Relacja z International Conference on Behavioral Addictions
W ramach międzynarodowej konferencji „4th International Conference on Behavioral Addictions”, która odbyła się w dniach 20-22 luty 2017 w Hajfie, nasz zespół prezentował wyniki badań, prowadzonych w ramach projektu hiperseksualność.pl.
Zapraszamy do zapoznania się z abstraktami naszych prezentacji.
1.Altered orbitofrontal reactivity during reward processing among problematic pornography users and pathological gamblers
MATEUSZ GOLA1,2 PHD, MAŁGORZATA WORDECHA1,3, MICHAŁ LEW-STAROWICZ5 MD, PHD, MARC N. POTENZA6,7 MD, PHD, ARTUR MARCHEWKA3 PHD and GUILLAUME SESCOUSSE4 PHD
1 Swartz Center for Computational Neuroscience, Institute for Neural Computations, University of California San Diego, San Diego, USA
2 Institute of Psychology, Polish Academy of Science, Warsaw, Poland
3 Laboratory of Brain Imaging, Neurobiology Center, Nencki Institute of Experimental Biology of Polish Academy of Science, Warsaw, Poland
4 Radboud University, Donders Institute for Brain, Cognition and Behavior, Nijmegen, Netherlands
5 III Department of Psychiatry, Institute of Psychiatry and Neurology, Warsaw, Poland
6 Departments of Psychiatry and Neurobiology, Child Study Center and CASAColumbia,Yale School of Medicine, New Haven, CT, USA
7 Connecticut Mental Health Center, New Haven, CT, USA
Background and aims: Frequent pornography use is highly relevant among young males (Hald, 2006). For majority, pornography viewing is a form of entertainment, but for some individuals problematic pornography use (PPU) accompanied by excessive masturbation is a reason for treatment seeking (Gola et al., 2016). What differentiate problematic and regular pornography users? And how does it mimic other problematic behaviors, such as e.g. pathological gambling?
Methods: Using fMRI methodology we examined brain reactivity towards erotic and monetary stimuli, disentangling cue-related ‘wanting’ from reward related ‘liking’ among 28 heterosexual males seeking treatment for PPU and 24 matched controls (Gola et al., 2016). The same procedure had been used previously in studies on pathological gambling (Sescousse et al., 2013).
Results: As we showed before (Gola et al., 2016) compared with control subjects, PPU subjects showed increased activation of brain reward circuits (ventral striatum) specifically for cues predicting erotic pictures but not for cues predicting monetary gains, which exactly mimics results of previous study with the same method on individuals with gambling disorder (Sescousse, et al., 2013). Here we focused on other brain region involved in reward processing – orbitofrontal cortex (OFC). As it had been shown, evolutionally older posterior OFC in healthy subjects is involved in processing of primary rewards (food and sex), while anterior OFC process secondary rewards (such as money or social reinforces). According to this state of art aOFC is in our study it was the only ROI expressing higher activations for monetary gains than erotic rewards in control subjects. But interestingly, for PPU subjects the aOFC was more active for erotic pictures than monetary rewards, while pOFC remained unchanged. The amount of this shift in aOFC was related to PPU severity measures. Among subjects with pathological gambling opposite pattern of changes was observed: pOFC was activated more for monetary rewards, while aOFC activations remained unchanged when compared to controls (Sescousse et al., 2013).
Conclusions: Our results suggest that PPU subjects may experience difficulties in differentiating between value of erotic and non-erotic rewards similarly to pathological gamblers in case of monetary and non-monetary rewards. Our results show also that PPU resembles neural and behavioral patterns well-described in gambling disorder although functional changes affects opposite brain structures in both groups.
2.How impulsivity is related to problematic pornography use? Longitudinal study among participants of 12-steps sexual addiction treatment program
EWELINA KOWALEWSKA1, JAROSLAW SADOWSKI2, MALGORZATA WORDECHA3, KAROLINA GOLEC4, MIKOLAJ CZAJKOWSKI, PhD2 and MATEUSZ GOLA, PhD3, 5
1Department of Psychology, University of Social Sciences and Humanities, Warsaw, Poland
2 Department of Economy, University of Warsaw, Warsaw, Poland
3 Institute of Psychology, Polish Academy of Sciences, Warsaw, Poland
4 Department of Psychology, University of Warsaw, Warsaw, Poland
5 Swartz Center for Computational Neuroscience, Institute for Neural Computations, University of California San Diego,San Diego, USA
Background and aims: Some research show relation between impulsivity and pornography use (Mainer et al.,2009; Mick & Hollander, 2006; Davis et al., 2002; Shapira et al., 2000). One aspect of impulsivity is the ability of delaying gratification and discounting. It remains unknown whether deferment of gratification is the cause or the result of frequent pornography use.
Methods: We measured discounting by MCQ questionnaire (Monetary Choice Questionnaire; Kirby & Marakovic, 1996) in two studies. In Study 1, data were collected from surveys conducted on a members of 12-steps groups for sexual addiction (N = 77, mean age 34.4, SD = 8.3) and control individuals (N = 171, mean age 25.6, SD = 6.4). In Study 2, we conducted repeated measurement after 3 months on a 17 members of 12-steps group for sexual addiction from Study 1 (N = 17, mean age 34.8, SD = 2.2). The average time of sexual abstinence in clinical group was 243.4 days (SD = 347.4, Min. = 2, Max. = 1216; Study 1) and 308.5 days (SD = 372.9, Min. = 1, Max. = 1281; Study 2). Both studies were performed via the Internet.
Results: In Study 1 time spent on pornography and masturbation was correlated positively with the discounting parameter. Correlations between these variables were stronger in among sex addicts (masturbation frequency, r = 0.30, p < 0.05; pornography use, r = 0.28, p < 0.05) than the control group (masturbation frequency, r = 0.23, p < 0.05; pornography use, r =0.19, p < 0.05) The strongest correlation (r = −0.39) occurs between the discounting parameter and sobriety among sex addicts. Contrary to our hypothesis average discounting function parameters were higher in control group than in group of sex addicts. In Study 2, results didn’t show significant relation between discounting and time of sexual abstinence. However, groups did not significantly differ in discounting between measurements and gain in sobriety during 3 months was not accompanied by decrease of discounting. Changes in sobriety could be better explained by number of mentee on 12-step program (r = 0.92, p < 0.05) or current step in 12-steps therapy (r = 0,68; p < 0,001) than by discounting.
Conclusions: The ability of delaying gratification is rather not modified by the pornography use. Probably it is a constant feature that can determine the frequency of pornography use in the general population. Among the members of the 12-steps groups for sex addicts the ability of delaying gratification, paradoxically, is higher than in the general population and is not modified during 3 months of working on a 12-steps program. Moreover, discounting does not change with the time of abstinence. This result may suggest that individuals with low discounting may be more prone to benefit form 12-step program, than those with high discounting.
3.Brief Pornography Screener: A comparison of US and Polish pornography users
SHANE W. KRAUS, PhD.,1 MATEUSZ GOLA, PhD.,2 EWELINA KOWALEWSKA,3 MICHAL LEW-STAROWICZ ,M.D., PhD.4 RANI A. HOFF, PhD.,5, 6 ELIZABETH PORTER, MBA,6 and MARC. N. POTENZA, M.D., PhD.5,7
1 New England MIRECC, Edith Nourse Rogers Memorial Veterans Hospital, Bedford MA, USA
2 Swartz Center for Computational Neuroscience, Institute for Neural Computations, University of California San Diego, San Diego, USA
3 Department of Psychology, University of Social Sciences and Humanities, Warsaw, Poland
4 Institute of Psychiatry and Neurology, 3rd Psychiatric Clinic, Warsaw, Poland
5 Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
6 MIRECC, VA CT Healthcare System, West Haven CT, USA
7 Department of Neuroscience, Child Study Center and the National Center on Addiction and Substance Abuse, Yale School of Medicine, USA
Background and aims: The current study evaluated the psychometric properties of a newly developed six-item questionnaire designed to identify behaviors, thoughts, and experiences associated with problematic use of pornography.
Methods: In Studies 1 and 2, 223 US military veterans and 703 Polish community members were administered the Brief Pornography Screener (BPS) and measures assessing frequency of pornography use, craving for pornography, problematic use of pornography, clinical hypersexuality, and impulsivity. In Study 3, 26 Polish male clinical patients were administered the BPS and measures of psychopathology.
Results: In Study 1, findings supported dropping one item from the questionnaire; the five remaining items were subjected to an exploratory factor analysis which yielded a one-factor solution with an eigenvalue of 3.75 that accounted for 62.5% of the total variance. The BPS also demonstrated high internal reliability (α = 0.89). Next, we found that BPS scores were significantly and positively associated with craving for pornography, problematic use of pornography, and hypersexuality, but weakly related to impulsivity. In Study 2, findings were similar in that BPS scores were positively associated with a measure of hypersexuality but weakly associated with scores on measures assessing obsessive-compulsive symptoms and impulsivity. Results also indicated that the one-factor solution yielded an excellent fit: χ2/df = 5.86, p = 0.00, RMSEA = 0.08, SRMR = 0.02, CFI = 0.99, and TLI = 0.97. In Study 3, we assessed the classification quality of BPS using an a priori selected group of patients against a control group. The ROC analysis indicated that the AUC value was 0.863 (SE = 0.024; p < 0.001; 95% CI: 81.5−91.1).
Conclusions: The BPS demonstrated promising psychometric properties across both US and Polish samples and could be used by clinicians in mental health settings to identify individuals with possible problematic use of pornography.
4.Treatment seeking for problematic pornography use among women
KAROL LEWCZUK1, JOANNA SZMYD2 and MATEUSZ GOLA3,4
1 Department of Psychology, University of Warsaw, Warsaw, Poland
2 Department of Cognitive Psychology, University of Finance and Management, Warsaw, Poland
3 Institute of Psychology, Polish Academy of Sciences, Warsaw , Poland
4 Swartz Center for Computational Neuroscience, Institute for Neural Computations, University of California San Diego,San Diego, USA
Backgrounds and aims: Previous studies examined psychological factors related to treatment-seeking for problematic pornography use (PU) among males. In this study we focused on females who seek treatment for problematic PU and examined the differences with regards to variables related to problematic PU between this group and the group of women that did not seek such treatment. Secondly, we investigated the relationships between critical constructs related to problematic PU with path analysis method, emphasizing the predictors for treatment-seeking among women. We also compared our results to previous studies on males.
Methods: A survey study was conducted on 719 Caucasian females 14 to 63 years old, including 39 treatment-seekers for problematic PU (referred by psychotherapists after their initial visit)
Results: Treatment-seeking among females is related to negative symptoms associated with PU, but also to the mere amount of PU. This stands in opposition to previously published analyses on males. Additionally, in the case of females, religiosity is a strong, significant predictor of treatment seeking.
Discussion: Differently from previous studies that focused on male samples, our analysis showed that in case of women mere amount of PU may be related with treatment-seeking behavior even after accounting for negative symptoms associated with PU. Moreover, religiousness is a significant predictor of treatment seeking among women, what may indicate that in case of women, treatment seeking for problematic PU is motivated not only by experienced negative symptoms of PU, but also personal beliefs about PU and social norms. Those factors should be taken into account in treatment.
Conclusions: Negative symptoms associated with pornography use, frequency of pornography use and religiousness are associated with treatment-seeking among women – this pattern is different than the results obtained in previous studies on males.
- Clinical diversity among males seeking treatment for compulsive sexual behaviors. Qualitative study followed by 10-week diary assessment.
MAŁGORZATA WORDECHA1, MATEUSZ WILK1, EWELINA KOWALEWSKA2, MACIEJ SKORKO1 and MATEUSZ GOLA1,3
1Institute of Psychology, Polish Academy of Sciences, Warsaw, Poland
2University of Social Sciences and Humanities, Warsaw, Poland
3Swartz Center for Computational Neuroscience, Institute for Neural Computations, University of California San Diego, San Diego, CA, USA
Background and aims: We wanted to assess similarities and diversity among males seeking treatment for compulsive sexual behaviors and verify a correspondence of perceived reasons of pornography use with real-life data.
Methods: We conducted semi-structuralized interviews with 9 males in age of 22–37 years (M= 31.7; SD = 4.85) followed by 10-week long diary assessment. During interviews we covered characteristic of CSB symptoms, underlying psychological mechanisms, and role of social relations. Using questioners’ methods, we verified qualitative data and in addition we conducted10-week long diary assessment to examine real-life patterns of CSB.
Results: All subjects expressed high level of severity of pornography use and masturbation. They also presented increased level of anxiety and declared that pornography use and masturbation serves for mood and stress regulation. There was high diversity in terms of impulsivity, social competence and other psychological mechanism underlying CSB. Data collected in diary assessment uncovered high diversity in patterns of sexual behaviors (such as frequency or binge pornography use, dyadic sexual activity) and triggers. It was impossible to fit one regression model for all subjects. Instead each subject had his own model of predictors of CSB mostly not related to decelerated triggers.
Discussion and conclusions: Despite similar scheme of problematic sexual behavior and accompanied emotions and thoughts CSB seems to have homogeneous psychological mechanisms. Individual analysis of longitudinal diary assessment uncovered high variability in individual predictors of pornography use and masturbation. Therefore, those individual patters have to be carefully studied in clinical settings to provide effective treatment.
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