ICD-11 for Mortality and Morbidity Statistics: 6C72 Compulsive sexual behaviour disorder
Compulsive sexual behaviour disorder is characterized by a persistent pattern of failure to control intense, repetitive sexual impulses or urges resulting in repetitive sexual behaviour. Symptoms may include repetitive sexual activities becoming a central focus of the person’s life to the point of neglecting health and personal care or other interests, activities and responsibilities; numerous unsuccessful efforts to significantly reduce repetitive sexual behaviour; and continued repetitive sexual behaviour despite adverse consequences or deriving little or no satisfaction from it. The pattern of failure to control intense, sexual impulses or urges and resulting repetitive sexual behaviour is manifested over an extended period of time (e.g., 6 months or more), and causes marked distress or significant impairment in personal, family, social, educational, occupational, or other important areas of functioning. Distress that is entirely related to moral judgments and disapproval about sexual impulses, urges, or behaviours is not sufficient to meet this requirement.
Pornography addiction – a supranormal stimulus considered in the context of neuroplasticity
ABSTRACT: Addiction has been a divisive term when applied to various compulsive sexual behaviors (CSBs), including obsessive use of pornography. Despite a growing acceptance of the existence of natural or process addictions based on an increased understanding of the function of the mesolimbic dopaminergic reward systems, there has been a reticence to label CSBs as potentially addictive. While pathological gambling (PG) and obesity have received greater attention in functional and behavioral studies, evidence increasingly supports the description of CSBs as an addiction. This evidence is multifaceted and is based on an evolving understanding of the role of the neuronal receptor in addiction-related neuroplasticity, supported by the historical behavioral perspective. This addictive effect may be amplified by the accelerated novelty and the ‘supranormal stimulus’ (a phrase coined by Nikolaas Tinbergen) factor afforded by Internet pornography.
Online Porn Addiction: What We Know and What We Don’t—A Systematic Review
ABSTRACT: In the last few years, there has been a wave of articles related to behavioral addictions; some of them have a focus on online pornography addiction. However, despite all efforts, we are still unable to profile when engaging in this behavior becomes pathological. Common problems include: sample bias, the search for diagnostic instrumentals, opposing approximations to the matter, and the fact that this entity may be encompassed inside a greater pathology (i.e., sex addiction) that may present itself with very diverse symptomatology. Behavioral addictions form a largely unexplored field of study, and usually exhibit a problematic consumption model: loss of control, impairment, and risky use. Hypersexual disorder fits this model and may be composed of several sexual behaviors, like problematic use of online pornography (POPU). Online pornography use is on the rise, with a potential for addiction considering the “triple A” influence (accessibility, affordability, anonymity). This problematic use might have adverse effects in sexual development and sexual functioning, especially among the young population. We aim to gather existing knowledge on problematic online pornography use as a pathological entity. Here we try to summarize what we know about this entity and outline some areas worthy of further research.
Is Internet Pornography Causing Sexual Dysfunctions? A Review with Clinical Reports
ABSTRACT: Traditional factors that once explained men’s sexual difficulties appear insufficient to account for the sharp rise in erectile dysfunction, delayed ejaculation, decreased sexual satisfaction, and diminished libido during partnered sex in men under 40. This review (1) considers data from multiple domains, e.g., clinical, biological (addiction/urology), psychological (sexual conditioning), sociological; and (2) presents a series of clinical reports, all with the aim of proposing a possible direction for future research of this phenomenon. Alterations to the brain's motivational system are explored as a possible etiology underlying pornography-related sexual dysfunctions. This review also considers evidence that Internet pornography’s unique properties (limitless novelty, potential for easy escalation to more extreme material, video format, etc.) may be potent enough to condition sexual arousal to aspects of Internet pornography use that do not readily transition to real-life partners, such that sex with desired partners may not register as meeting expectations and arousal declines. Clinical reports suggest that terminating Internet pornography use is sometimes sufficient to reverse negative effects, underscoring the need for extensive investigation using methodologies that have subjects remove the variable of Internet pornography use. In the interim, a simple diagnostic protocol for assessing patients with porn-induced sexual dysfunction is put forth.
The relationship between frequent pornography consumption, behaviours, and sexual preoccupancy among male adolescents in Sweden
KEY FINDINGS: Frequent users watched hard core pornography and violent pornography to a higher extent. Frequent users were more likely to have engaged in a wider range of sexual activities. Frequent users fantasised about trying sexual activities seen in hard core pornography. Frequent users showed signs of sexual preoccupancy and problematic pornography use.
Lower Psychological Well-Being and Excessive Sexual Interest Predict Symptoms of Compulsive Use of Sexually Explicit Internet Material Among Adolescent Boys
ABSTRACT: Although a growing body of literature addresses the effects of young people's use of sexually explicit Internet material, research on the compulsive use of this type of online content among adolescents and its associated factors is largely lacking. This study investigated whether factors from three distinct psychosocial domains (i.e., psychological well-being, sexual interests/behaviors, and impulsive-psychopathic personality) predicted symptoms of compulsive use of sexually explicit Internet material among adolescent boys. Links between psychosocial factors and boys' compulsive use symptoms were analyzed both cross-sectionally and longitudinally with compulsive use symptoms measured 6 months later (T2). Data were used from 331 Dutch boys (M age = 15.16 years, range 11-17) who indicated that they used sexually explicit Internet material. The results from negative binomial regression analyses indicated that lower levels of global self-esteem and higher levels of excessive sexual interest concurrently predicted boys' symptoms of compulsive use of sexually explicit Internet material. Longitudinally, higher levels of depressive feelings and, again, excessive sexual interest predicted relative increases in compulsive use symptoms 6 months later. Impulsive and psychopathic personality traits were not uniquely related to boys' symptoms of compulsive use of sexually explicit Internet material. Our findings, while preliminary, suggest that both psychological well-being factors and sexual interests/behaviors are involved in the development of compulsive use of sexually explicit Internet material among adolescent boys. Such knowledge is important for prevention and intervention efforts that target the needs of specific problematic users of sexually explicit Internet material.
Pornographic Picture Processing Interferes with Working Memory Performance
ABSTRACT: Some individuals report problems during and after Internet sex engagement, such as missing sleep and forgetting appointments, which are associated with negative life consequences. One mechanism potentially leading to these kinds of problems is that sexual arousal during Internet sex might interfere with working memory (WM) capacity, resulting in a neglect of relevant environmental information and therefore disadvantageous decision making. In this study, 28 healthy individuals performed 4 experimental manipulations of a pictorial 4-back WM task with neutral, negative, positive, or pornographic stimuli. Participants also rated 100 pornographic pictures with respect to sexual arousal and indicated masturbation urges previous to and following pornographic picture presentation. Results revealed worse WM performance in the pornographic picture condition of the 4-back task compared with the three remaining picture conditions. Furthermore, hierarchical regression analysis indicated an explanation of variance of the sensitivity in the pornographic picture condition by the subjective rating of the pornographic pictures as well as by a moderation effect of masturbation urges. Results contribute to the view that indicators of sexual arousal due to pornographic picture processing interfere with WM performance. Findings are discussed with respect to Internet sex addiction because WM interference by addiction-related cues is well known from substance dependencies.
Adolescents and web porn: a new era of sexuality
BACKGROUND: Pornography can affect the lifestyles of adolescents, especially in terms of their sexual habits and porn consumption, and may have a significant influence on their sexual attitudes and behaviors. RESULTS: All young people, on an almost daily basis, have access to Internet. Among those surveyed, 1163 (77.9%) of Internet users admit to the consumption of pornographic material, and of these, 93 (8%) access pornographic websites daily, 686 (59%) boys accessing these sites perceive the consumption of pornography as always stimulating, 255 (21.9%) define it as habitual, 116 (10%) report that it reduces sexual interest towards potential real-life partners, and the remaining 106 (9.1%) report a kind of addiction. In addition, 19% of overall pornography consumers report an abnormal sexual response, while the percentage rose to 25.1% among regular consumers. CONCLUSION: It is necessary to educate web users, especially young users, to a safe and responsible use of the Internet and of its contents. Moreover, public education campaigns should be increased in number and frequency to help improve knowledge of Internet-related sexual issues both by adolescents and by parents.
Addiction and mindfulness; pornography addiction and mindfulness-based therapy (ACT)
ABSTRACT: Mindfulness, more specifically acceptance and commitment therapy (ACT) may be the most optimal form of therapy to be used in treating problematic pornography use—use that may qualify as addiction, which falls within the realm of sex addiction. ACT would be beneficial to apply in a clinical setting for 1-on-1 therapy, coaching and sexuality workshops using the ACT model. Though some ambiguity exists on whether pornography addiction falls within the realm of sex addiction, there is sufficient theoretical framework to apply addiction identifiers to problematic pornography use, which further has implications to the benefits of using ACT in treating perceived problematic or addictive pornography use.