|Addiction and dependence glossary|
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. Neither the DSM-5 nor the ICD-11 classify pornography as a mental disorder or 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 their social life.
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 subtype 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.
According to the American Society of Addiction Medicine, some psychological and behavioral changes characteristic of addiction brain changes include addictive cravings, impulsiveness, weakened executive function, desensitization, and dysphoria.BOLD fMRI results have shown that individuals diagnosed with compulsive sexual behavior (CSB) show enhanced cue reactivity in brain regions associated traditionally with drug-cue reactivity. These regions include the amygdala and the ventral striatum. Men without CSB who had a long history of viewing pornography exhibited a less intense response to pornographic images in the left ventral putamen, possibly suggestive of desensitization. ASAMs position is inconsistent with the American Association of Sex Educators, Counselors, and Therapists, who cite strong evidence against such classification, describing ASAM as not informed by "by accurate human sexuality knowledge".
The status of pornography addiction as an addictive disorder, rather than simply a compulsivity, has been hotly contested. [ unreliable medical source? ] [ unreliable medical source? ] Furthermore, research suggests that the use of a pornography addiction label may indicate a socially (as opposed to clinically) driven nosology
It is worth considering whether the apparent epidemic of self-diagnosed pornography addicts seeking help today perhaps represents the ready uptake of a relatively new way to describe one’s problematic behaviour, and not the development of a modern disease entity whose description should dictate its treatment.— Kris Taylor, Nosology and metaphor: How pornography viewers make sense of pornography addiction
In November 2016, the American Association of Sexuality Educators, Counselors and Therapists (AASECT) issued a position statement on sex/porn addiction which states that AASECT "does not find sufficient empirical evidence to support the classification of sex addiction or porn addiction as a mental health disorder, and does not find the sexual addiction training and treatment methods and educational pedagogies to be adequately informed by accurate human sexuality knowledge. Therefore, it is the position of AASECT that linking problems related to sexual urges, thoughts or behaviors to a porn/sexual addiction process cannot be advanced by AASECT as a standard of practice for sexuality education delivery, counseling or therapy."
The 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.
Porn addiction is not a diagnosis in DSM-5 (or any previous version)."Viewing pornography online" is mentioned verbatim in the 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?
A number of studies have found neurological markers of addiction in internet porn users,which is consistent with a large body of research finding similar markers in other kinds of problematic internet users. Yet other studies found that critical biomarkers of addiction were missing, and most addiction biomarkers have never been demonstrated for pornography.
The International Classification of Disorders 11 (ICD-11) rejected "pornography addiction". Specifically, the World Health Organization (WHO) wrote: "Based on the limited current data, it would therefore seem premature to include [pornography viewing] in ICD-11."
Introductory psychology textbook authors Coon, Mitterer and Martini, passingly mentioning NoFap, speak of pornography as a "supernormal stimulus" but use the model of compulsion rather than 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.
Some clinicians and support organizations recommend voluntary use of Internet content-control software, internet monitoring, or both, to manage online pornography use.
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."
Studies of those with non-paraphilic expressions of hypersexuality have hypothesized that various mood disorders, as defined in the DSM, may occur more frequently in sexually compulsive men.
Compulsive sexual behavior has been treated with antidepressants including SSRIs and serotonin-norepinephrine reuptake inhibitors, naltrexone, a medication used to inhibit reward mechanisms in opiate or alcohol addictions, other mood-stabilizers, and anti-androgens.
There is only one representative sample to date concerning distress about sex video use.They found that of 10,131 women surveyed, 0.5% of women agreed with the statement that they were "addicted" to pornography; 1.2% (of 4,218 who viewed) when limited to women who say they viewed sex films. The comparable figure limiting to men who view sex films was 4.4%. This was without any clinical screening that should eliminate primary disorders (e.g., depression) or religious-based concerns, so these should be considered high-end estimates for potential disorders, if any exist.
Most studies of rates use a convenience sample. One study of a convenience sample of 9,265 people found that 1% of Internet users have concerns about their Internet use 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.
Twelve-step programs such as Sex Addicts Anonymous (SAA), Sexaholics Anonymous (SA), Sex and Love Addicts Anonymous (SLAA), Sexual Recovery Anonymous (SRA) and Sexual Compulsives Anonymous (SCA) are fellowships of men and women who share their experience, strength and hope with each other so they may overcome their common problem and help others recover from addiction or dependency, by using the 12 steps of AA and other recovery tools.
NoFap is an online community founded in 2011.It serves as a support group for those who wish to avoid the use of pornography, masturbation, and/or sexual intercourse. Recent peer-reviewed data highlighted considerable misogyny and poor understanding of sexual relationships in this online community.
There is also a PornFree reddit group which focuses on giving up porn rather than masturbation.
Additionally, Fight the New Drug, a Salt Lake City based non-profit, is a non-religious and non-legislative organization, which seeks to inform and educate individuals regarding pornography usage with science and personal stories. It is aimed at the youth demographic to raise awareness of potential problems with pornography
Celebrate Recovery (CR) is a Christian inter-denominational 12 step program with about 35,000 available groups and is open to any person who is struggling with life's bad habits, hurts, and hang-ups. CR was started in 1991 at Saddleback Church in CA, and the CR program is based on the 8 Beatitudes from Christ's sermon on the Mountain, and Twelve-step programs from Alcoholics Anonymous.
According to professor E.T.M. Laan, a sexologist working for the Academic Medical Center, it is usually the American religious right which claims the existence of pornography addiction and such claims are rare among sexologists.
A meta-analysis showed a correlation between a person being religious and perceiving themself as having a pornography addiction, possibly due to people using pornography despite their religion prohibiting it.
In 2013, American actor Joseph Gordon-Levitt wrote, directed, and starred in the comedy-drama film Don Jon , in which the protagonist is addicted to pornography.In an interview to promote the film, Gordon-Levitt discussed what he referred to as the "fundamental difference between a human being and an image on a screen".
In his 2014 autobiography, American actor Terry Crews talked about his long-standing pornography addiction, which he said had seriously affected his marriage and life and which he was only able to overcome after entering rehab in 2009.He now takes an active role in speaking out about pornography addiction and its impact.
In 2015, English comedian Russell Brand appeared in videos by American anti-pornography group Fight the New Drug, in which he discussed pornography and its harmful effects.Later that year, American actress Rashida Jones produced the documentary Hot Girls Wanted , which gave an in-depth look into the exploitation of women in the pornography industry.
In 2016, American comedian Chris Rock and his wife Malaak Compton divorced after 20 years of marriage,which Rock attributed to his infidelity and pornography addiction. He later discussed the details of his pornography addiction in his 2018 stand-up comedy special Tamborine .
French actress Juliette Binoche, English actor Hugh Grant, American actor Josh Radnor, and English actress Emma Thompson have also spoken out against pornography.
Paraphilia is the experience of intense sexual arousal to atypical objects, situations, fantasies, behaviors, or individuals.
Computer addiction is a form of behavioral addiction that can be described as the excessive or compulsive use of the computer which persists despite serious negative consequences for personal, social, or occupational function. Another clear conceptualization is made by Block, who stated that "Conceptually, the diagnosis is a compulsive-impulsive spectrum disorder that involves online and/or offline computer usage and consists of at least three subtypes: excessive gaming, sexual preoccupations, and e-mail/text messaging". Computer addiction is not currently included in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) as an official disorder. The concept of computer addiction is broadly divided into two types, namely offline computer addiction and online computer addiction. Offline computer addiction is normally used when speaking about excessive gaming behavior, which can be practiced both offline and online. Online computer addiction, also known as Internet addiction, gets more attention in general from scientific research than offline computer addiction, mainly because most cases of computer addiction are related to the excessive use of the Internet.
Hypersexuality is extremely frequent or suddenly increased libido. It is currently controversial whether it should be included as a clinical diagnosis used by mental healthcare professionals. Nymphomania and Satyriasis were terms previously used for the condition in women and men, respectively.
Hebephilia is the strong, persistent sexual interest by adults in pubescent children who are in early adolescence, typically ages 11–14 and showing Tanner stages 2 to 3 of physical development. It differs from pedophilia, and from ephebophilia. While individuals with a sexual preference for adults may have some sexual interest in pubescent-aged individuals, researchers and clinical diagnoses have proposed that hebephilia is characterized by a sexual preference for pubescent rather than adult partners.
Impulse-control disorder (ICD) is a class of psychiatric disorders characterized by impulsivity – failure to resist a temptation, an urge, or an impulse; or having the inability to not speak on a thought. Many psychiatric disorders feature impulsivity, including substance-related disorders, behavioral addictions, attention deficit hyperactivity disorder, Fetal Alcohol Spectrum Disorders, antisocial personality disorder, borderline personality disorder, conduct disorder and some mood disorders.
Substance dependence, also known as drug dependence, is an adaptive state that develops from repeated drug administration, and which results in withdrawal upon cessation of drug use. A drug addiction, a distinct concept from substance dependence, is defined as compulsive, out-of-control drug use, despite negative consequences. An addictive drug is a drug which is both rewarding and reinforcing. ΔFosB, a gene transcription factor, is now known to be a critical component and common factor in the development of virtually all forms of behavioral and drug addictions, but not dependence.
Sexual addiction, also known as sex addiction, is a state characterized by compulsive participation or engagement in sexual activity, particularly sexual intercourse, despite negative consequences.
Sexual anorexia is a pathological loss of "appetite" for romantic-sexual interaction, often the result of a fear of intimacy to the point that the person has severe anxiety surrounding sexual activity and emotional aspects. It is not a recognized pathology included in the Diagnostic and Statistical Manual of Mental Disorders.
Patrick Carnes is an American proponent of the viewpoint that some sexual behavior is an addiction. According to CBS News, he popularized the term sex addiction. He created the International Institute for Trauma and Addiction Professionals (IITAP), as well as numerous addiction treatment facilities, and created the CSAT certification.
Pedophilia is a psychiatric disorder in which an adult or older adolescent experiences a primary or exclusive sexual attraction to prepubescent children. Although girls typically begin the process of puberty at age 10 or 11, and boys at age 11 or 12, criteria for pedophilia extend the cut-off point for prepubescence to age 13. A person must be at least 16 years old, and at least five years older than the prepubescent child, for the attraction to be diagnosed as pedophilia.
An addictive behavior is a behavior, or a stimulus related to a behavior, that is both rewarding and reinforcing, and is associated with the development of an addiction. Addictions involving addictive behaviors are normally referred to as behavioral addictions.
Internet sex addiction, also known as cybersex addiction, has been proposed as a sexual addiction characterized by virtual Internet sexual activity that causes serious negative consequences to one's physical, mental, social, and/or financial well-being. It may also be considered a subset of the theorized Internet addiction disorder. Internet sex addiction manifests various behaviours: reading erotic stories; viewing, downloading or trading online pornography; online activity in adult fantasy chat rooms; cybersex relationships; masturbation while engaged in online activity that contributes to one's sexual arousal; the search for offline sexual partners and information about sexual activity.
The effects of pornography on individuals or their sexual relationships depend on the type of pornography used and differ from person to person. Pornographic material has been studied particularly for associations with addiction as well as effects on the brain over time. Some literature reviews suggest that pornographic images and films can be addictive, particularly when combined with masturbation, while others maintain that data remains inconclusive. Other research has looked at pornographic material's relation to sexual violence, with varying results.
Internet addiction disorder (IAD) also known as problematic internet use or pathological internet use is generally defined as problematic, compulsive use of the internet, that results in significant impairment in an individual's function in various life domains over a prolonged period of time. Young people are one of the groups at particular risk of developing Internet Addiction Disorder or Problematic Internet Use.
Behavioral addiction is a form of addiction that involves a compulsion to engage in a rewarding non-substance-related behavior – sometimes called a natural reward – despite any negative consequences to the person's physical, mental, social or financial well-being. Addiction canonically refers to substance abuse; however, the term connotation has been expanded to include behaviors that may lead to a reward since the 1990s. A gene transcription factor known as ΔFosB has been identified as a necessary common factor involved in both behavioral and drug addictions, which are associated with the same set of neural adaptations in the reward system.
Martin Paul Kafka is an American psychiatrist best known for his work on sex offenders, paraphilias and what he calls "paraphilia-related disorders" such as sex addiction and hypersexuality.
James M. Cantor is a Canadian clinical psychologist and sexologist, specializing in hypersexuality and atypical sexual interests. He is a former editor of the journal Sexual Abuse and an expert on paraphilias. His neuroscience research on brain differences in pedophiles has been cited as evidence that pedophilia is something unchangeable and that people are likely born with it.
Hypersexual disorder is a pattern of behavior involving intense preoccupation with sexual fantasies, urges and activities, leading to adverse consequences and clinically significant distress or impairment in social, occupational or other important functions. It was proposed in 2010 for inclusion in the Diagnostic and Statistical Manual of Mental Disorders Fifth Edition (DSM-5) of the American Psychiatric Association (APA).
Sexual masochism disorder (SMD) is the condition of experiencing recurring and intense sexual arousal in response to enduring moderate or extreme pain, suffering, or humiliation. The Diagnostic and Statistical Manual (DSM-5) of the American Psychiatric Association indicates that a person may have a masochistic sexual interest but that the diagnosis of sexual masochism disorder would only apply to individuals who also report psychosocial difficulties because of it.
NoFap is a website and community forum that serves as a support group for those who wish to give up pornography and masturbation. Its name comes from the slang term fap, referring to male masturbation. Reasons for this avoidance vary by individual, and may include religious and moral reasons, self-improvement, and physical beliefs that are not supported by medicine. The group's views and efforts to combat pornography addiction have been criticized as simplistic, outdated, and incorrect by neuroscientists, psychologists, and other medical professionals. The 'science' cited on NoFap is said to come from anti-porn activist Gary Wilson, "an Oregon man with no scientific training or background, who has made a career peddling pseudoscience."
Despite the importance of numerous psychosocial factors, at its core, drug addiction involves a biological process: the ability of repeated exposure to a drug of abuse to induce changes in a vulnerable brain that drive the compulsive seeking and taking of drugs, and loss of control over drug use, that define a state of addiction. ... A large body of literature has demonstrated that such ΔFosB induction in D1-type [nucleus accumbens] neurons increases an animal's sensitivity to drug as well as natural rewards and promotes drug self-administration, presumably through a process of positive reinforcement ... Another ΔFosB target is cFos: as ΔFosB accumulates with repeated drug exposure it represses c-Fos and contributes to the molecular switch whereby ΔFosB is selectively induced in the chronic drug-treated state.41. ... Moreover, there is increasing evidence that, despite a range of genetic risks for addiction across the population, exposure to sufficiently high doses of a drug for long periods of time can transform someone who has relatively lower genetic loading into an addict.
Substance-use disorder: A diagnostic term in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) referring to recurrent use of alcohol or other drugs that causes clinically and functionally significant impairment, such as health problems, disability, and failure to meet major responsibilities at work, school, or home. Depending on the level of severity, this disorder is classified as mild, moderate, or severe.
Addiction: A term used to indicate the most severe, chronic stage of substance-use disorder, in which there is a substantial loss of self-control, as indicated by compulsive drug taking despite the desire to stop taking the drug. In the DSM-5, the term addiction is synonymous with the classification of severe substance-use disorder.
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.
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.