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New Brain Study Questions Existence of “Sexual Addiction"

A new study explores how the brains of individuals having trouble controlling their use of online pornography respond to sexual images. The results differ from what has been found for drug and alcohol addictions, and may call into question the existence of "sexual addiction." Read More

New Brain Study Questions Existence of "Sexual Addiction"

I was eager to read this article to look at a different perspective on the Sexual Addiction debate. It is very exciting to see that there have been attempts at studying the neural responses to sexually stimulating images. I look forward to more research of the brain "in action" especially in lieu of the ongoing debate of Sexual Addiction and its inclusion into the DSM-V criteria.

Was the craving sated?

One immediate question about this study is whether the use of sexual images as triggers is the same as showing people drugs/drug paraphenalia to test for addiction.

The question is whether the sexual images are sating the cravings rather than merely triggering them. A better parallel for images of drug paraphenalia to test for "porn addiction" could be the outside of a sex-shop, or even a porn video loading on the internet.

Effectively the viewing of sexual images amongst heavy users of pornography might be the end goal of their addiction. It is success. The viewing of drugs is not the end goal but a tantalising reminder of the end goal. Hence the study does not compare the same things in regard to their hypothetical addiction.

Interesting, but inapposite

I don't think showing the images is a big problem. The end goal of the experience is fapping to the images. The images are triggers for the experience of fapping to the images. In other words, show me a guy who repeatedly and extendedly looks at porn without fapping and you're showing me a statue.

What I liked best about this interview is how humble Prouse is about the potential results. She is all about scientific method, null hypothesis, and the importance of replication.

A peer-reviewed rebuttal of this study's claims

‘High desire’, or ‘merely’ an addiction? A response to Steele et al. by Donald L. Hilton, Jr., MD
http://www.socioaffectiveneuroscipsychol.net/index.php/snp/article/view/...

Confused, or I have missed something

I think I have missed something here.
The post questions the existence of 'sexual addiction' and about 2/3 of the way through the interview, the following question is asked by Brian Mustanski:
"What about sex addicts who visit prostitutes or cheat?" The question speaks for itself, particularlly when contrasted by a previous questions which talks about volunteers (people who have problems) compared to people who do not have problems?
To use a sledgehammer here, it is possible to use neutral terminology - people, people who have problems, people who report having problems etc etc in an interview questioning the concept of sexual addiction. Yet Brian Mustanski refers to sex addicts as extant entities. A kinda post hoc ergo propter hoc fait accompli. Typical Latin French tomfoolery! What would that old, dusty, white, insignificant, male fool, Freud, have made of the fact that in an article whose raison d'être is the questioning of sexual addiction, the very subject of the study is called by the moniker whose existence is being questioned?
If you get my drift.
No more to say. After phoning my wife, I'm off to visit my local brothel after which a quickie with my mistress. I am/am not/or maybe could be a sex addict. Or not.

Naive

Comparing brain responses to mood-altering substances with brain responses to mood-altering behaviors is naive at best, clinically facetious at worst. The study appears functionally useless.

The clinicians are doing it

From Carnes (1983) all the way to the Sexual Recovery Institute treatment materials, they all draw direct parallels with substance abuse. I agree, this is completely moronic, and now we have some actual data to suggest one way in which the addiction model truly does not fit these problems.

Your readers might also be interested

in this item from the same journal issue, also about porn addiction:

"Pornography addiction – a supranormal stimulus considered in the context of neuroplasticity" by Donald L. Hilton Jr., MD

Full text: http://www.socioaffectiveneuroscipsychol.net/index.php/snp/article/view/...

Nonsense

The entire concept of "addiction" has always been so loaded with fundamentalist xtian ideologies of sin and redemption that I can't even find where science is supposed to find a foothold. How does one even define self-control or the lack of it without resorting to quasi-moral truisms?

Whether it's substance use, gambling, eating, sexual behavior or any other "addictive" behavior, there needs to be some serious rethinking of all the terms and concepts being tossed about. Otherwise, people are just pasting the name "science" on top of a script that was written in the 1830s.

A gap in logical inference

Mustanski asks, "What was the purpose of the study?" And Prause replies, "Our study tested whether people who report such problems [problems with regulating their viewing of online erotica] look like other addicts from their brain responses to sexual images."

But the study did not compare brain recordings from persons having problems regulating their viewing of online erotica to brain recordings from drug addicts and brain recordings from a non-addict control group, which would have been the obvious way to see if brain responses from the troubled group look more like the brain responses of addicts or non-addicts.

Instead, Prause claims that their within-subject design was a better method, where research subjects serve as their own control group. With this design, they found that the EEG response of their subjects (as a group) to erotic pictures was stronger than their EEG responses to other kinds of pictures. This is shown in the inline waveform graph (although for some reason the graph differs considerably from the actual graph in the published article).

So this group who reports having trouble regulating their viewing of online erotica has a stronger EEG response to erotic pictures than other kinds of pictures. Do addicts show a similarly strong EEG response when presented with their drug of choice? We don't know. Do normal, non-addicts show a response as strong as the troubled group to erotica? Again, we do not know. We don't know whether this EEG pattern is more similar to the brain patterns of addicts or non-addicts.

The Prause research team claims to be able to demonstrate whether the elevated EEG response of their subjects to erotica is an addictive brain response or just a high-libido brain response by correlating a set of questionnaire scores with individual differences in EEG response. But explaining differences in EEG response is a different question from exploring whether the overall group's response looks addictive or not. The Prause group reported that the only statistically significant correlation with the EEG response was a negative correlation (r=-.33) with desire for sex with a partner. In other words, there was a slight tendency for subjects with strong EEG responses to erotica to have lower desire for sex with a partner. How does that say anything about whether the brain responses of people who have trouble regulating their viewing of erotica are similar to addicts or non-addicts with a high libido?

PubMed

It appears that the journal in which the source article was published is not a PubMed indexed journal. This always makes me suspicious since there are a number of open source journals which will publish your laundry list if you pay them enough. Is this a reputable journal?

Peer-reviewed journal

Yes, Socioaffective Neuroscience and Psychology is a peer-reviewed journal, not a pay-for-play. It is relatively new, so they have not yet pursued (as far as I know) impact factor rankings yet. As all the article authors have plenty of pubs in IF-rated journals too, this was probably a requested, peer-reviewed manuscript.

I have posted a formal reply to this study

The following post is my response to this study - "UCLA's SPAN Lab Touts Empty Porn Study As Ground-Breaking"

http://pornstudyskeptics.blogspot.com/2013/07/uclas-span-lab-touts-empty...

I strongly agree of this

I strongly agree of this article, however we have to take consideration of those ideas for others benefit.

Cambride University - Brain scans find porn addiction

Below is one of many articles covering a new study by Cambridge University.

Pornography addiction leads to same brain activity as alcoholism or drug abuse, study shows
Cambridge University scientists reveal changes in brain for compulsive porn users which don't occur in those with no such habit

http://www.independent.co.uk/life-style/health-and-families/health-news/...

======================================

The above study contradicts claims made in the Prause study and related press. I say 'claims,' because the Prause study actually found increased arousal when subjects viewed porn, even though she characterized her study as not finding arousal to sexual images in this quote - PRAUSE: "The reason these findings present a challenge is that it shows their brains did not respond to the images like other addicts to their drug of addiction."

Actually, P300 readings were higher for porn images than for neutral images, which is exactly what would be expected for someone with an addiction.

On to the new study. The Cambridge study also examined cue-induced reaction, but did so in a standard, scientific manner. Thus it differs greatly in its design methodology as compared with Prause's effort.

Prause's only legitimate claim was that she found no correlations between questionnaire scores and EEG readings. This was to be expected, and is therefore meaningless. She used a heterogeneous group of subjects but showed them all the same images. That is, she recruited males, females, and 7 non-heterosexuals, yet they all viewed vanilla heterosexual sex.

1) Unlike the Prause study, the Cambridge used brain scans (fMRI) to assess the activity of the reward center (ventral stritaum), where cue reaction occurs with spikes of dopamine. This proceedure is well established and has been employed in dozens of Internet addiction and other addiction studies. In contrast, Prause measured EEGs, which only assess electrical activity of the cerebral cortex, and are open to wide interpretation.

2) Unlike the Prause study, the Cambridge study used a homogenous group of subjects: young, heterosexual males.

3) From what I understand, the Cambridge study matched subjects with their preferred genres of porn. This is the key difference between the Prause study and is one of several reasons she found no correlation with the questionnaires she administered. You can't show a gay person straight porn (as she did) and expect the meaningful results (Prause included 7 non-heterosexuals). More to the point, porn addicts have often escalated to certain genres they now find arousing, while old genres are relatively boring. For accurate results, a study must match porn genre to each subject.

4) Unlike the Prause study, the Cambridge study scanned the brains of matched controls. The Prause study had no control group. To this day Prause has no idea what normal EEG readings would have been for her subjects, yet she made far-reaching claims all over the press that her work unravels the concept of sex addiction. Unbelievable.

- PRAUSE: "If our study is replicated, these findings would represent a major challenge to existing theories of sex “addiction”

Replicating a study that is deeply flawed will not challenge anything.

Perhaps Prause's preconceptions led to a conclusion opposite of the results

My mind still boggles at the Prause claim that her subjects' brains did not respond to sexual images like drug addicts' brains respond to their drug, given that she reports higher P300 readings for the sexual images. Just like addicts who show P300 spikes when presented with their drug of choice.

How could she draw a conclusion that is the opposite of the actual results? I think it could be do to her preconceptions--what she expected to find. I wrote about this elsewhere. http://www.psychologytoday.com/blog/cui-bono/201308/preconceptions-may-c...

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Brian Mustanski, Ph.D., is Associate Professor at Northwestern University and the founding Director of the IMPACT LGBT Health and Development Program.

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