Increased sensitivity to erotic reward cues in subjects with compulsive sexual behaviors (2015)

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COMMENTS: This fMRI study compared reward center activity of controls to compulsive internet porn users. Compared to controls compulsive porn users had far greater reward center activity and attentional bias when exposed to sexual cues. Both findings align with the Cambridge University studies and the accepted model of addiction - incentive sensitization.


MATEUSZ K. GOLA*, MALGORZATA WORDECHA, GUILLAUME SESCOUSSE, BARTOSZ KOSSOWSKI and ARTUR MARCHEWKA

*Institute of Psychology, Polish Academy of Science, Warsaw, Poland; E-mail: mateusz.gola@gmail.com

Background and aims:

There is ongoing discussion among therapists and researchers, about how to conceptualize compulsive sexual behavior (CSB) and perform efficient psychotherapeutic intervention. Identifying key brain-circuits underlying CSB can shed light on this issue. In a previous study it has been shown (Sescousse et al., 2013), that pathological gamblers (PG) are more sensitive to monetary compared to non-monetary (in this case, erotic) incentives. This was reflected in shorter reaction times (RTs) and enhanced reactivity of the ventral striatum (VStr) in response to monetary cues (Mc) compared to non-Mc. If the brain mechanism underlying CSB is similar to PG, we should expect opposite results, i.e. shorter RTs for erotic cues (Ec) and blunted VStr response for non-Ec.

Methods:

We tested these hypotheses using fMRI and comparing the brain responses of 6 CSB (data acquisition in progress) and 5 healthy control subjects (HC), while they engaged in an incentive delay task manipulating both monetary and visual erotic rewards (left top in Figure).

Results:

CSB expresses significantly higher sensitivity (shorter RTs) to Ec then Mc (bottom in Figure), what is preceded by higher reactivity of VStr for Ec (compared to HC) during reward anticipation. No blunted response of VStr for non-Ec has been shown in CSB patients (top right in Figure).

Conclusions:

Our preliminary results point to a differential sensitivity to erotic versus non-erotic incentives in CSB patients, but with no blunted VStr response to non-Ec. Slightly different then PG, those results suggest higher CSB preference for Ec with no loss of ability to be stimulated by non-Ec.