Sunday, October 03, 2010

Is There Any Evidence for the "Porn-Addicted Brain"?



No definite peer reviewed work that I could find...


However a recent blog post by Dr. Donald L. Hilton, Jr., a Mormon spine surgeon and Clinical Associate Professor of Neurosurgery at University of Texas Health Sciences Center, claimed otherwise:
Can pornography use become an actual brain addiction?

. . .

Ten years ago evidence began to point to the addictive nature of over-consumption of natural behaviors which cause a dopaminergic reward to be experienced in the brain. For instance, Dr. Howard Schaffer, Director of Addiction Research at Harvard University, said in 2001, “I had great difficulty with my own colleagues when I suggested that a lot of addiction is the result of experience … repetitive, high-emotion, high-frequency experience. But it’s become clear that neuroadaptation–that is, changes in neural circuitry that help perpetuate the behavior–occurs even in the absence of drug-taking.” In the decade since he said this, he has focused his research more and more on the brain effects of natural addictions such as gambling...

The experts are fond of saying that addiction occurs when a habit “hijacks” brain circuits that evolved to reward survival- enhancing behavior such as eating and sex.
Pretty typical stuff about behavioral addictions and the overworked "neuroplasticity" concept. Is it even worth writing about any more? It is when a scholarly sounding science article written by a neurosurgeon appears on the website of a recovery organization driven by religious motives. The S.A. Lifeline Foundation condones only one type of sex: that between a married man and his wife. Everything else is wrong. Banish masturbation entirely. What if you're not married? You can look forward to a life of celibacy! No sex of any kind for you. And it's no surprise they promote reparation therapy to cure homosexuality:

Same Sex Attraction

For individuals experiencing unwanted same-sex-attraction (SSA), or same-gender-attraction (SGA), achieving sexual sobriety and recovery is crucial. Often they can feel a deep level of shame because of society’s tendency to automatically label all such as actively “gay” or “lesbian”. Many with these attractions have never experienced this lifestyle and many are married to a spouse who is heterosexual. Most have kept their attractions secret – which in many cases fuels a secret addiction to homosexual pornography or fantasy. Others wish to leave their former lifestyle and are seeking understanding and acceptance, but cannot seem to get past the continued pull of pornography and masturbation. Sexaholics Anonymous (SA) can help. SA is the only fellowship dealing with this addiction which defines “sobriety” for married persons as: no form of sex with self or with persons other than the spouse – meaning one’s partner in a marriage between a man and a woman. For the unmarried, sobriety means freedom from sex of any kind. For both the goal is progressive victory over lust.
What good is that?? The proscriptions of S.A. Lifeline Foundation are not only boring, they're harmful. The propagation of such degrees of guilt and shame throughout society is one reason why LGBT youth like Tyler Clementi kill themselves at alarming rates. So whatever your position on pornography and sexual addiction (Yes It Exists: the sex addicted brain! and Cupid's Poisoned Arrow; No It Doesn't: The Rogue Neuron and Dr Petra), it's clear that cloaking prudish sexual morality in the guise of science will make it more palatable to a wider audience.

In this video, Dr. Hilton stretches the truth about the existence of evidence demonstrating that pornography addiction changes the brain.

"A study looking at a form of sexual addiction showed the same thing [as studies on cocaine addiction and obesity], that those frontal lobes actually got smaller in addiction, in sexual addiction."



What he doesn't tell you is that the paper is on adult male pedophiles, convicted child molesters incarcerated at high-security forensic treatment facilities in Germany (Schiffer et al., 2007). These individuals go well beyond the pale of your average teenage wanker. In fact, it's rather offensive that he covertly uses a flagrant example of sexual pathology to illustrate his point. But he has to, because there are no other studies out there.

Hilton is more forthcoming about these results in his blog post:
So what about sexual addiction? In 2007 a VBM [voxel-based morphometry] study out of Germany looked specifically at pedophilia, and demonstrated almost identical finding to the cocaine, methamphetamine, and obesity studies. The significance of this study in relation to our topic cannot be overemphasized. It demonstrates that a sexual compulsion can cause physical, anatomic change in the brain, i.e., harm.
Sure, compulsive overconsumption of porn that intrudes upon one's daily life and hinders the ability to have healthy relationships is problematic, even when the viewer is not a criminal. And the escalating levels of violence, and weirdness, of internet video can add fuel to the fire. Religious organizations use this as an excuse for promoting campaigns to condemn any form of sex that occurs outside of holy matrimony.

Incorporation of the "addiction" and "dopamine" and "neuroplasticity" buzzwords is a new addition to their strategy. In the end, secular neuroscientists (i.e., most of us) should be upset that our work is being used for such purpose.

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17 Comments:

At October 03, 2010 8:50 AM, Blogger Tantalus Prime said...

A corollary to this is the overemphasis by some religious leaders on sex differences in the brain. They often use this as justification for the scriptural roles for husbands and wives. Related to the present topic though, they also use this research to argue that all men are sex addicts (we can't help it, we're wired that way) and women never are (because women of course never think about and never want it until they get married to a good Christian man). That would make for an interesting post some day.

 
At October 03, 2010 9:41 AM, Anonymous Anonymous said...

So, in your opinion addictive responses in the brain are only the result of extreme activity (pedophilia) or obsessive activity (interfering with daily "normal" activity) but are NOT present in other activities.

Yes, that makes complete sense. Our brains only respond to extreme activity. Normal brain activity can have absolutely NO similarity.

Even by scientific standards your argument is extremely weak.

You cannot find any studies on pornography, but what about gambling or other types of addictive behavior. I've read some great studies recently on anger management and behavior.

What you're saying makes very little sense. If a neurological basis can be found for ANY addictive behavior that doesn't involve drugs, why can't it be present in EVERY addictive behavior that doesn't involve drugs?

Are you saying that you are completely devoid of any kind of agenda to argue differently than those that clearly have an agenda?

I would be happy to agree that the science isn't settled yet for a specific mechanism for neuro-addictive behavior (certainly in regards to a particular area of the brain) - but I'd be very careful to say there is NO evidence of such.

 
At October 03, 2010 11:14 AM, Blogger Mike Ruhl said...

"Religious organizations use this as an excuse for promoting campaigns to condemn any form of sex that occurs outside of holy matrimony."

Some may, but the real reason we condemn it is because God himself condemned it in His Word.

 
At October 03, 2010 1:34 PM, Blogger The Neurocritic said...

Tantalus Prime - Good point! Women aren't supposed to have sex drives.

Hilton does have a slight nod towards protecting teenage girls. In He Restoreth My Soul, he says:

"It is important for those who have daughters to understand that although the numbers are smaller for girls, there is still a risk, both from visual pornography and primarily from chat rooms, text messaging, and verbal pornography."


Mike - You're right, of course. A literal reading of the Old Testament will suffice.

 
At October 03, 2010 2:23 PM, Blogger The Neurocritic said...

Anonymous - I see you have resorted to science by analogy...

I stand by my statement that I have yet to find any peer reviewed research that demonstrates brain changes directly related to "pornography addiction" (however one may define it). I never denied that such changes could occur. ALL experience changes the brain: learning to read, learning to juggle, learning a second language. It's such an overworked truism that I didn't bother to explain this (see Neuroplasticity is a dirty word).

In the absence of evidence, it is disingenuous to say that criminal pedophiles are equivalent to those who watch a lot of porn. It's like saying that anyone who occasionally feels like they're being watched (the experience of a "sensed presence") is the same as a paranoid schizophrenic who believes the CIA is engaged in an elaborate plot to spy on him and control his mind. You are arguing that one can use the brain changes in the latter as a proxy for the former.

I don't think so. That's unscientific.

In July I featured a three part series on neuroimaging studies of viewing erotic material, and how variations in sexual preferences influence the neural and behavioral responses:

Erotic or Disgusting?
Pleasure or Pain?
Tales of Passion and Disgust

I have also critiqued a published study on internet addiction: Does "Internet Addiction" Really Shrink Your Brain? (the answer: we don't really know based on that one paper). An excellent post by PsyBlog addresses the difficulties in defining internet addiction in the first place.

Finally, it turns out that use of the "destructive impact upon the human brain caused by viewing pornographic images" argument isn't new. Here's a classic 2005 post by Mind Hacks, Attack of the porno-zombies:

-----------
The Guardian reports on psychologist Judith Reisman, who argues that pornography is an ‘erototoxin’ that damages the brain, impairing cognition and rational thought:

“According to Dr Judith Reisman, pornography affects the physical structure of your brain turning you into a porno-zombie. Porn, she says, is an “erototoxin”, producing an addictive “drug cocktail” of testosterone, oxytocin, dopamine and serotonin with a measurable organic effect on the brain.”

In the first instance, she’s right. Pornography does physically affect the brain. In fact, everything we experience physically changes the brain in some way.

. . .

Critics note that Reisman is associated with the Lighted Candle Society, a right-wing Christian organisation aiming to promote ‘moral values’ and fund anti-porn brain scanning studies.
-----------

You can bet that if a neuroimaging paper on porn addiction IS published, I'll be among the first to blog about it...

 
At October 03, 2010 2:26 PM, Blogger The Neurocritic said...

Oh, and about my "agenda" - I do believe that preventing suicide among LGBT youth is extremely important.

 
At October 03, 2010 9:30 PM, Anonymous Spiny Norman said...

It's pretty obvious that Dr. Donald L. Hilton, Jr. is himself a type specimen of the porn-addicted brain.

(He's studying it just to see how bad it really is, you know.)

 
At October 05, 2010 7:56 AM, Anonymous Anonymous said...

Mr Neurocritic, Thank you for your good work here.

 
At October 05, 2010 1:32 PM, Blogger Ioana said...

Thank you for challenge this. I'm a neuroscience student and it scares me sometimes how people can distort and misuse results to "prove" their beliefs.

 
At October 11, 2010 9:35 AM, Blogger SleepRunning said...

This is a frontier for neuroscience for sure. Likely because of the socio-cultural belief factors and denial that plague all medical views of mental illnesses and especially addiction.

It seems to us that virtual, online compulsive sexual triggering and masturbation is far less harmful, personally and socially, than the real thing. It's really not that big a deal. And a symptom of a brain state -- not the "problem."

It does seem a testable hypotheses to generalize from other impulsive/compulsive brain disorders and mechanisms. But peer-reviewed studies are sorely needed.

We have been looking at the vole studies which are interesting in their focus on pair-bonding or not.

Finally, we will say that, anecdotally, we find sex addiction often a truly horrific condition. Using another person as the drug of choice often involves children, dependents and physical violence. Often those afflicted seek out positions of power, leadership and social acceptance to "feed" their habits. Political leaders, religious leaders, educational leaders are examples. Some of the stories of the victims are heartbreaking.

There too, however, the drive for social prominence seems to come under the category of impulsive/compulsive disorders which we see as symptoms of a inherited dopamine receptor deficits.

 
At October 12, 2010 10:54 AM, Anonymous Anonymous said...

Bravo dude!
In recent light of the suicides and position of "the church"... need more be said?
THANK YOU

 
At November 10, 2010 1:26 AM, Anonymous Anonymous said...

tantalus prime: interesting comment about women who "never think about and never want it until they get married to a good Christian man." I am not sure whether you were referring to just sex or pornography, but, here is your "interesting post:" I am a married Christian ( or am I just foolin myself?) woman who has found herself newly drawn to nude photos (of women for cryin out loud! Try to figure that one out since I have never been previously attracted to women). I even found myself masturbating to one pic that I found online in particular. My husband is a wonderful Christian man, so undeserving of such a sick wife ( I have depression and a personality disorder, too). It would break his heart (considering all the other stuff he has to put up with, not to mention my being unemployed now for 8 mos)if he were to find out what I have been up to. And of course, I cannot go to the church and expect to get any help (even depression can scare other Christians away and make them judgmental of Christians like me). I can't trust any of my friends, either. And I don't have $ for counseling (remember, I've been unemployed for 8 mos?). So, where's the hope? Can some pill alter my brain or make these new desires go away? The guilt is heavy. I feel like I am cheating on my sweet husband. How 'bout shock therapy or some other extreme treatment? Oh, I believe that addiction of any kind can and does change the brain on a physiological level. Hope mine isn't too damaged, yet.

 
At November 10, 2010 2:23 AM, Blogger The Neurocritic said...

Anonymous - I think Tantalus Prime was commenting on how religious leaders can brainwash believers like you into thinking you're abnormal. You are NOT abnormal, "sick" or "damaged".

I assume you are not about to renounce your religion, which would be one step towards changing your negative beliefs. If you would like to get help with accepting your sexuality while still remaining a Christian, I suggest you try to find a more liberal church in your area and seek counseling there. Reparative, or conversion therapy does not work. I recommend this paper by two Lutheran doctors, which rebuts the views of Pastor David Glesne and explains why reparative therapy doesn't work.

MISUNDERSTANDING HOMOSEXUALITY

. . .

The official APA position on reparation therapy includes the following statement: “All such therapies assume that homosexuality is morally wrong, medically pathological, and socially undesirable and are based on the beliefs that erotic desire for someone of the same gender should be eliminated or redirected and that there are interventions that are effective in changing sexual orientation. Neither of these beliefs has been validated by empirical study.”

 
At November 13, 2010 4:33 PM, Blogger gary said...

Neurocritic,
It appears that your only argument against the existence of Internet porn addiction is that it hasn’t been studied. That’s no argument; it only means no one wants to study it.
Those addicted to Internet porn experience dependence, tolerance, and withdrawal symptoms. Hopefully we can agree that their brains must have undergone changes.
Several studies have demonstrated that natural reinforcers, such as highly palatable food, can alter the brain in ways similar to addictive chemicals.
For example: Dopamine D2 receptors in addiction-like reward dysfunction and compulsive eating in obese rats.
Unlimited acces to especially enticing food caused a decline D2 receptors in the reward circuitry. It occurred rapidly, along with behavioral changes. The dopamine receptors had not returned to normal even two weeks after the animals were returned to normal food. Compare that to the rats taking cocaine – they had a similar drop in D2 receptors, yet their receptors returned to baseline in 2 days.
This means that unlimited access to an especially exciting version of a natural substance or phenomenon can lead to brain changes that indicate an addiction process. A decline in D2 is a known marker of an addiction process.
Simplified:
1. Overeating tasty food (sausage, cheesecake, frosting) CAUSED a reduction in dopamine receptors.
2. This also shows up in human findings.
3. One of the main findings in drug addictions is a decline in striatal dopamine receptors.
4. In short, natural reinforcers can be addictive if the stimulation is supranormal, i.e., higher than what our ancestors evolved with.
5) Orgasm is far more stimulating to the reward circuitry than sausage – yet both food and sex are natural reinforcers.
Moreover, Internet porn can be far different than an orgasm:
1) It affords extreme novelty – 100’s of new sexual partners per session. Novelty is highly stimulating to reward circuitry. This is what makes it so appealing, and potentially addictive. It is not Dad’s static, finite Playboy.
2) Unlike food and drugs, in which there is a limit to consumption, there are no physical limitations to Internet porn consumption - other than the need for sleep and bathroom breaks. The brain’s natural satiation mechanisms are not activated, unless one comes. Even then, the user can click to something more shocking to become aroused again
3) Unlike drugs and food, the brains natural aversion system doesn’t get activated with Internet porn. Aversion is different from satiation. One starts vomiting or getting sick when aversion is activated. Who loses interest in sexy images? Whose genes would allow that?
4) With food and drugs, one can only escalate (a marker of an addiction process) by consuming more. With Internet porn, one can escalate with novel “partners,” and by viewing new and unusual sexual practices. It’s quite common for addict to move to ever more extreme porn.

It seems you started with an opinion, rather than considering the obvious: Many are addicted to Internet porn and natural reinforcers can cause addiction – anyway you define addiction. So let’s hear your substantive objections to these points, okay?

 
At November 13, 2010 4:37 PM, Blogger gary said...

Neurocritic,
It appears that your only argument against the existence of Internet porn addiction is that it hasn’t been studied. That’s no argument; it only means no one wants to study it.
Those addicted to Internet porn experience dependence, tolerance, and withdrawal symptoms. Hopefully we can agree that their brains must have undergone changes.
Several studies have demonstrated that natural reinforcers, such as highly palatable food, can alter the brain in ways similar to addictive chemicals.
For example: Dopamine D2 receptors in addiction-like reward dysfunction and compulsive eating in obese rats.
Unlimited acces to especially enticing food caused a decline D2 receptors in the reward circuitry. It occurred rapidly, along with behavioral changes. The dopamine receptors had not returned to normal even two weeks after the animals were returned to normal food. Compare that to the rats taking cocaine – they had a similar drop in D2 receptors, yet their receptors returned to baseline in 2 days.
This means that unlimited access to an especially exciting version of a natural substance or phenomenon can lead to brain changes that indicate an addiction process. A decline in D2 is a known marker of an addiction process.
Simplified:
1. Overeating tasty food (sausage, cheesecake, frosting) CAUSED a reduction in dopamine receptors.
2. This also shows up in human findings.
3. One of the main findings in drug addictions is a decline in striatal dopamine receptors.
4. In short, natural reinforcers can be addictive if the stimulation is supranormal, i.e., higher than what our ancestors evolved with.
5) Orgasm is far more stimulating to the reward circuitry than sausage – yet both food and sex are natural reinforcers.

 
At November 13, 2010 4:38 PM, Blogger gary said...

CONTINUED......
Moreover, Internet porn can be far different than an orgasm:
1) It affords extreme novelty – 100’s of new sexual partners per session. Novelty is highly stimulating to reward circuitry. This is what makes it so appealing, and potentially addictive. It is not Dad’s static, finite Playboy.
2) Unlike food and drugs, in which there is a limit to consumption, there are no physical limitations to Internet porn consumption - other than the need for sleep and bathroom breaks. The brain’s natural satiation mechanisms are not activated, unless one comes. Even then, the user can click to something more shocking to become aroused again
3) Unlike drugs and food, the brains natural aversion system doesn’t get activated with Internet porn. Aversion is different from satiation. One starts vomiting or getting sick when aversion is activated. Who loses interest in sexy images? Whose genes would allow that?
4) With food and drugs, one can only escalate (a marker of an addiction process) by consuming more. With Internet porn, one can escalate with novel “partners,” and by viewing new and unusual sexual practices. It’s quite common for addict to move to ever more extreme porn.

It seems you started with an opinion, rather than considering the obvious: Many are addicted to Internet porn and natural reinforcers can cause addiction – anyway you define addiction. So let’s hear your substantive objections to these points, okay?

 
At December 15, 2015 7:10 PM, Anonymous dream said...

Thanks, Gary.

Other than that, I am here to make contact with you because I have questions for you.

Is there any way I can submit them?

 

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