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Exploring the clinical profile of problematic pornography use

Published online by Cambridge University Press:  21 July 2020

Campbell Ince Open the ORCID record for Campbell Ince [Opens in a new window] ,
Murat Yücel ,
Lucy Albertella Open the ORCID record for Lucy Albertella [Opens in a new window]  and
Leonardo F. Fontenelle Open the ORCID record for Leonardo F. Fontenelle [Opens in a new window]
Campbell Ince
Affiliation:
Turner Institute for Brain and Mental Health, Monash University, Melbourne, Australia
Murat Yücel
Affiliation:
Turner Institute for Brain and Mental Health, Monash University, Melbourne, Australia
Lucy Albertella
Affiliation:
Turner Institute for Brain and Mental Health, Monash University, Melbourne, Australia
Leonardo F. Fontenelle*
Affiliation:
Turner Institute for Brain and Mental Health, Monash University, Melbourne, Australia D’Or Institute for Research and Education (IDOR), Rio de Janeiro, Brazil Obsessive, Compulsive and Anxiety Spectrum Research Program, Institute of Psychiatry of the Federal University of Rio de Janeiro (IPUB/UFRJ), Rio de Janeiro, Brazil
*
*Author for correspondence: Leonardo F. Fontenelle Email: leo.fontenelle@monash.edu
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Abstract

Background

Although problematic pornography use (PPU) will soon be diagnosable through the International Classification for Diseases, 11th revision, its clinical profile remains contentious. The current study assessed whether PPU may be characterized by various symptoms sometimes observed among online recovery forums that currently lack empirical assessment, such as heightened cognitive-affective issues following pornography use and sexual dysfunction with partners as a result of escalating use.

Method

Cross-sectional surveys were completed by male PPUs (N = 138, mean age = 31.75 years, standard deviation = 10.72) recruited via online recovery communities and Amazon Mechanical Turk. Multiple regression analysis was performed using the Problematic Pornography Use Scale as the dependent variable and variables of interest (Arizona Sexual Experiences Scales modified for partnered sex and pornography use, Brunel Mood Scale, Social Interaction Anxiety Scale, and the Tolerance subscale from the Problematic Pornography Consumption Scale) and potential confounders (eg, comorbid psychopathology) as independent variables.

Results

Current levels of pornography use, indicators of tolerance and escalation, greater sexual functioning with pornography, and psychological distress were uniquely associated with PPU severity, while cognitive-affective issues after pornography use, impulsivity and compulsivity were not. Although sexual dysfunction did not predict PPU severity, nearly half the sample indicated sexual dysfunction with intimate partners.

Conclusions

The present findings suggest that PPU may be characterized by tolerance and escalation (as per substance addiction models), greater sexual responsivity toward pornography, and psychological distress. Meanwhile, the high rate of partnered sexual dysfunction observed suggests that PPU might be somewhat separable from other forms of compulsive sexual behavior.

Keywords

PornographyICD-11compulsive sexual behaviorbehavioral addictionsexual dysfunctionpornography addiction
Type
Original Research
Information
CNS Spectrums , Volume 26 , Issue 6: Special Issue: Functional Neurological Disorder , December 2021 , pp. 648 - 657
Copyright
© The Author(s), 2020. Published by Cambridge University Press

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References

World Health Organization. International classification of diseases for mortality and morbidity statistics (11th Revision). https://icd.who.int/browse11/l-m/en. Published 2018. Accessed October 1, 2020.Google Scholar
Derbyshire, KL, Grant, JE. Compulsive sexual behavior: a review of the literature. J Behav Addict. 2015;4(2):37–43. doi: 10.1556/2006.4.2015.003.CrossRefGoogle ScholarPubMed
Kraus, SW, Voon, V, Potenza, MN. Should compulsive sexual behavior be considered an addiction? Addiction. 2016;111(12):2097–2106. doi: 10.1111/add.13297.CrossRefGoogle ScholarPubMed
Cooper, A. Sexuality and the Internet: surfing into the new millennium. CyberPsychology & Behavior. 1998;1(2):187–193. doi: 10.1089/cpb.1998.1.187.CrossRefGoogle Scholar
Love, T, Laier, C, Brand, M, Hatch, L, Hajela, R. Neuroscience of Internet pornography addiction: a review and update. Behav Sci. 2015;5(3):388–433. doi: 10.3390/bs5030388.CrossRefGoogle ScholarPubMed
Wéry, A, Billieux, J. Problematic cybersex: conceptualization, assessment, and treatment. Addict Behav. 2017;64:238–246. doi: 10.1016/j.addbeh.2015.11.007.CrossRefGoogle ScholarPubMed
Fernandez, DP, Griffiths, MD. Psychometric instruments for problematic pornography use: a systematic review. Eval Health Professions. 2019. doi: 10.1177/0163278719861688.CrossRefGoogle Scholar
Kor, A, Zilcha-Mano, S, Fogel, YA, Mikulincer, M, Reid, RC, Potenza, MN. Psychometric development of the problematic pornography use scale. Addict Behav. 2014;39(5):861–868. doi: 10.1016/j.addbeh.2014.01.027.CrossRefGoogle ScholarPubMed
Stark, R, Klucken, T, Potenza, MN, Brand, M, Strahler, J. A current understanding of the behavioral neuroscience of compulsive sexual behavior disorder and problematic pornography use. Curr Behav Neurosci Rep. 2018;5(4):218–231. doi: 10.1007/s40473-018-0162-9.CrossRefGoogle Scholar
Leppink, EW, Chamberlain, SR, Redden, SA, Grant, JE. Problematic sexual behavior in young adults: Associations across clinical, behavioral, and neurocognitive variables. Psychiatry Res. 2016;246:230–235. doi: 10.1016/j.psychres.2016.09.044.CrossRefGoogle ScholarPubMed
Voon, V, Mole, TB, Banca, P, et al. Neural correlates of sexual cue reactivity in individuals with and without compulsive sexual behaviours. PloS One. 2014;9(7):e102419. doi: 10.1371/journal.pone.0102419.CrossRefGoogle ScholarPubMed
Sun, C, Bridges, A, Johnson, JA, Ezzell, MB. Pornography and the male sexual script: an analysis of consumption and sexual relations. Arch Sex Behav. 2016;45(4):983–994. doi: 10.1007/s10508-014-0391-2.CrossRefGoogle ScholarPubMed
Muusses, LD, Kerkhof, P, Finkenauer, C. Internet pornography and relationship quality: a longitudinal study of within and between partner effects of adjustment, sexual satisfaction and sexually explicit internet material among newly-weds. Comput Human Behav. 2015;45:77–84. doi: 10.1016/j.chb.2014.11.077.CrossRefGoogle Scholar
Perry, SL, Davis, JT. Are pornography users more likely to experience a romantic breakup? Evidence from longitudinal data. Sex Cult. 2017;21(4):1157–1176. doi: 10.1007/s12119-017-9444-8.CrossRefGoogle Scholar
Štulhofer, A, Buško, V, Landripet, I. Pornography, sexual socialization, and satisfaction among young men. Arch Sex Behav. 2010;39(1):168–178. doi: 10.1007/s10508-008-9387-0.CrossRefGoogle ScholarPubMed
Weinstein, AM, Zolek, R, Babkin, A, Cohen, K, Lejoyeux, M. Factors predicting cybersex use and difficulties in forming intimate relationships among male and female users of cybersex. Front Psychiatry. 2015;6:54. doi: 10.3389/fpsyt.2015.00054.CrossRefGoogle ScholarPubMed
Cavaglion, G. Cyber-porn dependence: voices of distress in an Italian internet self-help community. Int J Ment Health Addict. 2009;7(2):295–310. doi: 10.1007/s11469-008-9175-z.CrossRefGoogle Scholar
Wilson, G. Eliminate chronic internet pornography use to reveal its effects. Addicta. 2016;3:209–221. doi: 10.15805/addicta.2016.3.0107.CrossRefGoogle Scholar
Koob, GF, Volkow, ND. Neurocircuitry of addiction. Neuropsychopharmacology. 2010;35(1):217. doi: 10.1038/npp.2009.110.CrossRefGoogle Scholar
Kalman, TP. Clinical encounters with Internet pornography. J Am Acad Psychoanal Dyn Psychiatry. 2008;36(4):593–618. doi: 10.1521/jaap.2008.36.4.593.CrossRefGoogle ScholarPubMed
Bronner, G, Ben‐Zion, IZ. Unusual masturbatory practice as an etiological factor in the diagnosis and treatment of sexual dysfunction in young men. J Sexual Med. 2014;11(7):1798–1806. doi: 10.1111/jsm.12501.CrossRefGoogle ScholarPubMed
Park, B, Wilson, G, Berger, J, et al. Is Internet pornography causing sexual dysfunctions? A review with clinical reports. Behav Sci. 2016;6(3):17. doi: 10.3390/bs6030017.CrossRefGoogle ScholarPubMed
Gopalakrishnan, R, Thangadurai, P, Kuruvilla, A, Jacob, KS. Situational psychogenic anejaculation: a case study. Indian J Psychol Med. 2014;36(3):329. doi: 10.4103/0253-7176.135393.CrossRefGoogle ScholarPubMed
Porto, R. Male masturbation habits and sexual dysfunctions. Sexologies. 2016;25(4):160–165. doi: 10.1016/j.sexol.2016.03.004.CrossRefGoogle Scholar
Pizzol, D, Bertoldo, A, Foresta, C. Adolescents and web porn: a new era of sexuality. Int J Adolesc Med Health. 2016;28(2):169–173. doi: 10.1515/ijamh-2015-0003.CrossRefGoogle ScholarPubMed
Janssen, E, Bancroft, J. The dual-control model: the role of sexual inhibition and excitation in sexual arousal and behavior. Psychophysiol Sex. 2007;15:197–222.Google Scholar
Grubbs, JB, Gola, M. Is pornography use related to erectile functioning? Results from cross-sectional and latent growth curve analyses. J Sexual Med. 2019;16(1):111–125. doi: 10.1016/j.jsxm.2018.11.004.CrossRefGoogle ScholarPubMed
Landripet, I, Štulhofer, A. Is pornography use associated with sexual difficulties and dysfunctions among younger heterosexual men? J Sexual Med. 2015;12(5):1136–1139. doi: 10.1111/jsm.12853.CrossRefGoogle ScholarPubMed
Wilson, G. Your Brain on Porn: Internet Pornography and the Emerging Science of Addiction. Commonwealth Publishing; 2017.Google Scholar
Scanavino, M, Ventuneac, A, Abdo, CHN, et al. Compulsive sexual behavior and psychopathology among treatment-seeking men in São Paulo, Brazil. Psychiatry Res. 2013;209(3):518–524. doi: 10.1016/j.psychres.2013.01.021.CrossRefGoogle Scholar
Raymond, NC, Coleman, E, Miner, MH. Psychiatric comorbidity and compulsive/impulsive traits in compulsive sexual behavior. Compr Psychiatry. 2003;44(5):370–380. doi: 10.1016/S0010-440X(03)00110-X.CrossRefGoogle ScholarPubMed
Bőthe, B, Tóth-Király, I, Zsila, Á, Griffiths, MD, Demetrovics, Z, Orosz, G. The development of the problematic pornography consumption scale (PPCS). J Sex Res. 2018;55(3):395–406. doi: 10.1080/00224499.2017.1291798.CrossRefGoogle Scholar
Wéry, A, Billieux, J. Online sexual activities: an exploratory study of problematic and non-problematic usage patterns in a sample of men. Comput Human Behav. 2016;56:257–266. doi: 10.1016/j.chb.2015.11.046.CrossRefGoogle Scholar
Ley, D, Prause, N, Finn, P. The emperor has no clothes: a review of the ‘pornography addiction’model. Curr Sexual Health Rep. 2014;6(2):94–105. doi: 10.1007/s11930-014-0016-8.CrossRefGoogle Scholar
Kardefelt‐Winther, D, Heeren, A, Schimmenti, A, et al. How can we conceptualize behavioural addiction without pathologizing common behaviours? Addict. 2017;112(10):1709–1715. doi: 10.1111/add.13763.CrossRefGoogle ScholarPubMed
Reid, RC, Carpenter, BN, Hook, JN. Investigating correlates of hypersexual behavior in religious patients. Sex Addict Compulsivity. 2016;23(2–3):296–312. doi: 10.1080/10720162.2015.1130002.CrossRefGoogle Scholar
Gola, M, Lewczuk, K, Skorko, M. What matters: quantity or quality of pornography use? Psychological and behavioral factors of seeking treatment for problematic pornography use. J Sex Med. 2016;13(5):815–824. doi: 10.1016/j.jsxm.2016.02.169.CrossRefGoogle ScholarPubMed
Wilt, JA, Cooper, EB, Grubbs, JB, Exline, JJ, Pargament, KI. Associations of perceived addiction to internet pornography with religious/spiritual and psychological functioning. Sex Addict Compulsivity. 2016;23(2–3):260–278. doi: 10.1080/10720162.2016.1140604.CrossRefGoogle Scholar
Grubbs, JB, Exline, JJ, Pargament, KI, Hook, JN, Carlisle, RD. Transgression as addiction: religiosity and moral disapproval as predictors of perceived addiction to pornography. Arch Sexual Behav. 2015;44(1):125–136. doi: 10.1007/s10508-013-0257-z.CrossRefGoogle ScholarPubMed
Griffiths, MD. Internet sex addiction: a review of empirical research. Addict Res Theory. 2012;20(2):111–124. doi: 10.3109/16066359.2011.588351.CrossRefGoogle Scholar
Gola, M, Wordecha, M, Sescousse, G, et al. Can pornography be addictive? An fMRI study of men seeking treatment for problematic pornography use. Neuropsychopharmacology. 2017;42(10):2021. doi: 10.1038/npp.2017.78.CrossRefGoogle ScholarPubMed
Bőthe, B, Tóth-Király, I, Potenza, MN, Griffiths, MD, Orosz, G, Demetrovics, Z. Revisiting the role of impulsivity and compulsivity in problematic sexual behaviors. J Sex Res. 2019;56(2):166–179. doi: 10.1080/00224499.2018.1480744.CrossRefGoogle ScholarPubMed
Laier, C, Pekal, J, Brand, M. Cybersex addiction in heterosexual female users of Internet pornography can be explained by gratification hypothesis. Cyberpsychol Behav Social Network. 2014;17(8):505–511. doi: 10.1089/cyber.2013.0396.CrossRefGoogle ScholarPubMed
Kafka, MP. Hypersexual disorder: a proposed diagnosis for DSM-V. Ach Sex Behav. 2010;39(2):377–400. doi: 10.1007/s10508-009-9574-7.CrossRefGoogle ScholarPubMed
Kafka, MP, Hennen, J. A DSM-IV Axis I comorbidity study of males (n = 120) with paraphilias and paraphilia-related disorders. Sex Abuse: J Res Treat. 2002;14(4):349–366. doi: 10.1023/A:1020007004436.CrossRefGoogle ScholarPubMed
Reid, RC, Carpenter, BN, Gilliland, R, Karim, R. Problems of self-concept in a patient sample of hypersexual men with attention-deficit disorder. J Addict Med. 2011;5(2):134–140. doi: 10.1097/ADM.0b013e3181e6ad32.CrossRefGoogle Scholar
Reid, RC. Assessing readiness to change among clients seeking help for hypersexual behavior. Sex Addict Compulsivity. 2007;14(3):167–186. doi: 10.1080/10720160701480204.CrossRefGoogle Scholar
Peer, E, Vosgerau, J, Acquisti, A. Reputation as a sufficient condition for data quality on Amazon Mechanical Turk. Behav Res Methods. 2014;46(4):1023–1031. doi: 10.3758/s13428-013-0434-y.CrossRefGoogle ScholarPubMed
Odlaug, BL, Grant, JE. Impulse-control disorders in a college sample: results from the self-administered Minnesota Impulse Disorders Interview (MIDI). Prim Care Companion J Clin Psychiatry. 2010;12(2). doi: 10.4088/PCC.09m00842whi.Google Scholar
Kraus, SW, Krueger, RB, Briken, P, et al. Compulsive sexual behaviour disorder in the ICD‐11. World Psychiatry. 2018;17(1):109–110. doi: 10.1002/wps.20499.CrossRefGoogle ScholarPubMed
Chamberlain, SR, Grant, JE. Minnesota Impulse Disorders Interview (MIDI): Validation of a structured diagnostic clinical interview for impulse control disorders in an enriched community sample. Psychiatry Res. 2018;265:279-283. doi: 10.1016/j.psychres.2018.05.006.CrossRefGoogle Scholar
Grant, JE, Levine, L, Kim, D, Potenza, MN. Impulse control disorders in adult psychiatric inpatients. Am J Psychiatry. 2005;162(11):2184–2188. doi: 10.1176/appi.ajp.162.11.2184.CrossRefGoogle ScholarPubMed
Odlaug, BL, Lust, K, Schreiber, L, et al. Compulsive sexual behavior in young adults. Ann Clin Psychiatry. 2013;25(3):193–200.Google ScholarPubMed
Derbyshire, KL, Grant, JE. Neurocognitive findings in compulsive sexual behavior: a preliminary study. J Behav Addict. 2015;4(2):35–36. doi: 10.1556/2006.4.2015.004.CrossRefGoogle ScholarPubMed
Graham, MD, Young, RA, Valach, L, Alan Wood, R. Addiction as a complex social process: an action theoretical perspective. Addict Res Theory. 2008;16(2):121–133. doi: 10.1080/16066350701794543.CrossRefGoogle Scholar
Kraus, SW, Sweeney, PJ. Hitting the target: considerations for differential diagnosis when treating individuals for problematic use of pornography. Arch Sex Behav. 2019;48(2):431–435. doi: 10.1007/s10508-018-1301-9.CrossRefGoogle ScholarPubMed
McGahuey, CA, Gelenberg, AJ, Laukes, CA, et al. The Arizona sexual experience scale (ASEX): reliability and validity. J Sex Marital Therapy. 2000;26(1):25–40. doi: 10.1080/009262300278623.Google ScholarPubMed
Terry, PC, Lane, AM, Fogarty, GJ. Construct validity of the profile of mood states—adolescents for use with adults. Psychol Sport Exercise. 2003;4(2):125–139. doi: 10.1016/S1469-0292(01)00035-8.CrossRefGoogle Scholar
McNair, DM, Lorr, M, Droppleman, LF. Profile of Mood States: Manual. San Diego, CA: EdITS; 1992.Google Scholar
McNair, D, Lorr, M, Droppelman, L. Manual for the Profile of Mood States. San Diego, CA: Educational and Industrial Testing Service; 1971.Google Scholar
Peters, L, Sunderland, M, Andrews, G, Rapee, RM, Mattick, RP. Development of a short form Social Interaction Anxiety (SIAS) and Social Phobia Scale (SPS) using nonparametric item response theory: the SIAS-6 and the SPS-6. Psychol Assess. 2012;24(1):66. doi: 10.1037/a0024544.CrossRefGoogle Scholar
Lovibond, PF, Lovibond, SH. The structure of negative emotional states: comparison of the Depression Anxiety Stress Scales (DASS) with the Beck Depression and Anxiety Inventories. Behav Res Therapy. 1995;33(3):335–343. doi: 10.1016/0005-7967(94)00075-u.CrossRefGoogle ScholarPubMed
Cyders, MA, Littlefield, AK, Coffey, S, Karyadi, KA. Examination of a short English version of the UPPS-P Impulsive Behavior Scale. Addict Behav. 2014;39(9):1372–1376. doi: 10.1016/j.addbeh.2014.02.013.CrossRefGoogle Scholar
Lynam, D. Development of a short form of the UPPS-P Impulsive Behavior Scale. Unpublished technical report. 2013.CrossRefGoogle Scholar
Chamberlain, SR, Grant, JE. Initial validation of a transdiagnostic compulsivity questionnaire: the Cambridge–Chicago Compulsivity Trait Scale. CNS Spectr. 2018;23(5):340–346. doi: 10.1017/S1092852918000810.CrossRefGoogle ScholarPubMed
Kessler, RC, Adler, L, Ames, M, et al. The World Health Organization Adult ADHD Self-Report Scale (ASRS): a short screening scale for use in the general population. Psychol Med. 2005;35(2):245–256. doi: 10.1017/S0033291704002892.CrossRefGoogle Scholar
Grubbs, JB, Wilt, JA, Exline, JJ, Pargament, KI, Kraus, SW. Moral disapproval and perceived addiction to internet pornography: a longitudinal examination. Addiction. 2018;113(3):496–506.CrossRefGoogle ScholarPubMed
Qualtrics. Survey Research Suite: Research Core TM. Provo, UT: Qualtrics website. http://www.qualtrics.com. Published 2019. Accessed November 20, 2019.Google Scholar
Reid, RC, Li, DS, Gilliland, R, Stein, JA, Fong, T. Reliability, validity, and psychometric development of the Pornography Consumption Inventory in a sample of hypersexual men. J Marital Family Therapy. 2011;37(5):359–385.CrossRefGoogle Scholar
Cohen, J. Statistical Power Analysis for the Behavioral Sciences. New York, NY: Routledge; 2013.CrossRefGoogle Scholar
Daigre, C, Roncero, C, Rodríguez-Cintas, L, et al. Adult ADHD screening in alcohol-dependent patients using the Wender–Utah Rating Scale and the adult ADHD Self-Report Scale. J Atten Disord. 2015;19(4):328–334.CrossRefGoogle ScholarPubMed
Brand, M, Snagowski, J, Laier, C, Maderwald, S. Ventral striatum activity when watching preferred pornographic pictures is correlated with symptoms of Internet pornography addiction. Neuroimage. 2016;129:224–232. doi: 10.1016/j.neuroimage.2016.01.033.CrossRefGoogle ScholarPubMed
Hald, GM. Comment on: is pornography use associated with sexual difficulties and dysfunctions among younger heterosexual men? J Sex Med. 2015;12(5):1140–1141. doi: 10.1111/jsm.12877.CrossRefGoogle ScholarPubMed
Koob, GF, Le Moal, M. Plasticity of reward neurocircuitry and the ‘dark side’ of drug addiction. Nat Neurosci. 2005;8(11):1442 CrossRefGoogle ScholarPubMed
Ballester-Arnal, R, Castro-Calvo, J, Giménez-García, C, Gil-Juliá, B, Gil-Llario, M. Psychiatric comorbidity in compulsive sexual behavior disorder (CSBD). Addict Behav. 2020;107:106384. doi: 10.1016/j.addbeh.2020.106384.CrossRefGoogle Scholar
Kühn, S, Gallinat, J. Brain structure and functional connectivity associated with pornography consumption: the brain on porn. JAMA Psychiatry. 2014;71(7):827–834. doi: 10.1001/jamapsychiatry.2014.93.CrossRefGoogle ScholarPubMed
Levin, ME, Lillis, J, Hayes, SC. When is online pornography viewing problematic among college males? Examining the moderating role of experiential avoidance. Sex Addict Compulsivity. 2012;19(3):168–180. doi: 10.1080/10720162.2012.657150.Google Scholar
Grubbs, JB, Stauner, N, Exline, JJ, Pargament, KI, Lindberg, MJ. Perceived addiction to Internet pornography and psychological distress: examining relationships concurrently and over time. Psych Addict Behav. 2015;29(4):1056. doi: 10.1037/adb0000114.CrossRefGoogle ScholarPubMed
Booth, BM, Curran, G, Han, X, et al. Longitudinal relationship between psychological distress and multiple substance use: results from a three-year multisite natural-history study of rural stimulant users. J Stud Alcohol Drugs. 2010;71(2):258–267. doi: 10.15288/jsad.2010.71.258.CrossRefGoogle ScholarPubMed
Goudriaan, AE, Slutske, WS, Krull, JL, Sher, KJ. Longitudinal patterns of gambling activities and associated risk factors in college students. Addict. 2009;104(7):1219–1232. doi: 10.1111/j.1360-0443.2009.02573.x.CrossRefGoogle ScholarPubMed
Miner, MH, Raymond, N, Mueller, BA, Lloyd, M, Lim, KO. Preliminary investigation of the impulsive and neuroanatomical characteristics of compulsive sexual behavior. Psychiatry Res Neuroimag. 2009;174(2):146–151. doi: 10.1016/j.pscychresns.2009.04.008.CrossRefGoogle ScholarPubMed
Grubbs, JB, Kraus, SW, Perry, SL. Self-reported addiction to pornography in a nationally representative sample: the roles of use habits, religiousness, and moral incongruence. J Behav Addict. 2019;8(1):88–93. doi: 10.1556/2006.7.2018.134.CrossRefGoogle Scholar
Reid, RC. Personal perspectives on hypersexual disorder. Sex Addict Compulsivity. 2013;20(1–2):4–18. doi: 10.1080/10720162.2013.772876.Google Scholar
Duffy, A, Dawson, DL, Das Nair, R. Pornography addiction in adults: a systematic review of definitions and reported impact. J Sex Med. 2016;13(5):760–777. doi: 10.1016/j.jsxm.2016.03.002.CrossRefGoogle ScholarPubMed
Gola, M, Potenza, MN. Promoting educational, classification, treatment, and policy initiatives: commentary on: compulsive sexual behaviour disorder in the ICD-11 (Kraus et al., 2018). J Behav Addict. 2018;7(2):208–210. doi: 10.1556/2006.7.2018.51.CrossRefGoogle Scholar
Reid, RC, Davtian, M, Lenartowicz, A, Torrevillas, RM, Fong, TW. Perspectives on the assessment and treatment of adult ADHD in hypersexual men. Neuropsychiatry. 2013;3(3):295–308. doi: 10.2217/NPY.13.31.CrossRefGoogle Scholar
Whitley, R, Crawford, M. Qualitative research in psychiatry. Can J Psychiatry. 2005;50(2):108–114. doi: 10.1177/070674370505000206.CrossRefGoogle ScholarPubMed
Wordecha, M, Wilk, M, Kowalewska, E, Skorko, M, Łapiński, A, Gola, M. “Pornographic binges” as a key characteristic of males seeking treatment for compulsive sexual behaviors: qualitative and quantitative 10-week-long diary assessment. J Behav Addict. 2018;7(2):433–444. doi: 10.1556/2006.7.2018.33.CrossRefGoogle ScholarPubMed
Sniewski, L, Farvid, P. Hidden in shame: heterosexual men’s experiences of self-perceived problematic pornography use. Psychol Men Masc. 2019;21(2), 201–212. doi: 10.1037/men0000232.CrossRefGoogle Scholar
Grant, JE. Compulsive sexual behavior: a nonjudgmental approach. Current Psychiatry. 2018;17(2): 24–46.Google Scholar
Piquet-Pessôa, M, Ferreira, GM, Melca, IA, Fontenelle, LF. DSM-5 and the decision not to include sex, shopping or stealing as addictions. Curr Addict Rep. 2014;1(3):172–176. doi: 10.1007/s40429-014-0027-6.CrossRefGoogle Scholar
Gola, M, Potenza, MN. The proof of the pudding is in the tasting: data are needed to test models and hypotheses related to compulsive sexual behaviors. Arch Sex Behav. 2018;47(5):1323–1325. doi: 10.1007/s10508-018-1167-x.CrossRefGoogle ScholarPubMed
Georgiadis, J, Kringelbach, ML. The human sexual response cycle: brain imaging evidence linking sex to other pleasures. Prog Neurobiol. 2012;98(1):49–81. doi: 10.1016/j.pneurobio.2012.05.004.CrossRefGoogle ScholarPubMed
Koob, G, Kreek, MJ. Stress, dysregulation of drug reward pathways, and the transition to drug dependence. Am J Psychiatry. 2007;164(8):1149–1159. doi: 10.1176/appi.ajp.2007.05030503.CrossRefGoogle ScholarPubMed
Grabowski, J, Shearer, J, Merrill, J, Negus, SS. Agonist-like, replacement pharmacotherapy for stimulant abuse and dependence. Addict Behav. 2004;29(7):1439–1464. doi: 10.1016/j.addbeh.2004.06.018.CrossRefGoogle ScholarPubMed
Sniewski, L, Farvid, P. Abstinence or acceptance? A Case series of men’s experiences with an intervention addressing self-perceived problematic pornography use. Sex Addict Compulsivity. 2019;26(3–4):191–210. doi: 10.1080/10720162.2019.1645058.CrossRefGoogle Scholar
Studer, J, Marmet, S, Wicki, M, Gmel, G. Cybersex use and problematic cybersex use among young Swiss men: associations with sociodemographic, sexual, and psychological factors. J Behav Addict. 2019;8(4):794–803. doi: 10.1556/2006.8.2019.69.CrossRefGoogle ScholarPubMed
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