Brain Studies on Porn Users

Printer-friendly version

This page lists all the studies assessing the brain structure and functioning of Internet porn users. To date every study offers support for the porn addiction model (no studies falsify the porn addiction model). The results of these 33 neurological studies (and upcoming studies) are consistent with 210+ Internet addiction "brain studies", many of which also include internet porn use. All support the premise that internet porn use can cause addiction-related brain changes, as do 12 recent neuroscience-based reviews of the literature:

  1. Neuroscience of Internet Pornography Addiction: A Review and Update (2015). A thorough review of the neuroscience literature related to Internet addiction subtypes, with special focus on internet porn addiction. The review also critiques two recent headline-grabbing EEG studies which purport to have "debunked" porn addiction.
  2. Sex Addiction as a Disease: Evidence for Assessment, Diagnosis, and Response to Critics (2015), which provides a chart that takes on specific criticisms of porn/sex addiction, offering citations that counter them.
  3. Neurobiology of Compulsive Sexual Behavior: Emerging Science (2016). Excerpt: "Given some similarities between CSB and drug addictions, interventions effective for addictions may hold promise for CSB, thus providing insight into future research directions to investigate this possibility directly."
  4. Should Compulsive Sexual Behavior be Considered an Addiction? (2016). Excerpt: "Overlapping features exist between CSB and substance use disorders. Common neurotransmitter systems may contribute to CSB and substance use disorders, and recent neuroimaging studies highlight similarities relating to craving and attentional biases. Similar pharmacological and psychotherapeutic treatments may be applicable to CSB and substance addictions"
  5. Neurobiological Basis of Hypersexuality (2016). Excerpt: "Taken together, the evidence seems to imply that alterations in the frontal lobe, amygdala, hippocampus, hypothalamus, septum, and brain regions that process reward play a prominent role in the emergence of hypersexuality. Genetic studies and neuropharmacological treatment approaches point at an involvement of the dopaminergic system."
  6. Compulsive Sexual Behaviour as a Behavioural Addiction: The Impact of the Internet and Other Issues (2016). Excerpts: "more emphasis is needed on the characteristics of the internet as these may facilitate problematic sexual behaviour." and "clinical evidence from those who help and treat such individuals should be given greater credence by the psychiatric community."
  7. Cybersex Addiction (2015). Excerpts: "In recent articles, cybersex addiction is considered a specific type of Internet addiction. Some current studies investigated parallels between cybersex addiction and other behavioral addictions, such as Internet Gaming Disorder. Cue-reactivity and craving are considered to play a major role in cybersex addiction. Neuroimaging studies support the assumption of meaningful commonalities between cybersex addiction and other behavioral addictions as well as substance dependency."
  8. Searching for Clarity in Muddy Water: Future Considerations for Classifying Compulsive Sexual Behavior as An Addiction (2016).  Excerpts: "We recently considered evidence for classifying compulsive sexual behavior (CSB) as a non-substance (behavioral) addiction. Our review found that CSB shared clinical, neurobiological and phenomenological parallels with substance-use disorders. Although the American Psychiatric Association rejected hypersexual disorder from DSM-5, a diagnosis of CSB (excessive sex drive) can be made using ICD-10. CSB is also being considered by ICD-11."
  9. Is Internet Pornography Causing Sexual Dysfunctions? A Review With Clinical Reports (2016). An extensive review of the literature related to porn-induced sexual problems. Involving 7 US Navy doctors and Gary Wilson, the review provides the latest data revealing a tremendous rise in youthful sexual problems. It also reviews the neurological studies related to porn addiction and sexual conditioning via Internet porn. The doctors provide 3 clinical reports of men who developed porn-induced sexual dysfunctions. A second 2016 paper by Gary Wilson discusses the importance of studying the effects of porn by having subjects abstain from porn use: Eliminate Chronic Internet Pornography Use to Reveal Its Effects (2016).
  10. Integrating Psychological and Neurobiological Considerations Regarding The Development and Maintenance of Specific Internet-Use Disorders: An Interaction of Person-Affect-Cognition-Execution model (2016). A review of the mechanisms underlying the development and maintenance of specific Internet-use disorders, including "Internet-pornography-viewing disorder". The authors suggest that pornography addiction (and cybersex addiction) be classified as internet use disorders and placed with other behavioral addictions under substance-use disorders as addictive behaviors.
  11. Sexual Addiction chapter from Neurobiology of Addictions, Oxford Press (2016) - Excerpt: We review the neurobiological basis for addiction, including natural or process addiction, and then discuss how this relates to our current understanding of sexuality as a natural reward that can become functionally "unmanageable" in an individual's life.
  12. Neuroscientific Approaches to Online Pornography Addiction (2017) - Excerpt: In the last two decades, several studies with neuroscientific approaches, especially functional magnetic resonance imaging (fMRI), were conducted to explore the neural correlates of watching pornography under experimental conditions and the neural correlates of excessive pornography use. Given previous results, excessive pornography consumption can be connected to already known neurobiological mechanisms underlying the development of substance-related addictions.
  • See Questionable & Misleading Studies for highly publicized papers that are not what they claim to be.
  • See this page for the many studies linking porn use to sexual problems and decreased sexual & relationship satisfaction

"Brain Studies" (fMRI, MRI, EEG, Neuro-endocrine):

  1. Brain Structure and Functional Connectivity Associated With Pornography Consumption: The Brain on Porn (2014) - This Max Planck Institute fMRI study found less gray matter in the reward system (dorsal striatum) correlating with the amount of porn consumed. Max Planck Institute logo It also found that more porn use correlated with less reward circuit activation while briefly viewing sexual photos. Researchers believed their findings indicated desensitization, and possibly tolerance, which is the need for greater stimulation to achieve the same high. The study also reported that more porn viewing was linked to poorer connections between the reward circuit and prefrontal cortex - a common addiction-related brain change.
  2. Neural Correlates of Sexual Cue Reactivity in Individuals with and without Compulsive Sexual Behaviours (2014) - The first in a series of Cambridge University studies found the same brain activity pattern in porn addicts (CSB subjects) 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. The researchers also reported that 60% 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 second Cambridge University study. An excerpt: "Our findings of enhanced attentional bias... suggest possible overlaps with enhanced attentional bias observed in studies of drug cues in disorders of addictions. These findings converge with recent findings of neural reactivity to sexually explicit cues in [porn addicts] in a network similar to that implicated in drug-cue-reactivity studies and provide support for incentive Cambridge University logomotivation theories of addiction underlying the aberrant response to sexual cues in [porn addicts]."
  4. Novelty, Conditioning and Attentional Bias to Sexual Rewards (2015) - Another Cambridge University fMRI study. Compared to controls porn addicts preferred sexual novelty and conditioned cues associated porn. However, the brains of porn addicts habituated faster to sexual images. Since novelty preference wasn't pre-existing, porn addiction drives novelty-seeking in an attempt to overcome habituation and desensitization.
  5. Neural Substrates of Sexual Desire in Individuals with Problematic Hypersexual Behavior (2015) - This Korean fMRI study replicates other brain studies on porn users. Like the Cambridge University studies it found cue-induced brain activation patterns in sex addicts which mirrored the patterns of drug addicts. In line with several German studies it found alterations in the prefrontal cortex which match the changes observed in drug addicts. What's new is that the findings perfectly matched the prefrontal cortex activation patterns observed in drug addicts: Greater cue-reactivity to sexual images, yet inhibited response to other normal stimuli.
  6. Sexual Desire, not Hypersexuality, is Related to Neurophysiological Responses Elicited by Sexual Images (2013) - This EEG study was touted in the media as evidence against the existence of porn/sex addiction. Not so. This SPAN Lab study, like #7 below, actually lends support to the existence of both porn addiction and porn use down-regulating sexual desire. How so? The study reported higher EEG readings (relative to neutral pictures) when subjects were briefly exposed to pornographic photos. Studies consistently show that an elevated P300 occurs when addicts are exposed to cues (such as images) related to their addiction. However, due to methodological flaws the findings are uninterpretable: 1) the study had no control group for comparison; 2) subjects were heterogeneous (males, females, non-heterosexuals); 3) subjects were not screened for mental disorders or addictions; 4) the questionnaires were not validated for porn addiction. In line with the Cambridge University brain scan studies, this EEG study also reported greater cue-reactivity to porn correlating with less desire for partnered sex. To put another way - individuals with greater brain activation to porn would rather masturbate to porn than have sex with a real person. Shockingly, study spokesperson Nicole Prause claimed that porn users merely had "high libido", yet the results of the study say the exact opposite (their desire for partnered sex was dropping in relation to their porn use). Five peer-reviewed papers expose the truth: 1, 2, 3, 4, 5. Also see the extensive YBOP critique.
  7. Modulation of Late Positive Potentials by Sexual Images in Problem Users and Controls Inconsistent with "Porn Addiction" (2015) - Another SPAN Lab EEG (brain-wave) study comparing the 2013 subjects from the above study to an actual control group (yet it suffered from the same methodological flaws named above). The results: compared to controls "individuals experiencing problems regulating their porn viewing" had lower brain responses to one-second exposure to photos of vanilla porn. The lead author, Nicole Prause, claims these results "debunk porn addiction". What legitimate scientist would claim that their lone anomalous study has debunked an entire field of study? In reality, the findings of Prause et al. 2015 align perfectly with Kühn & Gallinat (2014), which found that more porn use correlated with less brain activation in response to pictures of vanilla porn. Prause's findings also align with Banca et al. 2015 which is #4 in this list. Moreover, another EEG study found that greater porn use in women correlated with less brain activation to porn. Lower EEG readings mean that subjects are paying less attention to the pictures. Put simply, frequent porn users were desensitized to static images of vanilla porn. They were bored (habituated or desensitized). See this extensive YBOP critique. Six peer-reviewed papers agree that this study actually found desensitization/habituation in frequent porn users (a sign of addiction): 1, 2, 3, 4, 5, 6.
  8. HPA Axis Dysregulation in Men With Hypersexual Disorder (2015) - A study with 67 male sex addicts and 39 age-matched controls. The Hypothalamus-Pituitary-Adrenal (HPA) axis is the central player in our stress response. Addictions alter the brain's stress circuits leading to a dysfunctional HPA axis. This study on sex addicts (hypersexuals) found altered stress responses that mirror the findings with substance addictions.
  9. The Role of Neuroinflammation in the Pathophysiology of Hypersexual Disorder (2016) - This study reported higher levels of circulating Tumor Necrosis Factor (TNF) in sex addicts when compared to healthy controls. Elevated levels of TNF (a marker of inflammation) have also been found in substance abusers and drug addicted animals (alcohol, heroin, meth). There were strong correlations between TNF levels and rating scales measuring hypersexuality. 
  10. Methylation of HPA Axis Related Genes in Men With Hypersexual Disorder (2017) - This is a follow-up of #8 above which found that sex addicts have dysfunctional stress systems - a key neuro-endocrine change caused by addiction. The current study found epigenetic changes on genes central to the human stress response and closely associated with addiction. With epigenetic changes, the DNA sequence isn't altered (as happens with a mutation). Instead, the gene is tagged and its expression is turned up or down (short video explaining epigenetics). The epigenetic changes reported in this study resulted in altered CRF gene activity. CRF is a neurotransmitter and hormone that drives addictive behaviors such as cravings, and is a major player in many of the withdrawal symptoms experienced in connection with substance and behavioral addictions, including porn addiction.
  11. Compulsive Sexual Behavior: Prefrontal And Limbic Volume and Interactions (2016) - Compared to healthy controls CSB subjects (porn addicts) had increased left amygdala volume and reduced functional connectivity between the amygdala and dorsolateral prefrontal cortex DLPFC. Reduced functional connectivity between the amygdala and the prefrontal cortex aligns with substance addictions. It is thought that poorer connectivity diminishes the prefrontal cortex's control over a user's impulse to engage in the addictive behavior. This study suggests that drug toxicity may lead to less gray matter and thus reduced amygdala volume in drug addicts. The amygdala is consistently active during porn viewing, especially during initial exposure to a sexual cue. Perhaps the constant sexual novelty and searching and seeking leads to a unique effect on the amygdala in compulsive porn users. Alternatively, years of porn addiction and severe negative consequences is very stressful - and chronic social stress is related to increased amygdala volume. Study #8 above found that "sex addicts" have a overactive stress system. Could the chronic stress related to porn/sex addiction, along with factors that make sex unique, lead to greater amygdala volume?
  12. Ventral Striatum Activity When Watching Preferred Pornographic Pictures is Correlated With Symptoms of Internet Pornography Addiction (2016) - Finding #1: Reward center activity (ventral striatum) was higher for preferred pornographic pictures. Finding #2: Ventral striatum reactivity correlated with the internet sex addiction score. Both findings indicate sensitization and align with the addiction model. The authors state that the "Neural basis of Internet pornography addiction is comparable to other addictions."
  13. Altered Appetitive Conditioning and Neural Connectivity in Subjects With Compulsive Sexual Behavior (2016) - A German fMRI study replicating two major findings from Voon et al., 2014 and Kuhn & Gallinat 2014. Main Findings: The neural correlates of appetitive conditioning and neural connectivity were altered in the CSB group. According to the researchers, the first alteration - heightened amygdala activation - might reflect facilitated conditioning (greater "wiring" to previously neutral cues predicting porn images). The second alteration - decreased connectivity between the ventral striatum and the prefrontal cortex - could be a marker for impaired ability to control impulses. Said the researchers, "These [alterations] are in line with other studies investigating the neural correlates of addiction disorders and impulse control deficits." The findings of greater amygdalar activation to cues (sensitization) and decreased connectivity between the reward center and the prefrontal cortex (hypofrontality) are two of the major brain changes seen in substance addiction. In addition, 3 of the 20 compulsive porn users suffered from "orgasmic-erection disorder".
  14. Compulsivity Across the Pathological Misuse of Drug and Non-Drug Rewards (2016) - A Cambridge University study comparing aspects of compulsivity in alcoholics, binge-eaters, video game addicts and porn addicts (CSB). Excerpts: CSB subjects were faster to learning from rewards in the acquisition phase compared to healthy volunteers and were more likely to perseverate or stay after either a loss or a win in the Reward condition. These findings converge with our previous findings of enhanced preference for stimuli conditioned to either sexual or monetary outcomes, overall suggesting enhanced sensitivity to rewards (Banca et al., 2016).
  15. Can Pornography be Addictive? An fMRI Study of Men Seeking Treatment for Problematic Pornography Use (2017) - Excerpts: Men with and without problematic porn use (PPU) differed in brain reactions to cues predicting erotic pictures, but not in reactions to erotic pictures themselves, consistent with the incentive salience theory of addictions. This brain activation was accompanied by increased behavioral motivation to view erotic images (higher 'wanting'). Ventral striatal reactivity for cues predicting erotic pictures was significantly related to the severity of PPU, amount of pornography use per week and number of weekly masturbations. Our findings suggest that like in substance-use and gambling disorders the neural and behavioral mechanisms linked to anticipatory processing of cues 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.
  16. Conscious and Non-Conscious Measures of Emotion: Do They Vary with Frequency of Pornography Use? (2017) - Study assessed porn user's responses (EEG readings & Startle Response) to various emotion-inducing images - including erotica. The study found several neurological  differences between low frequency porn users and high frequency porn users. An excerpt: Findings suggest that increased pornography use appears to have an influence on the brain’s non-conscious responses to emotion-inducing stimuli which was not shown by explicit self-report.
  17. Preliminary Investigation of The Impulsive And Neuroanatomical Characteristics of Compulsive Sexual Behavior (2009) - Primarily sex addicts. Study reports more impulsive behavior in a Go-NoGo task in sex addicts (hypersexuals) compared to control participants. Brain scans revealed that sex addicts had greater disorganized prefrontal cortex white matter. This finding is consistent with hypofrontality, a hallmark of addiction.

The above studies are all the "brain studies" published (or in the press) on internet porn users.

Together these brain studies found:

  1. The 3 major addiction-related brain changes: sensitization, desensitization, and hypofrontality.
  2. More porn use correlated with less grey matter in the reward circuit (dorsal striatum).
  3. More porn use correlated with less reward circuit activation when briefly viewing sexual images.
  4. More porn use correlated with disrupted neural connections between the reward circuit and prefrontal cortex.
  5. Addicts had greater prefrontal activity to sexual cues, but less brain activity to normal stimuli (matches drug addiction).
  6. 60% of compulsive porn addicted subjects in one study experienced ED or low libido with partners, but not with porn: all stated that internet porn use caused their ED/low libido.
  7. Enhanced attentional bias comparable to drug users. Indicates sensitization (a product of DeltaFosb).
  8. Greater wanting & craving for porn, but not greater liking. This aligns with the accepted model of addiction - incentive sensitization.
  9. Porn addicts have greater preference for sexual novelty yet their brains habituated faster to sexual images. Not pre-existing.
  10. The younger the porn users the greater the cue-induced reactivity in the reward center.
  11. Higher EEG (P300) readings when porn users were exposed to porn cues (which occurs in other addictions).
  12. Less desire for sex with a person correlating with greater cue-reactivity to porn images.
  13. More porn use correlated with lower LPP amplitude when briefly viewing sexual photos: indicates habituation or desensitization.
  14. Dysfunctional HPA axis and altered brain stress circuits, which occurs in drug addictions (and greater amygdala volume, which is associated with chronic social stress).
  15. Epigenetic changes on genes central to the human stress response and closely associated with addiction.
  16. Higher levels of Tumor Necrosis Factor (TNF) - which also occurs in drug abuse and addiction.

Neuro-Psychological Studies on Porn Users (most with only excerpts):

  1. Watching Pornographic Pictures on the Internet: Role of Sexual Arousal Ratings and Psychological-Psychiatric Symptoms for Using Internet Sex Sites Excessively (2011) - Results indicate that self-reported problems in daily life linked to online sexual activities were predicted by subjective sexual arousal ratings of the pornographic material, global severity of psychological symptoms, and the number of sex applications used when being on Internet sex sites in daily life, while the time spent on Internet sex sites (minutes per day) did not significantly contribute to explanation of variance in IATsex score. We see some parallels between cognitive and brain mechanisms potentially contributing to the maintenance of excessive cybersex and those described for individuals with substance dependence
  2. Pornographic Picture Processing Interferes with Working Memory Performance (2013) - 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. Results revealed worse WM performance in the pornographic picture condition of the 4-back task compared with the three remaining picture conditions. Findings are discussed with respect to Internet addiction because WM interference by addiction-related cues is well known from substance dependencies.
  3. Sexual Picture Processing Interferes with Decision-Making Under Ambiguity (2013) - Decision-making performance was worse when sexual pictures were associated with disadvantageous card decks compared to performance when the sexual pictures were linked to the advantageous decks. Subjective sexual arousal moderated the relationship between task condition and decision-making performance. This study emphasized that sexual arousal interfered with decision-making, which may explain why some individuals experience negative consequences in the context of cybersex use.
  4. Cybersex addiction: Experienced sexual arousal when watching pornography and not real-life sexual contacts makes the difference (2013) - The results show that indicators of sexual arousal and craving to Internet pornographic cues predicted tendencies towards cybersex addiction in the first study. Moreover, it was shown that problematic cybersex users report greater sexual arousal and craving reactions resulting from pornographic cue presentation. In both studies, the number and the quality with real-life sexual contacts were not associated to cybersex addiction. The results support the gratification hypothesis, which assumes reinforcement, learning mechanisms, and craving to be relevant processes in the development and maintenance of cybersex addiction. Poor or unsatisfying sexual real life contacts cannot sufficiently explain cybersex addiction.
  5. Cybersex addiction in heterosexual female users of internet pornography can be explained by gratification hypothesis (2014) - Results indicated that Internet porn users rated pornographic pictures as more arousing and reported greater craving due to pornographic picture presentation compared with non-users. Moreover, craving, sexual arousal rating of pictures, sensitivity to sexual excitation, problematic sexual behavior, and severity of psychological symptoms predicted tendencies toward cybersex addiction in porn users. Being in a relationship, number of sexual contacts, satisfaction with sexual contacts, and use of interactive cybersex were not associated with cybersex addiction.
  6. Empirical Evidence and Theoretical Considerations on Factors Contributing to Cybersex Addiction From a Cognitive Behavioral View (2014) - Previous work suggests that some individuals might be vulnerable to CA, while positive reinforcement and cue-reactivity are considered to be core mechanisms of CA development. In this study, 155 heterosexual males rated 100 pornographic pictures and indicated their increase of sexual arousal. Moreover, tendencies towards CA, sensitivity to sexual excitation, and dysfunctional use of sex in general were assessed. The results of the study show that there are factors of vulnerability to CA and provide evidence for the role of sexual gratification and dysfunctional coping in the development of CA.
  7. Prefrontal control and internet addiction: a theoretical model and review of neuropsychological and neuroimaging findings (2015) - Consistent with this, results from functional neuroimaging and other neuropsychological studies demonstrate that cue-reactivity, craving, and decision making are important concepts for understanding Internet addiction. The findings on reductions in executive control are consistent with other behavioral addictions, such as pathological gambling. They also emphasize the classification of the phenomenon as an addiction, because there are also several similarities with findings in substance dependency.  Moreover, the results of the current study are comparable to findings from substance dependency research and emphasize analogies between cybersex addiction and substance dependencies or other behavioral addictions.
  8. Implicit associations in cybersex addiction: Adaption of an Implicit Association Test with pornographic pictures. (2015) - Recent studies show similarities between cybersex addiction and substance dependencies and argue to classify cybersex addiction as a behavioral addiction. In substance dependency, implicit associations are known to play a crucial role. Results show positive relationships between implicit associations of pornographic pictures with positive emotions and tendencies towards cybersex addiction, problematic sexual behavior, sensitivity towards sexual excitation as well as subjective craving.
  9. Symptoms of cybersex addiction can be linked to both approaching and avoiding pornographic stimuli: results from an analog sample of regular cybersex users (2015) - Results showed that individuals with tendencies toward cybersex addiction tended to either approach or avoid pornographic stimuli. Additionally, moderated regression analyses revealed that individuals with high sexual excitation and problematic sexual behavior who showed high approach/avoidance tendencies, reported higher symptoms of cybersex addiction. Analogous to substance dependencies, results suggest that both approach and avoidance tendencies might play a role in cybersex addiction.
  10. Getting stuck with pornography? Overuse or neglect of cybersex cues in a multitasking situation is related to symptoms of cybersex addiction (2015) - Individuals with tendencies towards cybersex addiction seem to have either an inclination to avoid or to approach the pornographic material, as discussed in motivational models of addiction. The results of the current study point towards a role of executive control functions, i.e. functions mediated by the prefrontal cortex, for the development and maintenance of problematic cybersex use (as suggested by Brand et al., 2014). Particularly a reduced ability to monitor consumption and to switch between pornographic material and other contents in a goal adequate manner may be one mechanism in the development and maintenance of cybersex addiction.
  11. Trading Later Rewards for Current Pleasure: Pornography Consumption and Delay Discounting (2015) - Study 1: Participants completed a pornography use questionnaire and a delay discounting task at Time 1 and then again four weeks later. Participants reporting higher initial pornography use demonstrated a higher delay discounting rate at Time 2, controlling for initial delay discounting. Study 2:  Participants who abstained from pornography use demonstrated lower delay discounting than participants who abstained from their favorite food. The finding suggests that Internet pornography is a sexual reward that contributes to delay discounting differently than other natural rewards. It is therefore important to treat pornography as a unique stimulus in reward, impulsivity, and addiction studies and to apply this accordingly in individual as well as relational treatment.
  12. Sexual Excitability and Dysfunctional Coping Determine Cybersex Addiction in Homosexual Males (2015) - Recent findings have demonstrated an association between CyberSex Addiction (CA) severity and indicators of sexual excitability, and that coping by sexual behaviors mediated the relationship between sexual excitability and CA symptoms. The aim of this study was to test this mediation in a sample of homosexual males. Questionnaires assessed symptoms of CA, sensitivity to sexual excitation, pornography use motivation, problematic sexual behavior, psychological symptoms, and sexual behaviors in real life and online. Moreover, participants viewed pornographic videos and indicated their sexual arousal before and after the video presentation. Results showed strong correlations between CA symptoms and indicators of sexual arousal and sexual excitability, coping by sexual behaviors, and psychological symptoms. CA was not associated with offline sexual behaviors and weekly cybersex use time. Coping by sexual behaviors partially mediated the relationship between sexual excitability and CA. The results are comparable with those reported for heterosexual males and females in previous studies and are discussed against the background of theoretical assumptions of CA, which highlight the role of positive and negative reinforcement due to cybersex use.
  13. Subjective Craving for Pornography and Associative Learning Predict Tendencies Towards Cybersex Addiction in a Sample of Regular Cybersex Users (2016) - There is no consensus regarding the diagnostic criteria of cybersex addiction. Some approaches postulate similarities to substance dependencies, for which associative learning is a crucial mechanism. In this study, 86 heterosexual males completed a Standard Pavlovian to Instrumental Transfer Task modified with pornographic pictures to investigate associative learning in cybersex addiction. Additionally, subjective craving due to watching pornographic pictures and tendencies towards cybersex addiction were assessed. Results showed an effect of subjective craving on tendencies towards cybersex addiction, moderated by associative learning.  Overall, these findings point towards a crucial role of associative learning for the development of cybersex addiction, while providing further empirical evidence for similarities between substance dependencies and cybersex addiction.
  14. Exploring the Relationship between Sexual Compulsivity and Attentional Bias to Sex-Related Words in a Cohort of Sexually Active Individuals (2016) - 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: 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 two key results: 1) Higher sexual compulsivity scores correlated with greater interference (increased distraction) during the attentional bias task. This aligns with substance abuse studies. 2) Among those scoring high on sexual addiction, fewer years of sexual experience were related to greater attentional bias. 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 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."
  15. Mood changes after watching pornography on the Internet are linked to symptoms of Internet-pornography-viewing disorder (2016) - Excerpts: The main results of the study are that tendencies towards Internet Pornography Disorder (IPD) were associated negatively with feeling generally good, awake, and calm as well as positively with perceived stress in daily life and the motivation to use Internet pornography in terms of excitation seeking and emotional avoidance.  Furthermore, tendencies towards IPD were negatively related to mood before and after watching Internet pornography as well as an actual increase of good and calm mood. The relationship between tendencies towards IPD and excitement seeking due to Internet-pornography use was moderated by the evaluation of the experienced orgasm's satisfaction. Generally, the results of the study are in line with the hypothesis that IPD is linked to the motivation to find sexual gratification and to avoid or to cope with aversive emotions as well as with the assumption that mood changes following pornography consumption are linked to IPD (Cooper et al., 1999 and Laier and Brand, 2014).
  16. Problematic sexual behavior in young adults: Associations across clinical, behavioral, and neurocognitive variables (2016) - Individuals with Problematic Sexual Behaviors (PSB) exhibited several neuro-cognitive deficits. These findings indicate poorer executive functioning (hypofrontality) which is a key brain feature occurring in drug addicts. A few excerpts: From this characterization, it is be possible to trace the problems evident in PSB and additional clinical features, such as emotional dysregulation, to particular cognitive deficits…. If the cognitive problems identified in this analysis are actually the core feature of PSB, this may have notable clinical implications.
  17. Executive Functioning of Sexually Compulsive and Non-Sexually Compulsive Men Before and After Watching an Erotic Video (2017) - Exposure to porn affected executive functioning in men with "compulsive sexual behaviors", but not healthy controls. Poorer executive functioning when exposed to addiction-related cues is a hallmark of substance disorders (indicating both altered prefrontal circuits and sensitization). Excerpts: This finding indicates better cognitive flexibility after sexual stimulation by controls compared with sexually compulsive participants. These data support the idea that sexually compulsive men do not to take advantage of the possible learning effect from experience, which could result in better behavior modification. This also could be understood as a lack of a learning effect by the sexually compulsive group when they were sexually stimulated, similar to what happens in the cycle of sexual addiction, which starts with an increasing amount of sexual cognition, followed by the activation of sexual scripts and then orgasm, very often involving exposure to risky situations.

Articles Debunking Popular Naysayer Talking Points