The influence of stress on the processing of visual sexual stimuli (VSS) in men in relation to habitual VSS-consumption
Final Report Abstract
Negative reinforcement of pornography use by reduction of negative feelings or acute stress is discussed as a central mechanism in the development and maintenance of problematic pornography use (PPU). To investigate the role of visual sexual stimuli (VSS) processing under acute stress and its neural basis in relation to individual learning history, a sexual incentive delay (SID) paradigm was conducted in the current study with 172 healthy male subjects. Half of the subjects underwent a psychosocial stressor (Trier Social Stress Test, TSST) prior to the SID paradigm, and the other half underwent a placebo version without stress induction. The SID paradigm facilitates to temporally separate anticipation and consumption phases of VSS processing and thus enables to study them separately. With regard to acute stress effects, the current study found that a strong cortisol stress reaction was associated with increased nucleus accumbens (NAcc) reactivity to VSS anticipation cues. Moderation analyses showed that habitually higher consumption during high stress-induced cortisol response was associated with higher activations dorsal anterior cingulate cortex (dACC) and with lower activations in medial orbitofrontal cortex (mOFC). In particular, men who engage in heavy pornography use appear to be more responsive to the announcement of sexual stimuli under high stress. Regarding the general neural correlates of VSS anticipation, we found that these were not altered in connection with more PPU symptoms in this study. We found neural activation in many regions associated with reward processing as main effects of VSS anticipation as well as VSS viewing. This activation did not correlate with self-reported PPU symptoms or other risk factors. Instead, however, preference-dependent activation in the VSS consumption phase was associated with PPU symptoms: We first found that activation in NAcc, nucleus caudatus, and OFC during viewing of VSS was positively associated with individual ratings concerning valence and sexual arousal of these same VSS. These regions are known to be associated with the representation of subjective reward values, and NAcc and nucleus caudatus in particular appear to map a motivational component of reward value. Second, we found that this relationship between ratings and striatal activation in VSS use was more pronounced in individuals who reported more PPU symptoms. This suggests enhanced encoding of the motivational VSS value in these individuals. The results of this study may help to better assess the role of negative and positive reinforcement processes in PPU, thereby aiding the development of new therapy procedures and interventions. Further studies should investigate the clinical relevance and the question of causality of the observed relationships in longitudinal studies.
Publications
- (2017). Predictors for (problematic) use of Internet sexually explicit material: role of trait sexual motivation and implicit approach tendencies towards sexually explicit material. Sexual Addiction & Compulsivity, 24, 180-202
Stark, R., Kruse, O., Snagowski, J., Brand, M., Walter, B., Klucken, T., Wehrum-Osinsky, S.
(See online at https://doi.org/10.1080/10720162.2017.1329042) - (2018). A current understanding of the behavioral neuroscience of compulsive sexual behavior and problematic pornography use. Current Behavioral Neuroscience Reports, 5, 218-231
Stark, R., Klucken, T., Potenza, M. N., Brand, M., & Strahler, J.
(See online at https://doi.org/10.1007/s40473-018-0162-9) - (2018). Neural correlates of gender differences in distractibility by sexual stimuli. NeuroImage, 176, 499-509
Strahler, J., Kruse, O., Wehrum-Osinsky, S., Klucken, T., & Stark, R.
(See online at https://doi.org/10.1016/j.neuroimage.2018.04.072) - (2019). Attentional bias towards and distractibility by sexual cues: A meta-analytic integration. Neuroscience & Biobehavioral Reviews, 105, 276-287
Strahler, J., Baranowski, A., Walter, B., Huebner, N., & Stark, R.
(See online at https://doi.org/10.1016/j.neubiorev.2019.07.015) - (2019). Increased neural activity to emotional pictures in men with high testosteron concentrations. Social Cognitive and Affective Neuroscience, 14, 1009-1016
Klein, S., Kruse, O., Tapia Léon, I, Stalder, T., Stark, R. & Klucken, T.
(See online at https://doi.org/10.1093/scan/nsz067) - (2019). No sex difference found: Cues of sexual stimuli activate the reward system in both sexes. Neuroscience, 416, 63-73
Stark, R., Klein, S., Kruse, O., Weygandt, M., Leufgens, L.K., Schweckendiek, J., & Strahler, J.
(See online at https://doi.org/10.1016/j.neuroscience.2019.07.049) - (2019). Prevalence and determinants of problematic online pornography use in a sample of German women. Journal of Sexual Medicine, 16, 1274-1282
Baranowski, A., Vogl, R., & Stark, R.
(See online at https://doi.org/10.1016/j.jsxm.2019.05.010) - (2019). The Interaction of Person-Affect-Cognition-Execution (I-PACE) model for addictive behaviors: Update, generalization to addictive behaviors beyond internet-use disorders, and specification of the process character of addictive behaviors. Neuroscience & Biobehavioral Reviews, 104, 1-10
Brand, M., Wegmann, E., Stark, R., Müller, A., Wölfling, K., Robbins, T.W., & Potenza, M.
(See online at https://doi.org/10.1016/j.neubiorev.2019.06.032) - (2020). Subjective reward value of visual sexual stimuli is coded in human striatum and orbitofrontal cortex. Behavioural Brain Research, 393, 112792
Klein, S., Kruse, O., Markert, C., Tapia León, I., Strahler, J., & Stark, R.
(See online at https://doi.org/10.1016/j.bbr.2020.112792) - (2021). Sexual incentive delay in the scanner: Sexual cue and reward processing, and links to problematic porn consumption and sexual motivation. Journal of Behavioral Addictions, 10(1), 65–76
Markert, C., Klein, S., Strahler, J., Kruse, O., & Stark, R.
(See online at https://doi.org/10.1556/2006.2021.00018)
