Abstract

The Internet provides a large source of novel and rewarding stimuli, particularly with respect to sexually explicit materials. Novelty-seeking and cue-conditioning are fundamental processes underlying preference and approach behaviors implicated in disorders of addiction. Here we examine these processes in individuals with compulsive sexual behaviors (CSB), hypothesizing a greater preference for sexual novelty and stimuli conditioned to sexual rewards relative to healthy volunteers. Twenty-two CSB males and forty age-matched male volunteers were tested in two separate behavioral tasks focusing on preferences for novelty and conditioned stimuli. Twenty subjects from each group were also assessed in a third conditioning and extinction task using functional magnetic resonance imaging. CSB was associated with enhanced novelty preference for sexual, as compared to control images, and a generalized preference for cues conditioned to sexual and monetary versus neutral outcomes compared to healthy volunteers. CSB individuals also had greater dorsal cingulate habituation to repeated sexual versus monetary images with the degree of habituation correlating with enhanced preference for sexual novelty. Approach behaviors to sexually conditioned cues dissociable from novelty preference were associated with an early attentional bias to sexual images. This study shows that CSB individuals have a dysfunctional enhanced preference for sexual novelty possibly mediated by greater cingulate habituation along with a generalized enhancement of conditioning to rewards. We further emphasize a dissociable role for cue-conditioning and novelty preference on the early attentional bias for sexual cues. These findings have wider relevance as the Internet provides a broad range of novel and potentially rewarding stimuli.

Highlights

  • Why is online surfing so compulsively engaging to many individuals? The Internet provides a large source of novel and potentially rewarding stimuli

  • We have previously found that individuals with compulsive sexual behaviors (CSB) demonstrate greater regional brain activation in response to explicit sexual cues in the ventral striatum, dorsal anterior cingulate cortex and amygdala, regions implicated in drug cue reactivity and craving in disorders of addiction (Voon et al, 2014)

  • We conducted post-hoc analyses, which showed that CSB subjects had greater novelty preference for Sexual versus Control2 (p 1⁄4 0.039) whereas healthy volunteers (HVs) had greater novelty preference for Control1 versus Control2 (p 1⁄4 0.024)

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Summary

Introduction

Why is online surfing so compulsively engaging to many individuals? The Internet provides a large source of novel and potentially rewarding stimuli. The smell of cigarettes, places or friends associated with drug use, or the sight of money may act as conditioned cues and may enhance reactivity and trigger cravings, urges and relapse in disorders of addiction (for review see (Childress et al, 1993)). These cues are neutral stimuli that may inadvertently acquire motivational significance through the process of conditioning with repeated pairing with either drug rewards or other biologically relevant natural rewards such as food (Jansen, 1998) or sex (Pfaus et al, 2001; Toates, 2009)

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