Sexual incentive delay in the scanner: Sexual cue and reward processing, and links to problematic porn consumption and sexual motivation

Abstract

Background and aimsThe use of pornography, while unproblematic for the majority, can grow into addiction-like behavior which in its extreme form is labeled as compulsive sexual behavioral disorder in the ICD-11 (WHO, 2018). The aim of this study was to investigate the addiction-specific reactivity to cues in order to better understand underlying mechanisms in the development of this disorder.MethodsWe have used an optimized Sexual Incentive Delay Task to study brain activity in reward associated brain areas during an anticipation phase (with cues predicting pornographic videos, control videos or no videos) and a corresponding delivery phase in healthy men. Correlations to indicators of problematic pornography use, the time spent on pornography use, and trait sexual motivation were analyzed.ResultsThe results of 74 men showed that reward-related brain areas (amygdala, dorsal cingulate cortex, orbitofrontal cortex, nucleus accumbens, thalamus, putamen, caudate nucleus, and insula) were significantly more activated by both the pornographic videos and the pornographic cues than by control videos and control cues, respectively. However, we found no relationship between these activations and indicators of problematic pornography use, time spent on pornography use, or with trait sexual motivation.Discussion and conclusionsThe activity in reward-related brain areas to both visual sexual stimuli as well as cues indicates that optimization of the Sexual Incentive Delay Task was successful. Presumably, associations between reward-related brain activity and indicators for problematic or pathological pornography use might only occur in samples with increased levels and not in a rather healthy sample used in the present study.

Emerging experience with selected new categories in the ICD‐11: complex PTSD, prolonged grief disorder, gaming disorder, and compulsive sexual behaviour disorder

“…Since the inclusion of compulsive sexual behaviour disorder in the ICD‐11 was proposed, there has been a major expansion of research in this area 227 . A good deal of the early research was based on a conceptualization of “sex addiction” 242 , that later began to shift to a discussion of compulsive sexual behaviour, that does not entirely map to ICD‐11 compulsive sexual behaviour disorder 291,258‐297 , or simply “problematic sexual behaviours” 298 or “problematic pornography use” 299 . A good deal of the research in the past several years has focused on “hypersexuality” e.g., 301,302 , although this has only occasionally been operationalized as hypersexual disorder as it had been proposed for DSM‐5.…”

Systematic Review: Neurological Effects of Online Porn Consumption

“…., 2016;LEE et al, 2015;KUHN, GALLINAT., 2014;COSTUMERO et al, 2013;HUYNH et al, 2012;KARAMA et al, 2002;REDOUTÉ et al, 2000). During visual sexual stimulation, activation of the hypothalamus was observed in men (MARKERT et al, 2021;LEE et al, 2015;WEHRUM-OSINSKY et al, 2014;KARAMA et al, 2002), greater activation of the nucleus accumbens (MARKERT et al, 2021;KLEIN et al, 2020;WEHRUM-OSINSKY et al, 2014;COSTUMERO et al, 2013), increased amygdala activation (MARKERT et al, 2021;CERA et al, 2020;KARAMA et al, 2002) and also increased insular activity (MARKERT et al, 2021;CERA et al, 2020;PONSETI et al, 2009;KARAMA et al, 2002).…”

“…The chosen studies involved individuals aged between 18 and 49 years, with sample sizes ranging from 9 to 156 participants, and only 4 included women (LEE et al 2015;WEHRUM-OSINSKY et al, 2014;HUYNH et al, 2012;KARAMA et al, 2002). Most studies were developed in Europe (MARKERT et al 2021;CERA et al 2020;KLEIN et al 2020;WEHRUM-OSINSKY et al 2014;COSTUMERO et al 2013;HUYNH et al, 2012;PONSETI et al, 2012;PONSETI et al al. 2009;REDOUTÉ et al 2000) followed by North America (PRAUSE et al, 2015;KARAMA et al, 2002) and Asia (LEE et al, 2015;SEOK, PARK, SONH, 2016).…”

“…2009;REDOUTÉ et al 2000) followed by North America (PRAUSE et al, 2015;KARAMA et al, 2002) and Asia (LEE et al, 2015;SEOK, PARK, SONH, 2016). Regarding the evaluation method, neuroimaging techniques were applied in the majority, 8 studies used Functional Magnetic Resonance (CERA et al, 2020;SEOK, PARK, SOHN, et al 2016;LEE et al, 2015;WEHRUM-OSINSKY et al ., 2014;KUHN, GALLINAT, 2014;COSTUMERO et al, 2013;PONSETI et al, 2009;KARAMA et al, 2002), 2 used positron emission computed tomography (REDOUTÉ et al, 2000;HUYNH et al, 2000;HUYNH et al al., 2012) The effects observed in the human brain due to frequent pornography consumption were a decrease in gray matter (KUHN; GALLINAT, 2014), erosion of the prefrontal cortex (MARKERT et al, 2021;KLEIN., 2020;SEOK, PARK, SOHN. ., 2016;LEE et al, 2015;KUHN, GALLINAT., 2014;COSTUMERO et al, 2013;HUYNH et al, 2012;KARAMA et al, 2002;REDOUTÉ et al, 2000).…”

“…Pornography consumption still affects many regions of the limbic system, responsible for the individual's emotion and memory, emphasizing the involvement of the prefrontal cortex. (MARKERT et al, 2021;KLEIN., 2020;SEOK, PARK, SOHN., 2016;LEE et al, 2015;KUHN, GALLINAT., 2014;COSTUMERO et al, 2013;HUYNH et al, 2012;KARAMA et al, 2002;REDOUTÉ et al, 2000). According to BARR (2019), the prefrontal cortex, primarily responsible for human intelligent behavior (MACHADO, HAERTEL., 2014), suffers erosion as a result of pornography consumption, predisposing compulsive behavior.…”