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Research Spotlight

Novelty, Conditioning and Attentional Bias to Sexual Rewards

Paula Banca et al.

Journal of Psychiatric Research 72, (2016): 91-101

Key Takeaway:

This study found that men with compulsive sexual behavior (CSB) exhibited greater preference for novel sexual images over familiar sexual images. This is consistent with “habituation,” a condition in which an addict finds a particular stimulus less rewarding over time, and must seek out newer or stronger stimuli in order to satisfy their cravings. A second key finding was that men with CSB exhibited greater preference for abstract images that they were conditioned to associate with sexual images (similar to how Pavlov trained dogs to salivate at the sound of a bell). Third, the study found decreased function over time in areas of the brain associated drug cue reactivity and craving, indicating that men with CSB showed more rapid habituation to repeated sexual images.

Study Highlights

Novelty-seeking, cue-conditioning, and attentional bias are processes associated with the development and maintenance of addiction disorders.1 A team of Cambridge University researchers and others conducted this study to examine these processes in individuals who met diagnostic criteria for compulsive sexual behaviors (CSB), particularly compulsive use of Internet pornography.2 The researchers hypothesized that people with CSB would exhibit a greater preference for sexual novelty and images they associate with sexual rewards compared to healthy volunteers.

All the subjects in this study were heterosexual males: 22 CSB subjects and 40 comparably aged, healthy volunteers (HV). HV and CSB participants were matched in a 2:1 ratio to increase statistical power. Potential subjects with histories of substance abuse, psychiatric or compulsive disorders, and under the age 18 years of age were excluded. Participants completed two behavioral tasks to determine their preference for novel versus familiar sexual images, as well as their preference for cues conditioned to sexual, monetary, and neutral images. The sexual images used for testing “could be perceived as erotic rather than sexually explicit.”

In the first experiment designed to test preference for novelty, participants were shown pairs of images which included naked women, clothed women, or furniture. Subsequently they were shown more pairs of images, some of which included the familiar images, but with new images added. At this stage subjects were asked to choose an image for the possibility of winning ₤1. What they did not know is that the probability for selecting a “winning” image was 50% for either of the images displayed.

A second test again involved showing the participants paired images. This time the images were of a nude woman or a grey box. After seeing a series of such images, the images were paired with a novel abstract pattern and participants learned to associate the abstract patterns with either sexual or neutral images. Next, the participants were again asked to choose an image for a chance to win ₤1 and were told that the goal was to make as much money as possible. This time, however, they were told that one of the images was associated with a greater probability of winning. What they did not know was that the odds of winning were greater if the participant chose familiar images verses novel ones. The test was also repeated substituting images of money for the sexual images.

Finally, participants (20 CSB; 20 healthy volunteers) performed tasks during which they viewed images of a nude woman, a ₤1 coin, or a neutral grey box during an fMRI scan to assess their neural habituation to sexual, monetary, and neutral images.

The study reported:

  • The results of the first text found that CSB subjects were more likely to choose novel sexual images rather than familiar sexual images when the images were paired against a neutral object. In contrast, HVs were more likely to choose a novel image of a neutral human female when paired against pictures of neutral objects.
  • In the second test, CSB participants displayed a greater preference for abstract images (cues) that they were conditioned to associate with either sexual images or pictures of money.
  • The fMRI task revealed that CSB subjects demonstrated a greater decrease in dorsal anterior cingulate cortex (dACC) and right inferior temporal cortex activity over time when exposed to sexual versus neutral images compared to HVs. This finding is consistent with “habituation,” a condition in which an addict finds a particular stimulus less rewarding over time.3
  • Across all participants, novelty preference to repeated sexual images was predicted by greater habituation of daCC activity to sexual images.
  • Importantly, there were no differences in sensation-seeking scores between individuals with CSB and HV (sensation seeking is a personality trait describing people who seek excitement, such as through new and intense experiences). This suggests that rather than men with CSB engaging in more compulsive sexual behaviors because they are high sensation seekers, that their desire for novelty stems from a condition response to pornography as a sexual reward.
  • The study reported that “CSB individuals have a dysfunctional enhanced preference for sexual novelty…”4 Researchers also explained their work showed “experimentally what is observed clinically that CSB is characterized by novelty-seeking, conditioning, and habituation to sexual stimuli in males.”5
  • These results support and extend the findings of Voon et al., 2014,6 and that of Mechelmans et al., 2014.7
  • Co-author Valerie Voon commented on the study’s results saying, “Our findings are particularly relevant in the context of online pornography… It’s not clear what triggers sex addiction, but the seemingly endless supply of novel sexual images online helps feed their addiction, making it more and more difficult to escape.”8

Commentary

This study showed that men with compulsive sexual behavior exhibited a ”dysfunctional enhanced preference” for novel sexual images over familiar sexual images.9 This is consistent with “habituation,” a condition in which an addict finds a particular stimulus less rewarding over time, and must seek out newer or stronger stimuli in order to satisfy their cravings.

Habituation often leads pornography users to escalate to more extreme content over time. For example, in a 2016 study of French-speaking men who engaged in online sexual activities in the past three months, 46.9% of the men reported being involved in a practice or searching for pornographic content that was “previously not interesting” or “even disgusting” to them.10 

One pornography user describes the experience of habituation and escalation as follows:

I can say with absolute certainty that the fantasies I had about rape, homicide and submission were never there before hardcore porn use from 18-22. When I stayed away from porn for 5 months all those fantasies and urges were gone. My natural sexual taste was vanilla again and still is. Thing with porn is you need harder and harder material, more taboo, more exciting and ‘wrong’ to actually be able to get off.11

Another finding of this study was that people with CSB exhibited a greater preference for abstract cues that they were conditioned to associate with sexual images. This is similar to how the famous researcher Pavlov trained dogs to salivate at the sound of a bell. Based on repeated association, dogs were conditioned to associate the sound of the bell with food and would begin salivating at the sound of a bell even when food was not present. One implication of this is that a compulsive pornography user could be triggered to watch pornography based on conditioned cues in their environment that they have learned to associate with the habit. For example, a conditioned cue could be the sound of a door closing, indicating they are alone and have privacy to watch pornography.

Habituation, novelty-seeking, and cue-conditioning are hallmarks of addiction. Accordingly, this study lends particularly strong support to the pornography addiction model.

Footnotes

1 Paula Banca, Laurel S. Morris, Simon Mitchell, Neil A. Harrison, Marc N. Potenza, and Valerie Voon, “Novelty, Conditioning and Attentional Bias to Sexual Rewards.” Journal of Psychiatric Research 72, (2016): 91-101, https://doi.org/10.1016/j.jpsychires.2015.10.017

2 Ibid.

3 University of Cambridge, “Research, News: Online Porn May Feed Sex Addicts’ Desire for New Sexual Images,” November 23, 2015, https://www.cam.ac.uk/research/news/online-porn-may-feed-sex-addicts-desire-for-new-sexual-images (accessed April 25, 2024).

4 Banca et al., “Novelty, Conditioning and Attentional Bias,” 91.

5 Banca et al., “Novelty, Conditioning and Attentional Bias,” 99.

6 Valerie Voon, Thomas B. Mole, Paula Banca, et al., “Neural Correlates of Sexual Cue Reactivity in Individuals with and without Compulsive Sexual Behaviours,” PLOS ONE 9, no. 7 (2014): 1‒10, https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0102419

7 Daisy J. Mechelmans, Michael Irvine, Paula Banca, et al., “Enhanced Attentional Bias towards Sexually Explicit Cues in Individuals with and without Compulsive Sexual Behaviours,” PLOS ONE 9, no. 8 (2014): 1-7.

8 University of Cambridge, “Research, News: Online Porn May Feed.”

9 Banca et al., “Novelty, Conditioning and Attentional Bias,” 91.

10 Aline Wéry and Joel Billieux, “Online Sexual Activities: An Exploratory Study of Problematic and Non-problematic Usage Patterns in a Sample of Men,” Computers in Human Behavior 56 (2016): 257–266, https://doi.org/10.1016/j.chb.2015.11.046

11 Gary Wilson, Your Brain on Porn (UK: Commonwealth Publishing, 2014), 38. 

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