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.2021 Apr 2;10(1):65-76.
doi: 10.1556/2006.2021.00018.

Sexual incentive delay in the scanner: Sexual cue and reward processing, and links to problematic porn consumption and sexual motivation

Affiliations

Sexual incentive delay in the scanner: Sexual cue and reward processing, and links to problematic porn consumption and sexual motivation

Charlotte Markert et al. J Behav Addict..

Abstract

Background and aims: The use of pornography, while unproblematic for the majority, can grow into addiction-like behavior which in its extreme form is labeled as compulsive sexual behavioral disorder in the ICD-11 (WHO, 2018). The aim of this study was to investigate the addiction-specific reactivity to cues in order to better understand underlying mechanisms in the development of this disorder.

Methods: We have used an optimized Sexual Incentive Delay Task to study brain activity in reward associated brain areas during an anticipation phase (with cues predicting pornographic videos, control videos or no videos) and a corresponding delivery phase in healthy men. Correlations to indicators of problematic pornography use, the time spent on pornography use, and trait sexual motivation were analyzed.

Results: The results of 74 men showed that reward-related brain areas (amygdala, dorsal cingulate cortex, orbitofrontal cortex, nucleus accumbens, thalamus, putamen, caudate nucleus, and insula) were significantly more activated by both the pornographic videos and the pornographic cues than by control videos and control cues, respectively. However, we found no relationship between these activations and indicators of problematic pornography use, time spent on pornography use, or with trait sexual motivation.

Discussion and conclusions: The activity in reward-related brain areas to both visual sexual stimuli as well as cues indicates that optimization of the Sexual Incentive Delay Task was successful. Presumably, associations between reward-related brain activity and indicators for problematic or pathological pornography use might only occur in samples with increased levels and not in a rather healthy sample used in the present study.

Keywords: fMRI; pornography use; problematic pornography use; reward system; sexual incentive delay task; sexual motivation.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Fig. 1.
Fig. 1.
Sexual Incentive Delay Task. During the anticipation phase, the participants saw a cue (geometric figure). Following a variable time interval, a target was presented for a short time, to which the participants were asked to react as quickly as possible by pressing a button. If the cue in the anticipation phase was a CueVSS or a CueControl, a corresponding video could be obtained by reacting quickly to the target (see also Klein et al., 2020)
Fig. 2.
Fig. 2.
Intercorrelation of the addiction-associated characteristics (N = 73): s-IATsex and HBI = sum scores for problematic pornography use, TimePU = time spent on pornography in h/month; TSMQ = mean value for trait sexual motivation
Fig. 3.
Fig. 3.
ROI activity for the contrasts CueVSS–CueControl (A) and DeliveryVSS–DeliveryControl (B). Lines on the sagittal slice on the right side indicate the coronal slices depicted on the left. Cues signaling VSS (CueVSS) as compared to cues signaling massage clips (CueControl) elicited a higher BOLD response in putamen, NAcc, caudate, and insula. VSS clips (DeliveryVSS) compared to massage clips (DeliveryControl) elicited a higher BOLD response in thalamus, insula, amygdala, putamen, and OFC. Displayedt-values are thresholded att < 5
Fig. 4.
Fig. 4.
Correlation between the left nucleus accumbens' peak voxel activity and s-IATsex, HBI, time spent on pornography use in h/month (TimePU) and total scores of the TSMQ during the anticipation phase (upper row, NAcc [-6 8 -4]) and the delivery phase (bottom row, NAcc [-8 14 -8]) of the Sexual Incentive Delay Task (N = 73)
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