Neurobiology of Sex and Pornography Addictions: A Primer

Abstract

Contrary to the earlier notion that addiction is predominantly a substance dependency, research now suggests that any source or experience capable of stimulating an individual has addictive potential. This has led to a paradigm shift in the psychiatric understanding of behavioural addictions. These can refer to a range of behaviors such as gambling, video gaming, and sexual practices. Hypersexual behavior and pornography addiction come to the fore when the behavior becomes intensive, out of the individual’s control, and persists in that pattern despite harmful consequences and risk of harm to one’s emotional and/or physical health. The ongoing Coronavirus disease 2019 pandemic with its’ social distancing norms has further turned sexual practices to digital platforms with increase in pornography use, and hence addictions and unhealthy use of technology. There are several overlapping lines between these dimensions, and there are both components of compulsivity and impulsivity involved. Substantial evidence of neurobiological and psychological models has been used to conceptualize sex and pornography addictions. However, there is no academic consensus or operational criteria that can aid in diagnosing these conditions or estimating their impact. Moreover, the body of evidence on effective treatments is limited. With this background, this descriptive review looks at the various neurophysiological, genetic, and imaging markers of sex and pornography addictions including their possible evidence-based neuroplastic effects on the brain functioning and sexual behavior, and the neurobiological intersections with substance-abuse disorders, and finally outlines the future directions of related research.