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Can Pornography be Addictive? An fMRI Study of Men Seeking Treatment for Problematic Pornography Use.

Gola M1,2, Wordecha M2, Sescousse G3, Lew-Starowicz M4, Kossowski B5, Wypych M5, Makeig S1, Potenza MN6,7, Marchewka A5.

Pornography consumption is highly prevalent, particularly among young adult males. For some individuals, problematic pornography use (PPU) is a reason for seeking treatment. Despite the pervasiveness of pornography, PPU appears under-investigated, including with respect to the underlying neural mechanisms. Using functional magnetic resonance imaging (fMRI), we examined ventral striatal responses to erotic and monetary stimuli, disentangling cue-related 'wanting' from reward-related 'liking' among 28 heterosexual males seeking treatment for PPU and 24 heterosexual males without PPU.

Subjects engaged in an incentive delay task in the scanner, in which they received erotic or monetary rewards preceded by predictive cues. BOLD responses to erotic and monetary cues were analyzed and examined with respect to self-reported data on sexual activity collected over the 2 preceding months. Men with and without PPU differed in their striatal responses to cues predicting erotic pictures, but not in their responses to erotic pictures. PPU subjects when compared to control subjects showed increased activation of ventral striatum specifically for cues predicting erotic pictures but not for cues predicting monetary gains. Relative sensitivity to cues predicting erotic pictures versus monetary gains was significantly related to the increased behavioral motivation to view erotic images (suggestive of higher 'wanting'), severity of PPU, amount of pornography use per week and number of weekly masturbations.

Our findings suggest that, similar to what is observed in substance and gambling addictions, the neural and behavioral mechanisms associated with the anticipatory processing of cues specifically predicting erotic rewards relate importantly to clinically relevant features of PPU. These findings suggest that PPU may represent a behavioral addiction and that interventions helpful in targeting behavioral and substance addictions warrant consideration for adaptation and use in helping men with PPU.

Author information

  1. Swartz Center for Computational Neuroscience, Institute for Neural Computations, University of California San Diego, San Diego, USA.
  2. Institute of Psychology, Polish Academy of Sciences, Warsaw, Poland.
  3. Radboud University, Donders Institute for Brain, Cognition and Behavior, Nijmegen, Netherlands.
  4. III Department of Psychiatry, Institute of Psychiatry and Neurology, Warsaw, Poland.
  5. Laboratory of Brain Imaging, Neurobiology Center, Nencki Institute of Experimental Biology of Polish Academy of Sciences, Warsaw, Poland.
  6. Departments of Psychiatry and Neurobiology, Child Study Center and the National Center on Addiction and Substance Abuse, Yale School of Medicine, New Haven, CT, USA.
  7. Connecticut Mental Health Center, New Haven, CT, USA.
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