Differential patterns of amygdala and ventral striatum activation predict gender-specific changes in sexual risk behavior

Female Affective Perception of Mainstream and Paraphilic Pornography: Associations with Sexual and Psychological Intrapersonal Variables

Understanding affective perceptual processes can further contribute to the explanation of motivation and actions, as well as sexual risk behaviors. Pornography can be considered salient emotional content and is popular, also among females. Yet, the female perspective on pornography has often been overlooked and it remains unclear how individual variables may be associated with the affective perception of pornography and could provide a risk profile. Possible associations between several sexual and psychological intrapersonal variables and the affective perception of various forms of pornography were analyzed from the female perspective. A sample of 231 females (M = 21.87 years; SD = 3.9 years) provided ratings of affective valence, arousal, disgust, and moral and ethical acceptance for mainstream pornographic and paraphilic images of dominance, submission, or sexual violence. Paraphilic pornography was perceived as less pleasant, arousing, and moral and ethically acceptable, but more disgusting compared to mainstream pornography. This was more pronounced among females who had never consumed pornography. Results further suggest that the female affective perception of pornography was associated with the following sexual intrapersonal variables: sexual sensation seeking for physical sensations, erotophilia, lack of sexual control, problematic pornography consumption, and sexual disgust sensitivity. Of the assessed psychological intrapersonal variables, only anxiety was negatively associated with disgust for paraphilic pornography. It is important to further analyze the female affective perception of pornography and associated variables to include them in strategies for prevention and for addressing problematic consequences of the acceptance of specific sexual content and behaviors, especially related to sexualized violence.

Risky decision-making strategies mediate the relationship between amygdala activity and real-world financial savings among individuals from lower income households: A pilot study

Lower financial savings among individuals experiencing adverse social determinants of health (SDoH) increases vulnerabilities during times of crisis. SDoH including low socioeconomic status (low-SES) influence cognitive abilities as well as health and life outcomes that may perpetuate poverty and disparities. Despite evidence suggesting a role for financial growth in minimizing SDoH-related disparities and vulnerabilities, neurobiological mechanisms linked with financial behavior remain to be elucidated. As such, we examined the relationships between brain activity during decision-making (DM), laboratory-based task performance, and money savings behavior. Participants (N = 24, 14 females) from low-SES households (income<$20,000/year) underwent fMRI scanning while performing the Balloon Analogue Risk Task (BART), a DM paradigm probing risky- and strategic-DM processes. Participants also completed self-report instruments characterizing relevant personality characteristics and then engaged in a community outreach financial program where amount of money saved was tracked over a 6-month period. Regarding BART-related brain activity, we observed expected activity in regions implicated in reward and emotional processing including the amygdala. Regarding brain-behavior relationships, we found that laboratory-based BART performance mediated the impact of amygdala activity on real-world behavior. That is, elevated amygdala activity was linked with BART strategic-DM which, in turn, was linked with more money saved after 6 months. In exploratory analyses, this mediation was moderated by emotion-related personality characteristics such that, only individuals reporting lower alexithymia demonstrated a relationship between amygdala activity and savings. These outcomes suggest that DM-related amygdala activity and/or emotion-related personality characteristics may provide utility as an endophenotypic marker of individual's financial savings behavior.

Socio-demographic and social support factors related to substance use in South African in-school adolescents: Insights from the Girls Achieve Power (GAP Year) trial in three peri-urban settings

Background: Substance use is a significant public health problem worldwide, with consequences including violence, risky behaviours, and even death. Substance use amongst adolescents is increasing in South Africa, and limited research on frequency, risk and protective factors means that prevention interventions are difficult to design. This paper aims to describe and discuss factors associated with substance use among school-going adolescents in three peri-urban South African settings.

Methods: A cross-sectional analysis was conducted using baseline data from participants in the Girls Achieve Power (GAP Year) trial. Grade 8 learners (N=2383), aged 11-18, were recruited from 26 lowest quintile public high schools in three townships: Soweto and Thembisa in Gauteng Province, and Khayelitsha in Western Cape Province. A baseline survey gathered demographic and behavioural data. Questions relevant to substance use and social support were used for this analysis. Multivariate logistic regression analyses were conducted to identify factors associated with substance use. The final variables were included in an unadjusted and adjusted logistic regression for current substance use, and a multinomial logistic regression for frequency of substance use.

Results: A total of 22.5% (534) of participants indicated they had ever used substances. Being male was strongly associated with substance use (P<0.001), and less strongly with frequency of substance use. Age significantly predicted substance use, with older adolescents being more likely to engage in substance use (P<0.001); having a parent/guardian employed was negatively associated with substance use (P=0.021). Family-related social support variables were predictive of substance use. Being able to count on friends when things went wrong was predictive of lower frequency of substance use (P=0.019).

Conclusions: These results can inform the targeting of prevention interventions to males and younger learners, as well as ensuring youth interventions build family and peer support to make substance use less likely and less frequent.

An empirical study of affective and cognitive functions in Compulsive Sexual Behavior Disorder

BACKGROUND AND AIMS

Despite the inclusion of the Compulsive Sexual Behavior Disorder (CSBD) in the International Classification of Diseases, very little is known about the underlying affective and cognitive processes. To fill this gap, we compared CSBD subjects and Healthy-Controls (HC) across negative/positive valence, cognitive and sensorimotor systems, as proposed by the Research Domain Criteria framework.

METHODS

74 heterosexual CSBD and 66 matched HC males were studied with 10 questionnaires and 8 behavioral tasks. Analyses were conducted with frequent and Bayesian statistics.

RESULTS

CSBD individuals showed significantly higher (than HC) punishment sensitivity, anxiety, depression, compulsivity, and impulsivity symptoms. Frequentist statistical analysis revealed significant interaction between subject group and condition in Incentive Delay Task, concerning the strength of motivation and hedonic value of erotic rewards. Bayesian analysis produced evidence for the absence of group differences in Facial Discrimination Task, Risk-Ambiguity Task, and Learning Task. Also, Bayesian methods provided evidence for group differences in the Emotional Stroop Task and the Incentive Delay Task. Sexual Discounting Task, Attentional Network Task, and Stop Signal Task produced mixed results.

CONCLUSIONS

Higher punishment sensitivity and impulsivity among CSBD subjects, along with significant interaction between these groups and erotic vs. non-erotic reward processing is in line with previous findings on negative/positive valence alterations in CSBD patients. This result shows that there are similarities to substance and behavioral addictions. The absence of group differences and mixed results related to cognitive and sensorimotor systems raise concerns to what extent CSBD resembles a wide spectrum of impairments observed in disorders, and demand further research.

Prefrontal Executive Control Rescues Risk for Anxiety Associated with High Threat and Low Reward Brain Function

Compared with neural biomarkers of risk for mental illness, little is known about biomarkers of resilience. We explore if greater executive control-related prefrontal activity may function as a resilience biomarker by "rescuing" risk associated with higher threat-related amygdala and lower reward-related ventral striatum activity. Functional MRI was used to assay baseline threat-related amygdala, reward-related ventral striatum, and executive control-related prefrontal activity in 120 young adult volunteers. Participants provided self-reported mood and anxiety ratings at baseline and follow-up. A moderation model revealed a significant three-way interaction wherein higher amygdala and lower ventral striatum activity predicted increases in anxiety in those with average or low but not high prefrontal activity. This effect was specific to anxiety, with the neural biomarkers explaining ~10% of the variance in change over time, above and beyond baseline symptoms, sex, age, IQ, presence or absence of DMS-IV diagnosis, and both early and recent stress. Our findings are consistent with the importance of top-down executive control in adaptive regulation of negative emotions, and highlight a unique combination of neural biomarkers that may identify at-risk individuals for whom the adoption of strategies to improve executive control of negative emotions may prove particularly beneficial.

Women at Greater Sexual Risk for STIs/HIV Have a Lower Mesolimbic and Affective Bias Response to Sexual Stimuli

Young adult women in the United States have high rates of sexually transmitted infections, increasing the risk of human immunodeficiency virus (HIV). The underlying neurobiology of behaviors that increase the probability of contracting sexually-transmitted diseases (STIs) and HIV is just beginning to be explored. The current study assessed the link between sexual risk and the brain and behavioral response to sexual cues in emerging adult women. Our hypothesis was that women with more activity in reward/motivational circuitry would report higher sexual risk behaviors and would evidence higher positive affective bias to visual sexual stimuli. Women (n = 52; age = 18–24 years) who had protected sex 100% of the time (n = 17) vs. those who did not (n = 35), in the past 3 months, were compared on their brain response to 500 ms evocative (sex, aversive, food) vs. neutral cues in a blood-oxygen-level-dependent (BOLD) functional magnetic resonance imaging (fMRI) fast event-related design. Based on existing literature, an a priori anatomical “cue-reactive” mask was used to constrain the analyses. Self-reported sexual activity and the affective bias scores to sexual cues were examined as correlates with the brain response to cues. In contrast to our initial hypothesis, the higher sexual risk (Unprotected) group had significantly less activation in mesolimbic brain regions and lower (less positive) affective bias scores to sexual cues compared to the lower risk (Protected) group. As predicted, the brain response was positively correlated with sexual bias. Follow-up analyses showed an effect of partner “risk” (e.g., more vs. less knowledge of partner’s STIs/HIV status). This evidence suggests that women who have protected sex may view sexual-related stimuli more positively, reflected by a neural response in reward/motivational regions and more positive sexual bias scores. In contrast, young women at increased risk for STIs/HIV may feel more negatively about sexual-related stimuli, evidenced by a lower mesolimbic response and a less positive affective bias to sexual cues. These data may help identify young women who are at greatest risk for acquiring STIs and/or HIV, which carries added importance with the availability of new medications that can prevent HIV.

Sexual risk-taking and subcortical brain volume in adolescence

Background

The developmental period of adolescence marks the initiation of new socioemotional and physical behaviors, including sexual intercourse. However, little is known about neurodevelopmental influences on adolescent sexual decision-making.

Purpose

We sought to determine how subcortical brain volume correlated with condom use, and whether those associations differed by gender and pubertal development.

Methods

We used FreeSurfer to extract subcortical volume among N = 169 sexually experienced youth (mean age 16.07 years; 31.95% female). We conducted multiple linear regressions to examine the relationship between frequency of condom use and subcortical volume, and whether these associations would be moderated by gender and pubertal development.

Results

We found that the relationship between brain volume and condom use was better accounted for by pubertal development than by gender, and moderated the association between limbic brain volume and condom use. No significant relationships were observed in reward areas (e.g., nucleus accumbens) or prefrontal cortical control areas.

Conclusions

These data highlight the potential relevance of subcortical socioemotional processing structures in adolescents' sexual decision-making.

The cognitive aspects of sexual intimacy in dementia patients: a neurophysiological review

Changes in higher-order cognitive behaviors such as reward recognition, salience processing, novelty perception, decision-making, emotional contagion, motivation, and empathy may contribute to intimacy dysfunction. Network circuitry underlying these cognitive functions is often activated in sexually intimate behavior. We propose that sexual dysfunction in AD and bvFTD is more nuanced than is commonly believed, and propose how AD and bvFTD atrophy may correlate neuroanatomically to brain regions and networks that contribute to the higher-order cognitive aspects of intimacy. The characterization of sexual intimacy in dementias must be expanded to meet the needs of our dementia patients and their romantic partners.

Brain Imaging of Human Sexual Response: Recent Developments and Future Directions

PURPOSE OF REVIEW

The purpose of this study is to provide a comprehensive summary of the latest developments in the experimental brain study of human sexuality, focusing on brain connectivity during the sexual response.

RECENT FINDINGS

Stable patterns of brain activation have been established for different phases of the sexual response, especially with regard to the wanting phase, and changes in these patterns can be linked to sexual response variations, including sexual dysfunctions. From this solid basis, connectivity studies of the human sexual response have begun to add a deeper understanding of the brain network function and structure involved.

SUMMARY

The study of "sexual" brain connectivity is still very young. Yet, by approaching the brain as a connected organ, the essence of brain function is captured much more accurately, increasing the likelihood of finding useful biomarkers and targets for intervention in sexual dysfunction.

Heightened activity in social reward networks is associated with adolescents' risky sexual behaviors

Adolescent sexual risk behavior can lead to serious health consequences, yet few investigations have addressed its neurodevelopmental mechanisms. Social neurocircuitry is postulated to underlie the development of risky sexual behavior, and response to social reward may be especially relevant. Typically developing adolescents (N=47; 18M, 29F; 16.3±1.4years; 42.5% sexual intercourse experience) completed a social reward fMRI task and reported their sexual risk behaviors (e.g., lifetime sexual partners) on the Youth Risk Behavior Survey (YRBS). Neural response and functional connectivity to social reward were compared for adolescents with higher- and lower-risk sexual behavior. Adolescents with higher-risk sexual behaviors demonstrated increased activation in the right precuneus and the right temporoparietal junction during receipt of social reward. Adolescents with higher-risk sexual behaviors also demonstrated greater functional connectivity between the precuneus and the temporoparietal junction bilaterally, dorsal medial prefrontal cortex, and left anterior insula/ventrolateral prefrontal cortex. The greater activation and functional connectivity in self-referential, social reward, and affective processing regions among higher sexual risk adolescents underscores the importance of social influence underlying sexual risk behaviors. Furthermore, results suggest an orientation towards and sensitivity to social rewards among youth engaging in higher-risk sexual behavior, perhaps as a consequence of or vulnerability to such behavior.

Reward-Related Ventral Striatum Activity Buffers against the Experience of Depressive Symptoms Associated with Sleep Disturbances

Sleep disturbances represent one risk factor for depression. Reward-related brain function, particularly the activity of the ventral striatum (VS), has been identified as a potential buffer against stress-related depression. We were therefore interested in testing whether reward-related VS activity would moderate the effect of sleep disturbances on depression in a large cohort of young adults. Data were available from 1129 university students (mean age 19.71 ± 1.25 years; 637 women) who completed a reward-related functional MRI task to assay VS activity and provided self-reports of sleep using the Pittsburgh Sleep Quality Index and symptoms of depression using a summation of the General Distress/Depression and Anhedonic Depression subscales of the Mood and Anxiety Symptoms Questionnaire-short form. Analyses revealed that as VS activity increased the association between sleep disturbances and depressive symptoms decreased. The interaction between sleep disturbances and VS activity was robust to the inclusion of sex, age, race/ethnicity, past or present clinical disorder, early and recent life stress, and anxiety symptoms, as well as the interactions between VS activity and early or recent life stress as covariates. We provide initial evidence that high reward-related VS activity may buffer against depressive symptoms associated with poor sleep. Our analyses help advance an emerging literature supporting the importance of individual differences in reward-related brain function as a potential biomarker of relative risk for depression.SIGNIFICANCE STATEMENT Sleep disturbances are a common risk factor for depression. An emerging literature suggests that reward-related activity of the ventral striatum (VS), a brain region critical for motivation and goal-directed behavior, may buffer against the effect of negative experiences on the development of depression. Using data from a large sample of 1129 university students we demonstrate that as reward-related VS activity increases, the link between sleep disturbances and depression decreases. This finding contributes to accumulating research demonstrating that reward-related brain function may be a useful biomarker of relative risk for depression in the context of negative experiences.

A missense polymorphism in the putative pheromone receptor gene VN1R1 is associated with sociosexual behavior

Pheromones regulate social and reproductive behavior in most mammalian species. These effects are mediated by the vomeronasal and main olfactory systems. Effects of putative pheromones on human neuroendocrine activity, brain activity and attractiveness ratings suggest that humans may communicate via similar chemosignaling. Here we studied two samples of younger and older individuals, respectively, with respect to one nonsynonymous polymorphism in the gene encoding the human vomeronasal type-1 receptor 1, VN1R1, and one nonsynonymous polymorphism in the gene encoding the olfactory receptor OR7D4. Participants in both samples had self-reported their sociosexual behavior using the sociosexual orientation inventory, including questions regarding lifetime number of one-night stands, number of partners last year and expected number of partners the coming 5 years. In women, there was a significant association between the VN1R1 polymorphism and sociosexual behavior in both samples, driven specifically by the question regarding one-night stands. Our results support the hypothesis that human social interaction is modulated by communication via chemosignaling.

Adolescent cannabis use and repeated voluntary unprotected sex in women

BACKGROUND AND AIMS

Substance use has been implicated in the onset and maintenance of risky sexual behaviors, which have particularly devastating consequences in young women. This study examined whether (i) adolescent onset of cannabis use is associated with repeated voluntary unprotected sex in women and (ii) whether this association persists after accounting for correlated familial influences.

DESIGN

General population sample of female twins.

SETTING

Midwestern United States.

PARTICIPANTS

A total of 2784 sexually active twin women (15.5% African American) aged 18-27 years (assessed 2002-05), including 119 dizygotic (DZ) and 115 monozygotic (MZ) discordant pairs.

MEASUREMENTS

Self-report interview data on cannabis use that first occurred prior to age 17 (27.1%) and repeated voluntary unprotected sex (27.2%). Key covariates included early onset of regular drinking, regular smoking, sexual debut and menstruation as well as conduct disorder symptoms and childhood sexual abuse.

FINDINGS

Compared with never users and those who started using cannabis at a later age, adolescent cannabis users were more likely to report repeated voluntary unprotected sex [odds ratio (OR) = 2.69; 95% confidence interval (CI) = 2.24-3.22]. Genetic (r_g  = 0.57, 95% CI = 0.38-0.87) and non-shared environmental (r_e  = 0.21, 95% CI = 0.02-0.38) factors contributed to the association. After accounting for correlated familial factors, there was a consistent elevation in the likelihood of repeated voluntary unprotected sex in the exposed twin relative to her genetically identical never/late-onset user co-twin (unadjusted OR = 2.25, 95% CI = 1.14-4.44), even after adjustment for covariates (adjusted OR = 2.27, 95% CI = 1.08-4.80).

CONCLUSIONS

Women who start using cannabis during adolescence appear to be more likely to report voluntary engagement in repeated unprotected sex than women who never use cannabis or who initiate cannabis use after adolescence. The results appear to be independent of shared genetic influences.

An fMRI Study of Responses to Sexual Stimuli as a Function of Gender and Sensation Seeking: A Preliminary Analysis

Although sexual cues produce stronger neural activation in men than in women, mechanisms underlying this differential response are unclear. We examined the relationship of sensation seeking and the brain's response to sexual stimuli across gender in 27 subjects (14 men, M = 25.2 years, SD = 3.6, 85.2% Caucasian) who underwent functional magnetic resonance imaging (fMRI) while viewing sexual and nonsexual images. Whole-brain corrected significant clusters of regional activation were extracted and associated with gender, sensation seeking, and sexual behaviors. Men responded more to sexual than nonsexual images in the anterior cingulate/medial prefrontal cortex (ACC/mPFC), anterior insula/lateral orbitofrontal cortex, bilateral amygdala, and occipital regions. Sensation seeking related positively to ACC/mPFC (r = 0.65, p = 0.01) and left amygdala (r = 0.66, p = 0.01) response in men alone, with both of these correlations being significantly larger in men than in women (ps < 0.03). The relationship between brain responses and self-reported high-risk and low-risk sexual behaviors showed interesting, albeit nonsignificant, gender-specific trends. These findings suggest the relationship between sexual responsivity, sensation seeking, and sexual behavior is gender specific. This study indicates a need to identify the gender-specific mechanisms that underlie sexual responsivity and behaviors. In addition, it demonstrates that the nature of stimuli used to induce positive mood in imaging and other studies should be carefully considered.

Paroxetine Treatment of Problematic Pornography Use: A Case Series

Background How best to conceptualize problematic pornography use (PPU) and intervene most effectively remain debated, with obsessive-compulsive disorder (OCD) and addiction frameworks. We investigated the efficacy of the serotonin-reuptake inhibitor paroxetine in combination with cognitive-behavioral therapy in the treatment of problematic pornography use (PPU). Case presentation Three heterosexual males with PPU were treated with cognitive-behavioral therapy and paroxetine. Frequency of pornography use, other sexual behaviors, and anxiety were assessed during treatment. Discussion Paroxetine treatment, although seemingly initially effective in reducing pornography use and anxiety, appeared related to new compulsive sexual behaviors after 3 months. Conclusions Paroxetine may hold promise for short-term reduction of PPU and related anxiety, but new potentially distressing sexual behaviors may emerge. The cases suggest that PPU may arise from multiple domains. We propose an explanation of the effects based on recent neuroscientific research on sexual behaviors and alcohol use.

Risk Perception and Risk-Taking Behaviour during Adolescence: The Influence of Personality and Gender

This study investigated the influence of personality characteristics and gender on adolescents’ perception of risk and their risk-taking behaviour. Male and female participants (157 females: 116 males, aged 13–20) completed self-report measures on risk perception, risk-taking and personality. Male participants perceived behaviours as less risky, reportedly took more risks, were less sensitive to negative outcomes and less socially anxious than female participants. Path analysis identified a model in which age, behavioural inhibition and impulsiveness directly influenced risk perception, while age, social anxiety, impulsiveness, sensitivity to reward, behavioural inhibition and risk perception itself were directly or indirectly associated with risk-taking behaviour. Age and behavioural inhibition had direct relationships with social anxiety, and reward sensitivity was associated with impulsiveness. The model was representative for the whole sample and male and female groups separately. The observed relationship between age and social anxiety and the influence this may have on risk-taking behaviour could be key for reducing adolescent risk-taking behaviour. Even though adolescents may understand the riskiness of their behaviour and estimate their vulnerability to risk at a similar level to adults, factors such as anxiety regarding social situations, sensitivity to reward and impulsiveness may exert their influence and make these individuals prone to taking risks. If these associations are proven causal, these factors are, and will continue to be, important targets in prevention and intervention efforts.

What Matters: Quantity or Quality of Pornography Use? Psychological and Behavioral Factors of Seeking Treatment for Problematic Pornography Use

INTRODUCTION

Pornography has become popular with Internet technology. For most people, pornography use (PU) is entertainment; for some, it can result in seeking treatment for out-of-control behavior. Previous studies have suggested that PU can influence sexual behaviors, but the direct relation between frequency of PU and treatment-seeking behaviors has not been examined.

AIMS

To investigate whether individuals seeking treatment as a consequence of their problematic PU do so because of their quantity of pornography consumption or because of more complex psychological and behavioral factors related to PU, such as the severity of negative symptoms associated with PU and/or subjective feeling of loss of control over one's behavior.

METHODS

A survey study was conducted of 569 heterosexual Caucasian men 18 to 68 years old, including 132 seeking treatment for problematic PU (referred by psychotherapists after their initial visit).

MAIN OUTCOMES MEASURES

The main outcome measures were self-reported PU, its negative symptoms, and actual treatment-seeking behavior.

RESULTS

We tested models explaining sources of seeking treatment for problematic PU with negative symptoms associated with PU and additional factors (eg, onset and number of years of PU, religiosity, age, dyadic sexual activity, and relationship status). Seeking treatment was significantly, yet weakly, correlated solely with the frequency of PU (r = 0.21, P < .05) and this relation was significantly mediated by negative symptoms associated with PU (strong, nearly full mediation effect size; k(2) = 0.266). The relation between PU and negative symptoms was significant and mediated by self-reported subjective religiosity (weak, partial mediation; k(2) = 0.066) in those not seeking treatment. Onset of PU and age appeared to be insignificant. Our model was fairly fitted (comparative fit index = 0.989; root mean square error of approximation = 0.06; standardized root mean square residual = 0.035) and explained 43% of the variance in treatment-seeking behavior (1% was explained by frequency of PU and 42% was explained by negative symptoms associated with PU).

CONCLUSION

Negative symptoms associated with PU more strongly predict seeking treatment than mere quantity of pornography consumption. Thus, treatment of problematic PU should address qualitative factors, rather than merely mitigating the frequency of the behavior, because frequency of PU might not be a core issue for all patients. Future diagnostic criteria for problematic PU should consider the complexity of this issue.