In writing the initial paper of this debate, Pornography addiction: a neuroscience perspective (Surg Neurol Int 2011;2:19) our immediate concern was that there was remarkable silence in academic science on the subject of pornography as an addictive medium, as opposed to food, gambling, and other sources of natural addictions. We feel our paper partially filled a void between the neuroscience literature and that of the sciences of addiction, including natural addiction. We do not now nor did we when we wrote the paper consider our modest contributions to be the final word on the subject. We hoped that it would generate thought and debate, a goal which it seems to have accomplished.
Also, we believed, in our paper and responses to earlier reviews, that we had said all we needed to say in support of our observations and conclusions. However, there is one ascertion in the latest reviews we feel must be addressed, as silence on the matter could lead to a belief by some of affirmation, and that is the charge that one who is not engaged in primary research in this area somehow is not qualified to understand and therefore comment on the quality of science produced by the various investigators whose work we analyzed, and on the soundness of their conclusions.
This position of necessity requires two lines of response. The first is based upon the assumption that if we truly understood the science in this area we could only conclude as the reviewers, clinical psychologists, that pornography is not addictive. However, in accepting that premise one has to deal with the opposing findings of a paper from France that concluded that “the phenomenology of excessive nonparaphilic sexual disorder favors its conceptualization as an addictive behavior, rather than as an obsessive –compulsive , or an impulse control disorder.” (1) Additionally, we would have to ignore other authors whose behaviorally-based research supports the concept of behavioral addictions (2), including Internet addiction(3).
In the other line of response it can be noted that in the 44 years since the publication of the first paper by one of us ( CW)– who has during over one-half that time held various positions of editorial responsibilities–we have never encountered such a chauvinistic stance within the scientific community, regardless its stripes. We reject this rather unenlightened posture entirely, and hope the author upon reviewing his position would also. This premise is preposterous and, when controlling, denies related fields of clinical and social sciences the infusion of perspectives that otherwise prevent inbred bias. Along this line , it is interesting to note that the majority of the authors of reviews of our initial paper and subsequent responses are behavioral scientists, and do not address the significant volume of neurobiological literature on the subject.
Donald Hilton, Jr., MD San Antonio, Texas
Clark Watts, MD, JD Austin, Texas
References
1. Garcia FD, Thibaut F. Sexual addictions. Am J Drug Alcohol Abuse 2010; 36:254-60.
2. Grant JE, Potenza MN, Weinstein A, et al. Introduction to behavioral addictions. Am J Drug Alcohol abuse. 2010;36:233-41.
3. Weinstein A, Lejoyeux M. Internet addiction or excessive Internet use. Am J Drug Alcohol Abuse 2010;36:277-83.
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