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Approach and avoidance tendencies towards pornographic stimuli in hypersexual disorder

Veit, M1; Engel, J1; Sinke, C1; Kneer, J1; Laier, C2; Antons, S2; Hartmann, U1; Hillemacher, T3; Krüger, THC1

1: Hannover Medical School, Germany; 2: University Duisburg-Essen, Germany; 3: Klinikum Nuremberg, Germany

Objective(s): Hypersexual disorder (HD) comes with clinically significant personal distress for patients and further social and medical morbidity. Yet, there are heterogeneous attempts concerning etiology, phenomenology and diagnostic classification of HD. Several studies have outlined similarities between HD and addictive behaviors and substance dependencies. Attentional biases and implicit cognitions, in particular approach and avoidance tendencies, have been related to craving responses in substance dependent individuals. The rationale is that addiction-congruent images should facilitate pull (i.e., approach) responses in relation to neutral stimuli. Investigating these cognitive mechanisms in HD could help understanding the diagnosis in terms of a behavioral addiction, thus giving further options to address in therapy.

Material and Method(s): A sample of 46 HD patients and 37 healthy age- and intelligence-matched healthy control (HC) participants completed the Approach Avoidance Task (AAT; Rinck and Becker, 2007) modified with pornographic pictures. During the AAT participants either had to push pornographic stimuli away or pull them toward themselves with a joystick. Additionally, tendencies towards cybersex addiction were assessed.

Result(s): Patients with HD had significantly higher tendencies to approach pornographic stimuli in relation to HC. Thereof, HD patients with predominant symptoms of cybersex addiction showed significantly higher approach tendencies for pornographic images. No difference between HD patients and HC was found for approach scores for neutral stimuli. Overall reaction times showed significantly diverse attentional biases favoring pornographic versus neutral stimuli in HC but not in HD patients.  

Conclusion(s): Analogous to substance dependencies, results suggest that altered approach and avoidance tendencies toward addiction-congruent, i.e., pornographic stimuli might be a potential cognitive mechanism underlying HD. These results have wider relevance as a neuropsychological training of balancing approach and avoidance tendencies could be addressed in therapy.


Work supported by industry: no.

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