addiction Test Adapted to Online Sexual Activities: Validation and Links With Online Sexual Preferences and Addiction Symptoms. JOURNAL OF SEX RESEARCH 2016; 53:701-710. [PMID: 26422118 DOI: 10.1080/00224499.2015.1051213] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
The goal of this study was to investigate the psychometric properties of a French version of the short Internet Addiction Test adapted to online sexual activities (s-IAT-sex). The French version of the s-IAT-sex was administered to a sample of 401 men. The participants also completed a questionnaire that screened for sexual addiction (PATHOS). The relationships of s-IAT-sex scores with time spent online for online sexual activities (OSAs) and the types of OSAs favored were also considered. Confirmatory analyses supported a two-factor model of s-IAT-sex, corresponding to the factorial structure found in earlier studies that used the short IAT. The first factor regroups loss of control and time management, whereas the second factor regroups craving and social problems. Internal consistency for each factor was evaluated with Cronbach's α coefficient, resulting in .87 for Factor 1, .76 for Factor 2, and .88 for the global scale. Concurrent validity was supported by relationships with symptoms of sexual addiction, types of OSAs practiced, and time spent online for OSAs. The prevalence of sexual addiction (measured by PATHOS) was 28.1% in the current sample of self-selected male OSA users. The French version of the s-IAT-sex presents good psychometric properties and constitutes a useful tool for researchers and practitioners.
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Affiliation(s)
- Aline Wéry
- a Laboratory for Experimental Psychopathology, Psychological Sciences Research Institute , Catholic University of Louvain
| | - Jonathan Burnay
- b Department of Psychology: Cognition and Behavior , University of Liège
| | - Laurent Karila
- c Addiction Research and Treatment Center, Paul Brousse Hospital , Paris Sud-11 University
| | - Joël Billieux
- a Laboratory for Experimental Psychopathology, Psychological Sciences Research Institute , Catholic University of Louvain
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Brand M, Snagowski J, Laier C, Maderwald S. Ventral striatum activity when watching preferred pornographic pictures is correlated with symptoms of Internet pornography addiction. Neuroimage 2016; 129:224-232. [DOI: 10.1016/j.neuroimage.2016.01.033] [Citation(s) in RCA: 131] [Impact Index Per Article: 16.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2015] [Revised: 12/18/2015] [Accepted: 01/12/2016] [Indexed: 12/20/2022] Open
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Klucken T, Wehrum-Osinsky S, Schweckendiek J, Kruse O, Stark R. Altered Appetitive Conditioning and Neural Connectivity in Subjects With Compulsive Sexual Behavior. J Sex Med 2016; 13:627-36. [PMID: 26936075 DOI: 10.1016/j.jsxm.2016.01.013] [Citation(s) in RCA: 64] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2015] [Revised: 01/04/2016] [Accepted: 01/25/2016] [Indexed: 11/25/2022]
Abstract
INTRODUCTION There has been growing interest in a better understanding of the etiology of compulsive sexual behavior (CSB). It is assumed that facilitated appetitive conditioning might be an important mechanism for the development and maintenance of CSB, but no study thus far has investigated these processes. AIM To explore group differences in neural activity associated with appetitive conditioning and connectivity in subjects with CSB and a healthy control group. METHODS Two groups (20 subjects with CSB and 20 controls) were exposed to an appetitive conditioning paradigm during a functional magnetic resonance imaging experiment, in which a neutral stimulus (CS+) predicted visual sexual stimuli and a second stimulus (CS-) did not. MAIN OUTCOME MEASURES Blood oxygen level-dependent responses and psychophysiologic interaction. RESULTS As a main result, we found increased amygdala activity during appetitive conditioning for the CS+ vs the CS- and decreased coupling between the ventral striatum and prefrontal cortex in the CSB vs control group. CONCLUSION The findings show that neural correlates of appetitive conditioning and neural connectivity are altered in patients with CSB. The increased amygdala activation might reflect facilitated conditioning processes in patients with CSB. In addition, the observed decreased coupling could be interpreted as a marker for impaired emotion regulation success in this group.
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Affiliation(s)
- Tim Klucken
- Department of Psychotherapy and Systems Neuroscience, Justus Liebig University Giessen, Germany; Bender Institute of Neuroimaging, Justus Liebig University Giessen, Germany.
| | - Sina Wehrum-Osinsky
- Department of Psychotherapy and Systems Neuroscience, Justus Liebig University Giessen, Germany; Bender Institute of Neuroimaging, Justus Liebig University Giessen, Germany
| | - Jan Schweckendiek
- Department of Psychotherapy and Systems Neuroscience, Justus Liebig University Giessen, Germany; Bender Institute of Neuroimaging, Justus Liebig University Giessen, Germany
| | - Onno Kruse
- Department of Psychotherapy and Systems Neuroscience, Justus Liebig University Giessen, Germany; Bender Institute of Neuroimaging, Justus Liebig University Giessen, Germany
| | - Rudolf Stark
- Department of Psychotherapy and Systems Neuroscience, Justus Liebig University Giessen, Germany; Bender Institute of Neuroimaging, Justus Liebig University Giessen, Germany
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Seok JW, Sohn JH. Neural Substrates of Sexual Desire in Individuals with Problematic Hypersexual Behavior. Front Behav Neurosci 2015; 9:321. [PMID: 26648855 PMCID: PMC4663274 DOI: 10.3389/fnbeh.2015.00321] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2015] [Accepted: 11/10/2015] [Indexed: 11/13/2022] Open
Abstract
Studies on the characteristics of individuals with hypersexual disorder have been accumulating due to increasing concerns about problematic hypersexual behavior (PHB). Currently, relatively little is known about the underlying behavioral and neural mechanisms of sexual desire. Our study aimed to investigate the neural correlates of sexual desire with event-related functional magnetic resonance imaging (fMRI). Twenty-three individuals with PHB and 22 age-matched healthy controls were scanned while they passively viewed sexual and nonsexual stimuli. The subjects' levels of sexual desire were assessed in response to each sexual stimulus. Relative to controls, individuals with PHB experienced more frequent and enhanced sexual desire during exposure to sexual stimuli. Greater activation was observed in the caudate nucleus, inferior parietal lobe, dorsal anterior cingulate gyrus, thalamus, and dorsolateral prefrontal cortex in the PHB group than in the control group. In addition, the hemodynamic patterns in the activated areas differed between the groups. Consistent with the findings of brain imaging studies of substance and behavior addiction, individuals with the behavioral characteristics of PHB and enhanced desire exhibited altered activation in the prefrontal cortex and subcortical regions. In conclusion, our results will help to characterize the behaviors and associated neural mechanisms of individuals with PHB.
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Affiliation(s)
- Ji-Woo Seok
- Department of Psychology, Brain Research Institute, Chungnam National University Daejeon, South Korea
| | - Jin-Hun Sohn
- Department of Psychology, Brain Research Institute, Chungnam National University Daejeon, South Korea
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Trotzke P, Starcke K, Müller A, Brand M. Pathological Buying Online as a Specific Form of Internet Addiction: A Model-Based Experimental Investigation. PLoS One 2015; 10:e0140296. [PMID: 26465593 PMCID: PMC4605699 DOI: 10.1371/journal.pone.0140296] [Citation(s) in RCA: 65] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2015] [Accepted: 09/23/2015] [Indexed: 11/19/2022] Open
Abstract
The study aimed to investigate different factors of vulnerability for pathological buying in the online context and to determine whether online pathological buying has parallels to a specific Internet addiction. According to a model of specific Internet addiction by Brand and colleagues, potential vulnerability factors may consist of a predisposing excitability from shopping and as mediating variable, specific Internet use expectancies. Additionally, in line with models on addiction behavior, cue-induced craving should also constitute an important factor for online pathological buying. The theoretical model was tested in this study by investigating 240 female participants with a cue-reactivity paradigm, which was composed of online shopping pictures, to assess excitability from shopping. Craving (before and after the cue-reactivity paradigm) and online shopping expectancies were measured. The tendency for pathological buying and online pathological buying were screened with the Compulsive Buying Scale (CBS) and the Short Internet Addiction Test modified for shopping (s-IATshopping). The results demonstrated that the relationship between individual's excitability from shopping and online pathological buying tendency was partially mediated by specific Internet use expectancies for online shopping (model's R² = .742, p < .001). Furthermore, craving and online pathological buying tendencies were correlated (r = .556, p < .001), and an increase in craving after the cue presentation was observed solely in individuals scoring high for online pathological buying (t(28) = 2.98, p < .01, d = 0.44). Both screening instruments were correlated (r = .517, p < .001), and diagnostic concordances as well as divergences were indicated by applying the proposed cut-off criteria. In line with the model for specific Internet addiction, the study identified potential vulnerability factors for online pathological buying and suggests potential parallels. The presence of craving in individuals with a propensity for online pathological buying emphasizes that this behavior merits potential consideration within the non-substance/behavioral addictions.
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Affiliation(s)
- Patrick Trotzke
- Department of General Psychology: Cognition, University Duisburg-Essen, Duisburg, Germany
| | - Katrin Starcke
- Department of General Psychology: Cognition, University Duisburg-Essen, Duisburg, Germany
| | - Astrid Müller
- Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, Hannover, Germany
| | - Matthias Brand
- Department of General Psychology: Cognition, University Duisburg-Essen, Duisburg, Germany
- Erwin L. Hahn Institute for Magnetic Resonance Imaging, Essen, Germany
- * E-mail:
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Snagowski J, Wegmann E, Pekal J, Laier C, Brand M. Implicit associations in cybersex addiction: Adaption of an Implicit Association Test with pornographic pictures. Addict Behav 2015; 49:7-12. [PMID: 26026385 DOI: 10.1016/j.addbeh.2015.05.009] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2015] [Revised: 05/06/2015] [Accepted: 05/12/2015] [Indexed: 02/03/2023]
Abstract
Recent studies show similarities between cybersex addiction and substance dependencies and argue to classify cybersex addiction as a behavioral addiction. In substance dependency, implicit associations are known to play a crucial role, and such implicit associations have not been studied in cybersex addiction, so far. In this experimental study, 128 heterosexual male participants completed an Implicit Association Test (IAT; Greenwald, McGhee, & Schwartz, 1998) modified with pornographic pictures. Further, problematic sexual behavior, sensitivity towards sexual excitation, tendencies towards cybersex addiction, and subjective craving due to watching pornographic pictures were assessed. Results show positive relationships between implicit associations of pornographic pictures with positive emotions and tendencies towards cybersex addiction, problematic sexual behavior, sensitivity towards sexual excitation as well as subjective craving. Moreover, a moderated regression analysis revealed that individuals who reported high subjective craving and showed positive implicit associations of pornographic pictures with positive emotions, particularly tended towards cybersex addiction. The findings suggest a potential role of positive implicit associations with pornographic pictures in the development and maintenance of cybersex addiction. Moreover, the results of the current study are comparable to findings from substance dependency research and emphasize analogies between cybersex addiction and substance dependencies or other behavioral addictions.
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Affiliation(s)
- Jan Snagowski
- General Psychology: Cognition, University of Duisburg-Essen, Germany
| | - Elisa Wegmann
- General Psychology: Cognition, University of Duisburg-Essen, Germany
| | - Jaro Pekal
- General Psychology: Cognition, University of Duisburg-Essen, Germany
| | - Christian Laier
- General Psychology: Cognition, University of Duisburg-Essen, Germany
| | - Matthias Brand
- General Psychology: Cognition, University of Duisburg-Essen, Germany; Erwin L. Hahn Institute for Magnetic Resonance Imaging, Essen, Germany.
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Love T, Laier C, Brand M, Hatch L, Hajela R. Neuroscience of Internet Pornography Addiction: A Review and Update. Behav Sci (Basel) 2015; 5:388-433. [PMID: 26393658 PMCID: PMC4600144 DOI: 10.3390/bs5030388] [Citation(s) in RCA: 85] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2015] [Revised: 08/29/2015] [Accepted: 09/08/2015] [Indexed: 02/07/2023] Open
Abstract
Many recognize that several behaviors potentially affecting the reward circuitry in human brains lead to a loss of control and other symptoms of addiction in at least some individuals. Regarding Internet addiction, neuroscientific research supports the assumption that underlying neural processes are similar to substance addiction. The American Psychiatric Association (APA) has recognized one such Internet related behavior, Internet gaming, as a potential addictive disorder warranting further study, in the 2013 revision of their Diagnostic and Statistical Manual. Other Internet related behaviors, e.g., Internet pornography use, were not covered. Within this review, we give a summary of the concepts proposed underlying addiction and give an overview about neuroscientific studies on Internet addiction and Internet gaming disorder. Moreover, we reviewed available neuroscientific literature on Internet pornography addiction and connect the results to the addiction model. The review leads to the conclusion that Internet pornography addiction fits into the addiction framework and shares similar basic mechanisms with substance addiction. Together with studies on Internet addiction and Internet Gaming Disorder we see strong evidence for considering addictive Internet behaviors as behavioral addiction. Future research needs to address whether or not there are specific differences between substance and behavioral addiction.
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Affiliation(s)
- Todd Love
- Society for the Advancement of Sexual Health, Ardmore, PA 19003, USA.
| | - Christian Laier
- Department of General Psychology: Cognition, University of Duisburg-Essen, Duisburg 47057, Germany.
| | - Matthias Brand
- Department of General Psychology: Cognition, University of Duisburg-Essen, Duisburg 47057, Germany.
- Erwin L. Hahn Institute for Magnetic Resonance Imaging, Essen 45141, Germany.
| | - Linda Hatch
- Private Practice, Santa Barbara, CA 93103, USA.
| | - Raju Hajela
- Health Upwardly Mobile Inc., Calgary, AB T2S 0J2, Canada.
- Diagnostic and Descriptive Terminology Action Group (DDTAG), American Society of Addiction Medicine (ASAM), Chevy Chase, MD 93101, USA.
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Laier C, Pekal J, Brand M. Sexual Excitability and Dysfunctional Coping Determine Cybersex Addiction in Homosexual Males. CYBERPSYCHOLOGY BEHAVIOR AND SOCIAL NETWORKING 2015; 18:575-80. [PMID: 26374928 DOI: 10.1089/cyber.2015.0152] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Cybersex addiction (CA) has been mostly investigated in heterosexual males. Recent findings have demonstrated an association between CA severity and indicators of sexual excitability, and that coping by sexual behaviors mediated the relationship between sexual excitability and CA symptoms. The aim of this study was to test this mediation in a sample of homosexual males. Seventy-one homosexual males were surveyed online. Questionnaires assessed symptoms of CA, sensitivity to sexual excitation, pornography use motivation, problematic sexual behavior, psychological symptoms, and sexual behaviors in real life and online. Moreover, participants viewed pornographic videos and indicated their sexual arousal before and after the video presentation. Results showed strong correlations between CA symptoms and indicators of sexual arousal and sexual excitability, coping by sexual behaviors, and psychological symptoms. CA was not associated with offline sexual behaviors and weekly cybersex use time. Coping by sexual behaviors partially mediated the relationship between sexual excitability and CA. The results are comparable with those reported for heterosexual males and females in previous studies and are discussed against the background of theoretical assumptions of CA, which highlight the role of positive and negative reinforcement due to cybersex use.
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Affiliation(s)
- Christian Laier
- 1 Department of General Psychology: Cognition, University of Duisburg-Essen , Duisburg, Germany
| | - Jaro Pekal
- 1 Department of General Psychology: Cognition, University of Duisburg-Essen , Duisburg, Germany
| | - Matthias Brand
- 1 Department of General Psychology: Cognition, University of Duisburg-Essen , Duisburg, Germany .,2 Erwin L. Hahn Institute for Magnetic Resonance Imaging , Essen, Germany
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A Systematic Review of Online Sex Addiction and Clinical Treatments Using CONSORT Evaluation. CURRENT ADDICTION REPORTS 2015. [DOI: 10.1007/s40429-015-0055-x] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Snagowski J, Brand M. Symptoms of cybersex addiction can be linked to both approaching and avoiding pornographic stimuli: results from an analog sample of regular cybersex users. Front Psychol 2015; 6:653. [PMID: 26052292 PMCID: PMC4441125 DOI: 10.3389/fpsyg.2015.00653] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2015] [Accepted: 05/04/2015] [Indexed: 11/17/2022] Open
Abstract
There is no consensus regarding the phenomenology, classification, and diagnostic criteria of cybersex addiction. Some approaches point toward similarities to substance dependencies for which approach/avoidance tendencies are crucial mechanisms. Several researchers have argued that within an addiction-related decision situation, individuals might either show tendencies to approach or avoid addiction-related stimuli. In the current study 123 heterosexual males completed an Approach-Avoidance-Task (AAT; Rinck and Becker, 2007) modified with pornographic pictures. During the AAT participants either had to push pornographic stimuli away or pull them toward themselves with a joystick. Sensitivity toward sexual excitation, problematic sexual behavior, and tendencies toward cybersex addiction were assessed with questionnaires. Results showed that individuals with tendencies toward cybersex addiction tended to either approach or avoid pornographic stimuli. Additionally, moderated regression analyses revealed that individuals with high sexual excitation and problematic sexual behavior who showed high approach/avoidance tendencies, reported higher symptoms of cybersex addiction. Analogous to substance dependencies, results suggest that both approach and avoidance tendencies might play a role in cybersex addiction. Moreover, an interaction with sensitivity toward sexual excitation and problematic sexual behavior could have an accumulating effect on the severity of subjective complaints in everyday life due to cybersex use. The findings provide further empirical evidence for similarities between cybersex addiction and substance dependencies. Such similarities could be retraced to a comparable neural processing of cybersex- and drug-related cues.
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Affiliation(s)
- Jan Snagowski
- Department of General Psychology: Cognition, University of Duisburg-Essen Duisburg, Germany
| | - Matthias Brand
- Department of General Psychology: Cognition, University of Duisburg-Essen Duisburg, Germany ; Erwin L. Hahn Institute for Magnetic Resonance Imaging Essen, Germany
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