Infant hedonic/anhedonic processing index (HAPI-Infant): Assessing infant anhedonia and its prospective association with adolescent depressive symptoms

BACKGROUND

Anhedonia, an impairment in the motivation for or experience of pleasure, is a well-established transdiagnostic harbinger and core symptom of mental illness. Given increasing recognition of early life origins of mental illness, we posit that anhedonia should, and could, be recognized earlier if appropriate tools were available. However, reliable diagnostic instruments prior to childhood do not currently exist.

METHODS

We developed an assessment instrument for anhedonia/reward processing in infancy, the Infant Hedonic/Anhedonic Processing Index (HAPI-Infant). Exploratory factor and psychometric analyses were conducted using data from 6- and 12-month-old infants from two cohorts (N = 188, N = 212). Then, associations were assessed between infant anhedonia and adolescent self-report of depressive symptoms.

RESULTS

The HAPI-Infant (47-items), exhibited excellent psychometric properties. Higher anhedonia scores at 6 (r = 0.23, p < .01) and 12 months (r = 0.19, p < .05) predicted elevated adolescent depressive symptoms, and these associations were stronger than for established infant risk indicators such as negative affectivity. Subsequent analyses supported the validity of short (27-item) and very short (12-item) versions of this measure.

LIMITATIONS

The primary limitations of this study are that the HAPI-Infant awaits additional tests of generalizability and of its ability to predict clinical diagnosis of depression.

CONCLUSIONS

The HAPI-Infant is a novel, psychometrically strong diagnostic tool suitable for recognizing anhedonia during the first year of life with strong predictive value for later depressive symptoms. In view of the emerging recognition of increasing prevalence of affective disorders in children and adolescents, the importance of the HAPI-Infant in diagnosing anhedonia is encouraging. Early recognition of anhedonia could target high-risk individuals for intervention and perhaps prevention of mental health disorders.

The neuroscience of human empathy for pleasure: protocol for a scoping review

OBJECTIVE

The neuroscience of human empathy for pleasure and positive affect is an emergent, scarcely addressed topic. The main aim of this scoping review is to map the impact of this new research domain on the field of social and affective neuroscience.

INTRODUCTION

Most of the literature on empathy and affect sharing has hitherto focused on negative emotions, with a special focus on pain. However, understanding, sharing, and reacting to others' pleasures is an evolutionarily and socially important function. Our scoping review addresses this gap in the literature and tries to unify the available information under the empathy for pleasure umbrella.

INCLUSION CRITERIA

This scoping review is intended to cover studies on empathy for positive emotions, pleasant sensory outcomes, and other rewards in healthy individuals and neurological/neuropsychiatric/neurodevelopmental disorders populations.

METHODS

We will perform a systematic search in the Medline (PubMed), Scopus, and Web of Science (WoS) databases. Two authors will independently screen all titles, abstracts, and then full-text articles that meet the inclusion criteria. The year range of interest will be 2000-2022, and only journal articles published in English will be assessed. Data will be extracted and presented in tables and/or graphical representations to synthesize and describe the results. The extracted data will be reported in a comprehensive summary.

RESULTS

The final manuscript is intended for submission to an indexed journal in late 2023/beginning 2024.

CONCLUSIONS

To our knowledge, the present scoping review will be the first to address the variety and heterogeneity of available evidence on human empathy for pleasure. We ultimately aim at perusing the growing literature on this far-reaching field of study and informing future research.

SYSTEMATIC REVIEW REGISTRATION

The neuroscience of human empathy for pleasure: Protocol for a scoping review.  https://doi.org/10.17605/OSF.IO/W7H6J . (December 27, 2022).

A review of psychological and neuroscientific research on musical groove

When listening to music, we naturally move our bodies rhythmically to the beat, which can be pleasurable and difficult to resist. This pleasurable sensation of wanting to move the body to music has been called "groove." Following pioneering humanities research, psychological and neuroscientific studies have provided insights on associated musical features, behavioral responses, phenomenological aspects, and brain structural and functional correlates of the groove experience. Groove research has advanced the field of music science and more generally informed our understanding of bidirectional links between perception and action, and the role of the motor system in prediction. Activity in motor and reward-related brain networks during music listening is associated with the groove experience, and this neural activity is linked to temporal prediction and learning. This article reviews research on groove as a psychological phenomenon with neurophysiological correlates that link musical rhythm perception, sensorimotor prediction, and reward processing. Promising future research directions range from elucidating specific neural mechanisms to exploring clinical applications and socio-cultural implications of groove.

Sexual Health and Well-Being: A Framework to Guide Care

Although the acceptance of sex positivity centering pleasure and justice has grown, clinical and public health strategies for sexually transmitted infection management have remained focused on risk and adverse outcomes. To promote sex-positive health care practice in clinical settings and beyond, health care practitioners should use an integrated, patient-centered approach to sexual health. These strategies include initiating discussions, continued sexual health education, providing informative material for patients, and knowledge of different communication strategies. Patient-provider interactions might be enhanced by using such methods.

"What's Something You've Heard About Sex, But Are Unsure If It's True?": Assessing Middle and High School Students' Sex Education Questions

PURPOSE

Comprehensive sex education (CSE) encourages safer sex behavior for teens and young adults. However, young people recognize a gap between sex education as taught in the classroom and the reality of their sexual experiences. Thus, CSE should take into account the perspectives of its target population.

METHODS

The current project assesses young people's sexual uncertainties by analyzing open-ended responses that were anonymously submitted during in-person sex education sessions. These education programs were administered in middle and high schools in New York State by facilitators from Planned Parenthood Hudson Peconic, Inc. The authors analyzed 1,335 responses from a racially diverse sample of students between the ages of 10 and 21, with 75% of participants between 15 and 17 years old.

RESULTS

Using content analysis, the authors identified 49 recurring content codes in participants' responses, which were organized into 16 categories. Most responses centered around pregnancy, sexually transmitted infections, and how to prevent these outcomes. However, responses also highlighted topics that are not always covered with nuance and transparency, if at all, in sex education (e.g., withdrawal, effectiveness of condoms and other contraception, anal and oral sex). Additionally, gender analyses indicated that girls made greater reference to pain, while boys made greater reference to pleasure, which has implications for girls' development of a positive sexuality.

DISCUSSION

These results should be interpreted with a social equity lens to inform the development of needs-driven, target-based CSE programming.

Musical anhedonia, timbre, and the rewards of music listening

Pleasure in music has been linked to predictive coding of melodic and rhythmic patterns, subserved by connectivity between regions in the brain's auditory and reward networks. Specific musical anhedonics derive little pleasure from music and have altered auditory-reward connectivity, but no difficulties with music perception abilities and no generalized physical anhedonia. Recent research suggests that specific musical anhedonics experience pleasure in nonmusical sounds, suggesting that the implicated brain pathways may be specific to music reward. However, this work used sounds with clear real-world sources (e.g., babies laughing, crowds cheering), so positive hedonic responses could be based on the referents of these sounds rather than the sounds themselves. We presented specific musical anhedonics and matched controls with isolated short pleasing and displeasing synthesized sounds of varying timbres with no clear real-world referents. While the two groups found displeasing sounds equally displeasing, the musical anhedonics gave substantially lower pleasure ratings to the pleasing sounds, indicating that their sonic anhedonia is not limited to musical rhythms and melodies. Furthermore, across a large sample of participants, mean pleasure ratings for pleasing synthesized sounds predicted significant and similar variance in six dimensions of musical reward considered to be relatively independent, suggesting that pleasure in sonic timbres play a role in eliciting reward-related responses to music. We replicate the earlier findings of preserved pleasure ratings for semantically referential sounds in musical anhedonics and find that pleasure ratings of semantic referents, when presented without sounds, correlated with ratings for the sounds themselves. This association was stronger in musical anhedonics than in controls, suggesting the use of semantic knowledge as a compensatory mechanism for affective sound processing. Our results indicate that specific musical anhedonia is not entirely specific to melodic and rhythmic processing, and suggest that timbre merits further research as a source of pleasure in music.

Postural adjustments and perceptual responses of Nordic running: concurrent effects of poles and irregular terrain

PURPOSE

In the natural environment, humans must continuously negotiate irregular and unpredictable terrain. Recently, the poles have been extensively used during trial running events. However, we know little about how humans adjust posture and bilateral coordination to use poles in irregular terrain. Here, we compared kinematics, bilateral coordination and perceptual responses between regular (compact dust) and irregular terrain (medium-length grass) during running at preferred speed with and without poles.

METHODS

In this transversal observational study, thirteen young healthy adults (8 men; mean ± SD; age 29.1 ± 8.0 years, body mass 76.8 ± 11.4 kg; height 1.75 ± 0.08 m) were evaluated during running at a self-selected comfortable speed with and without poles on regular and irregular terrains.

RESULTS

Our results show that, despite more flexed pattern on lower-limb joints at irregular terrain, the usage of poles was not enough to re-stabilize the bilateral coordination. Also, the perceived exertion was impaired adding poles to running, probably due to more complex movement pattern using poles in comparison to free running, and the invariance in the bilateral coordination.

CONCLUSION

Besides the invariability of usage poles on bilateral coordination and lower-limb kinematics, the runners seem to prioritize postural stability over lower limb stiffness when running in medium-length grass given the larger range of ankle and knee motion observed in irregular terrain. Further investigations at rougher/hilly terrains will likely provide additional insights into the neuromotor control strategies used to maintain the stability and on perceptual responses using poles during running.

Anticipatory and consummatory pleasure in avoidant/restrictive food intake disorder

BACKGROUND

Recent research suggests that individuals with eating disorders (EDs) report elevated anhedonia, or loss of pleasure. Although individuals with avoidant/restrictive food intake disorder (ARFID) often express that they do not look forward to eating, it is unclear whether they experience lower pleasure than those without EDs. Thus, identifying whether individuals with ARFID experience anhedonia may yield important insights that inform clinical conceptualization and treatment.

METHODS

A sample of 71 participants ages 10-23 with full and subthreshold ARFID and 33 healthy controls (HCs) completed the Pica, ARFID, and Rumination Disorder Interview, a diagnostic interview to assess ARFID profile severity (lack of interest in food, sensory sensitivity, fear of aversive consequences) and the Temporal Experience of Pleasure Scale (TEPS), a self-report measure of consummatory and anticipatory pleasure. Statistical analyses were performed using the full TEPS and also the TEPS with food-related items removed.

RESULTS

The ARFID group reported significantly lower anticipatory and consummatory pleasure compared to HCs, but these differences were no longer significant after controlling for depression, nor after removing food items from the TEPS. Within the ARFID sample, greater ARFID severity was associated with lower anticipatory pleasure across analyses, and greater endorsement of the lack of interest in food profile was related to lower anticipatory pleasure. ARFID severity was also associated with lower consummatory pleasure using the full TEPS, but this relationship was no longer significant with food items removed.

CONCLUSIONS

These results provide initial evidence for lower pleasure before potentially pleasurable events in individuals with more severe ARFID, particularly those with the lack of interest phenotype. Our findings also suggest that depression is likely to contribute low pleasure in this population. Future research should seek to further characterize how dimensions of pleasure relate to the maintenance and treatment of ARFID symptoms.

Working together to increase Australian children's liking of vegetables: a position statement by the Vegetable Intake Strategic Alliance (VISA)

Children need to be repeatedly and consistently exposed to a variety of vegetables from an early age to achieve an increase in vegetable intake. A focus on enjoyment and learning to like eating vegetables at an early age is critical to forming favourable lifelong eating habits. Coordinated work is needed to ensure vegetables are available and promoted in a range of settings, using evidence-based initiatives, to create an environment that will support children’s acceptance of vegetables. This will help to facilitate increased intake and ultimately realise the associated health benefits. The challenges and evidence base for a new approach are described.

Psychometric properties of the Clinical Assessment Interview for Negative Symptoms (CAINS) in patients with depression and its relationship to affective symptoms

BACKGROUND

There is a conceptual overlap between negative and depressive symptoms, requiring further exploration to advance the understanding of negative symptoms. The aim of this study was to examine psychometric properties of the Clinical Assessment Interview for Negative Symptoms (CAINS) in patients with depression, and to explore the relationship between the negative and affective symptoms domains.

METHODS

Fifty-one patients with a depressive episode were included and interviewed with the CAINS and the Brief Psychiatric Rating Scale-Expanded (BPRS-E). Self-reported depressive symptoms were collected with the Montgomery-Asberg Depression Rating Scale (MADRS-S). Inter-rater agreement, internal consistency and validity measures were examined, as were correlations between negative and affective symptoms.

RESULTS

The intraclass correlation for the CAINS motivation and pleasure subscale (CAINS-MAP) was 0.98 (95% CI 0.96-0.99) and that for the expressional subscale (CAINS-EXP) was 0.81 (95% CI 0.67-0.89). Cronbach's alpha was 0.71 (95% CI 0.57-0.82) for the CAINS-MAP and 0.86 (95% CI 0.79-0.92) for the CAINS-EXP. The correlation with the negative symptoms subscale of the BPRS-E was 0.35 (p = 0.011, blinded/different raters) or 0.55 (p < 0.001, not blinded/same rater). The CAINS-MAP correlated with the affective symptoms subscale of the BPRS-E (r = 0.39, p = 0.005) and the MADRS-S total score (r = 0.50, p < 0.001), but not with anxiety symptoms.

CONCLUSIONS

Negative symptoms in depression can be assessed with the CAINS with good inter-rater agreement and acceptable internal consistency and validity. There are associations between negative and depressive symptoms that call for further exploration.

Problematic online anime (animation) use: It's relationship with viewers' satisfaction with life, emotions, and emotion regulation

Although there are numerous studies on problematic technology use, such as problematic video game use and problematic smartphone use, little is known about problematic online anime use. However, problematic online anime use warrants further examination because of anime's popularity and commercial importance. Furthermore, how emotion strategies and emotions (such as pleasure and arousal) invoked upon watching the online anime are associated with problematic online anime use is not examined in previous studies. To bridge these literature gaps and to contribute to the fields of emotion regulation and media psychology, this study adopts the emotion regulation theory and considers the relationships among viewers' satisfaction with life, feelings of pleasure and arousal arising from watching a particular online anime, cognitive emotion regulation strategies activated because of anime viewing, and potential to exhibit problematic behavior related to online anime use, which is operationalized as viewers' inability to control or reduce watching online anime. Data was collected from viewers who have watched the popular romantic comedy anime Kaguya-sama: Love Is War online via a major online discussion board in Taiwan through the purposive sampling method. Data analysis on the 190 online questionnaire returns (mostly from males and students) through the partial least squares analysis reveals that the emotion regulation theory can be used to examine viewers' perceptions of anime. In the online anime context, the emotion regulation strategy most likely to be invoked is positive refocusing (mean value of 3.68, measured through a 5-point Likert scale) which is in line with how people typically watch anime for immersion and escapism. Satisfaction with life demonstrates its robustness and flexibility in invoking the positive refocusing (path coefficient = 0.17) and refocus on planning (path coefficient = 0.13) strategies. It also lowers the adoption of the maladaptive strategy of catastrophizing (path coefficient = -0.18). While catastrophizing strategy (path coefficient = 0.31) and arousal (path coefficient = 0.24) add to problematic online anime use, pleasure (path coefficient = -0.27) lowers problematic online anime use. Thus, when viewers keep magnifying the severity of a bad situation they are in while watching online anime, instead of making them better, could lead them to the undesirable outcome of problematic online anime use. Although this study has provided several interesting insights, this study has only considered Kaguya-sama: Love Is War and used survey respondents' perception of their extent of problematic online anime use. To increase generalization, future studies could consider other types of anime and alternative means to measure problematic use, such as frequency of online anime viewing.

Exploring the impact of individualized pleasure-oriented exercise sessions in a health club setting: Protocol for a randomized controlled trial

Research on the relationship between exercise-induced affect and exercise or physical activity behavior has gained momentum in recent years, yielding several observational and longitudinal studies. However, experimental tests demonstrating a causal role of affective responses on exercise adherence are lacking. Given the need to devise exercise prescriptions that can facilitate adherence and promote regular physical activity, a Randomized Controlled Trial targeting individual pleasurable responses in a health-club setting will be conducted. The experimental protocol will compare two individualized evaluation, prescription, and supervision methods, adjusted for intensity, with the aim to explore their impact on behavioral, affective, and motivational outcomes. The planned study will be a pragmatic randomized, single-blinded, controlled superiority trial with two parallel groups and an allocation ratio of 1:1. Apparently healthy volunteer participants (N = 46) between 18 and 45 years old, who are not regularly active, will be randomly allocated to a control or experimental group. The control group will follow a general American College of Sports Medicine exercise prescription; the experimental group will follow the same prescription but with enhancements aimed at promoting pleasure: (1) individualization based on individual differences in preference for and tolerance of exercise intensity; (2) self-regulation of intensity; and (3) repeated assessments of core affect. The primary outcome will be post-intervention exercise-session attendance. Affective and motivational variables will be examined as secondary outcomes. The results are expected to advance exercise prescriptions by promoting affective regulation, thus helping to improve exercise adherence and related outcomes. TRIAL REGISTRATION: ClinicalTrials.gov; ID: NCT05416593.

The Relational Nature of Gender, the Pervasiveness of Heteronormative Sexual Scripts, and the Impact on Sexual Pleasure

This study examined how gender shapes sexual interactions and pleasure outcomes. We highlight varying expectations people have in regard to sex by combining questions about orgasm frequency and sexual pleasure. Our analysis was driven from a sample of 907 survey responses from cis women, cis men, trans women, trans men, non-binary, and intersex millennial respondents, 324 of which had gender-diverse sexual histories. The findings built upon previous literature about the orgasm gap by including those with underrepresented gender identities and expanding our conceptualization of gender's role in the gap beyond gender identity. Qualitative results indicated that individuals change their behavior based on their partner's gender and follow strong gendered scripts. Participants also relied upon heteronormative scripts and cis normative roles to set their interactions for the sexual encounter. Our findings support previous research on how gender identity impacts pleasure outcomes and has implications for how we might make gender progress in the arena of sexuality.

Treatment-related changes in insomnia, anticipatory pleasure, and depression symptoms: A proof-of-concept study with cancer survivors

OBJECTIVE/BACKGROUND

Cancer survivors have elevated rates of insomnia and depression. Insomnia increases risk for depression onset, and the Integrated Sleep and Reward (ISR) Model suggests that impairments in reward responding (e.g., ability to anticipate and/or experience pleasure) plays a central role in this relationship. Cognitive behavioral therapy for insomnia (CBT-I) is efficacious for treating chronic insomnia and reducing depression in cancer survivor populations. The effects of CBT-I on anticipatory and consummatory pleasure are theoretically and clinically meaningful, yet remain unexamined.

PATIENTS/METHODS

This secondary analysis of a pilot RCT (N = 40 cancer survivors with insomnia) explicated changes in anticipatory and consummatory pleasure and depression symptoms following a 4-session, synchronous, virtual CBT-I program versus enhanced usual care (referral to a behavioral sleep medicine clinic + sleep hygiene handout). Linear mixed models examined changes in anticipatory and consummatory pleasure and depression symptoms as predictors of changes in insomnia severity from baseline to post-intervention and 1-month follow-up.

RESULTS

CBT-I buffered against deterioration in anticipatory pleasure but not consummatory pleasure or depression symptoms. Across conditions, increased anticipatory pleasure was associated with insomnia reduction through 1-month follow-up, even after adjusting for changes in depression symptoms.

CONCLUSION

CBT-I may improve reward processing deficits in cancer survivors with insomnia. Findings provide support for the ISR Model and implicate pleasure as an important target for insomnia and depression.

Anticipatory and consummatory pleasure in eating disorders

BACKGROUND

Recent research suggests that anhedonia, or the inability to experience pleasure, is elevated in individuals with eating disorders (EDs). However, past literature has only studied anhedonia in EDs as a unidimensional construct rather than separately examining anticipatory (i.e., prediction of pleasure for a future event) and consummatory (i.e., enjoyment of a present event) pleasure. Given that these subcomponents of pleasure have distinct neurobiological correlates, studying pleasure as a multifaceted construct may yield important insights into the underlying mechanisms of binge eating or food restriction.

METHODS

A sample of 124 women with anorexia nervosa, bulimia nervosa, or other specified feeding or eating disorder and 84 control women (CW) completed self-report measures of anticipatory pleasure, consummatory pleasure, ED symptoms, depression, harm avoidance, and anxiety.

RESULTS

Individuals with EDs endorsed significantly lower anticipatory pleasure than CW, but there were no significant group differences in consummatory pleasure. Further, there were no significant differences in self-reported pleasure among ED diagnostic groups. Within the ED sample, anticipatory pleasure but not consummatory pleasure was positively related to binge eating frequency and significantly negatively correlated with cognitive ED symptoms, state and trait anxiety, and harm avoidance. Both anticipatory and consummatory pleasure was negatively associated with depression.

CONCLUSION

The results of the current study suggest that lower pleasure across the ED spectrum may be due to deficits in anticipatory, but not consummatory, pleasure. Future research should continue to explore the behavioral, affective, and neural correlates of anticipatory pleasure in EDs to characterize better how it relates to the onset and maintenance of binge eating and other eating disorder pathology.

More value from less food? Effects of epicurean labeling on moderate eating in the United States and in France

Emerging research has shown that sensory-based interventions (e.g., inviting people to mindfully focus on the multisensory aspects of eating) can be a viable alternative to nutrition-based interventions (e.g., nutrition labeling) to encourage moderate eating. We contribute to this literature in two ways. First, we propose a novel and simple sensory-based intervention to increase the appeal of moderate food portions in commercial settings, epicurean labeling, which consists in emphasizing the aesthetic, multisensory properties of the food when describing it on menus or packages. Second, we show theory-relevant cross-cultural differences in the effectiveness of this intervention between the United States and France, two food cultures at the opposite ends of the hedonic-utilitarian food attitude spectrum. We report the results of a multi-day field experiment at a French cafeteria showing that epicurean labeling, unlike nutrition labeling, reduces intake while increasing the perceived monetary value of the meal thanks to higher savoring. We then show in a matched cross-national online experiment that epicurean labeling is more effective in France than in the United States. We provide additional evidence of this cross-cultural variation in a study of 9154 food products sold in supermarkets in both countries. We find that epicurean labeling is more prevalent, but also more likely to be associated with smaller portions in France than in the United States. While sensory-based interventions are a promising alternative to nutrition-based interventions, it is necessary to develop business-friendly interventions that can be implemented in everyday life, as well as to consider cultural factors that can modulate their effectiveness.

High-intensity interval training elicits more enjoyment and positive affective valence than moderate-intensity training over a 12-week intervention in overweight young women

Background

The purpose of this study was to compare the differences in enjoyment and affect in response to four weight control intervention protocols over 12 weeks.

Methods

Sixty overweight young females were randomised into four intervention groups: repeated sprint training (RST, 6-sec all-out sprint interspersed with 9-sec rest), high-intensity interval training (HIIT) with short interval (HIIT₁₂₀, 1-min effort at 120% V̇O_2peak) and long interval (HIIT₉₀, 4-min effort at 90% V̇O_2peak), and moderate-intensity continuous training (MICT, 60% V̇O_2peak) by cycling over 12 weeks. The total workload in each training session in HIIT₁₂₀, HIIT₉₀, and MICT was confined to 200 kJ, while it was lower in RST with 57 ± 4 kJ. Enjoyment (Physical Activity Enjoyment Scale, PACES) and affective valence (Feeling Scale, FS) were measured throughout the intervention.

Results

The score of the PACES on average over 12 weeks showed a significant between-group effect that was lower in MICT (80.8 ± 11.8) compared with HIIT₁₂₀ (92.5 ± 11.4) and HIIT₉₀ (96.8 ± 13.9) (p < 0.05). In the 8th week, enjoyment was scored higher in two HIITs compared with MICT. In the 12th week, HIITs and RST were more enjoyable than MICT, where two HIITs were better than RST. The score of FS showed a significant between-group effect that was higher in HIIT₉₀ (1.5 ± 1.4) compared with HIIT₁₂₀ (0.2 ± 1.2) (p < 0.05), but a non-significant time or group-by-time interaction effect. A significant weight loss occurred in three interval training protocols (p < 0.05), but not in MICT. The V̇O_2peak significantly increased in four groups without between-group difference.

Conclusion

Interval training, especially the long-interval type, is an enjoyable and pleasant long-term exercise intervention for overweight young women. RST could be an alternative for weight control considering its time efficiency with comparable enjoyment and overall pleasure.

Cannabis use and sexual risk among MSM who drink: Understanding why more frequent cannabis users may engage in higher rates of condomless sex

BACKGROUND

Condomless anal intercourse (CAI) is the major risk factor for HIV transmission among men who have sex with men (MSM). MSM who are heavier cannabis users engage in CAI more frequently. However, little is known about the processes that may underlie this association. This study sought to understand the potential role of condom attitudes and condom-related planning in the association between cannabis use and CAI.

METHODS

This is a secondary data analysis of a study on alcohol use and sexual decision-making among MSM. Two hundred and fifty-eight MSM with moderate to heavy drinking were enrolled. Measures included CAI, cannabis use, attitudes about the influence of condoms on sexual pleasure, condom use planning, age, heavy episodic drinking, and use of pre-exposure prophylaxis (PrEP).

RESULTS

We conducted a negative binomial regression analysis controlling for age, PrEP, and heavy episodic drinking. Cannabis use frequency was a significant predictor of CAI (b =.333, p < .001). Indirect effects showed that while heavier cannabis users exhibited less condom-related planning (b = -0.106, p = 0.015) and more negative attitudes toward the impact of condom use on pleasure (b= -0.177, p = 0.004), cannabis use had a significant indirect effect on CAI only through attitude ratings.

CONCLUSIONS

MSM who are heavier cannabis users engage in more frequent CAI and exhibit an indirect effect on CAI through negative attitudes toward the impact of condoms on pleasure. These findings suggest the potential importance of addressing these condom attitudes in HIV-prevention interventions among MSM who use cannabis.

The World Association for Sexual Health's Declaration on Sexual Pleasure: A Technical Guide

This article provides technical guidance on the content, meaning, and application of the World Association of Sexual Health (WAS) Declaration on Sexual Pleasure to various stakeholders and practitioners working in the area of sexuality, sexual health, and sexual rights. A growing body of work shows that sexual pleasure is integral to broader health, mental health, sexual health, well-being and rights and indeed can lead to improvements in health. Yet, more research is needed to identify the best ways to incorporate sexual pleasure to achieve sexual health for different outcomes and populations. In the first part of this article, we deconstruct each statement from the WAS Declaration on Sexual Pleasure and provide key evidence from the literature supporting these statements. In the latter part of the article, we provide guidance on how to include sexual pleasure as a fundamental part of sexual health and sexual rights work. We include a series of case studies and highlight key actions and principles for advocacy, implementation, and quality assurance in terms of law and policy, comprehensive sexuality education, health care services and dissemination of knowledge. This technical document seeks to inspire our partners and collaborators to embark on a journey toward a pleasure-based approach to sexual health and sexual rights. Our hope is that the literature, guidance and case studies provided here can ignite ongoing advocacy and collaboration to embrace sexual pleasure in all settings.

Narrative imagery: Emotional modulation in the default mode network

The default mode network (DMN) is activated when constructing and imagining narrative events, with functional brain activity in the medial-prefrontal cortex hypothesized to be modulated during emotional processing by adding value (or pleasure) to the episodic representation. However, since enhanced reactivity during emotional, compared to neutral, content is a more frequent finding in both the brain and body in physiological, neural, and behavioral measures, the current study directly assesses the effects of pleasure and emotion during narrative imagery in the DMN by using a within-subject design to first identify the DMN during resting state and then assess activation during pleasant, neutral, or unpleasant imagery. Replicating previous findings, enhanced functional activity in the medial prefrontal cortex was found when imagining pleasant, compared to unpleasant, events. On the other hand, emotion-related activation was found when imagining either pleasant or unpleasant, compared to neutral, events in other nodes of the DMN including the posterior cingulate cortex (PCC), angular gyrus, anterior hippocampus, lateral temporal cortex, temporal pole, dorsomedial prefrontal cortex (dmPFC), and ventrolateral prefrontal cortex (vlPFC). Pervasive emotional modulation in the DMN is consistent with the view that a primary function of event retrieval and construction is to remember, recreate, and imagine motivationally relevant events important for planning adaptive behavior.

Sex in Chemsex: Sexual Response, Motivations, and Sober Sex in a Group of Italian Men Who Have Sex With Men With Sexualized Drug Use

BACKGROUND

Most studies on chemsex focus on the health risks associated with the practice, whereas less attention has been paid to the perception of sexual gratification in men who have sex with men (MSM) who use these substances.

AIM

The purpose of this study was to explore the effects of chemsex substances on sexual response, motivations to engage in chemsex and the relationship with sober sex.

METHODS

Thirty-one Italian cisgender MSM involved in sexualized drug use were interviewed and transcripts were thematically analyzed.

OUTCOMES

An ad hoc grid exploring sociodemographic data, chemsex sexual experience, motives, and relationships with sober sex was used during telephone-based interviews.

RESULTS

Participants showed significant individual differences in how chems may affect their sexual experience. The most reported effects were an increase in sexual desire and subjective arousal, access to higher disinhibition, possible erection and ejaculation difficulties, significant extension of the sexual experience duration, and an intensified perception of intimacy and pleasure. All the positive outcomes of substances on sex creates a great curiosity around chemsex, which is among the primary motives to engage in chemsex for the first time. Over time, other motives may emerge, also connected to substance abuse and craving. Some men reported to be motivated by their partners and friends and to use chemsex to cope with depressive mood/anxiety symptoms, stress and sexual problems. Many differences were reported between chemsex and sober sex. Chemsex seems to embody the idea of transgressive and exciting sex, while sober sex is outlined as a more intimate encounter, that can be significantly affected by performance anxiety.

CLINICAL TRANSLATION

These results offer some new perspectives that may add interesting information to the literature and be fundamental for future prevention and harm-reduction projects.

STRENGTHS & LIMITATIONS

Although this study is based on a small group of Italian MSM and the interviews were not audio-recorded, transcripts were consistent with scientific literature that considers it important to pay attention to the positive links between sex and substance use.

CONCLUSION

The promotion of safer sexual behavior should contemplate an in-depth discussion and recognition of both pleasurable and distressing aspects of chemsex sexual experience, its motivations over time and perceived differences with sober sex. Nimbi FM, Rosati F, Esposito RM, et al. Sex in Chemsex: Sexual Response, Motivations, and Sober Sex in a Group of Italian Men Who Have Sex With Men With Sexualized Drug Use. J Sex Med 2021;XX:XXX-XXX.

Framework for internal sensation of pleasure using constraints from disparate findings in nucleus accumbens

It is necessary to find a mechanism that generates first-person inner sensation of pleasure to understand what causes addiction and associated behaviour by drugs of abuse. The actual mechanism is expected to explain several disparate findings in nucleus accumbens (NAc), a brain region associated with pleasure, in an interconnected manner. Previously, it was possible to derive a mechanism for natural learning and explain: (1) Generation of inner sensation of memory using changes generated by learning; and (2) Long-term potentiation as an experimental delayed scaled-up change by the same mechanism that occur during natural learning. By extending these findings and by using disparate third person observations in NAc from several studies, present work provides a framework of a mechanism that generates internal sensation of pleasure that can provide interconnected explanations for: (1) Ability to induce robust long-term depression (LTD) in NAc from naïve animals; (2) Impaired ability to induce LTD in “addicted” state; (3) Attenuation of postsynaptic potentials by cocaine; and (4) Reduced firing of medium spiny neurons in response to cocaine or dopamine. Findings made by this work are testable.

Reprint of: Pharmacosex: Reimagining sex, drugs and enhancement

BACKGROUND

The use of drugs in sexual contexts is receiving closer attention in the media, public health bodies and communities than ever before. However, research to date is most often concerned with the sex-related drug use of lesbian, gay, bisexual, transgender and queer (LGBTQ) populations, and particularly men who have sex with men (MSM) engaging in 'chemsex'. Against a backdrop dominated by public health and medical science perspectives, this article seeks to move beyond prevailing sex on drug discourses characterised by risk and harm, or pleasure. Drawing on an expansive notion of enhancement, we explore intersections between drug consumption and sex via the concept of 'pharmacosex': the ways in which wider populations experiment with a range of illicit drugs that modify and enhance their sex lives in the context of broader processes of the pharmaceuticalisation of sexuality.

METHODS

Drawing on two empirical studies comprising a virtual ethnography and 45 interviews with participants across a range of gender and sexual identities who regularly combine sex and drugs, this article contributes to the growing body of research that attends to the materiality of drug consumption practices in relation to the historical and social contexts from which they emerge.

RESULTS

Our participants reported variegated and complex modes of enhancement in relation to a wide range of psychoactive substances. Participants described enhanced emotional connectedness, bodily sensations, disinhibition and desire, but they also discussed how sex enhances drug experiences. As important but currently neglected in research literature were the therapeutic dimensions of drug-taking reported, which cannot be neatly distinguished from purely hedonic motivations. While enhancement was also experienced by participants in more challenging ways in relation to shame, regret, risk and/or harm, these experiences simultaneously afforded space for the emergence of innovative practices of risk-management, safety and care.

CONCLUSION

This study exposes the diversity of practices and meanings sex-related drug use hold for participants, but also demonstrates the paucity of biomedical conceptions of sexual enhancement limited to stamina, function and libido, and the need for a more expansive approach. The study also raises questions about the extent to which contemporary discourses of self-improvement have come to 'inhabit' sexuality in the twenty-first century, and the role drugs might play in this context. By shifting the gaze from pathology to enhancement and exploring the plurality of practice, we can better understand the motivations for engaging in sex-related drug use, thereby circumventing knee-jerk counterproductive enforcement and policy responses.

Discipline for pleasure: a new governmentality of HIV prevention

This article explores recent HIV prevention campaigns for pre-exposure prophylaxis (PrEP), focusing on how they integrate pleasure and desire in their calls for self-discipline through a continual use of pharmaceuticals. This emerging type of health promotion, here represented by ads promoting the preventive use of pharmaceuticals, no longer simply approaches target groups with demands to abstain from harmful substances or practices and thus control risks, but also includes messages that recognize individuals' habits, values, and their desires for pleasure. Drawing on Foucault's work concerning discipline and security, we suggest that a novel, permissive discipline is emerging in contemporary HIV prevention. Further guided by Barthes's theory of images, we analyse posters used in prevention campaigns, scrutinizing their culture-specific imagery and linguistic messages, i.e. how the words and images interact. We conclude that these campaigns introduce a new temporality of prevention, one centred on pleasure through the pre-emption and planning that PrEP enables.

'I just drink to feel abnormal for some time': Reconfiguring heavy drinking and intoxication as pleasurable

BACKGROUND

The sociocultural norms moderating alcohol consumption in Nigeria were more permissive for men than women in the traditional era. Alcohol use among young people was taboo, and intoxication among men who occupy drinking spaces was punished. In contemporary Nigeria, heavy drinking and the 'culture of intoxication' are reified features of some young people's leisure lives.

METHODS

Drawing on the intersections of pleasure and intoxication, this study explores the interplay between deliberate heavy drinking and the positioning of intoxication experiences as pleasurable. We conducted 53 semi-structured interviews and 3 focus groups (N = 26) with 18-24-year-old youths in Benin City, Southern Nigeria.

RESULTS

Participants deliberately pursued heavy drinking and intoxication to experience 'altered bodily effects', to know the feelings of intoxication, and to master extreme drinking levels. Other explanations given for 'determined drunkenness' included fun and excitement. Participants sought pleasurable experiences of drinking through repeated deliberate drunkenness or by taking large quantities of spirits. 'Loss of control' experiences were described as fun and exciting, and participants laughed when friends showed them videos of their 'passing out' experiences. Gendered alcohol 'providing' rituals in peer networks that facilitated intoxication and loss of consciousness were used to enact friendships. Providing drinks for friends and consuming large quantities conferred a higher status on the buyer and drinker, respectively. Friendship networks performed double-edged roles by instigating heavy drinking and providing care for inebriated members.

CONCLUSION

The emerging drinking culture in Nigeria suggests that the cultural prohibitionist approach to young people's drinking should be reconsidered. Policymakers should implement public health interventions that promote low-risk drinking practices to mitigate the risks of heavy drinking and intoxication.

"It Just Kind of Cascades": A critical ethnography of methamphetamine-related pleasure among people in recovery

BACKGROUND

Despite its well documented risks and harms, methamphetamine use can also be experienced as a pleasurable, purposeful, and productive activity. Drug use discourse has historically deemphasised the pleasures of drug use, as they can contradict the expectations of neoliberalism that individuals be moderate, rational consumers. The purpose of this study was to explore the experiences of people trying to reduce or control their methamphetamine use, utilising a critical interactionist approach to excavate the subjugated knowledge of methamphetamine-related pleasure, and construct an understanding of methamphetamine use that incorporated these positive experiences.

METHODS

Qualitative interviews and ethnographic observation were conducted over an eight-month period with a group of twelve people using methamphetamine and accessing recovery services. Transcripts and fieldnotes were analysed thematically with a critical interactionist lens.

RESULTS

The pleasures of methamphetamine use were differentiated into pursuing the rush, exploring sociality, self-medication, and desiring productivity. The interwoven nature of these themes presents a multidimensional understanding of methamphetamine use resulting from a cascade of interacting causes and effects, rather than a linear product of individual choice or structural forces. These findings also highlight the complex symbiotic relationship between pleasure, productivity, and risk for people using methamphetamine which can be traced to the broader cultural and economic context in which use occurs.

CONCLUSION

Interventions and policies responding to harmful methamphetamine use must address the content and nature of the methamphetamine use cascade, acknowledging the diverse needs methamphetamine can meet for contemporary neoliberal citizens, and the sometimes complex and sophisticated purposes for which people may utilise its effects.

"Identifying Pleasure: a Diary-Approach to the Embodied Subjectivity of Students' Daily Life in Albania"

The present study examines the embodied feelings of daily-life among a sample of Albanian college students. The specific methodology of 'body-diaries' used for such a purpose goes beyond a mere experimental writing, it fosters a creative and (un)comfortable way for making sense of bodies as subjects. Sharing intimacy and co-constructing pleasure and pain takes place in the unpopular, pre-web 2.0, textual format of a diary, lacking of the contemporary usual online audience. The innovative aspect, here, is the explicit focus on putting one's body into words in daily-life. Such a methodology stems from embodiment and critical sexuality studies and follows the idea that symbolic realms and abstraction are always already materially located and speaking. The complex relationships between language and body is elaborated with respect to systemic and individual communication strategies. How do we come to terms with sensations of pleasure in our everyday routine? How do students approach themselves and others when explicitly asked to focus on bodily issues in a rapidly changing society like Albania? A a particular emphasis will be given, then, to the ongoing transformations between public and private spheres and related affective reconfigurations.

Reduced exploratory behavior in neuronal nucleoredoxin knockout mice

Nucleoredoxin is a thioredoxin-like redoxin that has been recognized as redox modulator of WNT signaling. Using a Yeast-2-Hybrid screen, we identified calcium calmodulin kinase 2a, Camk2a, as a prominent prey in a brain library. Camk2a is crucial for nitric oxide dependent processes of neuronal plasticity of learning and memory. Therefore, the present study assessed functions of NXN in neuronal Nestin-NXN^-/- deficient mice. The NXN-Camk2a interaction was confirmed by coimmunoprecipitation, and by colocalization in neuropil and dendritic spines. Functionally, Camk2a activity was reduced in NXN deficient neurons and restored with recombinant NXN. Proteomics revealed reduced oxidation in the hippocampus of Nestin-NXN^-/- deficient mice, including Camk2a, further synaptic and mitochondrial proteins, and was associated with a reduction of mitochondrial respiration. Nestin-NXN^-/- mice were healthy and behaved normally in behavioral tests of anxiety, activity and sociability. They had no cognitive deficits in touchscreen based learning & memory tasks, but omitted more trials showing a lower interest in the reward. They also engaged less in rewarding voluntary wheel running, and in exploratory behavior in IntelliCages. Accuracy was enhanced owing to the loss of exploration. The data suggested that NXN maintained the oxidative state of Camk2a and thereby its activity. In addition, it supported oxidation of other synaptic and mitochondrial proteins, and mitochondrial respiration. The loss of NXN-dependent pro-oxidative functions manifested in a loss of exploratory drive and reduced interest in reward in behaving mice.

'Defrosting' music chills with naltrexone: The role of endogenous opioids for the intensity of musical pleasure

The endogenous opioid system has been implicated during experiences of pleasure (i.e., from food or sex). Music can elicit intense emotional and bodily sensations of pleasure, called 'Chills'. We investigated the effects of an opioid antagonist (50 mg naltrexone) or placebo (40 μg d3-vitamin) while listening to self-selected music or other 'control' music selected by another participant. We used a novel technique of continuous measurement of pleasantness with an eye tracker system, where participants shifted their eyes along a visual analogue scale, in the semblance of a thermometer so that, as the music unfolded, gaze positions indicated the self-reported hedonic experience. Simultaneously, we obtained pupil diameters. Self-reported pleasure remained unchanged by naltrexone, which - however - selectively decreased pupillary diameters during 'Chills'. Hence, the endogenous μ-opioid signaling is not necessary for subjective enjoyment of music but an opioid blockade dampens pupil responses to peak pleasure, consistent with decreased arousal to the music.

Body surveillance and affective judgments of physical activity in daily life

Affective judgments are one of the strongest predictors of physical activity. Engaging in body surveillance during physical activity is theorized to reduce access to pleasant affective experiences thereby compromising the influence of affective judgments. However, empirical tests of this relationship are lacking. This study examined associations between body surveillance during physical activity and affective judgments (i.e., enjoyment and pleasure) of physical activity. Participants (N = 89; 53 % women, M_age = 20.32 years; SD_age = 1.59) completed an experience sampling protocol for 7 days and provided 7 self-reports/day. Participants reported their body surveillance when engaged in physical activity followed by their affective judgments of physical activity. At the within-person level, participants reported more negative affective judgments during instances when body surveillance was higher than usual. At the between-person level, participants higher in body surveillance reported more negative affective judgments on average. These findings extend correlates of body surveillance to include less favorable affective judgments. Although there is support for targeting affective judgments to promote physical activity, the utility of such efforts may be limited if body surveillance is present. These findings point to a new target for potentially enhancing affective judgements and the promotion of physical activity.

Common and distinct neural correlates of music and food-induced pleasure: A coordinate-based meta-analysis of neuroimaging studies

Neuroimaging studies have shown that, despite the abstractness of music, it may mimic biologically rewarding stimuli (e.g., food) in its ability to engage the brain's reward circuitry. However, due to the lack of research comparing music and other types of reward, it is unclear to what extent the recruitment of reward-related structures overlaps among domains. To achieve this goal, we performed a coordinate-based meta-analysis of 38 neuroimaging studies (703 subjects) comparing the brain responses specifically to music and food-induced pleasure. Both engaged a common set of brain regions, including the ventromedial prefrontal cortex, ventral striatum, and insula. Yet, comparative analyses indicated a partial dissociation in the engagement of the reward circuitry as a function of the type of reward, as well as additional reward type-specific activations in brain regions related to perception, sensory processing, and learning. These results support the idea that hedonic reactions rely on the engagement of a common reward network, yet through specific routes of access depending on the modality and nature of the reward.

Pleasure, addiction, and hypocretin (orexin)

The hypocretins/orexins were discovered in 1998. Within 2 years, this led to the discovery of the cause of human narcolepsy, a 90% loss of hypothalamic neurons containing these peptides. Further work demonstrated that these neurons were not simply linked to waking. Rather these neurons were active during pleasurable behaviors in waking and were silenced by aversive stimulation. This was seen in wild-type mice, rats, cats, and dogs. It was also evident in humans, with increased Hcrt release during pleasurable activities and decreased release, to the levels seen in sleep, during pain. We found that human heroin addicts have, on average, an increase of 54% in the number of detectable Hcrt neurons compared to "control" human brains and that these Hcrt neurons are substantially smaller than those in control brains. We found that in mice, chronic morphine administration induced the same changes in Hcrt neuron number and size. Our studies in the mouse allowed us to determine the specificity, dose response relations, time course of the change in the number of Hcrt neurons, and that the increased number of Hcrt neurons after opiates was not due to neurogenesis. Furthermore, we found that it took a month or longer for these anatomical changes in the mouse brain to return to baseline. Human narcoleptics, despite their prescribed use of several commonly addictive drugs, do not show significant evidence of dose escalation or substance use disorder. Similarly, mice in which the peptide has been eliminated are resistant to addiction. These findings are consistent with the concept that an increased number of Hcrt neurons may underlie and maintain opioid or cocaine use disorders.

Negotiating HIV and pregnancy prevention and sexual pleasure amongst heterosexual men and women in South Africa

Heterosexual sex, foremost its gender-power dynamics, is embedded in and informed by the socio-historical context in which it occurs. While safer sexual communication skills are well documented as key to the success of sexual and reproductive health programming and education, communication skills about the positive aspects of sexuality such as sexual pleasure are often limited if not absent. Using data from in-depth qualitative interviews with men and women aged 26-39 from a diverse set of backgrounds in Cape Town, South Africa, this study examines the ways in which gender-power dynamics manifest in negotiations of HIV and pregnancy prevention and sexual pleasure in the intimate spaces of heterosex. Findings fall under three themes: 1) condom negotiation as a replacement for other aspects of sexual communication; 2) self-efficacy in negotiating prevention and negotiating one's own sexual pleasure; and 3) the integral role men play in heterosexual encounters in the facilitation of women's sexual autonomy and women's sexual pleasure. This study contributes to research not only examining the positive and more nuanced realities of heterosex in the South African context, but also argues for the need to integrate positive aspects of sexuality into sexual and reproductive health programming in general.

Understanding How University Students Use Perceptions of Consent, Wantedness, and Pleasure in Labeling Rape

While the lack of consent is the only determining factor in considering whether a situation is rape or not, there is sufficient evidence that participants conflate wantedness with consent and pleasurableness with wantedness. Understanding how people appraise sexual scenarios may form the basis to develop appropriate educational packages. We conducted two large-scale qualitative studies in two UK universities in which participants read vignettes describing sexual encounters that were consensual or not, wanted or unwanted and pleasurable or not pleasurable. Participants provided free-text responses as to whether they perceived the scenarios to be rape or not and why they made these judgments. The second study replicated the results of the first and included a condition where participants imagined themselves as either the subject or initiator of the sexual encounter. The results indicate that a significant portion of our participants held attitudes reflecting rape myths and tended to blame the victim. Participants used distancing language when imagining themselves in the initiator condition. Participants indicated that they felt there were degrees of how much a scenario reflected rape rather than it simply being a dichotomy (rape or not). Such results indicate a lack of understanding of consent and rape and highlight avenues of potential educational materials for schools, universities or jurors.

The Clinics of Work: An Alternative Vision of Occupational Health

This theoretical paper depicts the clinics of work as a subdisciplinary and interdisciplinary field of the social psychology of work and organizations, interested in analyzing and intervening from a critical-clinical perspective in the subjectivity-work-context relationship, in the context of discomfort, suffering, and pleasure, and thus, in the mental health within this field. Consequently, it separates from traditional occupational health, which ignores subjective singularities. The subdiscipline of CW develops the determinants of pleasure, discomfort, and suffering at work, standing out in the process as a possible alternative of occupational health, based on research practice and intervention from a critical perspective.

Winter of our contentment: Examining risk, pleasure, and emplacement in later-life physical activity

In the West, many in the media and the health sector emphasize physical activity as important for the old, so that they can circumvent the impacts of aging and the associated costs. At the same time, neoliberal health discourse advises older people to avoid activities that may cause injuries, such as slips and falls, creating contradictions for older people who participate in sports on ice. In light of these mixed messages, this paper explores how older men understand their bodies through their participation in the seemingly risky sport of ice hockey. I conducted eighteen semi-structured interviews with older Canadian men who played hockey, identifying common themes related to aging, embodiment, risk and pleasure. Participants were aware that common-sense discourse produced hockey as risky for the old, but often downplayed this risk, privileging pleasure. Discourses associated with pleasure acted as an important way for older men to examine their bodies and contemplate the significance of hockey in their lives. Through the comradery players developed with each other, their interactions with the material objects of hockey, and their emplacement on hockey rinks and arenas, they found ways to celebrate their bodies as both aging and capable of experiencing pleasure - implicitly challenging neoliberal discourses of old age in the process.

Pharmacosex: Reimagining sex, drugs and enhancement

BACKGROUND

The use of drugs in sexual contexts is receiving closer attention in the media, public health bodies and communities than ever before. However, research to date is most often concerned with the sex-related drug use of lesbian, gay, bisexual, transgender and queer (LGBTQ) populations, and particularly men who have sex with men (MSM) engaging in 'chemsex'. Against a backdrop dominated by public health and medical science perspectives, this article seeks to move beyond prevailing sex on drug discourses characterised by risk and harm, or pleasure. Drawing on an expansive notion of enhancement, we explore intersections between drug consumption and sex via the concept of 'pharmacosex': the ways in which wider populations experiment with a range of illicit drugs that modify and enhance their sex lives in the context of broader processes of the pharmaceuticalisation of sexuality.

METHODS

Drawing on two empirical studies comprising a virtual ethnography and 45 interviews with participants across a range of gender and sexual identities who regularly combine sex and drugs, this article contributes to the growing body of research that attends to the materiality of drug consumption practices in relation to the historical and social contexts from which they emerge.

RESULTS

Our participants reported variegated and complex modes of enhancement in relation to a wide range of psychoactive substances. Participants described enhanced emotional connectedness, bodily sensations, disinhibition and desire, but they also discussed how sex enhances drug experiences. As important but currently neglected in research literature were the therapeutic dimensions of drug-taking reported, which cannot be neatly distinguished from purely hedonic motivations. While enhancement was also experienced by participants in more challenging ways in relation to shame, regret, risk and/or harm, these experiences simultaneously afforded space for the emergence of innovative practices of risk-management, safety and care.

CONCLUSION

This study exposes the diversity of practices and meanings sex-related drug use hold for participants, but also demonstrates the paucity of biomedical conceptions of sexual enhancement limited to stamina, function and libido, and the need for a more expansive approach. The study also raises questions about the extent to which contemporary discourses of self-improvement have come to 'inhabit' sexuality in the twenty-first century, and the role drugs might play in this context. By shifting the gaze from pathology to enhancement and exploring the plurality of practice, we can better understand the motivations for engaging in sex-related drug use, thereby circumventing knee-jerk counterproductive enforcement and policy responses.

The nose is hungrier than the eyes

Vision and olfaction are the main sensory channels for appraising food prior to eating. Motivational models often assume that these sensory channels function in an equivalent manner. We tested this notion by asking participants to rate their desire for some snacks only via smell and others only via vision. In the next phase, participants consumed a small sample of every snack, now with all of the senses available, rating liking and desire for more. After consuming a meal, participants repeated the desire/liking test. Sensing via olfaction, relative to vision, led to greater desire ratings irrespective of state. When hungry, judgments of liking and desire for more were higher for foods that were initially smelled relative to those that were initially seen. Across the meal, visually based desire ratings declined more than those based on smell, relative to ratings made when the snacks were tasted. Together, this suggests motivational equivalence does not hold for olfaction and vision. We suggest this may be due to a greater reliance on memory for generating visually based desire.

Using pharmacological manipulations to study the role of dopamine in human reward functioning: A review of studies in healthy adults

Dopamine (DA) plays a key role in reward processing and is implicated in psychological disorders such as depression, substance use, and schizophrenia. The role of DA in reward processing is an area of highly active research. One approach to this question is drug challenge studies with drugs known to alter DA function. These studies provide good experimental control and can be performed in parallel in laboratory animals and humans. This review aimed to summarize results of studies using pharmacological manipulations of DA in healthy adults. 'Reward' is a complex process, so we separated 'phases' of reward, including anticipation, evaluation of cost and benefits of upcoming reward, execution of actions to obtain reward, pleasure in response to receiving a reward, and reward learning. Results indicated that i) DAergic drugs have different effects on different phases of reward; ii) the relationship between DA and reward functioning appears unlikely to be linear; iii) our ability to detect the effects of DAergic drugs varies depending on whether subjective, behavioral, imaging measures are used.

Perceived pleasantness of gentle touch in healthy individuals is related to salivary oxytocin response and EEG markers of arousal

Affective touch plays an important role in human social bonding, affiliative behavior, and in general emotional well-being. A system of unmyelinated low-threshold mechanosensitive C-type afferents innervating hairy skin (C-tactile or CT system) is postulated to provide the neurophysiological background of affective touch perception. C-tactile afferents respond optimally to soft and slow strokes, and this response correlates positively with pleasure ratings of tactile stimuli. As gentle touch is consistently associated with oxytocin release further promoting prosocial behavior, it has been suggested that this effect is mediated by the response of C-tactile afferents. This study assesses a possible link between CT-optimal touch, its subjective pleasantness, EEG indices of cortical arousal, and peripheral oxytocin response. EEG was recorded in 28 healthy volunteers during resting state and tactile stimulation[gentle slow brush strokes on forearm (CT-targeted touch) and palm (non-CT-targeted touch)]. Saliva samples were collected before and after the touch stimulation. Oxytocin concentration increase was significantly associated with greater subjective ratings of CT-targeted touch but not of non-CT-targeted touch, and with lower peak alpha frequency values indicating decreased cortical arousal. The findings suggest that CT-targeted stimulation triggers oxytocin release but only when the touch is perceived at an individual level as having clearly positive affective salience. This corresponds to previous studies reporting that oxytocin response to touch can be related to different personality factors, and bears important implications for planning touch-based interventions in social and medical care.

Microstructure analysis of sucrose ingestion in the course of chronic treatment with imipramine

The analysis of licking microstructure provides measures which might be interpreted in terms of psychological constructs, such as pleasure and motivation, relevant for the interpretation of the effects of antidepressant drugs. The aim of this study was to characterise the effect of the prototypical antidepressant imipramine on the microstructure of licking for a 10% sucrose solution. In particular, ten 30-min sessions were performed in the course of a daily 21 day treatment with imipramine - 5, 10 and 20 mg/kg/die administered intraperitoneally. To interpret drug effects in relation to the presumed concentration of imipramine and its active metabolite desipramine, the experimental sessions were performed in an alternate order either 1-h or 24-h after imipramine administration. In the sessions performed 1-h after drug administration, the results showed a dose-dependent reduction of sucrose ingestion, accounted for by a reduction of the licking burst number. Moreover, reduced intra-burst lick rate and increased latency to lick were observed with the highest doses. Imipramine effect in the sessions performed 24-h after drug administration was similar but less pronounced. These results are consistent with the hypothesis that the reduction of sucrose ingestion might be due to reduced motivation and/or to a potentiation of satiety signals. These effects appear to be related, at least in part, to brain drug levels at testing time, and do not seem related to the mechanisms underlying the antidepressant therapeutic effect. However, these results might be relevant in explaining the effects of imipramine in models of drug-seeking and on body weight.

Enlightened hedonism? Independent drug checking amongst a group of ecstasy users

BACKGROUND

Research indicates that a body of ecstasy users across the globe employ 'home' drug testing technologies to learn more about the content of their drugs - a process referred to throughout this article as independent drug checking (IDC). Whilst a small number of studies offer accounts of this process, they do so through a narrow lens of harm reduction, potentially overlooking wider socio-cultural factors which may affect this. In response, this article draws on Slavoj Žižek's political theory of the cultural injunction to enjoy, situating IDC in the wider political economy of neoliberal consumer capitalism to contextualise and interpret its use as integral to pleasure and leisure.

METHODS

This empirical study documents the thoughts and experiences of a group of UK ecstasy users who independently use a privately owned drug-testing kit. Drawing on qualitative data generated through 20 semi-structured interviews, the article considers two research questions; what role did drug checking play in the group's drug journeys and leisure activities?; and is drug checking thought to be purposeful?

FINDINGS

For this group of ecstasy users, issues of safety and self-responsibility interweaved with the pursuit of pleasure as they sought to enjoy their drug consumption, but in a way that navigated potential harms. IDC therefore served to maximise pleasure via its 'guarantee' of a prolonged, enjoyable, authentic consumer experience whilst simultaneously safeguarding wellbeing via its premise of more responsible and controlled consumption practices.

CONCLUSION

IDC allowed this group of drug consumers to partake in 'enlightened hedonism' - demonstrating their conformity to the imperatives of capitalism and its social norms. Despite recognising the limitations of IDC and disclosing potentially harmful outcomes, the group's engagement with capitalist markets provided a belief that investment in your consumer experience can both improve it and make it safer - premises that belie the empirical reality.

Validation and extension of the Motivation and Pleasure Scale-Self Report (MAP-SR) across the schizophrenia spectrum in the Chinese context

BACKGROUND

Developed based on the Clinical Assessment Interview for Negative Symptoms (CAINS), the Motivation and Pleasure Scale-Self Report (MAP-SR) was designed to address the conceptual and psychometric limitations of other instruments assessing negative symptoms. We sought to validate and extend the applicability of the MAP-SR in the Chinese context across the schizophrenia spectrum.

METHODS

Three samples, including college students, individuals with social anhedonia and patients with schizophrenia, were recruited. Test-retest reliability, internal consistency, factor structure, and convergent/discriminant validity of the MAP-SR were examined. The group differences between the three participant groups were examined.

RESULTS

A four-factor structure of the MAP-SR was found consistently in all three groups of participants. The scale showed convergent/discriminant validity in patients with schizophrenia and individuals with social anhedonia, along with good reliability found in schizophrenia patients. The MAP-SR was also able to distinguish individuals with SocAnh and patients with SZ from matched controls.

CONCLUSIONS

The MAP-SR is a valid and reliable instrument in assessing negative symptoms in individuals along the schizophrenia spectrum.

Tracking two pleasures

Can people track several pleasures? In everyday life, pleasing stimuli rarely appear in isolation. Yet, experiments on aesthetic pleasure usually present only one image at a time. Here, we ask whether people can reliably report the pleasure of either of two images seen in a single glimpse. Participants (N = 13 in the original; +25 in the preregistered replication) viewed 36 Open Affective Standardized Image Set (OASIS) images that span the entire range of pleasure and beauty. On each trial, the observer saw two images, side by side, for 200 ms. An arrow cue pointed, randomly, left, right, or bidirectionally. Left or right indicated which image (the target) to rate while ignoring the other (the distractor); bidirectional requested rating the combined pleasure of both images. In half the blocks, the cue came before the images (precuing). Otherwise, it came after (postcuing). Precuing allowed the observer to ignore the distractor, while postcuing demanded tracking both images. Finally, we obtained single-pleasure ratings for each image shown alone. Our replication confirms the original study. People have unbiased access to their felt pleasure from each image and the average of both. Furthermore, the variance of the observer’s report is similar whether reporting the pleasure of one image or the average pleasure of two. The undiminished variance for reports of the average pleasure of two images indicates either that the underlying pleasure variances are highly correlated, or, more likely, that the variance arises in the common reporting process. In brief, observers can faithfully track at least two visual pleasures.

Anhedonia in Depressive Disorder: A Narrative Review

Since the introduction of DSM-III anhedonia has become a core depressive criterion and is defined as the loss of interest or pleasure. Although the origin of the word goes back to the end of the 19th century and numerous anhedonic symptoms are described in classic texts on depression, this centrality in the diagnosis of depression is only recent. Anhedonia is best described as a symptom complex with unclear boundaries cutting across the tripartite model of the mind (affect, volition, and cognition). Popular concepts of anhedonia pertain to the pleasure cycle and positive affectivity. These concepts partially overlap and are often mixed up, but clearly stem from different theoretical backgrounds: the affective science of reward processing versus more general, dimensional modelling of affect. The former concept seems more suitable to understand anhedonic emotions, the latter more suitable to understand anhedonic mood or trait. This narrative review covers the history of "anhedonia," the different anhedonic phenomena, and psychopathological concepts. An attempt is made to go beyond a merely descriptive psychopathology. Neurobiological and psychological insights shed a light on how symptoms are made and interconnected; these insights possibly call for a new psychopathological language.

Non-food rewards and highly processed food intake in everyday life

Reducing intake of highly processed, energy-dense food may prevent chronic disease. One proposed intervention strategy for reducing intake of these foods is to increase non-food reward experiences (e.g., music, socializing, art) in their place. However, research supporting this strategy has yet to establish temporal order between non-food reward experiences and highly processed food intake, and has yet to test mediators. The current study sought to build upon this literature with an ambulatory electronic diary study wherein the time-specific associations between non-food reward experiences and highly processed food intake were observed. A sample of 84 young adults reported on multiple types of non-food reward experiences and highly processed food intake hourly for two weekdays and two weekend days through an application on their personal electronic devices. Time-lagged analysis was employed to predict the odds of highly processed food intake in the following hour from non-food rewards experienced in the current hour. Secondary (e.g., receiving positive social feedback) and hedonic (e.g., viewing pleasant images) non-food reward experiences in the current hour predicted greater instead of lower odds of highly processed food intake in the following hour. These associations were mediated by increased subjective pleasure. Purely eudaimonic (e.g., affirming values), social (e.g., cooperating with others), and primary (e.g., having sex) reward experiences generally did not predict odds of highly processed food intake in the following hour. These results suggest that-at least for young adults-many non-food reward experiences may fail to reduce highly processed food intake, and some may even backfire. A different intervention strategy targeting reward processes implicated in highly processed food intake (e.g., interfering with conditioned learned associations) may prove a more promising avenue for improving physical health.

Pleasure and HIV biomedical discourse: The structuring of sexual and drug-related risks for gay and bisexual men who Party-n-Play

Party-n-Play (PNP) is a social practice that refers to sex that occurs under the influence of drugs. This study critically examined the risk and pleasure discourses of gay and bisexual men who PNP to explore how epistemic shifts associated with advancements in HIV biomedical sciences influence gay and bisexual men's perceptions of HIV risks and their sexual and drug-related practices. This study also aims to provide a more nuanced understanding of how sexual and drug-related risk practices of gay and bisexual men are entangled with their search for pleasure. The study was framed within poststructural Critical Discourse Analysis (CDA) methodology. In-depth one-hour interviews were conducted with 44 self-identified gay, bisexual, queer, or Two-Spirit men, who lived in Toronto, and who reported using drugs before or during sex with another man. The findings from this study demonstrated the capacity of biomedical discourses to affect respondents' HIV risk perceptions and practices. The transition from condom-centered prevention to today's context where new highly effective biomedical tools for HIV prevention are available created possibilities for greater intimacy, increased pleasure, and less anxiety about HIV tranmission, while challenging many years of preventive socialization among gay and bisexual men. However, this new context also rekindled deep-seated fears about HIV risk and viral load verifiability, reinforced unequal forms of biomedical self-governance and citizenship, and reproduced practices of biopolitics. While discourses on risk and pleasure were interwoven within complex PNP assemblages, the notion of pleasure was mobilized as a discursive tactic of self-control, and the division between normative and non-normative pleasures highlighted the consequence of biopolitical forces governing the production of discourses on sex and drugs. Future HIV social science research needs to attend to the fluid nature of the discursive environments of HIV prevention science, and consider how both the material context of PNP and its social/discursive elements operate together.

Opposite environmental gating of the experienced utility ('liking') and decision utility ('wanting') of heroin versus cocaine in animals and humans: implications for computational neuroscience

BACKGROUND

In this paper, we reviewed translational studies concerned with environmental influences on the rewarding effects of heroin versus cocaine in rats and humans with substance use disorder. These studies show that both experienced utility ('liking') and decision utility ('wanting') of heroin and cocaine shift in opposite directions as a function of the setting in which these drugs were used. Briefly, rats and humans prefer using heroin at home but cocaine outside the home. These findings appear to challenge prevailing theories of drug reward, which focus on the notion of shared substrate of action for drug of abuse, and in particular on their shared ability to facilitate dopaminergic transmission.

AIMS

Thus, in the second part of the paper, we verified whether our findings could be accounted for by available computational models of reward. To account for our findings, a model must include a component that could mediate the substance-specific influence of setting on drug reward RESULTS: It appears of the extant models that none is fully compatible with the results of our studies.

CONCLUSIONS

We hope that this paper will serve as stimulus to design computational models more attuned to the complex mechanisms responsible for the rewarding effects of drugs in real-world contexts.

The role of hedonics in the Human Affectome

Experiencing pleasure and displeasure is a fundamental part of life. Hedonics guide behavior, affect decision-making, induce learning, and much more. As the positive and negative valence of feelings, hedonics are core processes that accompany emotion, motivation, and bodily states. Here, the affective neuroscience of pleasure and displeasure that has largely focused on the investigation of reward and pain processing, is reviewed. We describe the neurobiological systems of hedonics and factors that modulate hedonic experiences (e.g., cognition, learning, sensory input). Further, we review maladaptive and adaptive pleasure and displeasure functions in mental disorders and well-being, as well as the experience of aesthetics. As a centerpiece of the Human Affectome Project, language used to express pleasure and displeasure was also analyzed, and showed that most of these analyzed words overlap with expressions of emotions, actions, and bodily states. Our review shows that hedonics are typically investigated as processes that accompany other functions, but the mechanisms of hedonics (as core processes) have not been fully elucidated.

Substance-Linked Sex in Heterosexual, Homosexual, and Bisexual Men and Women: An Online, Cross-Sectional "Global Drug Survey" Report

INTRODUCTION

Substance use in sexual contexts has received recent attention, but it has mostly been restricted to men who have sex with men and the so-called "chemsex" phenomenon.

AIM

To explore the use of licit and illicit substances in combination with sex in heterosexual, homosexual, and bisexual men and women; to explore substance-linked sex (SLS) differences across sexual orientation and sexes.

METHODS

An international online self-selecting cross-sectional drugs survey, the Global Drug Survey 2013 (n = 22,289), was conducted. Respondents were asked about which drugs (including alcohol) they had had sex while on; how frequently they used drugs to enhance sex; and how different drugs changed different aspects of the sexual experience. We report descriptive statistics and test differences between men and women and between different sexual orientations.

MAIN OUTCOME MEASURES

The following outcome measures were recorded: (i) Percentage of each group reporting last-year use of each drug with sex, (ii) Mean subjective rating (-10 to +10) from each group for each drug on each aspect of the sexual experience.

RESULTS

SLS occurred across sexual orientations and in both men and women. All groups reported that alcohol, cannabis, and 3,4-methylenedioxymethamphetamine (MDMA) were the most while commonly used drugs with sex. Larger proportions of homosexual and bisexual men had sex while on most drugs than heterosexual men (P < .001); and larger proportions of bisexual women had sex while on most drugs than heterosexual women (P < .004). ≥20% of each group reported having used drugs with the intention of enhancing a sexual experience; larger proportions of homosexual and bisexual men reported this behavior than heterosexual men (P < .001). There were clear dissociations between the effects of different drugs on different aspects of the sexual experience; although γ-hydroxybutyric acid/γ-butyrolactone and MDMA were rated consistently highly.

CLINICAL IMPLICATIONS

Men and women of different sexual orientations must be considered when forming harm reduction and treatment strategies. However, "chemsex" drugs were most commonly used by homosexual men; targeted messages to this group should continue.

STRENGTH & LIMITATIONS

Our study is highly novel; no previous study has investigated the combination of sex with this range of drugs. However, our survey is self-selecting, and some groups have a small sample size.

CONCLUSIONS

All groups reported SLS to some degree. However, differences in SLS between men and women and sexual orientations were found. Alcohol, cannabis, and MDMA were most commonly used with sex. "Chemsex" drugs were more commonly used by homosexual and bisexual men than heterosexual men. Lawn W, Aldridge A, Xia R, et al. Substance-Linked Sex in Heterosexual, Homosexual, and Bisexual Men and Women: An Online, Cross-Sectional "Global Drug Survey" Report. J Sex Med 2019;16:721-732.