Addiction Research and Articles About Research

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DSM manualsUnderstanding Internet porn addiction means understanding addiction mechanisms. All addictions hijack the same core neurocircuitry, which runs on the same neurochemicals (even though each addiction also involves additional neural circuits and neurochemicals that differ between addictions). In light of the latest scientific advances, the criticisms of the sexual-behavior addiction model are unfounded and outdated. See this 2015 paper by two medical doctors: Sex Addiction as a Disease: Evidence for Assessment, Diagnosis, and Response to Critics (2015), which provides a chart from that takes on specific criticisms and offers citations that counter them. For a thorough review of the neuroscience literature related to Internet addiction subtypes, with special focus on internet porn addiction, see - Neuroscience of Internet Pornography Addiction: A Review and Update (2015). The review also critiques two recent headline-grabbing EEG studies which purport to have "debunked porn addiction.

At this time, a handful of studies have examined the brains of porn users. Here are the 3 most important ones, and more are on the way:

  1. Brain Structure and Functional Connectivity Associated With Pornography Consumption: The Brain on Porn (2014) - A German study which found 3 significant addiction-related brain changes that correlated with the amount of porn consumed. It also found that the more porn consumed the less activity in the reward circuit, indicating desensitization, and increasing the need for greater stimulation (tolerance).
  2. Neural Correlates of Sexual Cue Reactivity in Individuals with and without Compulsive Sexual Behaviours (2014) - The first in a series of studies. It found the same brain activity as seen in drug addicts and alcoholics. It also found that porn addicts fit the accepted addiction model of wanting "it" more, but not liking "it" more. One other major finding (not reported in the media), was that over 50% of subjects (average age: 25) had difficulty achieving erections/arousal with real partners, yet could achieve erections with porn.
  3. Enhanced Attentional Bias towards Sexually Explicit Cues in Individuals with and without Compulsive Sexual Behaviours (2014)

The results of the Cambridge studies, and the German study provide very strong support for hypotheses put forth here a few years ago on YBOP. Together the studies found:

  • The 3 major addiction-related brain changes discussed in YBOP videos & articles: sensitization, desensitization, and hypofrontality,
  • Less arousal to sexual imagery (the need for greater stimulation).
  • The younger the porn user the greater the cue-induced reactivity in the reward center.
  • Very high rates of ED in young, compulsive porn users.

Prior to the above studies YBOP claimed that internet porn addiction was real and caused the same fundamental brain changes as seen in other addictions. We were confident in this claim because basic physiology rests on the fact that drugs do not create anything new or different; they simply increase or decrease normal brain functions. We already possess the machinery for addiction (mammalian mating/bonding/love circuitry), and for binging (storing calories, mating season). Moreover, years of addiction research have clearly demonstrated that addiction is a single condition, reflected in a typical constellation of signs, symptoms and behaviors (Natural Rewards, Neuroplasticity, and Non-Drug Addictions (2011).

These studies on Internet porn users should come as no surprise because more than 110 brain studies had already confirmed that "Internet addicts" develop the same major addiction-related brain changes that occur in all addictions. Many more assessment-based Internet addiction studies back up what the brain studies found. See our collections:

Internet porn, internet gaming, and social media are now being viewed as separate applications or subcategories of Internet use. An individual can be addicted to Facebook or Internet porn, while not having a "generalized Internet addiction". A 2006 Dutch study found that erotica had the highest addictive potential of all Internet applications.

No wonder. Internet erotica is an extreme version of natural rewards that we're all wired to pursue: sexual arousal and apparent mating opportunities. Today's extreme porn is as unnatural a "natural reinforcer" as today's junk food is. See our article Porn Then and Now: Welcome to Brain Training, and this excellent peer-reviewed article, with a current review of where neuroscience is with respect to Internet porn addiction: Pornography addiction – a supranormal stimulus considered in the context of neuroplasticity (2013).

Recent research on brain changes in response to "highly palatable foods" is revealing evidence of an addiction process. If gambling, gaming, Internet use and food can alter the brain in this way, it would have been amazing to believe that Internet porn alone could not.

This is why In 2011, 3000 doctors of the American Society for Addiction Medicine (ASAM) came out with a public statement clarifying that behavioral addictions (sexual, food, gambling) are fundamentally like substance addictions in terms of brain changes. Said ASAM:

"We all have the brain reward circuitry that makes food and sex rewarding. In fact, this is a survival mechanism. In a healthy brain, these rewards have feedback mechanisms for satiety or ‘enough.’ In someone with addiction, the circuitry becomes dysfunctional such that the message to the individual becomes ‘more’, which leads to the pathological pursuit of rewards and/or relief through the use of substances and behaviors."

ASAM specifically Addresed sexual behavior addictions:

QUESTION: This new definition of addiction refers to addiction involving gambling, food, and sexual behaviours. Does ASAM really believe that food and sex are addicting?

ANSWER: The new ASAM definition makes a departure from equating addiction with just substance dependence, by describing how addiction is also related to behaviours that are rewarding. ... This definition says that addiction is about functioning and brain circuitry and how the structure and function of the brains of persons with addiction differ from the structure and function of the brains of persons who do not have addiction. ... Food and sexual behaviours and gambling behaviours can be associated with the "pathological pursuit of rewards" described in this new definition of addiction.

Two world-renowned addiction researchers, and ASAM members, gave their opinions years before the new definition:

  • The head of the National Institute on Drug Abuse (NIDA) Doctor Nora Volkow, has suggested the agency's name be changed to the "National Institute for Diseases of Addiction," to address behavioral addictions such as pathological gambling, overeating and compulsive pornography use (More Addictions, Less Stigma).
  • Addiction researcher, Eric Nestler, has this Q & A on his website, Nestler Labs.

QUESTION: Do these changes occur naturally in your brain without the influence of a drug of abuse?

ANSWER: “It is likely that similar brain changes occur in other pathological conditions which involve the excessive consumption of natural rewards, conditions such as pathological over-eating, pathological gambling, sex addictions, and so on.”

A new European Journal of Behavioral Addictions started in 2012. There is also a yearly conference, and cybersex addiction is becoming a more frequent topic.

In 2013 the DSM grudgingly acknowledged the preponderance of evidence by creating a new behavioral addiction category. The DSM-5 finally conceded that all addictions appear to involve shared mechanism and brain changes.

“The idea of a non-substance-related addiction may be new to some people, but those of us who are studying the mechanisms of addiction find strong evidence from animal and human research that addiction is a disorder of the brain reward system, and it doesn’t matter whether the system is repeatedly activated by gambling or alcohol or another substance,” said Charles O’Brien, M.D., chair of the DSM-5 Work Group on Substance-Related and Addictive Disorders. “In functional brain imaging—whether with gamblers or drug addicts—when they are showed video or photograph cues associated with their addiction, the same brain areas are activated,” he explained.

Another DSM-5  work-group member (Sexual and Gender Identity Disorders) commenting in this article about Internet porn: Will quitting porn improve your life?

But the kind of definitive research that could explain what happens to the brain while watching porn simply hasn’t been done, says Dr. Richard Krueger, associate clinical professor of psychiatry at Columbia University’s college of physicians and surgeons. Kruger helped revise the sexual disorders section of the latest edition of the psychiatric bible, the Diagnostic and Statistical Manual of Mental Disorders, which doesn’t include sex or porn addiction due to lack of academic evidence that they exist. “The whole notion of what goes on in someone’s brain when they’re sexually excited is just starting to be evaluated,” he says.

He has little doubt porn addiction is real and will eventually garner enough attention to be recognized as a mental illness. But he’s skeptical it has the kind of universal neurological effects that some suggest. Other behaviours such as drinking alcohol or gambling are addictive to only a small minority of the people who engage in them—between one and 10 per cent, Krueger says. “I would argue for the same sort of hit rate with exposure to Internet pornography, that most people would do it and it won’t become a problem.”

Without a doubt, some brains are more sensitive than others to the potentially addictive effects of extreme stimuli. However, it's likely that the more intense our culture's sexual stimuli become, the greater the percentage of users who will show signs of imbalance—even those with fundamentally healthy brains. Also each generation uses more extreme synthetic stimulation than the previous one, and starts earlier with highspeed Internet porn. (Think smartphones.) Alas, adolescent brains are more vulnerable to addiction and sexual conditioning

We often see healthy guys who develop porn-related erectile dysfunction return to good health simply by avoiding internet porn. This suggests they didn't have other issues that would have accounted for their vulnerability. Not only do those with healthy brains benefit from rebooting (a time-out from all artificial sexual stimuli) and thereafter avoiding extreme stimuli, it's also likely that users with especially sensitive brains, the "canaries in the coal mine," can also ease some of their symptoms by consciously moving toward normal brain sensitivity.