Exploring the Relationship between Sexual Compulsivity and Attentional Bias to Sex-Related Words in a Cohort of Sexually Active Individuals (2016)

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COMMENTS: This study replicates the findings of this 2014 Cambridge University study that compared the attentional bias of porn addicts to healthy controls. The new study differs from the Cambridge one, however. Rather than comparing porn addicts to controls, the new study correlated scores on a sex addiction questionnaire to the results of a task assessing attentional bias (explanation of attentional bias). The study described three key results:

  1. Higher sexual compulsivity scores correlated with greater interference (increased distraction) during the attentional bias task. This aligns with substance abuse studies and the Cambridge University study. For example, in similar tests on alcoholics, words like "pub" and "booze" interfere with the subject's ability to process the task at hand.
  2. Here's what's new: The study correlated the "years of sexual activity" with 1) the sex addiction scores and also 2) the results of the attentional bias task. Among those scoring high on sexual addiction, fewer years of sexual experience were related to greater attentional bias. So higher sexual compulsivity scores + fewer years of sexual experience = greater signs of addiction (greater attentional bias, or interference). But attentional bias declines sharply in the compulsive users, and disappears at the highest number of years of sexual experience. The authors concluded that this result could indicate that more years of "compulsive sexual activity" lead to greater habituation or a general numbing of the pleasure response (desensitization). An excerpt from the conclusion section:

"One possible explanation for these results is that as a sexually compulsive individual engages in more compulsive behaviour, an associated arousal template develops [36–38] and that over time, more extreme behaviour is required for the same level of arousal to be realised. It is further argued that as an individual engages in more compulsive behaviour, neuropathways become desensitized to more ‘normalised’ sexual stimuli or images and individuals turn to more ‘extreme’ stimuli to realise the arousal desired. This is in accordance with work showing that ‘healthy’ males become habituated to explicit stimuli over time and that this habituation is characterised by decreased arousal and appetitive responses [39] . This suggests that more compulsive, sexually active participants have become ‘numb’ or more indifferent to the ‘normalised’ sex-related words used in the present study and as such display decreased attentional bias, while those with increased compulsivity and less experience still showed interference because the stimuli reflect more sensitised cognition."

3. Among participants with low scores on the sex addiction questionnaire attentional bias remains almost constant despite increased sexual experience.


Eur Addict Res. 2016 Oct 1;23(1):1-6.

Albery IP1, Lowry J, Frings D, Johnson HL, Hogan C, Moss AC.

Abstract

BACKGROUND/AIMS:

If sexual compulsivity and other addictive behaviours share common aetiology, contemporary proposals about the role of attentional processes in understanding addictive behaviours are relevant.

METHODS:

To examine attentional biases for sex-related words among sexually active individuals and the relationship between sexual compulsivity and sexual behavioural engagement with attentional bias, 55 sexually active individuals completed a modified Stroop task and the sexual compulsivity scale.

RESULTS:

Findings showed attentional bias towards sex-related stimuli among sexually active participants. In addition, among those with low levels of sexual compulsivity, levels of attentional bias were the same across all levels of sexual experience. Among those with higher levels of sexual compulsivity, greater attentional bias was linked with lower levels of sexual experience.

CONCLUSION:

Attentional preference for concern-related stimuli varies as a function of the interaction between how long a person has been active sexually and how compulsive their sexual behaviour is.

PMID: 27694756

DOI: 10.1159/000448732


 

FROM THE DISCUSSION

This paper explored the operation of attentional bias in a group of sexually active individuals. If we accept evidence to suggest that addictive and compulsive behaviours are common to the extent that they share structural and functional changes in reward pathways and those regions associated with impulse control and inhibitory regulation [6] , it should also be the case that addictive behaviours should also share a common pattern of response in cognitive indices related to such processes. Theoretically, it was argued that a number of approaches to understanding the development and maintenance of addictive behaviours concur with this reasoning. For instance, insensitive sensitisation theory proposes that the dopaminergic response to repeated substance use increases to the extent that it becomes sensitized, more motivationally salient, and triggers behaviour through the urge that one experiences in response to substance-related cues [18 Similarly, Franken [17] argued that after repeated experience with a substance, related cues become salient and are more likely to grab attention because of dopamine release in the corticostriatal circuit related to the perception of such cues. This reasoning suggests that individuals should display differential attention to cues related to the urgedfor behaviour. We tested whether individuals display such a pattern of response in a modified Stroop task, which has been used extensively to examine the diversion  of attentional resources towards concern-related stimuli. Findings showed that sexually active people do indeed show greater interference in the colour naming of sex related words relative to neutral stimuli, and the magnitude of this bias was significantly different from a baseline score (indicative of no interference). This evidence confirms a similar pattern of results to those reported for substance- related [21] and non-substance-related behavior including sexual behaviour [30–32, 35] .

While this evidence provides a demonstration of the operation of attentional bias in a population of sexually active individuals, we were also interested in exploring the relationship between longevity of behavioural engagement and related compulsivity for the operation of attentional bias. In line with those principles outlined in incentive sensitization theory [18] and the neuropsychopharmacological approach [17] , greater attentional bias should be related to repeated behavioural enactment and measures associated with excessive appetites or addiction across a variety of behaviours [15] . What is not clear from this approach, however, is how attentional bias for concern-related stimuli is predicted by the relationship between longevity of behavioural engagement and compulsivity

In line with previous related work in other addictive behaviours, it was an a priori prediction that there would be a positive relationship between behavioural engagement and sexual compulsivity in the prediction of attentional bias. Consistent with our findings, work examining the relationship between sexual compulsivity and attentional bias has previously demonstrated a positive correlation [11, 32] . However, our analyses add to this body of work by identifying the importance of the interaction between the period of active sexual engagement and sexual compulsivity scores for predicting attentional bias scores. It was observed that among those with low levels of sexual compulsivity, levels of attentional bias were the same across all levels of sexual experience. Among those with higher levels of sexual compulsivity, increased attentional bias was linked with lower levels of sexual experience and decreased attentional bias associated with higher levels of sexual experience. In essence, these findings highlight that attentional preference for concern-related stimuli varies as a function of the interaction between how long a person has been active sexually and how compulsive their sexual behaviour is.

One possible explanation for these results is that as a sexually compulsive individual engages in more compulsive behaviour, an associated arousal template develops [36–38] and that over time, more extreme behaviour is required for the same level of arousal to be realised. It is further argued that as an individual engages in more compulsive behaviour, neuropathways become desensitized to more ‘normalised’ sexual stimuli or images and individuals turn to more ‘extreme’ stimuli to realise the arousal desired. This is in accordance with work showing that ‘healthy’ males become habituated to explicit stimuli over time and that this habituation is characterised by decreased arousal and appetitive responses [39] . This suggests that more compulsive, sexually active participants have become ‘numb’ or more indifferent to the ‘normalised’ sex-related words used in the present study and as such display decreased attentional bias, while those with increased compulsivity and less experience still showed interference because the stimuli reflect more sensitised cognition. Future work is required to test this observation by comparing groups of sexually active individuals, high and low in sexual compulsivity, on sensitised and desensitised stimuli.