Research Spotlight

Can Pornography be Addictive? An fMRI Study of Men Seeking Treatment for Problematic Pornography Use

Mateusz Gola et al.

Neuropsychopharmacology 42, no. 10 (2017): 2021‒2031, doi:10.1038/npp.2017.78.

Key Takeaway:

This double-blind, experimental study applied a popular theory of addiction to pornography use by comparing the brain responses of men with and without problematic pornography use (PPU). Brain responses to sexual pictures in PPU men revealed dissociation between measures of “wanting” and “liking” but not in men without PPU, providing strong evidence that PPU may represent a behavioral addiction. This dissociation was significantly correlated to the severity of the PPU subjects’ compulsive sexual behaviors, the amount of pornography consumed, and frequency of masturbation reported.

Study Highlights

Researchers exploring incentive sensitization theory (IST) in the context of possible pornography addiction conducted a double-blind, experimental study that utilized functional magnetic resonance imaging (fMRI). This allowed them to compare ventral striatal1 responses of men with problematic pornography use (PPU) with those of men who used pornography at least once in the preceding year but had never experienced it as a problematic behavior.

Incentive Sensitization Theory Explained

Before proceeding to this study’s findings, it’s important to understand the theory underlying it. This requires a bit of extra reading, but the extra few minutes of your time is a good investment since this background information will help you fully appreciate the significance of Gola et al.’s findings. Here is a link to our article explaining incentive sensitization theory.


The subjects for this study were heterosexual males ranging in age from 18–48 years. The final analysis included data from 28 PPU subjects and 24 non-PPU subjects, all of whom were of comparable ages and incomes and without other psychiatric diagnoses. Participants completed a psychiatric interview, as well as self-assessments measuring sexual activity and substance abuse in the eight weeks preceding the fMRI. Finally, participants completed an incentive delay task2 during an fMRI session which measured their response times to sexual (“erotic” cues) and monetary cues predictive of rewards. Response times were used as an indicator of motivation. Participants were also asked to rate their liking of monetary and sexual rewards on a scale of 1 to 9 (1 do not like – 9 liking very much). These procedures also allowed researchers to observe blood-oxygen-level-dependent (BOLD) responses in the brain related to “wanting” (cues) and “liking” (rewards).


  • Greater Anxiety among PPU Men: Subjects with PPU exhibited higher trait anxiety (e.g., “the stable tendency to attend to, experience, and report negative emotions such as fears, worries, and anxiety across many situations”3) than subjects in the control group, though no PPU subjects met the criteria for anxiety disorder.
  • Similar Sexual Arousability: Responses to the Sexual Arousability Inventory revealed that there was not a significant difference in the self-reported, general level of sexual arousability between men with PPU and non-PPU men. This suggests that men with PPU are not engaging in more pornography use because they have greater sexual arousability.
  • Higher Sex Addiction Scores among Men with PPU: Men with PPU scored higher on a screening test for sex addiction than men without PPU.
  • More Pornography Use & Masturbation among PPU Men: PPU men reported more pornography use, more frequent masturbation per week, and higher maximum number of masturbations in one day, than comparison subjects. Men with PPU spent 5.6 times more minutes per week consuming pornography than men in the control group.


PPU Men Non PPU Men
Average minutes of pornography use per week 287.87 minutes 50.77 minutes
Longest time of pornography consumption in 1 day 284.74 minutes 70.55 minutes
Average frequency of masturbation per week 5.66 2.37
Average maximum number of masturbations in one day 5.21 3.1


  • Quicker Response to Sexual Motivational Cues among PPU Men: PPU men and controls displayed similar reaction times to cues predicting monetary reward, but not cues predicting sexual reward. The shortest reaction times to sexual reward cues were observed among PPU subjects. The “bigger” the anticipated reward, the quicker their reaction times. This demonstrates their higher motivation to view sexual rewards than controls and provides support for incentive sensitization theory rather than general impairments of reward processing.
  • BOLD Responses Show Cue-Related “Wanting” Dissociated from Reward-Related “Liking” among PPU Men: Compared to the control group, men with PPU showed increased BOLD response in the ventral striatum in response to sexual cues (i.e., during the anticipation phase), but not in the reward phase. This dissociation was also correlated to the severity of PPU’s compulsive sexual behaviors, amount of pornography consumption, and frequency of masturbation reported two months prior to the fMRI. This pattern of cue-related wanting dissociated from reward-related liking is in line with incentive sensitization theory and reflects the findings of other addiction-related research.
  • Similar Ventral Striatal Reactivity in Reward Phase: PPU men and controls showed differences in the cue phase but showed similar ventral striatal activity in the reward phase of tasks. This finding is consistent with dissociation between brain measures of “wanting” and “liking” of sexual stimuli in PPU men but not men in the control group.


Gola et al. found classic behavioral and neurobiological indicators of incentive sensitization among men with PPU but not controls including:

  1. quicker response times to—behavioral motivation for—cues predictive of sexual reward
  2. increased BOLD responses in the ventral striatum to cues predicting sexual reward, but not monetary rewards
  3. dissociation between “wanting” of sexual cues and “liking” of sexual rewards.

Dissociation between “wanting” and “liking” is a hallmark feature of IST. Further, the level of ventral striatal reactivity to sexual cues was significantly related to amount of pornography use per week, frequency of masturbation, and severity of PPU. The results also suggest that the conditioned response to cues associated with sexual reward “may overshadow motivational values of alternate sources of reward in men with PPU.”4 Finally, the increased BOLD responses in the ventral striatum of PPU men is significant because conditioned or salient cues are associated with increased blood-oxygen-level-dependent (BOLD) responses in the ventral striatum of the brain, as well as shorter reaction times.5 In summary, this study adds to the growing body of evidence demonstrating that problematic pornography users’ display striking similarities to people with substance and other behavioral addictions.


1 The striatum is the central interface of the cortico-basal ganglia-thalamic circuit which receives input from a variety of brain regions (e.g., prefrontal cortex, ventral tegmental area) to guide behavioral output, including motor planning, decision-making, motivation, and reward. As described by Yager et al. it is “a key site for the neuroplastic events that underlie addiction.” See Yager et al., “The Ins and Outs of the Striatum: Role in Drug Addiction,” Neuroscience 301 (2015): 529–541, doi:10.1016/j.neuroscience.2015.06.033.

2 An incentive delay task disentangles cue- (i.e., anticipation) and reward-related (i.e., outcome) phases, allowing for measurement of neural indicators of ‘wanting’ and ‘liking’ and for comparison of addiction-related stimuli with another reward. As described by Sescousse et al. it involves a cue presented during reward anticipation, followed by a delay period and a discrimination task, which involves correctly and quickly responding to a target. “Discrimination tasks” measure one’s ability to respond to different stimuli differently. Success on the discrimination task allows subjects to view the reward, while incorrect or slow responses lead to no reward. See Guillaume Sescousse, Jérôme Redouté, and Jean-Claude Dreher, “The Architecture of Reward Value Coding in the Human Orbitofrontal Cortex,” The Journal of Neuroscience 30, no. 39 (2010): 13096, doi:10.1523/JNEUROSCI.3501-10.2010.

3 Yori Gidron, “Trait Anxiety,” in Encyclopedia of Behavioral Medicine, eds. Marc D. Gellman and J. Rick Turner (New York: Springer, 2013), doi:10.1007/978-1-4419-1005-9_1539.

4 Gola et al., ibid, 2028.

5 Gola et al., ibid.


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