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Porn as Erototoxic | Posted: July 15, 2014

Cambridge Study: Internet porn addiction mirrors drug addiction

Your Brain On Porn, July 10, 2014

Comments: The long-awaited Voon study highlighted in the UK documentary "Porn on the Brain" is finally out. As expected, Cambridge University researchers found that compulsive porn users react to porn cues in the same way that drug addicts react to drug cues. But there's more.

Compulsive porn users craved porn (greater wanting), but did not have higher sexual desire (liking) than controls. This finding aligns perfectly with the current model of addiction, and refutes the  theory that "higher sexual desire" causeq compulsive porn use. Drug addicts are thought to be driven to seek their drug because they want - rather than enjoy - it. This abnormal process is known as incentive motivation. This is a hallmark of addiction disorders.

The other major finding (not reported in the media) was that over 50% of subjects (average age: 25) had difficulty achieving erections with real partners, yet could achieve erections with porn.

Finally, researchers found that younger subjects had enhanced reward circuit activity when exposed to porn cues. Higher dopamine spikes and greater reward sensitivity are major factors in adolescents being more vulnerable to addiction and sexual conditioning.

The results of the Cambridge study, and last month's German study (Brain Structure and Functional Connectivity Associated With Pornography Consumption: The Brain on Porn. 2014), provide very strong support for hypotheses put forth here on YBOP from its inception in 2011.

Together the 2 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.

Specifically, researchers found strong evidence of sensitization in compulsive porn users. Sensitization is hyper-reactivity to cues that leads to craving to use, and is considered to be the core addiction-related brain change. A large body of evidence suggests it's caused by the accumulation of DeltaFosB. Sensitization is assesed through using fMRIs to measure activity in specific reward circuit structures when subjects are exposed to cues - in this case sexual films. As lead researcher Valerie Voon said:

"There are clear differences in brain activity between patients who have compulsive sexual behaviour and healthy volunteers. These differences mirror those of drug addicts."

Another key finding is that compulsive porn users did not "like" the porn any more than the control group. This aligns perfectly with the addiction model as addicts experience strong cravings to use (wanting), but don't like "it" (whatever "it" may be) as strongly.

The researchers also asked the participants to rate the level of sexual desire that they felt whilst watching the videos, and how much they liked the videos. Drug addicts are thought to be driven to seek their drug because they want ­ rather than enjoy ­ it. This abnormal process is known as incentive motivation, a compelling theory in addiction disorders.

As anticipated, patients with compulsive sexual behaviour showed higher levels of desire towards the sexually explicit videos, but did not necessarily rate them higher on liking scores.

The above finding contradicts the argument that individuals having difficulty controlling their porn use simply posses higher libidos and like sex more than the rest of the population.

The Cambridge study arrives on the heels of a German study which correlated several brain changes with the frequency and years of porn used. Both studies simply confirm what 70 Internet addiction brain studies have shown - that the internet can induce pathological learning (addiction), and can cause the same brain changes as seen in drug addicts.

Below are articles about the study, and study excerpts with comments.


Sexual Addiction May Be Real After All

Key quotes:

  • "There is no question [these people] are suffering," said lead study author Dr. Valerie Voon. "Their behavior is having a negative impact on multiple levels of function, especially social function, and... they are unable to control their behaviors."
  • "I think [ours is] a study that can help people understand that this is a real pathology, this is a real disorder, so people will not dismiss compulsive sexual behavior as something moralistic," Voon said. "This is not different from how pathologic gambling and substance addiction were viewed several years ago."
  • Dr. Richard Krueger, associate clinical professor of psychiatry at Columbia University, said he believes the research will be a "seminal study" in the field.
  • "It's one, but one very substantial, bit of evidence," said Krueger, who from 2008 to 2013 served on the physician committee involved in proposing hypersexual disorder be added to the DSM-5. "[The study] supports the notion that this is a disease, in my view, and will influence experts and have some significant impact now through expression in the media."

By Tara Berman, MD. July 11, 2014

The debate over whether sex addiction actually exists may be put to bed by a new study that peers into the brains of those with compulsive sexual behaviors.

Researchers at the University of Cambridge used functional magnetic resonance imaging (fMRI) brain scans to compare the brain activity of 19 people with compulsive sexual behaviors to that of the same number of healthy subjects while both groups watched pornography.

What they found was that the brains of those with the compulsive sexual behaviors "lit up" in a different way from those without such compulsions. Interestingly, the patterns of brain activation in these people mirrored those seen in the brains of drug addicts when they were exposed to drugs. Moreover, the three particular regions that lit up more in sex addicts' brains - the ventral striatum, dorsal anterior cingulate and amygdala - are regions known to be involved in reward, motivation and craving.

The findings may lend weight to the concept of sex addiction as a legitimate disorder.

"There is no question [these people] are suffering," said lead study author Dr. Valerie Voon. "Their behavior is having a negative impact on multiple levels of function, especially social function, and... they are unable to control their behaviors."

According to Voon, as many as one in 25 adults may be affected by compulsive sexual behavior - an uncontrollable obsession with sexual thoughts, feelings or actions. Those who experience it often deal with feelings of shame and guilt, and treatment options are limited.

Currently there is no formally accepted definition of this condition. It had not yet been acknowledged in the DSM-5 - often referred to as the "bible" of psychiatric conditions. Until compulsive sexual behavior is recognized in this way, it will be hard for those with this condition to get the help and treatment that a growing number of psychological experts say they need.

"I think [ours is] a study that can help people understand that this is a real pathology, this is a real disorder, so people will not dismiss compulsive sexual behavior as something moralistic," Voon said. "This is not different from how pathologic gambling and substance addiction were viewed several years ago.

"People are experiencing a disorder they need help for and resources should be put towards funding this and treating this."

Psychological experts not involved with the research said the study may prove to be an important step in sexual addiction receiving the same degree as legitimacy as other behavioral addictions, such as compulsive gambling.

Dr. Richard Krueger, associate clinical professor of psychiatry at Columbia University, said he believes the research will be a "seminal study" in the field.

"It's one, but one very substantial, bit of evidence," said Krueger, who from 2008 to 2013 served on the physician committee involved in proposing hypersexual disorder be added to the DSM-5. "[The study] supports the notion that this is a disease, in my view, and will influence experts and have some significant impact now through expression in the media."

However, Dr. Reef Karim, an associate clinical professor and psychiatrist at UCLA, said the results should be interpreted with caution. Specifically, he said, the results would have to be shown in a larger, more diverse group of people in order to be verified.

"Aside from increasing the demographics from heterosexual men to women and those with different sexual orientations, you have to rule out other mental health issues that may cause people to act out sexually," said Karim, who is also director of the Control Center in Beverly Hills, a Mental Health Center that treats sex addiction, among other addiction disorders. He added that there are sometimes other conditions - such as bipolar disorder, ADHD and OCD - that drive patients to act out sexually.

Doctor's Take

While this may be an important study that peers into the minds of those with sexual compulsions, more research will be needed to further define sexual addition - as well as how it can be treated.

It is clear, however, that there are many people whose lives are negatively affected by these obsessions and compulsions. And despite how we label it, these people need help.

"The bottom line is that this is increasingly identified as source of distress in people and needs further characterization to develop better treatment for it," Krueger said.


Love is the drug, scientists find

Key Quotes:

  • Lead scientist Dr Valerie Voon, from Cambridge University, said: ''The patients in our trial were all people who had substantial difficulties controlling their sexual behaviour and this was having significant consequences for them, affecting their lives and relationships.
  • ''In many ways, they show similarities in their behaviour to patients with drug addictions. We wanted to see if these similarities were reflected in brain activity, too.
  • ''There are clear differences in brain activity between patients who have compulsive sexual behaviour and healthy volunteers. These differences mirror those of drug addicts.''
  • Dr John Williams, head of neuroscience and mental health at the Wellcome Trust, which funded the research, said: ''Compulsive behaviours, including watching porn to excess, overeating and gambling, are increasingly common.
  • ''This study takes us a step further to finding out why we carry on repeating behaviours that we know are potentially damaging to us. Whether we are tackling sex addiction, substance abuse or eating disorders, knowing how best, and when, to intervene in order to break the cycle is an important goal of this research.''

Cambridge University scientists find that those with drug addiction and sex addiction have similar neurological responses

By BST 11 Jul 2014

When Roxy Music star Bryan Ferry declared that ''love is the drug'' he may have been speaking the truth.

Cambridge University scientists have found that sex and drug addiction may be two sides of the same neurological coin.

When diagnosed sex addicts looked at explicit sexual images, it triggered brain activity very similar to that seen in people dependent on drugs.

But the researchers caution that this does not suggest pornography is generally addictive.

Lead scientist Dr Valerie Voon, from Cambridge University, said: ''The patients in our trial were all people who had substantial difficulties controlling their sexual behaviour and this was having significant consequences for them, affecting their lives and relationships.

''In many ways, they show similarities in their behaviour to patients with drug addictions. We wanted to see if these similarities were reflected in brain activity, too.

''There are clear differences in brain activity between patients who have compulsive sexual behaviour and healthy volunteers. These differences mirror those of drug addicts.''

Previous studies have suggested that up to one in 25 adults may be affected by an obsession with sexual thoughts, feelings or behaviour they are unable to control.

Public awareness of sex addiction has been raised by celebrities seeking help for the problem, including actors Michael Douglas and David Duchovny.

The Cambridge scientists recruited 19 male sex addicts and played them short videos featuring either explicit pornographic scenes or people engaged in exciting sports such as skiing or skydiving.

At the same time, the men's brain activity was monitored using a functional magnetic resonance imaging (fMRI) scanner. The experiment was repeated with a matched group of volunteers not affected by sex addiction.

Three regions of the brain were found to be especially more active in the brains of the sex addicts than in the healthy volunteers, the ventral striatum, dorsal anterior cingulate and amygdala.

All three are also known to be activated in drug addicts stimulated by the sight of drug-taking paraphernalia.

The ventral striatum and anterior cingulate are involved in the processing and anticipation of rewards, while the amygdala helps establish the significance of events and emotions.

Participants were also asked to rate the level of sexual desire they felt while watching the videos, and how much they liked them.

As expected, sex addicts showed higher levels of desire when watching pornography, but did not necessarily rate the explicit videos higher in their ''liking'' scores.

Younger participants exhibited more activity in the ventral striatum in response to pornographic videos, and this association was strongest in sex addicts.

Frontal control regions of the brain that act as a ''brake'' on extreme behaviour continue to develop into the mid-twenties, the scientists pointed out. This may account for greater impulsivity and risk taking in young people.

Dr Voon added: ''Whilst these findings are interesting, it's important to note, however, that they could not be used to diagnose the condition. Nor does our research necessarily provide evidence that these individuals are addicted to porn, or that porn is inherently addictive. Much more research is required to understand this relationship between compulsive sexual behaviour and drug addiction.''

Dr John Williams, head of neuroscience and mental health at the Wellcome Trust, which funded the research, said: ''Compulsive behaviours, including watching porn to excess, overeating and gambling, are increasingly common.

''This study takes us a step further to finding out why we carry on repeating behaviours that we know are potentially damaging to us. Whether we are tackling sex addiction, substance abuse or eating disorders, knowing how best, and when, to intervene in order to break the cycle is an important goal of this research.''

The findings appear in the online journal Public Library of Science ONE.


The full study: Neural Correlates of Sexual Cue Reactivity in Individuals with and without Compulsive Sexual Behaviours

Excerpts with comments (CSB refers to compulsive sexual behaviors):


Drug-cue-reactivity and craving studies of nicotine, cocaine and alcohol implicate networks including the ventral striatum, dACC and amygdala [13]. In the current study, these regions were activated during viewing of sexually explicit materials across the groups with and without CSB. The observation of stronger activations of these regions in CSB versus healthy volunteer participants is similar to findings observed for substance cues in substance addictions, suggesting neurobiological similarities across the disorders.

Translation: When exposed to cues, compulsive porn users mirrored drug addicts in the brain regions activated and levels of activation. However, compulsive porn users did not have higher libido or greater "liking". Instead, they experienced greater wanting or craving.


Sexual desire or subjective measures of wanting appeared dissociated from liking, in line with incentive-salience theories of addiction [12] in which there exists enhanced wanting but not liking of salient rewards.

Compared to healthy volunteers, CSB subjects had greater subjective sexual desire or wanting to explicit cues and had greater liking scores to erotic cues, thus demonstrating a dissociation between wanting and liking. CSB subjects also had greater impairments of sexual arousal and erectile difficulties in intimate relationships but not with sexually explicit materials highlighting that the enhanced desire scores were specific to the explicit cues and not generalized heightened sexual desire.

Translation: Compulsive porn users in this study aligned with the accepted model of addiction, called incentive motivation or incenetive sensitization. Addicts experience strong cravings to use "it" (wanting), yet they do not like "it" any more than non-addicts. Or as some say, "wanting it more, liking it less, yet never satisfied."


CSB subjects reported that as a result of excessive use of sexually explicit materials..... experienced diminished libido or erectile function specifically in physical relationships with women (although not in relationship to the sexually explicit material) (N = 11)... 

CSB subjects compared to healthy volunteers had significantly more difficulty with sexual arousal and experienced more erectile difficulties in intimate sexual relationships but not to sexually explicit material.

Translation: The average age of men with CSB was 25, yet 11 out of the 19 subjects experienced erectile dysfunction/diminished libido with partners, but not with porn. Researchers said this aligns with the addiction model and with the subjects experiencing higher reward center responses to porn cues. This finding does not support "higher sexual desire" as a cause of compulsive porn use.

Secondly, this completely dismantles the claim that compulsive porn users simply have higher sexual desire than those who aren't compulsive porn users. How do we know?

  1. Eleven of the 19 young men had difficulty achieving an erection/getting aroused with a real partner, but not to their favorite porn.
  2. The CSB did not have have higher generalized sexual desire.

The current and extant findings suggest that a common network exists for sexual-cue reactivity and drug-cue reactivity in groups with CSB and drug addictions, respectively. These findings suggest overlaps in networks underlying disorders of pathological consumption of drugs and natural rewards.

Translation: Sensitization in drug addiction and porn addiction involve the same brain changes within the same brain structures. The molecular mechanisms of sensitization are well established: accumulation of DeltaFosB in the reward center


We emphasize also that these findings are relevant particularly to the subgroup of individuals who develop difficulties with compulsive use of online sexually explicit materials and likely do not reflect on the wider population who use such materials in non-harmful manners. The findings indicate an influence of age on enhanced limbic reactivity to sexual rewards, particularly in the CSB group. Given the recent increases in Internet use, including among young individuals, and the ready access to online sexually explicit materials, future studies focusing on identifying risk factors for individuals (particularly youth) at risk for developing CSB are warranted.

Translation: Although the headlines about this study speak of "sex addiction," the study was really about internet porn addicts, with caution about younger Internet porn users.