Does "forced abstinence" from gaming lead to pornography use? Insight from the April 2018 crash of Fortnite's servers

How adolescents lose control over social networks: A process-based approach to problematic social network use

Social networks (SNs) are immensely popular, especially among teenagers, yet our understanding of problematic SNs remains limited. Understanding motivations and patterns of use is crucial given the current prevalence of problematic SNs use. Perarles et al. (2020) distinguish two behavioral control modes: Model-Free Control, where actions are characterized by actions driven by immediate gratification without reflective consideration for long-term consequences, and Model-Based Control, enabling planned and goal-directed actions. Both control modes can lead to problematic social network use. This study aims to delve into problematic SNs use and the underlying motives behind adolescents' participation in SNs, drawing upon the theoretical proposal by Perales et al. (2020). We conducted four focus groups with adolescents aged 13-17 (50 % female; Mage = 14.5, SD = 1.75), comprising two public school and two Catholic private school groups. Thematic analysis using Atlas.ti software revealed three themes. The first uncovers characteristics of problematic SNs use, including withdrawal, increased usage time, impaired control, behavioral salience and attentional capture and cognitive hijacking. The second spotlights motives, emphasizing emotional regulation, finding out what is going on, and social interaction. The third theme explores consequences such as compromised academic performance and physical harm. In conclusion, addressing both motives and problematic behaviors present a more effective approach to confronting SNs use challenges and fostering healthier online experiences for adolescents.

Withdrawal-like Symptoms in Problematic Pornography Use: A Scoping Review

OBJECTIVES

There is still debate whether problematic pornography use (PPU) can be understood as an addictive disorder, and little is known about withdrawal-like symptoms in these patients. Therefore, our aim was to summarize the existing scientific literature about this topic in the format of a scoping review.

METHODS

Potentially eligible references were retrieved from 6 databases (MEDLINE/PubMed, Web of Science, Embase, PsycINFO, LILACS, and SciELO) up to February 7, 2023. Studies were included if they reported original data about withdrawal-like symptoms in individuals with PPU. Studies investigating child pornography use, or in which it was not possible to extract data of interest were excluded. Data extracted from included studies and their quality assessment were described narratively.

RESULTS

A total of 937 references were retrieved, and 14 studies were included (n = 31,009 participants). According to our results, cravings were intense in most cases and frequent reasons for relapse. The proportion of participants experiencing other withdrawal-like symptoms (mental, sexual, and physical symptoms) reached up to 72.2% in the cross-sectional studies with this information available. Severity of withdrawal symptoms was associated with severity of PPU and frequency of pornography use. In some studies, measures of withdrawal symptoms were considered central symptoms of PPU and were significantly higher in individuals considering treatment. Masturbation was reported to alleviate withdrawal-like symptoms in some cases.

CONCLUSIONS

There is preliminary evidence for the existence of withdrawal-like symptoms in PPU. Future studies should investigate onset, characteristics, duration, and proportion of withdrawal-like symptoms in PPU with robust methodology, also investigating potential confounding variables.

Validation of the Thai Assessment of Criteria for Specific Internet-use Disorders (ACSID-11) among young adults

BACKGROUND

The Assessment of Criteria for Specific Internet-use Disorders (ACSID-11) is a consistent and comprehensive instrument to assess symptoms of specific internet-use disorders including those related to gaming, shopping, pornography use disorder, social networks use and gambling considering criteria in the eleventh revision of the International Classification of Diseases (ICD-11). However, to date, there is little evidence supporting instruments assessing major types of specific internet use disorders in Thailand. The aim of this present study was to assess the psychometric properties of the ACSID-11 among Thai young adults.

METHODS

A total of 612 participants were recruited. A confirmatory factor analysis (CFA) examined construct validity of the ACSID-11. Cronbach's α and McDonald's ω were used to assess reliability of the ACSID-11. Pearson correlations examined relationships between ACSID-11 domains and Internet Gaming Disorder Scale-Short Form (IGDS9-SF) scores.

RESULTS

The CFA supported validity of the Thai version of the ACSID-11 and a four-factor structure. Specific domains of the Thai ACSID-11, particularly gaming, were positively and significantly correlated with IGDS9-SF scores.

CONCLUSIONS

Data indicate that the Thai version of the ACSID-11 is a valid and reliable instrument to assess major types of specific internet use disorders. Additional studies are needed to further examine the validity and reliability of the Thai ACSID-11.

Engineered highs: Reward variability and frequency as potential prerequisites of behavioural addiction

Influential learning-based accounts of substance addictions posit the attribution of incentive salience to drug-associated cues, and its escalation by the direct dopaminergic effects of drugs. In translating this account to disordered gambling, we have noted how the intermittent nature of monetary rewards in gambling (i.e. the variable ratio) may allow for analogous learning processes, via effects on dopaminergic signalling. The aim of the present article is to consider how multiple sources of reward variability operate within modern gambling products, and how similar sources of variability, as well as some novel sources of variability, also apply to other digital products implicated in behavioural addictions, including gaming, shopping, social media and online pornography. Online access to these activities facilitates not only unparalleled accessibility but also introduces novel forms of reward variability, as seen in the effects of infinite scrolls and personalized recommendations. We use the term uncertainty to refer to the subjective experience of reward variability. We further highlight two psychological factors that appear to moderate the effects of uncertainty: 1) the timecourse of uncertainty, especially with regard to its resolution, 2) the frequency of exposure, allowing temporal compression. Collectively, the evidence illustrates how qualitative and quantitative variability of reward can confer addictive potential to non-drug reinforcers by exploiting the psychological and neural processes that rely on predictability to guide reward seeking behaviour.

[Behavioral (non-chemical) addictions and COVID-19]

The review examines the impact of the COVID-19 pandemic on the prevalence, manifestation, as well as the possibility of preventing and treating behavioral (non-chemical) addictions. Particular attention is paid to various manifestations of Internet addiction (IA): gaming, gambling, cybersexual and food addiction (FA). During the pandemic, Internet use increased significantly, leading to an increase in IA, mainly due to gaming, which correlated with the level of psychosocial problems. The increase in gambling occurred mainly in individuals with addiction or risk groups, while in the population the frequency of gambling decreased or did not change. Immediately after the start of the COVID-19 pandemic, the number of requests to porn sites increased dramatically, suggesting an increase in cybersex addiction. However, longitudinal studies in adolescents show a slight decrease in the interest in pornography in boys, and an increase from an initially low level in girls. The proportion of eating disorders and FA significantly increased. An increase in FA was associated with depression, anxiety, and also in obese individuals. In the era of COVID-19 prevention practices and general remedial activity should take into account the needs of the general population, emphasizing the importance of self-regulating and balanced lifestyles with moderate and sensible Internet use during the pandemic.

Impact of COVID-19 on pornography use: Evidence from big data analyses

INTRODUCTION

Coronavirus disease 2019 (COVID-19) has led to radical changes in social distancing awareness and affected social relationships. Owing to large-scale lockdown, home quarantine and social distancing requirements, it was anticipated that sexual activities would be severely impacted. However, retrospective self-report studies showed that pornography use and autoerotism increased during the pandemic.

AIM

This study used big-data databases available on the Internet to investigate factors that modulated pornography use during the pandemic.

METHODS

Daily relative search volume (RSV) data from Google Trends for the period from 24 February 2020 to 13 July 2020 were extracted. Pornhub traffic data were extracted from the Pornhub Insights website, for the period from 24 February 2020 to 13 July 2020. The parameter was defined as 'percent change in traffic compared to an average day in 2019'. The number of daily new cases of COVID-19 was extracted from the database on Our World in Data.

OUTCOME MEASURES

The normality of the data was examined using the Shapiro-Wilk test. All variables included in this study were non-normally distributed. Therefore, non-parametric tests or parametric tests with bootstrapping were adopted where appropriate.

RESULTS

According to Google Trends, the RSV for 'pornography' increased after late March 2020, which is close to the date when the World Health Organization declared COVID-19 a global pandemic. The number of daily new cases of COVID-19 was positively correlated with the traffic of Pornhub, a popular pornography website, and the RSV for 'pornography'. Moderation analysis demonstrated a significant main effect of daily new cases of COVID-19 and the RSV for 'social distancing' in predicting Pornhub traffic/RSV for 'pornography'. Furthermore, the RSV for 'social distancing' significantly moderated the relationship between daily new cases and Pornhub traffic/RSV for 'pornography'. A stronger COVID-pornography use association was observed with increased social distancing awareness.

CONCLUSION

Increased pornography consumption during the pandemic was observed, and it was associated with the severity of the pandemic. Social distancing awareness could be a key factor influencing interest in and use of pornography. Further studies on the changes in sexual desire and birth-rate control are worthwhile because long-term public health may be affected by the changes in sexual behaviour during the pandemic.

Internet and Pornography Use During the COVID-19 Pandemic: Presumed Impact and What Can Be Done

The COVID-19 pandemic continues to cause an immense psychosocial strain worldwide. Excessive use of the internet during these psychologically trying times, fueled by physical isolation as a result of lockdowns, has translated into dysfunctional behaviors. A growing body of evidence suggests an unprecedented increase in internet use and consumption of online pornography during the pandemic, and possibly even directly caused by it. In this review, the authors report data from relevant sources to show the rise in pornography use during lockdowns in different countries worldwide. In addition to a brief overview of the neurobiology of internet addiction broadly and problematic online pornography use specifically, similarities with substance use disorders are explained. Further, the current status of the debate about defining diagnostic criteria is discussed. Finally, the review sheds light on the potential detrimental outcomes during the future post-pandemic "re-adaptation," while simultaneously offering preventative and management strategies for harm reduction. The authors conclude that foresightedness with utilizing existing tools and therapies and exercising appropriate amounts of caution could go a long way in addressing the challenges that lie ahead in the post-pandemic era.

Substitute Addictions in Persons with Substance Use Disorders: A Scoping Review

Substitute addictions, addictive behaviors that sequentially replace each other's functions, have implications for recovery trajectories but remain poorly understood. We sought to scope the extent, range, and characteristics of research on substitute addictions in persons with substance use disorders. Method: Using Arksey and O'Malley's framework for scoping reviews, a systematic search was conducted to identify publications that referenced substitute addictions up to April 2018. Study characteristics were extracted and summarized to provide an overview of the extant literature. Results: The 63 included studies show that substitute addictions are terminologically and conceptually ambiguous. Much of the available literature is concentrated in developed contexts - and in particular the United States of America. While presentations varied, at least two sub-types of substitute addictions appeared: long-term replacement and temporary replacement. Existing theories suggest a multifactorial etiology. Conclusions: The findings suggest a strong need for: increased awareness of substitute addictions and its potential consequences for recovery; interventions that structure prevention and pre-, during-, and post-treatment interactions as well as future research to explore its nature and dynamics drawing on multiple methods.

The impact of COVID-19 pandemic on pornography habits: a global analysis of Google Trends

As the COVID-19 spread globally, social distancing, self-isolation/quarantine, and national lockdowns have become crucial to control the pandemic. However, these measures may also lead to increases in social isolation, loneliness, and stress, which can alter the consumption of pornography habits. The aim of the study was thus to explore the interest pattern in pornography and coronavirus-themed pornography during the COVID-19 outbreak. Google Trends® was employed to determine the most popular porn websites (Porn, XNXX, PornHub, xVideos, and xHamster), and coronavirus-themed pornography worldwide and in six nations with different COVID-19 outbreak and self-isolation recommendations. We analyzed every search trend on Google® from January 9, 2020 to May 25, 2020 using “joint point regression analysis”. Comparisons of week relative search volume (WRSV) and temporal patterns were analyzed to assess the change of interest in search terms during nations lockdowns. Paired t-test was used to compare WRSV values among the porn websites during the national lockdowns and the equivalent timespan of the weeks in the previous 4 years. The research trend of almost every keyword increased with significant inflection points for those nations with a straight “stay at home orders” (China, Italy, Spain, and France). “PornHub” and “Porn” showed the highest increase of interest worldwide with an average weekend percentage change (AWPC) of 4.9 and 3.8, respectively. The mean WRSV for keywords in USA and Sweden did not show a similar increase as the other nations. The WRSV percentage change with the historical data had a peak during the straight nations’ lockdowns (p < 0.01). All the nations had a significant increase in WRSV coronavirus-themed pornography for each keyword (p < 0.01) with an AWPC, ranging worldwide between 18.5 and 61.8 (p < 0.01), after the beginning of self-quarantine. As strengths this study uses a big data technology to collect worldwide trend of interest, however, data are anonymous and do not allow analysis of subpopulation groups. In conclusion, we demonstrated an increased interest in pornography and coronavirus-themed pornography after the outbreak of COVID-19 in nations with a straight “stay at home orders”.

Substitute addictions in the context of the COVID-19 pandemic

The global spread of COVID-19, subsequent stay-at-home requirements, spatial distancing measures, and long-term isolation present additional challenges for persons in recovery. Using an illustrative case from South Africa, we discuss COVID-19 related pornography use through the lens of relapse and substitute addiction. South Africa is the epicenter of the pandemic in Africa, and has issued an alcohol and cigarette ban. Historical examples suggest that responses to forced abstinence may include compliance and abstinence, but also seeking alternatives to the original addiction and substitution. Substitution of alternative activities/objects may provide similar appetitive effects to fill the void of the terminated addictive behavior, temporarily or in the long-term. While substitutes do not necessarily portend a relapse, coupled with isolation and reduced recovery support, they can potentiate relapse to the former or 'new' addictive behavior. Addiction professionals should be aware of the potential for such negative impacts during and after the COVID-19 pandemic.

Pornography use in the setting of the COVID-19 pandemic

With the global expansion of the COVID-19 pandemic, social or physical distancing, quarantines, and lockdowns have become more prevalent. Concurrently, Pornhub, one of the largest pornography sites, has reported increased pornography use in multiple countries, with global traffic increasing over 11% from late February to March 17, 2020. While some substantial increases have coincided with Pornhub making its premium services free to countries in lockdowned or quarantined jurisdictions, countries without such free premium access have also reported increases in the range of 4-24%. In addition, pornography searches using the terms "coronavirus", "corona", and "covid" have reached more than 9.1 million. In this letter, we discuss COVID-19-related pornography-use patterns and the impact they may have with respect to problematic pornography use.

High-Frequency Pornography Use May Not Always Be Problematic

BACKGROUND

Previously, variable-centered analytic approaches showed positive, weak-to-moderate associations between frequency of pornography use (FPU) and problematic pornography use (PPU). However, person-centered studies are sparse in the literature, and these could provide insight into whether there are individuals who use pornography frequently and do not experience problems or whether there are individuals with comparable high-frequency use who differ on reported experiencing of negative consequences.

AIM

The aims of the present study were (i) to identify profiles of pornography use based on FPU and PPU by applying a person-centered analytic approach and (ii) to examine whether the identified profiles could be distinguished based on theoretically relevant demographic and psychological constructs.

METHODS

Latent profile analyses were conducted on 3 nonclinical samples recruited from general websites and a pornography site (study 1: N = 14,006; study 2: N = 483; study 3: N = 672).

RESULTS

Results were consistent across all studies. 3 distinct pornography-use profiles emerged: nonproblematic low-frequency pornography use (68-73% of individuals), nonproblematic high-frequency pornography use (19-29% of individuals), and problematic high-frequency use (3-8% of individuals). Nonproblematic and problematic high-frequency-use groups showed differences in several constructs (ie, hypersexuality, depressive symptoms, boredom susceptibility, self-esteem, uncomfortable feelings regarding pornography, and basic psychological needs).

CLINICAL TRANSLATION

FPU should not be considered as a sufficient or reliable indicator of PPU because the number of people with nonproblematic high-frequency use was 3-6 times higher than that with problematic high-frequency use. These results suggest that individuals with PPU use pornography frequently; however, FPU may not always be problematic.

STRENGTHS & LIMITATIONS

Self-report cross-sectional methods have possible biases that should be considered when interpreting findings (eg, underreporting or overreporting). However, the present research included 3 studies and involved large community samples and visitors of a pornography website. The present study is the first that empirically investigated pornography-use profiles with a wide range of correlates using both severity of PPU and FPU as profile indicators on specific and general samples.

CONCLUSION

The present study is a first step in the differentiated examination of pornography-use profiles, taking into consideration both PPU and FPU, and it provides a foundation for further clinical and large-scale studies. Different psychological mechanisms may underlie the development and maintenance of FPU with or without PPU, suggesting different treatment approaches. Therefore, the present results may guide clinical work when considering reasons for seeking treatment for PPU. Bőthe B, Tóth-Király I, Potenza MN, et al. High-Frequency Pornography Use May Not Always Be Problematic. J Sex Med 2020;17:793-811.

Relationships among impulsive, addictive and sexual tendencies and behaviours: a systematic review of experimental and prospective studies in humans

Impulsivity's relationships to addictive and sexual behaviours raise questions regarding the extent impulsivity may constitute a vulnerability factor for subsequent addictive and sexual behaviours and/or results from each of these. Here, we systematically reviewed empirical support for impulsivity as a precipitating factor or a consequence of addictive or sexual behaviours. We restricted ourselves to recent, human studies with assessments over time, including at least one measure of impulsivity, addictive and sexual behaviours, yielding a review including 29 published reports from 28 studies. Findings point to generalized, self-reported impulsivity as a predictor of addictive and sexual behaviours at a wide range of severity, with elements of both impulsivity and compulsivity to these acts. Alcohol consumption often increases impulsive behaviour, including inclinations towards impulsive and potentially compulsive sexual acts. Research using the Sexual Delay Discounting Task has yielded findings linking impulsivity, addictive and sexual behaviour and as such is a valuable research tool that should be used more extensively. The present review identified gaps to be addressed in further research that concurrently examines facets of impulsivity, addictive and sexual behaviours, especially because criteria for compulsive sexual behaviour disorder have been included in the eleventh edition of the International Classification of Diseases. This article is part of the theme issue 'Risk taking and impulsive behaviour: fundamental discoveries, theoretical perspectives and clinical implications'.

Learning to lose control: A process-based account of behavioral addiction

Learning psycho(bio)logy has developed a solid corpus of evidence and theory regarding behavior control modes. The present article briefly reviews that literature and its influence on recent models in which the transition from goal-directed to compulsive behavior is identified as the main process underlying substance use disorders. This literature is also relevant to non-substance addictive disorders, and serves as basis to propose a restricted definition of behavioral addiction relying on the presence of behavior-specific compulsivity. Complementarily, we consider whether some activities can become disordered while remaining mostly goal-driven. Based on reinforcement learning models, relative outcome utility computation is proposed as an alternative mechanism through which dysfunctional behaviors (even not qualifying as addictive) can override adaptive ones, causing functional impairment. Beyond issues of conceptual delimitation, recommendations are made regarding the importance of identifying individual etiological pathways to dysregulated behavior, the necessity of accurately profiling at-risk individuals, and the potential hazards of symptom-based diagnosis. In our view, the validity of these recommendations does not depend on the position one takes in the nosological debate.

Diagnostic and Classification Considerations Regarding Gaming Disorder: Neurocognitive and Neurobiological Features

Video gaming and Internet use have become a part of the everyday lives of many individuals, especially during adolescence. Given the health concerns related to problematic gaming behaviors, gaming disorder (GD) has been included in the version of the 11th edition of The International Classification of Diseases (ICD-11) ratified by the secretariat of the World Health Organization. Given these considerations and others (including debate regarding the most appropriate classification of GD and how best to prevent and treat the condition), there is a need for further research into GD. Specifically, we suggest that researching intermediate phenotypes focusing on cognitive and neurobiological function may help clarify GD's relationships to other addictive disorders and more accurately define their relationships with core and associated features of GD. Overlaps in neural activity, cognitive functioning, and other features suggest that GD shares similarities with gambling and substance-use disorders and may best be classified as an addictive disorder. Individuals with GD differ from those with regular game use (RGU) on neurocognitive levels. However, concerns have been raised with respect to the differences between GD and substance-use disorders in certain dimensional features, such as tolerance. Additionally, it has been argued that differences between GD and RGU may not be fully captured by nomenclature systems like the ICD-11. Nonetheless, individuals seek treatment for help with GD, despite the limited data available for effective treatments. As more data are gathered from investigations of GD, they should be translated into refining criteria for GD and optimizing interventions.