Neurocognitive mechanisms in compulsive sexual behavior disorder (2018) – Excerpt analyzing Steele et al., 2013

Link to PDF of full paper Neurocognitive mechanisms in compulsive sexual behavior disorder (2018).

Note – numerous other peer-reviewed papers agree that Steele et al., 2013 supports the porn addiction model: Peer-reviewed critiques of Steele et al., 2013

Excerpts analyzing Steele et al., 2013 (which is citation 68):

Klucken and colleagues recently observed that participants with CSB as compared to participants without displayed greater activation of the amygdala during presentation of conditioned cues (colored squares) predicting erotic pictures (rewards) [66]. These results are like those from other studies examining amygdala activation among individuals with substance use disorders and men with CSB watching sexually explicit video clips [1, 67]. Using EEG, Steele and colleagues observed a higher P300 amplitude to sexual images (when compared to neutral pictures) among individuals self-identified as having problems with CSB, resonating with prior research of processing visual drug cues in drug addiction [68, 69].

COMMENTS: In the above excerpt the authors of the current review are saying that Steele et al’s findings indicate cue-reactivity in frequent porn users. This aligns with the addiction model and cue-reactivity is a neuro-physiological marker for addiction. While Steele et al. spokesperson Nicole Prause claimed that the subjects’ brain response differed from other types of addicts (cocaine was the example given by Prause) – this was not true, and not found anywhere in Steele et al., 2013

Furthermore, habituation may be revealed through decreased reward sensitivity to normally salient stimuli and may impact reward responses to sexual stimuli including pornography viewing and partnered sex [1, 68]. Habituation has also been implicated in substance and behavioral addictions [73-79].

COMMENTS: In the above excerpt the authors of this review are referring to Steele et al’s finding of greater cue-reactivity to porn related to less desire for sex with a partner (but not lower desire to masturbate to porn). To put another way – individuals with more brain activation and cravings related to porn would rather masturbate to porn than have sex with a real person. That’s less reward sensitivity to “partnered sex”, which is “normally salient stimuli”.  Together these two Steele et al. findings indicate greater brain activity to cues (porn images), yet less reactivity to natural rewards (sex with a person). Both are hallmarks of an addiction.

  1. Steele VR, Staley C, Fong T, Prause N. Sexual desire, not hypersexuality, is related to neurophysiological responses elicited by sexual images. Socioaffect Neurosci Psychol. 2013;3:20770.