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Implicit associations towards pornographic stimuli in hypersexual disorder

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

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

Objective(s): Hypersexual disorder describes extremely frequent sexual fantasies, sexual urges or sexual behaviors that often constitute a high mental burden. There is an ongoing debate whether hypersexual behavior should be classified as obsessive compulsive disorder, impulse control disorder or behavioral addiction. In substance dependencies implicit associations towards addiction related stimuli can be seen as result of neural sensitization leading to automatic approach behavior. Positive implicit associations may explain why problematic pornography users have difficulties resisting their automatically triggered impulses to consume pornography despite negative consequences.

Material and Method(s): Patients with hypersexual disorder (N=47) and healthy controls (N=38) matched regarding age and education completed an implicit association task. This neuropsychological test indicates the strength of automatic associations. The performed implicit association task measures performance speed in a classification tasks. Participants had to categorize pictorial stimuli along different dimensions (positive vs. negative or jogging vs. pornographic) as fast as possible while the pairing of the dimensions with the response (either positive and porn share the same response or negative and porn) changes. Furthermore, hypersexual behavior was assessed.

Result(s): Significant differences regarding implicit associations towards pornographic pictures were found between groups. Relative to healthy controls, patients with hypersexual behavior showed increased positive implicit associations toward pornographic material. Additionally a positive correlation between hypersexual behavior and positive implicit associations towards pornography was found.

Conclusion(s): In line with theoretical consideration the results show positive implicit associations towards pornography in individuals diagnosed with hypersexual disorder. As this behavior is similar to the behavior of drug addicts toward addiction related stimuli, these findings strengthen the hypothesis to categorize hypersexual disorder as an addiction. Further research regarding the interaction between automatic associations and behavioral control, a better understanding of excessive pornography consumption may lead to more differentiated and effective diagnostics and treatment.


Work supported by industry: no.

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