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Sexual Picture Processing Interferes with Decision-Making Under Ambiguity

Sexual Picture Processing Interferes with Decision-Making Under Ambiguity | Sex  Addiction | Scoop.it

"This study emphasized that sexual arousal interfered with decision-making, which may explain why some individuals experience negative consequences in the context of cybersex use."

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Bill Herring LCSW, CSAT's insight:


Curator comment: The neurological impact of chronic cybersex is a contentious topic, making studies like this one very important to the development of a scientific knowledge base.


Archives of Sexual Behavior

April 2014, Volume 43, Issue 3, pp 473-482


Abstract only. 

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The Gray Areas of Gray Matter

The Gray Areas of Gray Matter | Sex  Addiction | Scoop.it


"Neuroimaging is pretty cool, but it can’t do what its most enthusiastic boosters claim."

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Bill Herring LCSW, CSAT's insight:

Curator comment:  This blog post is being curated because it refences a book published earlier this summer,  Brainwashed: The Seductive Appeal of Mindless Neuroscience, which coins the term "neurorealism" to describe “the misbegotten propensity to regard brain images as inherently more ‘real’ or valid than other types of behavioral data.


The author then states that the recent ruckus-inducing Socioaffective Neuroscience and Psychology article "illustrates this tendency" by using neuroimaging to "discount the actual experiences of people who believe they have a problem".  Although the study did not claim that people don't experience many debilitating forms of dysregulated sexual desire, it's elicited several versions of a boiled-down opinion that people are addicted if they feel addicted. 


One author of a book written prior to the advent of fMRI technology remains unshaken in the belief that "(a)ddiction exists at the experiential level.  There is nothing more scientific about how attached people become to an addictive object—yes, heroin and alcohol included right along with sex, eating, video games, and shopping—than to understand how subjectively captivating and powerful it is for them......(E)xperiential analysis IS the science of addiction."  


A sense of certainty sometimes seems mighty inticing, even when kicking dirt on Bertrand Russell's dictum that "(t)he whole problem with the world is that fools and fanatics are always so certain of themselves, and wiser people so full of doubts."   Since there is ample room for more philosophers to join the swelling donnybrook about what is "true" about the nature of sex addiction, it's useful to keep in mind Wittgenstein's point that "(w)hether a proposition can turn out false depends on what I make count as determinants for that proposition."

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Porn, EEGs and the End of Sex Addiction?

Porn, EEGs and the End of Sex Addiction? | Sex  Addiction | Scoop.it


"The study by Steele, Staley, Fong and Prause is an important first step in filling in the picture of what many refer to as sex addiction, and the authors are incredibly generous, cautious, and thoughtful in their writing and interpretation of the results."


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Bill Herring LCSW, CSAT's insight:

Curator comment: Here is yet another opinion on a recent research study that has been extensively curated on this site over the past week, this one written by William M. Struthers, Ph.D, the author of "Wired for Intimacy: How Porn Hijacks the Male Brain". 

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Critque of Prause Study

Critque of Prause Study | Sex  Addiction | Scoop.it

"This.....study at its foundation does not address the issue of whether individuals seeking help for sex addiction, hypersexuality, etc. are experiencing a legitimate problem. It asks whether an addiction theory is the best explanation for this problem or whether there are alternative explanations that help us better understand this phenomenon. That’s it! "

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Bill Herring LCSW, CSAT's insight:

Curator comment:  Amid a torrent of commentary that has generally been casting more heat than light on the subject, this comprehensive analysis of the recent research article that has been garnering so much attention over the last few days (see the curation and commentary) is a welcome addition to the conversation.

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Gary Wilson's comment, August 20, 2013 11:15 AM
This Rory Reid "critique," is actually a veiled defense of the Nicole Prause study, and much of it responds to grave concerns we raised in this post: "UCLA's SPAN Lab Touts Empty Porn Study As Ground-Breaking" - http://pornstudyskeptics.blogspot.com/2013/07/uclas-span-lab-touts-empty-porn-study.html
Unfortunately, Reid's critique does not adequately address the concerns we raised, as explained in this reply post "Rory Reid Reply & Our Response." http://pornstudyskeptics.blogspot.com/2013/07/reidprause-reply-our-response.html
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Hypersexuality from resection of left occipital arteriovenous malformation

Hypersexuality from resection of left occipital arteriovenous malformation | Sex  Addiction | Scoop.it

"The authors report their experience on one patient with hypersexuality from resection of left occipital arteriovenous malformation. To the best of our knowledge, this is the first case reported in the literature. A 35-year-old right-handed female farmer suffered a sudden left occipital hemorrhage with subarachnoid and subdural hemorrhages of the left hemisphere. Transient left uncal herniation occurred at the onset and was released by conservative treatment. Digital subtraction angiography showed a brain left occipital arteriovenous malformation. After microsurgical resection of the arteriovenous malformation, the patient developed hypersexual behavior. Positron emission tomography showed hypermetabolism in the left frontal region and left posterior hippocampal gyrus and hypometabolism in the left anterior hippocampal gyrus and the left occipital surgical area. Theories concerning normal pressure perfusion breakthrough and specific areas in the brain responsible for the human sexual response are discussed."

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Bill Herring LCSW, CSAT's insight:

Curator comment: The above, which is the verbatim abstract, is all that is available online that is accessible to the general reader.


January 2010, Volume 33, Issue 1, pp 107-114
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Hypersexuality following septal injury

Hypersexuality following septal injury | Sex  Addiction | Scoop.it

"Hypersexuality is an uncommon consequence of brain injury. We report two cases of markedly increased sexual activity following septal damage sustained in the course of placement of ventriculoperitoneal shunts. These two cases, observations in animal experiments, and descriptions of altered behavior in humans with localized brain dysfunction indicate that a circuit involving the septal nuclei has an important role in the mediation of sexual behavior."


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Bill Herring LCSW, CSAT's insight:

Curator comment: This fairly dated publication is being curated to begin a comprehensive review of articles documenting a particular medical dimension of hypersexual symptoms.


Authors: Gorman, DG and Cummings, JL,

Source: Archives of Neurology, 1992 March, 49(3), 308-10.


Abstract only.

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Parent–Daughter Transmission of the Androgen Receptor Gene as an Explanation of the Effect of Father Absence on Age of Menarche

Parent–Daughter Transmission of the Androgen Receptor Gene as an Explanation of the Effect of Father Absence on Age of Menarche | Sex  Addiction | Scoop.it

Curator comment: This study references a predisposition to female sexual compulsivity, among other symptoms, as a result of father absence in early life.  The authors offer a genetic alternative to the traditional psychosocial explanation for this association, positing that a variant X–linked androgen receptor (AR) gene that predispose fathers to behaviors that include family abandonment may be passed to their daughters, causing early puberty, precocious sexuality, and behavior problems.


Note that this study was cited in "Biopsychosocial Model of Hypersexuality in Adolescent Girls With Bipolar Disorder: Strategies for Intervention", which is curated elsewhere on this site.


Source: Comings, D. E., Muhleman, D., Johnson, J. P. and MacMurray, J. P. (2002), Child Development, 73: 1046–1051.


Abstract only.

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Nymphomaniac Mice: A Disturbing Tale Of Genetic Engineering Gone Awry

Nymphomaniac Mice: A Disturbing Tale Of Genetic Engineering Gone Awry | Sex  Addiction | Scoop.it

"Geneticists have observed that a strand of genes named "HoxD," adjoining the area that they suppressed, reacted abnormally in the brain of mutant mice. This gene should normally act as a protein provider, which could be the cause of these abnormalities."

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Curator comment:  This is an especially idiotic headline exploiting the following recent research finding which revealed "compulsive sexual solicitation behavior" of some female mice after a strand in the genetic structuring situated in an area named "HoxD" was suppressed. (Click the following citation to read the abstract.)


Zakany, J. and Duboule, D., A Genetic Basis for Altered Sexual Behavior in Mutant Female Mice (Current Biology, Volume 22, Issue 18, 25 September 2012, Pages 1676–1680)



Source: Worldcrunch: "all news is global". October 22, 2012.

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The Genetics of Gambling and Behavioral Addictions

"Thus far......there are no other published family or twin studies available on compulsive buying, compulsive sexual behavior, or compulsive computer use......This review also points out the necessity for family studies on other behavioral addictions, such as compulsive buying, compulsive sexual behavior and compulsive computer use. Aside from evidence for family aggregation, these studies can yield important information regarding comorbid conditions and genetic and environmental effects that could help refine the phenotype of behavioral addictions........Due to the lack of genetic studies on compulsive buying, compulsive sexual behavior and compulsive computer use, it is early to speculate whether genetic findings in these behavioral addictions would be similar to the findings on pathological gambling. However, if neurobiology or neuroimaging studies show that similar areas are activated in pathological gambling and other behavioral addictions, it would be reasonable to hypothesize that molecular genetics findings would be consistent across different behavioral addictions."

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Lobo, D. and Kennedy, J. ,"The Genetics of Gambling and Behavioral Addictions", CNS Spectr. 2006;11(12)931-939 


CNS Spectrums: "First in Applied Neuroscience"


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The Neuroethics Blog: Drug Addiction and Sex Addiction: Are they “real” (brain) diseases?

The Neuroethics Blog: Drug Addiction and Sex Addiction: Are they “real” (brain) diseases? | Sex  Addiction | Scoop.it

"(W)e discussed the cultural assumptions influencing the scientific research on “sex addiction” and the ethical implications of this research for society.....As you can imagine, class discussion about these issues was lively."

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Curator comment: this neuroethical perspective is well worth reading.


Source: The Neuroethics Blog, hosted by the Center for Ethics, Neuroethics Program at Emory University.  April 24, 2012.

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Preliminary investigation of the impulsive and neuroanatomical characteristics of compulsive sexual behavior

This study provides a preliminary examination of the impulsive aspects of compulsive sexual behavior (CSB). Sixteen male subjects, eight CSB patients and eight non-patient controls, completed psychometric measures of impulsivity and compulsive sexual behavior, performed a behavioral task designed to assess impulse control (Go–No Go task), and underwent diffusion tensor imaging (DTI) procedures. The results indicated that CSB patients were significantly more impulsive; whether measured by psychometric testing or the Go-No Go procedure, than controls. The results also indicate that CSB patients showed significantly higher superior frontal region mean diffusivity (MD) than controls. A correlational analysis indicated significant associations between impulsivity measures and inferior frontal region fractional anisotropy (FA) and MD, but no associations with superior frontal region measures. Similar analyses indicated a significant negative association between superior frontal lobe MD and the Compulsive Sexual Behavior Inventory. Thus, while CSB patients were more impulsive than controls, the DTI results were not consistent with impulse control disorders.


Psychiatry Research: Neuroimaging, Volume 174, Issue 2, Pages 146-151, 30 November 2009, Authors:Michael H. Miner; Nancy Raymond; Bryon A. Mueller; Martin Lloyd; Kelvin O.Lim


Abstract only.

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Basic Science and Neurobiological Research: Potential Relevance to Sexual Compulsivity

Basic Science and Neurobiological Research: Potential Relevance to Sexual Compulsivity | Sex  Addiction | Scoop.it

One should not approach the issue of human sexual behavior without at least some appreciation of moral values and scientific research. When a person seems to be so driven that it becomes difficult to master erotic desires and he or she experiences difficulty serving his or her own best long-term interests, the concept of sexual compulsivity seems to be relevant. A better understanding of any associated neuropathologies may help to facilitate future treatments and public acceptance. In time, increased knowledge about the precise workings of the brain in reciprocally initiating and sustaining the sexual interests of the mind may facilitate a much clearer appreciation of the issues at hand.


Authors:Fred S. Berlin


Psychiatric Clinics of North America, Volume 31, Issue 4, Pages 623-642, December 2008


abstract only


Curator's note: Although this article is not research-oriented it is placed under the category of "Research: Neuroscience" for lack of a better category at the moment.

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Microstructure Abnormalities in Adolescents with Internet Addiction Disorder

This 2011 study investigated the morphology of the brain in adolescents with IAD (N = 18) using an optimized voxel-based morphometry (VBM) technique, and studied the white matter fractional anisotropy (FA) changes using the diffusion tensor imaging (DTI) method, linking these brain structural measures to the duration of IAD. The results of this study suggest that long-term internet addiction results in brain structural alterations.


Note: Entire article


Yuan K, Qin W, Wang G, Zeng F, Zhao L, et al. (2011) Microstructure Abnormalities in Adolescents with Internet Addiction Disorder. PLoS ONE 6(6): e20708. doi:10.1371/journal.pone.0020708

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Microstructure Abnormalities in Adolescents with Internet Addiction Disorder
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Brain Structure and Functional Connectivity Associated With Pornography Consumption

Brain Structure and Functional Connectivity Associated With Pornography Consumption | Sex  Addiction | Scoop.it

"The negative association of self-reported pornography consumption with the right striatum (caudate) volume, left striatum (putamen) activation during cue reactivity, and lower functional connectivity of the right caudate to the left dorsolateral prefrontal cortex could reflect change in neural plasticity as a consequence of an intense stimulation of the reward system, together with a lower top-down modulation of prefrontal cortical areas. Alternatively, it could be a precondition that makes pornography consumption more rewarding."

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Bill Herring LCSW, CSAT's insight:

 Curator comment: Note that although the researchers give support to the idea that frequent pornography consumption could structurally alter reward systems, this is not a longitudinal study, so these brain differences could have been present prior to the porn use.


This study is already making its way into the popular media, as in this article in the Daily Beast titled "Does Porn Cause Brain Shrinkage?"


Source:  JAMA Psychiatry. Published online May 28, 2014. doi:10.1001/jamapsychiatry.2014.93

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Pornography addiction - a supranormal stimulus considered in the context of neuroplasticity

Pornography addiction - a supranormal stimulus considered in the context of neuroplasticity | Sex  Addiction | Scoop.it

"Addiction has been a divisive term when applied to various compulsive sexual behaviors (CSBs), including obsessive use of pornography. Despite a growing acceptance of the existence of natural or process addictions based on an increased understanding of the function of the mesolimbic dopaminergic reward systems, there has been a reticence to label CSBs as potentially addictive....... Nevertheless, the new combined paradigm that amalgamates addictions to both substances and behaviors is beginning to assert itself....."

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Bill Herring LCSW, CSAT's insight:

Curator comment: A neurosurgeon offers his opinions about the application of the word "addiction" to human consumptive behavior such as sex, arguing that the presence of a "the new combined paradigm that amalgamates addictions to both substances and behaviors is beginning to assert itself (as) .....understanding of the power of the supranormal stimulus in the context of neuroplastic change continues to emerge".


SourceHILTON, D.. Pornography addiction - a supranormal stimulus considered in the context of neuroplasticity.Socioaffective Neuroscience & Psychology, North America, 3, jul. 2013. 


Note: entire article is available online.

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Misinformed Media Touts Bogus Sex Addiction Study

Why the media takes one bad study and distort its conclusions for shock value.


By Robert Weiss LCSW, CSAT-S and Stefanie Carnes PhD, CSAT-S
July 24, 2013


In a nationally distributed study published last week, a group of researchers argued that what is often termed as “sexual addiction” could be better understood as a pathological variation of “high sexual desire.” After the publication of this article, a multitude of media outlets suggested that the conclusions of this study demonstrate that there is no scientific basis for the diagnosis of sexual addiction. This has occurred despite the study being the first of its kind, riddled with methodological errors, and at best inconclusive with its findings. Nevertheless, it continues to get a lot of media attention, most likely because it addresses problematic human sexual behavior, which is always a media attention-getter.


In the study, researchers monitored the brain activity (using EEG technology) of 52 men and women who self-reported as having “problems controlling their viewing of sexual images.” The researchers then asked these individuals to look at more than 225 still photos - pictures of everything from violence to people skiing to men and women being sexual together - while the EEG measured their brain activity. Participants also completed several questionnaires about their sexual desire and activity. Essentially, researchers were looking for a correlation between EEG readings and the participants’ scores on the various questionnaires, thinking that any correlations might shed light on whether problematicporn use is caused by addiction (which is in essence a neurobiological dysfunction) or merely a high libido.


Since the study’s release, critics have cited numerous flaws in it, including concerns that the sample group differed significantly from treatment-seeking sex addicts and that the individual test subjects were not screened for other possible co-morbid conditions that could have interfered with the results. Additionally, there are serious questions about the strategy used to score one of the instruments in the study, which likely invalidated the measure and distorted the statistics. Basically, the researchers’ determination of a subject’s hypersexuality was primarily based on that individual’s responses to questions about having sex with a partner, whereas the brain scans were used to monitor solo sexual activity. As any sex addict can tell you, there is a huge difference in how most of them feel about and respond to in-the-flesh sex versus on-the-screen activity. The most readily apparent methodological error was the research team’s misuse of the Sexual Desire Inventory (SDI). Oddly, the researchers decided to use only part of this comprehensive questionnaire - inexplicably ignoring the questions about solo sexual activity, which, once again, was the exact activity they were monitoring with the brain scans.


Feeling confused? So are we.


Furthermore, the pre-screening of test subjects was wildly inadequate. The study lumped anyone who reported “issues with porn” into the same category. This means that some of the subjects were not likely porn addicts, while others may have been severely addicted. Adding to the quagmire is the fact that the researchers chose vastly different test subjects - men, women, heterosexuals, and homosexuals - and then showed them all the same heterosexually oriented sexual images (when clearly a gay participant would not respond to heterosexual images in the same way). In addition, the test subjects were shown only still images - hardly the streaming HD videos and live webcam shows that most were likely used to using.


Another criticism is the authors’ reliance on EEGs to measure subjects’ brain activity. Yes, EEGs are a useful scientific tool, but only to a certain extent. The simple truth is EEGs measure brain activity from the outside of the skull, making them the neurological equivalent of a blunt instrument. This is hardly definitive when looking at the complicated interplay of the numerous brain regions involved in the creation and expression of sexual desire (rewards, mood, memory, decision-making, etc.)


So, in a nutshell, this study is inconclusive at best, with conclusions drawn by the authors that don’t correlate to the data.


At least the researchers are not overtly indicating that the issue doesn’t exist. Instead, they argue that the problem is not an addiction and that conceptualizing it as “high sexual desire” would be more accurate. However, these researchers did not study the same areas of the brain or use the same technologies that have been utilized in previous research looking at process (behavioral) addictions. In an article released in the journal Socioaffective Neuroscience and Psychology, Dr. Donald Hilton summarizes much of the brain research that does lead scientists to believe that sex (and other natural processes) can be addictions. For a thorough review of this scientific literature see his article here. None of the brain regions looked at in Dr. Hilton’s work or the studies he cited were discussed or examined in the recently released study.


Amazingly, despite the study’s poor design, bad execution, and obvious limitations, the authors chose to formulate misguided conclusions and publish, even sending out an international press release touting their “achievement.”


Dr. Hilton argues that we are on the brink of a paradigm shift in our conceptualization of process addictions. He states, “During the shift, crisis and tension predominate, clouding the significance of the shift in the present. Nevertheless, the new combined paradigm that amalgamates addictions to both substances and processes is beginning to assert itself.” This assertion is evidenced by the fact that in the PubMed literature database the term “sexual addiction” is used almost three times as often as any other term that describes the disease. So is this current media frenzy simply part of the “crisis and tension” clouding our view during the midst of a shift?


Why is it that when two excellent articles come out, one supporting the addiction framework and one questioning it, that the media hones in on one and distorts its conclusions for shock value? What are the resulting repercussions for the tens of thousands of patients whose reality is denied and invalidated? In the 1980s sex addicts were told by mental health practitioners that their problem didn’t exist. Well, it did exist, and because therapists didn’t help them they created their own support groups, and now that network of “S-fellowships” provides critical, free care to tens of thousands of people daily. So while we as clinicians can continue to argue whether this is an addiction, a compulsion, an impulse control problem, or high sexual desire, we should not be arguing that the problem doesn’t exist. And the media shouldn’t either.


A similar phenomenon occurred with alcoholism at the turn of the century. Alcohol addiction was seen as a “moral failing” brought on by a “lack of willpower.” It wasn’t until many years later, when we began to fully understand the disease concept of addiction, that it became better understood. So why is it that society would rather call sex addicts “womanizers” and “schmucks” than use a paradigm that is helpful?


So, let’s consider the repercussions of our labels… So far we have sex addiction, sexual compulsion, impulse control disorder, hypersexual behavior disorder, out-of-control sexual behavior, problematic sexual behavior, and now a new one: high sexual desire. Using the label “sex addiction” rather than the others has a multitude of advantages. First, it is the language that the clients speak. Clients do not come to therapybecause they think they have “hypersexual behavior disorder,” they come because they are “sex addicts.” Second, it is the term most often used by physicians. Third, by using an addiction perspective you can reduce the shame, normalize the behavior, provide lots of ancillary resources and materials, and immerse the client in a community of support that involves accountability and taking responsibility for one’s behavior. In contrast, how are we as therapists to effectively help a patient with his or her “high sexual desire”?


And when did high sexual desire and sexual addiction become mutually exclusive concepts? Simply put, diagnosing a person as having a high sexual desire does not rule out sexual addiction. In fact, the research discussed above does nothing to refute the concept of sexual addiction and the growing body of literature that supports that idea. Either way, until a definitive ruling is out, let’s stick to the label that’s clinically useful (especially since it looks like the majority of the existing research supports that paradigm).



Robert Weiss LCSW, CSAT-S is Senior Vice President of Clinical Development with Elements Behavioral Health. A licensed UCLA MSW graduate and personal trainee of Dr. Patrick Carnes, he founded The Sexual Recovery Institute in Los Angeles in 1995. He has developed clinical programs for The Ranch in Nunnelly, Tennessee, Promises Treatment Centers in Malibu, and the aforementioned Sexual Recovery Institute in Los Angeles.He has also provided clinical multi-addiction training and behavioral health program development for the US military and numerous other treatment centers throughout the United States, Europe, and Asia.


Dr. Stefanie Carnes, Ph.D. is a licensed marriage and family therapist and an AAMFT approved supervisor. Her area of expertise includes working with patients and families struggling with multiple addictions such as sexual addiction, eating disorders and chemical dependency. Dr. Carnes is also a certified sex addiction therapist and supervisor, specializing in therapy for couples and families struggling with sexual addiction. Currently, she is the president of the International Institute for Trauma and Addiction Professionals. She is also the author of numerous research articles and publications including her books, Mending a Shattered Heart: A Guide for Partners of Sex Addicts, Facing Addiction: Starting Recovery from Alcohol and Drugs, and Facing Heartbreak: Steps to Recovery for Partners of Sex Addicts.


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Bill Herring LCSW, CSAT's insight:

Curator comment: Two of the most respected leaders of the sex addiction field respond to the so-called "Prause Study" that has been garnering so much media attention over the past week. This article made a brief appearance on the Psychology Today website.  The authors have given permission for it to be posted in its entiirety on this curated site.

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Pedro Tavares's curator insight, October 9, 2013 8:48 AM

controversial issues about Sexual Compulsion 

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Sexual desire, not hypersexuality, is related to neurophysiological responses elicited by sexual images

Sexual desire, not hypersexuality, is related to neurophysiological responses elicited by sexual images | Sex  Addiction | Scoop.it

"This study was designed to determine whether sexual desire level alone, or a cluster of symptoms unique to hypersexuality, predict neural reactivity to sexual stimuli."

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Bill Herring LCSW, CSAT's insight:

Curator comment: This is really three stories in one:

  1. the article itself;
  2. the reaction it has generated in the professional community;
  3. the way it has been sensationalized worldwide in the last week.


There is so much going on in all three of these dimensions that it will take more than one brief note to make sense of it all.  To start from the outside in, here are some headlines appearing the last few days, showing the entire spectrum of reporting:

  • "New Study Questions If Sex Addiction is Real"
  • "Scans of Sex Addixts' Brains Call Diagnosis into Question"
  • "Sex Addicts Not Technically Addicts: Study"
  • "New Study Undermines Sex Addiction"
  • "Brain Scans Suggest That Sex Addiction Doesn't Exist"
  • "Sex Addiction: Not a Disease Any More"
  • "Hypersexuality is Not a Real Disorder"
  • "UCLA Study Says Sex Addiction Isn't a Real Disorder"
  • "Watching Porn Does Not Mean You're a Sex Addict"
  • "Neuroscientists Reveal Why Sex Addiction Isn't a Real Disorder"
  • "Sex Addiction is Fake, Study Shows"
  • "Study Asks If Sex Addiction Real Disorder or Just Some Sleazy Excuse"

Numerous articles have cropped up online with phrases such as:"Listen up, gals. Quit hiding behind that fake diagnosis of sex addiction. It turns out your mother was right all along. You’re just a ho."


One news source put it this way:  "Sex addiction is not a mental illness, as is often believed. Rather, it’s caused by a high libido. This has been proved scientifically for the first time by researchers at the University of California....."


The study "proved" no such thing, nor claimed that it did. In essence, it showed photographs, including those of a sexual nature, to a group of people who self-identified as meeting criteria for a proposed hypersexuality disorder, and found that their EEG readings did not respond as the researchers anticipated.   The entire article is available for review.  


Here's an interview with one of the investigators that goes into the design, findings and conclusions in more depth.


Not surprisingly, critiques that call into question various aspects of the study are beginning to appear. Many of them are happening in professional online discussion groups that cannot be curated.  But others are starting to be available online, with more surely to come.  

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Acquired Sexual Paraphilia in Patients With Multiple Sclerosis

Acquired Sexual Paraphilia in Patients With Multiple Sclerosis | Sex  Addiction | Scoop.it

"Multiple sclerosis can present with a host of cognitive and psychological changes, but the appearance of hypersexuality and paraphilia is uncommon. This report illustrates the important observation that specific areas of the brain, in particular the hypothalamic and septal regions, may be involved in mediating abnormal sexual behavior."

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Bill Herring LCSW, CSAT's insight:

Curator comment: This 2002 case report is being curated in order to continue documenting the history of neurological findings associated with atypical presentations of rapid-onset hypersexual behavior.  In order to avoid a separate listing of the few articles relating to multiple sclerosis, this is an appropriate place to note the following:



Frohman, EM, Frohman, TC and Moreault, AM
Arch Neurol. 2002;59(6):1006-1010

Note: the entire article is available online, which is rare.

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Pornography addiction: A neuroscience perspective

"(A)ttention to process addictions requires focus on metabolic dysfunction in the mesolimbic salience pathways.......This commentary seeks to encourage an examination by clinical neuroscience specialties.....of the addictive nature of the pathology of pornography." 


Bill Herring LCSW, CSAT's insight:

Curator comment: It's rare to find an entire article available online rather than just an abstract.  This article isn't presented with the greatest clarity, but it does present some interesting findings and perspectives about the neuroscience of process addictions.


Authors: Donald Hilton and Clark Watts


Source: Surgical Neurology International, 2011; volume 2:19

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Pornography addiction: A neuroscience perspective

Pornography addiction: A neuroscience perspective | Sex  Addiction | Scoop.it

"Our role as healers suggests we can do more to investigate and treat human pathology related to this new entity of process or natural addiction, particularly given the growing weight of evidence supporting the neural basis of all addictive processes."

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Curator comment: This article is notable as much for its source and citations as for anything else.


Source: Hilton DL, Watts C. Pornography addiction: A neuroscience perspective. Surg Neurol Int 2011; 2:19.

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Lesions of the Medial Prefrontal Cortex Cause Maladaptive Sexual Behavior in Male Rats

Lesions of the Medial Prefrontal Cortex Cause Maladaptive Sexual Behavior in Male Rats | Sex  Addiction | Scoop.it


"This study suggests that mPFC dysfunction may contribute to sexual risk-taking or to compulsive seeking of sexual behavior. Although thought-provoking, it is not yet known whether these findings apply to humans."


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Biological Psychiatry, Volume 67, Issue 12, Pages 1199-1204, 15 June 2010, Authors:Jon F. Davis; Maarten Loos; Andrea R. Di Sebastiano; Jennifer L. Brown; Michael N. Lehman; Lique M.


Abstract only.

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Sex, Drugs, and Rock ‘N’ Roll: Hypothesizing Common Mesolimbic Activation as a Function of Reward Gene Polymorphisms

Sex, Drugs, and Rock ‘N’ Roll: Hypothesizing Common Mesolimbic Activation as a Function of Reward Gene Polymorphisms | Sex  Addiction | Scoop.it

"The nucleus accumbens.....plays a prominent role in mediating the reinforcing effects of drugs of abuse, food, sex, and other addictions.........This article focuses on sex addiction, but we hypothesize that.....biological drives may have common molecular genetic antecedents, which if impaired, lead to aberrant behaviors. Based on abundant scientific support, we further hypothesize that dopaminergic genes, and possibly other candidate neurotransmitter-related gene polymorphisms, affect both hedonic and anhedonic behavioral outcomes.........(W)e anticipate that future genotyping studies of sex addicts will provide evidence for polymorphic associations with specific clustering of sexual typologies based on clinical instrument assessments. We recommend that scientists and clinicians embark on research coupling the use of neuroimaging tools with dopaminergic agonistic agents to target specific gene polymorphisms systematically for normalizing hyper- or hypo-sexual behaviors."


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Authors: Kenneth Blum, Tonia Werner, Stefanie Carnes, Patrick Carnes, Abdalla Bowirrat, John Giordano, Marlene-Oscar-Berman & Mark Gold


Journal of Psychoactive Drugs: Vol. 44, No. 1 (2012), pp. 38-55.


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Addicted? New Study Shows Brain SPECT Imaging Sheds Light on Brain Functions That Lead to Bad Decisions

"Sex, food, alcohol and drug addictions may be more of a brain-health problem than a bad habit gone wrong, according to a new study published in the Journal of Psychoactive Drugs this month."

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The Neuropsychology and Neurology of Sexual Deviance: A Review and Pilot Study

Current neurological hypotheses of paraphilia posit that sexual deviance is associated with frontal and/or temporal lobe damage. This broad conception is based on few investigations, however, and the first goal of this study was to review the existing data derived from neuropsychiatry, neuroimaging and neuropsychology. It is concluded that although fronto-temporal dysfunctions are sporadically reported among sexual offenders, the evidence is scarce and it might not be specific to this type of offending. The second objective of this investigation was to gather preliminary neuropsychological data with more homogeneous subgroups of sexual offenders. A profile of lower-order executive dysfunctions (e.g. sustained attention and inhibition) and verbal deficits with intact or good capacities for higher-order executive functioning (e.g. reasoning and cognitive flexibility) and visuo-spatial processing was preferentially found among sexual offenders, suggesting basal fronto-temporal anomalies. Importantly, pedophiles were more consistently and severely impaired than rapists of adults. However, this basal fronto-temporal profile is not characteristic of sexual deviance, as it is also found in association with delinquency and criminality in general. Future neuropsychological and brain imaging studies should consider subgroups of sexual offenders and recruit nonsexual violent persons and non-violent individuals in order to disentangle the complex relations between brain anomalies and sexual deviance.


Authors: Christian C. Joyal, Deborah N. Black and Benoit Dassylva

Sex Abuse June 2007 vol. 19 no. 2 155-173


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Curator's note: although this article does not specifically pertain to sexual compulsivity, it is included on this site because of its relevance to a comprehensive understanding of neuropsychological functioning as it relates to sexual behavior.  

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Affective Neuroscience and the Treatment of Sexual Addiction

Affective Neuroscience and the Treatment of Sexual Addiction | Sex  Addiction | Scoop.it
Affective neuroscience illuminates the neuropsychobiological impact of traumatic early childhood attachment patterns on the affective, cognitive, and behavioral development of sexual addicts and their partners. It also guides therapists to access patients' blunted right hemisphere through awareness of their bodily states and, thereby, to remediate patients' hobbled capacities for establishing genuine relationships, achieving insight, and regulating emotions independently. By enriching the current cognitive-behavioral, task-oriented treatment with attention to the neurobiological causes, and costs, of sexual addiction, we create a recovery protocol that helps patients progress beyond sexual sobriety to achieve previously unattainable interpersonal connection, self-reflection, and internally regulated affective states.


Author: Alex Katehakis


(2009).  Sexual Addiction & Compulsivity: Vol. 16, No. 1, pages 1-31.


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Curator's note: While the abstract does not relate specifically to research protocols, the topic best warrants inclusion in the category of Research: Neurobiology

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