Abstract
Pornography has been repeatedly at the centre of public attention and has been controversially discussed for a long time. However, little is known about the connection between pornographic stimuli and individual (neuronal) processing of attention and memory. Here, the impact and neural underpinnings of pornographic pictures on working memory processes in a sample of subjects with compulsive sexual behaviour was investigated. Therefore, whilst using functional magnetic resonance imaging (fMRI), a letter n-back task with neutral or pornographic pictures in the background was employed in 38 patients and 31 healthy controls. On the behavioural level, patients were slowed down by pornographic material depending on their pornography consumption in the last week, which was reflected by a higher activation in the lingual gyrus. In addition, the lingual gyrus showed a higher functional connectivity to the insula during processing of pornographic stimuli in the patient group. In contrast, healthy subjects showed faster responses when confronted with pornographic pictures only with high cognitive load. Also, patients showed a better memory for pornographic pictures in a surprise recognition task compared to controls, speaking for a higher relevance of pornographic material in the patient group. These findings are in line with the incentive salience theory of addiction, especially the higher functional connectivity to the salience network with the insula as a key hub and the higher lingual activity during processing of pornographic pictures depending on recent pornography consumption.
Highlights
Pornography has been repeatedly at the centre of public attention and has been controversially discussed for a long time
The group × explicitness interaction showed that patients displayed longer reaction times when confronted with distracting pornographic pictures and the effect of pornographic pictures seemed to be driven by the patient group
This was supported by the analysis of the individual groups showing that, in healthy controls, reaction times were even facilitated through pornographic pictures, but only in the difficult condition, while in the patient group, pornographic material independent of the difficulty led to slower reaction times
Summary
Pornography has been repeatedly at the centre of public attention and has been controversially discussed for a long time. It is assumed that 3–7% of women and 10.3% − 11% of men are affected (Dickenson et al, 2018; Grubbs et al, 2019) It is characterized by excessive online pornography consumption and can be shown through ‘real life’ behaviour, such as risky casual sexual relations or anonymous sex. Using the dot-probe task, it could be shown that subjects excessively using online sexually explicit material had a greater attentional bias toward sexually explicit material (Mechelmans et al, 2014), leading to faster reaction times. It could be shown that the prolonged reaction time in a picture categorization task and a line orientation task on pornographic stimuli lead to prolonged reaction times and higher activation in the caudate nucleus, putamen, thalamus, ACC, and OFC, which was interpreted as an involvement of the reward system (Strahler et al, 2018)
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