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Mestre-Bach G, Potenza MN. Current Understanding of Compulsive Sexual Behavior Disorder and Co-occurring Conditions: What Clinicians Should Know about Pharmacological Options. CNS Drugs 2024; 38:255-265. [PMID: 38485889 DOI: 10.1007/s40263-024-01075-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/15/2024] [Indexed: 04/02/2024]
Abstract
Compulsive sexual behavior disorder (CSBD) has recently been recognized as a psychiatric disorder. Pharmacological treatments for CSBD have received little study and thus have limited empirical support. The main objective of the present work is to review existing literature on the efficacy of different drugs on the symptomatology of CSBD, including the subtype of problematic pornography use (PPU). The main pharmacological approaches to treating CSBD have included opioid antagonists (naltrexone and nalmefene), selective serotonin reuptake inhibitors (paroxetine, citalopram, fluoxetine, and sertraline), mood stabilizers (topiramate), tricyclic antidepressants (clomipramine), serotonin antagonist and reuptake inhibitors (nefazodone), and N-acetylcysteine. Since people with CSBD may experience different co-occurring disorders, these should be considered when choosing the best pharmacological treatment. Pharmacological therapy for CSBD/PPU has been suggested as an adjunct to psychological therapies, which, for the moment, have the most empirical evidence. However, to evaluate the efficacy of most of the drugs presented in this narrative review, data to date have only been available from case studies. Thus, empirical support is scant and generalizability of results is limited, highlighting the need for more research in this area.
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Affiliation(s)
- Gemma Mestre-Bach
- Instituto de Investigación, Transferencia e Innovación, Universidad Internacional de La Rioja, La Rioja, Spain
| | - Marc N Potenza
- Department of Psychiatry, Yale University School of Medicine, One Church Street, Rm 726, New Haven, CT, 06510, USA.
- Connecticut Mental Health Center, New Haven, CT, USA.
- Connecticut Council on Problem Gambling, Wethersfield, CT, USA.
- Wu Tsai Institute, Yale University, New Haven, CT, USA.
- Yale Child Study Center, Yale University School of Medicine, New Haven, CT, USA.
- Department of Neuroscience, Yale University School of Medicine, New Haven, CT, USA.
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2
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Taylor K. The social diagnoses of digital addictions: Technophobic ambivalences, the limits of the natural and imperatives of self-governance in the information age. SOCIOLOGY OF HEALTH & ILLNESS 2024; 46:18-36. [PMID: 36762929 DOI: 10.1111/1467-9566.13624] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 01/19/2023] [Indexed: 06/18/2023]
Abstract
The contemporary visibility of 'digital addictions' to online gaming, watching pornography, social media and so on suggests the discovery of some new form of technologically facilitated disease. Yet, what we actually see in the symptoms of these various behaviours when described as 'addictions' are a series of social problems that range from the interpersonal to the sociocultural. In the current article, I work to step outside of the individualising tendency of an addiction taxonomy to instead view digital addictions as a process of social diagnosis. In this way, digital addictions are understood as a reaction to historically and socioculturally informed forces. Specifically, I contend that a social diagnosis of the digital addiction concept tells us a great deal about contemporary cultural anxiety towards the ubiquity of digital media in our social worlds as it rubs up against concerns for productivity, socially lauded ideas of ostensibly 'natural' behaviours and worries about self-governance and self-control. I conclude with a series of pertinent questions about digital technologies, which are elided-if not actively foreclosed-within an addiction framework and which can better be made sense of by understanding digital addictions as a process of social diagnosis rather than the expression of a new kind of Internet borne illness.
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Affiliation(s)
- Kris Taylor
- School of Psychology, The University of Auckland, Auckland, New Zealand
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3
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Roza TH, Noronha LT, Shintani AO, Massuda R, Lobato MIR, Kessler FHP, Passos IC. Treatment Approaches for Problematic Pornography Use: A Systematic Review. ARCHIVES OF SEXUAL BEHAVIOR 2024; 53:645-672. [PMID: 37880509 DOI: 10.1007/s10508-023-02699-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 05/30/2023] [Accepted: 09/06/2023] [Indexed: 10/27/2023]
Abstract
Problematic pornography use (PPU) is an emerging condition associated with several negative psychological and sexual outcomes. This study aimed to systematically review treatment approaches for PPU. Potentially eligible studies were searched for in PubMed/MEDLINE, Embase, PsycINFO, and Web of Science up to April 1, 2023. The quality of the evidence was assessed with the use of the Joanna Briggs Institute's checklists, the Cochrane risk-of-bias tools, and the GRADE approach. A total of 8936 references were retrieved, and 28 studies were included in the systematic review (n = 500 participants). Included studies were case reports (k = 16), case series (k = 1), quasi-experimental investigations (k = 7), and randomized clinical trials (k = 4). The majority of included studies presented overall low quality and significant risk of bias, with all interventions receiving a low or very low rating according to the GRADE approach. Most studies investigated psychological interventions, with the predominance of second and third wave cognitive behavioral therapy interventions. Pharmacological treatments included opioid antagonists (naltrexone in most cases) and antidepressants, while one study investigated a protocol that included rTMS. Several investigations described the combination of psychological and pharmacological approaches. Most studies did not report on side effects, with online and self-help interventions presenting significant issues in terms of treatment adherence. Even though there are promising options that may have efficacy for the treatment of patients with PPU, the literature in the topic still presents significant limitations that compromise the reaching of more definitive conclusions.
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Affiliation(s)
- Thiago Henrique Roza
- Department of Psychiatry, Universidade Federal do Paraná, Rua Padre Camargo, 280, Curitiba, PR, CEP: 80060-240, Brazil.
- Laboratory of Molecular Psychiatry, Centro de Pesquisa Experimental and Centro de Pesquisa Clínica, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil.
- Graduate Program in Psychiatry and Behavioral Sciences, Department of Psychiatry, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil.
| | - Lucas Tavares Noronha
- Laboratory of Molecular Psychiatry, Centro de Pesquisa Experimental and Centro de Pesquisa Clínica, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil
| | - Augusto Ossamu Shintani
- Laboratory of Molecular Psychiatry, Centro de Pesquisa Experimental and Centro de Pesquisa Clínica, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil
- Graduate Program in Psychiatry and Behavioral Sciences, Department of Psychiatry, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Raffael Massuda
- Department of Psychiatry, Universidade Federal do Paraná, Rua Padre Camargo, 280, Curitiba, PR, CEP: 80060-240, Brazil
| | - Maria Inês Rodrigues Lobato
- Graduate Program in Psychiatry and Behavioral Sciences, Department of Psychiatry, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Felix Henrique Paim Kessler
- Graduate Program in Psychiatry and Behavioral Sciences, Department of Psychiatry, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Ives Cavalcante Passos
- Laboratory of Molecular Psychiatry, Centro de Pesquisa Experimental and Centro de Pesquisa Clínica, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil
- Graduate Program in Psychiatry and Behavioral Sciences, Department of Psychiatry, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
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Borgogna NC, Owen T, Johnson D, Kraus SW. No Magic Pill: A Systematic Review of the Pharmacological Treatments for Compulsive Sexual Behavior Disorder. JOURNAL OF SEX RESEARCH 2023:1-14. [PMID: 38047874 DOI: 10.1080/00224499.2023.2282619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/05/2023]
Abstract
Compulsive sexual behavior disorder (CSBD) is a burgeoning diagnostic construct. No systematic reviews of CSBD pharmacotherapy interventions have been conducted. We addressed this gap using a three-aim approach. We reviewed researchers' theoretical arguments for various pharmacotherapies, outcomes from pharmacotherapy trials, and the generalizability of the extant findings. Our review included k = 13 studies, with n = 141 participants. An opioid model of reward seeking was the most popular framework, though inconsistently specified. A serotonin model was also documented, though with few details. Naltrexone was the most prominently examined pharmacotherapy and the only medication that reliably demonstrated a therapeutic effect for some (but not all) indicators compared to placebo. Paroxetine and citalopram were also documented in placebo-controlled trials, though their incremental benefit compared to placebo is suspect. Several additional pharmacotherapies have been documented in case series contexts. Across studies, only one female participant was identified. All trials were conducted in developed nations, and race was rarely assessed. We conclude that the case for pharmacotherapy for CSBD is limited and should preferably not occur outside of clinical trial contexts. Naltrexone offers the best evidence for a potential research program, though new theoretically informed approaches are welcome. Finally, we call for additional pharmacotherapy research in women and non-White populations.
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Affiliation(s)
| | - Tyler Owen
- Department of Psychological Sciences, Texas Tech University
| | - David Johnson
- Department of Psychological Sciences, Texas Tech University
| | - Shane W Kraus
- Department of Psychology, University of Nevada - Las Vegas
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Dell’Osso B, Di Bernardo I, Vismara M, Piccoli E, Giorgetti F, Molteni L, Fineberg NA, Virzì C, Bowden-Jones H, Truzoli R, Viganò C. Managing Problematic Usage of the Internet and Related Disorders in an Era of Diagnostic Transition: An Updated Review. Clin Pract Epidemiol Ment Health 2021; 17:61-74. [PMID: 34497661 PMCID: PMC8386084 DOI: 10.2174/1745017902117010061] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Revised: 03/12/2021] [Accepted: 03/12/2021] [Indexed: 01/28/2023]
Abstract
INTRODUCTION Problematic Usage of the Internet (PUI) refers to a broad and likely heterogeneous group of Internet-related conditions associated with behavioural disturbances and functional impairment. METHODS Within PUI several conditions have been reported, including Gaming Disorder, Shopping Addiction, Cyberchondria, Gambling Disorder, Cyberpornography Addiction and Cyberbullying. While increasing reports in the field try to define the epidemiologic and clinical boundaries of these conditions, the rapid and continuous evolution of Internet related behaviours as well as their problematic/pathological expressions are often difficult to diagnose, assess, approach with treatment interventions and follow-up. RESULTS In addition, some of the PUI-related conditions show characteristics of addiction to the Internet as a preferential tool to engage in specific behaviours, while some others exclusively manifest on the Internet, making it necessary to find distinct assessment and treatment pathways. CONCLUSION The inclusion of Internet Gaming Disorder in Section III by the DSM-5 and the recognition of Gaming Disorder by the ICD-11 opened the way for a systematic clinical investigation of this and other PUI-related conditions, particularly in terms of preventive and therapeutic strategies. The present article is aimed at offering an updated clinical overview on the main expressions of PUI, focussing on the latest acquisitions in this evolving field.
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Affiliation(s)
- Bernardo Dell’Osso
- Department of Psychiatry, University of Milan, Department of Biomedical and Clinical Sciences “Luigi Sacco”, ASST Fatebenefratelli-Sacco, Milan, Italy
- Department of Psychiatry, Bipolar Disorders Clinic, Stanford Medical School, Stanford University, Stanford, CA, USA
- Aldo Ravelli” Center for Neurotechnology and Brain Therapeutic, University of Milan, 20142 Milan, Italy
| | - Ilaria Di Bernardo
- Department of Psychiatry, University of Milan, Department of Biomedical and Clinical Sciences “Luigi Sacco”, ASST Fatebenefratelli-Sacco, Milan, Italy
| | - Matteo Vismara
- Department of Psychiatry, University of Milan, Department of Biomedical and Clinical Sciences “Luigi Sacco”, ASST Fatebenefratelli-Sacco, Milan, Italy
| | - Eleonora Piccoli
- Department of Psychiatry, University of Milan, Department of Biomedical and Clinical Sciences “Luigi Sacco”, ASST Fatebenefratelli-Sacco, Milan, Italy
| | - Federica Giorgetti
- Department of Psychiatry, University of Milan, Department of Biomedical and Clinical Sciences “Luigi Sacco”, ASST Fatebenefratelli-Sacco, Milan, Italy
| | - Laura Molteni
- Department of Psychiatry, University of Milan, Department of Biomedical and Clinical Sciences “Luigi Sacco”, ASST Fatebenefratelli-Sacco, Milan, Italy
| | - Naomi A. Fineberg
- Hertfordshire Partnership University NHS Foundation Trust, Rosanne House, Welwyn Garden City, Hertfordshire AL8 6HG, UK
- Center for Clinical & Health Research Services, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, UK
- School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Calogero Virzì
- Department of Psychiatry, University of Milan, Department of Biomedical and Clinical Sciences “Luigi Sacco”, ASST Fatebenefratelli-Sacco, Milan, Italy
- Department of Clinical and Molecular Biomedicine, Psychiatry Unit, University of Catania, Catania, Italy
| | - Henrietta Bowden-Jones
- Central North West London NHS Trust, Division of Brain Science, Imperial College London, London, UK
| | - Roberto Truzoli
- Department of Psychiatry, University of Milan, Department of Biomedical and Clinical Sciences “Luigi Sacco”, ASST Fatebenefratelli-Sacco, Milan, Italy
| | - Caterina Viganò
- Department of Psychiatry, University of Milan, Department of Biomedical and Clinical Sciences “Luigi Sacco”, ASST Fatebenefratelli-Sacco, Milan, Italy
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Antons S, Brand M, Potenza MN. Neurobiology of cue-reactivity, craving, and inhibitory control in non-substance addictive behaviors. J Neurol Sci 2020; 415:116952. [DOI: 10.1016/j.jns.2020.116952] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Revised: 04/19/2020] [Accepted: 05/26/2020] [Indexed: 12/13/2022]
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Mead D, Sharpe M. Aligning the "Manifesto for a European Research Network into Problematic Usage of the Internet " with the Diverse Needs of the Professional and Consumer Communities Affected by Problematic Usage of Pornography. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E3462. [PMID: 32429206 PMCID: PMC7277927 DOI: 10.3390/ijerph17103462] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/29/2020] [Revised: 05/01/2020] [Accepted: 05/07/2020] [Indexed: 12/24/2022]
Abstract
The Manifesto for a European research network into Problematic Usage of the Internet was published in May 2018. It was written from the perspective of the COST Action Network, a programme of the European Cooperation in Science and Technology CA16207 and is expected to have significant influence on research funding priorities over the next decade. The Manifesto identified nine key research priorities to advance understanding in the field. Our analysis shows that while at the most general level it identified problematic usage of pornography (PUP) as a key research priority, it then barely mentioned it again within the body of the report. This paper uses the Manifesto's framework to suggest research areas into the problematic usage of pornography which are of particular relevance to clinicians and other professionals working in the field who want to develop approaches to assist individuals and target groups affected by PUP. It also looks at potential research opportunities inspired by the lived-experience of users withdrawing from PUP. A large number of opportunities are identified for new work on PUP across all nine key research areas of the Manifesto.
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Affiliation(s)
- Darryl Mead
- The Reward Foundation, The Melting Pot, Edinburgh EH2 2PR, UK;
- Digital Humanities, Information Studies, University College London, London WC1E 6BT, UK
| | - Mary Sharpe
- The Reward Foundation, The Melting Pot, Edinburgh EH2 2PR, UK;
- Lucy Cavendish College, University of Cambridge, Cambridge CB3 0BU, UK
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Nalmefene in the Treatment of Internet Pornography Addiction - A Case Report and Review of Literature. J Addict Med 2020; 14:348-351. [PMID: 31972764 DOI: 10.1097/adm.0000000000000602] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
: The mu-opioid antagonist nalmefene (18 mg per day) was administered in the treatment of a heterosexual male with internet pornography addiction. The patient had no other co-addictions or psychiatric comorbidities, allowing a direct measurement for the effectiveness of nalmefene on internet pornography addiction. Over a period of 72 weeks and an assessment frequency between 1 and 18 weeks, self-monitoring assessments of craving and pornography consumption were collected on different craving and obsessive-compulsive scales. Results indicate that nalmefene impressively decreased addictive symptoms. Importantly, the patient-induced discontinuation of nalmefene led to an immediate increase of craving scores and addictive behavior, which dropped again after restarting the medication. The patient has been in complete remission of symptoms for over a year under our supervision, and for further 2 years after that according to his account. Therefore, nalmefene seems to be a useful adjunction for patients with internet pornography addiction.
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Grover S, Shouan A. Cyberpsychiatric disorders: An overview of assessment and management. JOURNAL OF MENTAL HEALTH AND HUMAN BEHAVIOUR 2020. [DOI: 10.4103/0971-8990.309968] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
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10
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Affiliation(s)
- James Binnie
- Division of Psychology, School of Applied Sciences, London South Bank University, London, UK
| | - Paula Reavey
- Division of Psychology, School of Applied Sciences, London South Bank University, London, UK
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11
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Lee SY, Kim MS, Lee HK. Prevention Strategies and Interventions for Internet Use Disorders Due to Addictive Behaviors Based on an Integrative Conceptual Model. CURRENT ADDICTION REPORTS 2019. [DOI: 10.1007/s40429-019-00265-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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12
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Prevalence, Patterns and Self-Perceived Effects of Pornography Consumption in Polish University Students: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16101861. [PMID: 31137778 PMCID: PMC6571756 DOI: 10.3390/ijerph16101861] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Revised: 05/22/2019] [Accepted: 05/23/2019] [Indexed: 12/16/2022]
Abstract
This cross-sectional online survey of Polish students (n = 6463) assessed the frequency and patterns of pornography consumption, its self-perceived effects, the prevalence of self-perceived pornography addiction, and opinions on the potential effects of pornography and its legal status. Nearly 80% of students have been exposed to pornography (median age of first exposure: 14 years). Streaming videos were decidedly the most frequent form of use. In the subset of current users (n = 4260), daily use and self-perceived addiction was reported by 10.7% and 15.5%, respectively. The majority of those surveyed did not report any negative effects of pornography use on their sexual function, sexual, and relationship satisfaction. Instead, over one-quarter of students in relationships reported beneficial effects on its quality. The most common self-perceived adverse effects of pornography use included: the need for longer stimulation (12.0%) and more sexual stimuli (17.6%) to reach orgasm, and a decrease in sexual satisfaction (24.5%). Females and males with a Body Mass Index >25 kg/m2 more often reported a self-perceived decrease in relationship quality associated with pornography use. Age of first exposure was significantly associated with reported need for longer stimulation and more sexual stimuli to reach orgasm when using pornography, decrease in sexual satisfaction, and quality of romantic relationship, neglect of basic needs and duties due to pornography use, and self-perceived addiction in both females and males. The highest odds ratios were always observed for age <12 years in reference to exposure at >16 years. In the opinion of most of the surveyed students, pornography may have adverse effects on human health, although access restrictions should not be implemented. The study gives a broad insight into the pornography consumption in young Polish adults.
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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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Sniewski L, Farvid P, Carter P. The assessment and treatment of adult heterosexual men with self-perceived problematic pornography use: A review. Addict Behav 2018; 77:217-224. [PMID: 29069616 DOI: 10.1016/j.addbeh.2017.10.010] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2017] [Revised: 08/17/2017] [Accepted: 10/11/2017] [Indexed: 01/27/2023]
Abstract
Self-Perceived Problematic Porn Use (SPPPU) refers to an individual who self-identifies as addicted to porn because they feel they are unable to regulate their porn consumption, and that use interferes with everyday life. Although porn addiction has not been formally classified as its own distinct behavioral addiction, therapists and clinicians are advised to educate themselves on the current state of literature pertaining to pornography consumption given the widespread availability and consumption of sexually explicit material online. This review article begins with a general overview of pornography and porn use so that therapists and researchers can discern between non-intrusive and problematic pornography consumption patterns within their practice and understand the common characteristics of those that most commonly present with SPPPU. Thereafter, an overview and examination of therapeutic interventions for SPPPU will be identified and analysed. Finally, the review concludes with recommendations for therapists, clinicians, and future research.
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Worley J. The Role of Pleasure Neurobiology and Dopamine in Mental Health Disorders. J Psychosoc Nurs Ment Health Serv 2017; 55:17-21. [PMID: 28850647 DOI: 10.3928/02793695-20170818-09] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Recent evidence and research has demonstrated that the pleasure response and associated neurotransmitters and brain circuits play a significant role in substance use disorders (SUDs). It was thought that negative behaviors associated with SUDs resulted from negative choices, but it is now known that chemical changes in the brain drive those behaviors. Several mental health disorders (e.g., eating disorders, non-suicidal self-injury, compulsive sex behaviors, internet gaming, gambling) are also thought to involve those same pleasure responses, neurotransmitters, and brain regions. Studies have shown that the use of naltrexone, a dopamine antagonist, can reduce symptoms of these disorders. It is important for nurses to understand the underlying physiology of mental health disorders that are thought to have an addictive or craving component. This understanding can help reduce stigma. Educating patients about likely neurobiological causes for their disorders can also help reduce guilt and shame. Nurses should educate patients about these disorders and evidence-based treatments, including off-label use of naltrexone. [Journal of Psychosocial Nursing and Mental Health Services, 55(9), 17-21.].
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