1
|
Golder S, Walter B, Bengesser I, Kramer D, Muhl C, Tahmassebi N, Storz F, Markert C, Stark R. Compulsive sexual behavior disorder in an inpatient sample with substance use disorder. Sex Med 2024; 12:qfae003. [PMID: 38450258 PMCID: PMC10915581 DOI: 10.1093/sexmed/qfae003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2023] [Revised: 11/04/2023] [Accepted: 12/10/2023] [Indexed: 03/08/2024] Open
Abstract
Background Several studies indicate that compulsive sexual behavior disorder (CSBD) shares core elements with substance use disorder (SUD). These findings support the assumption of common mechanisms in addiction, which may lead to a higher tendency in patients with SUD to have comorbid CSBD. Nevertheless, this relationship between CSBD and SUD is poorly understood to date. Aim This study aimed to compare the prevalence of CSBD and its subtype pornography use disorder (PUD) between a SUD group and a matched control group. Herein, we aimed to test whether patients with SUD are more likely to have a comorbid CSBD/PUD. We further hypothesized that a higher CSBD/PUD prevalence in patients with SUD is accompanied by more pronounced CSBD- and PUD-related personal characteristics. Methods We assessed CSBD, PUD, and related personal characteristics in an inpatient SUD sample (N = 92) and a healthy control sample matched by age, gender, and educational level. Outcomes Primary outcomes were the diagnoses of CSBD/PUD as assessed by questionnaires. CSBD/PUD-related personal characteristics were the early onset of problematic pornography consumption, relationship status as a single person, a high sexual motivation, a high level of time spent watching pornography, and a high degree of problematic pornography consumption (Problematic Pornography Consumption Scale, short version). Results There was no significant difference between groups regarding CSBD prevalence (SUD sample, 3.3%; control sample, 7.6%) and PUD prevalence (SUD sample, 2.2%; control sample, 6.5%). We found relationship status as a single person and the sexual motivation dimension of importance of sex to be the only CSBD-related personal characteristics that were more pronounced in the SUD sample than the matched control group. Clinical Implications Results indicate no higher tendency for patients with SUD to develop comorbid CSBD/PUD, yet important vulnerabilities (eg, emotional dysregulation) should be considered when treating addictive disorder to prevent possible symptom displacement. Strengths and Limitations A strength of the study is that we compared a sample of patients with SUD with a matched control sample and used an instrument based on ICD-11 criteria for CSBD. Possible limitations are significant differences between the groups because of the restrictions in an inpatient clinic that may have influenced responses (eg, roommates) and that the control group was not screened for SUD. Therefore, the results should be interpreted with some caution. Conclusion We found no evidence of an overcomorbidity of SUD and CSBD/PUD. However, a higher rate of vulnerability factors for CSBD/PUD in the SUD sample might suggest some similarities between SUD and CSBD/PUD.
Collapse
Affiliation(s)
- Sarah Golder
- Department for Psychotherapy and Systems Neuroscience, University of Giessen, Giessen 35394, Germany
| | - Bertram Walter
- Department for Psychotherapy and Systems Neuroscience, University of Giessen, Giessen 35394, Germany
- Center for Mind, Brain and Behavior, Phillips-University Marburg and Justus-Liebig-University Giessen, Marburg/Giessen 35032, Germany
| | | | | | | | | | - Florian Storz
- Department for Psychotherapy and Systems Neuroscience, University of Giessen, Giessen 35394, Germany
| | - Charlotte Markert
- Department for Psychotherapy and Systems Neuroscience, University of Giessen, Giessen 35394, Germany
- Center for Mind, Brain and Behavior, Phillips-University Marburg and Justus-Liebig-University Giessen, Marburg/Giessen 35032, Germany
- Bender Institute of Neuroimaging, University of Giessen, Giessen 35394, Germany
| | - Rudolf Stark
- Department for Psychotherapy and Systems Neuroscience, University of Giessen, Giessen 35394, Germany
- Center for Mind, Brain and Behavior, Phillips-University Marburg and Justus-Liebig-University Giessen, Marburg/Giessen 35032, Germany
- Bender Institute of Neuroimaging, University of Giessen, Giessen 35394, Germany
| |
Collapse
|
2
|
Golder S, Markert C, Psarros R, Discher JP, Walter B, Stark R. Two subtypes of compulsive sexual behavior disorder. Front Psychiatry 2023; 14:1248900. [PMID: 38025451 PMCID: PMC10666180 DOI: 10.3389/fpsyt.2023.1248900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 10/11/2023] [Indexed: 12/01/2023] Open
Abstract
Models explaining addictive behaviors such as the Interaction of Person-Affect-Cognition-Execution (I-PACE) model emphasize the importance of reinforcement mechanisms for developing and maintaining these behaviors, including compulsive sexual behavior disorder (CSBD) as well as personal characteristics as vulnerability factors. This study aimed to determine whether there are CSBD subtypes distinguished by reinforcement sensitivity. We hypothesize that one subtype is sensitive to positive reinforcement (C+subtype) and one is sensitive to negative reinforcement (Ȼ-subtype). We calculated a cluster analysis with data from 62 patients with CSBD and tested differences between the identified clusters by t-test. The sample consisted only of men. Cluster variables were: the sensitivity to the Behavioral Inhibition and Approach System (BIS/BAS), the severity of depressive symptoms (BDI-II), the severity of Trait Anxiety (STAI-T), Sexual Sensation Seeking (SSSS), Thrill- and Adventure-Seeking (SSS-V subscale), Disinhibition (SSS-V subscale), Experience Seeking (SSS-V subscale), and Boredom Susceptibility (SSS-V subscale). Between-cluster differences were analyzed for Trait Sexual Motivation (TSMQ) and Sexual Compulsivity (SCS). The results showed a two-cluster solution with cluster 1 representing patients sensitive to negative reinforcement (Ȼ-subtype) and cluster 2 representing patients sensitive to positive reinforcement (C+subtype). No significant difference in symptom severity of Sexual Compulsivity between clusters was found. Cluster 2 showed higher Importance of Sex and a higher motivation to seek sexual encounters than cluster 2. We found a two-cluster solution regarding reinforcement sensitivity in patients with CSBD. This may have clinical implications regarding individual therapy by focusing on the underlying maintenance mechanisms.
Collapse
Affiliation(s)
- Sarah Golder
- Department for Psychotherapy and Systems Neuroscience, University of Giessen, Giessen, Germany
| | - Charlotte Markert
- Department for Psychotherapy and Systems Neuroscience, University of Giessen, Giessen, Germany
- Bender Institute of Neuroimaging, University of Giessen, Giessen, Germany
- Center for Mind, Brain and Behavior (CMBB), Phillips-University Marburg and Justus-Liebig-University Giessen, Marburg/Giessen, Germany
| | - Rhea Psarros
- Department for Psychotherapy and Systems Neuroscience, University of Giessen, Giessen, Germany
| | - Julian Peter Discher
- Department for Psychotherapy and Systems Neuroscience, University of Giessen, Giessen, Germany
| | - Bertram Walter
- Department for Psychotherapy and Systems Neuroscience, University of Giessen, Giessen, Germany
- Center for Mind, Brain and Behavior (CMBB), Phillips-University Marburg and Justus-Liebig-University Giessen, Marburg/Giessen, Germany
| | - Rudolf Stark
- Department for Psychotherapy and Systems Neuroscience, University of Giessen, Giessen, Germany
- Bender Institute of Neuroimaging, University of Giessen, Giessen, Germany
- Center for Mind, Brain and Behavior (CMBB), Phillips-University Marburg and Justus-Liebig-University Giessen, Marburg/Giessen, Germany
| |
Collapse
|
3
|
Yan H, Xiao S, Fu S, Gong J, Qi Z, Chen G, Chen P, Tang G, Su T, Yang Z, Wang Y. Functional and structural brain abnormalities in substance use disorder: A multimodal meta-analysis of neuroimaging studies. Acta Psychiatr Scand 2023; 147:345-359. [PMID: 36807120 DOI: 10.1111/acps.13539] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 01/19/2023] [Accepted: 02/12/2023] [Indexed: 02/23/2023]
Abstract
INTRODUCTION Numerous neuroimaging studies of resting-state functional imaging and voxel-based morphometry (VBM) have revealed that patients with substance use disorder (SUD) may present brain abnormalities, but their results were inconsistent. This multimodal neuroimaging meta-analysis aimed to estimate common and specific alterations in SUD patients by combining information from all available studies of spontaneous functional activity and gray matter volume (GMV). METHODS A whole-brain meta-analysis on resting-state functional imaging and VBM studies was conducted using the Seed-based d Mapping with Permutation of Subject Images (SDM-PSI) software, followed by multimodal overlapping to comprehensively investigate function and structure of the brain in SUD. RESULTS In this meta-analysis, 39 independent studies with 47 datasets related to resting-state functional brain activity (1444 SUD patients; 1446 healthy controls [HCs]) were included, as well as 77 studies with 89 datasets for GMV (3457 SUD patients; 3774 HCs). Patients with SUD showed the decreased resting-state functional brain activity in the bilateral anterior cingulate cortex/medial prefrontal cortex (ACC/mPFC). For the VBM meta-analysis, patients with SUD showed the reduced GMV in the bilateral ACC/mPFC, insula, thalamus extending to striatum, and left sensorimotor cortex. CONCLUSIONS This multimodal meta-analysis exhibited that SUD shows common impairment in both function and structure in the ACC/mPFC, suggesting that the deficits in functional and structural domains could be correlated together. In addition, a few regions exhibited only structural impairment in SUD, including the insula, thalamus, striatum, and sensorimotor areas.
Collapse
Affiliation(s)
- Hong Yan
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou, China
- Institute of Molecular and Functional Imaging, Jinan University, Guangzhou, China
| | - Shu Xiao
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou, China
- Institute of Molecular and Functional Imaging, Jinan University, Guangzhou, China
| | - Siying Fu
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou, China
- Institute of Molecular and Functional Imaging, Jinan University, Guangzhou, China
| | - Jiaying Gong
- Institute of Molecular and Functional Imaging, Jinan University, Guangzhou, China
- Department of Radiology, Six Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Zhangzhang Qi
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou, China
- Institute of Molecular and Functional Imaging, Jinan University, Guangzhou, China
| | - Guanmao Chen
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou, China
- Institute of Molecular and Functional Imaging, Jinan University, Guangzhou, China
| | - Pan Chen
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou, China
- Institute of Molecular and Functional Imaging, Jinan University, Guangzhou, China
| | - Guixian Tang
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou, China
- Institute of Molecular and Functional Imaging, Jinan University, Guangzhou, China
| | - Ting Su
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou, China
- Institute of Molecular and Functional Imaging, Jinan University, Guangzhou, China
| | - Zibin Yang
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou, China
- Institute of Molecular and Functional Imaging, Jinan University, Guangzhou, China
| | - Ying Wang
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou, China
- Institute of Molecular and Functional Imaging, Jinan University, Guangzhou, China
| |
Collapse
|
4
|
Turner D, Briken P, Grubbs J, Malandain L, Mestre-Bach G, Potenza MN, Thibaut F. The World Federation of Societies of Biological Psychiatry guidelines on the assessment and pharmacological treatment of compulsive sexual behaviour disorder. DIALOGUES IN CLINICAL NEUROSCIENCE 2022; 24:10-69. [PMID: 37522807 PMCID: PMC10408697 DOI: 10.1080/19585969.2022.2134739] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 09/18/2022] [Accepted: 10/03/2022] [Indexed: 11/18/2022]
Abstract
OBJECTIVES The current guidelines aim to evaluate the role of pharmacological agents in the treatment of patients with compulsive sexual behaviour disorder (CSBD). They are intended for use in clinical practice by clinicians who treat patients with CSBD. METHODS An extensive literature search was conducted using the English-language-literature indexed on PubMed and Google Scholar without time limit, supplemented by other sources, including published reviews. RESULTS Each treatment recommendation was evaluated with respect to the strength of evidence for its efficacy, safety, tolerability, and feasibility. Psychoeducation and psychotherapy are first-choice treatments and should always be conducted. The type of medication recommended depended mainly on the intensity of CSBD and comorbid sexual and psychiatric disorders. There are few randomised controlled trials. Although no medications carry formal indications for CSBD, selective-serotonin-reuptake-inhibitors and naltrexone currently constitute the most relevant pharmacological treatments for the treatment of CSBD. In cases of CSBD with comorbid paraphilic disorders, hormonal agents may be indicated, and one should refer to previously published guidelines on the treatment of adults with paraphilic disorders. Specific recommendations are also proposed in case of chemsex behaviour associated with CSBD. CONCLUSIONS An algorithm is proposed with different levels of treatment for different categories of patients with CSBD.
Collapse
Affiliation(s)
- Daniel Turner
- Department of Psychiatry and Psychotherapy, University Medical Center Mainz, Mainz, Germany
| | - Peer Briken
- Institute for Sex Research, Sexual Medicine, and Forensic Psychiatry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Joshua Grubbs
- Department of Psychology, Bowling Green State University, Bowling Green, OH, USA
| | - Leo Malandain
- Department of Psychiatry and Addictive Disorders, University Hospital Cochin (site Tarnier) AP-HP, Paris, France
| | - Gemma Mestre-Bach
- Facultad de Ciencias de la Salud, Universidad Internacional de La Rioja, La Rioja, Spain
| | - Marc N. Potenza
- Departments of Psychiatry and Neuroscience and Child Study Center, Yale School of Medicine, New Haven, CT, USA
- Connecticut Mental Health Center, New Haven, CT, USA
- Connecticut Council on Problem Gambling, Wethersfield, CT, USA
- Wu Tsai Institute, Yale University, New Haven, CT, USA
| | - Florence Thibaut
- Department of Psychiatry and Addictive Disorders, University Hospital Cochin (site Tarnier) AP-HP, Paris, France
- INSERM U1266, Institute of Psychiatry and Neurosciences, University of Paris Cité, Paris, France
| |
Collapse
|
5
|
Kondur HR, Lee TK, McIntosh R, Gouse H, Paul R, Grov C, Fuchs D, Gómez W, Dilworth SE, Neilands TB, Carrico AW. HIV-related drivers of sexual compulsivity and sexuality in sexual minority men who use methamphetamine. J Neurovirol 2022; 28:446-455. [PMID: 35821194 DOI: 10.1007/s13365-022-01085-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 05/22/2022] [Accepted: 06/14/2022] [Indexed: 10/17/2022]
Abstract
Although co-occurring methamphetamine (meth) use and HIV amplify the risk for neuropsychiatric comorbidities, the underlying neuroimmune mechanisms are not well characterized. We examined whether a detectable viral load and dysregulated metabolism of amino acid precursors for neurotransmitters predicted subsequent levels of sexual compulsivity and sexual sensation seeking. This 15-month longitudinal study enrolled 110 sexual minority men (SMM) living with HIV who had biologically confirmed meth use (i.e., reactive urine or hair toxicology results). Peripheral venous blood samples collected at baseline, 6 months, 12 months, and 15 months were used to measure a detectable viral load (> 40 copies/mL), the kynurenine/tryptophan (K/T) ratio, and the phenylalanine/tyrosine (P/T) ratio. The K/T and P/T ratios index dysregulated serotonin and catecholamine (e.g., dopamine) synthesis, respectively. In a cross-lagged panel model, a detectable viral load at 6 months predicted greater sexual compulsivity at 12 months after adjusting for prior levels of sexual compulsivity and recent stimulant use (β = 0.26, p = 0.046). A greater P/T ratio at baseline predicted decreased sexual sensation seeking at 6 months (β = - 0.25, p = 0.004) after adjusting for baseline sexual sensation seeking and recent stimulant use. Taken together, HIV replication and dysregulated catecholamine synthesis could potentiate sexual compulsivity while decreasing sexual pleasure in SMM who use meth.
Collapse
Affiliation(s)
- Hema R Kondur
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, 33136, USA
| | - Tae K Lee
- Department of Child Psychology and Education, Sungkyunkwan University, Seoul, Korea
| | - Roger McIntosh
- Department of Psychology, University of Miami, Coral Gables, FL, USA
| | - Hetta Gouse
- Department of Psychiatry, University of Cape Town, Cape Town, South Africa
| | - Robert Paul
- Department of Psychological Sciences, University of Missouri St. Louis, St. Louis, MO, USA
| | - Christian Grov
- Graduate School of Public Health and Health Policy, City University of New York, New York, NY, USA
| | | | - Walter Gómez
- Jane Addams College of Social Work, University of Illinois, Chicago, IL, USA
| | - Samantha E Dilworth
- School of Medicine, Department of Medicine, Division of Prevention Science, San Francisco Center for AIDS Prevention Studies, University of California, San Francisco, USA
| | - Torsten B Neilands
- School of Medicine, Department of Medicine, Division of Prevention Science, San Francisco Center for AIDS Prevention Studies, University of California, San Francisco, USA
| | - Adam W Carrico
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, 33136, USA.
| |
Collapse
|
6
|
Reed GM, First MB, Billieux J, Cloitre M, Briken P, Achab S, Brewin CR, King DL, Kraus SW, Bryant RA. Emerging experience with selected new categories in the ICD-11: complex PTSD, prolonged grief disorder, gaming disorder, and compulsive sexual behaviour disorder. World Psychiatry 2022; 21:189-213. [PMID: 35524599 PMCID: PMC9077619 DOI: 10.1002/wps.20960] [Citation(s) in RCA: 45] [Impact Index Per Article: 22.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Among the important changes in the ICD-11 is the addition of 21 new mental disorders. New categories are typically proposed to: a) improve the usefulness of morbidity statistics; b) facilitate recognition of a clinically important but poorly classified mental disorder in order to provide appropriate management; and c) stimulate research into more effective treatments. Given the major implications for the field and for World Health Organization (WHO) member states, it is important to examine the impact of these new categories during the early phase of the ICD-11 implementation. This paper focuses on four disorders: complex post-traumatic stress disorder, prolonged grief disorder, gaming disorder, and compulsive sexual behaviour disorder. These categories were selected because they have been the focus of considerable activity and/or controversy and because their inclusion in the ICD-11 represents a different decision than was made for the DSM-5. The lead authors invited experts on each of these disorders to provide insight into why it was considered important to add it to the ICD-11, implications for care of not having that diagnostic category, important controversies about adding the disorder, and a review of the evidence generated and other developments related to the category since the WHO signaled its intention to include it in the ICD-11. Each of the four diagnostic categories appears to describe a population with clinically important and distinctive features that had previously gone unrecognized as well as specific treatment needs that would otherwise likely go unmet. The introduction of these categories in the ICD-11 has been followed by a substantial expansion of research in each area, which has generally supported their validity and utility, and by a significant increase in the availability of appropriate services.
Collapse
Affiliation(s)
- Geoffrey M Reed
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
| | - Michael B First
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
| | - Joël Billieux
- Institute of Psychology, University of Lausanne, Lausanne, Switzerland
- Center for Excessive Gambling, Addiction Medicine, Lausanne University Hospitals, Lausanne, Switzerland
| | - Marylene Cloitre
- National Center for PTSD Dissemination and Training Division, VA Palo Alto Health Care, Menlo Park, CA, USA
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
| | - Peer Briken
- Institute for Sex Research and Forensic Psychiatry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Sophia Achab
- Outpatient Treatment Unit for Addictive Behaviors ReConnecte, Geneva University Hospitals, Geneva, Switzerland
- Psychological and Sociological Research and Training Unit, Department of Psychiatry, University of Geneva, Geneva, Switzerland
| | - Chris R Brewin
- Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Daniel L King
- College of Education, Psychology, and Social Work, Flinders University, Adelaide, SA, Australia
| | - Shane W Kraus
- Department of Psychology, University of Nevada, Las Vegas, NV, USA
| | - Richard A Bryant
- School of Psychology, University of New South Wales, Sydney, NSW, Australia
| |
Collapse
|
7
|
Predictors of Compulsive Sexual Behavior Among Treatment-Seeking Women. Sex Med 2022; 10:100525. [PMID: 35653876 PMCID: PMC9386638 DOI: 10.1016/j.esxm.2022.100525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 03/24/2022] [Accepted: 04/11/2022] [Indexed: 11/27/2022] Open
Abstract
Background Compulsive Sexual Behavior Disorder is currently included in the forthcoming eleventh revision of the International Classification of Diseases (ICD-11); however, prior studies have been conducted mostly on heterosexual, White/European male samples. Aim To examine the correlates of compulsive sexual behaviors (CSB) with sociodemographic and sexual history characteristics, as well as predictors of CSB in a sample of treatment-seeking Polish women. Methods Six hundred seventy-four (674) Polish women aged 18–66 completed an online-based survey. Outcomes Polish adaptation of the Sexual Addiction Screening Test-Revised (SAST-PL) was used to assess the severity of CSB symptoms. Brief Pornography Screen was used to measure problematic pornography use. The bivariate associations between SAST-PL scores and demographic and sexual history characteristics were also examined. A linear regression analysis was performed to identify variables related to the severity of CSB symptoms. Results Thirty one percent (31.8%) of women in the studied sample reported treatment seeking for CSB in the past. Problematic pornography use was the strongest predictor of CSB symptoms. Higher severity of CSB symptoms were observed among divorced/separated and single women compared to those who were married or in informal relation. Severity of CSB was positively related to the number of sexual partners during the last year, number of dyadic sexual intercourse during the last 7 days, and negatively associated with age of first sexual intercourse. Clinical Implications Our results suggest that CSB is a significant concern among women and more research is needed to identify protective (eg, relationship status) and risk (eg, problematic pornography use, number of past year sexual partners, frequency of past week masturbation) factors associated with CSB symptom severity among treatment-seeking women. Strengths & Limitations Our study is one of very few investigating predictors of CSB among women. Given the lack of precise estimates of the prevalence, as well as lack of psychometrically validated instruments measuring CSB in women, present findings should not be considered indicative of CSB prevalence among Polish women. Conclusion The lack of clinical data on women reporting issues with CSB remains an important target for future clinical research exploration. Kowalewska E, Gola M, Lew-Starowicz M, et al. Predictors of Compulsive Sexual Behavior Among Treatment-Seeking Women. Sex Med 2022;10:100525.
Collapse
|
8
|
Griffin KR, Way BM, Kraus SW. Controversies and Clinical Recommendations for the Treatment of Compulsive Sexual Behavior Disorder. CURRENT ADDICTION REPORTS 2021. [DOI: 10.1007/s40429-021-00393-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
9
|
Zhang M, Gao X, Yang Z, Wen M, Huang H, Zheng R, Wang W, Wei Y, Cheng J, Han S, Zhang Y. Shared gray matter alterations in subtypes of addiction: a voxel-wise meta-analysis. Psychopharmacology (Berl) 2021; 238:2365-2379. [PMID: 34313804 DOI: 10.1007/s00213-021-05920-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Accepted: 07/05/2021] [Indexed: 12/26/2022]
Abstract
BACKGROUND Numerous studies based on voxel-based morphometry (VBM) have revealed gray matter (GM) alterations in multiple brain regions for addiction. However, findings are poorly replicated, and it remains elusive whether distinct diagnoses of addiction are underpinned by shared abnormalities. Our aim was to conduct a quantitative meta-analysis of structural neuroimaging studies investigating GM abnormalities in two main categories of addiction: substance use disorders (SUD) and behavioral addictions (BA). METHOD A systematic database search was conducted in several databases from Jan 1, 2010, to Oct 23, 2020, to identify eligible VBM studies. Meta-analysis was performed with the seed-based d mapping software package to compare alternations between individuals with addiction-related disorders and healthy controls (HC). RESULTS A total of 59 VBM studies including 2096 individuals with addiction-related disorders and 2637 HC met the inclusion criteria. Individuals with addiction-related disorders showed shared GM volume decrease in bilateral prefrontal cortex, bilateral insula, bilateral rolandic operculum, left superior temporal gyrus, and right Heschl gyrus and GM increase in right lingual gyrus and right fusiform gyrus comparing with HC (p < 0.005). Subgroup analysis found heterogeneity between SUD and BA mainly in left inferior occipital gyrus and right striatum (p < 0.005). Meta-regression revealed that GM atrophy in right anterior cingulate (r = 0.541, p = 0.03 (uncorrected)) and left inferior frontal gyrus (r = 0.595, p = 0.015) were positively correlated with higher impulsivity. CONCLUSIONS This meta-analysis identified a concordance across subtypes of addiction in terms of the brain structural changes in prefrontal and insula areas, which may relate to higher impulsivity observed across addiction diagnoses. This concordance provides an organizing model that emphasizes the importance of shared neural substrates in addiction.
Collapse
Affiliation(s)
- Mengzhe Zhang
- Department of MRI, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Xinyu Gao
- Department of MRI, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Zhengui Yang
- Department of MRI, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Mengmeng Wen
- Department of MRI, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Huiyu Huang
- Department of MRI, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Ruiping Zheng
- Department of MRI, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Weijian Wang
- Department of MRI, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yarui Wei
- Department of MRI, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Jingliang Cheng
- Department of MRI, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
| | - Shaoqiang Han
- Department of MRI, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
| | - Yong Zhang
- Department of MRI, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
| |
Collapse
|
10
|
Draps M, Kowalczyk-Grębska N, Marchewka A, Shi F, Gola M. White matter microstructural and Compulsive Sexual Behaviors Disorder - Diffusion Tensor Imaging study. J Behav Addict 2021; 10:55-64. [PMID: 33570504 PMCID: PMC8969848 DOI: 10.1556/2006.2021.00002] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 10/30/2020] [Accepted: 12/27/2020] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND AND AIMS Even though the Compulsive Sexual Behavior Disorder (CSBD) was added to the ICD-11 under the impulse control category in 2019, its neural mechanisms are still debated. Researchers have noted its similarity both to addiction and to Obssesive-Compulsive Disorder (OCD). The aim of our study was to address this question by investigating the pattern of anatomical brain abnormalities among CSBD patients. METHODS Reviewing 39 publications on Diffusion Tensor Imaging (DTI) we have identified main abnormalities specific for addictions and OCD. Than we have collected DTI data from 36 heterosexual males diagnosed with CSBD and 31 matched healthy controls. These results were then compared to the addiction and OCD patterns. RESULTS Compared to controls, CSBD individuals showed significant fractional anisotropy (FA) reduction in the superior corona radiata tract, the internal capsule tract, cerebellar tracts and occipital gyrus white matter. Interestingly, all these regions were also identified in previous studies as shared DTI correlates in both OCD and addiction. DISCUSSION AND CONCLUSIONS Results of our study suggest that CSBD shares similar pattern of abnormalities with both OCD and addiction. As one of the first DTI study comparing structural brain differences between CSBD, addictions and OCD, although it reveals new aspects of CSBD, it is insufficient to determine whether CSBD resembles more an addiction or OCD. Further research, especially comparing directly individuals with all three disorders may provide more conclusive results.
Collapse
Affiliation(s)
- Małgorzata Draps
- Institute of Psychology, Polish Academy of Sciences, Warsaw, Poland,Corresponding author. E-mail:
| | | | - Artur Marchewka
- Laboratory of Brain Imaging, Neurobiology Center, Nencki Institute of Experimental Biology, Polish Academy of Sciences, Warsaw, Poland
| | - Feng Shi
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, USA
| | - Mateusz Gola
- Institute of Psychology, Polish Academy of Sciences, Warsaw, Poland,Swartz Center for Computational Neuroscience, Institute for Neural Computations, University of California San Diego, San Diego, USA
| |
Collapse
|
11
|
Kowalewska E, Gola M, Kraus SW, Lew-Starowicz M. Spotlight on Compulsive Sexual Behavior Disorder: A Systematic Review of Research on Women. Neuropsychiatr Dis Treat 2020; 16:2025-2043. [PMID: 32943868 PMCID: PMC7478918 DOI: 10.2147/ndt.s221540] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 08/07/2020] [Indexed: 12/16/2022] Open
Abstract
PURPOSE OF REVIEW World Health Organization recently included compulsive sexual behavior disorder (CSBD) to the upcoming 11th edition of International Classification of Diseases (6C72). Despite the potential benefits of this decision (eg, the acceleration of research in the field will allow the development of effective treatments), previous research focused mainly on men, and as a result, we do not have an accurate clinical picture of compulsive sexual behavior (CSB) among women. Therefore, in this systematic review, we aim to present available knowledge on this topical subject. Literature search was conducted in the guideline of PRISMA methodology. Studies were identified from multiple databases including Academic Search Ultimate, SocINDEX, PsycARTICLES, PsycINFO, PubMed, and MEDLINE. Out of a total of 10,531 articles identified and screened, 58 were included in this review. Included studies covered the following topics: prevalence and etiology of CSB, behavioral and cognitive processes involved, comorbidities, personality traits, psychosocial and interpersonal difficulties, traumatic experiences, and treatments. RECENT FINDINGS Available studies indicate that CSB symptom severity is lower in women than in men. Overall, women reported consuming pornography less often than men and exhibit lower rates of feeling urges to these materials. CSB symptoms (including problematic pornography use) have been found to be positively related to trait psychopathy, impulsivity, sensation seeking, attention-deficit/hyperactivity disorder symptoms, obsessive-compulsive disorder, pathological buying, sexual dysfunctions, general psychopathology, child sexual abuse, while negatively related to dispositional mindfulness. SUMMARY Conclusions that can be drawn from prior studies are considerably limited. There are no accurate estimates of the CSB prevalence or severity among women, and studies have been mostly conducted on non-clinical populations, which has limited application for women diagnosed with CSBD.
Collapse
Affiliation(s)
- Ewelina Kowalewska
- Department of Psychiatry, Centre of Postgraduate Medical Education, Warsaw, Poland
| | - Mateusz Gola
- Swartz Center for Computational Neuroscience, Institute for Neural Computations, University of California, San Diego, CA, USA
- Institute of Psychology, Polish Academy of Sciences, Warsaw, Poland
| | - Shane W Kraus
- Department of Psychology, University of Nevada, Las Vegas, NV, USA
| | - Michal Lew-Starowicz
- Department of Psychiatry, Centre of Postgraduate Medical Education, Warsaw, Poland
| |
Collapse
|