|Addiction and dependence glossary|
|• addiction – a medical condition characterized by compulsive engagement in rewarding stimuli despite adverse consequences|
|• addictive behavior – a behavior that is both rewarding and reinforcing|
|• addictive drug – a drug that is both rewarding and reinforcing|
|• dependence – an adaptive state associated with a withdrawal syndrome upon cessation of repeated exposure to a stimulus (e.g., drug intake)|
|• drug sensitization or reverse tolerance – the escalating effect of a drug resulting from repeated administration at a given dose|
|• drug withdrawal – symptoms that occur upon cessation of repeated drug use|
|• physical dependence – dependence that involves persistent physical–somatic withdrawal symptoms (e.g., fatigue and delirium tremens)|
|• psychological dependence – dependence that involves emotional–motivational withdrawal symptoms (e.g., dysphoria and anhedonia)|
|• reinforcing stimuli – stimuli that increase the probability of repeating behaviors paired with them|
|• rewarding stimuli – stimuli that the brain interprets as intrinsically positive or as something to be approached|
|• sensitization – an amplified response to a stimulus resulting from repeated exposure to it|
|• substance use disorder - a condition in which the use of substances leads to clinically and functionally significant impairment or distress|
|• tolerance – the diminishing effect of a drug resulting from repeated administration at a given dose|
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Pornography addiction is an addiction model of compulsive sexual activity with concurrent use of pornographic material, despite negative consequences to one's physical, mental, social, or financial well-being. Universally accepted diagnostic criteria do not exist for pornography addiction or problematic pornography viewing. The rewarding and reinforcing (i.e., addictive) properties of cybersex have been evidenced using cue reactivity experiments with pornographic cues in humans, which supports the classification of cybersex addiction as a true behavioral addiction.
Problematic internet pornography viewing is viewing of Internet pornography that is problematic for an individual due to personal or social reasons, including excessive time spent viewing pornography instead of interacting with others. Individuals may report depression, social isolation, career loss, decreased productivity, or financial consequences as a result of their excessive Internet pornography viewing impeding on their social life.
Symptoms and diagnosis
Universally accepted diagnostic criteria do not exist for pornography addiction or problematic pornography viewing. Pornography addiction is often defined operationally by the frequency of pornography viewing and negative consequences. The only diagnostic criteria for a behavioral addiction in the current Diagnostic and Statistical Manual of Mental Disorders are for pathological gambling, and they are similar to those for substance abuse and dependence, such as preoccupation with the behavior, diminished ability to control the behavior, tolerance, withdrawal, and adverse psychosocial consequences. Diagnostic criteria have been proposed for other behavioral addictions, and these are usually also based on established diagnoses for substance abuse and dependence.
A proposed diagnosis for hypersexual disorder includes pornography as a sub-type of this disorder. It included such criteria as time consumed by sexual activity interfering with obligations, repetitive engagement in sexual activity in response to stress, repeated failed attempts to reduce these behaviors, and distress or impairment of life functioning. A study on problematic Internet pornography viewing used the criteria of viewing Internet pornography more than three times a week during some weeks, and viewing causing difficulty in general life functioning.
The status of pornography addiction as an addictive disorder, rather than simply a compulsivity, has been hotly contested.[unreliable medical source?][unreliable medical source?] The current Diagnostic and Statistical Manual of Mental Disorders (DSM-5) includes a new section for behavioral addictions, but includes only one disorder: pathological gambling. One other behavioral addiction, Internet gaming disorder, appears in the conditions proposed for further study in DSM-5. Psychiatrists cited a lack of research support for refusing to include other behavioral disorders at this time, however, an extensive 2015 review of the neuroscience/neuropsych studies on pornography users now calls for internet addiction to be included in the DSM with internet pornography addiction as a subtype.[unreliable medical source?]
Porn addiction is not a diagnosis in DSM-5 (or any previous version). "Viewing pornography online" is mentioned verbatim inside DSM-5, but it is not considered a mental disorder either.
When the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) was being drafted, experts considered a proposed diagnostic addiction called hypersexual disorder, which also included a pornography subtype. But in the end, reviewers determined that there wasn't enough evidence to include hypersexual disorder or its subtypes in the 2013 edition.— Kirsten Weir, Is pornography addictive?
Richard Krueger, DSM-5 work-group member (Sexual and Gender Identity Disorders) and associate clinical professor of psychiatry at Columbia University’s College of Physicians and Surgeons, has said that he "has little doubt porn addiction is real and will eventually garner enough attention to be recognized as a mental illness" by the DSM, though he also suggested that "most people would do it and it won’t become a problem."
In 2011, the American Society of Addiction Medicine published a definition of addiction that for the first time stated that addiction includes pathological pursuit of all kinds of external rewards and not just substance dependence. However, this definition does not explicitly include porn addiction. Instead ASAM uses the phrase, "sexual behavior addiction".
Cognitive-behavioral therapy has been suggested as a possible effective treatment for pornography addiction based on its success with Internet addicts, though no clinical trials have been performed to assess effectiveness among pornography addicts as of 2012. Acceptance and commitment therapy has also been shown to be a potentially effective treatment for problematic Internet pornography viewing.
Sex researcher Alvin Cooper and colleagues suggested several reasons for using filters as a therapeutic measure, including curbing accessibility that facilitates problematic behavior and encouraging clients to develop coping and relapse prevention strategies. Cognitive therapist Mary Anne Layden suggested that filters may be useful in maintaining environmental control. Internet behavior researcher David Delmonico stated that, despite their limitations, filters may serve as a "frontline of protection."
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Most studies of rates use a convenience sample. One study of a convenience sample of 9,265 people found that 1% of Internet users are clearly addicted to cybersex and 17% of users meet criteria for problematic sexual compulsivity, meaning they score above one standard deviation of the mean on the Kalichman Sexual Compulsivity Scale.[full citation needed] A survey of 84 college-age males found that 20–60% of a sample of college-age males who use pornography found it to be problematic. Research on Internet addiction disorder indicates rates may range from 1.5 to 8.2% in Europeans and Americans. Internet pornography users are included in Internet users, and Internet pornography has been shown to be the Internet activity most likely to lead to compulsive disorders.
A 2014 released study identified a connection between a subjects religious beliefs and their self perception of pornography addiction. The study's lead author is Case Western Reserve University psychology doctoral student Joshua Grubbs; the study is titled "Transgression as Addiction: Religiosity and Moral Disapproval as Predictors of Perceived Addiction to Pornography" and was published in the journal Archives of Sexual Behavior. One of the findings of the study is that the results strongly indicate a predilection in religious people to believe they are addicted to pornography regardless of how much they watch or whether it negatively impacts their lives.
Sarah Diefendorf, a sociologist at the University of Washington, found that Evangelical men who took an abstinence pledge before marriage "still struggle with issues like excessive pornography viewing, masturbation" when married. In one study, half of Christian pastors said they used porn in the last year, and in another, roughly 50% of Christian men and 20% of Christian women self-report being addicted to porn.
According to E.T.M. Laan, a sexologist working for the Academic Medical Center, it is usually the religious right which claims the existence of pornography addiction and such claims are rare among the sexologists.
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- http://www.socioaffectiveneuroscipsychol.net/index.php/snp/article/view/23833/32589 "‘High desire’, or ‘merely’ an addiction? A response to Steele et al."
- American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders (Fifth ed.). Arlington, VA: American Psychiatric Publishing. pp. 481, 797–798. ISBN 978-0-89042-555-8.
In addition to the substance-related disorders, this chapter also includes gambling disorder, reflecting evidence that gambling behaviors activate reward systems similar to those activated by drugs of abuse and produce some behavioral symptoms that appear comparable to those produced by the substance use disorders. Other excessive behavioral patterns, such as Internet gaming, have also been described, but the research on these and other behavioral syndromes is less clear. Thus, groups of repetitive behaviors, which some term behavioral addictions, with such subcategories as "sex addiction," "exercise addiction," or "shopping addiction," are not included because at this time there is insufficient peer-reviewed evidence to establish the diagnostic criteria and course descriptions needed to identify these behaviors as mental disorders. ... Excessive use of the Internet not involving playing of online games (e.g., excessive use of social media, such as Facebook; viewing pornography online) is not considered analogous to Internet gaming disorder, and future research on other excessive uses of the Internet would need to follow similar guidelines as suggested herein. Excessive gambling online may qualify for a separate diagnosis of gambling disorder.
- Love T, Laier C, Brand M, Hatch L, Hajela R (2015). "Neuroscience of Internet Pornography Addiction: A Review and Update". Behav Sci (Basel). 5 (3): 388–433. doi:10.3390/bs5030388. PMID 26393658.
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- Since it is none of two behavioral addictions mentioned above.
- Tamsin McMahon Will quitting porn improve your life? A growing ‘NoFap’ movement of young men are saying no to porn and masturbation Maclean's, January 20, 2014. See the paragraph beginning with the words "He has little doubt".
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NoFap was originally founded by Alexander Rhodes on June 20, 2011 as a forum on the social media platform 'Reddit' and has since grown to become much more.
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- David J Ley (15 September 2015). "Your Belief in Porn Addiction Makes Things Worse: The label of "porn addict" causes depression but porn watching doesn't.". Retrieved 20 October 2015.
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- Staff. "Christians fear porn addiction: A psychology study found that people who regard themselves as very religious may regard themselves as addicts – even if they watch internet porn only once.". Health24.com. Retrieved 4 April 2014.
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- Paul Olaf Chelsen (2011). "An Examination of Internet Pornography Usage Among Male Students at Evangelical Christian Colleges". Loyola University Chicago.
79.3 percent of male undergraduate students at Evangelical colleges reported accessing Internet pornography at some point in the previous year, with 61.1 percent reported accessing Internet pornography at least some amount of time each week
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- Stafford, Duncan E (2010). Turned On: Intimacy in a Pornized Society (ISBN 978-0-9564987-1-7). Witting Press, Cambridge
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- Patrick Carnes (1991). Don't Call It Love: Recovery from Sexual Addiction (ISBN 978-0-553-35138-5) Bantam
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