DSM committee members explain why porn addiction will soon be in manual

Charles O’Brien, M.D., chair of the DSM-5 Work Group on Substance-Related and Addictive Disorders.

The idea of a non-substance-related addiction may be new to some people, but those of us who are studying the mechanisms of addiction find strong evidence from animal and human research that addiction is a disorder of the brain reward system, and it doesn’t matter whether the system is repeatedly activated by gambling or alcohol or another substance,” said Charles O’Brien, M.D., chair of the DSM-5 Work Group on Substance-Related and Addictive Disorders.


Dr. Richard Krueger, associate clinical professor of psychiatry at Columbia University’s college of physicians and surgeons

But the kind of definitive research that could explain what happens to the brain while watching porn simply hasn’t been done, says Dr. Richard Krueger, associate clinical professor of psychiatry at Columbia University’s college of physicians and surgeons. Kruger helped revise the sexual disorders section of the latest edition of the psychiatric bible, the Diagnostic and Statistical Manual of Mental Disorders, which doesn’t include sex or porn addiction due to lack of academic evidence that they exist. “The whole notion of what goes on in someone’s brain when they’re sexually excited is just starting to be evaluated,” he says.

He has little doubt porn addiction is real and will eventually garner enough attention to be recognized as a mental illness. But he’s skeptical it has the kind of universal neurological effects that some suggest. Other behaviours such as drinking alcohol or gambling are addictive to only a small minority of the people who engage in them—between one and 10 per cent, Krueger says. “I would argue for the same sort of hit rate with exposure to Internet pornography, that most people would do it and it won’t become a problem.”

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