Mental Health
Persistent appetitive memory in problematic pornography users.
Open Access: Yes.
Abstract
Background and Aims: Most men consume pornography, with a small but significant percentage losing control over their use. Since ICD-11, problematic pornography use can be diagnosed as “compulsive sexual behavior disorder.” Debate persists on whether problematic pornography use is an impulsecontrol disorder or a behavioral addiction. Mechanisms of learning and memory play a central role in addictive disorders but are presumably less relevant for impulse control disorders. Methods: One hundred thirty-nine heterosexual male users of pornography and gaming participated in our study which was part of a multi-center research project on internet use disorders in Germany. We focus on a subsample of fifty-eight non-problematic (n 5 35) and problematic pornography users (n 5 23, labeled pathological). FMRI data were collected during appetitive conditioning, extinction and recall. Pornographic, game, and money images served as unconditioned stimuli, geometric shapes as conditioned stimuli (CS). Results: During appetitive conditioning pathological pornography users showed a generally stronger response in ventral striatum to all CSs, whereas altered activations in extinction and recall were specific to the porn-associated CS. Greater activations in the dorsal anterior cingulate cortex during extinction and in the medial orbitofrontal cortex during recall suggest persistence of appetitive memory for pornography in pathological users, supported by valence ratings and skin conductance responses (SCR). Sensitization to the monetary cue also emerged in SCR. Discussion and Conclusions: Based on these new neurobiological findings, which are consistent with current addiction theories about stimulusspecific altered reward sensitivity and appetitive memory, we argue that problematic pornography use should be considered a behavioral addiction.
Relevance
“Pornographic stimuli elicited the strongest appetitive conditioning in both non-problematic and problematic users. Problematic pornography users showed generally increased ventral striatal responses to all reward cues in conditioning which could be a potential vulnerability factor. In addition, neural responses imply persistent cue reactivity to the CSþporn compared to the non-problematic users and contrasted with the control cue throughout extinction and recall one week later… Consistent with prominent addiction theories the reward system was persistently sensitized toward the problem associated pornographic stimulus but not to non-related stimuli in problematic users… his new neurobiological evidence further supports a diagnostic classification of pornography use disorder under behavioral addictions.”
Citation
