Excerpt critiquing Prause’s 2 EEG studies: Steele et al., 2013 & Prause et al., 2015 (citation 105 is Steele, citation 107 is Prause):
Evidence of this neural activity signalizing desire is particularly prominent in the prefrontal cortex [101] and the amygdala [102,103], being evidence of sensitization. Activation in these brain regions is reminiscent of financial reward [104] and it may carry a similar impact. Moreover, there are higher EEG readings in these users, as well as the diminished desire for sex with a partner, but not for masturbation to pornography [105], something that reflects also on the difference in erection quality [8]. This can be considered a sign of desensitization. However, Steele’s study contains several methodological flaws to consider (subject heterogeneity, a lack of screening for mental disorders or addictions, the absence of a control group, and the use of questionnaires not validated for porn use) [106]. A study by Prause [107], this time with a control group, replicated these very findings.The role of cue reactivity and craving in the development of cybersex addiction have been corroborated in heterosexual female [108] and homosexual male samples [109].
Comments: The above critique states that Prause’s 2015 EEG replicated the findings from her 2013 EEG study (Steele et al.): Both studies reported evidence of habituation or desensitization, which is consistent with the addiction model (tolerance). Let me explain.
It’s important to know that Prause et al., 2015 AND Steele et al., 2013 had the same “porn addicted” subjects. The problem is that Steele et al.had no control group for comparison! So Prause et al., 2015 compared the 2013 subjects from Steele et al., 2013 to an actual control group (yet it suffered from the same methodological flaws named above). The results: Compared to controls “individuals experiencing problems regulating their porn viewing” had lower brain responses to one-second exposure to photos of vanilla porn. The ACTUAL results of Prause’s two EEG studies:
Steele et al., 2013: Individuals with greater cue-reactivity to porn had less desire for sex with a partner, but not less desire to masturbate.
Prause et al., 2015: “Porn addicted users” had less brain activation to static images of vanilla porn. Lower EEG readings mean that the “porn addicted” subjects were paying less attention to the pictures.
A clear pattern emerges from the 2 studies: The “porn addicted users” were desensitized or habituated to vanilla porn, and those with greater cue-reactivity to porn preferred to masturbate to porn than have sex with a real person. Put simply they were desensitized (a common indication of addiction) and preferred artificial stimuli to a very powerful natural reward (partnered sex). There is no way to interpret these results as falsifying porn addiction. The findings support the addiction model.
Excerpt critiquing Steele et al., 2013 (citation 105 is Steele et al.)
Evidence of this neural activity signalizing desire is particularly prominent in the prefrontal cortex [101] and the amygdala [102,103], being evidence of sensitization. Activation in these brain regions is reminiscent of financial reward [104] and it may carry a similar impact. Moreover, there are higher EEG readings in these users, as well as the diminished desire for sex with a partner, but not for masturbation to pornography [105], something that reflects also on the difference in erection quality [8]. This can be considered a sign of desensitization. However, Steele’s study contains several methodological flaws to consider (subject heterogeneity, a lack of screening for mental disorders or addictions, the absence of a control group, and the use of questionnaires not validated for porn use) [106]. A study by Prause [107], this time with a control group, replicated these very findings. The role of cue reactivity and craving in the development of cybersex addiction have been corroborated in heterosexual female [108] and homosexual male samples [109].
Comments: Steele et al., 2013 was touted in the media as evidence against the existence of porn/sex addiction. It wasn’t. As the above review by medical doctors explained, Steele et al. actually lends support to the existence of both porn addiction and porn use down-regulating sexual desire. How so? The study reported higher EEG readings (relative to neutral pictures) when subjects were briefly exposed to pornographic photos. Studies consistently show that an elevated P300 occurs when addicts are exposed to cues (such as images) related to their addiction.
In line with the Cambridge University brain scan studies, this EEG study also reported greater cue-reactivity to porn correlating with less desire for partnered sex. To put it another way – individuals with greater brain activation to porn would rather masturbate to porn than have sex with a real person. Shockingly, study spokesperson Nicole Prause claimed that porn users merely had “high libido,” yet the results of the study say the exact opposite (subjects’ desire for partnered sex was dropping in relation to their porn use).
Claim: Former UCLA researcher Nicole Prause boldly claimed that her solitary EEG study “falsified the porn addiction model.”
Reality: The results indicate habituation/desensitization. Because this paper reported greater porn use related to less brain activation to vanilla porn it is listed on this website as supporting the hypothesis that chronic porn use down regulates sexual arousal. Put simply, the frequent porn users were bored by static images of ho-hum porn. (These findings parallel Kuhn & Gallinat., 2014.) These findings are consistent with tolerance, a sign of addiction. Tolerance is defined as a person’s diminished response to a drug or stimulus that is the result of repeated use. The seven peer-reviewed papers listed below agree with this YBOP assessment of Prause et al., 2015.
Twenty four studies have reported findings consistent with sensitization. Because frequent porn users had lower EEG readings than controls, lead author Nicole Prause claimed her paper, with its anomalous conclusions, “falsified” the porn addiction model. She claims that her EEG readings assessed “cue-reactivity,” rather than habituation. Even if Prause were correct, she conveniently ignores the gaping hole in her “falsification” assertion. Regardless of her claims about Prause et al. 2015 finding less cue-reactivity in frequent porn users, 24 other neurological studies have reported cue-reactivity or cravings (sensitization) in compulsive porn users: : 1,2,3,4, 5,6,7,8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24. Science doesn’t go with the lone anomalous study hampered by serious methodological flaws and biased spokespersons; science goes with the preponderance of evidence.
Note: In this 2018 presentation Gary Wilson exposes the truth behind 5 questionable and misleading studies, including the two Nicole Prause EEG studies (Steele et al., 2013 and Prause et al., 2015): Porn Research: Fact or Fiction?
Ten peer-reviewed analyses of Prause et al. 2015. Over the intervening years many more neuroscience-based studies have been published (MRI, fMRI, EEG, neuropsychological, hormonal). All provide strong support for the addiction model as their findings mirror the neurological findings reported in substance addiction studies. The real experts’ opinions on porn/sex addiction can be seen in this list of 30 recent literature reviews & commentaries (all consistent with the addiction model). The papers below all agree that the Prause et al. findings of habituation lend support to the porn addiction model. Paper #2 (by Gola) is solely devoted to parsing Prause et al., 2015. The other 9 papers contain brief sections analyzing Prause et al., 2015. The papers are listed by date of publication.
Excerpt critiquing Prause et al., 2015 (citation 309)
Another EEG study involving three of the same authors was recently published [309]. Unfortunately, this new study suffered from many of the same methodological issues as the prior one [303]. For example, it used a heterogeneous subject pool, the researchers employed screening questionnaires that have not been validated for pathological internet pornography users, and the subjects were not screened for other manifestations of addiction or mood disorders.
In the new study, Prause et al. compared EEG activity of frequent viewers of Internet pornography with that of controls as they viewed both sexual and neutral images [309]. As expected, the LPP amplitude relative to neutral pictures increased for both groups, although the amplitude increase was smaller for the IPA subjects. Expecting a greater amplitude for frequent viewers of Internet pornography, the authors stated, “This pattern appears different from substance addiction models”.
While greater ERP amplitudes in response to addiction cues relative to neutral pictures is seen in substance addiction studies, the current finding is not unexpected, and aligns with the findings of Kühn and Gallinat [263], who found more use correlated with less brain activation in response to sexual images. In the discussion section, the authors cited Kühn and Gallinat and offered habituation as a valid explanation for the lower LPP pattern. A further explanation offered by Kühn and Gallinat, however, is that intense stimulation may have resulted in neuroplastic changes. Specifically, higher pornography use correlated with lower grey matter volume in the dorsal striatum, a region associated sexual arousal and motivation [265].
It’s important to note that the findings of Prause et al. were in the opposite direction of what they expected [309]. One might expect frequent viewers of Internet pornography and controls to have similar LPP amplitudes in response to brief exposure to sexual images if pathological consumption of Internet pornography had no effect. Instead, the unexpected finding of Prause et al. [309] suggests that frequent viewers of Internet pornography experience habituation to still images. One might logically parallel this to tolerance. In today’s world of high-speed Internet access, it is very likely that frequent consumers of Internet pornography users view sexual films and videos as opposed to still clips. Sexual films produce more physiological and subjective arousal than sexual images [310] and viewing sexual films results in less interest and sexual responsiveness to sexual images [311]. Taken together, the Prause et al., and Kühn and Gallinat studies lead to the reasonable conclusion that frequent viewers of internet pornography require greater visual stimulation to evoke brain responses comparable to healthy controls or moderate porn users.
In addition, the statement of Prause et al. [309] that, “These are the first functional physiological data of persons reporting VSS regulation problems” is problematic because it overlooks research published earlier [262,263]. Moreover, it is critical to note that one of the major challenges in assessing brain responses to cues in Internet pornography addicts is that viewing sexual stimuli is the addictive behavior. In contrast, cue-reactivity studies on cocaine addicts utilize pictures related to cocaine use (white lines on a mirror), rather than having subjects actually ingest cocaine. Since the viewing of sexual images and videos is the addictive behavior, future brain activation studies on Internet pornography users must take caution in both experimental design and interpretation of results. For example, in contrast to the one-second exposure to still images used by Prause et al. [309], Voon et al. chose explicit 9-second video clips in their cue reactivity paradigm to more closely match Internet porn stimuli [262]. Unlike the one-second exposure to still images (Prause et al. [309]), exposure to 9-second video clips evoked greater brain activation in heavy viewers of internet pornography than did one-second exposure to still images. It is further concerning that the authors referenced the Kühn and Gallinat study, released at the same time as the Voon study [262], yet they did not acknowledge the Voon et al. study anywhere in their paper despite its critical relevance.
Biol Psychol. 2016 May 24. pii: S0301-0511(16)30182-X. doi: 10.1016/j.biopsycho.2016.05.003.
Gola Matuesz1. 1Swartz Center for Computational Neuroscience, Institute for Neural Computations, University of California San Diego, San Diego, USA; Institute of Psychology, Polish Academy of Science, Warsaw, Poland. Electronic address: [email protected].
Full Paper
Internet technology provides affordable and anonymous access to a wide range of pornography content (Cooper, 1998). Avail-able data show that 67.6% of male and 18.3% of female Danish young adults (18–30 years old) use pornography on the regular weekly basis (Hald, 2006). Among USA college students 93.2% of boys and 62.1% of girls were watching online pornography before age of 18 (Sabina, Wolak, & Finkelhor, 2008). For the majority of users, pornography viewing plays a role in entertainment, excitement, and inspiration (Rothman, Kaczmarsky, Burke, Jansen, & Baughman, 2014) (Häggström-Nordin, Tydén, Hanson,& Larsson, 2009), but for some, frequent pornography consumption is a source of suffering (about 8% out of users according to Cooper et al., 1999) and becomes a reason for seeking treatment (Delmonico and Carnes, 1999; Kraus, Potenza, Martino, & Grant,2015; Gola, Lewczuk, & Skorko, 2016; Gola and Potenza, 2016). Due to its widespread popularity and conflicting clinical observations, pornography consumption is an important social issue, garnering much attention in the media, (e.g., high-profile movies: “Shame” by McQueen and “Don Jon” by Gordon-Levitt) and from politicians(e.g., UK prime minister David Cameron’s 2013 speech on pornography use by kids), as well as neuroscience research (Steele, Staley,Fong, & Prause, 2013; Kühn and Gallinat, 2014; Voon et al., 2014).One of the most frequently asked questions is: whether pornography consumption can be addicting?
The finding of Prause, Steele, Staley, Sabatinelli, & Hajcak, (2015) published in the June issue of Biological Psychology delivers interesting data on this topic. The researchers showed that men and women reporting problematic pornography viewing (N = 55),1 exhibited lower late positive potential (LPP – an event related potential in EEG signaling associated with significance and subjective silence of the stimuli) to sexual images as compared with non-sexual images, when compared with the responses of controls. They also show that problematic pornography users with higher sexual desire have smaller LPP differences for sexual and non-sexual images. The authors concluded that: “This pattern of results appears inconsistent with some predictions made by addiction models” (p. 196) and announced this conclusion in the article’s title: “Modulation of late positive potentials by sexual images in problem users and controls inconsistent with “porn addiction””.
Unfortunately, in their article, Prause et al. (2015) did not explicitly define which model of addiction they were testing. Presented results when considered in relation to the most established models either do not provide clear verification of the hypothesis that problematic pornography use is an addiction (like in case of Incentive Salience Theory; Robinson and Berridge, 1993; Robinson, Fischer, Ahuja, Lesser, & Maniates, 2015) or support this hypothesis (like in case of Reward Deficiency Syndrome; Blum et al., 1996; 1996; Blum, Badgaiyan, & Gold, 2015). Below I explain it in details.
Correspondence address: Swartz Center for Computational Neuroscience, Institute for Neural Computations, University of California San Diego, 9500 Gilman Drive, San Diego, CA 92093-0559, USA. E-mail address: [email protected]
1 It is worthy to notice that the authors present results for male and female participants together, while recent studies shows that sexual images ratings of arousal and valence differs dramatically between genders (see: Wierzba et al., 2015)
2 This guess is supported by fact that references used in Prause et al. (2015) also refer to IST (i.e. Wölfling et al., 2011
Why theoretical framework and clear hypothesis matter
Based on the multiple uses of the term “cue-reactivity” by the authors we may guess that the authors have in mind Incentive Salience Theory (IST) proposed by Robinson and Berridge (Berridge, 2012; Robinson et al., 2015).2 This theoretical frame-work distinguishes two basic components of motivated behavior − “wanting” and “liking”. The latter is directly linked to the experienced value of the reward, while the former is related to the expected value of the reward, typically measured in relation to a predictive cue. In terms of Pavlovian learning, reward is an unconditioned stimulus (UCS) and cues associated with this reward through learning are conditioned stimuli (CS). Learned CSs acquire incentive salience and evoke “wanting”, reflected in motivated behavior (Mahler and Berridge, 2009; Robinson & Berridge, 2013). Thus they acquire similar properties as the reward itself. For example domesticated quail willingly copulate with a terrycloth object (CS) previously paired with the opportunity to copulate with a female quail (UCS), even if a real female is available (Cetinkaya and Domjan, 2006)
According to IST, addiction is characterized by increased “wanting” (elevated cue-related reactivity; i.e. higher LPP) and decreased “liking” (diminished reward-related reactivity; i.e. lower LPP). In order to interpret data within the IST framework researchers must clearly disentangle cue-related “wanting” and reward-related “liking.” Experimental paradigms testing both processes introduce separate cues and rewards (i.e. Flagel et al., 2011; Sescousse, Barbalat, Domenech, & Dreher, 2013; Gola, Miyakoshi, & Sescousse, 2015). Prause et al. (2015) instead use a much simpler experimental paradigm, wherein subjects passively view different pictures with sexual and non-sexual content. In such simple experimental design the crucial question from the IST perspective is: Do the sexual images play the role of cues (CS) or rewards (UCS)? And therefore: does the measured LPP reflect “wanting” or “liking”?
The authors assume that sexual images are cues, and there-fore interpret decreased LPP as a measure of diminished “wanting.”Diminished “wanting” with respect to cues would indeed be inconsistent with the IST addiction model. But many studies show that sexual pictures are not mere cues. They are rewarding in them-selves (Oei, Rombouts, Soeter, van Gerven, & Both, 2012; Stoléru,Fonteille, Cornélis, Joyal, & Moulier, 2012; reviewed in: Sescousse,Caldú, Segura, & Dreher, 2013; Stoléru et al., 2012). Viewing sexual images evokes ventral striatum (reward system) activity (Arnowet al., 2002; Demos, Heatherton, & Kelley, 2012; Sabatinelli, Bradley,Lang, Costa, & Versace, 2007; Stark et al., 2005; Wehrum-Osinskyet al., 2014), dopamine release (Meston and McCall, 2005) and both self-reported and objectively measured sexual arousal (review: Chivers, Seto, Lalumière, Laan, & Grimbos, 2010).
The rewarding properties of sexual images may be innate due to the fact that sex (like food) is a primary reward. But even if some-one rejects such innate rewarding nature, rewarding properties of erotic stimuli may be acquired due to Pavlovian learning. Under natural conditions, visual erotic stimuli (such as a naked spouse or pornographic video) may be a cue (CS) for sexual activity leading to the climax experience (UCS) as a result of either dyadic sex or solitary masturbation accompanying pornography consumption. Furthermore in the case of frequent pornography consumption, visual sexual stimuli (CS) are strongly associated with orgasm (UCS) and may acquire properties of reward (UCS; Mahler and Berridge, 2009; Robinson & Berridge, 2013) and then lead to approach (i.e.seeking pornography) and consummatory behaviors (i.e., hours of viewing before reaching climax).
Regardless of innate or learned reward value, studies show that sexual images are motivating in themselves, even without the possibility of climax. Thus they have intrinsic hedonic value for humans (Prévost, Pessiglione, Météreau, Cléry-Melin, & Dreher,2010) as well as rhesus macaques (Deaner, Khera, & Platt, 2005).Their rewarding value may even be amplified in an experimental setting, where a climax experience (natural UCS) is unavailable, as in the Prause et al.’s (2015) study (“participants in this study were instructed not to masturbate during the task”, p. 197). According to Berridge, task context influences reward prediction (Berridge,2012). Thus, as no other pleasure than sexual images was available here, the viewing of pictures was the ultimate reward (rather than simply a cue).
Decreased LPP for sexual rewards in problematic pornography users is consistent with addiction models
Taking all of the above into account we may assume that sexual images in the Prause et al. (2015) study, instead of being cues, might have played the role of rewards. If so, according to the IST framework, lower LPP for sexual vs. non-sexual pictures in problematic pornography users and subjects with high sexual desire indeed reflects diminished “liking”. Such a result is in line with the addiction model proposed by Berridge and Robinson (Berridge, 2012; Robinson et al., 2015). However, to fully verify an addiction hypothesis within IST framework, more advanced experimental studies, disentangling cue and reward are required. A good example of a well designed experimental paradigm was used in studies on gamblers by Sescousse, Redouté, & Dreher (2010). It employed monetary and sexual cues (symbolic stimuli) and clear rewards (monetary wins or sexual pictures). Due to lack of well defined cues and rewards in Prause et al. (2015) study, role of sexual pictures remains unclear and therefore obtained LPP effects are ambiguous within IST framework. For sure conclusion presented in the study’s title “Modulation of late positive potentials by sexual images in problem users and controls inconsistent with “porn addiction” is ungrounded with respect to IST
If we take another popular addiction model – Reward Deficency Syndrome (RDS; Blum et al., 1996, 2015) the data obtained by the authors actually speaks in favor of addiction hypothesis. RDS frame-work assumes that genetic predisposition to lower dopaminergic response for rewarding stimuli (expressed in diminished BOLD and electrophysiological reactivity) is related to sensation-seeking, impulsivity and higher risk of addiction. The authors’ findings of lower LPPs in problematic pornography users is entirely consistent with the RDS addiction model. If Prause et al. (2015) were testing some other model, less well known than IST or RDS, it would be highly desirable to present it briefly in their work.
Final remarks
The study by Prause et al. (2015) delivers interesting data on problematic pornography consumption.3 Yet, due to the lack of clear hypothesis statement which addiction model is tested and ambiguous experimental paradigm (hard to define role of erotic pictures), it is not possible to say if the presented results are against, or in favor of, a hypothesis about “pornography addiction.” More advanced studies with well defined hypotheses are called for. Unfortunately the bold title of Prause et al. (2015) article has already had an impact on mass media,4 thus popularizing scientifically unjustified conclusion. Due to the social and political importance of the topic of the effects of pornography consumption, researchers should draw future conclusions with greater caution. (emphasis supplied)
3 It is worthy to notice that in Prause et al. (2015) problematic users consume pornography in average for 3.8 h/week (SD = 1.3) it is almost the same as non-problematic pornography users in Kühn and Gallinat (2014) who consume in average 4.09 h/week (SD = 3.9). In Voon et al. (2014) problematic users reported 1.75 h/week (SD = 3.36) and problematic 13.21 h/week (SD = 9.85) – data presented by Voon during American Psychological Science conference in May 2015.
4 Examples of titles of popular science articles about Prause et al. (2015):“Porn is not as harmful as other addictions, study claims” (http://metro.co.uk/2015/07/04/porn-is-not-as-harmful-as-other-addictions-study-claims-5279530/), “Your Porn Addiction Isn’t Real” (http://www.thedailybeast.com/articles/2015/06/26/your-porn-addiction-isn-t-real.html), “Porn ’Addiction’ Isn’t Really Addiction, Neuroscientists Say” (http://www.huffingtonpost.com/2015/06/30/porn-addiction- n7696448.html)
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Steele, V. R., Staley, C., Fong, T., & Prause, N. (2013). Sexual desire, nothypersexuality, is related to neurophysiological responses elicited by sexual images. Socioaffective Neuroscience & Psychology, 3, 20770. http://dx.doi.org/10.3402/snp.v3i0.20770
Stoléru, S., Fonteille, V., Cornélis, C., Joyal, C., & Moulier, V. (2012). Functional neuroimaging studies of sexual arousal and orgasm in healthy men and women: a review and meta-analysis. Neuroscience and Biobehavioral Reviews,36(6), 1481–1509. http://dx.doi.org/10.1016/j.neubiorev.2012.03.006
Voon, V., Mole, T. B., Banca, P., Porter, L., Morris, L., Mitchell, S., . . . & Irvine, M.(2014). Neural correlates of sexual cue reactivity in individuals with and without compulsive sexual behaviours. Public Library of Science, 9(7), e102419.http://dx.doi.org/10.1371/journal.pone.0102419
Wehrum-Osinsky, S., Klucken, T., Kagerer, S., Walter, B., Hermann, A., & Stark, R.(2014). At the second glance: stability of neural responses toward visual sexual stimuli. The Journal of Sexual Medicine, 11(11), 2720–2737. http://dx.doi.org/10.1111/jsm.12653
Wierzba, M., Riegel, M., Pucz, A., Lesniewska, Z., Dragan, W., Gola, M., . . . &Marchewka, A. (2015). Erotic subset for the Nencki Affective Picture System (NAPS ERO): cross-sexual comparison study. Frontiers in Psychology, 6, 1336.
Wölfling, K., Mörsen, C. P., Duven, E., Albrecht, U., Grüsser, S. M., & Flor, H. (2011).To gamble or not to gamble: at risk for craving and relapse—learned motivated attention in pathological gambling. Biological Psychology, 87(2), 275–281. http://dx.doi.org/10.1016/j.biopsycho.2011.03.010
COMMENTS: While this paper is only a brief summation, it contains a few key observations. For example, it states that both Prause et al., 2015 and Kuhn & Gallinat, 2014 report a similar finding: greater porn use correlating with greater habituation to porn. Both studies reported lower brain activation in response to brief exposure to photos of vanilla porn. In the following excerpt “Lower late positive-potential” refers to the EEG findings of Prause et al.:
“In contrast, studies in healthy individuals suggest a role for enhanced habituation with excessive use of pornography. In healthy men, increased time spent watching pornography correlated with lower left putaminal activity to pornographic pictures (Kühn and Gallinat, 2014). Lower late positive-potential activity to pornographic pictures was observed in subjects with problematic pornography use.” (emphasis supplied)
Compulsive sexual behavior (CSB) is characterized by craving, impulsivity, social/occupational impairment, and psychiatric comorbidity. Prevalence of CSB is estimated around 3–6%, with a male predominance. Although not included in DSM-5, CSB can be diagnosed in ICD-10 as an impulse control disorder. However, debate exists about CSB’s classification (eg, as an impulsive-compulsive disorder, a feature of hypersexual disorder, an addiction, or along a continuum of normative sexual behavior).
Preliminary evidence suggests that dopamine may contribute to CSB. In Parkinson’s disease (PD), dopamine replacement therapies (Levo-dopa, dopamine agonists) have been associated with CSB and other impulse control disorders (Weintraub et al, 2010). A small number of case studies using naltrexone support its effectiveness at reducing urges and behaviors associated with CSB (Raymond et al, 2010), consistent with the possible opioidergic modification of mesolimbic dopamine function in reducing CSB. Currently, larger, adequately powered, neurochemical investigations and medication trials are needed to further understand CSB.
Incentive motivational processes relate to sexual cue reactivity. CSB vs non-CSB men had greater sex-cuerelated activation of the anterior cingulate, ventral striatum, and amygdala (Voon et al, 2014). In CSB subjects, functional connectivity of this network associated with cue-related sexual desire, thus resonating with findings in drug addictions (Voon et al, 2014). CSB men further show enhanced attentional bias to pornographic cues, implicating early attentional orienting responses as in addictions (Mechelmans et al, 2014). In CSB vs non-CSB PD patients, exposure to pornographic cues increased activation in the ventral striatum, cingulate and orbitofrontal cortex, linking also to sexual desire (Politis et al, 2013). A small diffusion-tensor imaging study implicates prefrontal abnormalities in CSB vs non-CSB men (Miner et al, 2009).
In contrast, studies in healthy individuals suggest a role for enhanced habituation with excessive use of pornography. In healthy men, increased time spent watching pornography correlated with lower left putaminal activity to pornographic pictures (Kühn and Gallinat, 2014). Lower late positive- potential activity to pornographic pictures was observed in subjects with problematic pornography use. These findings, while contrasting, are not incompatible. Habituation to picture cues relative to video cues may be enhanced in healthy individuals with excessive use; whereas, CSB subjects with more severe/pathological use may have enhanced cue reactivity.
Although recent neuroimaging studies have suggested some possible neurobiological mechanisms of CSB, these results should be treated as tentative given methodological limitations (eg, small sample sizes, cross-sectional designs, solely male subjects, and so on). Current gaps in research exist complicating definitive determination whether CSB is best considered as an addiction or not. Additional research is needed to understand how neurobiological features relate to clinically relevant measures like treatment outcomes for CSB. Classifying CSB as a ‘behavioral addiction’ would have significant implications for policy, prevention and treatment efforts; however, at this time, research is in its infancy. Given some similarities between CSB and drug addictions, interventions effective for addictions may hold promise for CSB, thus providing insight into future research directions to investigate this possibility directly. (emphasis supplied)
Kühn S, Gallinat J (2014). Brain structure and functional connectivity associated with pornography consumption: the brain on porn. JAMA Psychiatry 71: 827–834.
Mechelmans DJ, Irvine M, Banca P, Porter L, Mitchell S, Mole TB et al (2014). Enhanced attentional bias towards sexually explicit cues in individuals with and without compulsive sexual behaviours. PloS One 9: e105476.
Miner MH, Raymond N, Mueller BA, Lloyd M, Lim KO (2009). Preliminary investigation of the impulsive and neuroanatomical characteristics of compulsive sexual behavior. Psychiatry Res 174: 146–151.
Politis M, Loane C, Wu K, O’Sullivan SS, Woodhead Z, Kiferle L et al (2013). Neural response to visual sexual cues in dopamine treatment-linked hypersexuality in Parkinson’s disease. Brain 136: 400–411.
Raymond NC, Grant JE, Coleman E (2010). Augmentation with naltrexone to treat compulsive sexual behavior: a case series. Ann Clin Psychiatry 22: 55–62.
Voon V, Mole TB, Banca P, Porter L, Morris L, Mitchell S et al (2014). Neural correlates of sexual cue reactivity in individuals with and without compulsive sexual behaviours. PloS One 9: e102419.
Weintraub D, Koester J, Potenza MN, Siderowf AD, Stacy M, Voon V et al (2010). Impulse control disorders in Parkinson disease: a cross-sectional study of 3090 patients. Arch Neurol 67: 589–595. Neuropsychopharmacology Reviews (2016) 41, 385–386; doi:10.1038/npp.2015.300
COMMENTS: This review, like the other papers, says that Prause et al., 2015 aligns with Kühn & Gallinat, 2014 (Citation 72) which found that more porn use correlated with less brain activation in response to pictures of vanilla porn.
Excerpt describing Prause et al., 2015 (citation 73):
In contrast, other studies focusing on individuals without CSB have emphasized a role for habituation. In non-CSB men, a longer history of pornography viewing was correlated with lower left putaminal responses to pornographic photos, suggesting potential desensitization [72].Similarly, in an event-related potential study with men and women without CSB, those reporting problematic use of pornography had a lower late positive potential to pornographic photos relative to those not reporting problematic use. The late positive potential is elevated commonly in response to drug cues in addiction studies [73]. These findings contrast to, but are not incompatible with, the report of enhanced activity in the fMRI studies in CSB subjects; the studies differ in stimuli type, modality of measure and the population under study. The CSB study used infrequently shown videos compared to repeated photos; the degree of activation has been shown to differ to videos versus photos and habituation may differ depending on the stimuli. Furthermore, in those reporting problematic use in the event-related potential study, the number of hours of use was relatively low [problem: 3.8, standard deviation (SD) = 1.3 versus control: 0.6, SD = 1.5 hours/week] compared to the CSB fMRI study (CSB: 13.21, SD = 9.85 versus control: 1.75, SD = 3.36 hours/week). Thus, habituation may relate to general use, with severe use potentially associated with enhanced cue-reactivity. Further larger studies are required to examine these differences. (emphasis supplied)
COMMENTS: This review, like the other papers, says that Prause et al., 2015 aligns with Kühn & Gallinat, 2014 (Citation 72) which found that more porn use correlated with less brain activation in response to pictures of vanilla porn.
Excerpt analyzing Prause et al., 2015 (citation 130):
A 2015 EEG study by Prause et al. compared frequent viewers of Internet pornography (mean 3.8 h/week) who were distressed about their viewing to controls (mean 0.6 h/week) as they viewed sexual images (1.0 s exposure) [130]. In a finding that parallels Kühn and Gallinat, frequent Internet pornography viewers exhibited less neural activation (LPP) to sexual images than controls [130]. The results of both studies suggest that frequent viewers of Internet pornography require greater visual stimulation to evoke brain responses when compared with healthy controls or moderate Internet pornography users [167,168]. In addition, Kühn and Gallinat reported that higher Internet pornography use correlated with lower functional connectivity between the striatum and the prefrontal cortex. Dysfunction in this circuitry has been related to inappropriate behavioral choices regardless of potential negative outcome [169]. In line with Kühn and Gallinat, neuropsychological studies report that subjects with higher tendency towards cybersex addiction have reduced executive control function when confronted with pornographic material [53,114]. (emphasis supplied)
COMMENTS: This EEG study on porn users cited 3 Nicole Prause EEG studies. The authors believe that all 3 Prause EEG studies actually found desensitization or habituation in frequent porn users (which often occurs with addiction). The excerpts below these 3 citations indicate the following Nicole Prause EEG studies (#8 is Prause et al., 2015):
7 – Prause, N.; Steele, V.R.; Staley, C.; Sabatinelli, D. Late positive potential to explicit sexual images associated with the number of sexual intercourse partners. Soc. Cogn. Affect. Neurosc. 2015, 10, 93–100.
8 – Prause, N.; Steele, V.R.; Staley, C.; Sabatinelli, D.; Hajcak, G. Modulation of late positive potentials by sexual images in problem users and controls inconsistent with “porn addiction”. Biol. Psychol. 2015, 109, 192–199.
14 – Steele, V.R.; Staley, C.; Fong, T.; Prause, N. Sexual desire, not hypersexuality, is related to neurophysiological responses elicited by sexual images. Socioaffect. Neurosci. Psychol. 2013, 3, 20770
Event-related potentials (ERPs) have often been used as a physiological measure of reactions to emotional cues, e.g., [24]. Studies utilizing ERP data tend to focus on later ERP effects such as the P300 [14] and Late-Positive Potential (LPP) [7, 8] when investigating individuals who view pornography. These later aspects of the ERP waveform have been attributed to cognitive processes such as attention and working memory (P300) [25] as well as sustained processing of emotionally-relevant stimuli (LPP) [26]. Steele et al. [14] showed that the large P300 differences seen between viewing of sexually explicit images relative to neutral images was negatively related to measures of sexual desire, and had no effect on participants’ hypersexuality. The authors suggested that this negative finding was most probably due to the images shown not having any novel significance to the participant pool, as participants all reported viewing high volumes of pornographic material, consequently leading to the suppression of the P300 component. The authors went on to suggest that perhaps looking at the later occurring LPP may provide a more useful tool, as it has been shown to index motivation processes. Studies investigating the effect pornography use has on the LPP have shown the LPP amplitude to be generally smaller in participants who report having higher sexual desire and problems regulating their viewing of pornographic material [7, 8]. This result is unexpected, as numerous other addiction-related studies have shown that when presented with a cue-related emotion task, individuals who report having problems negotiating their addictions commonly exhibit larger LPP waveforms when presented images of their specific addiction-inducing substance [27]. Prause et al. [7, 8]offer suggestions as to why the use of pornography may result in smaller LPP effects by suggesting that it may be due to a habituation effect, as those participants in the study reporting overuse of pornographic material scored significantly higher in the amount of hours spent viewing pornographic material.
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Studies have consistently shown a physiological downregulation in processing of appetitive content due to habituation effects in individuals who frequently seek out pornographic material [3, 7, 8]. It is the authors’ contention that this effect may account for the results observed.
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Future studies may need to utilise a more up-to-date standardised image database to account for changing cultures. Also, maybe high porn users downregulated their sexual responses during the study. This explanation was at least used by [7, 8] to describe their results which showed a weaker approach motivation indexed by smaller LPP (late positive potential) amplitude to erotic images by individuals reporting uncontrollable pornography use. LPP amplitudes have been shown to decrease upon intentional downregulation [62, 63]. Therefore, an inhibited LPP to erotic images may account for lack of significant effects found in the present study across groups for the “erotic” condition. (emphasis supplied)
Excerpt analyzing Prause et al., 2015 (which is citation 87):
A study using EEG, conducted by Prause and colleagues, suggested that individuals who feel distressed about their pornography use, as compared to a control group who do not feel distress about their use of pornography, may require more/greater visual stimulation to evoke brain responses [87]. Hypersexual participants—individuals‘ experiencing problems regulating their viewing of sexual images’ (M=3.8 hours per week)—exhibited less neural activation (measured by late positive potential in the EEG signal) when exposed to sexual images than did the comparison group when exposed to the same images. Depending on the interpretation of sexual stimuli in this study (as a cue or reward; for more see Gola et al. [4]), the findings may support other observations indicating habituation effects in addictions [4]. In 2015, Banca and colleagues observed that men with CSB preferred novel sexual stimuli and demonstrated findings suggestive of habituation in the dACC when exposed repeatedly to the same images [88]. Results of the aforementioned studies suggest that frequent pornography use may decrease reward sensitivity, possibly leading to increased habituation and tolerance, thereby enhancing the need for greater stimulation to be sexually aroused. However, longitudinal studies are indicated to examine this possibility further. Taken together, neuroimaging research to date has provided initial support for the notion that CSB shares similarities with drug, gambling, and gaming addictions with respect to altered brain networks and processes, including sensitization and habituation. (emphasis supplied)
Excerpt critiquing Prause’s 2 EEG studies: Steele et al., 2013 & Prause et al., 2015 (citation 105 is Steele, citation 107 is Prause):
Evidence of this neural activity signalizing desire is particularly prominent in the prefrontal cortex [101] and the amygdala [102,103], being evidence of sensitization. Activation in these brain regions is reminiscent of financial reward [104] and it may carry a similar impact. Moreover, there are higher EEG readings in these users, as well as the diminished desire for sex with a partner, but not for masturbation to pornography [105], something that reflects also on the difference in erection quality [8]. This can be considered a sign of desensitization. However, Steele’s study contains several methodological flaws to consider (subject heterogeneity, a lack of screening for mental disorders or addictions, the absence of a control group, and the use of questionnaires not validated for porn use) [106]. A study by Prause [107], this time with a control group, replicated these very findings. The role of cue reactivity and craving in the development of cybersex addiction have been corroborated in heterosexual female [108] and homosexual male samples [109].
COMMENTS: The above critique states that Prause’s 2015 EEG replicated the findings from her 2013 EEG study (Steele et al.): Both studies reported evidence of habituation or desensitization, which is consistent with the addiction model (tolerance). Let me explain.
It’s important to know that Prause et al., 2015 AND Steele et al., 2013 had the same “porn addicted” subjects. The problem is that Steele et al.had no control group for comparison! So Prause et al., 2015 compared the 2013 subjects from Steele et al., 2013 to an actual control group (yet it suffered from the same methodological flaws named above). The results: Compared to controls “individuals experiencing problems regulating their porn viewing” had lower brain responses to one-second exposure to photos of vanilla porn. The ACTUAL results of Prause’s two EEG studies:
Steele et al., 2013: Individuals with greater cue-reactivity to porn had less desire for sex with a partner, but not less desire to masturbate.
Prause et al., 2015: “Porn addicted users” had less brain activation to static images of vanilla porn. Lower EEG readings mean that the “porn addicted” subjects were paying less attention to the pictures.
A clear pattern emerges from the 2 studies: The “porn addicted users” were desensitized or habituated to vanilla porn, and those with greater cue-reactivity to porn preferred to masturbate to porn than have sex with a real person. Put simply they were desensitized (a common indication of addiction) and preferred artificial stimuli to a very powerful natural reward (partnered sex). There is no way to interpret these results as falsifying porn addiction. The findings support the addiction model.
First, Steele et al. (2013) found that individuals with viewing of visual sexual stimuli (VSS) induced a greater amplitude of the P300 component when viewing erotic images than when viewing neutral images. The results seem to confirm the notion that online pornography leads to an individual’s hunger for online pornography, but Steele’s research lacks normal subjects for reference. In addition, LPP components appear later than P300. Late positive potential is associated with the stimulation of significant material processing and better reflects the individual’s desire to watch pornographic material (Hilton, 2014) (the greater the individual’s desire to watch pornography, the greater the LPP volatility). In this regard, Prause and Steele et al. (2015) added individuals who viewed less pornographic material to VSS individuals in the improvement experiment, and found that subjects who had excessively viewed pornographic material problems and reported more sexual desire were watching erotic images. The induced LPP amplitude is smaller, and this result seems to be contrary to the idea that online pornography-related clues induce a sense of craving. Actually, some scholars have pointed out that the erotic images used in the study by Prause and Steele may be an addiction in itself. Consumer goods, not addictive cues (Gola et al., 2017; Gola, Wordecha, Marchewka, & Sescousse, 2016). Therefore, according to the Theory of Incentive-Salience Theory (IST) in drug addiction, as the degree of addiction deepens, the cues of addiction can induce the addicted desire of addicted individuals to become more and more addicted. (Berridge, 2012; Robinson, Fischer, Ahuja, Lesser, & Maniates, 2015), but the addiction to the addicted individuals has gradually decreased, and the decrease in LPP amplitude indicates that CA may be addicted to drugs.
Comments: The above critique is very similar to other peer-reviewed papers in that it contrasts and compares Prause’s 2013 EEG study (Steele et al.) with Prause et al., 2015. As with all other analyses, this one agrees with Gola’s analysis. In reality, both studies reported evidence of habituation or desensitization, which is consistent with the addiction model (tolerance), as explained above.
Comments: Ignoring Prause et al.’s unsupported title, the authors accepted the most likely explanation mentioned in Prause et al., 2015: “Prauseetal. suggested that this unexpected finding may be due to habituation effects, as the participants who presented with the reduced LPP waveform also scored significantly higher in the amount of hours they spent viewing pornographic material.”
Excerpt mentioning Prause et al., 2015:
Studies investigating neural attributes to problematic or frequent pornographic material use are relatively scarce. Unproblematic or infrequent use of pornographic material generally induces an enhanced LPP waveform when individuals are presented with erotic visual information (Prauseetal., 2015). A larger amplitude LPP is an index of sustained processing of emotionally relevant stimuli and is a marker of motivational significance (Voon etal., 2014). In contrast, with regard to ERP effects of problem viewing of visual sexual stimuli, existing literature has generally shown a reduced amplitude LPP component. Prauseetal. presented individuals who either reported or denied problematic pornography use with emotion-inducing images (including explicit sexual images). Individuals who reported problems policing their pornography use and who had a stronger desire for sex demonstrated lower LPP amplitudes in response to the explicit sexual images. Prauseetal. suggested that this result was unexpected. Numerous studies of individuals with addictive behaviors have employed cuerelated emotional tasks. Typically, these studies have found an increased LPP amplitude when presented with images of the individual’s addiction-inducing substance (Minnix etal., 2013). Prauseetal. suggested that this unexpected finding may be due to habituation effects, as the participants who presented with the reduced LPP waveform also scored significantly higher in the amount of hours they spent viewing pornographic material.
In the last year, an audacious red herring has insinuated itself into the tweets and blogs of some AASECT sexologists: the notion that PIED (porn-induced erectile dysfunction) is caused by masturbation. Without offering any scientific support, this band of porn-apologists has determined to persuade us that porn is not behind the recent rise of coital ED in online porn enthusiasts (Gotta be anything but porn, right?). So far off the mark is the suggestion that waxing the one-eyed wonder weasel is the culprit, that if you see anyone proposing it as the cause of youthful ED you can be confident that you’re dealing with a propagandist pushing a pro-porn agenda (or someone who has been misinformed by such a person).
Why is this claim so, well, fishy? First, true sexuality experts never claim that tugging the slug causes youthful ED. Certainly urologists, the frontline experts in men’s sexual health, don’t. The fact is, virtually no one in the history of modern sexology (save these few brash sexologists) has ever suggested masturbation causes chronic erectile dysfunction in young men.
While these propagandists are purposely vague in describing exactly how stroking the poker might produce chronic ED in otherwise healthy young men, the only logical conclusion is that they’re suggesting that masturbation is causing trauma so severe that those injured cannot achieve an erection. In effect, the propagandists are blaming the tremendous rise in youthful ED on traumatic masturbation. Trouble is, trauma so severe that young men cannot achieve an erection is a type of organic ED (easily diagnosed by healthcare givers). While there are several studies indicating a 500-1000% increase in ED in men under 40, no study suggests severe tissue damage is behind this tremendous rise. There’s absolutely no evidence for such a claim.
Most men with porn-induced ED can still get an erection with porn
Most men with porn-induced ED can achieve an erection and masturbate to climax just fine…as long as they’re viewing internet porn. This fact alone debunks the fairytale that traumatic masturbation habits are behind the tremendous rise in inexplicable ED. If a guy can achieve an erection with porn, but goes limp without it, that’s porn-induced ED. It’s not organic ED.
If you are wondering if your (or your partner’s) sluggish or absent erections during partnered sex are a consequence of porn use, try a test recently proposed by doctors for men under 40 with otherwise unexplained ED:
Observe your erection when masturbating alone with internet porn. On another occasion, try it without porn. If you can easily achieve your goals with internet pornography, but not without it, then your sexual dysfunctions may be associated with its use.
How could “masturbation habits” produce withdrawal symptoms or the “flatline”?
Nearly every man with porn-induced ED reports a similar constellation of physical and psychological symptoms when they stop porn use/masturbation. Most report varying degrees of withdrawal symptoms such as agitation, anxiety, insomnia, lethargy, depression, mood swings, brain fog, and severe cravings to view porn.
Within 1-2 weeks, most men experience what is called the “flatline”: severe loss of libido accompanied by perceived decreases in genital sensation or size. The flatline can last a few weeks to several months. In young men the flatline can be intermittent. In the last 2 years some young men have reported “flatlines” that linger for 1-3 years. How could such symptoms be caused by masturbation? They can’t.
ED isn’t caused by masturbation, but delayed ejaculation might be related to certain habits
Although many young porn users have never cranked the shank without porn, masturbation and porn use must be considered separately in order to reveal the correct etiology (cause) of particular sexual dysfunctions. Delayed ejaculation (difficulty climaxing with a partner), as contrasted with ED, may be partially related to masturbation style, such as edging for hours or death-grip without lube.
However, absent underlying organic or psychological problems, erections and sexual arousal are not problems in youthful masturbators unless they are using porn. Similarly, regardless of masturbation style, conditioning one’s sexuality to aspects of porn viewing can lead to difficulties climaxing with a partner.
It’s vital to keep separate the origins of today’s sexual dysfunctions, lest sufferers overlook the role of supernormally stimulating porn in their difficulties.
Although masturbation has been touted as beneficial for decades, 15 years ago erectile dysfunction rates (with partners) were negligible (2-5%) in sexually active men under 40. Since the advent of streaming porn, researchers report rates as high as 30% in this same age group. Rates of low libido and research correlating porn use with sexual and relationship problems have also soared.
Younger men, who presumably have been polishing the rocket for fewer years than older men, often need longer to recover normal desire for real partners and normal sexual function than men whose sexual template formed prior to the advent of streaming porn in 2007 (regardless of masturbation frequency). This suggests that porn-conditioning, especially in youngsters, is contributing to youthful sexual dysfunctions. A striking bit of evidence that internet porn is the key variable comes from an Italian study in which high school seniors were asked about low sexual desire. 16% of those who used Internet pornography more than once a week reported low sexual desire, compared with 0% in non-consumers.
When has masturbation ever caused a 9-month refractory period in twenty-somethings?
Never. Undaunted by reality, some porn-apologist sexologists assert that unprecedented youthful ED is “just a refractory period” (the brief, natural downtime after ejaculation). Really? Why then are some young men needing months and months without masturbation to porn to recover? Why are they reporting abnormally low attraction for real partners? Why can they get erections to internet porn, but not without it?
Still other sexologists doggedly parrot the outdated assumption that all youthful ED with partners is solely “performance anxiety.” Yet if a young man cannot masturbate without porn in private – but can perform just fine masturbating privately with internet porn, isn’t it a bit premature to conclude his issue is “anxiety about performance?” Is he “anxious when performing” with his own hand?
Where is the scientific evidence to support either of these bald assertions?
Yet another AASECT sexologist writes that to find out what’s really going on he, “would like to see a study where young men watch porn and don’t masturbate.” What can he be thinking? If the goal is to find out what’s really going on, wouldn’t a better study design compare internet porn users with ED to men who have never (or very rarely) used internet porn when masturbating?
Or even better, have young porn users with unexplained ED eliminate porn use for an extended time and monitor the results (compared with porn-using controls). If their ED remits, then porn is the cause. That’s what researchers did in the first few studies on this page. In line with these studies, YBOP has collected thousands self-reports by men who have healed sexual dysfunctions by giving up internet porn.
There is no support whatsoever for the claim that the “real” problem behind unprecedented youthful ED is masturbation rather than online (or VR) porn. Physiologically, how could good ole do-it-yourself pleasuring explain changes in some users’ sexual templates that are so profound that encounters with real partners are no longer arousing? How could they explain the alarmingly long recovery times some young men are reporting?
Stubborn, undesired alterations to biological arousal patterns indicate the presence of alterations to the sexual centers of the brain. Masturbation mechanics alone can’t account for them. Those affected have, in effect, inadvertently re-conditioned their sexuality (retrained their brains) by means of today’s supernormally stimulating streaming (and virtual reality) porn.
In contrast to the “masturbation causes ED” theory, there’s considerable scientific support for the “sexual template altered by supernormally stimulating porn” hypothesis. See the next section, and the list on this page.
What do responsible experts say?
Medical doctors around the world are addressing the reality of porn’s influence, reporting the difficulties their patients are facing, and theorizing about how such grave, unprecedented sexual dysfunctions could develop in men under 40. Consider the following:
In a 2016 paper published in Sexologies psychiatrist Robert Porto, MD, President of the European Federation of Sexology, stated (repeatedly) that masturbation is, “harmless and even helpful.” However, when excessive and accompanied by cyber-pornography use, it “has been seen to play a role in the etiology of certain types of erectile dysfunction or coital anejaculation.” Porto’s study reports on 35 patients with these severe sexual dysfunctions, 19 of whom regained satisfactory sexual activity after extensive treatment. Incidentally, porn users who are not addicted are also at risk for developing porn-related sexual dysfunctions.
Is Internet Pornography Causing Sexual Dysfunctions? A Review with Clinical Reports (2016), a team of doctors, including both urologists and psychiatrists, reviewed extensive scientific literature as well as three case reports. Citing internet porn’s unique properties (limitless novelty, potential for easy escalation to more extreme material, video format, etc.) they proposed that it may be potent enough to condition sexual arousal to aspects of internet porn use that do not readily transition to real-life partners. The doctors suggested further study of key brain changes associated with addition/sexual conditioning using comparisons of viewers with abstaining viewers. (Note: this paper also formally critiques two sexology papers purporting to “debunk” porn-induced ED.)
To date, 100+ studies link porn use to sexual problems, lower arousal to sexual stimuli, and poorer sexual and relationship satisfaction.
In addition to the above studies, this page contains articles and videos by over 130 experts (urology professors, urologists, psychiatrists, psychologists, sexologists, MDs) who acknowledge and have successfully treated porn-induced ED and porn-induced loss of sexual desire.
Below this piece, you can see an excerpt and discussion about a review by a neuroscientist/MD, which demonstrates why “controlling for masturbation” is unnecessary.
Growing evidence suggests that men under 40 with unprecedented, otherwise unexplained ED have conditioned their climaxes to aspects of internet/virtual-reality porn that have little to do with partnered sex. Again, porn characteristics such as effortless escalation to more extreme material during a viewing session, unending novelty, hyper-arousing delivery formats and so forth, are altering some brains’ sexual templates in ways that cause major sexual dysfunctions, and are challenging to reverse.
There’s also growing evidence that heavy porn users show more evidence of “desensitization,” that is blunted sexual responsiveness. In fact, it’s not unusual for those who recover (by leaving digital porn behind) to report that orgasm and sexual activity begin to feel more pleasurable. Before they quit, it’s likely much of their arousal comes from anticipation of using (in response to cues associated with porn use) and seeking sexual novelty – rather than masturbation itself (which many report is easier to quit than porn-viewing). In addicts, dopamine rises higher for cues than it does for actual use. This can drive escalation in digital porn users.
In short, it’s the search for a buzz that drives overuse (and related problems). And that buzz increasingly comes from porn cues and porn-seeking – not from masturbation (in heavy users). This reality reveals the shortsightedness of the suggestion that “whacking it is the problem.”
Enjoy irony?
This current campaign to confuse porn consumers about the underlying cause of their ED is being carried out by pro-porn sexologists, including some trained at the Kinsey Institute. Ironically, it was Kinsey sexologists who first recognized and publicized the phenomena of porn-induced low desire and reduced sexual responsiveness!
In 2007, Kinsey researchers reported that half of subjects recruited from bars and bathhouses, where video pornography was “omnipresent,” were unable to achieve erections in the lab in response to video porn. In talking to the subjects, researchers discovered that high exposure to pornography videos apparently resulted in lower responsivity and an increased need for more extreme, specialized or “kinky” material to become aroused. The researchers even redesigned their study to include more varied clips and permit some self-selection. A quarter of the participants’ genitals still did not respond normally.
The researchers in that study certainly did not suggest that masturbation style or frequency explained the weak erections! They pointed instead to the omnipresent porn and variety – which was uniquely present in the bars where they gathered their subjects even before streaming online porn was widely available. Sadly, and irresponsibly, they chose not to investigate this unsettling, novel phenomenon further.
Were they and their colleagues so firmly persuaded that “sex positivity” requires pro-porn denial of severe sexual dysfunctions like chronic ED and abnormally low desire that they not only refused to research this phenomenon, but now try to mislead us by insisting that bopping the bologna, not porn use, causes sexual dysfunction?
Bottom line: Humanity urgently needs researchers who will use sound science (and neuroscience) to investigate human sexuality and the effects of today’s unique sexual environment. Not propagandists serving up red herrings.
For now, common sense (and the existing solid research) must serve. As a recovery forum member commented:
How are people so unaware of Porn-Induced ED? There are ads for boner pills all over every page of every porn website. The porn company profits on every click you make along the way to breaking your dick (and they KNOW you are breaking your dick, thus all the boner pill ads everywhere) and then they profit off your boner pill clicks as well. It’s rather like Philip Morris, while profiting off of your online cigarette orders, having ads for Chronic Obstructive Pulmonary Disease meds and lung transplants all over the same pages that are selling you the cigarettes, and then profiting again off the clicks you make on behalf of your ruined lungs.
The pro-porn PhD’s who concocted this unsupported talking point
It appears that this meme was created by David Ley and Nicole Prause. In this article Prause comments on a study by medical doctors correlating porn addiction with erectile dysfunction:
Plus, this study hasn’t been peer-reviewed or formally published yet, says Nicole Prause, Ph.D., founder of Liberos, a sex research and biotechnology company in Los Angeles.
And there really is no distinction between whether actual porn is causing sexual dysfunction or if the physical act of masturbation is, she points out.
“People aren’t eating popcorn when they watch porn—they’re masturbating. What that means is, whenever you have a behavior that always occurs with another behavior, you cannot separate the effects of the two,” she explains. “They have no reason to say that the effects they observed are due to porn. They could just as well be due to masturbation. They would have to study that specifically, either in an experiment or statistically remove the effects of masturbation.”
Nicole Prause, by her own admission, vehemently rejects the concept of porn addiction. For example, a quote from a Martin Daubney article about sex/porn addictions:
Dr Nicole Prause, principal investigator at the Sexual Psychophysiology and Affective Neuroscience (Span) Laboratory in Los Angeles, calls herself a “professional debunker” of sex addiction.
In addition, Nicole Prause’s former Twitter slogan reveals that she lacks the impartiality required for scientific research:
“Studying why people choose to engage in sexual behaviors without invoking addiction nonsense“
It should be noted that Nicole Prause offered (for a fee) her “expert” testimony against “sex addiction”.
It seems as though Prause has been selling her services to profit from the claimed anti-porn addiction conclusions of her two EEG studies (1, 2), even though numerous peer-reviewed critiques say both studies support the addiction model (Steele et al., 2013: 1, 2, 3, 4, 5, 6, 7, 8. Prause et al., 2015: 1, 2, 3, 4. 5, 6, 7, 8, 9.).
The fledgling Sexual health Alliance (SHA) advisory board includes David Ley and two other RealYourBrainOnPorn.com “experts” (Justin Lehmiller & Chris Donahue). RealYBOP is a group of openly pro-porn, self-proclaimed “experts” headed by Nicole Prause. This group is currently engaged in illegal trademark infringement and squatting directed toward the legitimate YBOP. Put simply, those trying to silence YBOP are also being paid by the porn industry to promote its/their businesses, and assure users that porn and cam sites cause no problems (note: Nicole Prause has close, public ties to the porn industry as thoroughly documented on this page).
In this article, Ley dismisses his compensated promotion of the porn industry:
Granted, sexual health professionals partnering directly with commercial porn platforms face some potential downsides, particularly for those who’d like to present themselves as completely unbiased. “I fully anticipate [anti-porn advocates] to all scream, ‘Oh, look, see, David Ley is working for porn,’” says Ley, whose name is routinely mentioned with disdain in anti-masturbation communities like NoFap.
But even if his work with Stripchat will undoubtedly provide fodder to anyone eager to write him off as biased or in the pocket of the porn lobby, for Ley, that tradeoff is worth it. “If we want to help [anxious porn consumers], we have to go to them,” he says. “And this is how we do that.”
David J. Ley, Ph.D., is a clinical psychologist and AASECT-certified supervisor of sex therapy, based in Albuquerque, NM. He has provided expert witness and forensic testimony in a number of cases around the United States. Dr. Ley is regarded as an expert in debunking claims of sexual addiction, and has been certified as an expert witness on this topic. He has testified in state and federal courts.
Contact him to obtain his fee schedule and arrange an appointment to discuss your interest.
Ley also profits from selling two books that deny sex and porn addiction (“The Myth of Sex Addiction,” 2012 and “Ethical Porn for Dicks,” 2016). Pornhub (which is owned by porn giant MindGeek) is one of the five back-cover endorsements listed for Ley’s 2016 book about porn:
The above is just the tip of the Prause and Ley iceberg.
Review by neuroscientist/MD demonstrates why “controlling for masturbation” is unnecessary
As the excerpt below explains neurologically,watching porn is the same as having sex – even if you are not masturbating. This debunks 2 major claims by Prause/Ley:
1) That “porn studies must control for masturbation.” No need to ask about masturbation frequency when watching porn is neurologically akin to masturbation.
2) That “watching porn is really a cue for masturbation.” This is the claim that porn viewing is not the addictive behavior in question; masturbation is the addiction. Why does this matter? Prause’s 2015 EEG study “debunking porn addiction” reported slightly lessbrain activation in the frequent porn users when viewing images of vanilla porn. Prause said this was the opposite of the addiction model, claiming that watching porn was a cue for masturbation. (Addicts typically have greater brain response to cues for using – e.g., cocaine addicts seeing white powder will respond with more brain activation relative to healthy controls than they will to actual use.) 6 peer-reviewed papers have disagreed with Prause about her conclusion, saying that viewing porn is the addiction, and that Prause’s frequent porn users were desensitized or habituated to vanilla porn – hence reduced brain activation. They were bored. One study disproved her theory directly: Can pornography be addictive? An fMRI study of men seeking treatment for problematic pornography use.
In the current conceptual framework, where sexual arousal is part of sexual consummation, having sex does not require physical genital contact either with another individual or masturbatory. Take the example of pornography. Thinking about ways to gain access to it, or actively searching for it, and perhaps experiencing desire during the process, is considered sexual wanting. Watching selected pornographic material, even without masturbation, can be considered “having sex” when there is genital arousal. Likewise, when individuals achieve sexual arousal or even orgasm by sheer mental force (with no external physical contact), this also qualifies as “having sex” (Komisaruk and Whipple, 2011).
Steele et al., 2013 spokesperson Nicole Prause conducted several interviews about her July, 2013 EEG study on people complaining of having difficulties controlling their porn use. Commenting under the Psychology Today interview of Nicole Prause, senior psychology professor emeritus John A. Johnson said:
Mustanski asks, “What was the purpose of the study?” And Prause replies, “Our study tested whether people who report such problems [problems with regulating their viewing of online erotica] look like other addicts from their brain responses to sexual images.”
But the study did not compare brain recordings from persons having problems regulating their viewing of online erotica to brain recordings from drug addicts and brain recordings from a non-addict control group, which would have been the obvious way to see if brain responses from the troubled group look more like the brain responses of addicts or non-addicts.
Instead, Prause claims that their within-subject design was a better method, where research subjects serve as their own control group. With this design, they found that the EEG response of their subjects (as a group) to erotic pictures was stronger than their EEG responses to other kinds of pictures. This is shown in the inline waveform graph (although for some reason the graph differs considerably from the actual graph in the published article).
So this group who reports having trouble regulating their viewing of online erotica has a stronger EEG response to erotic pictures than other kinds of pictures. Do addicts show a similarly strong EEG response when presented with their drug of choice? We don’t know. Do normal, non-addicts show a response as strong as the troubled group to erotica? Again, we do not know. We don’t know whether this EEG pattern is more similar to the brain patterns of addicts or non-addicts.
The Prause research team claims to be able to demonstrate whether the elevated EEG response of their subjects to erotica is an addictive brain response or just a high-libido brain response by correlating a set of questionnaire scores with individual differences in EEG response. But explaining differences in EEG response is a different question from exploring whether the overall group’s response looks addictive or not. The Prause group reported that the only statistically significant correlation with the EEG response was a negative correlation (r=-.33) with desire for sex with a partner. In other words, there was a slight tendency for subjects with strong EEG responses to erotica to have lower desire for sex with a partner. How does that say anything about whether the brain responses of people who have trouble regulating their viewing of erotica are similar to addicts or non-addicts with a high libido?
Two months later Johnson published this psychology Today blog post which he posted about under Prause’s interview.
My mind still boggles at the Prause claim that her subjects’ brains did not respond to sexual images like drug addicts’ brains respond to their drug, given that she reports
higher P300 readings for the sexual images. Just like addicts who show P300 spikes when presented with their drug of choice.
How could she draw a conclusion that is the opposite of the actual results? I think it could be do to her preconceptions–what she expected to find. I wrote about this elsewhere.
http://www.psychologytoday.com/blog/cui-bono/201308/preconceptions-may-color-conclusions-about-sex-addiction
When I first conceived this blog post and began to compose it about a month ago, my original intention was to describe in exquisite detail the specific ways in which I saw the proponents of opposite sides of the debate exaggerating or overextending their arguments beyond the actual data in the study. I subsequently changed my mind when I observed a firestorm of emotionally-charged rhetoric erupting among the debate participants. Not arguments about what the data logically implied, but ad hominem threats, including threats of legal action. I saw a PT blog post disappear, apparently because one of the parties demanded that it be taken down. I even received a couple of angry emails myself because one of the parties had heard that I had raised questions about the proper interpretation of the research in question in a scientific forum.
So, I have decided to quietly tip-toe out of the room. I have also decided to go ahead and post here what I had already composed a month ago, simply to present an example of my empirical claim that science is not a purely objective enterprise, and that actual scientists can become very personally and emotionally involved in their work. The controversy in question is also an excellent example of a common trend among U.S. researchers to overestimate soft-science results.
It seems to me that passion is a double-edged sword. On the good side, passion for a subject means the person is willing to invest a lot of time and energy on that subject. Why would someone study something unless he or she had a passion for it?
On the other hand, if the passionate person already has his/her mind made up, all of that passionate energy is going to be directed toward one possibility, right or wrong. And when wrong, passion leads to blindness to the truth.
I am likely to stay out of these debates and let the empirical researchers decide.
Submitted by Anonymous on November 2, 2013 – 6:26pm
As you mention, this debate since rife with agendas. However, linking a science debate to some random dude trying to sell books? How is this an improvement? I also think you missed the point of the study…all people show the pattern. This group (1) looks exactly like everyone else, and (2) just to be sure, the brain measure wasn’t related to any measure of hypersexuality (though it was to desire for sex with a partner). I’m not sure why it wasn’t related to desire to masturbate too, although the authors administered the whole scale and do talk about why that might be.
If the point of the study was to show that “all people” (not just alleged sex addicts) show a spike in P300 amplitude when viewing sexual images, you are correct–I do not get the point, because the study employed only alleged sex addicts. If the study *had* employed a non-addict comparison group and found that they also showed the P300 spike, then the researchers would have had a case for their claim that the brains of so-called sex addicts react that same as non-addicts, so maybe there is no difference between alleged addicts and non-addicts. Instead, the study showed that the self-described addicts showed the P300 spike in response to their self-described addictive “substance” (sexual images), just like cocaine addicts show a P300 spike when presented with cocaine, alcoholics show a P300 spike when presented with alcohol, etc.
As for what the correlations between P300 amplitude and other scores show, the only significant correlation was a *negative* correlation with desire for sex with a partner. In other words, the stronger the brain response to the sexual image, the *less* desire the person had for sex with a real person. This sounds to me like the profile of someone who is so fixated on images that s/he has trouble connecting sexually with people in real life. I would say that this person has a problem. Whether we want to call this problem an “addiction” is still arguable. But I do not see how this finding demonstrates the *lack* of addiction in this sample.
To my knowledge, my post did not contain links to a random dude trying to sell books. The Porn Study Critiques site contains contributions by a number of individuals interested in the debate, and I invited readers to judge for themselves which arguments might have merit. I did not notice any book advertisements on that site.
Submitted by Anonymous on November 3, 2013 – 8:37pm
Okay, I’m going to be optimistic and assume neither the author of this PT post nor the authors of the research article are intentionally biased. On the one hand, that change (sexual pics having the highest change) I would estimate has been replicated by at least 100 laboratories in controls. It’s extremely stable. Also, controls are exactly people who are on the low/absent end of the construct of interest. The regressions (not correlations) conducted, could be critiqued for not having the low end well-represented, but the range of the construct appears represented. Finally, we don’t know that a control wasn’t collected. Science is slow. It could be coming before you throw the scientist out with the biohazard (ha!)
That said, there are many questions this study raises:
1. How would a person with other sexual problems respond?
2. What will change with different kinds of pictures?
3. What about films?
The bigger question, though, is…why did it take so long to get a study like this done in the first place? Really, both the pro and con crowd should be embarrassed by the poor level of science in this area.
There are actual scientists blogging about this topic if you need better links. This is a blogger who appears to have no credentials and made many mistakes in their “review”. I’ll even give you the pro-addiction science links. PT shouldn’t be relying on crappy reviews like that. Perhaps it was meant to be a commentary on bias that the PT author chose only a pro-addiction link only from a non-scientist blogger?
I may have biases on this topic, but if I do, I am not aware of them, and I certainly am not intentionally trying to skew the debate one way or another. So you are right to assume that any bias in my writing is not intentional. Whether the authors of the study are intentionally biased, I cannot say. I do suspect that they wanted their study to demonstrate that the neural responses of alleged sex addicts are indistinguishable from the responses of non-addicts in order to discredit the concept of sex addiction. They certainly were willing to report in the popular media that their study cast grave doubt on the concept of sex addiction. But of course without a control group of non-addicts to show that neural responses between the two groups are indistinguishable, the claim of discrediting the concept of sex addiction is premature.
You say we don’t know if a control group was run. In response to this question in a scientific forum, the researchers said they did not have a control group because none was needed, that their subjects served as their own control in their within-subjects design. I found that response unintelligible because the only comparisons made with their within-subjects design were the P300 responses to the different types of photographic stimuli. This demonstrated that the P300 spike was higher for the erotic images was higher than for the other images. But whether the relative magnitude is similar to or different from self-described non-addicts, we don’t know. If there are findings from hundreds of laboratories on this one, the authors could have made that comparison. But they didn’t.
If the researchers had included self-described non-addicts in their study, the statistically significant negative correlation between P300 amplitude and desire for sex with a partner could have been even stronger than the coefficient they reported. The correlation they found was probably reduced due to restriction of range in P300 amplitude. So they did themselves a disservice by not including a more diverse sample that included people who did not report problems regulating their online viewing of erotica.
I use the terms regression and correlation interchangeably. Whether one conducts a simple bivariate regression or one of the forms of multiple regression, it’s all a version of the general linear model. We abbreviate the Pearson correlation coefficient with the small letter r, which stands for regression. Let’s not get side-tracked on irrelevancies.
Because I do not have a stake in the sex addiction debate, I don’t want to pick only on this anti-addiction research study and not the pro-addiction critics of the study. The blog to which I linked contains reviews which are certainly biased in their own way, although again I do not want to speculate on whether the bias is intentional or not. I was asked by the author of one of the reviews on this site to look at his critique before it was published, so I did, and I described what I thought was correct and incorrect in the critique. He followed some, but not all, of my suggestions for revising his critique. So, yes, there are mistakes in the review because not all of my suggestions were followed. I pointed to this blog merely as a starting place for the issues that are being debated. If you could provide links to higher-quality commentary (either pro-addiction or anti-addiction), that would be a great service to those in the audience who are interested in the concept of sex addiction.
As I said, my major interest is in the psychological factors that affect the conduct and interpretation of scientific research, more than the concept of sex addiction per se. Perhaps it was easier for me to point to the site of a true believer in the concept of sex addiction to illustrate possible psychological factors affecting the interpretation of research than to a more staid, neutral site maintained by professional sex researchers. If there is such an allegedly non-biased site (pro- or anti-addiction), I’d love to get the URL to see for myself whether it is indeed unbiased. Finding a non-biased discussion of sex addiction would be a first for me.
Indeed. Sounds to me like the author perhaps ought to have paid greater heed to your feedback, prior to publishing.
Hate to point out what is so painfully obvious here, buuuut, it can be safely said that if the major debate surrounding one’s publishing is it’s validity, rather than it’s content, there is a definite problem.
Yes, if the problem is not obvious, it should be. This problem is not unique, though, to this particular topic. It runs rampant in academic psychology.
Psychologists get so much training in critical thinking, by which I mean looking for flaws in research studies and generating alternative interpretations of results, that most of us have developed hypertrophy of our critical function and atrophy of our constructive, creative function. Psychologists will endlessly pick at flaws in the methodology of studies that do not support the content they already believe. This an indication of a problem with the discipline of psychology as a whole. No study is absolutely methodologically perfect, even published studies that have undergone thorough review. It’s one thing to be able to find flaws in studies that draw conclusions you don’t like; it is another to design and conduct a study the produces unequivocal support for an alternative view.
Submitted by Anonymous on November 6, 2013 – 6:58pm
Eh, not to get sidetracked but “We abbreviate the Pearson correlation coefficient with the small letter r, which stands for regression” definitely not. Regression locates the error differently than correlation. You can easily tell who actually read the study reviewed…if they say “correlation” they did not know what was done statistically (guy in your link made the same mistake). Don’t be that guy!
Anyway, I didn’t find a ton of scientific bloggers talking about this issue, but there were some really nice, more balanced reviews you could reference:
Other PT blogger and academic addictions guy:
http://www.psychologytoday.com/blog/addiction-in-society/201307/the-apocryphal-debate-about-sex-addiction
From the main guy trying to get hypersexuality into the DSM:
http://www.rory.net/pages/prausecritque.html
A guy who publishes on addiction, though not about this study:
http://www.sexologytoday.org/2012/03/steve-mcqueens-shame-valid-portrayal-of.html
Sure beats a random massage therapist in Oregon for their ability to more evenly critique. I don’t agree with all these either, of course, but that’s the point. These at least highlight the good and the bad, whereas the critique cited is actually factually false (e.g., the SNP authors collected and reported the entire SDI scale). It’s always better not to promote patently false information!
Let me quote from the study, which I actually did read prior to writing my post. From http://www.socioaffectiveneuroscipsychol.net/index.php/snp/article/view/20770/28995:
“Pearson’s correlations were calculated among the mean amplitudes measured in the P300 window and the self-report questionnaire data. The only correlation reaching significance was the difference score calculated between neutral and pleasant–sexual conditions in the P300 window with the desire for sex with a partner measure, r(52) = − 0.332, p =0.016.”
Yes, the researchers also conducted some multiple regression analyses, but you can see from the above quote that they computed Pearson correlation coefficients.
Furthermore, I maintain that regression and correlation are not two different things. I am aware that some people say that the correlation coefficient, r, is “merely” a quantitative index of the strength of the linear relationship between x and y, whereas regression refers to estimating either x or y in terms of the best-fitting line, either y’ = bx + a or x’ = by + a. But if we regress y on x, the optimal value for the slope, b, is r * Sy/Sx. Pick up any textbook on psychological statistics (e.g., Quinn McNemar) and read its discussion of correlation and regression.
Thank you for adding the additional references. I was familiar with Peele’s position (Stanton Peele is indeed a legitimate expert on the topic), and I had read Rory Reid’s piece, but not the James Cantor post (although I am familiar with and respect his thinking). These additional references are a service to those who want more information.
Submitted by Anonymous on November 6, 2013 – 11:15pm
“To directly assess the relationship between condition amplitude differences in the P300, two-step hierarchical regressions were calculated.”
I’m frequently statistical consultant, and you’re embarrassing yourself. The errors term is different between regression and correlation…they are, in fact “two different things”. How on earth are you employed in a psych dept? At least stay away from my students!
I am not sure why you provided the quote from the study, “two-step hierarchical regressions were calculated,” when I already acknowledge that the researchers’ analyses included both multiple regression and the computation of Pearson correlations.
As I said, “Yes, the researchers also conducted some multiple regression analyses, but you can see from the above quote that they computed Pearson correlation coefficients.”
The reason that I pulled out the quote, “Pearson’s correlations were calculated . . . ” was because you implied that I and the critic did not read the study. You said, “You can easily tell who actually read the study reviewed…if they say ‘correlation’ they did not know what was done statistically (guy in your link made the same mistake).”
If you want to maintain that regression and correlation are two different things, be my guest. I have no idea who your students are because you are anonymous. Even if I did, I would not bother them. I am not embarrassed about my career as a psychologist; I hope that you find your career satisfying.
Much has transpired since July, 2013.
UPDATE: Seven peer-reviewed analysis of Steele et al., 2013 align with the following critique. Paper #1 is solely devoted to Steele et al. Papers 2-7 contain sections analyzing Steele et al.
Update 3: In this 2018 presentation Gary Wilson exposes the truth behind 5 questionable and misleading studies, including this study (Steele et al., 2013): Porn Research: Fact or Fiction?
Nicole Prause touts yet another of her letters to the editor as “debunking” the existence of sex addiction and porn addiction (“Compulsive sexual behaviour disorder” in the upcoming ICD-11). Yet it does not. This 240-word opinion piece (Prause et al., 2017) cites zero studies to support its claims, providing only a single, easily refuted sentence as its sole “evidence” countering the addiction model.
This Prause-penned letter in Lancet, signed by four allies (Erick Janssen, Janniko Georgiadis, Peter Finn and James Pfaus), was a reply to another short letter: Is excessive sexual behaviour an addictive disorder? (Potenza et. al., 2017), authored by Marc Potenza, Mateusz Gola, Valerie Voon, Ariel Kor and Shane Kraus. (Both are reproduced below in full.)
Incidentally, three of Prause’s four co-signers in Lancet also lent their names to her earlier 2016 Salt Lake Tribune Op-Ed attacking Fight The New Drug and its position on internet porn. That Salt Lake Tribune 600-word Op-Ed was chock full of unsupported assertions calculated to mislead the lay public. And its authors, Prause and friends, failed to support a single claim. The Op-Ed cited only 4 papers – none of which had anything to do with porn addiction, porn’s effects on relationships, or porn-induced sexual problems. Several experts responded with this dismantling of the Prause Op-Ed: Op-Ed: Who exactly is misrepresenting the science on pornography? (2016). Unlike the “neuroscientists” of the initial Op-Ed, the response authors cited several hundred studies and multiple reviews of the literature that supported their statements.
The one PhD in the Lancet effort who is missing from the Salt Lake Tribune Op-Ed (Peter Finn) happened to co-author a 2014 propaganda piece with Prause and David Ley (the author of The Myth of Sex Addiction), entitled The Emperor Has No Clothes: A Review of the ‘Pornography Addiction’ Model (2014). The paper was not a genuine review, and, difficult as it may be to believe, virtually nothing in the Ley/Prause/Finn paper is accurate or supported by the citations within the paper. The following is a very long analysis of the paper which goes line-by-line, citation by citation, exposing the many shenanigans Ley/Prause/Finn incorporated in their “review”: The Emperor Has No Clothes: A Fractured Fairytale Posing As A Review. Its most remarkable aspect is that it omitted any study that either reported negative effects related to porn use or found porn addiction – and yet labelled itself a “review!”
Turning to Prause’s Lancet effort, we should mention that not one of the five Prause et al., 2017 signers has ever published a study involving verified “porn or sex addicts.” Moreover, some who signed Prause’s Lancet letter have histories of feverishly attacking the concept of porn and sex addiction (thus demonstrating stark bias). In contrast, each of the five Potenza et al. 2017 co-authors (who wrote the first letter on this subject in Lancet) has published multiple studies involving subjects with compulsive sexual behavior disorder (including landmark brain studies on porn users and sex addicts).
In their Comment in The Lancet Psychiatry, John B Saunders and colleagues1aptly described current debates regarding the consideration and classification of gambling and gaming disorders as addictive disorders, which occurred during the generation of DSM-52 and in anticipation of ICD-11.3 Compulsive sexual behaviour disorder is being proposed as an impulse-control disorder for ICD-11.3 However, we believe the logic applied by Saunders and colleagues1 might also apply to compulsive sexual behaviour disorder. Compulsive sexual behaviour disorder (operationalised as hypersexual disorder) was considered for inclusion in DSM-5 but ultimately excluded, despite the generation of formal criteria and field trial testing.2 This exclusion has hindered prevention, research, and treatment efforts, and left clinicians without a formal diagnosis for compulsive sexual behaviour disorder.
Research into the neurobiology of compulsive sexual behaviour disorder has generated findings relating to attentional biases, incentive salience attributions, and brain-based cue reactivity that suggest substantial similarities with addictions.4 Compulsive sexual behaviour disorder is being proposed as an impulse-control disorder in ICD-11, consistent with a proposed view that craving, continued engagement despite adverse consequences, compulsive engagement, and diminished control represent core features of impulse-control disorders.5 This view might have been appropriate for some DSM-IV impulse-control disorders, specifically pathological gambling. However, these elements have long been considered central to addictions, and in the transition from DSM-IV to DSM-5, the category of Impulse Control Disorders Not Elsewhere Classified was restructured, with pathological gambling renamed and reclassified as an addictive disorder.2 At present, the ICD-11 beta draft site lists the impulse-control disorders, and includes compulsive sexual behaviour disorder, pyromania, kleptomania, and intermittent explosive disorder.3
There are both pros and cons regarding the classification of compulsive sexual behaviour disorder as an impulse-control disorder. On one hand, inclusion of compulsive sexual behaviour disorder in ICD-11 could improve consistency in diagnosis, treatment, and study of individuals with this disorder. On the other hand, classification of compulsive sexual behaviour disorder as an impulse-control disorder as opposed to an addictive disorder might negatively influence treatment and study by limiting treatment availability, treatment training, and research efforts. Compulsive sexual behaviour disorder seems to fit well with non-substance addictive disorders proposed for ICD-11, consistent with the narrower term of sex addiction currently proposed for compulsive sexual behaviour disorder on the ICD-11 draft website.3 We believe that classification of compulsive sexual behaviour disorder as an addictive disorder is consistent with recent data and might benefit clinicians, researchers, and individuals suffering from and personally affected by this disorder.
American Psychiatric Association. Diagnostic and statistical manual of mental disorders (DSM-5). American Psychiatric Association Publishing, Arlington; 2013. Google Scholar
Marc Potenza and colleagues1 advocated classifying “excessive sexual behaviour” as an addictive disorder in ICD-11. Sex has components of liking and wanting that share neural systems with many other motivated behaviours.2However, experimental studies do not support key elements of addiction such as escalation of use, difficulty regulating urges, negative effects, reward deficiency syndrome, withdrawal syndrome with cessation, tolerance, or enhanced late positive potentials. A key neurobiological feature of addiction is the increased responsiveness of glutamate neurons that synapse on the nucleus accumbens. These changes might affect long-term sensitisation of the mesocorticolimbic dopamine pathway, as manifested by a range of symptoms including cue-induced craving and compulsive drug use. 3To date, research on the effects of sex on glutamate function and its modulation of dopamine pathways is scarce.
Sex is a primary reward, with unique peripheral representation. Engagement in sex is positively associated with health and life satisfaction. Sex does not allow for supraphysiological stimulation. Research in this area has yet to investigate actual partnered sexual behaviours. Experimental work has been limited to sexual cues, or secondary rewards, using images. More research is needed, but data concerning frequent or excessive sex do not support its inclusion as an addiction. Also, data are not sufficient to differentiate between compulsive and impulsive models. Many other approaches exist, including well-supported non-pathological models.4 Potenza and colleagues5also stated that addiction criteria were not met for sexual behaviours: we agree with this earlier conclusion.
References:
Is excessive sexual behaviour an addictive disorder? Lancet Psychiatry.2017; 4: 663-664PubMed
Sex for fun: a synthesis of human and animal neurobiology. Nat Rev Urol.2012; 9: 486-498PubMed
Drug addiction as a pathology of staged neuroplasticity. Neuropsychopharmacology.2008; 33: 166-180PubMed
Hypersexuality: a critical review and introduction to the “sexhavior cycle”. Arch Sex Behav.2017; DOI:10.1007/s10508-017-0991-8<
Should compulsive sexual behavior be considered an addiction? Addiction.2016; 111: 2097-2106PubMed
Debunking the solitary sentence containing everything Prause et al. 2017 had to offer
Prause’s Lancet effort contains only a single sentence (and no supporting citations) to counter the Potenza et al. commentary. (In support of Potenza et al., consider these 20 commentaries/reviews asserting that CSBD should be categorized under the “addictive behaviors” category in WHO’s new ICD-11.) Prause et al. provides seven so-called “key elements of addiction” its authors claim studies have yet to find in porn or sex addicts:
PRAUSE ET AL: However, experimental studies do not support key elements of addiction such as escalation of use, difficulty regulating urges, negative effects, reward deficiency syndrome, withdrawal syndrome with cessation, tolerance, or enhanced late positive potentials.
Reality check:
Three of Prause’s seven items are not really accepted as “key elements of addiction”: Reward deficiency syndrome, enhanced late positive potentials, and withdrawal. In fact, however, studies have reported both withdrawal and reward deficiency syndrome in porn user and sex addicts. Her other purported key element of addiction (“enhanced late positive potentials”) has only been assessed in a widely criticized Nicole Prause EEG study. Seven peer-reviewed papers agree that Prause’s finding of lower EEG readings (lower late positive potentials) actually means that frequent porn users were bored by vanilla porn (an indication of possible addiction). In fact, these formal analyses of Prause’s paper agree that she found desensitization/habituation in frequent porn users (consistent with the addiction model): 1, 2, 3, 4, 5, 6, 7, 8.
Thus, contrary to Prause’s claims, six of the seven so-called “elements of addiction” have been identified in studies on porn users and/or sex addicts – and the seventh rests solely on her own dubious claim (that it is “key”) and her own disputed analysis.
Readers need to ask themselves why Prause et al. would attempt to mislead them.
Before we provide empirical support for the “key elements of addiction” that Prause et al. claimed were absent, let’s briefly examine what addiction experts believe are actually the key elements of addiction:
Studies reporting sensitization in porn users/sex addicts: 1,2,3,4, 5,6,7,8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22. Assessed through cue-reactivity brain studies or strong cravings to use.
Studies reporting desensitization or habituation in porn users/sex addicts: 1,2, 3, 4, 5, 6. Manifests as decreased reward sensitivity (less pleasure), habituation to porn (lower brain activation), tolerance (escalation to new genres).
Studies reporting poorer executive functioning (hypofrontality) or altered prefrontal activity in porn users/sex addicts: 1,2, 3,4,5, 6, 7, 8, 9, 10, 11, 12, 13, 14. Manifests as weakened willpower, cravings, inability to control use, poor decision making.
Studies indicating a dysfunctional stress system in porn users/sex addicts: 1, 2, 3. Manifests as even minor stress leading to cravings and relapse because it activates powerful sensitized pathways. In addition, quitting an addiction activates the brain’s stress systems leading to many of the withdrawal symptoms common to all addictions, such as anxiety, irritability and mood swings.
As we can see Prause et al., 2017, cherry-picked and misrepresented key elements of addiction to produce a “official” letter to link to on social media and to email journalists.
Empirical support for the “key elements of addiction” that Prause et al. claimed were absent
In this section we provide empirical support for the “key elements of addiction” that Prause falsely asserted were absent.
PRAUSE ET AL: However, experimental studies do not support key elements of addiction such as escalation of use, difficulty regulating urges, negative effects, reward deficiency syndrome, withdrawal syndrome with cessation, tolerance, or enhanced late positive potentials.
1) “escalation of use” and “tolerance”
Prause et al. incorrectly lists “tolerance” and “escalation of use” as separate elements of addiction. Tolerance, which is the need for greater stimulation in order to achieve the same level of arousal is also called habituation (less and less response to a drug or a stimulus). With drug abusers tolerance/habituation manifests as needing higher doses to achieve the same high. This is escalation of use. With porn users, tolerance/habituation leads to boredom with current genre or type of porn: greater stimulation is often achieved by escalating to new or more extreme genres of porn.
Forty-nine percent mentioned at least sometimes searching for sexual content or being involved in OSAs that were not previously interesting to them or that they considered disgusting.
“The Dual Control Model: The Role Of Sexual Inhibition & Excitation In Sexual Arousal And Behavior,” 2007. Indiana University Press, Editor: Erick Janssen, pp.197-222. In an experiment employing video porn (of the type used in previous experiments), 50% of the young men couldn’t become aroused or achieve erections with porn (average age was 29). The shocked researchers discovered that the men’s erectile dysfunction was,
related to high levels of exposure to and experience with sexually explicit materials.
The men experiencing erectile dysfunction had spent a considerable amount of time in bars and bathhouses where porn was “omnipresent,” and “continuously playing.” The researchers stated:
Conversations with the subjects reinforced our idea that in some of them a high exposure to erotica seemed to have resulted in a lower responsivity to “vanilla sex” erotica and an increased need for novelty and variation, in some cases combined with a need for very specific types of stimuli in order to get aroused.
How about a brain scan study? “Brain Structure and Functional Connectivity Associated With Pornography Consumption: The Brain on Porn” (Kühn & Gallinat, 2014). This Max Planck Institute fMRI study found less grey matter in the reward system (dorsal striatum) correlating with the amount of porn consumed. It also found that more porn use correlated with less reward circuit activation while briefly viewing sexual photos. Researchers hypothesized that their findings indicated desensitization, and possibly tolerance, which is the need for greater stimulation to achieve the same level of arousal. Lead author Simone Kühn said the following about her study:
This could mean that regular consumption of pornography dulls the reward system. … We therefore assume that subjects with high pornography consumption require ever stronger stimuli to reach the same reward level …. This is consistent with the findings on the functional connectivity of the striatum to other brain areas: high pornography consumption was found to be associated with diminished communication between the reward area and the prefrontal cortex.
Online explicit stimuli are vast and expanding, and this feature may promote escalation of use in some individuals. For instance, healthy males viewing repeatedly the same explicit film have been found to habituate to the stimulus and find the explicit stimulus as progressively less sexually arousing, less appetitive and less absorbing (Koukounas and Over, 2000). … We show experimentally what is observed clinically that Compulsive Sexual Behavior is characterized by novelty-seeking, conditioning and habituation to sexual stimuli in males.
This same habituation effect occurs in healthy males who are repeatedly shown the same porn video. But when they then view a new video, the level of interest and arousal goes back to the original level. This implies that, to prevent habituation, the sex addict would need to seek out a constant supply of new images. In other words, habituation could drive the search for novel images.
“Our findings are particularly relevant in the context of online pornography,” adds Dr Voon. “It’s not clear what triggers sex addiction in the first place and it is likely that some people are more pre-disposed to the addiction than others, but the seemingly endless supply of novel sexual images available online helps feed their addiction, making it more and more difficult to escape.”
In reality, the findings of Prause et al. 2015 align perfectly with Kühn & Gallinat (2014), which found that more porn use correlated with less brain activation in response to pictures of vanilla porn. The Prause et al. findings also align with Banca et al. 2015, which reported that lower EEG readings meant that subjects were paying less attention to the pictures than controls. Put simply, frequent porn users were desensitized to static images of vanilla porn. They were bored (habituated or desensitized). See this extensive YBOP critique. Eight peer-reviewed papers agree that Prause et al. 2015 actually found desensitization/habituation in frequent porn users (consistent with addiction): 1, 2, 3, 4, 5, 6, 7, 8.
A study that reported both tolerance and withdrawal (two items Prause’s Lancet piece falsely claimed that no study had assessed): “The Development of the Problematic Pornography Consumption Scale (PPCS)” (2017) – This paper developed and tested a problematic porn use questionnaire that was modeled after substance addiction questionnaires. This 18-item questionnaire assessed tolerance and withdrawal with the following 6 questions:
———-
Each question was scored from one to seven on a Likert scale: 1- Never, 2- Rarely, 3- Occasionally, 4- Sometimes, 5- Often, 6- Very Often, 7- All the Time. The graph below grouped porn users into 3 categories based on their total scores: “Nonproblematic,” “Low risk,” and “At risk.” Results below show that many porn users experience both tolerance and withdrawal
Put simply, this study actually asked about escalation (tolerance) and withdrawal – and both are reported by some porn users.
I could provide 20 more studies reporting or suggesting habituation to “regular porn” along with escalation into more extreme and unusual genres, but Prause et al. is already exposed for what it is – propaganda masquerading as a scholarly letter to the editor
2) “negative effects”
Since hundreds of studies have linked porn/sex addiction and porn use to myriad negative effects, Prause’s Lancet claim that no study has reported negative effects exposes the letter as a scam.
This preposterous claim is debunked by the hundreds of studies examining assessing compulsive sexual behaviour, most of which employed one or more of the following porn/sex addiction instruments. The core element of an addiction is “continued use despite severe negative consequences.” That’s why following questionnaires all asked about negative effects related to CSB (links are to Google scholar studies):
A total of 109 publications that contained 135 studies were reviewed. The findings provided consistent evidence that both laboratory exposure and regular, everyday exposure to this content are directly associated with a range of consequences, including higher levels of body dissatisfaction, greater self-objectification, greater support of sexist beliefs and of adversarial sexual beliefs, and greater tolerance of sexual violence toward women. Moreover, experimental exposure to this content leads both women and men to have a diminished view of women’s competence, morality, and humanity.
22 studies from 7 different countries were analyzed. Consumption was associated with sexual aggression in the United States and internationally, among males and females, and in cross-sectional and longitudinal studies. Associations were stronger for verbal than physical sexual aggression, although both were significant. The general pattern of results suggested that violent content may be an exacerbating factor.
Collectively, these studies suggest that youth who consume pornography may develop unrealistic sexual values and beliefs. Among the findings, higher levels of permissive sexual attitudes, sexual preoccupation, and earlier sexual experimentation have been correlated with more frequent consumption of pornography…. Nevertheless, consistent findings have emerged linking adolescent use of pornography that depicts violence with increased degrees of sexually aggressive behavior. The literature does indicate some correlation between adolescents’ use of pornography and self-concept. Girls report feeling physically inferior to the women they view in pornographic material, while boys fear they may not be as virile or able to perform as the men in these media. Adolescents also report that their use of pornography decreased as their self-confidence and social development increase. Additionally, research suggests that adolescents who use pornography, especially that found on the Internet, have lower degrees of social integration, increases in conduct problems, higher levels of delinquent behavior, higher incidence of depressive symptoms, and decreased emotional bonding with caregivers.
3) “difficulty regulating urges”
The claim that no study has assessed “difficultly regulating urges” is as untrue as the preceding claim concerning negative effects. The many porn and sex addiction questionnaires listed under #2 assessed whether subjects had trouble controlling their porn use or sexual behaviors. Once again, “inability to control use, despite negative consequences” is a hallmark of an addiction process – and is assessed by standard questionnaires. We provide a few examples from the above list of porn/sex addiction instruments.
No need to fill up this section with CSB questionnaires. You get the idea – Prause et al’s claim that no study has ever assessed “inability to control use” is nonsense and an affront to the Lancet journal that published their letter.
4) “reward deficiency syndrome”
As mentioned above “Reward Deficiency Syndrome” (RDS) is not a universally agreed upon element of addiction. Prause et al. tossed RDS into their list to give the false impression that it was a key element addiction that had yet to be assessed. Although there is not a scholarly consensus about RDS, it has been assessed (more below).
As conceived by researcher Kenneth Blum, “Reward Deficiency Syndrome” is described as genetically-induced low dopamine signalling, probably arising from a deficiency in dopamine receptors. According to Blum’s hypothesis, RDS manifests as feeling less pleasure (anhedonia) than people with so-called normal dopamine functioning. Moreover, those with RDS with be more likely compensate for low dopamine (less pleasure) by over-consuming natural rewards (junk food, gambling sex) and addictive drugs, and thus run a higher chance of becoming addicts.
Despite its appeal, there are some serious problems with the RDS model. I’ll name just two. We know from dozens of studies that drug or alcohol use itself leads to a reduction in dopamine receptor density, or at least dopamine receptor activation, because those receptors tend to burn out or become desensitized when we keep bombarding them with fun stuff.
In other words, RDS isn’t always genetic, as it can be caused by the addiction process itself. When addiction causes lower dopamine signaling, or a decline in reward sensitivity, its called desensitization. As explained earlier, desensitization leads to tolerance, which is a need for greater an greater stimulation to achieve the same high or arousal state. Contrary to Prause’s vague assertions about RDS, six neuroscience-based studies have reported findings consistent with desensitization or habituation: 1,2, 3, 4, 5, 6. If we also consider the many habituation and escalation studies listed above, 30 more arguably fall under “desensitization” or “decreased reward sensitivity.”.
The prevailing theory of addiction – the incentive-sensitization model and the evidence supporting it – were completely ignored by Prause et al. The neurological changes caused by sensitization manifest as increased “wanting” or craving while liking or pleasure diminishes. As Potenza et al pointed out, many CSB studies have reported findings consistent with the incentive sensitization model:
Research into the neurobiology of compulsive sexual behaviour disorder has generated findings relating to attentional biases, incentive salience attributions, and brain-based cue reactivity that suggest substantial similarities with addictions.
All the above can be considered support for the incentive-sensitization model of addiction. The CSB studies aligning with this model: 1,2,3,4, 5,6,7,8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22.
5) “withdrawal syndrome with cessation”
The fact is, withdrawal symptoms are not required to diagnose an addiction. First, you will find the language “neither tolerance nor withdrawal is necessary or sufficient for a diagnosis…” in both the DSM-IV-TR and DSM-5. Second, the oft-repeated sexology claim that “real” addictions cause severe, life-threatening withdrawal symptoms mistakenly conflates physiological dependence with addiction-related brain changes. An excerpt from this 2015 review of literature provides a technical explanation (Neuroscience of Internet Pornography Addiction: A Review and Update):
A key point of this stage is that withdrawal is not about the physiological effects from a specific substance. Rather, this model measures withdrawal via a negative affect resulting from the above process. Aversive emotions such as anxiety, depression, dysphoria, and irritability are indicators of withdrawal in this model of addiction [43,45]. Researchers opposed to the idea of behaviors being addictive often overlook or misunderstand this critical distinction, confusing withdrawal with detoxification [46,47].
In claiming that withdrawal symptoms must be present to diagnosis an addiction Prause et al. makes the rookie mistake of confusing physical dependency with addiction. These terms are not synonymous (Pfaus made this same error in a 2016 article that YBOP critiqued: YBOP response to Jim Pfaus’s “Trust a scientist: sex addiction is a myth” January, 2016)
That said, internet porn research and numerous self-reports demonstrate that some porn users experience withdrawal and/or tolerance – which are also often characteristic of physical dependency. In fact, ex-porn users regularly report surprisingly severe withdrawal symptoms, which are reminiscent of drug withdrawals: insomnia, anxiety, irritability, mood swings, headaches, restlessness, poor concentration, fatigue, depression, and social paralysis, as well as the sudden loss of libido that guys call the ‘flatline’ (apparently unique to porn withdrawal). Another sign of physical dependency reported by porn users is inability to get an erection or to have an orgasm without using porn.
As for studies, only three have directly asked porn users/sex addicts about withdrawal symptoms. All 3 reported withdrawal symptoms: 1, 2, 3. Two of the studies are described below.
First let’s reconsider the study described in the tolerance/escalation section above, the goal of which was to develop and test a problematic porn use questionnaire. Note that substantial evidence of both “tolerance” and “withdrawal” was found in at-risk users and low-risk users.
The reason Prause’s Lancet letter listed “enhanced late positive potentials” is because she and her team had found lower late positive potentials in her 2015 study – Prause et al., 2015.
EEGs measure electrical activity, or brain waves, on the scalp. “Enhanced late positive potentials” are EEG readings measured immediately after an image seen by the subject. This is but one of many spikes in electrical activity assessed by an EEG, and very much up for interpretation.
What is agreed upon is that lower EEG readings in Prause’s frequent porn users meant they paid less attention to the photos of vanilla porn than the subjects who used less porn. The former were simply bored. Undeterred, Prause boldly claimed “This pattern appears different from substance addiction models.”
But Prause’s finding of lower brain activation for the more frequent porn users actually aligns with the addiction model: it indicates desensitization (habituation) and tolerance, which is the need for greater stimulation to achieve arousal. Seven peer-reviewed papers agree that Prause et al., 2015 actually found desensitization/habituation (a sign of addiction):
Even if Prause were correct that her subjects had less “cue-reactivity,” rather than habituation, she conveniently ignores the gaping hole in her “falsification” assertion: 21 other neurological studies have reported cue-reactivity or cravings (incentive sensitization) in compulsive porn users: 1,2,3,4, 5,6,7,8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22. Scientific consensus doesn’t rest on someone’s claims about a lone anomalous study hampered by serious methodological flaws; scientific consensus rests on the preponderance of evidence (unless you are agenda-driven).
Responding to the Prause et al., 2017 “glutamate transmission” red herring
PRAUSE ET AL: A key neurobiological feature of addiction is the increased responsiveness of glutamate neurons that synapse on the nucleus accumbens. These changes might affect long-term sensitisation of the mesocorticolimbic dopamine pathway, as manifested by a range of symptoms including cue-induced craving and compulsive drug use. 3 To date, research on the effects of sex on glutamate function and its modulation of dopamine pathways is scarce.
Why was this included in the Prause letter? Decades of animal research have molded the prevailing theory of addiction: the incentive-sensitization model of addiction. The central brain change behind the theory is as described above – long-term sensitization of the mesocorticolimbic dopamine via glutamate neurons. That’s quite a mouthful, but YBOP wrote a relatively simple article about it in 2011 (with a few pictures): Why Do I Find Porn More Exciting Than A Partner? (2011).
In simple terms, thoughts, feelings, and memories from all over the brain are sent to the brain’s reward system via glutamate-releasing pathways. With addiction, these glutamate pathways become super-powerful, or sensitized. These sensitized pathways can be thought of as Pavlovian conditioning on turbos. When activated by thoughts or triggers, sensitized pathways blast the reward circuit, firing up hard-to-ignore cravings.
But here’s the deal. There are already 21 neuroscience-based studies reporting brain activation patterns and cue-induced cravings definitively demonstrating sensitization in CSB subjects and porn users: 1,2,3,4, 5,6,7,8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22. We don’t need glutamate studies, which have only been recently done in human subjects, and are very expensive and challenging to interpret.
Responding to Prause et al., 2017 “supraphysiological stimulation” red herring
PRAUSE ET AL: Sex is a primary reward, with unique peripheral representation. Engagement in sex is positively associated with health and life satisfaction. Sex does not allow for supraphysiological stimulation.
Prause presents us with two red herrings having nothing to do with the debate surrounding compulsive sexual behavior disorder.
Red herring #1: “Engagement in sex is positively associated with health and life satisfaction“.
While engaging in sexual intercourse is often correlated with better health indices, this has nothing to with porn use, porn addiction, sex addiction, or engaging in other types of sexual activities (the term “sex” is vague, non-scientific, and shouldn’t be used as a catch-all in an academic journal).
First, many of the so-called health benefits claimed to be associated with orgasm, masturbation or “sex” are in fact associated with close contact with another human being, not necessarily with orgasm, and not with masturbation. More specifically, claimed correlations between a few isolated health indicators sexual intercourse are probably just correlations arising from healthier populations who naturally engage in more sex and masturbation. They are not causal.
Specifically, this review of literature (The Relative Health Benefits of Different Sexual Activities, 2010) found that sexual intercourse was related to positive effects, while masturbation was not. In some cases masturbation was negatively related to health benefits – meaning that more masturbation correlated with poorer health indicators. The conclusion of the review:
“Based upon a broad range of methods, samples, and measures, the research findings are remarkably consistent in demonstrating that one sexual activity (Penile-Vaginal Intercourse and the orgasmic response to it) is associated with, and in some cases, causes processes associated with better psychological and physical functioning.”
“Other sexual behaviors (including when Penile-Vaginal Intercourse is impaired, as with condoms or distraction away from the penile–vaginal sensations) are unassociated, or in some cases (such as masturbation and anal intercourse) inversely associated with better psychological and physical functioning.”
“Sexual medicine, sex education, sex therapy, and sex research should disseminate details of the health benefits of specifically Penile-Vaginal Intercourse, and also become much more specific in their respective assessment and intervention practices.”
Red herring #2: “Sex does not allow for supraphysiological stimulation“.
Only a handful of people would know that Prause et al. is attempting to discredit the concept of internet pornography as a supernormal stimulus. As its co-authors misuse the term “supraphysiological stimulation,” it’s clear that they have no idea what Nobel laureate Nikolaas Tinbergen meant when he coined the term ‘supernormal stimulus’ (or supranormal).
First, supraphysiological levels of neurotransmitters, such as dopamine or endogenous opioids, are not required for chronic use to induce addiction-related brain changes. For example, the two most addictive drugs (meaning those which hook the greatest percentage of users) – nicotine and opiates – increase reward center dopamine by 200%. This is same levels of dopamine seen in sexual arousal (sex and orgasm produce the highest levels of dopamine and endogenous opioids naturally available).
Moreover, sexual arousal and addictive drugs activate the exact same reward circuit nerve cells. In contrast, there’s only a small percentage of nerve-cell activation-overlap between addictive drugs and other natural rewards such as food or water. The fact that meth, cocaine, and heroin turn on the same nerve cells that make sexual stimulation so compelling helps explain why they can be so addictive.
Finally we have the obvious: both the DSM5 and the ICD-11 recognize behavioral addictions. The DSM5 (2013) contains a diagnosis for gambling addiction, while the new ICD-11 (2018) has diagnoses for gambling addiction as well as video-game addiction, and contains a diagnosis suitable for porn addiction or sex addiction: “Compulsive Sexual Behavior Disorder.”
We now have access to a glut of larger-than-life temptations, from candy to pornography to atomic bombs, which cater to outmoded but persistent instinctive drives with dangerous results. In the 1930s Dutch Nobel laureate Niko Tinbergen found that birds that lay small, pale blue eggs speckled with grey preferred to sit on giant, bright blue plaster dummies with black polka dots. A male silver washed fritillary butterfly was more sexually aroused by a butterfly-sized rotating cylinder with horizontal brown stripes than it is by a real, live female of its own kind. Mother birds preferred to try feeding a fake baby bird beak held on a stick by Tinbergen’s students if the dummy beak was wider and redder than a real chick’s. Male stickleback fish ignored a real male to fight a dummy if its underside was brighter red than any natural fish. Tinbergen coined the term “supernormal stimuli” to describe these imitations, which appeal to primitive instincts and, oddly, exert a stronger attraction than real things. Animals encounter supernormal stimuli mostly when experimenters build them. We humans can produce our own: super sugary drinks, French fries, huge-eyed stuffed animals, diatribes about menacing enemies.
A supernormal stimulus is not defined as supra-physiological response. Rather, it is based upon a comparison between what an animal evolved to find compelling and an exaggerated (perhaps synthetic) version of that same compelling stimulus. Female birds, for example, struggled to sit on Tinbergen’s larger-than life, vividly spotted plaster eggs while their own pale, dappled eggs perished untended.
Internet porn is considered a supernormal stimulus because it provides endless sexual novelty. With internet porn, it’s not just the unending sexual novelty that buzzes our reward system. The reward system fires up for other emotions and stimuli too, all of which often feature prominently in viewers:
Anything that violates expectations – shock, surprise, or more than we could have imagined
Erotic words and pictures have been around a long time. So has the neurochemical rush from novel mates. Yet the novelty of a once-a-month Playboy evaporates as soon as you turn the pages. Would anyone call Playboy or softcore videos “shocking” or “anxiety-producing?” Would either violate the expectations of a computer-literate boy over the age of 12? Neither compares with the “searching and seeking” of a multiple-tab Google porn prowl. What makes internet porn unique is that you can keep your dopamine (and sexual arousal) jacked up with the click of a mouse or tap on a screen.
Many of these same emotional states (anxiety, shame, shock, surprise) not only elevate dopamine, but each can also boost stress hormones and neurotransmitters (norepinephrine, epinephrine, cortisol). These stress neurochemicals increase excitement while amplifying dopamine’s already powerful effects. Other qualities that set internet porn apart from other potentially addictive substances and behaviors:
To increase sexual arousal (and raise declining dopamine) one can instantly switch genres during a masturbation session. Couldn’t do that before 2006 and the arrival of streaming tube sites.
Unlike photos of naked people, videos replace your imagination, and may shape your sexual tastes, behavior, or trajectory (especially so for adolescents).
Porn is stored in your brain, which allows you to recall it anytime you need a “hit.”
Unlike food and drugs, for which there is a limit to consumption, there are no physical limitations to internet porn consumption. The brain’s natural satiation mechanisms are not activated, unless one climaxes. Even then, the user can click to something more exciting to become aroused again.
With food and drugs one can only escalate (a marker of an addiction process) by consuming more. With internet porn one can escalate both with more novel “partners” and by viewing new and unusual genres. It’s quite common for a porn user to move to evermore extreme porn. A user can also escalate by viewing compilation videos or by using VR porn.
Highly palatable foods (concentrated sugars/fats/salt), video games, and internet porn are recognized as supernormal stimuli. Here are a few peer-reviewed papers exploring internet applications (porn, video games, Facebook) as supernormal stimuli:
Some internet activities, because of their power to deliver unending stimulation (and activation of the reward system), are thought to constitute supernormal stimuli [24], which helps to explain why users whose brains manifest addiction-related changes get caught in their pathological pursuit. Nobel Prize winning scientist Nikolaas Tinbergen [25] posited the idea of “supernormal stimuli,” a phenomenon wherein artificial stimuli can be created that will override an evolutionarily developed genetic response. To illustrate this phenomenon, Tinbergen created artificial bird eggs that were larger and more colorful than actual bird eggs. Surprisingly, the mother birds chose to sit on the more vibrant artificial eggs and abandon their own naturally laid eggs. Similarly, Tinbergen created artificial butterflies with larger and more colorful wings, and male butterflies repeatedly tried to mate with these artificial butterflies in lieu of actual female butterflies. Evolutionary Psychologist Dierdre Barrett took up this concept in her recent book Supernormal Stimuli: How Primal Urges Overran Their Evolutionary Purpose [26]. “Animals encounter supernormal stimuli mostly when experimenters build them. We humans can produce our own.” [4] (p. 4). Barrett’s examples range from candy to pornography and highly salted or unnaturally sweetened junk food to highly engaging interactive video game playing. In short, generalized internet chronic overuse is highly stimulating. It recruits our natural reward system, but potentially activates it at higher levels than the levels of activation our ancestors typically encountered as our brains evolved, making it liable to switch into an addictive mode [27].
Supernormal (SN) stimuli are artificial products that activate reward pathways and approach behavior more so than naturally occurring stimuli for which these systems were intended. Many modern consumer products (e.g., snack foods, alcohol, and pornography) appear to incorporate SN features, leading to excessive consumption, in preference to naturally occurring alternatives. No measure currently exists for the self-report assessment of individual differences or changes in susceptibility to such stimuli. Therefore, an anticipatory pleasure scale was modified to include items that represented both SN and natural (N) classes of rewarding stimuli. Exploratory factor analysis yielded a two-factor solution, and as predicted, N and SN items reliably loaded on separate dimensions. Internal reliability for the two scales was high, ρ =.93 and ρ =.90, respectively. The two-dimensional measure was evaluated via regression using the N and SN scale means as predictors and self-reports of daily consumption of 21 products with SN features as outcomes. As expected, SN pleasure ratings were related to higher SN product consumption, while N pleasure ratings had either negative or neutral associations to consumption of these products. We conclude that the resulting two-dimensional measure is a potentially reliable and valid self-report measure of differential preference for SN stimuli. While further evaluation is needed (e.g., using experimental measures), the proposed scale may play a useful role in the study of both trait- and state-based variation in human susceptibility to SN stimuli.
Processed foods, psychoactive substances, some retail goods, and various social media and gaming products are readily overconsumed, presenting numerous population health challenges (Roberts, van Vught, & Dunbar, 2012). Evolutionary psychology provides a persuasive explanation of excessive consumption. Animals, including humans, tend to approach (i.e., gather, acquire, and consume) stimuli that provide the highest relative reward for their efforts, thereby optimizing their utility (Chakravarthy & Booth, 2004; Kacelnik & Bateson, 1996). Neurological reward mechanisms evolved to promote adaptive behavior by reinforcing stimuli that send signals of promoting fitness, such as providing nutrients or reproductive opportunities. Tinbergen (1948) coined the term “Supernormal Stimulus” upon finding that animals tend to exhibit heightened responses to exaggerated versions of natural stimuli. This “selection asymmetry” (Staddon, 1975; Ward, 2013) is not maladaptive in natural environments in which exaggerated versions of the stimulus are rare—but presents problems when artificial and exaggerated alternatives exist. For example, the newly hatched herring gull prefers to peck at a fabricated thin red rod with white bands at its tip, rather than its mother’s naturally red spotted thin beak (Tinbergen & Perdeck, 1951). In the context of resource selection, the outcome is a behavioral heuristic of “get all you can”: an adaptive strategy in natural environments where resource supply is scarce or unreliable. In the modern human environment, many highly rewarding experiences exist in the form of artificial consumer products that have been designed or refined to be supernormal. That is, they stimulate an evolved reward system to a degree not found in natural stimuli (Barrett, 2010). For example, psychoactive substances (Nesse & Berridge, 1997), commercial fast-food products (Barrett, 2007), gambling products (Rockloff, 2014), television shows (Barrett, 2010; Derrick, Gabriel, & Hugenberg, 2009), digital social networking and the Internet (Rocci, 2013; Ward, 2013), and various retail products, such as expensive cars (Erk, Spitzer, Wunderlich, Galley, & Walter, 2002), high-heeled shoes (Morris, White, Morrison, & Fisher, 2013), cosmetics (Etcoff, Stock, Haley, Vickery, & House, 2011), and children’s toys (Morris, Reddy, & Bunting, 1995) have all been discussed as forms of modern day supernormal stimuli. For some of these stimuli, neurological evidence has shown that they tend to activate dopamine pathways intensely, hijacking the reward response designed for natural rewards, thereby promoting excess consumption and in some cases, addiction (Barrett, 2010; Blumenthal & Gold, 2010; Wang et al., 2001).
To varying degrees, supernormal stimuli tend to be unhealthy. The ready availability of high-calorie takeaway meals and snacks, the toxicity of alcohol and other substances, the sedentary activity involved in watching television, using digital media and gaming products, and the expense of retail items or gambling, all serve to provide an environment that fosters unhealthy behavioral choices, leading to harms (Barrett, 2007, 2010; Birch, 1999; Hantula, 2003; Ward, 2013). This makes the study of susceptibility of modern humans to supernormal stimuli of practical significance. In the current report, we use the term supernormal stimuli to refer to modern human products and experiences that are characterized by asymmetric selectivity (uncontrolled approach to more intense variants) and being made artificially abundant in the modern world. These products are often processed, refined, or synthesized consumer goods including snack foods or substances. Less obvious examples include messages received via social media. Although at times less stimulating than a face-to-face conversation, this communication method provides prolonged enhanced visual, speed, and delivery characteristics. Similarly, most modern day clothing and other retail products exhibit similar enhanced signifiers of rarity or desirability, with attendant implications for sexual or social status. Consumption or acquisition of these products is theorized to provide immediate reward due to being interpreted as fitness enhancing.
It has been suggested a preference for supernormal reward could be the result of differences in dopamine functioning. Dopamine deficiency has been found to be related to various forms of excess consumption including alcohol abuse, binge eating, problem gambling, and Internet addiction (Bergh, Eklund, Södersten, & Nordin, 1997; Blum, Cull, Braverman, & Comings, 1996; Johnson & Kenny, 2010; Kim et al., 2011). The concept of supernormal susceptibility is consistent with an interpretation in terms of individual variability in the dopamine functioning. Dopaminergic pathways, evolved to prioritize resource acquisition and consumption in a resource-scarce environment, are likely to be particularly sensitive to psychoactive substances, energy-dense food, and other modern day consumer products exhibiting exaggerated reward properties (Barrett, 2010; Nesse & Berridge, 1997; Wang et al., 2001). If this is the case, then the two-dimensional NPS/SNPS described here would be expected to discriminate individuals with dopamine dysfunction. Future research might profitably employ neurophysiological techniques in conjunction with self-report measures, in order to confirm the correspondences between these two levels of description.
Supernormal experiences are inherently unhealthy and amenable to excess consumption due to their processed characteristics (e.g., snacks and take away foods) and encouraging prolonged sedentary behavior (e.g., social networking and gaming). Therefore, the ability to identify individuals who prefer these types of reward provides a valuable contribution to those researching, treating, and preventing population health problems caused by over consumption.
Addiction has been a divisive term when applied to various compulsive sexual behaviors (CSBs), including obsessive use of pornography. Despite a growing acceptance of the existence of natural or process addictions based on an increased understanding of the function of the mesolimbic dopaminergic reward systems, there has been a reticence to label CSBs as potentially addictive. While pathological gambling (PG) and obesity have received greater attention in functional and behavioral studies, evidence increasingly supports the description of CSBs as an addiction. This evidence is multifaceted and is based on an evolving understanding of the role of the neuronal receptor in addiction-related neuroplasticity, supported by the historical behavioral perspective. This addictive effect may be amplified by the accelerated novelty and the ‘supranormal stimulus’ (a phrase coined by Nikolaas Tinbergen) factor afforded by Internet pornography….
It is surprising that food addiction would not be included as a behavioral addiction, despite studies demonstrating dopaminergic receptor downregulation in obesity (Wang et al., 2001), with reversibility seen with dieting and normalization of body mass index (BMI) (Steele et al., 2010). The concept of a ‘supranormal stimulus’, invoking Nikolaas Tinbergen’s term (Tinbergen, 1951), has recently been described in the context of intense sweetness surpassing cocaine reward, which also supports the premise of food addiction (Lenoir, Serre, Laurine, & Ahmed, 2007). Tinbergen originally found that birds, butterflies, and other animals could be duped into preferring artificial substitutes designed specifically to appear more attractive than the animal’s normal eggs and mates. There is, of course, a lack of comparable functional and behavioral work in the study of human sexual addiction, as compared to gambling and food addictions, but it can be argued that each of these behaviors can involve supranormal stimuli. Deirdre Barrett (2010) has included pornography as an example of a supranormal stimulus…..
Pornography is a perfect laboratory for this kind of novel learning fused with a powerful pleasure incentive drive. The focused searching and clicking, looking for the perfect masturbatory subject, is an exercise in neuroplastic learning. Indeed, it is illustrative of Tinbergen’s concept of the ‘supranormal stimulus’ (Tinbergen, 1951), with plastic surgery–enhanced breasts presented in limitless novelty in humans serving the same purpose as Tinbergen’s and Magnus’s artificially enhanced female butterfly models; the males of each species prefer the artificial to the naturally evolved (Magnus, 1958; Tinbergen, 1951). In this sense, the enhanced novelty provides, metaphorically speaking, a pheromone-like effect in human males, like moths, which is ‘inhibiting orientation’ and ‘disrupting pre-mating communication between the sexes by permeating the atmosphere’ (Gaston, Shorey, & Saario, 1967)…..
Even public opinion seems to be trying to describe this biologic phenomenon, as in this statement from Naomi Wolf; ‘For the first time in human history, the images’ power and allure have supplanted that of real naked women. Today real naked women are just bad porn’ (Wolf, 2003). Just as Tinbergen’s and Magnus’s ‘butterfly porn’ successfully competed for male attention at the expense of real females (Magnus, 1958; Tinbergen, 1951), we see this same process occurring in humans.
Arguably, the most important development in the field of problematic sexual behavior is the way in which the Internet is influencing and facilitating compulsive sexual behavior [73]. Unlimited high-definition sexual videos streaming via “tube sites” are now free and widely accessible, 24 h a day via computers, tablets and smartphones, and it has been suggested that Internet pornography constitutes a supernormal stimulus, an exaggerated imitation of something our brains evolved to pursue because of its evolutionary salience [74,75]. Sexually explicit material has been around for a long time, but (1) video pornography is significantly more sexually arousing than other forms of pornography [76,77] or fantasy [78]; (2) novel sexual visuals have been shown to trigger greater arousal, faster ejaculation, and more semen and erection activity compared with familiar material, perhaps because attention to potential novel mates and arousal served reproductive fitness [75,79,80,81,82,83,84]; and (3) the ability to self-select material with ease makes Internet pornography more arousing than pre-selected collections [79]. A pornography user can maintain or heighten sexual arousal by instantly clicking to a novel scene, new video or never encountered genre. A 2015 study assessing Internet pornography’s effects on delay discounting (choosing immediate gratification over delayed rewards of greater value) states, “The constant novelty and primacy of sexual stimuli as particularly strong natural rewards make internet pornography a unique activator of the brain’s reward system. … It is therefore important to treat pornography as a unique stimulus in reward, impulsivity, and addiction studies” [75] (pp. 1, 10).
Novelty registers as salient, enhances reward value, and has lasting effects on motivation, learning and memory [85]. Like sexual motivation and the rewarding properties of sexual interaction, novelty is compelling because it triggers bursts of dopamine in regions of the brain strongly associated with reward and goal-directed behavior [66]. While compulsive Internet pornography users show stronger preference for novel sexual images than healthy controls, their dACC (dorsal anterior cingulate cortex) also shows more rapid habituation to images than healthy controls [86], fueling the search for more novel sexual images. As co-author Voon explained about her team’s 2015 study on novelty and habituation in compulsive Internet pornography users, “The seemingly endless supply of novel sexual images available online [can feed an] addiction, making it more and more difficult to escape” [87]. Mesolimbic dopamine activity can also be enhanced by additional properties often associated with Internet pornography use such as, violation of expectations, anticipation of reward, and the act of seeking/surfing (as for Internet pornography) [88,89,90,91,92,93]. Anxiety, which has been shown to increase sexual arousal [89,94], may also accompany Internet pornography use. In short, Internet pornography offers all of these qualities, which register as salient, stimulate dopamine bursts, and enhance sexual arousal.
Prause et al., 2017 doesn’t understand the addiction model
PRAUSE ET AL: Also, data are not sufficient to differentiate between compulsive and impulsive models.
Another red herring. Unlike the authors of Potenza et al., the authors of Prause et al., are not addiction experts – and it shows. Studies repeatedly report that addiction features elements of both impulsivity and compulsivity. (A Google Scholar search for addiction + impulsivity + compulsivity returns 22,000 citations.) Here are simple definitions of impulsivity and compulsivity:
Impulsivity: Acting quickly and without adequate thought or planning in response to internal or external stimuli. A predisposition to accept smaller immediate rewards over larger delayed gratification and an inability to stop a behavior toward gratification once it’s set in motion.
Compulsivity: Refers to repetitive behaviors that are performed according to certain rules or in a stereotypical fashion. These behaviors persevere even in the face of adverse consequences.
The use of “compulsive” in the new ICD-11 diagnosis isn’t meant to denote the neurological underpinnings of Compulsive Sexual Behavior Disorder: “continued repetitive sexual behaviour despite adverse consequences.” Instead “compulsive,” as used in the ICD-11, is a descriptive term that has been in use for years, and is often employed interchangeably with “addiction.” (For example a Google scholar search for compulsion + addiction returns 130,000 citations.)
Thus, whatever you or your healthcare giver want to call it – “hypersexuality,” “porn addiction,” “sex addiction,” “out-of-control sexual behavior,” “cybersex addiction” – if the behaviors fall within the “Compulsive Sexual Behaviour Disorder” description, the condition can be diagnosed using the ICD-11 CSBD diagnosis.
Background: Steele et al., 2013 and David Ley’s “Your Brain on Porn – It’s NOT Addictive“.
On March 6th, 2013 David Ley and study spokesperson Nicole Prause teamed up to write a Psychology Today blog post about Steele et al., 2013 called “Your Brain on Porn – It’s NOT Addictive“. Its oh-so-catchy title is misleading as it has nothing to do with Your Brain on Porn or the neuroscience presented there. Instead, David Ley’s March, 2013 blog post limits itself to a fictional account of a single flawed EEG study – Steele et al., 2013.
Prause’s carefully orchestrated PR campaign resulted in worldwide media coverage with all the headlines claiming that sex addiction had been debunked(!). In TV interviews and in the UCLA press release Nicole Prause made two wholly unsupported claims about her EEG study:
Subjects’ brains did not respond like other addicts.
Hypersexuality (sex addiction) is best understood as “high desire.”
Neither of those findings are actually in Steele et al. 2013. In fact, the study reported the exact opposite of what Nicole Prause and David Ley claimed:
What Steele et al., 2013 actually stated as its “neurological findings”:
“the P300 mean amplitude for the pleasant–sexual condition was more positive than the unpleasant, and pleasant–non-sexual conditions”
Translation: Frequent porn users had greater cue-reactivity (higher EEG readings) to explicit sexual images relative to neutral pictures. This is exactly the same as what occurs when drug addicts are exposed to cues related their addiction.
What Steele et al., 2013 actually stated as its “sexual desire” findings:
“Larger P300 amplitude differences to pleasant sexual stimuli, relative to neutral stimuli, was negativelyrelated to measures of sexual desire, but not related to measures of hypersexuality.”
Translation: Negatively means lower desire. Individuals with greater cue-reactivity to porn had lower desire to have sex with a partner (but not lower desire to masturbate). To put another way – individuals with more brain activation and cravings for porn preferred to masturbate to porn than have sex with a real person.
Together these two Steele et al. findings indicate greater brain activity to cues (porn images), yet less reactivity to natural rewards (sex with a person). Both are hallmarks of an addiction, indicating both sensitization and desensitization.
“My mind still boggles at the Prause claim that her subjects’ brains did not respond to sexual images like drug addicts’ brains respond to their drug, given that she reports higher P300 readings for the sexual images. Just like addicts who show P300 spikes when presented with their drug of choice. How could she draw a conclusion that is the opposite of the actual results? I think it could be due to her preconceptions–what she expected to find.”
Mustanski asks, “What was the purpose of the study?” And Prause replies, “Our study tested whether people who report such problems [problems with regulating their viewing of online erotica] look like other addicts from their brain responses to sexual images.”
But the study did not compare brain recordings from persons having problems regulating their viewing of online erotica to brain recordings from drug addicts and brain recordings from a non-addict control group, which would have been the obvious way to see if brain responses from the troubled group look more like the brain responses of addicts or non-addicts.
Instead, Prause claims that their within-subject design was a better method, where research subjects serve as their own control group. With this design, they found that the EEG response of their subjects (as a group) to erotic pictures was stronger than their EEG responses to other kinds of pictures. This is shown in the inline waveform graph (although for some reason the graph differs considerably from the actual graph in the published article).
So this group who reports having trouble regulating their viewing of online erotica has a stronger EEG response to erotic pictures than other kinds of pictures. Do addicts show a similarly strong EEG response when presented with their drug of choice? We don’t know. Do normal, non-addicts show a response as strong as the troubled group to erotica? Again, we do not know. We don’t know whether this EEG pattern is more similar to the brain patterns of addicts or non-addicts.
The Prause research team claims to be able to demonstrate whether the elevated EEG response of their subjects to erotica is an addictive brain response or just a high-libido brain response by correlating a set of questionnaire scores with individual differences in EEG response. But explaining differences in EEG response is a different question from exploring whether the overall group’s response looks addictive or not.
Before we get to the eight peer-reviewed analyses of Steele et al., 2013 I provide the state of the research in 2020:
Porn/sex addiction? This page lists 55 neuroscience-based studies (MRI, fMRI, EEG, neuropsychological, hormonal). All provide strong support for the addiction model as their findings mirror the neurological findings reported in substance addiction studies.
Eight peer-reviewed analyses of Steele et al., 2013
Over the intervening years many more neuroscience-based studies have been published (MRI, fMRI, EEG, neuropsychological, hormonal). All provide strong support for the addiction model as their findings mirror the neurological findings reported in substance addiction studies. The real experts’ opinions on porn/sex addiction can be seen in this list of 30 recent literature reviews & commentaries (all support the addiction model).
Seven of the peer-reviewed papers chose to analyze what Steele et al. 2013 actually reported – not what Prause put forth in her PR campaign. All describe how the Steele et al. findings lend support to the porn addiction model. The papers are in alignment with the YBOP critique. Three of the papers also describe the study’s flawed methodology and unsubstantiated conclusions. Paper #1 is solely devoted to Steele et al., 2013. Papers 2-8 contain sections analyzing Steele et al., 2013. They are listed by date of publication:
The validity of an argument depends on the soundness of its premises. In the recent paper by Steele et al., conclusions are based on the initial construction of definitions relating to ‘desire’ and ‘addiction’. These definitions are based on a series of assumptions and qualifications, the limitations of which are acknowledged by the authors initially, but inexplicably ignored in reaching the firm conclusions the authors make. Yet, the firmness of these conclusions is unwarranted, not only as a result of conceptually problematic initial premises but also due to problematic methodology.
Consider, for instance, the concept of ‘sexual desire’. The first paragraph acknowledges that ‘sexual desires must be consistently regulated to manage sexual behaviors’, and must be controlled when either illegal (pedophilia) or inappropriate (infidelity). The paragraph ends with the inference that the term ‘sexual addiction’ does not describe a problematic entity per se, but that it merely describes a subset of individuals with high levels of desire.
The next paragraph references a paper by Winters et al., which suggests that ‘dysregulated sexuality … may simply be a marker of high sexual desire and the distress associated with managing a high degree of sexual thoughts, feelings, and needs’ (Winters, Christoff, & Gorzalka, 2010). It is based on these assumptions that Steele et al. then proceeds to question a disease model for this ‘distress’ associated with controlling sexual ‘desire’. For a comparison of different ‘desire’ templates, television viewing in children is used as an example. The last two sentences in this paragraph establish the premise that the rest of the paper then tries to prove:
Treatments focus on reducing the number of hours viewing television behaviorally without a disease overlay such as ‘television addiction’ and are effective. This suggests a similar approach might be appropriate for high sexual desire if the proposed disease model does not add explanatory power beyond merely high sexual desire. (Steele, Staley, Fong, & Prause, 2013)
Based on this comparison, that of desire to watch TV in children and desire for sex in adults, the authors then launch into a discussion on event-related potentials (ERPs) and a subsequent description of their study design, followed by results and discussion, and culminating in the following summary:
In conclusion, the first measures of neural reactivity to visual sexual and non-sexual stimuli in a sample reporting problems regulating their viewing of similar stimuli fail to provide support for models of pathological hypersexuality, as measured by questionnaires. Specifically, differences in the P300 window between sexual and neutral stimuli were predicted by sexual desire, but not by any (of three) measures of hypersexuality. (Steele et al., 2013)
With this statement the authors put forward the premise that high desire, even if it is problematic to those who experience it, is not pathologic, no matter the consequence.
Others have described significant limitations of this study. For instance, author Nicole Prause stated in an interview, ‘Studies of drug addictions, such as cocaine, have shown a consistent pattern of brain response to images of the drug of abuse, so we predicted that we should see the same pattern in people who report problems with sex if it was, in fact, an addiction’. John Johnson has pointed out several critical issues with this use of the Dunning et al. (2011) paper she cites as a basis for comparison with the Steele et al. paper. First, the Dunning et al. paper used three controls: abstinent cocaine users, current users, and drug naïve controls. The Steele et al. paper had no control group of any kind. Second, the Dunning et al. paper measured several different ERPs in the brain, including early posterior negativity (EPN), thought to reflect early selective attention, and late positive potential (LPP), thought to reflect further processing of motivationally significant material. Furthermore, the Dunning study distinguished the early and late components of the LPP, thought to reflect sustained processing. Moreover, the Dunning et al. paper distinguished between these different ERPs in abstinent, currently using, and healthy control groups. The Steele et al. paper, however, looked only at one ERP, the p300, which Dunning compared to the early window of the LLP. The Steele et al. authors even acknowledged this critical flaw in design: ‘Another possibility is that the p300 is not the best place to identify relationships with sexually motivating stimuli. The slightly later LPP appears more strongly linked to motivation’. Steel et al. admit that they are in fact not able to compare their results to the Dunning et al. study, yet their conclusions effectively make such a comparison. Regarding the Steele et al. study, Johnson summarized, ‘The single statistically significant finding says nothing about addiction. Furthermore, this significant finding is a negative correlation between P300 and desire for sex with a partner (r=−0.33), indicating that P300 amplitude is related to lower sexual desire; this directly contradicts the interpretation of P300 as high desire. There are no comparisons to other addict groups. There are no comparisons to control groups. The conclusions drawn by the researchers are a quantum leap from the data, which say nothing about whether people who report trouble regulating their viewing of sexual images have or do not have brain responses similar to cocaine or any other kinds of addicts’ (personal communication, John A. Johnson, PhD, 2013).
Although other serious deficiencies in this study design include lack of an adequate control group, heterogeneity of study sample, and a failure to understand the limitations of the ability of the P300 to qualitatively and quantitatively discriminate and differentiate between ‘merely high sexual desire’ and pathologically unwanted sexual compulsions, perhaps the most fundamental flaw relates to the use and understanding of the term ‘desire’. It is clear that in constructing this definitional platform, the authors minimize the concept of desire with the word ‘merely’. Desire, as related to biological systems in the context of sexuality, is a complex product of mesencephalic dopaminergic drive with telencephalic cognitive and affective mediation and expression. As a primal salience factor in sex, dopamine is increasingly recognized as a key component in sexual motivation, which has been widely conserved in the evolutionary tree (Pfaus, 2010). Genes relating to both the design and expression of sexual motivation are seen across phyla and also span intra-phyla complexity. While there are obvious differences between sex, food seeking, and other behaviors, which are essential to evolutionary fitness, we now know there are similarities in the molecular machinery from which biologically beneficial ‘desire’ emanates. We now know that these mechanisms are designed to ‘learn’, in a neural connecting and modulating way. As Hebb’s law states, ‘Neurons that fire together, wire together’. We became aware of the brain’s ability to alter its structural connectivity with reward learning in early studies relating to drug addiction, but have now seen neuronal reward-based learning with such seemingly diverse natural desires relating to sex and salt craving.
Definitions relating to desire are important here; biological salience, or ‘wanting’, is one thing, whereas we consider ‘craving’ to have more ominous implications as it is used in the literature relating to drug addiction and relapse. Evidence demonstrates that craving states relating to appetites for biologically essential necessities such as salt and sex invoke – with deprivation followed by satiation – a neuroplastic process involving a remodeling and arborizing of neuronal connections (Pitchers et al., 2010; Roitman et al., 2002). Notably, a desperate desire is effected by craving states associated with conditions that portend the possible death of the organism such as salt deficiency, which induces the animal to satiate and avoid death. Drug addiction in humans, interestingly, can affect a comparable craving leading to a similar desperation to satiate in spite of the risk of death, an inversion of this elemental drive. A similar phenomenon occurs with natural addictions as well, such as the individual with morbid obesity and severe cardiac disease continuing to consume a high fat diet, or one with a sexual addiction continuing to engage in random sexual acts with strangers despite an elevated probability of acquiring sexually transmitted diseases such as HIV and hepatitis. That gene sets driving signaling cascades essential to this craving conundrum are identical for both drug addiction and the most basic of natural cravings, salt, supports a hijacking, usurping role for addiction (Liedtke et al., 2011). We also better understand how complex systems associated with and effecting these changes involve genetic molecular switches, products, and modulators such as DeltaFosB, orexin, Cdk5, neural plasticity regulator activity-regulated cytoskeleton-associated protein (ARC), striatally enriched protein tyrosine phosphatase (STEP), and others. These entities form a complex signaling cascade, which is essential to neural learning.
What we experience affectively as ‘craving’, or very ‘high desire’, is a product of mesencephalic and hypothalamic impetus which projects to, participates in, and is part of cortical processing resulting from this convergence of conscious and unconscious information. As we demonstrated in our recent PNAS paper, these natural craving states ‘likely reflect usurping of evolutionary ancient systems with high survival value by the gratification of contemporary hedonic indulgences’ (Liedtke et al., 2011, PNAS), in that we found that these same salt ‘craving’ gene sets were previously associated with cocaine and opiate addiction. The cognitive expression of this ‘desire’, this focus on getting the reward, the ‘craving’ to experience satiation again is but a conscious ‘cortical’ expression of a deeply seated and phyolgenetically primitive drive originating in the hypothalamic/mesencephalic axis. When it results in an uncontrolled and – when expressed – destructive craving for a reward, how do we split neurobiological hairs and term it ‘merely’ high desire rather than addiction?
The other issue relates to immutability. Nowhere in the Steele et al. paper is there a discussion as to why these individuals have ‘high desire’. Were they born that way? What is the role, if any, of environment on both qualitative and quantitative aspect of said desire? Can learning affect desire in at least some of this rather heterogeneous study population? (Hoffman & Safron, 2012). The authors’ perspective in this regard lacks an understanding of the process of constant modulation at both cellular and macroscopic levels. We know, for instance, that these microstructural changes seen with neuronal learning are associated with macroscopic changes as well. Numerous studies confirm the importance of plasticity, as many have compellingly argued: ‘Contrary to assumptions that changes in brain networks are possible only during critical periods of development, modern neuroscience adopts the idea of a permanently plastic brain’ (Draganski & May, 2008); ‘Human brain imaging has identified structural changes in gray and white matter that occur with learning … learning sculpts brain structure’ (Zatorre, Field, & Johansen-Berg, 2012).
Finally, consider again the author’s term ‘merely high sexual desire’. Georgiadis (2012) recently suggested a central dopaminergic role for humans in this midbrain to striatum pathway. Of all the natural rewards, sexual orgasm involves the highest dopamine spike in the striatum, with levels up to 200% of baseline (Fiorino & Phillips, 1997), which is comparable with morphine (Di Chiara & Imperato, 1988) in experimental models. To trivialize, minimize, and de-pathologize compulsive sexuality is to fail to understand the central biological role of sexuality in human motivation and evolution. It demonstrates a naiveté with regard to what is now an accepted understanding of current reward neuroscience, in that it pronounces sexual desire as inherent, immutable, and uniquely immune from the possibility of change either qualitatively or quantitatively. Even more critically, however, as illustrated by the Steele et al. paper, is that this myopic dogma fails to comprehend the truth that neuroscience now tells us that ‘high desire’, when it results in compulsive, unwanted, and destructive behavior, is ‘merely’ an addiction.
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Excerpt critiquing Steele et al., 2013 (Citation 25 is Steele et al.)
Our findings suggest dACC activity reflects the role of sexual desire, which may have similarities to a study on the P300 in CSB subjects correlating with desire[25]. We show differences between the CSB group and healthy volunteers whereas this previous study did not have a control group. The comparison of this current study with previous publications in CSB focusing on diffusion MRI and the P300 is difficult given methodological differences. Studies of the P300, an event related potential used to study attentional bias in substance use disorders, show elevated measures with respect to use of nicotine [54], alcohol [55], and opiates [56], with measures often correlating with craving indices. The P300 is also commonly studied in substance-use disorders using oddball tasks in which low-probability targets are frequently mixed with high-probability non-targets. A meta-analysis showed that substance-use-disordered subjects and their unaffected family members had decreased P300 amplitude compared to healthy volunteers [57]. These findings suggest substance-use disorders may be characterized by impaired allocation of attentional resources to task-relevant cognitive information (non-drug targets) with enhanced attentional bias to drug cues. The decrease in P300 amplitude may also be an endophenotypic marker for substance-use disorders. Studies of event-related potentials focusing on motivation relevance of cocaine and heroin cues further report abnormalities in the late components of the ERP (>300 milliseconds; late positive potential, LPP) in frontal regions, which may also reflect craving and attention allocation [58]–[60]. The LPP is believed to reflect both early attentional capture (400 to 1000 msec) and later sustained processing of motivationally significant stimuli. Subjects with cocaine use disorder had elevated early LPP measures compared to healthy volunteers suggesting a role for early attentional capture of motivated attention along with attenuated responses to pleasant emotional stimuli. However, the late LPP measures were not significantly different from those in healthy volunteers [61]. The generators of the P300 event-related potential for target-related responses is believed to be the parietal cortex and cingulate [62]. Thus, both dACC activity in the present CSB study and P300 activity reported in a previous CSB study may reflect similar underlying processes of attentional capture. Similarly, both studies show a correlation between these measures with enhanced desire. Here we suggest that dACC activity correlates with desire, which may reflect an index of craving, but does not correlate with liking suggestive of on an incentive-salience model of addictions.
Excerpt critiquing Steele et al., 2013 (citation 303):
An EEG study on those complaining of problems regulating their viewing of internet pornography has reported the neural reactivity to sexual stimuli [303]. The study was designed to examine the relationship between ERP amplitudes when viewing emotional and sexual images and questionnaire measures of hypersexuality and sexual desire. The authors concluded that the absence of correlations between scores on hypersexuality questionnaires and mean P300 amplitudes when viewing sexual images “fail to provide support for models of pathological hypersexuality” [303] (p. 10). However, the lack of correlations may be better explained by arguable flaws in the methodology. For example, this study used a heterogeneous subject pool (males and females, including 7 non-heterosexuals). Cue-reactivity studies comparing the brain response of addicts to healthy controls require homogenous subjects (same sex, similar ages) to have valid results. Specific to porn addiction studies, it’s well established that males and females differ appreciably in brain and autonomic responses to the identical visual sexual stimuli [304, 305, 306]. Additionally, two of the screening questionnaires have not been validated for addicted IP users, and the subjects were not screened for other manifestations of addiction or mood disorders.
Moreover, the conclusion listed in the abstract, “Implications for understanding hypersexuality as high desire, rather than disordered, are discussed” [303] (p. 1) seems out of place considering the study’s finding that P300 amplitude was negatively correlated with desire for sex with a partner. As explained in Hilton (2014), this finding “directly contradicts the interpretation of P300 as high desire” [307]. The Hilton analysis further suggests that the absence of a control group and the inability of EEG technology to discriminate between “high sexual desire” and “sexual compulsion” render the Steele et al. findings uninterpretable [307].
Finally, a significant finding of the paper (higher P300 amplitude to sexual images, relative to neutral pictures) is given minimal attention in the discussion section. This is unexpected, as a common finding with substance and internet addicts is an increased P300 amplitude relative to neutral stimuli when exposed to visual cues associated with their addiction [308]. In fact, Voon, et al. [262] devoted a section of their discussion analyzing this prior study’s P300 findings. Voon et al. provided the explanation of importance of P300 not provided in the Steele paper, particularly in regards to established addiction models, concluding,
“Thus, both dACC activity in the present CSB study and P300 activity reported in a previous CSB study[303] may reflect similar underlying processes of attentional capture. Similarly, both studies show a correlation between these measures with enhanced desire. Here we suggest that dACC activity correlates with desire, which may reflect an index of craving, but does not correlate with liking suggestive of on an incentive-salience model of addictions.” [262] (p. 7)
So while these authors [303] claimed that their study refuted the application of the addiction model to CSB, Voon et al. posited that these authors actually provided evidence supporting said model.
Excerpt analyzing Steele et al., 2013 (citation 48):
A 2013 EEG study by Steele et al. reported higher P300 amplitude to sexual images, relative to neutral pictures, in individuals complaining of problems regulating their Internet pornography use [48]. Substance abusers also exhibit greater P300 amplitude when exposed to visual cues associated with their addiction [148]. In addition, Steele et al. reported a negative correlation between P300 amplitude and desire for sex with a partner [48]. Greater cue reactivity to Internet pornography paired with less sexual desire for partnered sex, as reported by Steele et al., aligns with the Voon et al. finding of “diminished libido or erectile function specifically in physical relationships with women” in compulsive Internet pornography users [31]. Supporting these findings, two studies assessing sexual desire and erectile function in “hypersexuals” and compulsive Internet pornography users reported associations between measures of hypersexuality, and reduced desire for partnered sex and sexual difficulties [15,30]. Additionally, the 2016 survey of 434 men who viewed Internet pornography at least once in the last three months reported that problematic use was associated with higher levels of arousabilty, yet lower sexual satisfaction and poorer erectile function [44]. These results should be viewed in light of the multiple neuropsychology studies that have found that sexual arousal to Internet pornography cues and cravings to view pornography were related to symptom severity of cybersex addiction and self-reported problems in daily life due to excessive Internet pornography use [52,53,54,113,115,149,150]. Taken together, multiple and varied studies on Internet pornography users align with the incentive-salience theory of addiction, in which changes in the attraction value of an incentive correspond with changes in activation of regions of the brain implicated in the sensitization process [31,106]. To sum up, in alignment with our hypothesis, various studies report that greater reactivity toward pornographic cues, cravings to view, and compulsive pornography use are associated with sexual difficulties and diminished sexual desire for partners.
In the excerpts below these 3 citations indicate the following Nicole Prause EEG studies (#14 is Steele et al., 2013):
7 – Prause, N.; Steele, V.R.; Staley, C.; Sabatinelli, D. Late positive potential to explicit sexual images associated with the number of sexual intercourse partners. Soc. Cogn. Affect. Neurosc. 2015, 10, 93–100.
8 – Prause, N.; Steele, V.R.; Staley, C.; Sabatinelli, D.; Hajcak, G. Modulation of late positive potentials by sexual images in problem users and controls inconsistent with “porn addiction”. Biol. Psychol. 2015, 109, 192–199.
14 – Steele, V.R.; Staley, C.; Fong, T.; Prause, N. Sexual desire, not hypersexuality, is related to neurophysiological responses elicited by sexual images. Socioaffect. Neurosci. Psychol. 2013, 3, 20770
Event-related potentials (ERPs) have often been used as a physiological measure of reactions to emotional cues, e.g., [24]. Studies utilizing ERP data tend to focus on later ERP effects such as the P300 [14] and Late-Positive Potential (LPP) [7, 8] when investigating individuals who view pornography. These later aspects of the ERP waveform have been attributed to cognitive processes such as attention and working memory (P300) [25] as well as sustained processing of emotionally-relevant stimuli (LPP) [26]. Steele et al. [14] showed that the large P300 differences seen between viewing of sexually explicit images relative to neutral images was negatively related to measures of sexual desire, and had no effect on participants’ hypersexuality. The authors suggested that this negative finding was most probably due to the images shown not having any novel significance to the participant pool, as participants all reported viewing high volumes of pornographic material, consequently leading to the suppression of the P300 component. The authors went on to suggest that perhaps looking at the later occurring LPP may provide a more useful tool, as it has been shown to index motivation processes. Studies investigating the effect pornography use has on the LPP have shown the LPP amplitude to be generally smaller in participants who report having higher sexual desire and problems regulating their viewing of pornographic material [7, 8]. This result is unexpected, as numerous other addiction-related studies have shown that when presented with a cue-related emotion task, individuals who report having problems negotiating their addictions commonly exhibit larger LPP waveforms when presented images of their specific addiction-inducing substance [27]. Prause et al. [7, 8] offer suggestions as to why the use of pornography may result in smaller LPP effects by suggesting that it may be due to a habituation effect, as those participants in the study reporting overuse of pornographic material scored significantly higher in the amount of hours spent viewing pornographic material.
———–
Studies have consistently shown a physiological downregulation in processing of appetitive content due to habituation effects in individuals who frequently seek out pornographic material [3, 7, 8]. It is the authors’ contention that this effect may account for the results observed.
————
Future studies may need to utilise a more up-to-date standardised image database to account for changing cultures. Also, maybe high porn users downregulated their sexual responses during the study. This explanation was at least used by [7, 8] to describe their results which showed a weaker approach motivation indexed by smaller LPP (late positive potential) amplitude to erotic images by individuals reporting uncontrollable pornography use. LPP amplitudes have been shown to decrease upon intentional downregulation [62, 63]. Therefore, an inhibited LPP to erotic images may account for lack of significant effects found in the present study across groups for the “erotic” condition.
Excerpts analyzing Steele et al., 2013 (which is citation 68):
Klucken and colleagues recently observed that participants with CSB as compared to participants without displayed greater activation of the amygdala during presentation of conditioned cues (colored squares) predicting erotic pictures (rewards) [66]. These results are like those from other studies examining amygdala activation among individuals with substance use disorders and men with CSB watching sexually explicit video clips [1, 67]. Using EEG, Steele and colleagues observed a higher P300 amplitude to sexual images (when compared to neutral pictures) among individuals self-identified as having problems with CSB, resonating with prior research of processing visual drug cues in drug addiction [68, 69].
YBOP comments: In the above excerpt the authors of the current review are saying that Steele et al’s findings indicate cue-reactivity in frequent porn users. This aligns with the addiction model and cue-reactivity is a neuro-physiological marker for addiction. While Steele et al. spokesperson Nicole Prause claimed that the subjects’ brain response differed from other types of addicts (cocaine was the example given by Prause) – this was not true, and not reported anywhere in Steele et al., 2013
————-
Furthermore, habituation may be revealed through decreased reward sensitivity to normally salient stimuli and may impact reward responses to sexual stimuli including pornography viewing and partnered sex [1, 68]. Habituation has also been implicated in substance and behavioral addictions [73-79].
YBOP comments: In the above excerpt the authors of this review are referring to Steele et al’s finding of greater cue-reactivity to porn related to less desire for sex with a partner (but not lower desire to masturbate to porn). To put another way – individuals with more brain activation and cravings related to porn preferred to masturbate to porn than have sex with a real person. That’s less reward sensitivity to “partnered sex”, which is “normally salient stimuli”. Together these two Steele et al. findings indicate greater brain activity to cues (porn images), yet less reactivity to natural rewards (sex with a person). Both are hallmarks of an addiction.
Excerpt critiquing Steele et al., 2013 (citation 105 is Steele et al.)
Evidence of this neural activity signalizing desire is particularly prominent in the prefrontal cortex [101] and the amygdala [102,103], being evidence of sensitization. Activation in these brain regions is reminiscent of financial reward [104] and it may carry a similar impact. Moreover, there are higher EEG readings in these users, as well as the diminished desire for sex with a partner, but not for masturbation to pornography [105], something that reflects also on the difference in erection quality [8]. This can be considered a sign of desensitization. However, Steele’s study contains several methodological flaws to consider (subject heterogeneity, a lack of screening for mental disorders or addictions, the absence of a control group, and the use of questionnaires not validated for porn use) [106]. A study by Prause [107], this time with a control group, replicated these very findings. The role of cue reactivity and craving in the development of cybersex addiction have been corroborated in heterosexual female [108] and homosexual male samples [109].
First, Steele et al. (2013) found that individuals with viewing of visual sexual stimuli (VSS) induced a greater amplitude of the P300 component when viewing erotic images than when viewing neutral images. The results seem to confirm the notion that online pornography leads to an individual’s hunger for online pornography, but Steele’s research lacks normal subjects for reference. In addition, LPP components appear later than P300. Late positive potential is associated with the stimulation of significant material processing and better reflects the individual’s desire to watch pornographic material (Hilton, 2014) (the greater the individual’s desire to watch pornography, the greater the LPP volatility). In this regard, Prause and Steele et al. (2015) added individuals who viewed less pornographic material to VSS individuals in the improvement experiment, and found that subjects who had excessively viewed pornographic material problems and reported more sexual desire were watching erotic images. The induced LPP amplitude is smaller, and this result seems to be contrary to the idea that online pornography-related clues induce a sense of craving. Actually, some scholars have pointed out that the erotic images used in the study by Prause and Steele may be an addiction in itself. Consumer goods, not addictive cues (Gola et al., 2017; Gola, Wordecha, Marchewka, & Sescousse, 2016). Therefore, according to the Theory of Incentive-Salience Theory (IST) in drug addiction, as the degree of addiction deepens, the cues of addiction can induce the addicted desire of addicted individuals to become more and more addicted. (Berridge, 2012; Robinson, Fischer, Ahuja, Lesser, & Maniates, 2015), but the addiction to the addicted individuals has gradually decreased, and the decrease in LPP amplitude indicates that CA may be addicted to drugs.
This study reported the following rates of sexual functioning problems in 16-21 year old males (data from 2010-2012):
Lacked interest in having sex: 10.5%
Difficulty reaching climax: 8.3%
Difficulty achieving or maintaining an erection: 7.8%
The above rates are significantly higher than those reported prior to the advent of the internet. For example, erectile dysfunction rates for men under 40 were consistently reported as 2% in studies done before the year 2000. In the 1940s, the Kinsey report concluded that the prevalence of ED was less than 1%in men younger than 30 years. The ED rates for men 21 may is likely closer to 1%. If these 6-8 year-old rates are accurate this would indicate a 400%-800% increase in ED rates for men ages 16-21! That said, this study’s rates are considerably lower than several other recent studies on young men (especially ED rates). See this review for many more details and studies: Is Internet Pornography Causing Sexual Dysfunctions? A Review with Clinical Reports (2016).
A few factors may account for under-reporting of male sexual problems:
1) How data was gathered:
“Participants were interviewed at home by a trained interviewer, using a combination of computer-assisted face-to-face and computer-assisted self-interview (CASI) for the more sensitive questions”
It’s quite possible that adolescents would be less than fully forthcoming in a face to face in-home interview. Recent studies finding higher rates of sexual problems in young people were anonymous online surveys. For example, this 2014 study on Canadian adolescents reported that 53.5% of males aged 16-21 had symptoms indicative of a sexual problem. Erectile dysfunction was the most common (27%), followed by low sexual desire (24%), and problems with orgasm (11%).
2) The study gathered its data between August, 2010 and September, 2012. That’s 6-8 years ago. Studies reporting a significant rise In youthful ED first appeared in 2011.
3) Many of the other studies used the IIEF-5 or IIEF-6, which assess sexual problems on a scale, as opposed to the simple yes or no (in the past 3 months) employed in the current paper.
Concern about young people’s sexuality is focused on the need to prevent harmful outcomes such as sexually transmitted infections and unplanned pregnancy. Although the benefit of a broader perspective is recognized, data on other aspects of sexuality, particularly sexual function, are scant. We sought to address this gap by measuring the population prevalence of sexual function problems, help seeking, and avoidance of sex in young people.
Methods
A cross-sectional stratified probability sample survey (Natsal-3) of 15,162 women and men in Britain (response rate: 57.7%), using computer-assisted self-interviews. Data come from 1875 (71.9%) sexually active, and 517 sexually inactive (18.7%), participants aged 16–21 years. Measures were single items from a validated measure of sexual function (the Natsal-SF).
Results
Among sexually active 16- to 21-year-old participants, 9.1% of men and 13.4% of women reported a distressing sexual problem lasting 3 months or more in the last year. Most common among men was reaching a climax too quickly (4.5%), and among women was difficulty in reaching climax (6.3%). Just over a third (35.5%) of men and 42.3% of women reporting a problem had sought help, but rarely from professional sources. Among those who had not had sex in the last year, just >10% of young men and women said they had avoided sex because of sexual difficulties.
Conclusions
Distressing sexual function problems are reported by a sizeable minority of sexually active young people. Education is required, and counseling should be available, to prevent lack of knowledge, anxiety, and shame progressing into lifelong sexual difficulties.
Keywords
Young people;
Early adulthood;
Sexual function problems;
Sexual dysfunction;
Sexual well-being;
Help seeking;
Avoidance of sex;
Prevalence;
Population survey
Implications and Contribution
This nationally representative data from Britain shows that distressing sexual function problems are not uncommon in young people (aged 16–21 years). In sex education and sexual health services, professionals need to acknowledge the importance of sexual well-being and provide opportunities for young people to raise and discuss their concerns.
Professional interest in young people’s sexual behavior is most often driven by concern to prevent the harms of sex, primarily unplanned pregnancy and sexually transmitted infection (STI) transmission [1], [2] and [3] and, increasingly, nonconsensual sex. Qualitative work suggests that young people themselves are equally concerned with issues affecting their sexual well-being. They may be anxious about their sexual orientation or identity [4], feel social pressure to consent to activities they dislike or find painful [5], or struggle against norms that make it difficult to admit to experiences that are less than ideal [6] and [7].
While issues around volition, sexual identity, and sexual reputation have been quite well documented, less is known about problems young people might have with sexual response and function. This is partly because sexual function problems are assumed to be more relevant to older adults. Sexual function is defined as an individual’s ability to respond sexually or to experience sexual pleasure [8] and sexual function problems are those that interfere with these. Population prevalence studies of sexual function problems typically include participants as young as 16 or 18 years, but often use broad age categories, up to 29 years [9] and rarely provide specific detail on young people under 24 years [10], [11] and [12]. Few studies have focused specifically on early adulthood, and these have not generally used nationally representative data [13] and [14].
There is increasing recognition that sexual health should be considered broadly [15] and [16], and the holistic definition endorsed by WHO—“a state of physical, emotional, mental and social well-being in relation to sexuality” [17]—is steadily gaining currency. In young people, sexual health includes “positive developmental contributions of sexuality, as well as the acquisition of skills pertinent to avoiding adverse sexual outcomes” [18]. There is evidence that goals relating to sexual satisfaction and pleasure shape both risk taking and risk-reduction practices [16] and [19]. For instance, fears about erectile functioning among young men have been shown to contribute to resistance to condom use [20] and to inconsistent use [21]. Good sexual health in adolescents is associated with risk reduction behaviors, such as condom use and sexual abstinence [18], and sexual function in adults is inversely associated with risk behavior [22]. Interventions that safeguard pleasure may therefore be more effective than those that ignore this aspect [16] and [23]. The current lack of data on sexual function in young people limits efforts to address sexual health holistically and reinforces the belief that sexual function and well-being are less relevant to prevention interventions targeting young people [1] and [24].
We have previously reported on the prevalence of sexual function problems in adults aged 16–74 years using data from the third National Survey of Sexual Attitudes and Lifestyles (Natsal-3) [22]. Here, we use this same data set to address the gap in empirical data on sexual function problems (including those that cause distress), help seeking about one’s sex life, and avoidance of sex because of problems, in young people aged 16–21 years in Britain.
Methods
Participants and procedure
We present data from 16- to 21-year-old participants in Natsal-3, a stratified probability sample survey of 15,162 men and women aged 16–74 years in Britain, interviewed between September 2010 and August 2012. We focus on the early adulthood period and the early stages of sexual careers before young people “settle” into longer term partnerships and sexual habits. We used a multistage, clustered, and stratified probability sample design, with the U.K. Postcode Address File as the sampling frame and postcode sectors (n = 1,727) selected as a primary sampling unit. Within each primary sampling unit, 30 or 36 addresses were selected at random, and within each household, an eligible adult was selected using a Kish grid. After weighting to adjust for unequal probabilities of selection, the Natsal-3 sample was broadly representative of the British population as described by 2011 Census figures [25].
Participants were interviewed at home by a trained interviewer, using a combination of computer-assisted face-to-face and computer-assisted self-interview (CASI) for the more sensitive questions. The interviewer was present and available to help while participants completed the CASI but did not view answers. At the end of the CASI sections, answers were “locked” into the computer and were inaccessible to the interviewer. The interview lasted for about an hour, and participants received £15 as a token of appreciation. The survey instrument underwent thorough cognitive testing and piloting [26].
The overall response rate was 57.7% of all eligible addresses (64.8% among participants aged 16–44 years). The cooperation rate (proportion of respondents at eligible addresses where contact was made agreeing to take part in the survey) was 65.8%. Details of the survey methodology are published elsewhere [25] and [27]. Natsal-3 was approved by the Oxfordshire Research Ethics Committee A. Participants provided oral consent for interviews.
Outcome measures
Participants reporting vaginal, oral, or anal sex with one or more partner in the past year were classified as “sexually active” and asked whether they had experienced any of a list of eight difficulties with their sex life lasting 3 months or longer in the past year. These were lacked interest in having sex, lacked enjoyment in sex, felt anxious during sex, felt physical pain as a result of sex, felt no excitement or arousal during sex, did not reach a climax (experience an orgasm) or took a long time to reach a climax despite feeling excited or aroused, reached climax (experienced an orgasm) more quickly than you would like, had an uncomfortably dry vagina (asked of women only), and had trouble getting or keeping an erection (asked of men only). For each item, they endorsed (responded yes), participants were then asked how they felt about the problem (response options: not at all distressed; a little distressed; fairly distressed; very distressed). We also asked how long they had experienced the difficulty and how often symptoms occurred (data not presented in this article).
All sexually experienced participants (those who had ever had a sexual experience), regardless of their sexual activity in the last year, were asked to appraise their sex life overall, including whether they had avoided sex because of sexual difficulties experienced by themselves or their partner (agree strongly, agree, neither agree nor disagree, disagree, disagree strongly). Participants agreeing strongly or agreeing were then presented with the same list of problems and asked to indicate which, if any, had caused them to avoid sex. Additional response options were as follows: “my partner had one (or more) sexual difficulty” and “none of these things caused me to avoid sex.” Multiple responses were allowed. Participants were also asked if they felt distressed or worried about their sex life using a five-point Likert scale. Finally, participants were asked whether they had sought help or advice regarding their sex life from any of a list of sources in the last year, and if yes, to select all that apply. These options were subsequently grouped as family member/friend, media/self-help (includes information and support sites on the internet; self-help books/information leaflets; self-help groups; helpline), and professional (includes general practitioner/family doctor; sexual health/genito-urinary medicine/STI clinic; psychiatrist or psychologist; relationship counselor; other type of clinic or doctor), or have not sought any help. These items come from the Natsal-SF; a measure of sexual function specifically designed and validated for use in this and other population prevalence surveys. The 17-item Natsal-SF measure has good fit (comparative fit index = .963; Tucker Lewis index = .951; root mean square error of approximation = .064), can discriminate between clinical and general population groups, and has good test–retest reliability (r = .72) [22] and [28].
Statistical analysis
All analyses were done using the complex survey functions of Stata (version 12; StataCorp LP, College Station, TX) to account for the weighting, clustering, and stratification of the data. Analysis was restricted to all sexually experienced men and women aged 16–21 years. Item nonresponse in Natsal-3 was low (almost always <5%, and often 1%–3%), so patients with missing data were excluded from analysis. Among sexually active participants (those reporting at least one sexual partner in the year before interview), we present descriptive statistics for reporting of sexual function problems (lasting 3 or more months in the last year), and the proportion distressed by their problem. We also report the proportion seeking help from the range of sources, stratified by reporting one or more sexual function problem. For participants who were not sexually active in the last year, we report descriptive statistics for three outcomes: sexual satisfaction, distress about sex life, and avoidance of sex because of a sexual difficulty.
Results
Most men and women (72%) aged 16–21 years reported having one or more sexual partner in the last year and so were categorized as sexually active (854 men and 1,021 women). Table 1 shows the proportion of these men reporting each of eight sexual function problems lasting 3 months or more in the last year. A third of these men (33.8%) experienced one or more sexual function problem (first column of Table 1), and 9.1% reported one or more distressing sexual function problem(s) (second column); implying that among men reporting one or more problem, just over a quarter (26.9%) felt distressed (third column).
Table 1.
Experience of sexual function problems, and distress about these problems, among sexually active young men, aged 16–21 years
% Reporting each sexual function problem
% Reporting each problem and distress about it
Of those reporting each sexual function problem, % fairly or very distressed about it
Denominator varies for each individual sexual function problem in this column. The unweighted and weighted denominator listed is for those that experienced one or more of these problems.
Among men, reaching a climax too quickly was the most common problem (13.2%). Just over a third of men with this problem (34.2%) felt distressed about it, making it the most common distressing problem among sexually active 16- to 21-year-old men (4.5%). Difficulty getting and keeping an erection was less commonly reported (7.8%), but more frequently caused distress (among 42.1%) and was thus the second most common distressing problem (by 3.3% of men in the age group). Although lack of interest in sex was the second most commonly reported problem (experienced by 10.5%), only 13.2% of men reporting this problem were distressed by it, and overall, 1.4% experienced it as a distressing problem. Three distressing problems were reported by <1% of sexually active young men: pain, lacking excitement/arousal, and lacking enjoyment.
Table 2 shows the proportion of young sexually active women reporting each sexual function problem, and of those experiencing the problem, the proportion distressed about it. Just under half (44.4%) of these women experienced one or more sexual function problem lasting 3 months or more in the last year, and 13.4% reported a distressing problem; implying that of those reporting one or more problem, just less than a third (30.2%) were distressed.
Table 2.
Experience of sexual function problems, and distress about these problems, among sexually active young women, aged 16–21 years
% Reporting each sexual function problem
% Reporting each problem and distress about it
Of those reporting each sexual function problem, % fairly or very distressed about it
Denominator varies for each individual sexual function problem in this column. The unweighted and weighted denominator listed is for those that experienced one or more of these problems.
The most common problems among women were lacking interest in sex (22.0%) and experiencing difficulty in reaching climax (21.3%), and these were also the most common distressing problems (5.3% and 6.3%, respectively). The problems most commonly associated with distress were feeling anxious during sex (34.7%), feeling physical pain as a result of sex (35.9%), and lacking excitement or arousal (31.6%), but these problems were less frequently reported, resulting in overall prevalence estimates for distressing problems at 2.8%, 3.2%, and 2.5%, respectively. Reaching a climax too quickly was least commonly reported (3.9%) and was experienced as distressing by only 10.8% of women reporting it, resulting in overall prevalence for distressing early climax of <1%.
Among young people who were sexually active in the last year, 6.3% of men and 6.8% of women said that they had avoided sex because of a sexual difficulty. Among young men (Figure 1), the most common reasons for avoidance were difficulty getting or keeping an erection, reaching a climax too quickly, and lack of interest (reported by 26.1%, 24.4%, and 25.1%, respectively, of all young men who said they had avoided sex). Among young women (Figure 1), the most common reasons for avoidance were lack of interest (reported by 45.5% of women who had avoided sex), followed by lack of enjoyment, anxiety, and pain (reported by 21.2%, 25.3%, and 23.7%, respectively, of women who had avoided sex).
Figure 1.
Reasons for avoiding sex among sexually active young people who reported avoiding sex because of a sexual difficulty.
Help or advice seeking among sexually active participants
Overall, 26% (22.9–29.5) of sexually active men and 36.3% (33.1–39.7) of sexually active women had sought help about their sex life in the last year (last row, Tables 1 and 2). Figure 2 shows the proportions consulting the different sources, stratified by experience of sexual function problem. Those reporting one or more problem more commonly sought help compared with those reporting no problems (35.5% vs. 21% for men; p < .001 and 42.3% vs. 31.1%; p = .001). Where young people did seek help, family members and friends were the most common source followed by the media/self-help. Professional help was least commonly sought. Among young people reporting one or more sexual function problem, 3.6% (1.9–6.8) of men and 7.9% (5.8–10.6) of women had consulted professionals about their sex life in the last year.
Figure 2.
Proportion of young people who sought help or advice about their sex life by experience of sexual function problem and gender. SF = sexual function.
Distress and avoidance among young people who did not have sex in the last year
In total, 262 men and 255 women were sexually experienced (had ever had a sexual experience) but did not report having sex in the year before interview (Table 3). Just over one in six of these men (17.4%) and around one in eight of these women (12%) reported being distressed about their sex life, and around one in 10 (10%) of men and women said they had avoided sex because of sexual difficulties that either they or their partner experienced. There was no gender difference in reporting distress or avoidance.
Table 3.
Proportion of sexually inactive 16- to 21-year-olds reporting distress about sex life, satisfaction with sex life, and avoidance of sex
Men
Women
Denominators
262, 165
255, 138
Percent
95% CI
Percent
95% CI
Distressed or worried about sex life
17.40
12.8–23.4
12.00
8.3–17.2
Avoided sex because of own or partner’s sexual difficulties
These nationally representative data show that approximately one in 10 sexually active young men and one in eight sexually active young women report a distressing sexual problem lasting 3 months or more in the last year. The most commonly reported distressing problem among all sexually active men was reaching a climax too quickly (4.5%), and among young women, was difficulty reaching climax (6.3%). Over a third of men and more than four in 10 women reporting one or more sexual function problem had sought help, but rarely from professional sources. Among those who had not had sex in the year before interview, one in 10 young men and women said they had avoided sex because of sexual difficulties.
The strengths of this study are that it is based on a large population-based probability sample and addresses an important gap in the empirical evidence on sexual function problems among the young. Although the response rate of the overall survey (57.7%) represents a potential source of bias, the response rate among 16- to 44-year-olds was higher, at 64.8%. We have previously noted the recent general decline in survey response rates, coupled with more stringent methods for calculating them, and have also noted that our response rates are in line with other major social surveys in United Kingdom [25] and [27]. Nonetheless, systematic bias in agreement to participate is possible, and we used survey weights to reduce this bias (see Methods). Items on sexual problems are sensitive, and self-reported data may be subject to recall bias and prone to under-reporting. We sought to minimize reporting bias by describing sexual function problems as “common difficulties” [22], by cognitively pretesting items [28], and by using computer-assisted self-interviewing [25].
Our data show sexual function problems are not uncommon in this age group. Estimates of the proportions of sexually active 16- to 21-year-old men and women reporting sexual function problems are not much lower than for the entire Natsal-3 population, 41.6% for men and 51.2% for women [22]. Several population-based studies have included and reported on younger age groups [10], [11], [12] and [29] although comparison is limited by variation in survey methodology and categorization of both sexual problems and their severity. A recent Canadian study [13], for example, found that 50% of sexually active 16- to 21-year-old men and women reported a sexual problem, of whom, half reported associated distress, although the small, nonrandom sample and differences in definition suggest the need for caution in interpretation. Among young men, our prevalence estimate for erectile difficulties (7.8%) is midway between the 4.3% found in an Australian study of sexually active 16- to 19-year-olds [10] and 11% among sexually active 16- to 24-year-olds in a study in Portugal [12]. Our estimate of 13.2% for early ejaculation is slightly lower than the Australian study (15.3%) and much lower than the Portuguese study (40%). Among young women, our prevalence estimates for lack of interest (22%) and difficulty in reaching orgasm (21.3%) are slightly lower than those in the Australian study (36.7% and 29%, respectively) and comparable with rates of approximately 20% and 27% in a Swedish study of women aged 18–24 years [11].
It has been suggested that a proportion of problems in young people arise from a “practice effect” and that they disappear over time as young people gain confidence and experience. In support of this, O’Sullivan et al. [13] found that in young men, a longer period of sexual experience was associated with better erectile functioning and greater satisfaction with intercourse. On the other hand, a proportion of adults with sexual function problems report lifelong symptoms, in other words, symptoms that appeared at or before time of their sexual debut and have not subsided [8] and [30]. A number of factors contributing to sexual difficulties are typically shaped in childhood and adolescence. These include inadequate sex education, difficulty in communicating about sex, anxiety about one’s body or sexuality, and confusion or shame about one’s sexual orientation or desires [31]. Sexual difficulties may also reflect the struggle to achieve positive sexuality within the confines of restrictive and gendered social norms, for instance, an acceptance that women should expect and endure pain [5]. The sexual double standard whereby women are censored and men rewarded for their sexual desire appears particularly resistant to cultural change [32], although recent research suggests variation in the extent to which young people assimilate these cultural scripts in their own relationships [33].
Over 25 years since the essay by Fine and McClelland [34] on the missing discourse of desire in sex education, young people continue to perceive a gap in their knowledge relating to psychosocial aspects of sex and often report feeling ill equipped to manage sexual intimacy. Natsal-3 data suggest that 42% of men and 47% of women wish they had known more about psychosexual topics at the time they first felt ready to have sex, including nearly 20% of men and 15% of women who wished they had known how to make sex more satisfying [35]. Similarly, in a mixed method study from New Zealand, students aged 16–19 years ranked “how to make sexual activity more enjoyable for both partners” and “emotions in relationships” among the top five topics they wished to know more about in school sex education [24]. While young people say they want to talk about pleasure, nonpenetrative alternatives to intercourse, and power relations in sexual relationships, school sex education tends to neglect these topics, the content instead reflecting the protectionist concerns of adults in authority [36].
Calls for inclusion of pleasure in sex education are not new [37]. The silence on sexual well-being from educative sources is filled by other sources such as friends and media; and, according to Natsal-3, nearly a quarter of young men cite pornography as one of their sources of information about sex [35]. Although some users perceive a positive impact on their sex life [38], pornography may lead to unrealistic and harmful expectations of sex among young men [39], potentially exacerbating sexual function problems. Sex education could do much to debunk myths, discuss pleasure, promote gender equitable relationships, and emphasize the key roles of communication and respect within relationships to militate against sexual problems.
The low proportion of young people with distressing problems who seek help or advice is perhaps unsurprising. Help seeking is uncommon, even among adults with sexual function problems [40]. Sex education could do much to address concerns, (1) by meeting gaps in knowledge; (2) by reassuring young people that problems are common and legitimate; and (3) by strengthening links to youth friendly services. Providers, in turn, need to be aware that young people attending for other sexual health needs (such as contraception and STI testing) may be struggling with concerns related to their sexual function. Given the prevalence of these concerns, it may be appropriate for providers to initiate discussion by asking about sexual function within a standard patient history, and future studies might evaluate the usefulness of this approach.
Without reliable data on young people’s sexual function and well-being, calls for attention to this aspect of their sexual health can only be speculative. There is a pressing need for further youth-focused research exploring the scope of problems, their etiology and ramifications. In particular, there is a need for valid measurement tools that are specifically tailored to young people’s issues.
In conclusion, if we wish to improve sexual well-being in the population, we need to reach individuals and couples as they embark on their sexual careers, to prevent lack of knowledge, anxiety, and shame turning into lifelong sexual difficulties. Our data provide a strong empirical impetus for taking this preventive action.
Acknowledgments
Natsal-3 is a collaboration between University College London (London, UK), the London School of Hygiene and Tropical Medicine (London, UK), NatCen Social Research, Public Health England (formerly the Health Protection Agency), and the University of Manchester (Manchester, United Kingdom). The funders had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; and preparation, review, or approval of the article; and decision to submit the article for publication. The authors thank the study participants, the team of interviewers from NatCen Social Research, operations, and computing staff from NatCen Social Research.
Funding Sources
The study was supported by grants from the Medical Research Council (G0701757) and the Wellcome Trust (084840), with contributions from the Economic and Social Research Council and Department of Health. Since September 2015, K.R.M. has been core funded by the UK Medical Research Council (MRC); MRC/CSO Social & Public Health Sciences Unit, University of Glasgow (MC_UU_12017-11).
While Ley’s title says we must rely on “good science,” it is Ley who links to only a single paper (which actually supports the concept of porn addiction). In contrast, Zimbardo provides 14 references (13 studies, one article) and a link to his new book “Man, Interrupted: Why Young Men are Struggling & What We Can Do About It”. Zimbardo could have cited many more studies, as you will see.
Ley Links to Only a Single Citation, and It Supports Porn Addiction
Ley provides plenty of bluster, but there’s not a single citation in Ley’s post that refutes anything in Zimbardo’s post. In fact, Ley’s article links to only one citation – which is a recent review of the literature on compulsive sexual behaviors, by Shane Kraus, Valerie Voon & Marc Potenza. Contrary to Ley’s claim, the “Voon review” actually supports the existence of porn addiction. An excerpt from the review:
“Overlapping features exist between CSB [compulsive sexual behavior] and substance use disorders. Common neurotransmitter systems may contribute to CSB and substance use disorders, and recent neuroimaging studies highlight similarities relating to craving and attentional biases.”
In other words, the research on CSBs has much in common with substance abuse disorders, even if cautious scientists want to see further evidence. Two of the authors of this review (Valerie Voon & Marc Potenza) are top addiction neuroscientists. Together they have published three studies on “porn addicts.” Two of the studies were fMRIs (brain scans), while one was neuropsychological (attentional bias). While Voon and Potenza tend to be very guarded, they stated that their three brain studies align perfectly with the addiction model (1, 2, 3). Ley ignores all of this and excerpts the cautious portion of the paper, which is a normal feature of serious scientific papers. Then he interprets it for us, claiming it means the data is conflicted (rather than merely still limited):
“Insufficient data are available regarding what clusters of symptoms may best constitute CSB (Compulsive Sexual Behavior) or what threshold may be most appropriate for defining CSB. Such insufficient data complicate classification, prevention and treatment efforts. While neuroimaging data suggest similarities between substance addictions and CSB, data are limited by small sample sizes, solely male heterosexual samples, and cross-sectional design.”
Read the above carefully. Yes, the researchers want more data. (They always do.) However, Kraus, Voon and Potenza clearly state that the existing data points for substance addictions and CSBs are neurobiologically similar. Simply put, drug addictions and compulsive sexual behaviors share similar neurobiological features and brain changes. By the way, nearly all the brain studies cited in this review to demonstrate that CSBs are very similar to substance abuse disorders involved compulsive internet porn users. It’s not surprising as a separate review (Neurobiology of Compulsive Sexual Behavior: Emerging Science. 2016) published a month earlier by Kraus, Voon and Potenza concluded:
“Given some similarities between CSB and drug addictions, interventions effective for addictions may hold promise for CSB, thus providing insight into future research directions to investigate this possibility directly.”
In other words, the conflict does not lie in the neuroscience on porn addicts, which is clear, and very similar to that on substance abusers. Instead, the conflict surrounds what “cluster of symptoms” best defines compulsive sexual behaviors (CSB). The difficulty agreeing on a cluster of symptoms arises from the fact that the researchers fail to tease apart sex addiction from Internet porn addiction, lumping them together as “CSBs.”
Compulsive sexual behaviour disorder (operationalised as hypersexual disorder) was considered for inclusion in DSM-5 but ultimately excluded, despite the generation of formal criteria and field trial testing. This exclusion has hindered prevention, research, and treatment efforts, and left clinicians without a formal diagnosis for compulsive sexual behaviour disorder.
Research into the neurobiology of compulsive sexual behaviour disorder has generated findings relating to attentional biases, incentive salience attributions, and brain-based cue reactivity that suggest substantial similarities with addictions. Compulsive sexual behaviour disorder is being proposed as an impulse-control disorder in ICD-11, consistent with a proposed view that craving, continued engagement despite adverse consequences, compulsive engagement, and diminished control represent core features of impulse-control disorders. This view might have been appropriate for some DSM-IV impulse-control disorders, specifically pathological gambling. However, these elements have long been considered central to addictions, and in the transition from DSM-IV to DSM-5, the category of Impulse Control Disorders Not Elsewhere Classified was restructured, with pathological gambling renamed and reclassified as an addictive disorder. At present, the ICD-11 beta draft site lists the impulse-control disorders, and includes compulsive sexual behaviour disorder, pyromania, kleptomania, and intermittent explosive disorder.
Compulsive sexual behaviour disorder seems to fit well with non-substance addictive disorders proposed for ICD-11, consistent with the narrower term of sex addiction currently proposed for compulsive sexual behaviour disorder on the ICD-11 draft website. We believe that classification of compulsive sexual behaviour disorder as an addictive disorder is consistent with recent data and might benefit clinicians, researchers, and individuals suffering from and personally affected by this disorder.
There’s a reason that Ley provided zero studies while Zimbardo tucked in 13. Truth be told, Zimabardo could have cited 20 more neuroscience-based studies on CSB subjects. Put simply, Ley’s post omitted all 39 neuroscience-based studies on porn users that have been published in the last few years (up-to-date list). So far, the results of every “brain study” (MRI, fMRI, EEG, neuropsychological, neuro-endocrine) offer support for the concept of porn addiction. In addition to reporting the same fundamental brain changes as seen in substance addicts, a few studies also reported that greater porn use is associated with erectile dysfunction, decreased libido, anorgasmia, delayed ejaculation, and reduced neural response to images of vanilla porn.
LEY: “Dr. Zimbardo goes on to cite several studies and articles which have alleged that pornography has a neurological effect. Unfortunately, there’s the problem of causation versus correlation, again, something I learned about in basic research classes.”
RESPONSE: This single sentence demonstrates a profound lack of knowledge as to how research works.
When someone uses “no causation has been demonstrated” it makes listening scientists doubt that person’s basic understanding of science or research. When it comes to psychological and medical studies little research reveals causation directly. For example, all studies on the relationship between lung cancer and cigarette smoking are correlative – but cause and effect are settled.
In light of ethical requirements researchers are usually precluded from constructing experimental research designs which would prove pornography causes certain harms. Therefore, they must instead use correlational models. Over time, when a significant body of correlational studies are amassed in any given research area, there comes a point where the body of evidence can be said to prove a point of theory, even though there were no experimental studies. Put another way, no single correlation study could ever provide a “smoking gun” in an area of study, but the converging evidence of multiple correlational studies is used to establish evidence. When it comes to porn use, nearly every study published is correlative. To “prove” porn use is causing erectile dysfunction or addiction-related brain changes you would have to do one of two things:
Have two large groups of identical twins separated at birth. Make sure one group never watches porn. Make sure that every individual in the other group watches the exact same type of porn, for exact same hours, and the exact same age. Continue the experiment for 30 years or so, followed by assessment of the differences.
Eliminate the variable whose effects you wish to measure. Specifically, have porn users stop, and assess the changes months (years?) later. This is exactly what is occurring informally online as thousands of young men stop internet porn use to alleviate chronic non-organic sexual dysfunctions (that turn out to have been caused by porn use).
To this date only 8 studies have removed porn and observed the results. All 8 found significant changes. Five of those studies had compulsive porn users with severe sexual dysfunctions abstain from porn. Those 5 studies demonstrate causation as patients healed chronic sexual dysfunctions by removing a single variable: porn. The 8 studies:
1) Trading Later Rewards for Current Pleasure: Pornography Consumption and Delay Discounting (2015) – This study reported that greater porn use was correlated with less ability to delay gratification. The researchers assessed porn users a month later and found that continued porn use correlated with less ability to delay gratification. Finally, researchers divided subjects into 2 groups: Half tried to abstain from their favorite food; half tried to abstain from internet porn. The subjects who tried to abstain from porn experienced significant changes: they scored better on their ability to delay gratification. The researchers said:
“The finding suggests that Internet pornography is a sexual reward that contributes to delay discounting differently than other natural rewards. It is therefore important to treat pornography as a unique stimulus in reward, impulsivity, and addiction studies and to apply this accordingly in individual as well as relational treatment.”
“When asked about masturbatory practices, he reported that in the past he had been masturbating vigorously and rapidly while watching pornography since adolescence. The pornography originally consisted mainly of zoophilia, and bondage, domination, sadism, and masochism, but he eventually got habituated to these materials and needed more hardcore pornography scenes, including transgender sex, orgies, and violent sex. He used to buy illegal pornographic movies on violent sex acts and rape and visualized those scenes in his imagination to function sexually with women. He gradually lost his desire and his ability to fantasize and decreased his masturbation frequency.”
In conjunction with weekly sessions with a sex therapist, the patient was instructed to avoid any exposure to sexually explicit material, including videos, newspapers, books, and internet pornography.
After 8 months, the patient reported experiencing successful orgasm and ejaculation. He renewed his relationship with that woman, and they gradually succeeded in enjoying good sexual practices.
4) Is Internet Pornography Causing Sexual Dysfunctions? A Review with Clinical Reports (2016) – An extensive review of the literature related to porn-induced sexual problems. Involving US Navy doctors, the review provides the latest data revealing a tremendous rise in youthful sexual problems. It also reviews the neurological studies related to porn addiction and sexual conditioning via Internet porn. The doctors provide 3 clinical reports of men who developed porn-induced sexual dysfunctions. Two of the three men healed their sexual dysfunctions by eliminating porn use. The third man experienced little improvement as he was unable to abstain from porn use.
Traditional factors that once explained men’s sexual difficulties appear insufficient to account for the sharp rise in erectile dysfunction, delayed ejaculation, decreased sexual satisfaction, and diminished libido during partnered sex in men under 40. This review (1) considers data from multiple domains, e.g., clinical, biological (addiction/urology), psychological (sexual conditioning), sociological; and (2) presents a series of clinical reports, all with the aim of proposing a possible direction for future research of this phenomenon. Alterations to the brain’s motivational system are explored as a possible etiology underlying pornography-related sexual dysfunctions. This review also considers evidence that Internet pornography’s unique properties (limitless novelty, potential for easy escalation to more extreme material, video format, etc.) may be potent enough to condition sexual arousal to aspects of Internet pornography use that do not readily transition to real-life partners, such that sex with desired partners may not register as meeting expectations and arousal declines. Clinical reports suggest that terminating Internet pornography use is sometimes sufficient to reverse negative effects, underscoring the need for extensive investigation using methodologies that have subjects remove the variable of Internet pornography use.
5) Male masturbation habits and sexual dysfunctions (2016) – It’s by a French psychiatrist who is the current president of the European Federation of Sexology. While the abstract shifts back and forth between Internet pornography use and masturbation, it’s clear that he’s mostly referring to porn-induced sexual dysfunctions (erectile dysfunction and anorgasmia). The paper revolves around his clinical experience with 35 men who developed erectile dysfunction and/or anorgasmia, and his therapeutic approaches to help them. The author states that most of his patients used porn, with several being addicted to porn. The abstract points to internet porn as the primary cause of the problems (keep in mind that masturbation does not cause chronic ED, and it is never given as a cause of ED). Excerpts:
Intro: Harmless and even helpful in his usual form widely practiced, masturbation in its excessive and pre-eminent form, generally associated today to pornographic addiction, is too often overlooked in the clinical assessment of sexual dysfunction it can induce.
Results: Initial results for these patients, after treatment to “unlearn” their masturbatory habits and their often associated addiction to pornography, are encouraging and promising. A reduction in symptoms was obtained in 19 patients out of 35. The dysfunctions regressed and these patients were able to enjoy satisfactory sexual activity.
Conclusion: Addictive masturbation, often accompanied by a dependency on cyber-pornography, has been seen to play a role in the etiology of certain types of erectile dysfunction or coital anejaculation. It is important to systematically identify the presence of these habits rather than conduct a diagnosis by elimination, in order to include habit-breaking deconditioning techniques in managing these dysfunctions.
6) How difficult is it to treat delayed ejaculation within a short-term psychosexual model? A case study comparison (2017) – A report on two “composite cases” illustrating the causes and treatments for delayed ejaculation (anorgasmia). “Patient B” represented several young men treated by the therapist. Interestingly, the paper states that Patient B’s “porn use had escalated into harder material”, “as is often the case”. The paper says that porn-related delayed ejaculation is not uncommon, and on the rise. The author calls for more research on porn’s effects of sexual functioning. Patient B’s delayed ejaculation was healed after 10 weeks of no porn. Excerpts:
The cases are composite cases taken from my work within the National Health Service in Croydon University Hospital, London. With the latter case (Patient B), it is important to note that the presentation reflects a number of young males who have been referred by their GPs with a similar diagnosis. Patient B is a 19-year-old who presented because he was unable to ejaculate via penetration. When he was 13, he was regularly accessing pornography sites either on his own through internet searches or via links that his friends sent him. He began masturbating every night while searching his phone for image…If he did not masturbate he was unable to sleep. The pornography he was using had escalated, as is often the case (see Hudson-Allez, 2010), into harder material (nothing illegal)…
We agreed that he would no longer use pornography to masturbate. This meant leaving his phone in a different room at night. We agreed that he would masturbate in a different way….
Patient B was able to achieve orgasm via penetration by the fifth session; the sessions are offered fortnightly in Croydon University Hospital so session five equates to approximately 10 weeks from consultation. He was happy and greatly relieved. In a three-month follow-up with Patient B, things were still going well.
Patient B is not an isolated case within the National Health Service (NHS) and in fact young men in general accessing psychosexual therapy, without their partners, speaks in itself to the stirrings of change.
7) Situational Psychogenic Anejaculation: A Case Study (2014) – The details reveal a case of porn-induced anejaculation. The husband’s only sexual experience prior to marriage was frequent masturbation to pornography – where he was able to ejaculate. He also reported sexual intercourse as less arousing than masturbation to porn. The key piece of information is that “re-training” and psychotherapy failed to heal his anejaculation. When those interventions failed, therapists suggested a complete ban on masturbation to porn. Eventually this ban resulted in successful sexual intercourse and ejaculation with a partner for the first time in his life. A few excerpts:
A is a 33-year-old married male with heterosexual orientation, a professional from a middle socio-economic urban background. He has had no premarital sexual contacts. He watched pornography and masturbated frequently. His knowledge about sex and sexuality was adequate. Following his marriage, Mr. A described his libido as initially normal, but later reduced secondary to his ejaculatory difficulties. Despite thrusting movements for 30-45 minutes, he had never been able to ejaculate or achieve orgasm during penetrative sex with his wife.
What didn’t work:
Mr. A’s medications were rationalized; clomipramine and bupropion were discontinued, and sertraline was maintained at a dose of 150 mg per day. Therapy sessions with the couple were held weekly for the initial few months, following which they were spaced to fortnightly and later monthly. Specific suggestions including focusing on sexual sensations and concentrating on the sexual experience rather than ejaculation were used to help reduce performance anxiety and spectatoring. Since problems persisted despite these interventions, intensive sex therapy was considered.
Eventually they instituted a complete ban on masturbation (which means he continued to masturbate to porn during the above failed interventions):
A ban on any form of sexual activity was suggested. Progressive sensate focus exercises (initially non-genital and later genital) were initiated. Mr. A described an inability to experience the same degree of stimulation during penetrative sex as compared to that which he experienced during masturbation. Once the ban on masturbation was enforced, he reported an increased desire for sexual activity with his partner.
After an unspecified amount of time, the ban on masturbation to porn lead to success:
Meanwhile, Mr. A and his wife decided to go ahead with Assisted Reproductive Techniques (ART) and underwent two cycles of intrauterine insemination. During a practice session, Mr. A ejaculated for the first time, following which he has been able to ejaculate satisfactorily during a majority of the couple’s sexual interactions.
The length of the longest streak participants performed before taking part in the survey correlates with time preferences. The second survey will answer the question if longer periods of abstinence render participants more able to delay rewards, or if more patient participants are more likely to perform longer streaks.
Longer periods of abstinence most likely cause less risk aversion (which is good). The second survey will provide the final proof.
Personality correlates with length of streaks. The second wave will reveal if abstinence influences personality or if personality can explain variation in the length of streaks.
Results of the Second Wave – Main Findings
Abstaining from pornography and masturbation increases the ability to delay rewards
Participating in a period of abstinence renders people more willing to take risks
Abstinence renders people more altruistic
Abstinence renders people more extroverted, more conscientious, and less neurotic
LEY: “Numerous studies have now demonstrated that high porn-users tend to be people with higher libido“
RESPONSE: There’s a reason Ley provides no citation. Study after study refutes this often repeated Ley meme.
Ley’s “higher libido” claim appears to based on his blog post with the catchy title: “Your Brain on Porn – It’s NOT Addictive”. The Ley blog post is not about the science behind YBOP. Instead, it’s about a single EEG study, whose lead author is his colleague Nicole Prause: (Steele et al. 2013). Both Ley and Prause claimed that the study’s findings support the premise that porn/sex addiction is nothing more than “high sexual desire.”
Contrary to claims by Ley and Prause, Steeleet al. reported greater cue-reactivity to porn correlating with LESS desire for sex with a partner (but not lower desire to masturbate to porn). To put it another way – individuals with more brain activation and cravings for porn would rather masturbate to porn than have sex with a real person. This is not an indication of “high sexual desire.”
Greater cue reactivity to porn coupled with lower desire for sex with real partners aligns the 2014 Cambridge University brain study on porn addicts. The actual findings of Steeleet al., 2013 do not support its conclusion, or Ley’s blog post assertions. Six subsequent peer-reviewed papers say that the Steele et al. findings actually lend support to the porn addiction model (as opposed to the “high sexual desire” hypothesis): 1, 2, 3, 4, 5, 6.
In 2015, Nicole Prause published a second EEG study, which found LESS neural response (with brief exposure to still images) in “porn addicts” when compared to controls (Steele et al., 2013 had no control subjects) This is evidence of abnormally reduced desire in porn addicts. These findings align perfectly with Kühn & Gallinat (2014), which found that more porn use correlated with less brain activation in response to pictures of vanilla porn. In other words, “porn addicts” were desensitized and – far from having high sexual desire – needed greater stimulation than non-addicts to be turned on. Put simply, the results of Prause’s second EEG study indicate LESS sexual arousal – not higher sexual desire. Seven peer-reviewed papers all agree that Prause et al., 2015 actually found desensitization/habituation in frequent porn users: 1, 2, 3, 4. 5, 6, 7.
In fact, Prause stated in this recent Quora post that she no longer believes that “sex addicts” have high libidos:
“I was partial to the high sex drive explanation, but this LPP study we just published is persuading me to be more open to sexual compulsivity.”
Since Prause has flip-flopped, where is Ley’s support for the “porn/sex addiction = high libido” claim? Below are multiple studies that tested, and falsified, David Ley’s “high libido = sex/porn addiction” claim entirely:
“On an adapted version of the Arizona Sexual Experiences Scale [43], CSB subjects compared to healthy volunteers had significantly more difficulty with sexual arousal and experienced more erectile difficulties in intimate sexual relationships but not to sexually explicit material (Table S3 in File S1).”
CSB subjects reported that as a result of excessive use of sexually explicit materials….. experienced diminished libido or erectile function specifically in physical relationships with women (although not in relationship to the sexually explicit material)…
“Hypersexuality was significantly correlated with proneness to sexual boredom and more problems with erectile function.”
6) “Adolescents and web porn: a new era of sexuality (2015)” – This Italian study analyzed the effects of Internet porn on high school seniors, co-authored by urology professor Carlo Foresta, president of the Italian Society of Reproductive Pathophysiology. The most interesting finding is that 16% of those who consume porn more than once a week report abnormally low sexual desire compared with 0% in non-consumers (and 6% for those who consume less than once a week). From the study:
“21.9% define it as habitual, 10% report that it reduces sexual interest towards potential real-life partners, and the remaining, 9.1% report a kind of addiction. In addition, 19% of overall pornography consumers report an abnormal sexual response, while the percentage rose to 25.1% among regular consumers.”
“We assume that subjects with a high porn consumption need increasing stimulation to receive the same amount of reward. That could mean that regular consumption of pornography more or less wears out your reward system. That would fit perfectly the hypothesis that their reward systems need growing stimulation.”
“The more hours participants reported consuming pornography, the smaller the BOLD response in left putamen in response to sexual images. Moreover, we found that more hours spent watching pornography was associated with smaller gray matter volume in the striatum, more precisely in the right caudate reaching into the ventral putamen. We speculate that the brain structural volume deficit may reflect the results of tolerance after desensitization to sexual stimuli.”
10) Sexual Desire, not Hypersexuality, is Related to Neurophysiological Responses Elicited by Sexual Images (2013) – This EEG study was touted in the media as evidence against the existence of porn/sex addiction. Not so. This SPAN Lab study, like #11 below, actually lends support to the existence of both porn addiction and porn use down-regulating sexual desire. How so? The study reported higher EEG readings (relative to neutral pictures) when subjects were briefly exposed to pornographic photos. Studies consistently show that an elevated P300 occurs when addicts are exposed to cues (such as images) related to their addiction. However, due to methodological flaws the findings are uninterpretable: 1) the study had no control group for comparison; 2) subjects were heterogeneous (males, females, non-heterosexuals); 3) subjects were not screened for mental disorders or addictions; 4) the questionnaires were not validated for porn addiction. In line with the Cambridge University brain scan studies, this EEG study also reported greater cue-reactivity to porn correlating with less desire for partnered sex. To put another way – individuals with greater brain activation to porn would rather masturbate to porn than have sex with a real person. Shockingly, study spokesperson Nicole Prause claimed that porn users merely had “high libido”, yet the results of the study say the exact opposite (their desire for partnered sex was dropping in relation to their porn use). Six peer-reviewed papers expose the truth: 1, 2, 3, 4, 5, 6. Also see the extensive YBOP critique.
11) Modulation of Late Positive Potentials by Sexual Images in Problem Users and Controls Inconsistent with “Porn Addiction” (2015) – Another SPAN Lab EEG (brain-wave) study comparing the 2013 subjects from the above study to an actual control group (yet it suffered from the same methodological flaws named above). The results: compared to controls “individuals experiencing problems regulating their porn viewing” had lower brain responses to one-second exposure to photos of vanilla porn. The lead author, Nicole Prause, claims these results “debunk porn addiction”. What legitimate scientist would claim that their lone anomalous study has debunked an entire field of study? In reality, the findings of Prause et al. 2015 align perfectly with Kühn & Gallinat (2014), which found that more porn use correlated with less brain activation in response to pictures of vanilla porn. Prause’s findings also align with Banca et al. 2015 which is #4 in this list. Moreover, another EEG study found that greater porn use in women correlated with less brain activation to porn. Lower EEG readings mean that subjects are paying less attention to the pictures. Put simply, frequent porn users were desensitized to static images of vanilla porn. They were bored (habituated or desensitized). See this extensive YBOP critique. Seven peer-reviewed papers agree that this study actually found desensitization/habituation in frequent porn users (a sign of addiction): 1, 2, 3, 4, 5, 6, 7.
In couples where only one partner used pornography, we found more problems related to arousal (male) and negative (female) self-perception.
The couples who did not use pornography… may be considered more traditional in relation to the theory of sexual scripts. At the same time, they did not seem to have any dysfunctions.
“Among men who masturbated frequently, 70% used pornography at least once a week. A multivariate assessment showed that sexual boredom, frequent pornography use, and low relationship intimacy significantly increased the odds of reporting frequent masturbation among coupled men with decreased sexual desire.”
“Among men [with decreased sexual desire] who used pornography at least once a week [in 2011], 26.1% reported that they were unable to control their pornography use. In addition, 26.7% of men reported that their use of pornography negatively affected their partnered sex and 21.1% claimed to have attempted to stop using pornography.”
Mental health specialists should take in consideration the possible effects of pornography consumption on men sexual behaviors, men sexual difficulties and other attitudes related to sexuality. In the long term pornography seems to create sexual dysfunctions, especially the individual’s inability to reach an orgasm with his partner. Someone who spends most of his sexual life masturbating while watching porn engages his brain in rewiring its natural sexual sets so that it will soon need visual stimulation to achieve an orgasm.
Many different symptoms of porn consumption, such as the need to involve a partner in watching porn, the difficulty in reaching orgasm, the need for porn images in order to ejaculate turn into sexual problems. These sexual behaviors may go on for months or years and it may be mentally and bodily associated with the erectile dysfunction, although it is not an organic dysfunction. Because of this confusion, which generates embarrassment, shame and denial, lots of men refuse to encounter a specialist
Pornography offers a very simple alternative to obtain pleasure without implying other factors that were involved in human’s sexuality along the history of mankind. The brain develops an alternative path for sexuality which excludes “the other real person” from the equation. Furthermore, pornography consumption in a long term makes men more prone to difficulties in obtaining an erection in a presence of their partners.
Further, we found no associations between the CSBI Control scale and the BIS-BAS. This would indicate that lack of sexual behavior control is related to specific sexual excitation and inhibitory mechanisms and not to more general behavioral activation and inhibitory mechanisms. This would seem to support conceptualizing hypersexuality as a dysfunction of sexuality as proposed by Kafka. Further, it does not appear that hypersexuality is a manifestation of high sex drive, but that it involves high excitation and a lack of inhibitory control, at least with respect to inhibition owing to expected negative outcomes.
Emerging research supports the notion that sexual compulsivity (SC) and hypersexual disorder (HD) among gay and bisexual men (GBM) might be conceptualized as comprising three groups—Neither SC nor HD; SC only, and Both SC and HD—that capture distinct levels of severity across the SC/HD continuum.
Nearly half (48.9 %) of this highly sexually active sample was classified as Neither SC nor HD, 30 % as SC Only, and 21.1 % as Both SC and HD. While we found no significant differences between the three groups on reported number of male partners, anal sex acts, or anal sex acts
17) The effects of sexually explicit material use on romantic relationship dynamics (2016) – As with many other studies, solitary porn users report poorer relationship and sexual satisfaction. Employing the Pornography Consumption Effect Scale (PCES), the study found that higher porn use was related to poorer sexual function, more sexual problems, and a “worse sex life”. An excerpt describing the correlation between the PCES “Negative Effects” on “Sex Life” questions and frequency of porn use:
There were no significant differences for the Negative Effect Dimension PCES across the frequency of sexually explicit material use; however, there were significant differences on the Sex Life subscale where High Frequency Porn Users reported greater negative effects than Low Frequency Porn Users.
18) Male masturbation habits and sexual dysfunctions (2016) – It’s by a French psychiatrist who is the current president of the European Federation of Sexology. While the abstract shifts back and forth between Internet pornography use and masturbation, it’s clear that he’s mostly referring to porn-induced sexual dysfunctions (erectile dysfunction and anorgasmia). The paper revolves around his clinical experience with 35 men who developed erectile dysfunction and/or anorgasmia, and his therapeutic approaches to help them. The author states that most of his patients used porn, with several being addicted to porn. The abstract points to internet porn as the primary cause of the problems (keep in mind that masturbation does not cause chronic ED, and it is never given as a cause of ED). Excerpts:
Intro: Harmless and even helpful in his usual form widely practiced, masturbation in its excessive and pre-eminent form, generally associated today to pornographic addiction, is too often overlooked in the clinical assessment of sexual dysfunction it can induce.
Results: Initial results for these patients, after treatment to “unlearn” their masturbatory habits and their often associated addiction to pornography, are encouraging and promising. A reduction in symptoms was obtained in 19 patients out of 35. The dysfunctions regressed and these patients were able to enjoy satisfactory sexual activity.
Conclusion: Addictive masturbation, often accompanied by a dependency on cyber-pornography, has been seen to play a role in the etiology of certain types of erectile dysfunction or coital anejaculation. It is important to systematically identify the presence of these habits rather than conduct a diagnosis by elimination, in order to include habit-breaking deconditioning techniques in managing these dysfunctions.
“related to high levels of exposure to and experience with sexually explicit materials.“
The men experiencing erectile dysfunction had spent a considerable amount of time in bars and bathhouses where porn was “omnipresent,” and “continuously playing“. The researchers stated:
“Conversations with the subjects reinforced our idea that in some of them a high exposure to erotica seemed to have resulted in a lower responsivity to “vanilla sex” erotica and an increased need for novelty and variation, in some cases combined with a need for very specific types of stimuli in order to get aroused.”
20) Online sexual activities: An exploratory study of problematic and non-problematic usage patterns in a sample of men (2016) – This Belgian study from a leading research university found problematic Internet porn use was associated with reduced erectile function and reduced overall sexual satisfaction. Yet problematic porn users experienced greater cravings. The study appears to report escalation, as 49% of the men viewed porn that “was not previously interesting to them or that they considered disgusting.” (See studies reporting habituation/desensitization to porn and escalation of porn use) Excerpts:
“This study is the first to directly investigate the relationships between sexual dysfunctions and problematic involvement in OSAs. Results indicated that higher sexual desire, lower overall sexual satisfaction, and lower erectile function were associated with problematic OSAs (online sexual activities). These results can be linked to those of previous studies reporting a high level of arousability in association with sexual addiction symptoms (Bancroft & Vukadinovic, 2004; Laier et al., 2013; Muise et al., 2013).”
In addition, we finally have a study that asks porn users about possible escalation to new or disturbing porn genres. Guess what it found?
“Forty-nine percent mentioned at least sometimes searching for sexual content or being involved in OSAs that were not previously interesting to them or that they considered disgusting, and 61.7% reported that at least sometimes OSAs were associated with shame or guilty feelings.”
Note – This is the first study to directly investigate the relationships between sexual dysfunctions and problematic porn use. Two other studies claiming to have investigated correlations between porn use and erectile functioning cobbled together data from earlier studies in an unsuccessful attempt to debunk porn-induced ED. Both were criticized in the peer-reviewed literature: paper 1 was not an authentic study, and has been thoroughly discredited; paper 2 actually found correlations that support porn-induced ED. Moreover, paper 2 was only a “brief communication” that did not report important data.
21) Altered Appetitive Conditioning and Neural Connectivity in Subjects With Compulsive Sexual Behavior (2016) – “Compulsive Sexual Behaviors” (CSB) means the men were porn addicts, because CSB subjects averaged nearly 20 hours of porn use per week. The controls averaged 29 minutes per week. Interestingly, 3 of the 20 CSB subjects mentioned to interviewers that they suffered from “orgasmic-erection disorder,” while none of the control subjects reported sexual problems.
Young men who prefer pornography to real-world sexual encounters might find themselves caught in a trap, unable to perform sexually with other people when the opportunity presents itself, a new study reports. Porn-addicted men are more likely to suffer from erectile dysfunction and are less likely to be satisfied with sexual intercourse, according to survey findings presented Friday at the American Urological Association’s annual meeting, in Boston.
Among participants who responded to the open-ended question (n=718), problematic usage was self-identified by 88 respondents. Male participants who reported problematic usage of pornography highlighted effects in three areas: on sexual function, arousal and relationships. Responses included “I think it has been a negative influence in many ways but at the same time I can’t stop using it” (Male, Aged 18–19).
Findings suggested that latency erotic disruption by way of sexually explicit material (SEM) and/or child sexual abuse may be associated to adult online sexual behaviors.
Furthermore, results demonstrated that latency SEM exposure was a significant predictor of adult sexual dysfunctions.
We hypothesized that exposure to latency SEM exposure would predict adult use of SEM. Study findings supported our hypothesis, and demonstrated that latency SEM exposure was a statistically significant predictor of adult SEM use. This suggested that individuals who were exposed to SEM during latency, may continue this behavior into adulthood. Study findings also indicated that latency SEM exposure was a significant predictor of adult online sexual behaviors.
In short, the evidence is piling up that internet porn erodes normal sexual desire, leaving users less responsive to pleasure. They may crave porn, but that is more likely evidence of an addiction-related brain change known as “sensitization” (hyper-reactivity to addiction-related cues). Cravings certainly cannot be assumed to be evidence of greater libido.
LEY: “It is most likely that these dispositions correlate with neurological characteristics, which these studies are finding. In other words, these neurological characteristics are in fact the cause, not the effect.”
RESPONSE: Without a shred of evidence or a single example, Ley is claiming that the brain changes found the 39 studies addiction must have existed before porn use. In reality, the two main addiction-related brain changes reported by the studies can only develop from chronic use:
Sensitization: Chronic use leads to altered nerve connections which cause the reward circuitry to buzz in response to addiction-related cues or thoughts. This Pavlovian memory is what induces severe cravings that make the addiction far more compelling than other activities in the addict’s life. (Studies reporting sensitization in internet porn users: 1,2,3,4, 5,6,7,8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20.)
Desensitization: Chronic use leads to the individual becoming less sensitive to pleasure, which often manifests as the need for greater and greater stimulation to achieve the same buzz. This is referred to as tolerance and only occurs with chronic use. (Studies reporting desensitization in porn users: : 1,2, 3, 4, 5, 6.)
It’s quite telling that Ley is incapable of naming these “neurological characteristics.” Reality: The mechanisms of addiction have been studied for nearly 60 years. The very specific brain changes caused by addiction have been elucidated down to the cellular, protein, and epigenetic levels. These brain changes have been correlated over and over with the behaviors collectively known as the “addiction phenotype.” Addiction-like behaviors can be induced in animals simply by increasing a single protein within the reward center (Deltafosb). In short, a lot is known about the biology of addiction – more than any other mental disorder – even if it remains unknown to Dr. Ley.
Four major brain changes are involved with both drug and behavioral addictions, as outlined in this paper published this year in The New England Journal of Medicine: “Neurobiologic Advances from the Brain Disease Model of Addiction (2016)“. This landmark review by the Director of the National Institute on Alcohol Abuse and Alcoholism (NIAAA) George F. Koob, and the director of the National Institute on Drug Abuse (NIDA) Nora D. Volkow, not only outlines the brain changes involved in addiction, it also states in its opening paragraph that sex addiction exists:
“We conclude that neuroscience continues to support the brain disease model of addiction. Neuroscience research in this area not only offers new opportunities for the prevention and treatment of substance addictions and related behavioral addictions (e.g., to food, sex, and gambling)….”
I find it interesting that Dr. Ley seems to always claim that there’s no scientific support for porn addiction, yet not only do 37 studies provide support for porn/sex addiction, the world’s top addiction experts do also. The little bubble he has constructed, where porn addiction cannot possibly exist, is seriously out of step with science.
LEY: “Grubbs also found recently that the identity of “porn addict” is an iatrogenic concept, which creates harm and distress, by telling an individual to hate and fear their own sexuality“
Both Ley’s and the Grubbs study’s claims depend upon two false premises:
That Grubbs’s porn addiction test (CPUI) assesses “perceived porn addiction” rather than actual addiction. It does not. Grubbs et al. re-labeled Grubbs’s self-created porn addiction test as a “perceived porn addiction” test. However, this Cyber Pornography Use Inventory (CPUI) questionnaire is in fact similar to many other drug and behavioral addiction questionnaires. Like other addiction tests, the CPUI assesses behaviors and symptoms common to all addictions, such as: the inability to control use; compulsion to use, cravings to use, negative psychological, social and emotional effects; and preoccupation with using. In fact, only 1 of its 9 questions even hints at “perceived addiction.” Yet we are told that a person’s total score for all 9 questions is synonymous with “perceived addiction” rather than addiction itself. Very misleading, very clever, and without any scientific basis.
That Grubbs found little correlation between CPUI scores and hours of porn use. Contrary to Ley’s claim, Grubbs found a pretty strong correlation between hours of use and the CPUI! From p. 6 of the study:
“Additionally, average daily pornography use in hourswas significantly and positively associated with depression, anxiety, and anger, as well as withperceived addiction.”
Stop the presses! This excerpt directly contradicts all the headlines, which claim that pornography use was NOT strongly correlated with psychological distress or “perceived addiction.” Again, whenever you see the phrase “perceived addiction” it actually denotes the subjects’ total score on the CPUI (which is a porn addiction test). Really get this: The Grubbs study did NOT assess “perceived addiction.” There are many more details in this critique that debunks assertions put forth in lay articles and the claims made within the Grubbs’s studies: Is Joshua Grubbs pulling the wool over our eyes with his “perceived porn addiction” research? (2016).
Update: Joshua Grubbs published a study testing the talking point that religious people are more likely to believe they are addicted to porn (even though the Grubbs studies never assessed “belief in being addicted porn”). Faced with thoughtful skepticism about his assumptions, and reservations about the unfounded claims that his CPUI-9 instrument could indeed distinguish “perceived pornography addiction” from genuine problematic porn use, Dr. Grubbs did the right thing as a scientist. He pre-registered a study to test his hypotheses/assumptions directly. Pre-registration is a sound scientific practice that prevents researchers from changing hypotheses after collecting data.
The results contradicted both his earlier conclusions and the meme (“porn addiction is just shame”) that the press helped to popularize.
Dr. Grubbs set out to prove that religiosity was the main predictor of “believing yourself addicted to porn.” He and his team of researchers surveyed 3 rather large, diverse samples (male, female, etc.): Who’s a Porn Addict? Examining the Roles of Pornography Use, Religiousness, and Moral Incongruence. (He posted the results online, although his team’s paper has not yet been formally published).
This time, however, he didn’t rely on his CPUI-9 instrument. (The CPUI-9 includes 3 “guilt and shame/emotional distress” questions not normally found in addiction instruments – and which skew its results, causing religious porn users to score higher and non-religious users to score lower than subjects do on standard addiction-assessment instruments.) Instead, the Grubbs team asked 2 direct yes/no questions of porn users (“I believe that I am addicted to internet pornography.” “I would call myself an internet pornography addict.”), and compared results with scores on a “moral disapproval” questionnaire.
Directly contradicting his earlier claims, Dr. Grubbs and his research team found that believing you are addicted to porn correlates most strongly withdaily hours of porn use, not with religiousness. As noted above, some of Grubbs studies also found that hours of use was a stronger predictor of “perceived addiction” than religiosity. From the new study’s abstract:
In contrast to prior literature indicating that moral incongruence and religiousness are the best predictors of perceived addiction [using the CPUI-9], results from all three samples indicated that male gender and pornography use behaviors were the most strongly associated with self-identification as a pornography addict.
Based on their results, Dr. Grubbs and his co-authors advise that,
“mental and sexual health professionals should take the concerns of clients identifying as pornography addicts seriously.”
LEY: “There has not been a single peer-reviewed paper published which demonstrate any evidence that ED related to porn use is a real phenomenon.“
RESPONSE: Absolutely false. And it’s not just erectile dysfunction. Several studies have found relationships between porn use in young men and ED, anorgamsia, low sexual desire, delayed ejaculation and lower brain activation to sexual images. In addition this page contains articles and videos by over 100 experts (urology professors, urologists, psychiatrists, psychologists, sexologists, MDs) who acknowledge and have successfully treated porn-induced ED and porn-induced loss of sexual desire.
Studies reporting links between porn use/sex addiction and ED, anorgamsia, low sexual desire, delayed ejaculation, and lower brain activation to sexual images.
In addition to the studies below, this page contains articles and videos by over 130 experts (urology professors, urologists, psychiatrists, psychologists, sexologists, MDs) who acknowledge and have successfully treated porn-induced ED and porn-induced loss of sexual desire. The first 7 studies demonstrate causation as participants eliminated porn use and healed chronic sexual dysfunctions:
1) Is Internet Pornography Causing Sexual Dysfunctions? A Review with Clinical Reports (2016)– An extensive review of the literature related to porn-induced sexual problems. Involving 7 US Navy doctors, the review provides the latest data revealing a tremendous rise in youthful sexual problems. It also reviews the neurological studies related to porn addiction and sexual conditioning via Internet porn. The doctors provide 3 clinical reports of men who developed porn-induced sexual dysfunctions. Two of the three men healed their sexual dysfunctions by eliminating porn use. The third man experienced little improvement as he was unable to abstain from porn use. Excerpt:
Traditional factors that once explained men’s sexual difficulties appear insufficient to account for the sharp rise in erectile dysfunction, delayed ejaculation, decreased sexual satisfaction, and diminished libido during partnered sex in men under 40. This review (1) considers data from multiple domains, e.g., clinical, biological (addiction/urology), psychological (sexual conditioning), sociological; and (2) presents a series of clinical reports, all with the aim of proposing a possible direction for future research of this phenomenon. Alterations to the brain’s motivational system are explored as a possible etiology underlying pornography-related sexual dysfunctions. This review also considers evidence that Internet pornography’s unique properties (limitless novelty, potential for easy escalation to more extreme material, video format, etc.) may be potent enough to condition sexual arousal to aspects of Internet pornography use that do not readily transition to real-life partners, such that sex with desired partners may not register as meeting expectations and arousal declines. Clinical reports suggest that terminating Internet pornography use is sometimes sufficient to reverse negative effects, underscoring the need for extensive investigation using methodologies that have subjects remove the variable of Internet pornography use.
2) Male masturbation habits and sexual dysfunctions (2016) – It’s by a French psychiatrist who is the current president of the European Federation of Sexology. While the abstract shifts back and forth between Internet pornography use and masturbation, it’s clear that he’s mostly referring to porn-induced sexual dysfunctions (erectile dysfunction and anorgasmia). The paper revolves around his clinical experience with 35 men who developed erectile dysfunction and/or anorgasmia, and his therapeutic approaches to help them. The author states that most of his patients used porn, with several being addicted to porn. The abstract points to internet porn as the primary cause of the problems (keep in mind that masturbation does not cause chronic ED, and it is never given as a cause of ED). 19 of the 35 men saw significant improvements in sexual functioning. The other men either dropped out of treatment or are still trying to recover. Excerpts:
Intro: Harmless and even helpful in his usual form widely practiced, masturbation in its excessive and pre-eminent form, generally associated today to pornographic addiction, is too often overlooked in the clinical assessment of sexual dysfunction it can induce.
Results: Initial results for these patients, after treatment to “unlearn” their masturbatory habits and their often associated addiction to pornography, are encouraging and promising. A reduction in symptoms was obtained in 19 patients out of 35. The dysfunctions regressed and these patients were able to enjoy satisfactory sexual activity.
Conclusion: Addictive masturbation, often accompanied by a dependency on cyber-pornography, has been seen to play a role in the etiology of certain types of erectile dysfunction or coital anejaculation. It is important to systematically identify the presence of these habits rather than conduct a diagnosis by elimination, in order to include habit-breaking deconditioning techniques in managing these dysfunctions.
3)Unusual masturbatory practice as an etiological factor in the diagnosis and treatment of sexual dysfunction in young men (2014) – One of the 4 case studies in this paper reports on a man with porn-induced sexual problems (low libido, fetishes, anorgasmia). The sexual intervention called for a 6-week abstinence from porn and masturbation. After 8 months the man reported increased sexual desire, successful sex and orgasm, and enjoying “good sexual practices. This is the first peer-reviewed chronicling of a recovery from porn-induced sexual dysfunctions. Excerpts from the paper:
“When asked about masturbatory practices, he reported that in the past he had been masturbating vigorously and rapidly while watching pornography since adolescence. The pornography originally consisted mainly of zoophilia, and bondage, domination, sadism, and masochism, but he eventually got habituated to these materials and needed more hardcore pornography scenes, including transgender sex, orgies, and violent sex. He used to buy illegal pornographic movies on violent sex acts and rape and visualized those scenes in his imagination to function sexually with women. He gradually lost his desire and his ability to fantasize and decreased his masturbation frequency.”
In conjunction with weekly sessions with a sex therapist, the patient was instructed to avoid any exposure to sexually explicit material, including videos, newspapers, books, and internet pornography.
After 8 months, the patient reported experiencing successful orgasm and ejaculation. He renewed his relationship with that woman, and they gradually succeeded in enjoying good sexual practices.
4) How difficult is it to treat delayed ejaculation within a short-term psychosexual model? A case study comparison (2017) – A report on two “composite cases” illustrating the causes and treatments for delayed ejaculation (anorgasmia). “Patient B” represented several young men treated by the therapist. Interestingly, the paper states that Patient B’s “porn use had escalated into harder material”, “as is often the case”. The paper says that porn-related delayed ejaculation is not uncommon, and on the rise. The author calls for more research on porn’s effects of sexual functioning. Patient B’s delayed ejaculation was healed after 10 weeks of no porn. Excerpts:
The cases are composite cases taken from my work within the National Health Service in Croydon University Hospital, London. With the latter case (PatientB), it is important to note that the presentation reflects a number of young males who have been referred by their GPs with a similar diagnosis. Patient B is a 19-year-old who presented because he was unable to ejaculate via penetration. When he was 13, he was regularly accessing pornography sites either on his own through internet searches or via links that his friends sent him. He began masturbating every night while searching his phone for image…If he did not masturbate he was unable to sleep. The pornography he was using had escalated, as is often the case (see Hudson-Allez, 2010), into harder material (nothing illegal)…
Patient B was exposed to sexual imagery via pornography from the age of 12 and the pornography he was using had escalated to bondage and dominance by the age of 15.
We agreed that he would no longer use pornography to masturbate. This meant leaving his phone in a different room at night. We agreed that he would masturbate in a different way….
Patient B was able to achieve orgasm via penetration by the fifth session; the sessions are offered fortnightly in Croydon University Hospital so session five equates to approximately 10 weeks from consultation. He was happy and greatly relieved. In a three-month follow-up with Patient B, things were still going well.
Patient B is not an isolated case within the National Health Service (NHS) and in fact young men in general accessing psychosexual therapy, without their partners, speaks in itself to the stirrings of change.
This article therefore supports previous research that has linked masturbation style to sexual dysfunction and pornography to masturbation style. The article concludes by suggesting that the successes of psychosexual therapists in working with DE are rarely recorded in the academic literature, which has allowed the view of DE as a difficult disorder to treat remain largely unchallenged. The article calls for research into pornography usage and its effect on masturbation and genital desensitisation.
5) Situational Psychogenic Anejaculation: A Case Study (2014) – The details reveal a case of porn-induced anejaculation. The husband’s only sexual experience prior to marriage was frequent masturbation to pornography – where he was able to ejaculate. He also reported sexual intercourse as less arousing than masturbation to porn. The key piece of information is that “re-training” and psychotherapy failed to heal his anejaculation. When those interventions failed, therapists suggested a complete ban on masturbation to porn. Eventually this ban resulted in successful sexual intercourse and ejaculation with a partner for the first time in his life. A few excerpts:
A is a 33-year-old married male with heterosexual orientation, a professional from a middle socio-economic urban background. He has had no premarital sexual contacts. He watched pornography and masturbated frequently. His knowledge about sex and sexuality was adequate. Following his marriage, Mr. A described his libido as initially normal, but later reduced secondary to his ejaculatory difficulties. Despite thrusting movements for 30-45 minutes, he had never been able to ejaculate or achieve orgasm during penetrative sex with his wife.
What didn’t work:
Mr. A’s medications were rationalized; clomipramine and bupropion were discontinued, and sertraline was maintained at a dose of 150 mg per day. Therapy sessions with the couple were held weekly for the initial few months, following which they were spaced to fortnightly and later monthly. Specific suggestions including focusing on sexual sensations and concentrating on the sexual experience rather than ejaculation were used to help reduce performance anxiety and spectatoring. Since problems persisted despite these interventions, intensive sex therapy was considered.
Eventually they instituted a complete ban on masturbation (which means he continued to masturbate to porn during the above failed interventions):
A ban on any form of sexual activity was suggested. Progressive sensate focus exercises (initially non-genital and later genital) were initiated. Mr. A described an inability to experience the same degree of stimulation during penetrative sex as compared to that which he experienced during masturbation.Once the ban on masturbation was enforced, he reported an increased desire for sexual activity with his partner.
After an unspecified amount of time, the ban on masturbation to porn lead to success:
Meanwhile, Mr. A and his wife decided to go ahead with Assisted Reproductive Techniques (ART) and underwent two cycles of intrauterine insemination. During a practice session, Mr. A ejaculated for the first time, following which he has been able to ejaculate satisfactorily during a majority of the couple’s sexual interactions.
This paper explores the phenomenon of pornography induced erectile dysfunction (PIED), meaning sexual potency problems in men due to Internet pornography consumption. Empirical data from men who suffer from this condition have been collected. A combination of topical life history method (with qualitative asynchronous online narrative interviews) and personal online diaries has been employed. The data have been analyzed using theoretical interpretative analysis (according to McLuhan’s media theory), based on analytic induction. The empirical investigation indicates that there is a correlation between pornography consumption and erectile dysfunction that suggests causation. The findings are based on 11 interviews along with two video diaries and three text diaries. The men are between the ages of 16 and 52; they report that an early introduction to pornography (usually during adolescence) is followed by daily consumption until a point is reached where extreme content (involving, for example, elements of violence) is needed to maintain arousal. A critical stage is reached when sexual arousal is exclusively associated with extreme and fast-paced pornography, rendering physical intercourse bland and uninteresting. This results in an inability to maintain an erection with a real-life partner, at which point the men embark on a “re-boot” process, giving up pornography. This has helped some of the men to regain their ability to achieve and sustain an erection.
Introduction to the results section:
Having processed the data, I have noticed certain patterns and recurring themes, following a chronological narrative in all of the interviews. These are: Introduction. One is first introduced to pornography, usually before puberty. Building a habit. One begins to consume pornography regularly. Escalation. One turns to more “extreme” forms of pornography, content-wise, in order to achieve the same effects previously achieved through less “extreme” forms of pornography. Realization.One notices sexual potency problems believed to be caused by pornography use. “Re-boot” process.One tries to regulate pornography use or eliminate it completely in order to regain one’s sexual potency. The data from the interviews are presented based on the above outline.
7) Hidden in Shame: Heterosexual Men’s Experiences of Self-Perceived Problematic Pornography Use (2019) – Interviews of 15 male porn users. Several of the men reported porn addiction, escalation of use, and porn-induced sexual problems. Excerpts relevant to porn-induced sexual dysfunctions, including Michael – who significantly improve his erectile function during sexual encounters by severely limiting his porn use:
Some men talked about seeking professional help to address their problematic pornography use. Such attempts at help-seeking had not been productive for the men, and at times even exacerbated feelings of shame. Michael, a university student who used pornography primarily as a coping mechanism for study-related stress, was having issues with erectile dysfunction during sexual encounters with women and sought help from his General Practitioner Doctor (GP):
Michael: When I went to the doctor at 19 [. . .], he prescribed Viagra and said [my issue] was just performance anxiety. Sometimes it worked, and sometimes it didn’t. It was personal research and reading that showed me the issue was porn [. . .] If I go to the doctor as a young kid and he prescribes me the blue pill, then I feel like no one is really talking about it. He should be asking about my porn use, not giving me Viagra. (23, Middle-Eastern, Student)
As a result of his experience, Michael never went back to that GP and started doing his own research online. He eventually found an article discussing a man approximately his age describing a similar type of sexual dysfunction, which caused him to consider pornography as a potential contributor. After making a concerted effort to lower his pornography use, his erectile dysfunction issues began to improve. He reported that even though his total frequency of masturbation did not reduce, he only watched pornography for about half of those instances. By halving the amount of times he combined masturbation with pornography, Michael said he was able to significantly improve his erectile function during sexual encounters with women.
Phillip, like Michael, sought help for another sexual issue related to his pornography use. In his case, the problem was a noticeably reduced sex drive. When he approached his GP about his issue and its links to his pornography use, the GP reportedly had nothing to offer and instead referred him to a male fertility specialist:
Phillip: I went to a GP and he referred me to specialist who I didn’t believe was particularly helpful. They didn’t really offer me a solution and weren’t really taking me seriously. I ended up paying him for six weeks of testosterone shots, and it was $100 a shot, and it really didn’t do anything. That was their way to treat my sexual dysfunction. I just do not feel the dialogue or situation was adequate. (29, Asian, Student)
Interviewer: [To clarify a previous point you mentioned, is this the experience] that prevented you from seeking help thereafter?
Phillip: Yup.
The GPs and specialists sought by the participants seemed to offer only biomedical solutions, an approach that has been criticized within literature (Tiefer, 1996). Hence, the service and treatment these men were able to receive from their GPs was not only deemed inadequate, but also alienated them from further accessing professional help. Although biomedical responses seem to be the most popular answer for doctors (Potts, Grace, Gavey, & Vares, 2004), a more holistic and client-centered approach is needed, as the issues highlighted by men are likely psychological and possibly created by pornography use.
Lastly, men reported the impacts pornography had had on their sexual function, something that has only recently been examined within the literature. For example, Park and colleagues (2016) found that Internet pornography viewing might be associated with erectile dysfunction, decreased sexual satisfaction, and diminished sexual libido. Participants in our study reported similar sexual dysfunctions, which they attributed to pornography use. Daniel reflected on his past relationships in which he was not able to get and keep an erection. He associated his erectile dysfunction with his girlfriends’ bodies not comparing to what he had become attracted to when watching pornography:
Daniel: My previous two girlfriends, I stopped finding them arousing in a way that wouldn’t have happened to someone who was not watching porn. I had seen so many naked female bodies, that I knew the particular things that I liked and you just start forming a very clear ideal about what you want in a woman, and real women aren’t like that. And my girlfriends didn’t have perfect bodies and I think that’s fine, but I think that got in the way of finding them arousing. And that caused problems in the relationships. There are times I couldn’t sexually perform because I was not aroused. (27, Pasifika, Student)
The remaining studies are listed by date of publication:
“related to high levels of exposure to and experience with sexually explicit materials.“
The men experiencing erectile dysfunction had spent a considerable amount of time in bars and bathhouses where porn was “omnipresent,” and “continuously playing“. The researchers stated:
“Conversations with the subjects reinforced our idea that in some of them a high exposure to erotica seemed to have resulted in a lower responsivity to “vanilla sex” erotica and an increased need for novelty and variation, in some cases combined with a need for very specific types of stimuli in order to get aroused.”
9) Clinical encounters with internet pornography (2008)– Comprehensive paper, with four clinical cases, written by a psychiatrist who became aware of the negative effects internet porn was having on some of his male patients. The excerpt below describes a 31 year old man who escalated into extreme porn and developed porn-induced sexual tastes and sexual problems. This is one of the first peer-reviewed papers to depict porn use leading to tolerance, escalation, and sexual dysfunctions:
A 31-year-old male in analytic psychotherapy for mixed anxiety problems reported that he was experiencing difficulty becoming sexually aroused by his current partner. After much discussion about the woman, their relationship, possible latent conflicts or repressed emotional content (without arriving at a satisfactory explanation for his complaint), he provided the detail that he was relying on a particular fantasy to become aroused. Somewhat chagrined, he described a “scene” of an orgy involving several men and women that he had found on an Internet pornography site that had caught his fancy and become one of his favorites. Over the course of several sessions, he elaborated upon his use of Internet pornography, an activity in which he had engaged sporadically since his mid-20s. Relevant details about his use and the effects over time included clear descriptions of an increasing reliance on viewing and then recalling pornographic images in order to become sexually aroused. He also described the development of a “tolerance” to the arousing effects of any particular material after a period of time, which was followed by a search for new material with which he could achieve the prior, desired level of sexual arousal.
As we reviewed his use of pornography, it became evident that the arousal problems with his current partner coincided with use of pornography, whereas his “tolerance” to the stimulating effects of particular material occurred whether or not he was involved with a partner at the time or was simply using pornography for masturbation. His anxiety about sexual performance contributed to his reliance on viewing pornography. Unaware that the use itself had become problematic, he had interpreted his waning sexual interest in a partner to mean that she was not right for him, and had not had a relationship of greater than two months’ duration in over seven years, exchanging one partner for another just as he might change websites.
He also noted that he now could be aroused by pornographic material that he once had no interest in using. For example, he noted that five years ago he had little interest in viewing images of anal intercourse but now found such material stimulating. Similarly, material that he described as “edgier,” by which he meant “almost violent or coercive,” was something that now elicited a sexual response from him, whereas such material had been of no interest and was even off-putting. With some of these new subjects, he found himself anxious and uncomfortable even as he would become aroused.
Findings suggested that latency erotic disruption by way of sexually explicit material (SEM) and/or child sexual abuse may be associated to adult online sexual behaviors.
Furthermore, results demonstrated that latency SEM exposure was a significant predictor of adult sexual dysfunctions.
We hypothesized that exposure to latency SEM exposure would predict adult use of SEM. Study findings supported our hypothesis, and demonstrated that latency SEM exposure was a statistically significant predictor of adult SEM use. This suggested that individuals who were exposed to SEM during latency, may continue this behavior into adulthood. Study findings also indicated that latency SEM exposure was a significant predictor of adult online sexual behaviors.
In couples where only one partner used pornography, we found more problems related to arousal (male) and negative (female) self-perception.
In those couples where one partner used pornography there was a permissive erotic climate. At the same time, these couples seemed to have more dysfunctions.
The couples who did not use pornography... may be considered more traditional in relation to the theory of sexual scripts. At the same time, they did not seem to have any dysfunctions.
Couples who both reported pornography use grouped to the positive pole on the ‘‘Erotic climate’’ function and somewhat to the negative pole on the ‘‘Dysfunctions’’ function.
12)Cyber-porn dependence: voices of distress in an Italian internet self-help community (2009)– This study reports on a narrative analysis of two thousand messages written by 302 members of an Italian self-help group for cyberdependents (noallapornodipendenza). It sampled 400 messages from each year (2003–2007). Excerpts relevant to porn-induced sexual dysfunctions:
For many their condition is reminiscent of an addicted escalation with new levels of tolerance. Many of them in fact search for increasingly more explicit, bizarre and violent images, bestiality included….
Many members complain about increased impotence and lack of ejaculation, feeling in their real life like “a dead man walking” (“vivalavita” #5014). The following example concretizes their perceptions (“sul” #4411)….
Many participants stated that they usually spend hours looking at and collecting pictures and movies holding their erect penis in their hand, unable to ejaculate, waiting for the ultimate, extreme image to release the tension. For many the final ejaculation puts an end to their torture (supplizio) (“incercadiliberta” #5026)…
Problems in heterosexual relations are more than frequent. People complain they have erection problems, lack of sexual relations with their spouses, lack of interest in sexual intercourse, feeling like a person who has eaten hot, spicy food, and consequently cannot eat ordinary food. In many cases, as also reported by spouses of cyber dependents, there are indications of male orgasmic disorder with the inability to ejaculate during intercourse. This sense of desensitization in sexual relationships is well expressed in the following passage (“vivaleiene” #6019):
Last week I had an intimate relation with my girlfriend; nothing bad at all, despite the fact after the first kiss I didn’t feel any sensation. We didn’t finish the copulation because I didn’t want to.
Many participants expressed their real interest in “chatting on line” or “telematic contact” instead of physical touch, and a pervasive and unpleasant presence of pornographic flashbacks in their mind, during sleep and during sexual intercourse.
As stressed, the claim of a real sexual dysfunction is echoed by many testimonials from female partners. But also forms of collusion and contamination appear in these narratives. Here are a few of the most striking comments of these female partners…
Most of the messages sent to the Italian self help group do indicate the presence of pathology by those participants, according to the model of salience (in real life), mood modification, tolerance, withdrawal symptoms and interpersonal conflict, a diagnostic model developed by Griffiths (2004)….
In line with the Cambridge University brain scan studies, this EEG study also reported greater cue-reactivity to porn correlating with less desire for partnered sex. To put it another way – individuals with greater brain activation to porn would rather masturbate to porn than have sex with a real person. Shockingly, study spokesperson Nicole Prause claimed that porn users merely had “high libido,” yet the results of the study say the exact opposite (subjects’ desire for partnered sex was dropping in relation to their porn use).
Together these two Steele et al. findings indicate greater brain activity to cues (porn images), yet less reactivity to natural rewards (sex with a person). That”s sensitization & desensitization, which are hallmarks of an addiction. Eight peer-reviewed papers explain the truth: Also see this extensive YBOP critique.
“We assume that subjects with a high porn consumption need increasing stimulation to receive the same amount of reward. That could mean that regular consumption of pornography more or less wears out your reward system. That would fit perfectly the hypothesis that their reward systems need growing stimulation.”
“The more hours participants reported consuming pornography, the smaller the BOLD response in left putamen in response to sexual images. Moreover, we found that more hours spent watching pornography was associated with smaller gray matter volume in the striatum, more precisely in the right caudate reaching into the ventral putamen. We speculate that the brain structural volume deficit may reflect the results of tolerance after desensitization to sexual stimuli.”
15) Neural Correlates of Sexual Cue Reactivity in Individuals with and without Compulsive Sexual Behaviours (2014) – This fMRI study by Cambridge University found sensitization in porn addicts which mirrored sensitization in drug addicts. It also found that porn addicts fit the accepted addiction model of wanting “it” more, but not liking “it” more. The researchers also reported that 60% of subjects (average age: 25) had difficulty achieving erections/arousal with real partners as a result of using porn, yet could achieve erections with porn. From the study (“CSB” is compulsive sexual behaviours):
“CSB subjects reported that as a result of excessive use of sexually explicit materials…..[they] experienced diminished libido or erectile function specifically in physical relationships with women (although not in relationship to the sexually explicit material)”
“Compared to healthy volunteers, CSB subjects had greater subjective sexual desire or wanting to explicit cues and had greater liking scores to erotic cues, thus demonstrating a dissociation between wanting and liking. CSB subjects also hadgreater impairments of sexual arousal and erectile difficulties in intimate relationships but not with sexually explicit materials highlighting that the enhanced desire scores were specific to the explicit cues and not generalized heightened sexual desire.”
In reality, the findings of Prause et al. 2015 align perfectly with Kühn & Gallinat (2014), which found that more porn use correlated with less brain activation in response to pictures of vanilla porn. Prause et al. findings also align with Banca et al. 2015. Moreover, another EEG study found that greater porn use in women correlated with less brain activation to porn. Lower EEG readings mean that subjects are paying less attention to the pictures. Put simply, frequent porn users were desensitized to static images of vanilla porn. They were bored (habituated or desensitized). See this extensive YBOP critique. Nine peer-reviewed papers agree that this study actually found desensitization/habituation in frequent porn users (consistent with addiction): Peer-reviewed critiques of Prause et al., 2015
17)Adolescents and web porn: a new era of sexuality (2015)– This Italian study analyzed the effects of Internet porn on high school seniors, co-authored by urology professor Carlo Foresta, president of the Italian Society of Reproductive Pathophysiology. The most interesting finding is that 16% of those who consume porn more than once a week report abnormally low sexual desire compared with 0% in non-consumers (and 6% for those who consume less than once a week). From the study:
“21.9% define it as habitual, 10% report that it reduces sexual interest towards potential real-life partners, and the remaining, 9.1% report a kind of addiction. In addition, 19% of overall pornography consumers report an abnormal sexual response, while the percentage rose to 25.1% among regular consumers.”
18) Patient Characteristics by Type of Hypersexuality Referral: A Quantitative Chart Review of 115 Consecutive Male Cases (2015) – A study on men (average age 41.5) with hypersexuality disorders, such as paraphilias, chronic masturbation or adultery. 27 of the men were classified as “avoidant masturbators,” meaning they masturbated (typically with porn use) one or more hours per day, or more than 7 hours per week. 71% of the men who chronically masturbated to porn reported sexual functioning problems, with 33% reporting delayed ejaculation (a precursor to porn-induced ED).
What sexual dysfunction do 38% of the remaining men have? The study doesn’t say, and the authors have ignored repeated requests for details. Two primary choices for male sexual dysfunction are erectile dysfunction and low libido. It should be noted that the men were not asked about their erectile functioning without porn. This, if all their sexual activity involved masturbating to porn, and not sex with a partner, they might never realize they had porn-induced ED. (For reasons known only to her, Prause cites this paper as debunking the existence of porn-induced sexual dysfunctions.)
Mental health specialists should take in consideration the possible effects of pornography consumption on men sexual behaviors, men sexual difficulties and other attitudes related to sexuality. In the long term pornography seems to create sexual dysfunctions, especially the individual’s inability to reach an orgasm with his partner. Someone who spends most of his sexual life masturbating while watching porn engages his brain in rewiring its natural sexual sets (Doidge, 2007) so that it will soon need visual stimulation to achieve an orgasm.
Many different symptoms of porn consumption, such as the need to involve a partner in watching porn, the difficulty in reaching orgasm, the need for porn images in order to ejaculate turn into sexual problems. These sexual behaviors may go on for months or years and it may be mentally and bodily associated with the erectile dysfunction, although it is not an organic dysfunction. Because of this confusion, which generates embarrassment, shame and denial, lots of men refuse to encounter a specialist
Pornography offers a very simple alternative to obtain pleasure without implying other factors that were involved in human’s sexuality along the history of mankind. The brain develops an alternative path for sexuality which excludes “the other real person” from the equation. Furthermore, pornography consumption in a long term makes men more prone to difficulties in obtaining an erection in a presence of their partners.
Among men who masturbated frequently, 70% used pornography at least once a week. A multivariate assessment showed that sexual boredom, frequent pornography use, and low relationship intimacy significantly increased the odds of reporting frequent masturbation among coupled men with decreased sexual desire.
Among men [with decreased sexual desire] who used pornography at least once a week [in 2011], 26.1% reported that they were unable to control their pornography use. In addition, 26.7% of men reported that their use of pornography negatively affected their partnered sex and 21.1% claimed to have attempted to stop using pornography.
Hypersexual” behavior represents a perceived inability to control one’s sexual behavior. To investigate hypersexual behavior, an international sample of 510 self-identified heterosexual, bisexual, and homosexual men and women completed an anonymous online self-report questionnaire battery.
Thus, the data indicated that hypersexual behavior is more common for males, and those who report being younger in age, more easily sexually excited, more sexually inhibited due to the threat of performance failure, less sexually inhibited due to the threat of performance consequences, and more impulsive, anxious, and depressed
23) Online sexual activities: An exploratory study of problematic and non-problematic usage patterns in a sample of men (2016) – This Belgian study from a leading research university found problematic Internet porn use was associated with reduced erectile function and reduced overall sexual satisfaction. Yet problematic porn users experienced greater cravings. The study appears to report escalation, as 49% of the men viewed porn that “was not previously interesting to them or that they considered disgusting.” (See studies reporting habituation/desensitization to porn and escalation of porn use) Excerpts:
“This study is the first to directly investigate the relationships between sexual dysfunctions and problematic involvement in OSAs. Results indicated that higher sexual desire, lower overall sexual satisfaction, and lower erectile function were associated with problematic OSAs (online sexual activities). These results can be linked to those of previous studies reporting a high level of arousability in association with sexual addiction symptoms (Bancroft & Vukadinovic, 2004; Laier et al., 2013; Muise et al., 2013).”
In addition, we finally have a study that asks porn users about possible escalation to new or disturbing porn genres. Guess what it found?
“Forty-nine percent mentioned at least sometimes searching for sexual content or being involved in OSAs that were not previously interesting to them or that they considered disgusting, and 61.7% reported that at least sometimes OSAs were associated with shame or guilty feelings.”
Note – This is the first study to directly investigate the relationships between sexual dysfunctions and problematic porn use. Two other studies claiming to have investigated correlations between porn use and erectile functioning cobbled together data from earlier studies in an unsuccessful attempt to debunk porn-induced ED. Both were criticized in the peer-reviewed literature: paper #1 was not an authentic study, and has been thoroughly discredited; paper #2 actually found correlations that support porn-induced sexual dysfunction. Moreover, paper 2 was only a “brief communication” that did not report important data which the authors reported at a sexology conference.
More specifically, couples, where no one used, reported more relationship satisfaction than those couples that had individual users. This is consistent with the previous research (Cooper et al., 1999; Manning, 2006), demonstrating that the solitary use of SEM results in negative consequences.
Employing the Pornography Consumption Effect Scale (PCES), the study found that higher porn use was related to poorer sexual function, more sexual problems, and a “worse sex life”. An excerpt describing the correlation between the PCES “Negative Effects” on “Sex Life” questions and frequency of porn use:
There were no significant differences for the Negative Effect Dimension PCES across the frequency of sexually explicit material use; however, there were significant differences on the Sex Life subscale where High Frequency Porn Users reported greater negative effects than Low Frequency Porn Users.
25) Altered Appetitive Conditioning and Neural Connectivity in Subjects With Compulsive Sexual Behavior (2016)– “Compulsive Sexual Behaviors” (CSB) means the men were porn addicts, because CSB subjects averaged nearly 20 hours of porn use per week. The controls averaged 29 minutes per week. Interestingly, 3 of the 20 CSB subjects mentioned to interviewers that they suffered from “orgasmic-erection disorder,” while none of the control subjects reported sexual problems.
Finally, we found that frequency of pornography consumption was also directly related to a relative preference for pornographic rather than partnered sexual excitement. Participants in the present study primarily consumed pornography for masturbation. Thus, this finding could be indicative of a masturbatory conditioning effect (Cline, 1994; Malamuth, 1981; Wright, 2011). The more frequently pornography is used as an arousal tool for masturbation, the more an individual may become conditioned to pornographic as opposed to other sources of sexual arousal.
Among participants who responded to the open-ended question (n=718), problematic usage was self-identified by 88 respondents. Male participants who reported problematic usage of pornography highlighted effects in three areas: on sexual function, arousal and relationships. Responses included “I think it has been a negative influence in many ways but at the same time I can’t stop using it” (Male, Aged 18–19). Some female participants also reported problematic usage, with many of these reporting negative feelings like guilt and shame, impact on sexual desire and compulsions relating to their use of pornography. For example as one female participant suggested; “It makes me feel guilty, and I’m trying to stop. I don’t like how I feel that I need it to get myself going, it’s not healthy.” (Female, Aged 18–19)
Over the last decade, a large increase in the prevalence and accessibility of Internet pornography has provided increased causes of DE associated with Althof’s second and third theory. Reports from 2008 found on average 14.4% of boys were exposed to pornography before the age of 13 and 5.2% of people viewed pornography at least daily.76 A 2016 study revealed that these values had both increased to 48.7% and 13.2%, respectively.76 An earlier age of first pornographic exposure contributes to DE through its relationship with patients exhibiting CSB. Voon et al. found that young men with CSB had viewed sexually explicit material at an earlier age than their age-controlled healthy peers.75 As previously mentioned, young men with CSB can fall victim to Althof’s third theory of DE and preferentially choose masturbation over partnered sex due to a lack of arousal in relationships. An increased number of men watching pornographic material daily also contributes to DE through Althof’s third theory. In a study of 487 male college students, Sun et al. found associations between the use of pornography and a decreased self-reported enjoyment of sexually intimate behaviors with real-life partners.76 These individuals are at an elevated risk of preferentially choosing masturbation over sexual encounters, as demonstrated in a case report by Park et al. A 20-year-old enlisted male presented with difficulty achieving orgasm with his fiancée for the previous six months. A detailed sexual history revealed that the patient relied on Internet pornography and use of a sex toy described as a “fake vagina” to masturbate while deployed. Over time, he required content of an increasingly graphic or fetish nature to orgasm. He admitted that he found his fiancée attractive but preferred the feeling of his toy because he found it more stimulating that real intercourse.77 An increase in the accessibility of Internet pornography places younger men at risk of developing DE through Althof’s second theory, as demonstrated in the following case report: Bronner et al. interviewed a 35-year-old healthy man presenting with complaints of no desire to have sex with his girlfriend despite being mentally and sexually attracted to her. A detailed sexual history revealed that this scenario had happened with the past 20 women he tried to date. He reported extensive use of pornography since adolescence that initially consisted of zoophilia, bondage, sadism, and masochism, but eventually progressed to transgender sex, orgies, and violent sex. He would visualize the pornographic scenes in his imagination to function sexually with women, but that gradually stopped working.74 The gap between the patient’s pornographic fantasies and real life became too large, causing a loss of desire. According to Althof, this will present as DE in some patients.73 This recurring theme of requiring pornographic content of an increasingly graphic or fetish nature to orgasm is defined by Park et al. as hyperactivity. As a man sensitizes his sexual arousal to pornography, sex in real life no longer activates the proper neurological pathways to ejaculate (or produce sustained erections in the case of ED).77
Increased use of and exposure to pornography are increasingly damaging normal relations and even the health of young men, according to a study released Monday by Brno’s University Hospital.
It said many young men were simply not prepared for normal relationships because of the myths created by the pornography they were watching. Many men turned on by pornography could not physically get stimulated in a relationship, the study added. Psychological and even medical treatment was required, the report said.
In the Sexological department of the Faculty Hospital in Brno, we also record more and more frequent cases of young men who are not able to have a normal sex life as a result of pornography, or to establish a relationship.
The fact that pornography is not merely a “diversification” of sex life but often has a negative impact on the quality of partner sexuality is evidenced by the increasing number of patients in the Sexual Section of Brno University Hospital who, due to excessive monitoring of inappropriate sexual content, are getting into health and relationship problems.
In middle age, male partners are replacing partner sex with pornography (masturbation is available anytime, faster, without psychological, physical or material investment). At the same time, sensitivity to normal (real) sexual stimuli accompanied by the risk of having sex-related dysfunctions associated only with a partner is significantly reduced by the monitoring of pornography. This is a risk of intimacy and proximity in the relationship, ie the psychological separation of partners, the need for masturbation on the Internet is gradually increasing – the risk of addiction increases and, last but not least, sexuality can change in its intensity but also in the quality of normal pornography is not enough, and these people resort to perversion (eg, sado-masochistic or zoophilous).
As a result, excessive monitoring of pornography may result in addiction, which is manifested by sexual dysfunction, disorder of relationships leading to social isolation, disrupted concentration, or neglect of work responsibilities, where only sex plays a dominant role in life.
Low sexual desire, reduced satisfaction in sexual intercourse, and erectile dysfunction (ED) are increasingly common in young population. In an Italian study from 2013, up to 25% of subjects suffering from ED were under the age of 40 [1], and in a similar study published in 2014, more than half of Canadian sexually experienced men between the age of 16 and 21 suffered from some kind of sexual disorder [2]. At the same time, prevalence of unhealthy lifestyles associated with organic ED has not changed significantly or has decreased in the last decades, suggesting that psychogenic ED is on the rise [3]. The DSM-IV-TR defines some behaviors with hedonic qualities, such as gambling, shopping, sexual behaviors, Internet use, and video game use, as “impulse control disorders not elsewhere classified”—although these are often described as behavioral addictions [4]. Recent investigation has suggested the role of behavioral addiction in sexual dysfunctions: alterations in neurobiological pathways involved in sexual response might be a consequence of repeated, supernormal stimuli of various origins.
Among behavioral addictions, problematic Internet use and online pornography consumption are often cited as possible risk factors for sexual dysfunction, often with no definite boundary between the two phenomena. Online users are attracted to Internet pornography because of its anonymity, affordability, and accessibility, and in many cases its usage could lead users through a cybersex addiction: in these cases, users are more likely to forget the “evolutionary” role of sex, finding more excitement in self-selected sexually explicit material than in intercourse.
In literature, researchers are discordant about positive and negative function of online pornography. From the negative perspective, it represents the principal cause of compulsive masturbatory behavior, cybersex addiction, and even erectile dysfunction.
While the Grubbs paper consistently downplays the correlations between higher pornography use and poorer erections, correlations were reported in all 3 groups – especially for sample 3, which was the most relevant sample as it was the largest sample and averaged higher levels of porn use. Most importantly, this sample’s age range is the most likely to report PIED. Not surprisingly, sample 3 had the strongest correlation between higher levels of porn use and poorer erectile functioning (–0.37). Below are the 3 groups, with their average daily minutes of porn viewing and the correlations between erectile functioning amount of use (a negative sign means poorer erections linked to greater porn use):
Sample 1 (147 men): average age 19.8 – Averaged 22 minutes of porn/day. (–0.18)
Sample 2 (297 men): average age 46.5 – Averaged 13 minutes of porn/day. (–0.05)
Sample 3 (433 men): average age 33.5 – Averaged 45 minutes of porn/day. (–0.37)
Fairly straightforward results: the sample that used the most porn (#3) had the strongest correlation between greater porn use and poorer erections, while the group that use the least (#2) had the weakest correlation between greater porn use and poorer erections. Why didn’t Grubbs emphasize this pattern in his write-up, instead of using statistical manipulations to try to make it disappear? To summarize:
Sample #1: Average age 19.8 – Note that 19-year old porn users rarely report chronic porn-induced (especially when only using 22 minutes a day). The vast majority of porn-induced ED recovery stories YBOP has gathered are by men aged 20-40. It generally takes time to develop PIED.
Sample #2: Average age 46.5 – They averaged only 13 minutes per day! With a standard deviation of 15.3 years, some portion of these men were fifty-something. These older men did not start out using internet porn during adolescence (making them less vulnerable to conditioning their sexual arousal solely to internet porn). Indeed, just as Grubbs found, the sexual health of slightly older men has always been better and more resilient over all, than users who began using digital porn during adolescence (such as those with an average age of 33 in sample 3).
Sample #3: Average age 33.5 – As already mentioned, sample 3 was the largest sample and averaged higher levels of porn use. Most importantly, this age range is the most likely to report PIED. Not surprisingly, sample 3 had the strongest correlation between higher levels of porn use and poorer erectile functioning (–0.37).
Grubbs also correlated porn addiction scores with erectile functioning. The results reveal that even in subjects with relatively healthy erectile functioning, porn addiction was significantly related to poorer erections (–0.20 to –0.33). As before, the strongest correlation between porn addiction and poorer erections (–0.33) occurred in Grubbs’s largest sample, and the sample of an average age most likely to report porn-induced ED: sample 3, average age: 33.5 (433 subjects).
Wait a minute you ask, how dare I say significantly related? Doesn’t the Grubbs study confidently declare that the relationship was only “small to moderate,” meaning it’s no big deal? As we explored in the critique, Grubbs’s use of descriptors varies remarkably, depending upon which Grubbs study you read. If the Grubbs study is about porn use causing ED, then the above numbers represent a meager correlation, tossed aside in his spin-laden write-up.
32) Survey of Sexual Function and Pornography (2019) – In this study, researchers looked for a link between ED and indices of pornography addiction using a “craving” questionnaire. While no such link turned up (perhaps because users don’t accurately assess their degree of “craving” until they attempt to quit using), some other interesting correlations appeared in their results. Excerpts:
Rates of erectile dysfunction were lowest in those [men] preferring partnered sex without pornography (22.3%) and increased significantly when pornography was preferred over partnered sex (78%).
…Pornography and sexual dysfunction are common among young people.
…Those [men] who used on an almost daily basis or more had ED rates of 44% (12/27) compared to 22% (47/213) for those more “casual” users (≤5x/week), reaching significance on univariate analysis (p=0.017). It may be that volume does play a role to some extent.
…The proposed pathophysiology of PIED seems plausible and is based on a variety of researchers work and not a small collection of researchers that might be swayed by an ethical bias. Also supporting the “causation” side of the argument are reports of men regaining normal sexual function after discontinuation of excessive pornography use.
…Only prospective studies will be able to definitively solve the question of causation or association, including interventional studies evaluating the success of abstention in treating ED in heavy pornography users. Additional populations that warrant special consideration include adolescents. There has been concern raised that early exposure to graphic sexual material may affect normal development. The rate of teenagers being exposed to pornography before the age of 13 has gone up three fold over the last decade, and now hovers around 50%.
Young men who prefer pornography to real-world sexual encounters might find themselves caught in a trap, unable to perform sexually with other people when the opportunity presents itself, a new study reports. Porn-addicted men are more likely to suffer from erectile dysfunction and are less likely to be satisfied with sexual intercourse, according to survey findings presented Friday at the American Urological Association’s annual meeting, in Boston.
“The rates of organic causes of erectile dysfunction in this age cohort are extremely low, so the increase in erectile dysfunction that we have seen over time for this group needs to be explained,” Christman said. “We believe that pornography use may be one piece to that puzzle”.
The most common self-perceived adverse effects of pornography use included: the need for longer stimulation (12.0%) and more sexual stimuli (17.6%) to reach orgasm, and a decrease in sexual satisfaction (24.5%)…
The present study also suggests that earlier exposure may be associated with potential desensitization to sexual stimuli as indicated by a need for longer stimulation and more sexual stimuli required to reach orgasm when consuming explicit material, and overall decrease in sexual satisfaction…
Various changes of pattern of pornography use occurring in the course of the exposure period were reported: switching to a novel genre of explicit material (46.0%), use of materials that do not match sexual orientation (60.9%) and need to use more extreme (violent) material (32.0%)…
35) Sexual and reproductive health and rights in Sweden 2017 (2019)– A 2017 survey by The Swedish Public Health Authority contains a section discussing their findings on pornography. relevant here, greater pornography use was related to poorer sexual health and decreased sexual dissatisfaction. Excerpts:
Forty-one percent of men aged 16 to 29 are frequent users of pornography, i.e. they consume pornography on a daily basis or almost on a daily basis. The corresponding percent among women is 3 percent. Our results also show an association between frequent pornography consumption and poorer sexual health, and an association with transactional sex, too high expectations of one’s sexual performance, and dissatisfaction with one’s sex life. Almost half of the population state that their pornography consumption does not affect their sex life, while a third do not know if it affects it or not. A small percentage of both women and men say their pornography use has a negative effect on their sex life. It was more common among men with higher education to regularly use pornography compared to men with lower education.
There is a need for more knowledge on the link between pornography consumption and health. An important preventive piece is to discuss the negative consequences of pornography with boys and young men, and school is a natural place to do this.
Pedro self-reported as being a virgin. Pedro talked about the feelings of shame he experienced with his past attempts at sexual intimacy with women. His most recent potential sexual encounter ended when his fear and anxiety prevented him from getting an erection. He attributed his sexual dysfunction to pornography use…
Pedro reported a significant decrease in pornography viewing by the end of the study and an overall improvement in mood and mental health symptoms. Despite increasing the dosage of one of his anti-anxiety medications during the study due work stress, he said he would continue meditating because of the self-reported benefits of calmness, focus, and relaxation he experienced after each session.
Pablo (age 29):
Pablo felt he had little to no control over his pornography use. Pablo spent several hours each day ruminating on pornography, either while actively engaged in watching pornographic content or by thinking about watching pornography at the next possible opportunity when he was busy doing something else. Pablo went to a doctor with concerns about sexual dysfunctions he was experiencing, and though he disclosed concerns about his pornography use to his doctor, Pablo was instead referred to a male fertility specialist where he was given shots of testosterone. Pablo reported the testosterone intervention as having no benefit or usefulness to his sexual dysfunction, and the negative experience prevented him from reaching out for any further help with regards to his pornography use. The pre-study interview was the first time Pablo was able to converse openly with anybody regarding his pornography use…
The percentage of teens that experienced alterations of their sexuality: 2004/05: 7.2%, 2012/13: 14.5%
The percentage of teens with low sexual desire: 2004/05: 1.7%, 2012/13: 10.3% (that’s a 600% increase in 8 years)
Foresta also describes his upcoming study, “Sexuality media and new forms of sexual pathology sample 125 young males, 19-25 years” (Italian name – “Sessualità mediatica e nuove forme di patologia sessuale Campione 125 giovani maschi“). The results from the study (pages 77-78), which used the International Index of Erectile Function Questionnaire, found that regular porn users scored 50% lower on sexual desire domain and 30% lower of the erectile functioning domain.
The most common phrase is “erectile dysfunction” – which is mentioned more than three times as often as any other phrase – followed by “internet porn,” “performance anxiety,” and “watching porn.”
Clearly, porn is a frequently discussed subject: “I have been viewing internet pornography frequently (4 to 5 times a week) for the past 6 years,” one man writes. “I am in my mid-20s and have had a problem getting and maintaining an erection with sexual partners since my late teens when I first started looking at internet porn.”
LEY: However, Dr. Zimbardo fails to acknowledge or consider the tremendous social changes which occurred with the invention of erectile performance medications, and which dramatically increased willingness to disclose erectile dysfunction, by reducing the shame associated with it.
Ley cited nothing as, once again, there is no empirical support for his claim that the introduction of Viagra (1997) led to men finally tell the truth in studies on sexual dysfunction (13 years later). These are not the rates of men visiting their doctors to request ED medication. The ED rates cited refer only to peer-reviewed studies (usually anonymous) on population wide rates of sexual dysfunction. To put it another way, the ‘Viagra hypothesis’ is claiming that in every single study published between 1948 and 2010, in countries all over the world, the young male participants consistently lied about their erectile functioning. Then, all of a sudden, in 2010 all the young men (and only the young men) began to tell the truth about their ED problems. This is absurd. Ley’s claim is like saying that the introduction of aspirin led to anonymous studies reporting a 1000% increase in headaches among only one age group. A few more points that refute the “Viagra causes ED” claim:
1) The claim about “willingness to disclose” doesn’t apply here. The ED and low libido rates are not rates for men visiting their doctor for erectile dysfunction. Instead, the ED and low libido rates come from studies mostly employing anonymous standardized questionnaires where men rate the quality of their erections and arousal during sex. That has not changed because Viagra was introduced.
2) The exponential rise in ED and low libido rates occurred only in men under 40. This alone refutes Ley’s claim.
3) In this same time period there was a concomitant increase in low sexual desire (and evidence of increases in difficulty orgasming too). The largest US study from 1992 reported 5% of men under 40 had low sexual desire.
A 2014 Canadian study reported low sexual desire in 24% of 16-21 year olds!
Again, this aligns with a 2015 study on Italian high school seniors (18-19), which found that 16% of those who use porn more than once per week reported abnormally low sexual desire. Non-porn users reported 0% low sexual desire (as one would expect in 18-year olds).
4) These days, ED rates are often higher for young men than for old men (who obviously used less internet porn growing up). The 2014 Canadian study reported that 53.5% of males aged 16-21 have symptoms indicative of a sexual problem. Erectile dysfunction was the most common (27%), followed by low sexual desire (24%), and problems with orgasm (11%).
Reality check: these rates are higher than those reported for 50-60 year olds in the large 1992 study on men 18-60!
5) Two studies published AFTER Viagra was introduced report higher ED rates in young men. If Viagra ads caused ED in men, wouldn’t we see far higher rates in older men? These were studies of the same European countries using the same questionnaires (GSSAB). Instead rates in young men are abnormally high now.
The 2001-2002 ED rates for men 40-80 were about 13% in Europe.
By 2011, ED rates in young Europeans, 18-40, ranged from 14-28%.
6) Common sense: There’s absolutely no evidence to suggest that a young man today would be any less embarrassed or ashamed when experiencing erectile dysfunction than a young man was in 1995 (once again, shame is irrelevant as all data came from studies using anonymous questionnaires).
LEY: Indeed, multiple peer-reviewed articles have now been published which found no evidence for PIED, but instead, found the opposite effect, that porn use and concomitant masturbation, is likely to result in delayed orgasm.
RESPONSE TO FIRST PART: “multiple peer-reviewed articles have now been published which found no evidence for PIED”
First, there’s only one way to confirm whether erectile dysfunction is porn-induced (PIED) or not: Eliminate porn use for a extended period of time and see if the sufferer regains normal erectile functioning. Three studies have done this, thus proving the existence of porn-induced sexual dysfunctions. See this list of 24 studies linking porn use/sex addiction to sexual problems (the first 5 demonstrate causation as participants eliminated porn use and healed chronic sexual dysfunctions).
The “multiple articles” that Ley could be referring to are really only two papers that claimed to have found little relationship between the amount of porn use and erectile dysfunction. The first paper, Prause & Pfaus 2015, has been so roundly criticized for missing data, unsupported claims, poor methodology, and statements that are in direct opposition of its data, that it is, in effect, discredited. It was formally critiqued in an academic journal by a researcher and reproductive medicine doctor. This lay critique exposes even more holes in the paper.
A second paper (Landripet & Stulhofer) found extraordinarily high rates of low libido and ED in men under 40 (it wasn’t a full study, but a “brief communication”). Contrary to Ley’s claims, the study actually found a few correlations between ED and porn use. The abstract doesn’t mention a pretty important correlation: Only 40% of the Portuguese men used porn “frequently,” while the 60% of the Norwegians used porn “frequently.” The Portuguese men had far less sexual dysfunction than the Norwegians.
Elsewhere, the authors acknowledge a statistically significant association between more frequent porn use and ED, but claim the effect size was small. However, this claim may be misleading according to an MD who is a skilled statistician and has authored many studies:
Analyzed a different way (Chi Squared), … moderate use (vs. infrequent use) increased the odds (the likelihood) of having ED by about 50% in this Croatian population. That sounds meaningful to me, although it is curious that the finding was only identified among Croats.
Here’s the sneaky part that says a lot about the two authors: Landripet & Stulhofer’s “brief communication” omitted three significant correlations they presented to a European conference (excerpts from their abstract):
Reporting a preference for specific pornographic genres were significantly associated with erectile (but not ejaculatory or desire-related) male sexual dysfunction.
Increased pornography use was slightly but significantly associated with decreased interest for partnered sex and more prevalent sexual dysfunction among women
The authors blow this finding off and ignore it in reaching their conclusions, as they also ignore Danish porn researcher Gert Martin Hald’s formal commentary about the study, in which he says:
However, in pornography research, the interpretation of “size” may depend as much on the nature of the outcome studied as the magnitude of the relationship found. Accordingly, if the outcome is to be considered “sufficiently adverse” (e.g., sexual aggressive behaviors), even small effect sizes may carry considerable social and practical significance [2].
Gert Martin Hald’s editorial comments emphasize the need to assess more variables (mediators, moderators) than just frequency per week in the last 12 months:
Third, the study does not address possible moderators or mediators of the relationships studied nor is it able to determine causality. Increasingly, in research on pornography, attention is given to factors that may influence the magnitude or direction of the relationships studied (i.e., moderators) as well as the pathways through which such influence may come about (i.e., mediators). Future studies on pornography consumption and sexual difficulties may also benefit from an inclusion of such focuses.
In other words, using only a single limited variable such as “hours of use in the last month” may not reveal anything. It’s already established in studies on both internet porn addiction (1, 2, 3) and internet video-gaming addiction, that symptoms do not correlate with “hours of use.” Instead of just current hours of use, a combination of variables appears to correlate best with porn-induced ED. These may include:
Ratio of masturbation to porn versus masturbation without porn
Ratio of sexual activity with a person versus masturbation to porn
Gaps in partnered sex (where one relies only on porn)
Virgin or not
Total hours of use
Years of use
Age started using porn
Escalation to new genres
Development of porn-induced fetishes (from escalating to new genres of porn)
Level of novelty per session (i.e. compilation videos, multiple tabs)
Addiction-related brain changes or not
Presence of hypersexuality/porn addiction
The better way to research the phenomenon of porn-induced sexual dysfunctions, is to remove the variable of internet porn use and observe the outcome. Such research reveals causation instead of correlations open to interpretation. My site has documented a few thousand men who removed internet porn and recovered from chronic sexual dysfunctions.
SUMMARY: Only one valid study has attempted to correlate the amount of porn use with ED. Contrary to Ley’s claim, this study reports at least one meaningful correlation between ED and porn use. Offsetting this single “brief communication,” we have 35 studies reporting relationships between porn use in young men and ED, anorgasmia, low sexual desire, delayed ejaculation and lower brain activation to sexual images.
LEY: “Indeed, multiple peer-reviewed articles have now been published which found no evidence for PIED, but instead, found the opposite effect, that porn use and concomitant masturbation, is likely to result in delayed orgasm.”
RESPONSE TO SECOND PART: “but instead, found the opposite effect, that porn use and concomitant masturbation, is likely to result in delayed orgasm.”
The study classified 27 men as “avoidant masturbators,” meaning they masturbated to porn one or more hours per day or more than 7 hours per week. 71% of the compulsive porn users reported sexual functioning problems, with 33% reporting delayed ejaculation.
What sexual dysfunction do 38% of the remaining men have? The study doesn’t say, and the authors have publicly refused to give details. The two other primary choices for male sexual dysfunction are ED and low libido. You do the math.
In reality, porn-induced delayed ejaculation is often a precursor to porn-induced erectile dysfunction. Like ED, delayed ejaculation is one of the primary reasons men choose to abstain from porn in search of recovery. This page contains many stories by men who recovered from porn-induced delayed ejaculation. Delayed ejaculation arises from the same brain changes that eventually lead to full blown PIED (i.e. desensitization/habituation and conditioning one’s sexual arousal to everything associated with internet porn use instead of to real partners).
SUMMARY: Ley is trying to spin a 71% rate of sexual dysfunction in compulsive porn users into evidence that porn use is really beneficial! That’s Ley as his best.
LEY: Numerous research studies in the past year from authors such as Joshua Grubbs of Case Western and Alexander Stulhofer of Croatia, have consistently confirmed the role of morality and religiosity in the backgrounds of those who identify as sex or porn addicts. In other words, both of these researchers have demonstrated that sex/porn addicts are not in fact watching more porn or having more sex than anyone else – they just feel worse and more conflicted about the sex they are having.
RESPONSE: Numerous? Since there are no citations let’s consider the two studies mentioned: In the case of Grubbs and Stulhofer how have the researchers distinguished between shame related to sex/porn and shame from the inability to control use despite negative consequences? This is left unexplained. (In other words, they haven’t.)
Compared to the rest of the sample, men in the hypersexuality group had significantly higher odds of being single, not exclusively heterosexual, religious, depressed, prone to sexual boredom, experiencing substance abuse consequences, holding negative attitudes toward pornography use, and evaluating one’s sexual morality more negatively. In contrast, the high sexual desire group differed from controls only in reporting more positive attitudes toward pornography use.
First, Stulhofer reported very little overlap between the hypersexuality group (sex/porn addicts) and the high libido group. As explained above, this refutes Ley’s claim that “hypersexuals” simply have high sexual desire.
Second, the addicts held negative attitudes towards pornography use. Is it really so odd for an addict to feel bad about being unable to control use despite the negative consequences? Wouldn’t we expect an out-of-control alcoholic to have negative feelings towards drinking alcohol? What does the phrase “evaluating one’s sexual morality” mean when it is applied to out-of-control porn use that is impacting one’s life negatively? It could be as simple as, “Addicts experience negative feelings towards their addiction.”
As for Grubbs et al‘s results, might they be explained, in part, by the fact that religious people are generally better informed (or, in some cases overly informed) about the risks of internet porn use, so they “connect the dots” more quickly and in higher percentages when asked about their addiction? Religious people are probably also more inclined to try stopping, and therefore more likely to experience distressing withdrawal symptoms or recognize their inability to control their (perhaps) infrequent use. Withdrawal symptoms are anxiety-producing in themselves. In contrast, the non-religious simply don’t think to experiment with stopping porn so they may not experience severe cravings and withdrawal symptoms unless they slam into a wall o’ hurt and try quitting.
If religion were the key factor in a “belief in porn addiction,” one would expect the majority of those on the recovery forums to be religious. That is not what we see. The most popular English-speaking porn-recovery forum we know of, r/nofap, polled their members (back in 2012). 60+% of their members were non-religious (23% Christian). Shortly after that poll, a “Christian nofap” was founded, which means that the percentage of religious on r/nofap is even lower now. In a later member survey, only 11% were quitting for religious reasons. Since that first poll, the number of members on r/nofap has exploded. It’s 170K+ members now, and overwhelming non-religious.
Grubbs needs better methodology – methodology that does not conflate shame arising from “being unable to quit an addiction that is producing negative effects” with shame arising from porn’s content. Two quite different phenomena.
Is it Ethical for a Psychologist to Consistently Attack a Self-Help Group?
Ley suggests that NoFap, a porn-recovery forum, is somehow dangerous. In this piece he continues his ongoing defamatory attacks on the NoFap community. If he disagrees with the scientific findings on internet porn users’ brains (which support the efforts on NoFap), he should take it up with the researchers themselves, not take it out on a self-help community. This is like attacking cancer patients because one disagrees with oncology protocols. (Nofap moderator dismantles Ley’s article)
Not only is it disturbing that Ley attacks people endeavoring to recover from the effects of overconsuming internet porn, it may be a violation of various principles of the American Psychological Association. The APA has 5 guiding principles for all psychologists and Ley’s chronic disparaging of NoFap appears to violate all 5:
Principle A: Beneficence 4.05 and Nonmaleficence (in part)
… In their professional actions, psychologists seek to safeguard the welfare and rights of those with whom they interact professionally and other affected persons… …. Because psychologists’ scientific and professional judgments and actions may affect the lives of others, they are alert to and guard against personal, financial, social, organizational or political factors that might lead to misuse of their influence…
Principle B: Fidelity and Responsibility (in part)
Psychologists … are aware of their professional and scientific responsibilities to society and to the specific communities in which they work. Psychologists uphold professional standards of conduct, clarify their professional roles and obligations, accept appropriate responsibility for their behavior and seek to manage conflicts of interest that could lead to exploitation or harm. …
Principle C: Integrity (in part)
Psychologists seek to promote accuracy, honesty and truthfulness in the science, teaching and practice of psychology. In these activities psychologists do not steal, cheat or engage in fraud, subterfuge or intentional misrepresentation of fact.
Principle D: Respect for People’s Rights (in part)
Psychologists exercise reasonable judgment and take precautions to ensure that their potential biases, the boundaries of their competence and the limitations of their expertise do not lead to or condone unjust practices.
Principle E: Dignity (in part)
Psychologists respect the dignity and worth of all people, and the rights of individuals to privacy, confidentiality, and self-determination.
UPDATE: David Ley financial conflicts of interest (COI)
The fledgling Sexual health Alliance (SHA) advisory board includes David Ley and two other RealYourBrainOnPorn.com “experts” (Justin Lehmiller & Chris Donahue). RealYBOP is a group of openly pro-porn, self-proclaimed “experts” headed by Nicole Prause. This group is currently engaged in illegal trademark infringement and squatting directed toward the legitimate YBOP. Put simply, those trying to silence YBOP are also being paid by the porn industry to promote its/their businesses, and assure users that porn and cam sites cause no problems (note: Nicole Prause has close, public ties to the porn industry as thoroughly documented on this page).
In this article, Ley dismisses his compensated promotion of the porn industry:
Granted, sexual health professionals partnering directly with commercial porn platforms face some potential downsides, particularly for those who’d like to present themselves as completely unbiased. “I fully anticipate [anti-porn advocates] to all scream, ‘Oh, look, see, David Ley is working for porn,’” says Ley, whose name is routinely mentioned with disdain in anti-masturbation communities like NoFap.
But even if his work with Stripchat will undoubtedly provide fodder to anyone eager to write him off as biased or in the pocket of the porn lobby, for Ley, that tradeoff is worth it. “If we want to help [anxious porn consumers], we have to go to them,” he says. “And this is how we do that.”
David J. Ley, Ph.D., is a clinical psychologist and AASECT-certified supervisor of sex therapy, based in Albuquerque, NM. He has provided expert witness and forensic testimony in a number of cases around the United States. Dr. Ley is regarded as an expert in debunking claims of sexual addiction, and has been certified as an expert witness on this topic. He has testified in state and federal courts.
Contact him to obtain his fee schedule and arrange an appointment to discuss your interest.
Nicole Prause also profits from denying sex and porn addiction. From her Liberos website (page since removed, and Prause had it removed from the Internet WayBack Machine):
“Sex addiction” is increasingly being used as a defense in legal proceedings, but its scientific status is poor. We have provided expert testimony to describe the current state of the science and acted as legal consultants to help teams understand the current state of the science in this area to successfully represent their client.
Legal consultations and testimony are generally are [sic] billed on an hourly rate.
Most shockingly, Prause & Ley engage in targeted harassment, defamation and cyber-stalking. See this page that was created to counter the ongoing harassment and false claims made by former UCLA researcher Nicole Prause as part of an ongoing “astroturf” campaign to persuade people that anyone who disagrees with her conclusions deserves to be reviled.
COI #3: Ley makes money selling two books that deny sex and porn addiction (“The Myth of Sex Addiction,” 2012 and “Ethical Porn for Dicks,” 2016). Pornhub (which is owned by porn giant MindGeek) is one of the five back-cover endorsements listed for Ley’s 2016 book about porn:
COI #4: Finally, David Ley makes money via CEU seminars, where he promotes the addiction-deniers’ ideology set forth in his two books (which recklessly(?) ignores dozens of studies and the significance of the new Compulsive Sexual Behavior Disorder diagnosis in the World Health Organization’s diagnostic manual) . Ley is compensated for his many talks featuring his biased views of porn. In this 2019 presentation Ley appears to support and promote adolescent porn use: Developing Positive Sexuality and Responsible Pornography Use in Adolescents.
Excerpt analyzing Prause et al., 2015 (which is citation 87)
A study using EEG, conducted by Prause and colleagues, suggested that individuals who feel distressed about their pornography use, as compared to a control group who do not feel distress about their use of pornography, may require more/greater visual stimulation to evoke brain responses [87]. Hypersexual participants—individuals‘ experiencing problems regulating their viewing of sexual images’ (M=3.8 hours per week)—exhibited less neural activation (measured by late positive potential in the EEG signal) when exposed to sexual images than did the comparison group when exposed to the same images. Depending on the interpretation of sexual stimuli in this study (as a cue or reward; for more see Gola et al. [4]), the findings may support other observations indicating habituation effects in addictions [4]. In 2015, Banca and colleagues observed that men with CSB preferred novel sexual stimuli and demonstrated findings suggestive of habituation in the dACC when exposed repeatedly to the same images [88]. Results of the aforementioned studies suggest that frequent pornography use may decrease reward sensitivity, possibly leading to increased habituation and tolerance, thereby enhancing the need for greater stimulation to be sexually aroused. However, longitudinal studies are indicated to examine this possibility further. Taken together, neuroimaging research to date has provided initial support for the notion that CSB shares similarities with drug, gambling, and gaming addictions with respect to altered brain networks and processes, including sensitization and habituation.
COMMENTS: The authors of the current review agree with six other peer-reviewed papers (1, 2, 3,4,5, 6.): Lower EEG readings mean that subjects are paying less attention to the pictures. They were bored (habituated or desensitized). The lead author claims these results “debunk porn addiction”, but other researchers disagree with her over-the-top assertions. You have to ask yourself – “What legitimate scientist would claim that their lone anomalous study has debunked a well established field of study?”
Prause N, Steele VR, Staley C, Sabatinelli D, Proudfit GH. Modulation of late positive potentials by sexual images in problem users and controls inconsistent with “porn addiction”. Biol Psychol. 2015;109:192-9.
Purpose of review: The current review summarizes the latest findings concerning neurobiological mechanisms of compulsive sexual behavior disorder (CSBD)and provides recommendations for future research specific to the diagnostic classification of the condition.
Recent findings: To date, most neuroimaging research on compulsive sexual behavior has provided evidence of overlapping mechanisms underlying compulsive sexual behavior and non-sexual addictions. Compulsive sexual behavior is associated with altered functioning in brain regions and networks implicated in sensitization, habituation, impulse dyscontrol, and reward processing in patterns like substance, gambling, and gaming addictions. Key brain regions linked to CSB features include the frontal and temporal cortices, amygdala, and striatum, including the nucleus accumbens.
Summary: Despite much neuroscience research finding many similarities between CSBD and substance and behavioral addictions, the World Health Organization included CSBD in the ICD-11 as an impulse-control disorder. Although previous research has helped to highlight some underlying mechanisms of the condition, additional investigations are needed to fully understand this phenomenon and resolve classification issues surrounding CSBD.
Introduction
Compulsive sexual behavior (CSB) is a debated topic that is also known as sexual addiction, hypersexuality, sexual dependence, sexual impulsivity, nymphomania, or out-of-control sexual behavior [1-27]. Although precise rates are unclear given limited epidemiological research, CSB is estimated to affect 3-6% of the adult population and is more common in men than women [28-32]. Due to the associated distress and impairment reported by men and women with CSB [4-6, 30, 33-38], the World Health Organization (WHO) has recommended including Compulsive Sexual Behavior Disorder(CSBD)in the forthcoming 11th edition of the International Classification of Diseases (6C72)[39]. This inclusion should help increase access to treatment for unserved populations, reduce stigma and shame associated with help-seeking, promote concerted research efforts, and increase international attention on this condition[40, 41].We acknowledge that over the last 20 years there have been varying definitions used to describe dysregulated sexual behaviors often characterized by excessive engagement in nonparaphilic sexual activities (e.g., frequent casual/anonymous sex, problematic use of pornography). For the current review, we will use the term CSB as an overarching term for describing problematic, excessive sexual behavior.
CSB has been conceptualized as an obsessive–compulsive-spectrum disorder, an impulse-control disorder, or addictive behavior [42, 43]. The symptoms of CSBD are like those proposed in 2010forthe DSM-5 diagnosis of hypersexual disorder [44]. Hypersexual disorder was ultimately excluded by American Psychiatric Association from DSM-5 for multiple reasons; the lack of neurobiological and genetic studies was among the most noted reasons [45, 46]. More recently, CSB has received considerable attention in both popular culture and social sciences, particularly given health disparities affecting at-risk and underserved groups. Despite the considerable increase in studies of CSB (including those studying “sexual addiction,” “hypersexuality,” “sexual compulsivity”), relatively little research has examined neural underpinnings of CSB [4, 36]. This article reviews neurobiological mechanisms of CSB and provides recommendations for future research, particularly as related to diagnostic classification of CSBD.
CSB as an Addictive Disorder
Brain regions involved in processing rewards are likely important for understanding the origins, formation, and maintenance of addictive behaviors [47]. Structures within a so-called ‘reward system’ are activated by potentially reinforcing stimuli, such as addictive drugs in addictions. A major neurotransmitter involved in processing rewards is dopamine, particularly within the mesolimbic pathway involving the ventral tegmental area (VTA) and its connections with the nucleus accumbens (NAc), as well as the amygdala, hippocampus, and prefrontal cortex [48]. Additional neurotransmitters and pathways are involved in processing rewards and pleasure, and these warrant considerations given that dopamine has been implicated to varying degrees in individual drug and behavioral addictions in humans [49-51].
According to the incentive salience theory, different brain mechanisms influence motivation to obtain reward (‘wanting’) and the actual hedonic experience of reward (‘liking’) [52]. Whereas ‘wanting’ may be closely related to dopaminergic neurotransmission in the ventral striatum (VStr) and orbitofrontal cortex, networks dedicated to creating wanting motivations and pleasurable feelings are more complex [49, 53, 54].
VStr reward-related reactivity has been studied in addictive disorders such as alcohol, cocaine, opioid use disorders, and gambling disorder[55-58]. Volkow and colleagues describe four important components of addiction: (1) sensitization involving cue reactivity and craving, (2) desensitization involving habituation, (3) hypofrontality, and (4) malfunctioning stress systems[59]. Thus far, research of CSB has largely focused on cue reactivity, craving, and habituation. The first neuroimaging studies of CSB were focused on examining potential similarities between CSB and addictions, with a specific focus on the incentive salience theory that is based on preconscious neural sensitization related to changes in dopamine-related motivation systems[60]. In this model, repeated exposure to potentially addictive drugs may change brain cells and circuits that regulate the attribution of incentive salience to stimuli, which is a psychological process involved in motivated behavior. Because of this exposure, brain circuits may become hypersensitive (or sensitized), thereby contributing to the development of pathological levels of incentive salience for target substances and their associated cues. Pathological incentive motivation (‘wanting’) for drugs may last for years, even if drug use is discontinued. It may involve implicit (unconscious wanting) or explicit (conscious craving) processes. The incentive salience model has been proposed to potentially contribute to the development and maintenance of CSB [1, 2].
Data support the incentive salience model for CSB. For example, Voon and colleagues examined cue-induced activity in the dorsal anterior cingulate cortex (dACC) –Vstr –amygdala functional network [1].Men with CSB as compared to those without showed increased VStr, dACC, and amygdala responses to pornographic video clips. These findings in the context of the larger literature suggest that sex and drug-cue reactivity involve largely overlapping regions and networks[61, 62]. Men with CSB as compared to those without also reported higher wanting (subjective sexual desire) of pornography stimuli and lower liking which is consistent with an incentive salience theory[1]. Similarly, Mechelmans and colleagues found that men with CSB as compared to men without showed enhanced early attentional bias towards sexually explicit stimuli but not to neutral cues [2]. These findings suggest similarities in enhanced attentional bias observed in studies examining drug cues in addictions.
In 2015, Seok and Sohn found that among men with CSB as compared to those without, greater activity was observed in the dorsolateral prefrontal cortex (dlPFC), caudate, inferior supramarginal gyrus of the parietal lobe, dACC, and thalamus in response to sexual cues[63]. They also found that the severity of CSB symptoms was correlated with cue-induced activation of the dlPFC and thalamus. In 2016, Brand and colleagues observed greater activation of the VStr for preferred pornographic material as compared to non-preferred pornographic material among men with CSB and found that VStr activity was positively associated with self-reported symptoms of addictive use of Internet pornography (assessed by the short Internet Addiction Test modified for cybersex (s-IATsex) [64, 65].
Klucken and colleagues recently observed that participants with CSB as compared to participants without displayed greater activation of the amygdala during presentation of conditioned cues (colored squares) predicting erotic pictures (rewards) [66]. These results are like those from other studies examining amygdala activation among individuals with substance use disorders and men with CSB watching sexually explicit video clips [1, 67].Using EEG, Steele and colleagues observed a higher P300 amplitude to sexual images (when compared to neutral pictures) among individuals self-identified as having problems with CSB, resonating with prior research of processing visual drug cues in drug addiction [68, 69].
In 2017, Gola and colleagues published results of a study using functional magnetic resonance imaging (fMRI) to examine Vstr responses to erotic and monetary stimuli among men seeking treatment for CSB and men without CSB [6]. Participants were engaged in an incentive delay task[54, 70, 71] while undergoing fMRI scanning. During this task, they received erotic or monetary rewards preceded by predictive cues. Men with CSB differed from those without in VStr responses to cues predicting erotic pictures, but not in their responses to erotic pictures. Additionally, men with CSB versus without CSB showed greater VStr activation specifically for cues predicting erotic pictures and not for those predicting monetary rewards. Relative sensitivity to cues (predicting erotic pictures vs. monetary gains) was found to be related to an increased behavioral motivation for viewing erotic images (‘wanting’), intensity of CSB, amount of pornography used per week, and frequency of weekly masturbation. These findings suggest similarities between CSB and addictions, an important role for learned cues in CSB, and possible treatment approaches, particularly interventions focused on teaching skills to individuals to successfully cope with cravings/urges [72]. Furthermore, habituation may be revealed through decreased reward sensitivity to normally salient stimuli and may impact reward responses to sexual stimuli including pornography viewing and partnered sex [1, 68]. Habituation has also been implicated in substance and behavioral addictions [73-79].
In 2014, Kuhn and Gallinat observed decreased VStr reactivity in response to erotic pictures in a group of participants watching pornography frequently, when compared to participants watching pornography rarely[80].Decreased functional connectivity between the left dlPFC and right VStr was also observed. Impairment in fronto-striatal circuity has been related to inappropriate or disadvantageous behavioral choices irrespective of potential negative outcome and impaired regulation of craving in drug addiction [81, 82]. Individuals with CSBmay have reduced executive control when exposed to pornographic material [83, 84]. Kuhn and Gallinat also found that the gray matter volume of the right striatum(caudate nucleus), which has been implicated in approach-attachment behaviors and related to motivational states associated with romantic love, was negatively associated with duration of internet pornography viewing[80, 85, 86]. These findings raise the possibility that frequent use of pornography may decrease brain activation in response to sexual stimuli and increase habituation to sexual pictures although longitudinal studies are needed to exclude other possibilities.
A study using EEG, conducted by Prause and colleagues, suggested that individuals who feel distressed about their pornography use, as compared to a control group who do not feel distress about their use of pornography, may require more/greater visual stimulation to evoke brain responses [87]. Hypersexual participants—individuals‘ experiencing problems regulating their viewing of sexual images’ (M=3.8 hours per week)—exhibited less neural activation (measured by late positive potential in the EEG signal) when exposed to sexual images than did the comparison group when exposed to the same images. Depending on the interpretation of sexual stimuli in this study (as a cue or reward; for more see Gola et al. [4]), the findings may support other observations indicating habituation effects in addictions [4].In 2015, Banca and colleagues observed that men with CSB preferred novel sexual stimuli and demonstrated findings suggestive of habituation in the dACC when exposed repeatedly to the same images [88]. Results of the aforementioned studies suggest that frequent pornography use may decrease reward sensitivity, possibly leading to increased habituation and tolerance, thereby enhancing the need for greater stimulation to be sexually aroused. However, longitudinal studies are indicated to examine this possibility further. Taken together, neuroimaging research to date has provided initial support for the notion that CSB shares similarities with drug, gambling, and gaming addictions with respect to altered brain networks and processes, including sensitization and habituation.
CSB as an Impulse-Control Disorder?
The category of “Impulse-Control Disorders Not Elsewhere Classified” in DSM-IV was heterogeneous in nature and included multiple disorders that have since been re-classified as being addictive (gambling disorder) or obsessive-compulsive-related (trichotillomania) in DSM-5[89, 90]. The current category in the DSM-5 focuses on disruptive, impulse-control and conduct disorders, becoming more homogeneous in its focus by including kleptomania, pyromania, intermittent explosive disorder, oppositional defiant disorder, conduct disorder, and antisocial personality disorder[90]. The category of impulse-control disorders in the ICD-11includes these first three disorders and CSBD, raising questions regarding the most appropriate classification. Given this context, how CSBD relates to the transdiagnostic construct of impulsivity warrants additional consideration for classification as well as clinical purposes.
Impulsivity may be defined as a, “predisposition towards rapid, unplanned reactions to internal or external stimuli with diminished regard to the negative consequences to the impulsive individual or others” [91]. Impulsivity has been associated with hypersexuality [92]. Impulsivity is a multidimensional construct with different types (e.g., choice, response) that may have trait and state characteristics [93-97]. Different forms of impulsivity may be assessed via self-report or via tasks. They may correlate weakly or not all, even within the same form of impulsivity; importantly, they may relate differentially to clinical characteristics and outcomes [98]. Response impulsivity maybe measured by performance on inhibitory control tasks, such as the stop signal or Go/No-Go tasks, whereas choice impulsivity may be assessed through delay discounting tasks [94, 95, 99].
Data suggest differences between individuals with and without CSB on self-report and task-based measures of impulsivity [100-103]. Furthermore, impulsivity and craving seem to be associated with the severity of symptoms of dysregulated pornography use, such as loss of control [64, 104]. For instance, one study found interacting effects of levels of impulsivity measured by self-report and behavioral tasks with respect to cumulative influences on symptom severity of CSB [104].
Among treatment-seeking samples, 48% to 55% of people may exhibit high levels of generalized impulsivity on Barratt Impulsiveness Scale [105-107]. In contrast, other data suggest that some patients seeking treatment for CSB do not have other impulsive behaviors or comorbid addictions beyond their struggles with sexual behaviors which is consistent with findings from a large online survey of men and women suggesting relatively weak relations between impulsivity and some aspects of CSB (problematic pornography use) and stronger relations with others (hypersexuality) [108, 109]. Similarly, in a study using different measures of individuals with problematic pornography use(mean time of weekly pornography use = 287.87 minutes) and those without (mean time of weekly pornography use = 50.77 minutes) did not differ on self-reported (UPPS-P Scale) or task-based (Stop Signal Task)measures of impulsivity [110].Further, Reid and colleagues did not observe differences between individuals with CSB and healthy controls on neuropsychological tests of executive functioning (i.e., response inhibition, motor speed, selective attention, vigilance, cognitive flexibility, concept formation, set shifting),even after adjusting for cognitive ability in analyses [103]. Together, findings suggest that impulsivity may link most strongly to hypersexuality but not to specific forms of CSB like problematic pornography use. It raises questions about CSBD’s classification as an impulse-control disorder in the ICD-11 and highlights the need for precise assessments of different forms of CSB. This is particularly important since some research indicates that impulsivity and subdomains of impulse-control disorder differ on conceptual and pathophysiological level [93, 98, 111].
CSB as an Obsessive-Compulsive-Spectrum Disorder?
One condition (trichotillomania) classified as an impulse-control disorder in DSM-IV has been reclassified with obsessive-compulsive disorder (OCD) as an obsessive-compulsive and related disorder in DSM-5[90]. Other DSM-IV impulse-control disorders like gambling disorder exhibit significant differences from OCD, supporting their classification in separate categories [112]. Compulsivity is a transdiagnostic construct that involves, “the performance of repetitive and functionally impairing overt or covert behavior without adaptive function, performed in a stereotyped or habitual fashion, either according to rigid rules or as a means to avoid negative consequences”[93]. OCD exhibits high levels of compulsivity; however, so do substance addictions and behavioral addictions like gambling disorder [98]. Traditionally, compulsive and impulsive disorders were construed as lying along opposite ends of a spectrum; however, data suggest the constructs as being orthogonal with many disorders scoring high on measures of both impulsivity and compulsivity [93, 113]. Regarding CSB, sexual obsessions have also been described as time-consuming and interfering and may relate theoretically to OCD or to OCD-related features [114].
Recent studies assessing obsessive-compulsive features using the Obsessive-Compulsive Inventory –Revised (OCI-R) did not show elevations among individuals with CSB [6, 37, 115]. Similarly, a large online survey found aspects of compulsivity only weakly related to problematic pornography use[109]. Together, these findings do not show strong support for considering CSB as an obsessive-compulsive-related disorder. Neural features underlying compulsive behaviors have been described and overlap across multiple disorders [93]. Further studies using psychometrically validated and neuroimaging methods in larger clinical treatment seeking samples are needed to examine further how CSBD may relate to compulsivity and OCD.
Structural Neural Changes among CSB Individuals
Thus far, most neuroimaging studies have focused on functional alterations in individuals with CSB, and results suggest that CSB symptoms are linked to specific neural processes[1, 63, 80]. Although task-based studies have deepened our knowledge about regional activation and functional connectivity, additional approaches should be used.
White-or gray-matter measures have been studied in CSB [102, 116]. In 2009, Miner and colleagues found that individuals with CSB as compared to those without displayed higher superior frontal region mean diffusivity and exhibited poorer inhibitive control. In a study of men with and without CSB from 2016, greater left amygdala volume was observed in the CSB group and relatively reduced resting-state functional connectivity was observed between the amygdala and dlPFC [116]. Reduction of brain volumes in the temporal lobe, frontal lobe, hippocampus, and amygdala were found to be related to the symptoms of hypersexuality in patients with dementia or Parkinson’s disease [117, 118]. These seemingly opposing patterns of amygdala volume relating to CSB highlight the importance of considering co-occurring neuropsychiatric disorders in understanding the neurobiology of CSB.
In 2018, Seok and Sohn used voxel-based morphometry (VBM) and resting-state connectivity analysis to examine gray-matter and resting-state measures in CSB [119]. Men with CSB showed significant gray-matter reduction in the temporal gyrus. Left superior temporal gyrus (STG) volume was negatively correlated with the severity of CSB (i.e., Sexual Addiction Screening Test-Revised [SAST ] and Hypersexual Behavior Inventory [HBI] scores)[120, 121]. Additionally, altered left STG-left precuneus and left STG-right caudate connectivities were observed. Lastly, results revealed a significant negative correlation between severity of CSB and functional connectivity of the left STG to the right caudate nucleus.
While the neuroimaging studies of CSB have been illuminating, little is still known about alternations in brain structures and functional connectivity among CSB individuals, particularly from treatment studies or other longitudinal designs. Integration of findings from other domains (e.g., genetic and epigenetic) will also be important to consider in future studies. Additionally, findings directly comparing specific disorders and incorporating transdiagnostic measures will allow for collection of important information that could inform classification and intervention development efforts currently underway.
Conclusions and Recommendations
This article reviews scientific knowledge regarding neural mechanisms of CSB from three perspectives: addictive, impulse-control, and obsessive-compulsive. Several studies suggest relationships between CSB and increased sensitivity for erotic rewards or cues predicting these rewards, and others suggest that CSB is related to increased cue-conditioning for erotic stimuli [1, 6, 36, 64, 66]. Studies also suggest that CSB symptoms are associated with elevated anxiety [34, 37,122]. Although gaps exist in our understanding of CSB, multiple brain regions (including frontal, parietal and temporal cortices, amygdala, and striatum) have been linked to CSB and related features.
CSBD has been included in the current version oftheICD-11as an impulse-control disorder [39]. As described by the WHO, ‘Impulse-control disorders are characterized by the repeated failure to resist an impulse, drive, or urge to perform an act that is rewarding to the person, at least in the short-term, despite consequences such as longer-term harm either to the individual or to others, marked distress about the behaviour pattern, or significant impairment in personal, family, social, educational, occupational, or other important areas of functioning’ [39]. Current findings raise important questions regarding the classification of CSBD. Many disorders characterized by impaired impulse-control are classified elsewhere in the ICD-11 (for example, gambling, gaming, and substance-use disorders are classified as being addictive disorders) [123].
Currently, CSBD constitutes a heterogeneous disorder, and further refinement of CSBD criteria should distinguish between different subtypes, some of which may relate to the heterogeneity of sexual behaviors problematic for individuals [33, 108, 124]. Heterogeneity in CSBD may in part explain seeming discrepancies which are noticeable across studies. Although neuroimaging studies find multiple similarities between CSB and substance and behavioral addictions, additional research is needed to fully understand how neurocognition relates to the clinical characteristics of CSB, especially with respect to sexual behaviors subtypes. Multiple studies have focused exclusively on problematic use of pornography which may limit generalizability to other sexual behaviors. Further, inclusion/exclusion criteria for CSB research participants have varied across studies, also raising questions regarding generalizability and comparability across studies.
Future Directions
Several limitations should be noted with respect to current neuroimaging studies and be considered when planning future investigations (see Table 1). A primary limitation involves small sample sizes that are largely white, male, and heterosexual. More research is needed to recruit larger, ethnically diverse samples of men and women with CSB and individuals of different sexual identities and orientations. For example, no systematic scientific studies have investigated neurocognitive processes of CSB in women. Such studies are needed given data linking sexual impulsivity to greater psychopathology in women as compared to men and other data which suggest gender-related differences in clinical populations with CSB [25, 30]. As women and men with addictions may demonstrate different motivations (e.g., relating to negative versus positive reinforcement) for engaging in addictive behaviors and show differences in stress and drug-cue responsivity, future neurobiological studies should consider stress systems and related processes in gender-related investigations of CSBD given its current inclusion in the ICD-11 as a mental health disorder [125, 126].
Similarly, there is also a need to conduct systematic research focusing on ethnic and sexual minorities to clarify our understanding of CSB among these groups. Screening instruments for CSB have been mostly tested and validated on white European men. Moreover, current studies have focused predominantly on heterosexual men. More research examining clinical characteristics of CSB among gay and bisexual men and women is needed. Neurobiological research of specific groups (transgender, polyamorous, kink, other) and activities (pornography viewing, compulsive masturbation, casual anonymous sex, other) is also needed. Given such limitations, existing results should be interpreted cautiously.
Direct comparison of CSBD with other disorders (e.g., substance use, gambling, gaming, and other disorders)is needed, as is incorporation of other non-imaging modalities (e.g., genetic, epigenetic) and use of other imaging approaches. Techniques like positron emission tomography could also provide important insight into neurochemical underpinnings of CSBD.
The heterogeneity of CSB may also be clarified through careful assessment of clinical features that may be obtained in part from qualitative research like focus group ordiary assessment methods [37]. Such research could also provide insight into longitudinal questions like whether problematic pornography use may lead to sexual dysfunction, and integrating neurocognitive assessments into such studies could provide insight into neurobiological mechanisms. Further, as behavioral and pharmacological interventions are formally tested for their efficacies in treating CSBD, integration of neurocognitive assessments could help identify mechanisms of effective treatments for CSBD and potential biomarkers. This last point may be particularly important because the inclusion of CSBD in the ICD-11 will likely increase the number of individuals seeking treatment for CSBD. Specifically, the inclusion of CSBD in the ICD-11 should raise awareness in patients, providers, and others and potentially remove other barriers (e.g., reimbursement from insurance providers) that may currently exist for CSBD.
Excerpts analyzing Steele et al., 2013 (which is citation 68):
Klucken and colleagues recently observed that participants with CSB as compared to participants without displayed greater activation of the amygdala during presentation of conditioned cues (colored squares) predicting erotic pictures (rewards) [66]. These results are like those from other studies examining amygdala activation among individuals with substance use disorders and men with CSB watching sexually explicit video clips [1, 67]. Using EEG, Steele and colleagues observed a higher P300 amplitude to sexual images (when compared to neutral pictures) among individuals self-identified as having problems with CSB, resonating with prior research of processing visual drug cues in drug addiction [68, 69].
COMMENTS: In the above excerpt the authors of the current review are saying that Steele et al’s findings indicate cue-reactivity in frequent porn users. This aligns with the addiction model and cue-reactivity is a neuro-physiological marker for addiction. While Steele et al. spokesperson Nicole Prause claimed that the subjects’ brain response differed from other types of addicts (cocaine was the example given by Prause) – this was not true, and not found anywhere in Steele et al., 2013.
Furthermore, habituation may be revealed through decreased reward sensitivity to normally salient stimuli and may impact reward responses to sexual stimuli including pornography viewing and partnered sex [1, 68]. Habituation has also been implicated in substance and behavioral addictions [73-79].
COMMENTS: In the above excerpt the authors of this review are referring to Steele et al’s finding of greater cue-reactivity to porn related to less desire for sex with a partner (but not lower desire to masturbate to porn). To put another way – individuals with more brain activation and cravings related to porn would rather masturbate to porn than have sex with a real person. That’s less reward sensitivity to “partnered sex”, which is “normally salient stimuli”. Together these two Steele et al. findings indicate greater brain activity to cues (porn images), yet less reactivity to natural rewards (sex). Both are hallmarks of addiction.
Steele VR, Staley C, Fong T, Prause N. Sexual desire, not hypersexuality, is related to neurophysiological responses elicited by sexual images. Socioaffect Neurosci Psychol. 2013;3:20770.
Purpose of review: The current review summarizes the latest findings concerning neurobiological mechanisms of compulsive sexual behavior disorder (CSBD)and provides recommendations for future research specific to the diagnostic classification of the condition.
Recent findings: To date, most neuroimaging research on compulsive sexual behavior has provided evidence of overlapping mechanisms underlying compulsive sexual behavior and non-sexual addictions. Compulsive sexual behavior is associated with altered functioning in brain regions and networks implicated in sensitization, habituation, impulse dyscontrol, and reward processing in patterns like substance, gambling, and gaming addictions. Key brain regions linked to CSB features include the frontal and temporal cortices, amygdala, and striatum, including the nucleus accumbens.
Summary: Despite much neuroscience research finding many similarities between CSBD and substance and behavioral addictions, the World Health Organization included CSBD in the ICD-11 as an impulse-control disorder. Although previous research has helped to highlight some underlying mechanisms of the condition, additional investigations are needed to fully understand this phenomenon and resolve classification issues surrounding CSBD.
Introduction
Compulsive sexual behavior (CSB) is a debated topic that is also known as sexual addiction, hypersexuality, sexual dependence, sexual impulsivity, nymphomania, or out-of-control sexual behavior [1-27]. Although precise rates are unclear given limited epidemiological research, CSB is estimated to affect 3-6% of the adult population and is more common in men than women [28-32]. Due to the associated distress and impairment reported by men and women with CSB [4-6, 30, 33-38], the World Health Organization (WHO) has recommended including Compulsive Sexual Behavior Disorder(CSBD)in the forthcoming 11th edition of the International Classification of Diseases (6C72)[39]. This inclusion should help increase access to treatment for unserved populations, reduce stigma and shame associated with help-seeking, promote concerted research efforts, and increase international attention on this condition[40, 41].We acknowledge that over the last 20 years there have been varying definitions used to describe dysregulated sexual behaviors often characterized by excessive engagement in nonparaphilic sexual activities (e.g., frequent casual/anonymous sex, problematic use of pornography). For the current review, we will use the term CSB as an overarching term for describing problematic, excessive sexual behavior.
CSB has been conceptualized as an obsessive–compulsive-spectrum disorder, an impulse-control disorder, or addictive behavior [42, 43]. The symptoms of CSBD are like those proposed in 2010forthe DSM-5 diagnosis of hypersexual disorder [44]. Hypersexual disorder was ultimately excluded by American Psychiatric Association from DSM-5 for multiple reasons; the lack of neurobiological and genetic studies was among the most noted reasons [45, 46]. More recently, CSB has received considerable attention in both popular culture and social sciences, particularly given health disparities affecting at-risk and underserved groups. Despite the considerable increase in studies of CSB (including those studying “sexual addiction,” “hypersexuality,” “sexual compulsivity”), relatively little research has examined neural underpinnings of CSB [4, 36]. This article reviews neurobiological mechanisms of CSB and provides recommendations for future research, particularly as related to diagnostic classification of CSBD.
CSB as an Addictive Disorder
Brain regions involved in processing rewards are likely important for understanding the origins, formation, and maintenance of addictive behaviors [47]. Structures within a so-called ‘reward system’ are activated by potentially reinforcing stimuli, such as addictive drugs in addictions. A major neurotransmitter involved in processing rewards is dopamine, particularly within the mesolimbic pathway involving the ventral tegmental area (VTA) and its connections with the nucleus accumbens (NAc), as well as the amygdala, hippocampus, and prefrontal cortex [48]. Additional neurotransmitters and pathways are involved in processing rewards and pleasure, and these warrant considerations given that dopamine has been implicated to varying degrees in individual drug and behavioral addictions in humans [49-51].
According to the incentive salience theory, different brain mechanisms influence motivation to obtain reward (‘wanting’) and the actual hedonic experience of reward (‘liking’) [52]. Whereas ‘wanting’ may be closely related to dopaminergic neurotransmission in the ventral striatum (VStr) and orbitofrontal cortex, networks dedicated to creating wanting motivations and pleasurable feelings are more complex [49, 53, 54].
VStr reward-related reactivity has been studied in addictive disorders such as alcohol, cocaine, opioid use disorders, and gambling disorder[55-58]. Volkow and colleagues describe four important components of addiction: (1) sensitization involving cue reactivity and craving, (2) desensitization involving habituation, (3) hypofrontality, and (4) malfunctioning stress systems[59]. Thus far, research of CSB has largely focused on cue reactivity, craving, and habituation. The first neuroimaging studies of CSB were focused on examining potential similarities between CSB and addictions, with a specific focus on the incentive salience theory that is based on preconscious neural sensitization related to changes in dopamine-related motivation systems[60]. In this model, repeated exposure to potentially addictive drugs may change brain cells and circuits that regulate the attribution of incentive salience to stimuli, which is a psychological process involved in motivated behavior. Because of this exposure, brain circuits may become hypersensitive (or sensitized), thereby contributing to the development of pathological levels of incentive salience for target substances and their associated cues. Pathological incentive motivation (‘wanting’) for drugs may last for years, even if drug use is discontinued. It may involve implicit (unconscious wanting) or explicit (conscious craving) processes. The incentive salience model has been proposed to potentially contribute to the development and maintenance of CSB [1, 2].
Data support the incentive salience model for CSB. For example, Voon and colleagues examined cue-induced activity in the dorsal anterior cingulate cortex (dACC) –Vstr –amygdala functional network [1].Men with CSB as compared to those without showed increased VStr, dACC, and amygdala responses to pornographic video clips. These findings in the context of the larger literature suggest that sex and drug-cue reactivity involve largely overlapping regions and networks[61, 62]. Men with CSB as compared to those without also reported higher wanting (subjective sexual desire) of pornography stimuli and lower liking which is consistent with an incentive salience theory[1]. Similarly, Mechelmans and colleagues found that men with CSB as compared to men without showed enhanced early attentional bias towards sexually explicit stimuli but not to neutral cues [2]. These findings suggest similarities in enhanced attentional bias observed in studies examining drug cues in addictions.
In 2015, Seok and Sohn found that among men with CSB as compared to those without, greater activity was observed in the dorsolateral prefrontal cortex (dlPFC), caudate, inferior supramarginal gyrus of the parietal lobe, dACC, and thalamus in response to sexual cues[63]. They also found that the severity of CSB symptoms was correlated with cue-induced activation of the dlPFC and thalamus. In 2016, Brand and colleagues observed greater activation of the VStr for preferred pornographic material as compared to non-preferred pornographic material among men with CSB and found that VStr activity was positively associated with self-reported symptoms of addictive use of Internet pornography (assessed by the short Internet Addiction Test modified for cybersex (s-IATsex) [64, 65].
Klucken and colleagues recently observed that participants with CSB as compared to participants without displayed greater activation of the amygdala during presentation of conditioned cues (colored squares) predicting erotic pictures (rewards) [66]. These results are like those from other studies examining amygdala activation among individuals with substance use disorders and men with CSB watching sexually explicit video clips [1, 67].Using EEG, Steele and colleagues observed a higher P300 amplitude to sexual images (when compared to neutral pictures) among individuals self-identified as having problems with CSB, resonating with prior research of processing visual drug cues in drug addiction [68, 69].
In 2017, Gola and colleagues published results of a study using functional magnetic resonance imaging (fMRI) to examine Vstr responses to erotic and monetary stimuli among men seeking treatment for CSB and men without CSB [6]. Participants were engaged in an incentive delay task[54, 70, 71] while undergoing fMRI scanning. During this task, they received erotic or monetary rewards preceded by predictive cues. Men with CSB differed from those without in VStr responses to cues predicting erotic pictures, but not in their responses to erotic pictures. Additionally, men with CSB versus without CSB showed greater VStr activation specifically for cues predicting erotic pictures and not for those predicting monetary rewards. Relative sensitivity to cues (predicting erotic pictures vs. monetary gains) was found to be related to an increased behavioral motivation for viewing erotic images (‘wanting’), intensity of CSB, amount of pornography used per week, and frequency of weekly masturbation. These findings suggest similarities between CSB and addictions, an important role for learned cues in CSB, and possible treatment approaches, particularly interventions focused on teaching skills to individuals to successfully cope with cravings/urges [72]. Furthermore, habituation may be revealed through decreased reward sensitivity to normally salient stimuli and may impact reward responses to sexual stimuli including pornography viewing and partnered sex [1, 68]. Habituation has also been implicated in substance and behavioral addictions [73-79].
In 2014, Kuhn and Gallinat observed decreased VStr reactivity in response to erotic pictures in a group of participants watching pornography frequently, when compared to participants watching pornography rarely[80].Decreased functional connectivity between the left dlPFC and right VStr was also observed. Impairment in fronto-striatal circuity has been related to inappropriate or disadvantageous behavioral choices irrespective of potential negative outcome and impaired regulation of craving in drug addiction [81, 82]. Individuals with CSBmay have reduced executive control when exposed to pornographic material [83, 84]. Kuhn and Gallinat also found that the gray matter volume of the right striatum(caudate nucleus), which has been implicated in approach-attachment behaviors and related to motivational states associated with romantic love, was negatively associated with duration of internet pornography viewing[80, 85, 86]. These findings raise the possibility that frequent use of pornography may decrease brain activation in response to sexual stimuli and increase habituation to sexual pictures although longitudinal studies are needed to exclude other possibilities.
A study using EEG, conducted by Prause and colleagues, suggested that individuals who feel distressed about their pornography use, as compared to a control group who do not feel distress about their use of pornography, may require more/greater visual stimulation to evoke brain responses [87]. Hypersexual participants—individuals‘ experiencing problems regulating their viewing of sexual images’ (M=3.8 hours per week)—exhibited less neural activation (measured by late positive potential in the EEG signal) when exposed to sexual images than did the comparison group when exposed to the same images. Depending on the interpretation of sexual stimuli in this study (as a cue or reward; for more see Gola et al. [4]), the findings may support other observations indicating habituation effects in addictions [4].In 2015, Banca and colleagues observed that men with CSB preferred novel sexual stimuli and demonstrated findings suggestive of habituation in the dACC when exposed repeatedly to the same images [88]. Results of the aforementioned studies suggest that frequent pornography use may decrease reward sensitivity, possibly leading to increased habituation and tolerance, thereby enhancing the need for greater stimulation to be sexually aroused. However, longitudinal studies are indicated to examine this possibility further. Taken together, neuroimaging research to date has provided initial support for the notion that CSB shares similarities with drug, gambling, and gaming addictions with respect to altered brain networks and processes, including sensitization and habituation.
CSB as an Impulse-Control Disorder?
The category of “Impulse-Control Disorders Not Elsewhere Classified” in DSM-IV was heterogeneous in nature and included multiple disorders that have since been re-classified as being addictive (gambling disorder) or obsessive-compulsive-related (trichotillomania) in DSM-5[89, 90]. The current category in the DSM-5 focuses on disruptive, impulse-control and conduct disorders, becoming more homogeneous in its focus by including kleptomania, pyromania, intermittent explosive disorder, oppositional defiant disorder, conduct disorder, and antisocial personality disorder[90]. The category of impulse-control disorders in the ICD-11includes these first three disorders and CSBD, raising questions regarding the most appropriate classification. Given this context, how CSBD relates to the transdiagnostic construct of impulsivity warrants additional consideration for classification as well as clinical purposes.
Impulsivity may be defined as a, “predisposition towards rapid, unplanned reactions to internal or external stimuli with diminished regard to the negative consequences to the impulsive individual or others” [91]. Impulsivity has been associated with hypersexuality [92]. Impulsivity is a multidimensional construct with different types (e.g., choice, response) that may have trait and state characteristics [93-97]. Different forms of impulsivity may be assessed via self-report or via tasks. They may correlate weakly or not all, even within the same form of impulsivity; importantly, they may relate differentially to clinical characteristics and outcomes [98]. Response impulsivity maybe measured by performance on inhibitory control tasks, such as the stop signal or Go/No-Go tasks, whereas choice impulsivity may be assessed through delay discounting tasks [94, 95, 99].
Data suggest differences between individuals with and without CSB on self-report and task-based measures of impulsivity [100-103]. Furthermore, impulsivity and craving seem to be associated with the severity of symptoms of dysregulated pornography use, such as loss of control [64, 104]. For instance, one study found interacting effects of levels of impulsivity measured by self-report and behavioral tasks with respect to cumulative influences on symptom severity of CSB [104].
Among treatment-seeking samples, 48% to 55% of people may exhibit high levels of generalized impulsivity on Barratt Impulsiveness Scale [105-107]. In contrast, other data suggest that some patients seeking treatment for CSB do not have other impulsive behaviors or comorbid addictions beyond their struggles with sexual behaviors which is consistent with findings from a large online survey of men and women suggesting relatively weak relations between impulsivity and some aspects of CSB (problematic pornography use) and stronger relations with others (hypersexuality) [108, 109]. Similarly, in a study using different measures of individuals with problematic pornography use(mean time of weekly pornography use = 287.87 minutes) and those without (mean time of weekly pornography use = 50.77 minutes) did not differ on self-reported (UPPS-P Scale) or task-based (Stop Signal Task)measures of impulsivity [110].Further, Reid and colleagues did not observe differences between individuals with CSB and healthy controls on neuropsychological tests of executive functioning (i.e., response inhibition, motor speed, selective attention, vigilance, cognitive flexibility, concept formation, set shifting),even after adjusting for cognitive ability in analyses [103]. Together, findings suggest that impulsivity may link most strongly to hypersexuality but not to specific forms of CSB like problematic pornography use. It raises questions about CSBD’s classification as an impulse-control disorder in the ICD-11 and highlights the need for precise assessments of different forms of CSB. This is particularly important since some research indicates that impulsivity and subdomains of impulse-control disorder differ on conceptual and pathophysiological level [93, 98, 111].
CSB as an Obsessive-Compulsive-Spectrum Disorder?
One condition (trichotillomania) classified as an impulse-control disorder in DSM-IV has been reclassified with obsessive-compulsive disorder (OCD) as an obsessive-compulsive and related disorder in DSM-5[90]. Other DSM-IV impulse-control disorders like gambling disorder exhibit significant differences from OCD, supporting their classification in separate categories [112]. Compulsivity is a transdiagnostic construct that involves, “the performance of repetitive and functionally impairing overt or covert behavior without adaptive function, performed in a stereotyped or habitual fashion, either according to rigid rules or as a means to avoid negative consequences”[93]. OCD exhibits high levels of compulsivity; however, so do substance addictions and behavioral addictions like gambling disorder [98]. Traditionally, compulsive and impulsive disorders were construed as lying along opposite ends of a spectrum; however, data suggest the constructs as being orthogonal with many disorders scoring high on measures of both impulsivity and compulsivity [93, 113]. Regarding CSB, sexual obsessions have also been described as time-consuming and interfering and may relate theoretically to OCD or to OCD-related features [114].
Recent studies assessing obsessive-compulsive features using the Obsessive-Compulsive Inventory –Revised (OCI-R) did not show elevations among individuals with CSB [6, 37, 115]. Similarly, a large online survey found aspects of compulsivity only weakly related to problematic pornography use[109]. Together, these findings do not show strong support for considering CSB as an obsessive-compulsive-related disorder. Neural features underlying compulsive behaviors have been described and overlap across multiple disorders [93]. Further studies using psychometrically validated and neuroimaging methods in larger clinical treatment seeking samples are needed to examine further how CSBD may relate to compulsivity and OCD.
Structural Neural Changes among CSB Individuals
Thus far, most neuroimaging studies have focused on functional alterations in individuals with CSB, and results suggest that CSB symptoms are linked to specific neural processes[1, 63, 80]. Although task-based studies have deepened our knowledge about regional activation and functional connectivity, additional approaches should be used.
White-or gray-matter measures have been studied in CSB [102, 116]. In 2009, Miner and colleagues found that individuals with CSB as compared to those without displayed higher superior frontal region mean diffusivity and exhibited poorer inhibitive control. In a study of men with and without CSB from 2016, greater left amygdala volume was observed in the CSB group and relatively reduced resting-state functional connectivity was observed between the amygdala and dlPFC [116]. Reduction of brain volumes in the temporal lobe, frontal lobe, hippocampus, and amygdala were found to be related to the symptoms of hypersexuality in patients with dementia or Parkinson’s disease [117, 118]. These seemingly opposing patterns of amygdala volume relating to CSB highlight the importance of considering co-occurring neuropsychiatric disorders in understanding the neurobiology of CSB.
In 2018, Seok and Sohn used voxel-based morphometry (VBM) and resting-state connectivity analysis to examine gray-matter and resting-state measures in CSB [119]. Men with CSB showed significant gray-matter reduction in the temporal gyrus. Left superior temporal gyrus (STG) volume was negatively correlated with the severity of CSB (i.e., Sexual Addiction Screening Test-Revised [SAST ] and Hypersexual Behavior Inventory [HBI] scores)[120, 121]. Additionally, altered left STG-left precuneus and left STG-right caudate connectivities were observed. Lastly, results revealed a significant negative correlation between severity of CSB and functional connectivity of the left STG to the right caudate nucleus.
While the neuroimaging studies of CSB have been illuminating, little is still known about alternations in brain structures and functional connectivity among CSB individuals, particularly from treatment studies or other longitudinal designs. Integration of findings from other domains (e.g., genetic and epigenetic) will also be important to consider in future studies. Additionally, findings directly comparing specific disorders and incorporating transdiagnostic measures will allow for collection of important information that could inform classification and intervention development efforts currently underway.
Conclusions and Recommendations
This article reviews scientific knowledge regarding neural mechanisms of CSB from three perspectives: addictive, impulse-control, and obsessive-compulsive. Several studies suggest relationships between CSB and increased sensitivity for erotic rewards or cues predicting these rewards, and others suggest that CSB is related to increased cue-conditioning for erotic stimuli [1, 6, 36, 64, 66]. Studies also suggest that CSB symptoms are associated with elevated anxiety [34, 37,122]. Although gaps exist in our understanding of CSB, multiple brain regions (including frontal, parietal and temporal cortices, amygdala, and striatum) have been linked to CSB and related features.
CSBD has been included in the current version oftheICD-11as an impulse-control disorder [39]. As described by the WHO, ‘Impulse-control disorders are characterized by the repeated failure to resist an impulse, drive, or urge to perform an act that is rewarding to the person, at least in the short-term, despite consequences such as longer-term harm either to the individual or to others, marked distress about the behaviour pattern, or significant impairment in personal, family, social, educational, occupational, or other important areas of functioning’ [39]. Current findings raise important questions regarding the classification of CSBD. Many disorders characterized by impaired impulse-control are classified elsewhere in the ICD-11 (for example, gambling, gaming, and substance-use disorders are classified as being addictive disorders) [123].
Currently, CSBD constitutes a heterogeneous disorder, and further refinement of CSBD criteria should distinguish between different subtypes, some of which may relate to the heterogeneity of sexual behaviors problematic for individuals [33, 108, 124]. Heterogeneity in CSBD may in part explain seeming discrepancies which are noticeable across studies. Although neuroimaging studies find multiple similarities between CSB and substance and behavioral addictions, additional research is needed to fully understand how neurocognition relates to the clinical characteristics of CSB, especially with respect to sexual behaviors subtypes. Multiple studies have focused exclusively on problematic use of pornography which may limit generalizability to other sexual behaviors. Further, inclusion/exclusion criteria for CSB research participants have varied across studies, also raising questions regarding generalizability and comparability across studies.
Future Directions
Several limitations should be noted with respect to current neuroimaging studies and be considered when planning future investigations (see Table 1). A primary limitation involves small sample sizes that are largely white, male, and heterosexual. More research is needed to recruit larger, ethnically diverse samples of men and women with CSB and individuals of different sexual identities and orientations. For example, no systematic scientific studies have investigated neurocognitive processes of CSB in women. Such studies are needed given data linking sexual impulsivity to greater psychopathology in women as compared to men and other data which suggest gender-related differences in clinical populations with CSB [25, 30]. As women and men with addictions may demonstrate different motivations (e.g., relating to negative versus positive reinforcement) for engaging in addictive behaviors and show differences in stress and drug-cue responsivity, future neurobiological studies should consider stress systems and related processes in gender-related investigations of CSBD given its current inclusion in the ICD-11 as a mental health disorder [125, 126].
Similarly, there is also a need to conduct systematic research focusing on ethnic and sexual minorities to clarify our understanding of CSB among these groups. Screening instruments for CSB have been mostly tested and validated on white European men. Moreover, current studies have focused predominantly on heterosexual men. More research examining clinical characteristics of CSB among gay and bisexual men and women is needed. Neurobiological research of specific groups (transgender, polyamorous, kink, other) and activities (pornography viewing, compulsive masturbation, casual anonymous sex, other) is also needed. Given such limitations, existing results should be interpreted cautiously.
Direct comparison of CSBD with other disorders (e.g., substance use, gambling, gaming, and other disorders)is needed, as is incorporation of other non-imaging modalities (e.g., genetic, epigenetic) and use of other imaging approaches. Techniques like positron emission tomography could also provide important insight into neurochemical underpinnings of CSBD.
The heterogeneity of CSB may also be clarified through careful assessment of clinical features that may be obtained in part from qualitative research like focus group ordiary assessment methods [37]. Such research could also provide insight into longitudinal questions like whether problematic pornography use may lead to sexual dysfunction, and integrating neurocognitive assessments into such studies could provide insight into neurobiological mechanisms. Further, as behavioral and pharmacological interventions are formally tested for their efficacies in treating CSBD, integration of neurocognitive assessments could help identify mechanisms of effective treatments for CSBD and potential biomarkers. This last point may be particularly important because the inclusion of CSBD in the ICD-11 will likely increase the number of individuals seeking treatment for CSBD. Specifically, the inclusion of CSBD in the ICD-11 should raise awareness in patients, providers, and others and potentially remove other barriers (e.g., reimbursement from insurance providers) that may currently exist for CSBD.
Purpose of review: The current review summarizes the latest findings concerning neurobiological mechanisms of compulsive sexual behavior disorder (CSBD) and provides recommendations for future research specific to the diagnostic classification of the condition.
Recent findings: To date, most neuroimaging research on compulsive sexual behavior has provided evidence of overlapping mechanisms underlying compulsive sexual behavior and non-sexual addictions. Compulsive sexual behavior is associated with altered functioning in brain regions and networks implicated in sensitization, habituation, impulse dyscontrol, and reward processing in patterns like substance, gambling, and gaming addictions. Key brain regions linked to CSB features include the frontal and temporal cortices, amygdala, and striatum, including the nucleus accumbens.
Summary: Despite much neuroscience research finding many similarities between CSBD and substance and behavioral addictions, the World Health Organization included CSBD in the ICD-11 as an impulse-control disorder. Although previous research has helped to highlight some underlying mechanisms of the condition, additional investigations are needed to fully understand this phenomenon and resolve classification issues surrounding CSBD.
Introduction
Compulsive sexual behavior (CSB) is a debated topic that is also known as sexual addiction, hypersexuality, sexual dependence, sexual impulsivity, nymphomania, or out-of-control sexual behavior [1-27]. Although precise rates are unclear given limited epidemiological research, CSB is estimated to affect 3-6% of the adult population and is more common in men than women [28-32]. Due to the associated distress and impairment reported by men and women with CSB [4-6, 30, 33-38], the World Health Organization (WHO) has recommended including Compulsive Sexual Behavior Disorder(CSBD)in the forthcoming 11th edition of the International Classification of Diseases (6C72)[39]. This inclusion should help increase access to treatment for unserved populations, reduce stigma and shame associated with help-seeking, promote concerted research efforts, and increase international attention on this condition[40, 41].We acknowledge that over the last 20 years there have been varying definitions used to describe dysregulated sexual behaviors often characterized by excessive engagement in nonparaphilic sexual activities (e.g., frequent casual/anonymous sex, problematic use of pornography). For the current review, we will use the term CSB as an overarching term for describing problematic, excessive sexual behavior.
CSB has been conceptualized as an obsessive–compulsive-spectrum disorder, an impulse-control disorder, or addictive behavior [42, 43]. The symptoms of CSBD are like those proposed in 2010forthe DSM-5 diagnosis of hypersexual disorder [44]. Hypersexual disorder was ultimately excluded by American Psychiatric Association from DSM-5 for multiple reasons; the lack of neurobiological and genetic studies was among the most noted reasons [45, 46]. More recently, CSB has received considerable attention in both popular culture and social sciences, particularly given health disparities affecting at-risk and underserved groups. Despite the considerable increase in studies of CSB (including those studying “sexual addiction,” “hypersexuality,” “sexual compulsivity”), relatively little research has examined neural underpinnings of CSB [4, 36]. This article reviews neurobiological mechanisms of CSB and provides recommendations for future research, particularly as related to diagnostic classification of CSBD.
CSB as an Addictive Disorder
Brain regions involved in processing rewards are likely important for understanding the origins, formation, and maintenance of addictive behaviors [47]. Structures within a so-called ‘reward system’ are activated by potentially reinforcing stimuli, such as addictive drugs in addictions. A major neurotransmitter involved in processing rewards is dopamine, particularly within the mesolimbic pathway involving the ventral tegmental area (VTA) and its connections with the nucleus accumbens (NAc), as well as the amygdala, hippocampus, and prefrontal cortex [48]. Additional neurotransmitters and pathways are involved in processing rewards and pleasure, and these warrant considerations given that dopamine has been implicated to varying degrees in individual drug and behavioral addictions in humans [49-51].
According to the incentive salience theory, different brain mechanisms influence motivation to obtain reward (‘wanting’) and the actual hedonic experience of reward (‘liking’) [52]. Whereas ‘wanting’ may be closely related to dopaminergic neurotransmission in the ventral striatum (VStr) and orbitofrontal cortex, networks dedicated to creating wanting motivations and pleasurable feelings are more complex [49, 53, 54].
VStr reward-related reactivity has been studied in addictive disorders such as alcohol, cocaine, opioid use disorders, and gambling disorder[55-58]. Volkow and colleagues describe four important components of addiction: (1) sensitization involving cue reactivity and craving, (2) desensitization involving habituation, (3) hypofrontality, and (4) malfunctioning stress systems[59]. Thus far, research of CSB has largely focused on cue reactivity, craving, and habituation. The first neuroimaging studies of CSB were focused on examining potential similarities between CSB and addictions, with a specific focus on the incentive salience theory that is based on preconscious neural sensitization related to changes in dopamine-related motivation systems[60]. In this model, repeated exposure to potentially addictive drugs may change brain cells and circuits that regulate the attribution of incentive salience to stimuli, which is a psychological process involved in motivated behavior. Because of this exposure, brain circuits may become hypersensitive (or sensitized), thereby contributing to the development of pathological levels of incentive salience for target substances and their associated cues. Pathological incentive motivation (‘wanting’) for drugs may last for years, even if drug use is discontinued. It may involve implicit (unconscious wanting) or explicit (conscious craving) processes. The incentive salience model has been proposed to potentially contribute to the development and maintenance of CSB [1, 2].
Data support the incentive salience model for CSB. For example, Voon and colleagues examined cue-induced activity in the dorsal anterior cingulate cortex (dACC) –Vstr –amygdala functional network [1].Men with CSB as compared to those without showed increased VStr, dACC, and amygdala responses to pornographic video clips. These findings in the context of the larger literature suggest that sex and drug-cue reactivity involve largely overlapping regions and networks[61, 62]. Men with CSB as compared to those without also reported higher wanting (subjective sexual desire) of pornography stimuli and lower liking which is consistent with an incentive salience theory[1]. Similarly, Mechelmans and colleagues found that men with CSB as compared to men without showed enhanced early attentional bias towards sexually explicit stimuli but not to neutral cues [2]. These findings suggest similarities in enhanced attentional bias observed in studies examining drug cues in addictions.
In 2015, Seok and Sohn found that among men with CSB as compared to those without, greater activity was observed in the dorsolateral prefrontal cortex (dlPFC), caudate, inferior supramarginal gyrus of the parietal lobe, dACC, and thalamus in response to sexual cues[63]. They also found that the severity of CSB symptoms was correlated with cue-induced activation of the dlPFC and thalamus. In 2016, Brand and colleagues observed greater activation of the VStr for preferred pornographic material as compared to non-preferred pornographic material among men with CSB and found that VStr activity was positively associated with self-reported symptoms of addictive use of Internet pornography (assessed by the short Internet Addiction Test modified for cybersex (s-IATsex) [64, 65].
Klucken and colleagues recently observed that participants with CSB as compared to participants without displayed greater activation of the amygdala during presentation of conditioned cues (colored squares) predicting erotic pictures (rewards) [66]. These results are like those from other studies examining amygdala activation among individuals with substance use disorders and men with CSB watching sexually explicit video clips [1, 67].Using EEG, Steele and colleagues observed a higher P300 amplitude to sexual images (when compared to neutral pictures) among individuals self-identified as having problems with CSB, resonating with prior research of processing visual drug cues in drug addiction [68, 69].
In 2017, Gola and colleagues published results of a study using functional magnetic resonance imaging (fMRI) to examine Vstr responses to erotic and monetary stimuli among men seeking treatment for CSB and men without CSB [6]. Participants were engaged in an incentive delay task[54, 70, 71] while undergoing fMRI scanning. During this task, they received erotic or monetary rewards preceded by predictive cues. Men with CSB differed from those without in VStr responses to cues predicting erotic pictures, but not in their responses to erotic pictures. Additionally, men with CSB versus without CSB showed greater VStr activation specifically for cues predicting erotic pictures and not for those predicting monetary rewards. Relative sensitivity to cues (predicting erotic pictures vs. monetary gains) was found to be related to an increased behavioral motivation for viewing erotic images (‘wanting’), intensity of CSB, amount of pornography used per week, and frequency of weekly masturbation. These findings suggest similarities between CSB and addictions, an important role for learned cues in CSB, and possible treatment approaches, particularly interventions focused on teaching skills to individuals to successfully cope with cravings/urges [72]. Furthermore, habituation may be revealed through decreased reward sensitivity to normally salient stimuli and may impact reward responses to sexual stimuli including pornography viewing and partnered sex [1, 68]. Habituation has also been implicated in substance and behavioral addictions [73-79].
In 2014, Kuhn and Gallinat observed decreased VStr reactivity in response to erotic pictures in a group of participants watching pornography frequently, when compared to participants watching pornography rarely[80].Decreased functional connectivity between the left dlPFC and right VStr was also observed. Impairment in fronto-striatal circuity has been related to inappropriate or disadvantageous behavioral choices irrespective of potential negative outcome and impaired regulation of craving in drug addiction [81, 82]. Individuals with CSBmay have reduced executive control when exposed to pornographic material [83, 84]. Kuhn and Gallinat also found that the gray matter volume of the right striatum(caudate nucleus), which has been implicated in approach-attachment behaviors and related to motivational states associated with romantic love, was negatively associated with duration of internet pornography viewing[80, 85, 86]. These findings raise the possibility that frequent use of pornography may decrease brain activation in response to sexual stimuli and increase habituation to sexual pictures although longitudinal studies are needed to exclude other possibilities.
A study using EEG, conducted by Prause and colleagues, suggested that individuals who feel distressed about their pornography use, as compared to a control group who do not feel distress about their use of pornography, may require more/greater visual stimulation to evoke brain responses [87]. Hypersexual participants—individuals‘ experiencing problems regulating their viewing of sexual images’ (M=3.8 hours per week)—exhibited less neural activation (measured by late positive potential in the EEG signal) when exposed to sexual images than did the comparison group when exposed to the same images. Depending on the interpretation of sexual stimuli in this study (as a cue or reward; for more see Gola et al. [4]), the findings may support other observations indicating habituation effects in addictions [4].In 2015, Banca and colleagues observed that men with CSB preferred novel sexual stimuli and demonstrated findings suggestive of habituation in the dACC when exposed repeatedly to the same images [88]. Results of the aforementioned studies suggest that frequent pornography use may decrease reward sensitivity, possibly leading to increased habituation and tolerance, thereby enhancing the need for greater stimulation to be sexually aroused. However, longitudinal studies are indicated to examine this possibility further. Taken together, neuroimaging research to date has provided initial support for the notion that CSB shares similarities with drug, gambling, and gaming addictions with respect to altered brain networks and processes, including sensitization and habituation.
CSB as an Impulse-Control Disorder?
The category of “Impulse-Control Disorders Not Elsewhere Classified” in DSM-IV was heterogeneous in nature and included multiple disorders that have since been re-classified as being addictive (gambling disorder) or obsessive-compulsive-related (trichotillomania) in DSM-5 [89, 90]. The current category in the DSM-5 focuses on disruptive, impulse-control and conduct disorders, becoming more homogeneous in its focus by including kleptomania, pyromania, intermittent explosive disorder, oppositional defiant disorder, conduct disorder, and antisocial personality disorder[90]. The category of impulse-control disorders in the ICD-11includes these first three disorders and CSBD, raising questions regarding the most appropriate classification. Given this context, how CSBD relates to the transdiagnostic construct of impulsivity warrants additional consideration for classification as well as clinical purposes.
Impulsivity may be defined as a, “predisposition towards rapid, unplanned reactions to internal or external stimuli with diminished regard to the negative consequences to the impulsive individual or others” [91]. Impulsivity has been associated with hypersexuality [92]. Impulsivity is a multidimensional construct with different types (e.g., choice, response) that may have trait and state characteristics [93-97]. Different forms of impulsivity may be assessed via self-report or via tasks. They may correlate weakly or not all, even within the same form of impulsivity; importantly, they may relate differentially to clinical characteristics and outcomes [98]. Response impulsivity maybe measured by performance on inhibitory control tasks, such as the stop signal or Go/No-Go tasks, whereas choice impulsivity may be assessed through delay discounting tasks [94, 95, 99].
Data suggest differences between individuals with and without CSB on self-report and task-based measures of impulsivity [100-103]. Furthermore, impulsivity and craving seem to be associated with the severity of symptoms of dysregulated pornography use, such as loss of control [64, 104]. For instance, one study found interacting effects of levels of impulsivity measured by self-report and behavioral tasks with respect to cumulative influences on symptom severity of CSB [104].
Among treatment-seeking samples, 48% to 55% of people may exhibit high levels of generalized impulsivity on Barratt Impulsiveness Scale [105-107]. In contrast, other data suggest that some patients seeking treatment for CSB do not have other impulsive behaviors or comorbid addictions beyond their struggles with sexual behaviors which is consistent with findings from a large online survey of men and women suggesting relatively weak relations between impulsivity and some aspects of CSB (problematic pornography use) and stronger relations with others (hypersexuality) [108, 109]. Similarly, in a study using different measures of individuals with problematic pornography use(mean time of weekly pornography use = 287.87 minutes) and those without (mean time of weekly pornography use = 50.77 minutes) did not differ on self-reported (UPPS-P Scale) or task-based (Stop Signal Task)measures of impulsivity [110].Further, Reid and colleagues did not observe differences between individuals with CSB and healthy controls on neuropsychological tests of executive functioning (i.e., response inhibition, motor speed, selective attention, vigilance, cognitive flexibility, concept formation, set shifting),even after adjusting for cognitive ability in analyses [103]. Together, findings suggest that impulsivity may link most strongly to hypersexuality but not to specific forms of CSB like problematic pornography use. It raises questions about CSBD’s classification as an impulse-control disorder in the ICD-11 and highlights the need for precise assessments of different forms of CSB. This is particularly important since some research indicates that impulsivity and subdomains of impulse-control disorder differ on conceptual and pathophysiological level [93, 98, 111].
CSB as an Obsessive-Compulsive-Spectrum Disorder?
One condition (trichotillomania) classified as an impulse-control disorder in DSM-IV has been reclassified with obsessive-compulsive disorder (OCD) as an obsessive-compulsive and related disorder in DSM-5[90]. Other DSM-IV impulse-control disorders like gambling disorder exhibit significant differences from OCD, supporting their classification in separate categories [112]. Compulsivity is a transdiagnostic construct that involves, “the performance of repetitive and functionally impairing overt or covert behavior without adaptive function, performed in a stereotyped or habitual fashion, either according to rigid rules or as a means to avoid negative consequences”[93]. OCD exhibits high levels of compulsivity; however, so do substance addictions and behavioral addictions like gambling disorder [98]. Traditionally, compulsive and impulsive disorders were construed as lying along opposite ends of a spectrum; however, data suggest the constructs as being orthogonal with many disorders scoring high on measures of both impulsivity and compulsivity [93, 113]. Regarding CSB, sexual obsessions have also been described as time-consuming and interfering and may relate theoretically to OCD or to OCD-related features [114].
Recent studies assessing obsessive-compulsive features using the Obsessive-Compulsive Inventory –Revised (OCI-R) did not show elevations among individuals with CSB [6, 37, 115]. Similarly, a large online survey found aspects of compulsivity only weakly related to problematic pornography use[109]. Together, these findings do not show strong support for considering CSB as an obsessive-compulsive-related disorder. Neural features underlying compulsive behaviors have been described and overlap across multiple disorders [93]. Further studies using psychometrically validated and neuroimaging methods in larger clinical treatment seeking samples are needed to examine further how CSBD may relate to compulsivity and OCD.
Structural Neural Changes among CSB Individuals
Thus far, most neuroimaging studies have focused on functional alterations in individuals with CSB, and results suggest that CSB symptoms are linked to specific neural processes[1, 63, 80]. Although task-based studies have deepened our knowledge about regional activation and functional connectivity, additional approaches should be used.
White-or gray-matter measures have been studied in CSB [102, 116]. In 2009, Miner and colleagues found that individuals with CSB as compared to those without displayed higher superior frontal region mean diffusivity and exhibited poorer inhibitive control. In a study of men with and without CSB from 2016, greater left amygdala volume was observed in the CSB group and relatively reduced resting-state functional connectivity was observed between the amygdala and dlPFC [116]. Reduction of brain volumes in the temporal lobe, frontal lobe, hippocampus, and amygdala were found to be related to the symptoms of hypersexuality in patients with dementia or Parkinson’s disease [117, 118]. These seemingly opposing patterns of amygdala volume relating to CSB highlight the importance of considering co-occurring neuropsychiatric disorders in understanding the neurobiology of CSB.
In 2018, Seok and Sohn used voxel-based morphometry (VBM) and resting-state connectivity analysis to examine gray-matter and resting-state measures in CSB [119]. Men with CSB showed significant gray-matter reduction in the temporal gyrus. Left superior temporal gyrus (STG) volume was negatively correlated with the severity of CSB (i.e., Sexual Addiction Screening Test-Revised [SAST ] and Hypersexual Behavior Inventory [HBI] scores)[120, 121]. Additionally, altered left STG-left precuneus and left STG-right caudate connectivities were observed. Lastly, results revealed a significant negative correlation between severity of CSB and functional connectivity of the left STG to the right caudate nucleus.
While the neuroimaging studies of CSB have been illuminating, little is still known about alternations in brain structures and functional connectivity among CSB individuals, particularly from treatment studies or other longitudinal designs. Integration of findings from other domains (e.g., genetic and epigenetic) will also be important to consider in future studies. Additionally, findings directly comparing specific disorders and incorporating transdiagnostic measures will allow for collection of important information that could inform classification and intervention development efforts currently underway.
Conclusions and Recommendations
This article reviews scientific knowledge regarding neural mechanisms of CSB from three perspectives: addictive, impulse-control, and obsessive-compulsive. Several studies suggest relationships between CSB and increased sensitivity for erotic rewards or cues predicting these rewards, and others suggest that CSB is related to increased cue-conditioning for erotic stimuli [1, 6, 36, 64, 66]. Studies also suggest that CSB symptoms are associated with elevated anxiety [34, 37,122]. Although gaps exist in our understanding of CSB, multiple brain regions (including frontal, parietal and temporal cortices, amygdala, and striatum) have been linked to CSB and related features.
CSBD has been included in the current version of theICD-11 as an impulse-control disorder [39]. As described by the WHO, ‘Impulse-control disorders are characterized by the repeated failure to resist an impulse, drive, or urge to perform an act that is rewarding to the person, at least in the short-term, despite consequences such as longer-term harm either to the individual or to others, marked distress about the behaviour pattern, or significant impairment in personal, family, social, educational, occupational, or other important areas of functioning’ [39]. Current findings raise important questions regarding the classification of CSBD. Many disorders characterized by impaired impulse-control are classified elsewhere in the ICD-11 (for example, gambling, gaming, and substance-use disorders are classified as being addictive disorders) [123].
Currently, CSBD constitutes a heterogeneous disorder, and further refinement of CSBD criteria should distinguish between different subtypes, some of which may relate to the heterogeneity of sexual behaviors problematic for individuals [33, 108, 124]. Heterogeneity in CSBD may in part explain seeming discrepancies which are noticeable across studies. Although neuroimaging studies find multiple similarities between CSB and substance and behavioral addictions, additional research is needed to fully understand how neurocognition relates to the clinical characteristics of CSB, especially with respect to sexual behaviors subtypes. Multiple studies have focused exclusively on problematic use of pornography which may limit generalizability to other sexual behaviors. Further, inclusion/exclusion criteria for CSB research participants have varied across studies, also raising questions regarding generalizability and comparability across studies.
Future Directions
Several limitations should be noted with respect to current neuroimaging studies and be considered when planning future investigations (see Table 1). A primary limitation involves small sample sizes that are largely white, male, and heterosexual. More research is needed to recruit larger, ethnically diverse samples of men and women with CSB and individuals of different sexual identities and orientations. For example, no systematic scientific studies have investigated neurocognitive processes of CSB in women. Such studies are needed given data linking sexual impulsivity to greater psychopathology in women as compared to men and other data which suggest gender-related differences in clinical populations with CSB [25, 30]. As women and men with addictions may demonstrate different motivations (e.g., relating to negative versus positive reinforcement) for engaging in addictive behaviors and show differences in stress and drug-cue responsivity, future neurobiological studies should consider stress systems and related processes in gender-related investigations of CSBD given its current inclusion in the ICD-11 as a mental health disorder [125, 126].
Similarly, there is also a need to conduct systematic research focusing on ethnic and sexual minorities to clarify our understanding of CSB among these groups. Screening instruments for CSB have been mostly tested and validated on white European men. Moreover, current studies have focused predominantly on heterosexual men. More research examining clinical characteristics of CSB among gay and bisexual men and women is needed. Neurobiological research of specific groups (transgender, polyamorous, kink, other) and activities (pornography viewing, compulsive masturbation, casual anonymous sex, other) is also needed. Given such limitations, existing results should be interpreted cautiously.
Direct comparison of CSBD with other disorders (e.g., substance use, gambling, gaming, and other disorders)is needed, as is incorporation of other non-imaging modalities (e.g., genetic, epigenetic) and use of other imaging approaches. Techniques like positron emission tomography could also provide important insight into neurochemical underpinnings of CSBD.
The heterogeneity of CSB may also be clarified through careful assessment of clinical features that may be obtained in part from qualitative research like focus group ordiary assessment methods [37]. Such research could also provide insight into longitudinal questions like whether problematic pornography use may lead to sexual dysfunction, and integrating neurocognitive assessments into such studies could provide insight into neurobiological mechanisms. Further, as behavioral and pharmacological interventions are formally tested for their efficacies in treating CSBD, integration of neurocognitive assessments could help identify mechanisms of effective treatments for CSBD and potential biomarkers. This last point may be particularly important because the inclusion of CSBD in the ICD-11 will likely increase the number of individuals seeking treatment for CSBD. Specifically, the inclusion of CSBD in the ICD-11 should raise awareness in patients, providers, and others and potentially remove other barriers (e.g., reimbursement from insurance providers) that may currently exist for CSBD.
Table 1.Recommendations for neuroscientific studies of Compulsive Sexual Behavior Disorder.
Data
Goal
Behavioral
Self-report
Neurobiological
▪ Conduct intercultural studies on larger samples; include more women, ethnic and sexual minorities, economicallydisadvantaged persons and persons with cognitive and physical disabilities
Clinical
Behavioral
Self-report
Neurobiological
▪ Large, well-powered field trials to assess and validate proposed CSBD diagnostic criteria
▪ Examinethe heterogeneous natureof CSBD
▪ Examine the role of impulsivity and other transdiagnostic constructs in the development and maintenance of CSBD
▪ Assess the relationship between brain structure and function and treatment outcomesfor treatment-seeking individuals with CSBD
Clinical
Pharmacological
Neurobiological
▪ Identification of efficacious and well tolerated pharmacological and behavioral treatments in randomized clinical trials of individuals with CSBD
Neurobiological
▪ Further examination of structural,functional, neurochemical and other data and their integration
▪ Examine neurobiological mechanisms underlying specific aspects of CSBD including sexual function and dysfunction
Genetic
▪ Conduct genome-wide association studies (GWAS) on CSBD
▪ Examine genetic factors that may serve as vulnerability factors for the development of CSBD
▪ Study environmental and epigenetic influences on processes in CSBD
(This section was created after sections 2-9 were created.)
I was under the impression that people looked to Retraction Watch for responsible, thoroughly vetted articles about research. After my recent experience however, I can only ask, “Who’s watching Retraction Watch?” To whom or what is Retraction Watch accountable for oversight when it engages in irresponsible journalism?
On June 13, Retraction Watch (RW) published an inaccurate and biased account of events surrounding Behavioral Sciences paper Park et al., 2016. Among other distortions, the piece omitted material details about Nicole Prause’s unsuccessful (and unseemly) 3-year campaign to have the paper retracted (documented in the next 8 sections).
Prause, a former academic, apparently contacted RW personnel and fed them the particulars she wanted in print – and RW apparently swallowed them whole and duly published them. My response appears underneath the Retraction Watch article. However, RW edited my comment substantially before it would post it. Here I supply various missing details.
First, my comment is a redacted version of an email I sent to Adam Marcus and Ivan Oransky of RW shortly after the piece appeared. After 3 days of back-and-forth emails, RW eventually posted some of the proposed content (from my email), but demanded that I remove content that revealed the ways in which RW had not performed its journalistic duties.
Here is more of the story.
1) Senior author, and Naval officer, Andrew Doan MD PhD requested that Adam Marcus speak to me for clarification on details surrounding the paper (after Marcus contacted him). Doan did this because he and my other 6 co-authors are Active Duty in the US Navy and “cannot speak about the paper in detail without permission from the public affairs office US Navy.” Marcus chose not to contact me. Instead he ran with everything Prause fed him. From my original email:
I’ve read your piece, “Journal corrects, but will not retract, controversial paper on internet porn.” As the prime objective of Retraction Watch is integrity in publishing, I believe you will want to correct this article in numerous important respects. In its current form it contains many errors and much defamatory misinformation. I regret that you didn’t contact me as Dr. Doan suggested, so that these errors could have been avoided.
2) RW principals Adam Marcus and Ivan Oransky were copied on the May, 2018 MDPI-Prause email exchanges. As I said in one of my emails to RW:
I am deeply concerned about Retraction Watch’s selective use of bits of the MDPI emails that Dr. Prause copied you on. As I was also sent those emails, I know there was a lot of other information in them. The omitted bits included lies and unprofessional attacks on others by Dr. Prause. While Dr. Lin’s metaphor was unfortunate (English is not his first or second language), I think his remark needs to be ‘heard’ in light of the fact that Dr. Prause has been badgering his company directly, and indirectly via COPE, for almost two straight years. His exasperation is easily understood. Giving Dr. Prause a “pass” on her offensive behavior while highlighting his was unkind and, more important, leaves your readers with a very skewed perspective.
It must be noted that RW was not copied on the endless stream of emails, from the previous 3 years, where Prause harassed MDPI, the US Navy, the 7 Navy doctors, The Reward Foundation, the publisher of my book, etc., etc. Nor is anyone privy to her many private emails to COPE and its officers.
3) In the May, 2018 MDPI-Prause email exchanges, Marcus and Oransky were twice given this extensive page documenting Prause’s long history of harassing researchers, authors, medical doctors, therapists, psychologists, a former UCLA colleague, a UK charity, men in recovery, a senior TIME magazine editor, several professors, IITAP, SASH, Fight The New Drug, MDPI, and the head of the academic journal CUREUS. In essence, RW ignored Prause’s documented misbehavior to publish its Prause-inspired hit piece.
4) In a follow-up email asking why RW had failed to post my (redacted) comment, I mentioned to Marcus and Oransky that the core assertion of RW’s hit piece was mistaken:
As things stand, even the premise of your article is false. My affiliation with The Reward Foundation (TRF) was always clearly stated, both in the initial Behavioral Sciences article and in the recent correction (the original PubMed version). The purpose of the newly published correction was to counter Dr. Prause’s incessant defamatory claims that I receive money from TRF, and that I make money from my book (my proceeds for which, in fact, go to the charity).
5) In both my emails to RW, I clearly addressed the second primary assertion in their article:
It is also important to clarify that Dr. Prause’s “77 unaddressed points” claim is untrue. I have the documentation of these points and our team’s responses (and the documentation that 25 of the 77 “points” had nothing to do with the Behavioral Sciences paper).
See this section for more details surrounding Prause’s so-called “77 points,” and her unprofessional involvement with an earlier, much different version of our paper, submitted to Yale Journal of Biology and Medicine.
6) In both my emails to RW, I clearly stated that Prause was lying about the California investigation:
Next, it is crucial to correct Dr. Prause’s false assertion that California’s investigation of her behavior is over and that she has prevailed. It is not over; an investigator has invited me to testify in the coming months (date TBD).
It’s quite telling that Marcus and Oransky
(1) did not correct the RW article’s false assertions and misleading statements,
(2) redacted evidence in my proposed post that they were very aware of Prause’s defamatory statements and long history of harassment and proceeded anyway,
(3) chose not communicate with me prior to publication, even though the paper’s senior author requested they do so,
(4) subtly suggested I was the harasser by falsely stating that the California investigation was complete and decided in Prause’s favor, and by linking to a Daily Beast account of events, and
(5) have not corrected or unpublished their hit piece as irresponsible journalism, nor publicly apologized to the authors and journal whose reputations they smeared without cause.
A few more points about the RW article not covered in my comment. The first paragraph states:
“After publication, critics asked COPE to look at the paper.”
“Critics” plural? It was only one “critic” who emailed either MDPI or COPE: Prause. She emailed the US Navy multiple times, reported the 7 doctors on the paper to their medical boards, and turned to social media to harass me, MDPI, and researchers who publish in MDPI – as part of a long campaign to avoid writing a formal scholarly reply to the paper and instead to try to have it retracted via behind-the-scenes maneuvering and public misinformation.
The article said:
“COPE, which has no enforcement authority, said in an email to the publisher that it would have recommended retraction of the article.”
COPE was only concerned about one issue (based on the “facts” fed to it): consent. COPE said the following:
“should this case have been raised at one of our COPE forums, we feel the recommendation would have been to consider the retraction of the article on the basis of consent requirements not following expectations”…..
While COPE’s answer is hypothetical, based on whatever “facts” Prause apparently supplied it, the authors and MDPI are truly puzzled by the response. In reality, the US Navy doctors more than complied with their Naval Medical Center – San Diego’s IRB consent rules. The Naval Medical Center San Diego’s IRB policy does not consider case reports of less than four patients in a single article to be human subject research and does not require the patients to consent to inclusion in an article. Although the researchers were not required to obtain consent, for two cases, verbal and written consents were obtained. In the third case where anonymity was unlikely to be compromised, no written consent was obtained.
Incidentally, at Dr. Prause’s insistence, after the paper was published, the actions of the Navy co-authors with respect to this paper were thoroughly reviewed in an independent Navy investigation. Result? I have a copy of the official report by a Navy lawyer affirming that the co-authors complied with all the IRB’s rules.
The RW article also said:
“Among the the [sic] claims is that one of the authors, Gary Wilson, failed to adequately disclose his work with The Reward Foundation,”
This is false. As explained earlier, my affiliation with The Reward Foundation (TRF) was always clearly stated, both in the initial Behavioral Sciences article and in the recent correction (the original PubMed version). The purpose of the newly published correction was to counter Dr. Prause’s incessant defamatory claims that I receive money from TRF, and that I make money from my book (my proceeds for which, in fact, go to the charity).
In the absence of adequate oversight, RW readers may want to be skeptical about ingesting RW’s blog posts without independent investigation. RW seems to be willing to allow itself to be used by agenda-driven forces even when alerted that further investigation is needed.
Prause is obsessed with MDPI because (1) Behavioral Sciences published two articles that Prause disagrees with (because they discussed papers by her, among hundreds of papers by other authors), and (2) Gary Wilson is a co-author of Park et al., 2016. Prause has a long history of cyberstalking and defaming Wilson, chronicled in this very extensive page. The two papers:
The second paper (Park et al.) didn’t analyze Prause’s research. It cited findings in 3 of her papers. At the request of a reviewer during the peer-review process, it addressed the third, a 2015 paper by Prause & Pfaus, by citing a scholarly piece in a journal that heavily, accurately criticized the paper. (There was not enough space in Park et al. to address all the weaknesses and unsupported claims in Prause & Pfaus, 2015).
Prause immediately insisted that MDPI retract Park et al., 2016. The professional response to scholarly articles one disapproves of is to publish a comment outlining any objections. Behavioral Sciences’s parent company, MDPI, invited Prause to do this. She declined. It must be noted that Prause attacks Wilson and his website constantly and publicly.
Instead of publishing a formal comment, she unprofessionally turned to threats and social media (and most recently the Retraction Watch blog) to bully MDPI into retracting Park et al., of which I am a co-author with 7 US Navy physicians (including two urologists, two psychiatrists and a neuroscientist). In addition, she informed MDPI that she had filed complaints with the American Psychological Association. She then filed complaints with all the doctors’ medical boards. She also pressured the doctors’ medical center and Institutional Review Board, causing a lengthy, thorough investigation, which found no evidence of wrongdoing on the part of the paper’s authors.
Prause also complained repeatedly to COPE (Committee on Publication Ethics). COPE finally wrote MDPI with a hypothetical inquiry about retraction, based on Prause’s narrative that the “patients weren’t consented.” MDPI thoroughly re-investigated the consents obtained by the doctors who authored the paper, as well as US Navy policy around obtaining consents.
Please note that the Naval Medical Center San Diego’s IRB does not consider case reports of less than four patients in a single article to be human subject research and does not require the patients to consent to inclusion in an article. Although the researchers were not required to obtain consent, for two cases, verbal and written consents were obtained. In the third case where anonymity was unlikely to be compromised, no written consent was obtained.
Incidentally, at Dr. Prause’s insistence, after the paper was published, the actions of the Navy co-authors with respect to this paper were thoroughly reviewed in an independent Navy investigation. Result? I have a copy of the official report by a Navy lawyer affirming that the co-authors complied with all the IRB’s rules.
Accordingly, MDPI declined to retract the paper. This was explained to COPE, without further objection from COPE. As long as researchers comply with their institution’s IRB consent rules (which was the case here), there is no problem. Yet Prause continues to claim falsely that this issue was unresolved and that “the patients were not consented” and retraction is appropriate.
Prause also complained to COPE that I had an undisclosed conflict of interest. Background: I disclosed my affiliation with The Reward Foundation in the paper from the start. This is not a conflict of interest. In 2018, the journal issued a correction that changed the language describing my affiliation to make it crystal clear (even to Prause) that no conflict of interest existed. It mentions my book, the fact that my proceeds from the book go to The Reward Foundation, and the fact that my affiliation is an unremunerated position. Prause has continued to claim (falsely) that I have been accepting thousands of pounds from the charity. Proof that she is mistaken is documented elsewhere on this page.
Pre-MDPI history: The Yale Journal of Biology & Medicine, and “Janey Wilson”
The story of Prause’s efforts relating to the paper that was ultimately published as Park et al. actually begins before the involvement of MDPI and Behavioral Sciences. An earlier, much shorter version of the paper, with the same authors and author affiliations as it had when later submitted to Behavioral Sciences, was first submitted to Yale Journal of Biology and Medicine (YJBM). It’s worth reviewing certain conduct in connection with this paper when it was under consideration by YJBM.
One of the 2 reviewers of the paper gave it a scathing review with 70+ criticisms, and it was duly rejected. Around the time that YJBM rejected the paper, a “Janey Wilson” began harassing my book publisher, Commonwealth Publishing, and the registered charity to which I donate my share of my book’s proceeds. (I am the author of Your Brain On Porn: Internet Pornography and the Emerging Science of Addiction.) A detailed account of “Janey’s” extensive, groundless harassment is set forth at the bottom of this page.
Note: The submission to YJBM was the only place my affiliation with the charity, The Reward Foundation (TRF), could be found, as it was nowhere public. In other words, apart from the Board of TRF and myself, only the YJBM editor and its two reviewers knew about this affiliation. And yet, “Janey” claimed to have evidence of this affiliation, and used my affiliation to fabricate various allegations of wrongdoing by TRF and me. She even filed a nuisance report with the Scottish Charity Regulator, to no avail.
Later, Dr. Prause submitted her scathing YJBM review with 70+ criticisms to a regulatory board (as part of an effort to have the published paper retracted), thus confirming she had indeed provided the YJBM with an unfavorable review of the paper. (Further evidence that she was a YJBM reviewer turned up during the Behavioral Sciences submission process, as recounted below.) Incidentally, Prause’s actions are a clear violation of COPE’s rules for peer reviewers (Section 5 of the “Guidelines on Good Publication Practice”), which require reviewers to keep confidential anything they learn through the review process.
YJBM was informed of (1) the harassing behavior engaged in by “Janey,” (2) “Janey’s” possible true identity, and (3) the fact that “Janey” may have violated COPE’s rules for peer reviewers by making public confidential information about me.
The paper was promptly accepted by YJBM…and then not published in that journal after all, due to the journal’s decision that it was too late to make the requested revisions and still meet the print deadline for YJBM’s special “Addiction” issue.
Behavioral Sciences version of Park et al.
A revised and updated version of the paper was then submitted to the journal Behavioral Sciences. After a few rounds of reviews and further restructuring it was accepted as a review of the literature, with case studies. Its final form was quite different from the original YJBM submission.
During this process, the paper was reviewed by no fewer than 6 reviewers. Five passed it, some with some suggested revisions, and one harshly rejected it (guess who?).
Phase one of this process unfolded as follows: The paper was reviewed twice, one of them the harsh rejection, one favorable. Puzzled by the harsh rejection, Behavioral Sciences sent the paper out for review to 2 other reviewers. These reviewers passed the paper. Behavioral Sciences cautiously rejected the paper but allowed the authors to “revise and resubmit.” As part of this process, the authors were given all of the comments by the reviewers (but not their identities). The reviewers’ concerns were thoroughly addressed, point by point (available upon request).
From these comments, it became evident that the “harsh reviewer” of the Behavioral Sciences paper had also reviewed the paper at YJBM.About a third of the 77 points raised did not relate to the Behavioral Sciences submission at all.They referred to material that was only present in the earlier version of the paper, the one that had been submitted to YJBM.
In other words, the harsh reviewer had cut and pasted dozens of criticisms from a review done at another journal (YJBM), which no longer had any relevance to the paper submitted to Behavioral Sciences. This is highly unprofessional. Moreover, Prause eventually revealed herself as the author of these criticisms in her complaint to the regulatory boards (see above), in which she shared her YJBM review of the obsolete version of the paper.
Incidentally, when Prause was asked to review the paper at Behavioral Sciences she apparently did not reveal that she had already reviewed the paper at another journal. It would have been standard reviewer etiquette to reveal the earlier review.
Let me summarize Prause’s multiple objections to our paper. Again, 25 or so of them had nothing whatsoever to do with the Behavioral Sciences paper Prause had been asked by Behavioral Sciences to review. They referred to its first submission at YJBM. This alone should disqualify the entire review from further consideration.
Yet, we carefully combed through each comment looking for any useful insights, and wrote a comprehensive response to all comments for Behavioral Sciences and its editors. Almost all of the remaining 50 critical comments were either scientifically inaccurate, groundless, or were simply false statements. Some were repetitive. Several complained about the presence of quotations from the 3 patients, even though the paper was submitted as “a review with clinical reports.” Some made claims about some of the sources we cited, but the claims were simply not supported by the papers themselves. More than 10 comments insisted that the doctors were not competent to examine their patients for the case studies(!).
In short, while reviewers’ comments always improve any paper to some degree, there really wasn’t the need to “fix” much of the paper itself in light of Prause’s comments. What we did do was strengthen the paper itself with 50 more citations, lest other readers make any of the same errors.
The paper was rewritten and revised. Next, two more reviewers and a supervisory editor reviewed and passed it with various suggestions, including a suggestion to restructure it as a “review with case studies.” Satisfied that all legitimate concerns had been addressed, Behavioral Sciences published the paper.
Retraction efforts
Immediately Prause began demanding that the paper be retracted. Among other efforts, she sent this unprofessional private email message threatening MDPI with bad press if they refused to retract the paper:
“This was filed August 24, 2016. It is now November 12, 2016….. If I do not hear anything within the next two weeks, we will begin by writing the board of that journal with the facts of the case. Multiple retraction watchdogs are already aware and waiting to hear that retraction is occurring, but will instead publish about the failure to retract if necessary.”
Here’s another of her private threats to MDPI on Mon, Nov 14, 2016:
“Behavioral Sciences is the definition of a predatory journal and was recognized on Beall’s predatory journal list until you threatened him to remove it. The first media coverage of this should appear late this week in a national outlet. We gave you every chance to retract this fake paper.”
MDPI disagreed with Prause’s concerns or assessment of the paper, and did not retract the it, pending further investigation of her assertions. The saga continues, and a summary of it appears at the very end of this page.
In any event, after her dubious retraction demands, Prause began defaming MDPI (and its journal Behavioral Sciences) as “predatory” on social media.
Prause uses social media to harass MDPI, researchers who publish in MDPI journals, and anyone citing Park et al., 2016
Out of nowhere Prause attacks MDPI in November, 2017, tweeting an article that has nothing to do with MDPI:
MDPI responds:
This causes Prause to go on a Twitter rampage (a few of her tweets below):
MDPI responds to Prause:
CEO of MDPI Franck Vazquez, Ph.D, also responds, as does Prause:
Prause keeps going (MDPI ignores her Twitter tagging):
Has Prause been trying to have MDPI thrown out of PubMed and other indices based on her untruths? Three tweets from August, 2016 – just a few weeks after Park et al., 2016 was published:
From a hit piece containing several false statements by Prause: http://www.patheos.com/blogs/mormontherapist/2016/12/op-ed.html. One article referred to is the review by 7 Navy doctors and me, the other is co-authored by other experts, including Todd Love PsyD – whom Prause has also harassed. Again, MDPI was formally exonerated and removed even before Beall took his list down.
Prause has also tried to interfere with other MDPI journal issues by defaming MDPI:
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Here are examples of Prause unprofessionally shaming others for collaborating/publishing with/receiving awards from MDPI:
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Here Prause plays her favorite card – accusing others of misogyny – without a shred of evidence (just as she has done with me and countless others).
More unfounded accusations of misogyny:
Prause falsely claims the Behavioral Sciences paper she attacked was retracted. This is both defamatory and unprofessional.
The Twitter conversation continues:
“Pornaddiction recovery” tweets two YBOP lists, which causes Prause to tweet a paper by Gary Wilson and Navy doctors. Prause falsely claims that she badgered COPE into suggesting a retraction. It’s all bullshit.
After a lengthy, thorough, time-consuming investigation, MDPI decided not to retract the paper, and circulated a draft editorial criticizing Prause’s unprofessional behavior. As soon as Prause was informed, she initiated an unprofessional, untruthful email exchange with MDPI, copying various bloggers she hoped would take her word for things and publish defamatory articles. Retraction Watch has already complied with her demand.
It’s 2019 and Prause continues to search twitter for unrelated material so she has an excuse to tweet her falsehoods and the bogus Retraction Watch article:
On February 16, 2019, a sexual medicine specialist presented a talk at the 21st Congress of the European Society for Sexual Medicine on the Internet’s impact on sexuality. A few slides describing porn-induced sexual problems, citing Park et al., 2016, were tweeted. The tweets caused Nicole Prause, David Ley, Joshua Grubbs and their allies to Twitter-rage on Park et al., 2016.
Several of Prause’s tweets allude to a keynote address by Gary Wilson scheduled for the 2018 ISSM conference. Suddenly and without explanation my talk was mysteriously cancelled. It seems likely that Dr. Prause was behind the cancellation as she is the only one to report (boast about?) the cancellation (repeatedly) on social media. She has a long history of making false reports to organizations and governing bodies.
It’s likely that Prause fed the ISSM conference organizers her usual collection of falsehoods. For example, I suspect she pointed out that I had been reported to the Oregon Board of Psychology (without cause) for “practicing psychology without a license.” I say this because, not long after the conference, I received a letter from the Board exonerating me of doing so (they could not reveal who had filed the malicious complaint).
Dr. Prause also regularly claims to people, including perhaps the conference organizers, that I hold myself out as a professor. This is also untrue. (See this link for details: Ongoing – Prause falsely claims that Wilson has misrepresented his credentials.) She may also have told the organizers her oft-repeated lies that I have a restraining order against me for her safety, and that I have been reported to the FBI. There is no such “no contact” order, and I have already made public a report from the FBI clearing me and confirming Prause as lying. Below are examples of Prause’s February 16, 2019 Twitter-rage related to Park et al., 2016:
The same day, NatureReviewsUrology (NRU) quoted from the talk, not from our paper. This NRU tweet is the one that drew the most Twitter rage from Pause and her followers attacking our paper, even though our paper did not say the following, and really said nothing about porn addiction. As an aside, Prause’s claims about “falsified data” are untrue and unsupported.
There is no documentation of anything, other than Prause’s endless string of unsupported, defamatory claims, chronicled on these 3 pages:
The truth is, I was most likely uninvited as a keynote speaker by the ISSM due to the behind-the-scenes efforts of Prause and her chum and co-author Jim Pfaus (ISSM member), who used his long-time influence to put the screws to the ISSM committee. As I engaged in none of the accused wrongdoings, Prause clearly fabricated some crazy lies to scare the ISSM off (in keeping with her pattern of behavior documented on this page). A screenshot of Gary Wilson’s scheduled talk at the 2018 ISSM conference held in Portugal:
The committee asked me to speak because: (1) I was on Park et al., 2016, and, (2) I had given a very popular TEDx talk, which touched on porn-induced ED. A screenshot of the formal invitation:
On social media, Prause has stated that she got my talk cancelled because I presented “fake credentials.” For example, Prause’s tweet attacking the ESSM talk, and her claiming that Gary Wilson was uninvited because he “gave false credentials”:
Proof that Prause is lying: in back and forth emails, I reminded the ISSM committee that I did not have a PhD or MD (see below). Still, the committee insisted I present and even paid for my flight to Portugal despite the cancellation (which was not normally done).
More tweets attacking the 2019 ESSM talk and Park et al., 2016:
No, COPE did not suggest retraction, even though Prause harassed them for 3 straight years. As soon as COPE understood that all Navy consent rules had been complied with, all talk of retraction ended.
Another falsehood about “addiction being ruled out.” Diagnostic manuals such as the DSM and ICD do not use the word “addiction” to describe any addiction: they use “disorder.” In reality, the latest version of the World Health Organization’s medical diagnostic manual, The International Classification of Diseases (ICD-11), contains a new diagnosis suitable for diagnosing what is commonly referred to as ‘porn addiction’ or ‘sex addiction.’ It’s called “Compulsive Sexual Behavior Disorder” (CSBD).
Out of the blue, Prause tweets an attack on MDPI: The following downgraded rating by Norwegian Register was a clerical error, that was later corrected. See the explanation of the MDPI Wikipedia page: https://en.wikipedia.org/wiki/Talk:MDPI#Reply_1-APR-2019
A link to the corrected version showing that MDPI was not downgraded in 2019 (it was clerical error that was eventually corrected). While the 2020 rating may also be an error, the Norwegian register does show “0’ – but it’s “not again”. Notice that Prause is attempting to fool the public by tweeting 2 screenshots of the ratings; one with only 2020, and a screenshot of the 2019 error that was later corrected. Prause’s screenshots:
First showing only 2020
Second showing the uncorrected error:
Prause is lying about MDPI’s 2019 rating, as seen in a screenshot of the recent ratings:
It appears that the 2020 rating will be adjusted at the beginning of the year.
In response, Prause trolls a 3-month old Frank Vasquez tweet:
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August, 2019: Prause and David Ley team up to lie about Park et al., 2016. The paper is posted in a thread were Ley misrepresents the state research, claiming porn addiction doesn’t exist. Immediately Ley responds with defamation – claiming the authors paid to have Park et al., 2016 published:
May 24-27, 2018 – Prause creates multiple sock-puppets to edit the MDPI Wikipedia page (and is banned for sock-puppetry & defamation)
In an earlier section we recounted Prause’s harassment of MDPI and its journal Behavioral Sciences. We also chronicled Prause’s long history of employing multiple fake usernames on Wikipedia (which violates its rules) to harass many of the individuals or organizations listed on this page. For example:
Prause’s latest Wikipedia barrage occurred from May 24th to the 27th and involved at least 6 fake usernames (called “sock-puppets” in Wikipedia jargon). The following links take you to all the edits by these particular usernames (“user contributions”):
The first four usernames edited the MDPI Wikipedia page, while 3 of the 6 edited the Nofap Wikipedia page, the Sex Addiction page and the Pornography Addiction page. All 3 pages are obsessions of Prause. Even Wikipedia recognized the usernames as belonging to the same person because all the names were banned for “sock-puppetry.” We can be sure it was Prause editing the MDPI page because:
1) The most recent batch of emails between MDPI and Nicole Prause started on May 22, with MDPI notifying all involved that one minor technical correction and an editorial would be forthcoming. This enraged Prause who responded with a string of demands and threats, followed by false accusations and personal attacks.
Welcome to Wikipedia. Although everyone is welcome to contribute constructively to the encyclopedia, your addition of one or more external links to the page Nicole Prause has been reverted.
I have images that verify each of the claims (e.g., email from the publisher, email from the listed editor, etc.). RetractionWatch and other outlets are considering writing reviews of it as well, but I cannot be sure those will materialize. How is best to provide such evidence that verifies the claims? As embedded image? Written elsewhere with images and linked?
Let’s provide a few examples of the “NeuroSex” edits (lies) related to Gary Wilson and to Park et al., 2016 – followed by Wilson’s comments:
Wilson comment: NeuroSex linked to a redacted document, claiming that Gary Wilson was paid 9,000 pounds by Scotish charity The Reward Foundation. Two days earlier Prause falsely claimed to journal publisher MDPI (and others) that, based on the charity’s recent public filing (with a name redacted, as is standard), expense reimbursements paid to a charity officer were in fact paid to Wilson. Prause has not checked her facts, and she is mistaken (again). Wilson has never received any money from The Reward Foundation. Gary Wilson forwarded Prause’s claim to Darryl Mead, Chair of The Reward Foundation. His response is above:
From: Foundation Reward <[email protected]>
Sent: Thursday, May 24, 2018 8:17 AM
To: gary wilson
Subject: Re: Concerns raised to the attention of COPE by Nicole Prause. Manuscript ID behavsci-133116
Dear Gary:
I have looked into this. Prause said:
On 22/05/2018 20:48, Nicole Prause wrote:
> It appears Wilson did receive money from The Reward Foundation. Attached is The Reward Foundation Annual Report. Per item C6 referring to travel that describes Gary Wilson’s travel totaling 9,027 pounds.
>
> I request that any correction include this financial COI, or time be allotted to properly demonstrate that this was not a financial conflict of interest.
>
> Nicole Prause, Ph.D. Liberos <http://www.liberoscenter.com>
This is a reference to our 2016-17 Annual Accounts. A version of the accounts with identity redaction was published by the Office of the Scottish Charity Regulator and can be downloaded at https://www.oscr.org.uk/search/charity-details?number=SC044948#results, copy attached. This redaction process is done by OSCR without input from the named charity.
The relevant section with redaction reads as per this screen shot.
The individual referred to in C6 is Darryl Mead, the Chair of the Reward Foundation. I am that person and I made the claim for reimbursement of travel and other costs.
The original document reads as follows:
There is no reference to Gary Wilson in any part of the expenditure for the Reward Foundation because there were no payments to him.
With best wishes,
Darryl Mead
In summary, Prause falsely accused Wilson of receiving funds from The Reward Foundation. She then publicized her lie to MDPI, COPE, RetractionWatch, and others, using the redacted document she submitted (just as NeuroSex lied to Wikipedia in her failed attempt to have her related edits accepted).
Update, 6-7-18: For no reason in particular given that I had not posted and no one cited my work or mentioned me, Prause posted a comment on the ICD-11 about Gary Wilson (must create a username to view comments). In this comment Prause repeats the above lie she stated in an email exchange with MDPI, RetractionWatch, and COPE (and on Wikipedia):
Over the next few days Nicole Prause posted 4 more libelous comments on the ICD-11 attacking Gary Wilson and continuing to falsely assert that he is a paid employee of The Reward Foundation. Darryl Mead, the Chair of The Reward Foundation, eventually responded:
As Expected, Prause responded with several more lies and personal attacks.
Update, 6-18-18: Prause created another Wikipedia username to edit the MDPI wikipedia page – https://en.wikipedia.org/wiki/Special:Contributions/185.51.228.245 – and added the following:
In 2016, another MDPI journal, Behavioral Sciences, published a review paper claiming pornography caused erectile dysfunction. Six scientists independently contacted MDPI concerned about fraud and other issues in the article, initiating an independent review by the Committee on Publication Ethics (COPE). COPE recommended retracting the article.[31] The listed paper editor, Scott Lane, denied having served as the editor. Thus, the paper appears not to have undergone peer-review. Further, two authors had undisclosed conflicts of interest. Gary Wilson’s association with The Reward Foundation did not properly identify it as an activist, anti-pornography organization. Wilson also had posted extensively in social media that the study was “by the US Navy”, although the original paper stated that it did not reflect the views of the US Navy. The other author, Dr. Andrew Doan, was an ophthalmologist who ran an anti-pornography ministry Real Battlefield Ministries, soliciting donations for their speaking.[32] Further, the Committee on Publication Ethics determined that the cases were not properly, ethically consented for inclusion. MDPI issued a correction for some of these issues,[33] but has refused to post corrections for others to date as described by Retraction Watch.[31]
Several of the above lies debunked:
There were not 6 scientists – only Prause contacted MDPI.
My association with The Reward Foundation was fully disclosed from the beginning. As explained earlier, my affiliation with The Reward Foundation (TRF) was always clearly stated, both in the initial Behavioral Sciences article and in the recent correction (the original PubMed version). The purpose of the newly published correction was to counter Dr. Prause’s incessant defamatory claims that I receive money from TRF, and that I make money from my book (my proceeds for which, in fact, go to the charity)
I posted that the paper involved 7 US Navy doctors. The Navy had no problems with my comments.
Dr. Andrew Doan is both an MD and a PhD (Neuroscience – Johns Hopkins), is the former of Head of “Addictions and Resilience Research” in the Department of Mental Health at the Naval Medical Center. (He has since been transferred and promoted, and has different responsibilities.) Doan has authored multiple papers on behavioral addiction/pathologies relating to technologies (in some cases with a co-author of the paper you have written about here). In short, he is a qualified senior author. Those other papers can be found here: https://www.ncbi.nlm.nih.gov/pubmed/?term=doan+klam. His non-profit, Real Battlefield Ministries (RBM), did not discuss pornography prior to publication of the paper. Even if RBM had presented on pornography it would not have been a conflict of interest.
As described above, COPE’s decision was hypothetical and did not apply to our paper as the US Navy doctors more than complied with their Naval Medical Center – San Diego’s IRB consent rules. The Naval Medical Center San Diego’s IRB policy does not consider case reports of less than four patients in a single article to be human subject research and does not require the patients to consent to inclusion in an article. Although the researchers were not required to obtain consent, for two cases, verbal and written consents were obtained. In the third case where anonymity was unlikely to be compromised, no written consent was obtained. Incidentally, at Dr. Prause’s insistence, after the paper was published, the actions of the Navy co-authors with respect to this paper were thoroughly reviewed in an independent Navy investigation. Result? I have a copy of the official report by a Navy lawyer affirming that the co-authors complied with all the IRB’s rules.
In a sworn affidavit filed in Federal Court, Gary Wilson stated that Prause (1) used a false identity (Janey Wilson) to defame and harass Wilson, his publisher, and The Reward Foundation, (2) lied in emails, on Wikipedia, and in public comments when stating that Gary Wilson received financial compensation from The Reward Foundation
Prause’s lies and harassment has finally caught up with her.
As thoroughly explained in the previous section Gary Wilson donates the proceeds of his book to The Reward Foundation. Wilson accepts no money, and has never received a dime for any of his efforts. YBOP accepts no ads and Wilson has accepted no fees for speaking. As documented in these sections, Prause has constructed a libelous fairy tale that Wilson is being paid by the same charity he donates his book proceeds to:
In fact, this is not true. The above two sections are addressed in Gary Wilson’s sworn affidavit, which is part of the Dr. Hilton’s defamation lawsuit filed against Dr. Prause.
In a sworn affidavit filed in Federal Court, Gary Wilson stated (under penalty of perjury) that (1) Nicole Prause used a false identity (Janey Wilson) to defame and harass Wilson, his publisher, and The Reward Foundation, (2) that Prause lied in emails, on Wikipedia and in public comments when stating that Gary Wilson received financial compensation from The Reward Foundation.
Prause lies about Gary Wilson in emails to MDPI, David Ley, Neuro Skeptic, Adam Marcus of Retraction Watch, and COPE (May, 2018)
In the May, 2018 email exchanges with MDPI & COPE, Prause copied bloggers who are positioned to damage the reputations of MDPI in the media, if they choose. Ley blogs on Psychology Today and has often served as the Mouth of Prause. Neuro Skeptic has a popular blog that disparages legitimate (and sometimes dubious) research. Adam Marcus writes for Retraction Watch. Prause also copied Iratxe Puebla, who works for COPE, an organization that addresses publication ethics. Already, Adam Marcus of Retraction Watch has taken the bait without adequate investigation.
In her defamatory articles, tweets, and Quora posts Prause has knowingly and falsely stated that I (Gary Wilson) claimed to be “professor in biology” “doctor” or a “neuroscientist.” I was an Adjunct Instructor at Southern Oregon University and taught human anatomy, physiology & pathology at other venues. Although careless journalists and websites have assigned me an array of titles in error over the years (including a now-defunct page on a website that pirates many TEDx talks and describes the speakers carelessly without contacting them) I have always stated that I taught anatomy & physiology. I have never said I had a PhD or was a professor. Prause told the same lie to the email recipients:
PRAUSE EMAIL #1 (5-1-2018)
On Tue, May 1, 2018 at 10:11 PM, Nicole Prause >
Additionally, Mr. Wilson is now using this publication to claim to be a doctor online to unsuspecting patients (attached).
Below is the screenshot Prause uses to “prove” that I have misrepresented my credentials (again, this Gary Wilson page no longer exists). Note: Until Prause produced her “proof,” I had never seen this site and had never communicated with its hosts, never uploaded the page in question and never removed it. Thus I certainly never provided a bio, or claims of “professorship.”
I taught at Southern Oregon University on two occasions. I also taught anatomy, physiology and pathology at a number of other schools over a period of two decades, and was certified to teach these subjects by the education departments of both Oregon and California. I do not seek speaking engagements and have never accepted fees for speaking. Moreover, YBOP accepts no ads, and the proceeds from my book go to a registered charity.
On the “about” page the Keynotes.org website said that it is not an agency and that anyone could upload a video and speaker bio: Keynotes.org is not an agency, but rather, a media site…. Keynotes.org is crowdsourced and fueled by TrendHunter.com, the world’s largest trend spotting website. Again, I’ve never uploaded anything to the site, and I have no idea who uploaded this page (or ordered it removed).
The above screen-shot was part of a larger article by Prause where she falsely claimed that I was fired from Southern Oregon University: March, 2018 – Libelous Claim that Gary Wilson Was Fired. In her article, which was posted on a pornography-related site and Quora, Prause published redacted versions of my Southern Oregon University employment records, falsely stating I was fired and had never before taught at SOU. As with her claims surrounding The Reward Foundation, Prause lied about the true content of what’s in the redacted documents. By the way, David Ley also tweeted the Prause article several times, saying I was fired from SOU (screenshots on the page).
In an email to MDPI, COPE, Ley, Neuroskeptic, Adam Marcus of Retraction Watch and others Prause falsely claimed that I had received money from The Reward Foundation.
It appears Wilson did receive money from The Reward Foundation. Attached is The Reward Foundation Annual Report. Per item C6 referring to travel that describes Gary Wilson’s travel totaling 9,027 pounds.
I request that any correction include this financial COI, or time be allotted to properly demonstrate that this was not a financial conflict of interest.
Nicole Prause, Ph.D. Liberos
Prause has not checked her facts, and she is mistaken. I have never received any money from The Reward Foundation. I forwarded Prause’s claim to Darryl Mead, Chair of The Reward Foundation, who debunked Prause’s claims: See Above For Documentation.
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PRAUSE EMAIL #3 (5-22-2018)
In many of her emails to MDPI (and others), Prause mentioned her “77 criticisms” and falsely claimed that they had not been addressed. This was just the latest:
On Tue, May 22, 2018 at 9:36 AM, Nicole Prause>
I provided a 77 point critique prior to publication that was, true to the predatory journal lists MDPI appeared on, was ignored.
This means Prause was one of two reviewers of the Yale Journal of Biology and Medicine submission – and thus “Janey Wilson.” As explained, many of the 77 so-called problems were carelessly copied and pasted from Prause’s review of the YJBM submission; 25 of them had nothing to do with the Behavioral Sciences submission. In other words, the only reviewer to condemn the paper had cut and pasted dozens of criticisms from a review done at another journal (YJBM), which no longer had any relevance to the paper submitted to Behavioral Sciences. This is highly unprofessional.
Even apart from that glaring irregularity, few of the 77 problems could be considered legitimate. Yet, we carefully combed through each comment mining for useful insights, and wrote a comprehensive response to all comments for Behavioral Sciences and its editors. Almost all of the remaining 50 critical comments were either scientifically inaccurate, groundless, or were simply false statements. Some were repetitive. The authors provided MDPI with a point by point response to each so-called problem.
The exploits of “Janey Wilson” (Prause)
See copies of actual emails below this summary.
Shortly after my book was published in 2015, Prause wrote to my publisher for information, using an alias (“Janey Wilson”). Presuming “Janey” was legitimate, Dan Hind of Commonwealth Publishing advised her that my share of book proceeds went to The Reward Foundation, a registered Scottish charity.
“Janey Wilson” immediately informed the charity that Wilson was “falsely holding himself out publicly as being affiliated with The Reward Foundation,” and saying she had proof. The only way she could have “proof” of this not-yet-public affiliation was if she had seen the academic paper I had co-authored. It’s a violation of publication ethics rules to disclose or misuse information learned through the review process.
“Janey’s” information failed to elicit the desired outrage from The Reward Foundation (as I was indeed affiliated with the Foundation, serving in an unremunerated position as “Honorary Science Officer”). Undaunted, “Janey” then reported The Reward Foundation to the Scottish Charity Regulator for imagined financial and other alleged misdeeds.
The charity was so new that no financial filings had been required yet, so it was not even legally possible for the Reward Foundation to have committed the financial reporting transgressions that “Janey” alleged.
Around the time that “Janey” (1) wrote The Reward Foundation to tell it about my “false” claim of affiliation, and (2) reported the charity itself to the Scottish Charity Regulator, “Janey” also wrote the Edinburgh organization where the charity is domiciled with false claims about me and The Reward Foundation (see below). The Edinburgh entity is called “The Melting Pot.” It’s an umbrella organization that hosts various small enterprises. “Janey” apparently simultaneously posted about this on the redddit/pornfree porn recovery forum – Gary Wilson is profiting from YBOP:
The above is hardly surprising as Prause has employed many sock-puppet identities to post, primarily on porn-recovery forums, about Wilson. For exmaple hundreds of comments by Prause’s apparent avatars can be found at the links below. And, they are but an incomplete collection:
Another reddit/pornfree post that appeared about the same time (Prause deleted her sockpuppet’s username, as she often did after posting):
Janey/Prause made the irrational claim that I was “paying off” The Reward Foundation for a TEDx talk opportunity that occurred years earlier, in 2012. It had been arranged in 2011, years before the charity was conceived of or organized. Obviously, no such subterfuge was needed. I had the right to give my book proceeds to anyone at any point, or put them in my pocket. I chose the Reward Foundation because I respect its balanced, educational objective.
Neither organization (the Scottish Charity Regulator nor the Melting Pot) responded to “Janey,” as she offered no evidence, and wouldn’t identify herself, claiming “whistleblower status” (although, of course, she wasn’t an employee of either, and was not under threat). Had the charity not had a strong, respected relationship with the Melting Pot, and had it already been required to file financial statements with the Scottish Charity Regulator, “Janey’s” malicious claims might have done a lot of damage to the charity’s reputation and initiated a time-consuming, costly audit, etc.
In late 2016, Prause outed herself as “Janey Wilson” when she demanded (repeatedly and unsuccessfully) that Dan Hind of Commonwealth Publishing confirm my connection with the Scottish charity called The Reward Foundation to Prause in writing. Copying both MDPI (the ultimate publisher of the paper discussed earlier) and a publication ethics organization (COPE), Prause told Commonwealth’s Hind that he had already written her to this effect.
However, the only correspondence Hind had with anyone on the subject of Wilson and The Reward Foundation was with “Janey,” and he has stated this in writing (below). Thus, Prause has now outed herself as the former “Janey.” When Hind didn’t respond to Prause’s repeated demands, she then demanded the information via Commonwealth’s web designer – accompanied, as usual, by defamation and threat:
You may wish to encourage the site content owner that you designed to clarify that his author was caught claiming to “donate” proceeds from a book that actually went into his own pocket. Mr. Hind has failed to respond to inquiries with the Committee on Publication Ethics. I assume you would not want your name entangled in fraud like this in any way.
Prause seems to believe that the fact that my share of book proceeds goes to a Scottish registered charity, which I listed as my affiliation for purposes of two academic papers published in 2016, means that I am somehow pocketing the proceeds (from my own book) – and thus have a conflict of interest, which is purportedly grounds, in her mind, for my paper being retracted. Does any of this make any sense in light of the facts?
In fact, I am not on the Board of the charity, and certainly have no say over the book proceeds it receives as a consequence of my irrevocable donation. Incidentally, my affiliation is now public, as it is mentioned in both papers I published in 2016. In short, there is nothing hidden or improper going on, and no conflict of interest whatsoever – despite Prause’s claims behind the scenes and publicly.
Within days of Nicole Prause (as herself) emailing MDPI to demand that they retract Park et al., 2016, Twitter account “pornhelps” attacked Mary Sharpe of The Reward Foundation. In the tweet @pornhelps all but admits she is Prause:
Prause, a Kinsey grad and former academic, calls herself a neuroscientist, and appears to have started college about 15 years earlier. Not long after this revealing tweet “pornhelps” deleted both its Twitter account and website (pornhelps.com) – as it became apparent to others that Prause often tweeted with this account and helped with the website.
The following sections of Prause page provide examples of Prause and “pornhelps” simultaneously attacking and defaming some of Prause’s favorites targets (men who run porn-recovery forums, porn addiction researchers, TIME editor Belinda Luscombe, who wrote a cover story Prause didn’t approve of):
Update: In May, 2018 Prause falsely claimed to journal publisher MDPI (and others) that, based on the charity’s recent public filing (with a name redacted, as is standard), expense reimbursements paid to a charity officer were in fact paid to me. I forwarded Prause’s claim to Darryl Mead, Chair of The Reward Foundation, who debunked Prause’s claims: See Above For Documentation.
———-
A few of the other emails referred in the “Janey” story:
2015
[“Janey’s” exchange with my publisher]
From: Daniel Hind <[email protected]>
Date: Thu, Mar 26, 2015 at 10:15 AM
Subject: RE: Concern about for-profit posing as non-profit at Melting Pot
I was contacted by someone called Janey Wilson on Saturday. The full exchange between us is cut and pasted below. As you can see I told her that the author’s revenues are paid to the Reward Foundation.
I should have checked with you, I guess. I am sorry if I have created unnecessary complications for anyone.
———- Forwarded message ———-
From: Dan Hind <[email protected]>
Date: Tue, Mar 24, 2015 at 9:33 AM
Subject: Re: Wilson text To: Janey Wilson <[email protected]>
The Charity Commission is a register of charities in England and Wales. The Reward Foundation is registered in Scotland.
Here is its listing on the Scottish Charity Register –
This is the government registry, so I am not sure where else it could be. You might want to alert your author that they might be contributing to a scam. I cannot buy based on this, and I don’t think anyone else should either.
J
——-
On Mon, Mar 23, 2015 at 4:42 AM, Dan Hind <[email protected]> wrote:
Dear Ms Wilson,
The author’s income supports the Reward Foundation, a registered charity in the UK.
On Sat, Mar 21, 2015 at 6:17 AM, Janey Wilson <[email protected]> wrote:
Hi,
I saw the proceeds from this book are all going to research. Which organization is benefiting? I would like to see if I can list it on my taxes as a deduction.
———
[“Janey’s” exchange with The Melting Pot]
On 25 March 2015 at 12:08 Mohammad Abushaaban <[email protected]> wrote:
Mary – hope you are keeping strong.
I’ve received this strangely out of the blue email from a Janey Wilson…
Do you know this person?
Give it a read and let me know your thoughts.
Thanks
Mo.
———- Forwarded message ———- From: Janey Wilson <[email protected]>
Date: 25 March 2015 at 04:09
Subject: Concern about for-profit posing as non-profit at Melting Pot
To: [email protected]
Dear Mohammad Abushaaban,
I write out of concern for The Reward Foundation housed at The Melting Pot, which is posing as a non-profit. In 2012, Mary Sharpe was responsible for selecting TEDX speakers in Glasgow. She made the extremely odd decision to have a massage therapist with no neuroscience background, Gary Wilson, rave about the neuroscience of “porn addiction”. The talk was so poor it is currently under investigation for its pseudoscience by TEDX. Now, Mr. Wilson appears to be paying Mary Sharpe for this opportunity.
Specifically, he is selling a book and all the proceeds of the book are said to be going to The Reward Foundation for “research”:
www.therewardfoundation.org
Yet, Mary Sharpe is not a researcher, has no neuroscience background, and the charity lists no way for any real scientist to apply for these funds. The money appears to be going directly in to her pocket, likely in exchange for her earlier TEDX favor. The charity further has chosen not to openly provide links to their financials.
I have filed this complaint with the Scottish Charity Register as well. I suggest you consider investigating how else Ms. Sharpe might be using pseudo-science to fleece concerned individuals. That hardly seems in line with any of the aspirational goals listed on the Melting Pot website.
From: Janey Wilson <[email protected]>
Date: 22 April 2015 at 17:21
Subject: Re: Concern about for-profit posing as non-profit at Melting Pot
To: Mohammad Abushaaban <[email protected]>
I now have documentation that Gary Wilson himself is claiming to be a member of the Reward Foundation. While he is not listed on the new website page (http://www.rewardfoundation.org/who-we-are.html), this represents a rather worse transgression. He claims to “donate” the proceeds of his book to research, which is now going to a charity that has no research plans and of which he is a part. Mary Sharpe may not even be aware he is making these claims, I am not sure, but he has now made them publicly.
——–
As explained above, an earlier and substantially different version of the paper I co-authored with 7 US Navy doctors, Park, et al., was first submitted in March, 2015 to the Yale Journal of Biology and Medicine as part of its “Addiction” issue. This paper was the only place my affiliation with the Reward Foundation could be found at the time of “Janey’s” exchanges, as it was nowhere public. So “Janey” had to have seen the paper sent to YJBM for review.
——-
2016
Prause contacting my publisher, Dan Hind, eventually outing herself as “Janey Wilson”
Sent: 03 November 2016 21:27 To: Dan Hind; [email protected] Cc: Dr. Franck Vazquez | CEO | MDPI; Iratxe Puebla; [email protected]; Martyn Rittman; Dr. Shu-Kun Lin; Jim Pfaus Subject: Re: Book financial beneficiary
Mr. Hind,
We already have a previous email from you verifying that Gary Wilson has sent all the proceeds of his book to the organization he actually is employed by, The Reward Foundation. You may choose not to verify this information for the Committee on Publication Ethics, but the previous email can be supplied to them as well.
Your author failed to disclose his financial conflict of interest in numerous publications now to profit himself while claiming to “donate” the proceeds to the public (and to you). This already is public knowledge that you either can be on record to help expose or profiteer, as you please.
You may wish to encourage the site content owner that you designed to clarify that his author was caught claiming to “donate” proceeds from a book that actually went into his own pocket. Mr. Hind has failed to respond to inquiries with the Committee on Publication Ethics. I assume you would not want your name entangled in fraud like this in any way.
March, 2015 an earlier version of Park et al. was submitted to the Yale Journal of Biology and Medicine. The submission to YJBM was the only place my affiliation with the charity The Reward Foundation (TRF), could be found, as it was nowhere public.
Between March 21st and April 22nd of 2015, “Janey Wilson” sent several emails to Dan Hind of Commonwealth Publishing, Mohammad Abushaaban of The Melting Pot Edinburgh (which houses The Reward Foundation), and the Scottish Charity Regulator. All contain unsupported claims of wrongdoing. It seemed likely from the content and distinctive style that “Janey” was actually Nicole Prause – which was later confirmed.
The YJBM was informed of the harassing behavior (engaged in by one of their two reviewers posing at “Janey Wilson”). When it was suggested that Dr. Prause might be behind these bizarre emails and the paper’s initial rejection, the paper was promptly accepted…and then not published after all, based on a claim that it was too late to meet the print deadline for the YJBM’s “Addiction” issue.
An updated version of the paper was then submitted to the journal Behavioral Sciences. Four individuals reviewed the paper with 3 accepting and Prause (as we later discovered) rejecting it with her list of “77 problems”.
Many of her 77 so-called problems were carelessly copied and pasted from Prause’s review of the YJBM submission, as 25 of them had nothing to do with the Behavioral Sciences paper.
Few of the 77 problems could be considered legitimate. The authors provided MDPI with a point by point response to each so-called problem.
Park et al. was revised and re-reviewed by two more reviewers.
As soon as Park et al., 2016 was published, Prause began her campaign to have the paper retracted, sending countless of messages to MDPI, COPE, the Navy, the doctors’ medical boards, and my publisher (and possibly PubMed, the FTC and who knows where else).
MDPI offered Prause the opportunity to publish a formal comment on Park et al, in Behavioral Sciences. Prause declined. If the paper were truly inadequate, it would be a simple matter to discredit it with a formal comment.
In late 2016, Prause outed herself as “Janey Wilson” when she demanded (repeatedly and unsuccessfully) that my publisher confirm my connection with the Scottish charity called The Reward Foundation to Prause in writing. Copying both MDPI (the ultimate publisher of the paper mentioned above) and a publication ethics organization, Prause told Commonwealth’s Dan Hind that he had already written her to this effect. Yet he had only corresponded about the connection with “Janey.”
While vicious in her attacks, and often lying about me and the paper’s content, Prause ultimately came up with only 2 issues that COPE would consider (1) Gary Wilson’s unremunerated position with The Reward Foundation, (2) Consents by the three individuals featured in the case studies.
Although I very much sympathize with COPE, and can easily envision the battering their Committee must have endured, in my view, neither is valid reason for retraction or even for a correction (although such superficial corrections are no big deal), as
My unremunerated connection with The Reward Foundation was plainly not a conflict of interest and my affiliation had already been revealed in the original paper, and
The Navy followed its guidelines for consent (which actually don’t require any written consents for case studies with fewer than 4 patients). Even so, in an abundance of physician-ly caution, full written prior consent was obtained for two individuals. For the third, not enough details to require consent were deemed given in the paper. A US Navy investigation confirmed that the doctors complied with all the IRB’s rules.
Even if some might disagree with me, it is evident that neither of these points involves “fraud” or misconduct, as Prause continues to insist.
What’s going on here?
For years both Prause and Ley have teamed up to defame, harass and cyber-stalk individuals and organizations that have warned of porn’s harms or published research reporting porn’s harms. Recently, Prause and Ley escalated their unethical and often illegal activities in support of a porn industry agenda. For example, 0n January 29, 2019, Prause filed a trademark application to obtain YOURBRAINONPORN and YOURBRAINONPORN.COM. In April 2019, a group headed by Prause and Ley engaged in unlawful trademark infringement of YourBrainOnPorn.com by creating “RealYourBrainOnPorn.com.
In July of 2019, David Ley and two of the better known RealYBOP “experts” (Justin Lehmiller and Chris Donaghue) began openly collaborating with the porn industry. All 3 are on the advisory board of the fledgling Sexual Health Alliance (SHA). In a blatant financial conflict of interest, David Ley and the SHA are being compensated by porn industry giant xHamster to promote its websites (i.e. StripChat) and to convince users that porn addiction and sex addiction are myths!
More on Nicole Prause
In 2013 former UCLA researcher Nicole Prause began openly harassing, libeling and cyberstalking Gary Wilson. (Prause has not been employed by an academic institution since January, 2015.) Within a short time she also began targeting others, including researchers, medical doctors, therapists, psychologists, a former UCLA colleague, a UK charity, men in recovery, a TIME magazine editor, several professors, IITAP, SASH, Fight The New Drug, Exodus Cry, NoFap.com, RebootNation, YourBrainRebalanced, the academic journal Behavioral Sciences, its parent company MDPI, US Navy medical doctors, the head of the academic journal CUREUS, and the journal Sexual Addiction & Compulsivity.
While spending her waking hours harassing others, Prause cleverly cultivated – with zero verifiable evidence – a myth that she was “the victim” of most anyone who dared to disagree with her irresponsible assertions surrounding porn’s effects or the current state of porn research. To counter the ongoing harassment and false claims, YBOP was compelled to document some of Prause’s activities. Consider the following pages. (Additional incidents have occurred that we are not at liberty to divulge – as Prause’s victims fear further retribution.)
In the beginning Prause employed dozens of fake usernames to post on porn recovery forums, Quora, Wikipedia, and in the comment sections under articles. Prause rarely used her real name or her own social media accounts. That all changed after UCLA chose not to renew Prause’s contract (around January, 2015).
Prause began to put her name to falsehoods, openly cyber-harassing multiple individuals and organizations on social media and elsewhere. Since Prause’s primary target was Gary Wilson (hundreds of social media comments along with behind the scenes email campaigns), it became necessary to monitor and document Prause’s tweets and posts. This was done for her victims’ protection, and crucial for any future legal actions.
It soon became apparent that Prause’s tweets and comments were rarely about sex research, neuroscience, or any other subject related to her claimed expertise. In fact, the vast majority of Prause’s posts could be divided into two overlapping categories:
Indirect support of the porn industry: Defamatory & ad hominem comments targeting individuals and organizations that she labeled as “anti-porn activists” (often claiming to be a victim of these individuals and organizations). Documented here: page 1, page 2.
countless misrepresentations of the state of pornography research and attacks on porn studies or porn researchers.
The following pages contain a sampling of tweets and comments related to #2 – her vigorous support of the porn industry and its chosen positions. YBOP is of the view that Prause’s unilateral aggression has escalated to such frequent and reckless defamation (falsely accusing her many victims of “physically stalking her,” “misogyny,” “encouraging others to rape her,” and “being neo-Nazis”), that we are compelled to examine her possible motives. This material is divided into 4 main sections:
Please note: There is unequivocal evidence that the porn industry funded the sexology profession for decades. Sexology’s agenda still appears to serve the porn industry. Thus, the evidence on this page should be viewed in a larger context. See Hugh Hefner, the International Academy of Sex Research, and Its Founding President to understand how porn-industry friendly sexologists influenced the Kinsey Institute. Prause is a Kinsey grad.
More on David Ley
David Ley’s financial conflicts of interest (COI) seem evident.
The fledgling Sexual health Alliance (SHA) advisory board includes David Ley and two other RealYourBrainOnPorn.com “experts” (Justin Lehmiller & Chris Donahue). RealYBOP is a group of openly pro-porn, self-proclaimed “experts” headed by Nicole Prause. This is also the group currently engaged in illegal trademark infringement and squatting directed toward the legitimate YBOP. Put simply, those trying to silence YBOP are also being paid by the porn industry to promote its/their businesses, and assure users that porn and cam sites cause no problems (note: Nicole Prause has close, public ties to the porn industry as documented on this page).
In this article, Ley dismisses his compensated promotion of the porn industry:
Granted, sexual health professionals partnering directly with commercial porn platforms face some potential downsides, particularly for those who’d like to present themselves as completely unbiased. “I fully anticipate [anti-porn advocates] to all scream, ‘Oh, look, see, David Ley is working for porn,’” says Ley, whose name is routinely mentioned with disdain in anti-masturbation communities like NoFap.
But even if his work with Stripchat will undoubtedly provide fodder to anyone eager to write him off as biased or in the pocket of the porn lobby, for Ley, that tradeoff is worth it. “If we want to help [anxious porn consumers], we have to go to them,” he says. “And this is how we do that.”
David J. Ley, Ph.D., is a clinical psychologist and AASECT-certified supervisor of sex therapy, based in Albuquerque, NM. He has provided expert witness and forensic testimony in a number of cases around the United States. Dr. Ley is regarded as an expert in debunking claims of sexual addiction, and has been certified as an expert witness on this topic. He has testified in state and federal courts.
Contact him to obtain his fee schedule and arrange an appointment to discuss your interest.
COI #3: Ley makes money selling two books that deny sex and porn addiction (“The Myth of Sex Addiction,” 2012 and “Ethical Porn for Dicks,” 2016). Pornhub (which is owned by porn giant MindGeek) is one of the five back-cover endorsements listed for Ley’s 2016 book about porn:
COI #4: Finally, David Ley makes money via CEU seminars, where he promotes the addiction-deniers’ ideology set forth in his two books (which recklessly(?) ignores dozens of studies and the significance of the new Compulsive Sexual Behavior Disorder diagnosis in the World Health Organization’s diagnostic manual). Ley is compensated for his many talks featuring his biased views of porn. In this 2019 presentation Ley appears to support and promote adolescent porn use: Developing Positive Sexuality and Responsible Pornography Use in Adolescents.
In August 2017, Behavioral Sciences published the article [1], which includes a case study of three individuals in the US Navy. The paper underwent our usual editorial process, including peer review, and was accepted for publication. Since then, we have received a number of complaints from a single individual claiming that the paper is seriously flawed and calling for withdrawal of the article. In this comment we wish to reiterate that the correct procedures were followed in the handling of the manuscript and to publicly counter some of the claims. The Committee for Publication Ethics (COPE) considered some of these issues and we are grateful for their advice and cooperation. We also wish to thank the authors for their cooperation.
One serious claim leveled against the paper was that the required consent was not sought from the three individuals featured in the case studies presented. According to the instructions for authors posted on the Behavioral Sciences website, informed consent should be obtained for case studies where there is any risk that individuals could be identified. When asked to confirm this point, the authors verified that consent had been obtained for two individuals and that for the third not enough details were shared in the paper to require consent. The editorial office has seen redacted copies of the consent form used and is satisfied with the authors’ explanation.
Another issue was that the academic editor of the article was not aware that he was making a final decision to accept article [1] for publication. Behavioral Sciences uses a standard template to invite editors to make the final decision to accept manuscripts, which was also done in this case. Since the complaint, the original academic editor has informed us that he was not aware that this was his role for the paper. We re-evaluated the peer review process with the (now former) Editor-in-Chief John Coverdale and made the decision that the manuscript should not be removed for this reason. In the published Correction [2], the academic editor information has been amended.
Numerous claims about conflicts of interest of the authors were made in relation to [1]. Only one non-financial conflict of interest was found to be substantiated and the paper has been updated [2].
Consequently, MDPI has updated its instructions for authors to provide more clarity about informed consent issues and to better guide authors in this area. Our requirements and policies have not changed and we continue to follow the guidelines provided by COPE.
We believe that the dispute surrounding this paper arose from a difference of opinion in terms of the treatment of individuals using high levels of pornography, and was not motivated by genuine concerns about the editorial work around the paper [3]. Our view is that the correct way to deal with such a dispute is by presenting arguments and counter-arguments in a peer-reviewed, scientific context where all conflicts of interest from both parties are properly disclosed. Personal criticism does not have a place in this context and attempts to shut down those with opposing views by removing their work from the literature is not the correct approach. We know that the majority of authors and readers approach research in a constructive and engaged way and we wish to advocate this approach for the benefit of the research community as a whole.
References
[1] Park, B.Y.; Wilson, G.; Berger, J.; Christman, M.; Reina, B.; Bishop, F.; Klam, W.P.; Doan, A.P. Is Internet Pornography Causing Sexual Dysfunctions? A Review with Clinical Reports. Sci.2016, 6, 17.
[2] Park, B.Y. et al.; Correction: Park, B.Y., et al. Is Internet Pornography Causing Sexual Dysfunctions? A Review with Clinical Reports Sci. 2016, 6, 17. Behav. Sci.2018, 8, 55.
What’s not clear in this article is that my (Wilson’s) affiliation with The Reward Foundation was disclosed from the start (see the original PubMed version, published in August, 2016 – https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5039517/). The correction was published for my protection, in an attempt to stop Dr. Prause from continuing to claim that I was being paid by The Reward Foundation as a lobbyist, or just being “paid off.” (She has publicly advanced several baseless theories about my imagined corruption.) In the journal’s correction, only the title of my book (“Your Brain On Porn: Internet Pornography and the Emerging Science of Addiction”) and a clear indication of my unremunerated role at The Reward Foundation were added. Again, this was to prevent further assertions of any possible financial conflict of interest. Corrected version: http://www.mdpi.com/2076-328X/8/6/55/htm
Put simply, the correction was meant to protect me from Prause and her littany of falsehoods surrounding this paper.
Not long after Park et al., 2016 was published Prause went on the warpath against MDPI, Behavioral Sciences, and the authors of Park et al., employing multiple avenues of overt and covert attack (documented on this extensive page – Prause’s efforts to have Behavioral Sciences review paper (Park et al., 2016) retracted ). One avenue of attack was to edit the MDPI Wikipedia page using multiple aliases (sockpuppets), which violates Wikipedia rules. To date we have identified at least 30 likely Prause sockpuppets.
Let’s begin with Wikipedia user NeuroSex, who had a least 8 other aliases – all of which were banned as Wikipedia sockpuppets of NeuroSex. Neurosex, her sockpuppets, and other Prause sockpuppets have edited Wikipedia, inserting false information about Gary Wilson, Park et al. and MDPI.
I have images that verify each of the claims (e.g., email from the publisher, email from the listed editor, etc.). RetractionWatch and other outlets are considering writing reviews of it as well, but I cannot be sure those will materialize. How is best to provide such evidence that verifies the claims? As embedded image? Written elsewhere with images and linked?
Let’s provide a few examples of the “NeuroSex” edits (lies) related to Gary Wilson and to Park et al., 2016 – followed by Wilson’s comments:
Gary Wilson comment: NeuroSex linked to a redacted document, claiming that Gary Wilson was paid 9,000 pounds by Scottish charity The Reward Foundation. Two days earlier Prause falsely claimed to journal publisher MDPI (and others) that, based on the charity’s recent public filing (with a name redacted, as is standard), expense reimbursements paid to a charity officer were in fact paid to Wilson. Prause has not checked her facts, and she is mistaken (again). Wilson has never received any money from The Reward Foundation. Prause has repeated this same lie elsewhere.
Three sockpuppets of NeuroSex who edited the MDPI Wikpedia page (links show list of edits for each sockpuppet):
Wikipedia is an important source of community-based knowledge and MDPI supports the endeavor to openly disseminate knowledge, which closely matches the goals of MDPI. Unfortunately, some editors of the Wikipedia page about MDPI lack objectivity. This leaves the article heavily biased and uninformative about the majority of MDPI’s activities. Any potential improvements added to the page are quickly removed. We have made a number of attempts to discuss with Wikipedia editors to improve the quality of the article, but without success. Thus, for the time being, we do not recommend Wikipedia as a reliable source of information about MDPI.
Almost three quarters of the Wikipedia article covers controversial topics, mentioning 4 out of over 200,000 published papers, one instance where 10 editorial board members resigned (in 2018 we had over 43,000 Editorial Board Members and Guest Editors), and inclusion on Jeffrey Beall’s list, known as a source biased against open access and from which MDPI was removed (see our response here). While we do not object to these topics being mentioned, the way in which they are presented is misleading.
Responses to some of the topics covered can be found at:
Comment on Park, B., et al. Is Internet Pornography Causing Sexual Dysfunctions? A Review with Clinical Reports Behav. Sci. 2016, 6, 17: https://www.mdpi.com/about/announcements/1616.
A large parent company posting two official statements related to the unethical behavior by a rogue PhD may be without precedent.
COMMENTS: This new study (abstract below) is being touted as a “failed replication” of a highly cited 1989 experiment, thus proving that porn use has little effect of intimate relationships.
First, it’s absurd to claim that experimental studies can demonstrate if porn viewing really causes negative relationship effects.” Experiments where college-aged guys view a few Playboy centerfolds (as in the study) can tell you nothing about the effects of your husband masturbating to hard-core videos clips day after day for years on end.
In reality, every single study involving males has reported that more porn use linked to poorer sexual or relationship satisfaction. In all, nearly 60 studies link porn use to less sexual and relationship satisfaction. Of these 60 relationship studies 7 are longitudinal studies that control for variables or studies where subjects abstain from porn. To date seven longitudinal relationship studies have been published that reveal the real-life consequences of ongoing porn use. All reported that porn use relates to poorer relationship/sexual outcomes:
The 2017 study attempted to replicate a 1989 study that exposed men and women in committed relationships to erotic images of the opposite sex. The 1989 study found that men who were exposed to the nude Playboy centerfolds rated their partners as less attractive and reported less love for their partner. As the 2017 findings failed to replicate the 1989 findings, we are told that the 1989 study got it wrong, and that porn use cannot diminish love or desire. Whoa! Not so fast.
The replication “failed” because our cultural environment has become “pornified.” The 2017 researchers didn’t recruit 1989 college students who grew up watching MTV after school. Instead their subjects grew up surfing PornHub for gang bang and orgy video clips.
In 1989 how many college students had seen an X-rated video? Not too many. How many 1989 college students spent every masturbation session, from puberty on, masturbating to multiple hard-core clips in one session? None. The reason for the 2017 results is evident: brief exposure to a still image of a Playboy centerfold is a big yawn compared to what college men in 2017 have been watching for years. Even the authors admitted the generational differences with their first caveat:
1) First, it is important to point out that the original study was published in 1989. At the time, exposure to sexual content may not have been as available, whereas today, exposure to nude images is relatively more pervasive, and thus being exposed to a nude centerfold may not be enough to elicit the contrast effect originally reported. Therefore, the results for the current replication studies may differ from the original study due to differences in exposure, access, and even acceptance of erotica then versus now.
In a rare instance of unbiased prose even David Ley felt compelled to point out the obvious:
It may be that the culture, men, and sexuality have substantially changed since 1989. Few adult men these days haven’t seen pornography or nude women—nudity and graphic sexuality are common in popular media, from Game of Thrones to perfume advertisements, and in many states, women are permitted to go topless. So it’s possible that men in the more recent study have learned to integrate the nudity and sexuality they see in porn and everyday media in a manner which doesn’t affect their attraction or love for their partners. Perhaps the men in the 1989 study had been less exposed to sexuality, nudity, and pornography.
Keep in mind that this experiment doesn’t mean internet porn use hasn’t affected men’s attraction for their lovers. It just means that looking at “centerfolds” has no immediate impact these days. Many men report radical increases in attraction to partners after giving up internet porn. And, of course, there is also the longitudinal evidence cited above demonstrating the deleterious effects of porn viewing on relationships.
Finally, it’s important to note that the authors of this paper are colleagues of Taylor Kohut at the University of Western Ontario. This group of researchers, headed by William Fisher, has been publishing questionable studies, which consistently produce results that on the surface appear to counter the vast literature linking porn use to myriad negative outcomes. Moreover, both Kohut and Fisher played big roles in the defeat of Motion 47 in Canada.
Here are two recent studies from Kohut, Fisher and colleagues at Western Ontario that garnered widespread and misleading headlines:
In their 2017 study, Kohut, Fisher and Campbell appear to have skewed the sample to produce the results they were seeking. Whereas most studies show that a tiny minority of porn users’ female partners use porn, in this study 95% of the women used porn on their own (85% of the women had used porn since the beginning of the relationship). Those rates are higher than in college-aged men, and far higher than in any other porn study! In other words, the researchers appear to have skewed their sample to produce the results they were seeking. Reality: Cross-sectional data from the largest US survey (General Social Survey) reported that only 2.6% of women had visited a “pornographic website” in the last month.
In addition, Kohut’s study asked only “open ended” questions where subjects could ramble on about porn. The researchers read the ramblings and decided, after the fact, what answers were “important” (fit their desired narrative?). In other words, the study did not correlate porn use with any objective, scientific variable assessment of sexual or relationship satisfaction (as did the nearly 60 studies that show porn use in linked to negative effects on relationships). Everything reported in the paper was included (or excluded) at the unchallenged discretion of the authors.
Taylor Kohut co-authors framed egalitarianismas: Support for (1) Abortion, (2) Feminist identification, (3) Women holding positions of power, (4) Belief that family life suffers when the woman has a full-time job, and oddly enough (5) Holding more negative attitudes toward the traditional family. Secular populations, which tend to be more liberal, have far higher rates of porn use than religious populations. By choosing these criteria and ignoring endless other variables, lead author Kohut and his co-authors knew they would end up with porn users scoring higher on this study’s carefully chosen selection of what constitutes “egalitarianism.” Then the authors chose a title that spun it all. In reality, these findings are contradicted by nearly every other published study. (See this list of over 25 studies linking porn use to sexist attitudes, objectification and less egalitarianism.)
Note: This 2018 presentation exposes the truth behind 5 questionable and misleading studies, including the two studies just discussed: Porn Research: Fact or Fiction?
Three preregistered, high-powered replications of Kenrick et al. (1989)
Exposed men and women in committed relationships to opposite sex erotica
After exposure assessed ratings of attractiveness and love for partner
Effects of original and replication studies were meta-analyzed
Across the three studies we did not find support for the original finding.
Kenrick, Gutierres, and Goldberg (1989; Study 2) demonstrated that men, but not women, in committed relationships exposed to erotic images of opposite-sex others reported lower ratings for their partner’s sexual attractiveness (d = 0.91) and less love for their partner (d = 0.69) than men exposed to images of abstract art. This research has implications for understanding the possible effects of erotica on men in relationships, but has not been replicated. We conducted three preregistered, high-powered close replications, and meta-analyzed the effects of the original and replication studies. We did not find support for the original finding that exposure to attractive images of opposite-sex others affects males’ ratings of their partners’ sexual attractiveness or love for their partner.
☆ This research was supported by a grant awarded to Lorne Campbell by the Social Sciences and Humanities Research Council of Canada [grant number 122848].
COMMENTS: At first glance this 2018 paper seemed promising as it recommended that pornography use be added as a part of patient evaluation:
As part of the sexual history, information on sexual habits can be useful, both in diagnosing ED and in selecting the optimal treatment. Sexual habits include frequency of intercourse, predictability, timing, masturbation habits, and use of pornography; these are new to the updated model.
However, the next paragraph gives us this garbage:
Pornography use has become common, and clinicians should be aware that its consumption might represent a factor in the ED report. Well-controlled studies on the impact of pornography on ED are lacking, and the available evidence is conflicting.72,73 A recent study indicated that, rather than use itself, the mode in which pornography is used is related to distress and sexual dysfunction.74 Findings indicated that recreational use of pornography can enhance sexual stimulation, but its use in distressed individuals may contribute to sexual dysfunction.74
But the real reason why YBOP critiqued citation 74 is that it committed a fatal mistake: The study used the ASEX to measure sexual function, and not the standard IIEF. The ASEX doesn’t distinguish between sexual functioning during masturbation (typically to internet porn) and partnered sex, while the IIEF is only for sexually active subjects. As today’s porn users who develop sexual dysfunctions typically experience them during partnered sex, this research is basically useless in understanding porn’s effects on sexual function.
Many of the subjects were rating the quality of their orgasms, arousal and erections while masturbating to porn – not while having sex! Again, most have no problems attaining erections or climaxing to screens – whether due to internet porn’s endless novelty and ready availability of more extreme porn online, or due to the fact that today’s heavy porn users have trained (sensitized) their brains to screen-based arousal, not real people.
Additional information provided in the citation 74 study actually supports this hypothesis, as the compulsive porn users were mostly males and avoided partnered sex:
Sexual behaviors reported by these individuals suggest that their pornography use might be framed into a broader pattern of compulsive sexuality that includes avoidance of sexual interactions with a partner.
Moreover, only 38% of the compulsive porn users had partners. (NOTE: this doesn’t mean that 38% had sex with a partner, as a common symptom of porn addiction is choosing porn over partnered sex). In any case, at least 62% of the compulsive subjects were porn addicts who didn’t have sex with real people. This means that the vast majority of the compulsive porn users in this study were assessing their arousal and erections while masturbating to porn, not while having sex with a partner. Thus, dysfunction rates would be expected to be far lower than if the researchers had only asked porn users who could answer about partnered sex.
Measuring sexual performance in solo porn users creates a huge confound, and the authors of citation 74 were mistaken to claim their results bear any relation to sexual dysfunction studies that use the IIEF. The ASEX that they used measures “apples,” while the IIEF measures “oranges.” Only the latter can reveal sexual dysfunctions during partnered sex – which, again, is where the sexual dysfunctions typically arise first in today’s porn users.
Profits and paid consultants: suppressing the link between porn and ED
Pfizer funded this study to publicize its carefully constructed ED narrative, which ignores the evidence that internet porn is likely the chief culprit of ED in men under 40 today. Instead, the authors of the study want us to believe that porn use “only causes sexual problems in distressed individuals.”
Seven of the paper’s eight authors disclose that they have received money from Pfizer, the maker of Viagra. In fact, one of the authors is a full-time employee of Pfizer. Pfizer alsofunded the study, and funded editorial and medical writing assistance for the paper, so it’s possible the authors did little but collect their consulting fees. [See “Disclosures” below.]
Makers of sexual enhancement drugs like Pfizer don’t want the general public to consider the growing evidence that internet porn use is causing erectile dysfunction. These drugs used to be sold only to men over 40, because ED was so rare in younger men. But now overuse of internet porn is causing ED in younger men at very high rates. Today, these drug manufacturers are making millions from the sale of their drugs to men who could avert ED by avoiding internet porn, or recover by eliminating its use – if they understood the true risk of internet porn use. Drug manufacturers can’t make money from men quitting internet porn.
This is very disturbing. The lead author of this paper, urologist John Mulhall MD, is also the Editor-in-Chief of The Journal of Sexual Medicine. This suggests that Pfizer is strongly influencing the relevant research on ED, and paying experts in the field to legitimize the narrative it has crafted suppressing the link between internet pornography and erectile health.
If Dr. Mulhall and Pfizer genuinely cared about men’s erectile health, they would be funding, performing and publishing studies on the effects of internet porn on ED.
Erectile dysfunction (ED) is a common condition that may affect men of all ages; in 1999, a Process of Care Model was developed to provide clinicians with recommendations regarding the evaluation and management of ED.
Aim
To reflect the evolution of the study of ED since 1999, this update to the process of care model presents health care providers with a tool kit to facilitate patient interactions, comprehensive evaluation, and counseling for ED.
Methods
A cross-disciplinary panel of international experts met to propose updates to the 1999 process of care model from a global perspective. The updated model was designed to be evidence-based, data-driven, and accessible to a wide range of health care providers.
Outcomes
This article summarizes the resulting discussion of the expert meeting and focuses on ED evaluation. The management of ED is discussed in an article by Muhall et al (J Sex Med 2018;15:XXX-XXX).
Results
A comprehensive approach to the evaluation of ED is warranted because ED may involve both psychological and organic components. The updated process of care model for evaluation was divided into core and optional components and now focuses on the combination of first-line pharmacotherapy and counseling in consideration of patient sexual dynamics.
Clinical Implications
Patient evaluation for ED should encompass a variety of aspects, including medical history, sexual history, physical examination, psychological evaluation, laboratory testing, and possibly adjunctive testing.
Strengths & Limitations
This update draws on author expertise and experience to provide multi-faceted guidance for the evaluation of ED in a modern context. Although a limited number of contributors provided input on the update, these experts represent diverse fields that encounter patients with ED. Additionally, no meta-analyses were performed to further support the ED evaluation guidelines presented.
Conclusion
Comprehensive evaluation of ED affords health care providers an opportunity to address medical, psychological/psycho-social, and sexual issues associated with ED, with the ultimate goal being effective management and possibly resolution of ED. While some or all techniques described in the updated model may be needed for each patient, evaluation should in all cases be thorough.
J. Mulhall is/has been a consultant for Absorption Pharmaceuticals, AMS, Lilly, Meda, Nexmed, Pfizer Inc, and Vivus and has participated in: scientific studies/trials for AMS, Pfizer Inc, and Vivus; other for Alliance for Fertility Preservation and Association of Peyronie’s Disease Advocates. A. Giraldi is/has been a speaker for Pfizer Inc and Eli Lilly. G. Hackett is a speaker for and adviser to Pfizer Inc, Bayer, and Besins. W.J.G. Hellstrom is/has been a paid consultant and/or speaker for Abbvie, Allergan, Boston Scientific, Coloplast, Endo, Lipocine, Menarini, and Pfizer Inc. E.A. Jannini is/has been a paid consultant and/or speaker for Bayer, Ibsa, Menarini, Otsuka, Pfizer Inc, and Shionogi. E. Rubio-Aurioles is a paid consultant to Pfizer Inc. L. Trost has nothing to declare. T.A. Hassan is a full-time employee of Pfizer Inc.
Funding: This study was funded by Pfizer Inc. Editorial and medical writing assistance was provided by Jill E. Kolesar, PhD, of Complete Healthcare Communications LLC (West Chester, PA, USA), a CHC Group company, and was funded by Pfizer Inc.
∗2017 Process of Care in ED Expert Panel members: Urologists (John P. Mulhall, USA; Landon Trost, USA; Wayne J. G. Hellstrom, USA); Endocrinologist (Emmanuele A. Jannini, Italy); Sexologist and Urologist (Geoff Hackett, UK); Psychiatrist (Annamaria Giraldi, Denmark); Sexologist (Eusebio Rubio-Aurioles, Mexico).
COMMENTS: The present study is a further analysis of an earlier study that has already been critiqued by YBOP: Cyberpornography: Time Use, Perceived Addiction, Sexual Functioning, and Sexual Satisfaction (2016). Both studies involved the same subjects, with the earlier study reporting that greater porn use was related to both less sexual satisfaction and less sexual dysfunction. The new study added a twist by categorizing the porn users into 3 distinct groups:
In line with the earlier study the current study reported that “compulsive porn users” had both less sexual satisfaction and less sexual dysfunction. As explained in the earlier critique, this finding is inconsistent with nearly every other study on compulsive porn users and sex addicts, which generally report less sexual satisfaction and greater sexual dysfunction. How could more porn use be related to bothless sexual satisfaction and less sexual dysfunction?
The most probable answer is the same as for the earlier study by the same team of researchers: This study used the ASEX to measure sexual function, and not the standard IIEF. The ASEX doesn’t distinguish between sexual functioning during masturbation (typically to digital porn) and partnered sex, while the IIEF is only for sexually active subjects. As today’s porn users who develop sexual dysfunctions typically experience them during partnered sex, this research is basically useless in understanding porn’s effects on sexual function.
Many of the subjects were rating the quality of their orgasms, arousal and erections while masturbating to porn – not while having sex. Again, most have no problems attaining erections or climaxing to screens – whether due to the endless novelty and ready availability of more extreme porn online, or due to the fact that today’s heavy porn users have trained (sensitized) their brains to screen-based arousal, not real people.
Additional information provided in the current study actually supports this hypothesis as the compulsive porn users were mostly males and avoided partnered sex:
“Sexual behaviors reported by these individuals suggest that their pornography use might be framed into a broader pattern of compulsive sexuality that includes avoidance of sexual interactions with a partner.”
Moreover, only 38% of the compulsive porn users had partners. (NOTE: this doesn’t mean that 38% had sex with a partner, as a common symptom of porn addiction is choosing porn over partnered sex). In any case, at least 62% of the compulsive subjects were porn addicts who didn’t have sex with real people. This means that the vast majority of the compulsive porn users in these two studies were assessing their arousal and erections while masturbating to porn, not while having sex with a partner. Thus, dysfunction rates would be expected to be far lower than if the researchers had only asked porn users who could answer about partnered sex.
Many guys who use porn solo have no idea that they have sexual dysfunctions during partnered sex. Believing they have abnormally high libidos because they are masturbating so frequently, with erections, they are often baffled when they get with a partner and discover that “it doesn’t work right.” Since the advent of streaming internet porn, rates of sexual dysfunctions have jumped in men, and among problematic porn users, rates of sexual dysfunctions (with partners) are as high as 71%! There’s nothing in this paper to suggest that the cause is underlying “compulsivity” that mysteriously drives them away from partners, rather than simply internet porn addiction itself. (Addicts typically prefer their addictive activity or substance to other activities.)
Measuring sexual performance in solo porn users creates a huge confound, and the researchers were mistaken to claim their results bear any relation to sexual dysfunction studies that use the IIEF. The ASEX that they used measures “apples,” while the IIEF measures “oranges.” Only the latter can reveal sexual dysfunctions during partnered sex – which is where the sexual dysfunctions typically arise first in today’s porn users.
Summary: The peculiar results of greater sexual dissatisfaction and yet less sexual dysfunction are almost certainly due to the fact that the researchers used the wrong instrument to measure sexual dysfunction in porn users, and therefore included a lot of subjects who were not having partnered sex. And drew unsupported conclusions as a consequence.
J Sex Med. 2017 Jan;14(1):78-85. doi: 10.1016/j.jsxm.2016.10.016.
Although findings concerning sexual outcomes associated with cyberpornography use are mixed, viewing explicit sexual content online is becoming a common activity for an increasing number of individuals.
Aim
To investigate heterogeneity in cyberpornography-related sexual outcomes by examining a theoretically and clinically based model suggesting that individuals who spend time viewing online pornography form three distinct profiles (recreational, at-risk, and compulsive) and to examine whether these profiles were associated with sexual well-being, sex, and interpersonal context of pornography use.
Methods
The present cluster-analytic study was conducted using a convenience sample of 830 adults who completed online self-reported measurements of cyberpornography use and sexual well-being, which included sexual satisfaction, compulsivity, avoidance, and dysfunction.
Main Outcomes Measures
Dimensions of cyberpornography use were assessed using the Cyber Pornography Use Inventory. Sexual well-being measurements included the Global Measure of Sexual Satisfaction, the Sexual Compulsivity Scale, the Sexual Avoidance Subscale, and the Arizona Sexual Experiences Scale.
Results
Cluster analyses indicated three distinct profiles: recreational (75.5%), highly distressed non-compulsive (12.7%), and compulsive (11.8%). Recreational users reported higher sexual satisfaction and lower sexual compulsivity, avoidance, and dysfunction, whereas users with a compulsive profile presented lower sexual satisfaction and dysfunction and higher sexual compulsivity and avoidance. Highly distressed less active users were sexually less satisfied and reported less sexual compulsivity and more sexual dysfunction and avoidance. A larger proportion of women and of dyadic users was found among recreational users, whereas solitary users were more likely to be in the highly distressed less active profile and men were more likely to be in the compulsive profile.
Conclusion
This pattern of results confirms the existence of recreational and compulsive profiles but also demonstrates the existence of an important subgroup of not particularly active, yet highly distressed consumers. Cyberpornography users represent a heterogeneous population, in which each subgroup is associated with specific sexual outcomes.
COMMENTS: This study reported two seemingly contradictory findings in regard to porn use:
More time spent viewing porn correlated with lower sexual satisfaction
More time spent viewing porn correlated withless sexual dysfunction
Wouldn’t it make sense for poorer sexual satisfaction to always be related to more sexual dysfunction? How could more porn use be related to bothless sexual satisfaction and less sexual dysfunction?
The probable answer: This study used the ASEX to measure sexual function, and not the standard IIEF. The ASEX doesn’t distinguish between sexual functioning during masturbation (typically to digital porn) and partnered sex, while the IIEF is only for sexually active subjects. This means that many of the subjects were rating the quality of their orgasms, arousal and erections while masturbating to porn – not while having sex. In fact, the demographics suggest a good many were answering as if they were masturbating to porn:
The average age was 25
90% of the men regularly used porn
Only 35% of the subjects were cohabiting (33% were single; 30% were “dating”)
Internet porn users often experience greater sexual arousal and better erections while using porn. Only very rarely do men who develop porn-induced ED lose sexual function during masturbation sessions with digital porn (although amazingly enough, a few do become that dysfunctional). Most users don’t notice their declining sexual dysfunction due to porn use if they are self-pleasuring because most manage to keep clicking to something hotter or more extreme until they can “get the job done.”
It is with partners that digital porn users typically notice their porn-related sexual dysfunctions, and this happens because they have conditioned their sexual response to screens, fetishes, constant seeking and searching, and endless novelty. Not to partnered sex. The ASEX test (that this research team used) won’t pick up partnered-sex dysfunctions – unless the researchers tell them to apply it only to partnered sex. This research team didn’t do that in this study. (We know because we corresponded with an author.)
This also explains the apparent anomaly, namely that these subjects report low “sexual satisfaction” – when also given a questionnaire that did specify partnered sexual activities. Many porn users today can’t have successful sex with partners, or orgasm with partners, or they report feeling “numb dick” with partners – both oral and intercourse (but have no such problems when only using digital porn). Multiple studies link porn use to sexual problems and lower sexual satisfaction. So far 3 of these studies demonstrate porn use is causing sexual dysfunction – as participants eliminated porn use and healed chronic sexual dysfunctions.
———–
Findings relevant to the Grubbs CPUI
This study also found that porn addiction, as measured by the Grubbs’s CPUI, was very strongly related to the amount of porn viewed. Several lay articles about the Joshua Grubbs studies (“perceived addiction studies”) have claimed that the amount of porn use was unrelated to the scores on on the CPUI. This and other claims surrounding the perceived addiction studies have been debunked by this extensive critique.
A little background. In 2010 Grubbs created a questionnaire to assess porn addiction: the CPUI. In 2013 Grubbs published a study claiming that his actual porn addiction questionnaire had been magically transformed into a “perceived porn addiction” questionnaire (much more here). There is no such as a “perceived addiction” test – for any addiction, including porn addiction, and his test was never validated as such. Anyhow, questions 1-6 of the CPUI-9 assess the signs and symptoms common to all addictions, while questions 7-9 (Emotional Distress) assess guilt, shame and remorse. As a result, “actual porn addiction” closely aligns with questions 1-6 (Compulsivity & Access Efforts).
Compulsivity:
I believe I am addicted to Internet pornography.
I feel unable to stop my use of online pornography.
Even when I do not want to view pornography online, I feel drawn to it
Access Efforts:
At times, I try to arrange my schedule so that I will be able to be alone in order to view pornography.
I have refused to go out with friends or attend certain social functions to have the opportunity to view pornography.
I have put off important priorities to view pornography.
Emotional Distress:
I feel ashamed after viewing pornography online.
I feel depressed after viewing pornography online.
I feel sick after viewing pornography online.
The current study found that the amount of porn used was robustly related to questions 1-6, yet not at all related to questions 7-9. This means that the amount of porn used is a very strong factor in the development of a porn addiction. On the other hand, shame and guilt were not associated with porn use, and have nothing to do with porn addiction. In short “perceived addiction” as a concept is unsupported when one looks closely.
Using pornography through the Internet is now a common activity even if associated sexual outcomes, including sexual satisfaction, are highly variable. The present study tested a two-step sequential mediation model whereby cyberpornography time use is related to sexual satisfaction through the association with, in a first step, perceived addiction to cyberpornography (i.e., perceived compulsivity, effort to access, and distress toward pornography) and with, in a second step, sexual functioning problems (i.e., sexual dysfunction, compulsion, and avoidance). These differential associations were also examined across gender using model invariance across men and women. A sample of 832 adults from the community completed self-report online questionnaires. Results indicated that 51 percent of women and 90 percent of men reported viewing pornography through the Internet. Path analyses showed indirect complex associations in which cyberpornography time use is associated with sexual dissatisfaction through perceived addiction and sexual functioning problems. These patterns of associations held for both men and women.
FROM FULL STUDY:
First, even when controlling for perceived addiction to cyberpornography and overall sexual functioning, cyberpornography use remained directly associated with sexual dissatisfaction. Even though this negative direct association was of small magnitude, time spent viewing cyberpornography seems to be a robust predictor of lower sexual satisfaction.
Justin Lehmiller, a regular paid contributor to Playboy Magazine, and now partnering with xHamster, unconvincingly attempts to debunk the well documented rise in youthful erectile dysfunction with this April, 2018 blog post. Since it was published David Ley and Nicole Prause frequently tweet Lehmiller’s blog post as “proof” that youthful ED rates haven’t changed in the last 30 years. According to Ley and Prause this means that porn use cannot cause sexual problems.
Before we address Lehmiller’s sleight of hand attempting to make porn-induced sexual dysfunction disappear, let’s examine the evidence.
Historical ED rates
Erectile dysfunction was first assessed in 1940s when the Kinsey report concluded that the prevalence of ED was less than 1% in men younger than 30 years, and less than 3% in those 30–45. While ED studies on young men are relatively sparse, this 2002 meta-analysis of 6 high-quality ED studies reported that 5 of the 6 reported ED rates for men under 40 were approximately2%. The 6th study reported figures of 7-9%, but the question used could not be compared to assessments used for the 5 other studies, and did not assess chronic erectile dysfunction. The anomalous study asked, “Did you have trouble maintaining or achieving an erection any time in the last year?” (Yet this inconsistent study is the one that Lehmiller irresponsibly uses for comparison.)
At the end of 2006 the world of online porn changed. Free, streaming porn tube sites came online and gained instant popularity. This changed the nature of porn consumption radically. For the first time in history, viewers could click to new material or escalate to more extreme material with ease during a masturbation session without any wait.
Nine studies published since 2010
Ten studies published since 2010 reveal a tremendous rise in erectile dysfunctions. This is documented in this lay article and in this peer-reviewed paper involving 7 US Navy doctors – Is Internet Pornography Causing Sexual Dysfunctions? A Review with Clinical Reports (2016). In the 10 studies, erectile dysfunction rates for men under 40 ranged from 14% to 37%, while rates for low libido ranged from 16% to 37%. Other than the advent of streaming porn (2006) no variable related to youthful ED has appreciably changed in the last 10-20 years (smoking rates are down, drug use is steady, obesity rates in males 20-40 up only 4% since 1999 – see this study).
The recent jump in sexual problems coincides with the publication of 35 studies linking porn use and “porn addiction” to sexual problems and lower arousal to sexual stimuli. It’s important to note that the first 5 studiesin the list demonstrate causation, as participants eliminated porn use and healed chronic sexual dysfunctions. For some reason, Lehmiller failed to acknowledge the existence of any of this research. In addition to the studies listed, this page contains articles and videos by over 130 experts (urology professors, urologists, psychiatrists, psychologists, sexologists, MDs) who acknowledge and have successfully treated, porn-induced ED and porn-induced loss of sexual desire.
Lehmiller carefully selected two mismatched studies, with data separated by 18 years, in an attempt to convince the reader that ED rates have always been around 8% for men under 40:
1) The “way things were study” from 1992 is the one that asked: “Did you have trouble maintaining or achieving an erection any timein the last year?” Rates of yes to this question were between 7-9%.
2) In contrast, this “modern study” with 2010-12 data (from NATSAL) is the one that asked whether men had trouble getting or keeping an erection fora period of three or more months during the last year.” This study reported the following rates of sexual functioning problems in 16-21 year old males:
Lacked interest in having sex: 10.5%
Difficulty reaching climax: 8.3%
Difficulty achieving or maintaining an erection: 7.8%
Lehmiller “summarized” these findings for the vision-impaired as he tried to mislead them:
Although these data were collected in different Western countries and the question wording differed, it’s striking how similar the figures are considering that the data were collected 20 years apart. This suggests that perhaps rates of ED aren’t on the rise among young men after all.
Sorry Justin, but the questions are not “worded differently”; they are completely different questions. The 1992 study asked whether over the course of the last year at any point you had trouble getting it up. This includes when you were drunk, sick, just wanked three times in a row, experienced performance anxiety, whatever. I’m surprised it’s only 7-9%. In contrast, the 2010 study asked whether you had a persistent problem of erectile dysfunction over a period of three months or more. This was for 16-21 year olds, not men 39 and under!
As one recovery-forum member observed, Justin Lehmiller’s “science analysis” is Buzzfeed level clickbait, not science journalism.
But you may ask: Why are the ED rates about 8% in the 2010-2012 study, yet 14-37% in the 9 other studies published since 2010?
First, 8% isn’t insignificant, as 8% would indicate a 600%-800% increase for men under 40.
Second, it wasn’t men under 40 – it was 16 to 21 year olds, so virtually none of them should have chronic ED. In the 1940s, the Kinsey report concluded that the prevalence of ED was less than 1% in men younger than 30 years,
Third, unlike the other 9 studies that employed anonymous surveys, this study used face to face in-home interviews. (It’s quite possible that adolescents would be less than fully forthcoming under such circumstances.)
The study gathered its data between August, 2010 and September, 2012. Studies reporting a significant rise in under-25 ED first appeared in 2011. More recent studies on 25-and-under sujects report even higher rates (see this 2014 study on Canadian adolescents).
Many of the other studies used the IIEF-5 or IIEF-6, which assess sexual problems on a scale, as opposed to the simple yes or no (in the past 3 months) employed in Lehmiller’s cherry-picked paper.
Two studies using the exact same questionnaire: 2001 vs. 2011 (GSSAB)
Before leaving this topic, it would be well to look at some of the most irrefutable research that demonstrates a radical rise in ED rates over a decade using very large samples (which increase reliability). All the men were assessed using the same (yes/no) question about ED, as part of the Global Study of Sexual Attitudes and Behavior (GSSAB), administered to 13,618 sexually active men in 29 countries. That occurred in 2001-2002.
A decade later, in 2011, the same “sexual difficulties” (yes/no) question from the GSSAB was administered to 2,737 sexually active men in Croatia, Norway and Portugal. The first group, in 2001-2002, wereaged 40-80. The second group, in 2011, were 40 and under.
Based on the findings of prior studies one would predict the older men would have far higher ED scores than the younger men, whose scores should have been negligible. Not so. In just a decade, things had changed radically. The 2001-2002 ED rates for men 40-80 were about 13% in Europe. By 2011, ED rates in Europeans, ages 18-40, ranged from 14-28%!
What changed in men’s sexual environment during this time? Well, major changes were internet penetration and access to porn videos (followed by access to streaming porn in 2006, and then smartphones on which to view it). In the 2011 study on Croatians, Norwegians and Portuguese, the Portuguese had the lowest rates of ED and the Norwegians had the highest. In 2013, internet penetration rates in Portugal were only 67%, compared with 95% in Norway.
In line with clinical, anecdotal, and experimental evidence
The image below appeared in an analysis of ED posts from MedHelp forums. “Nearly 60% of men posting on the forums were under 24 years old. This was a surprising finding for researchers, as erectile dysfunction is generally considered a condition that strikes older men.”
An Irish Times poll asked thousands of readers about ED, and the number of men 24-34 with issues was 28%:
Click on graphics from 2015 Irish Times poll to see ED rates, which show higher rates in young men than in men 35-49!
Documented recovery stories
About 3,000 self-reports of recovery from ED and other sexual dysfunctions after quitting internet porn can be found on these pages:
Experts, not employed by Playboy, who recognize and treat porn-induced sexual dysfunctions
Justin Lehmiller may be right in step with a few agenda-driven sexologists, but he’s out of step with professionals who treat men. Since YBOP came online in 2011 over 120 sexual experts (urology professors, urologists, psychiatrists, psychologists, sexologists, MDs) who acknowledge and treat porn-induced sexual problems have published articles or appeared on radio and TV. Note: Urologists have twice presented evidence of porn-induced sexual dysfunctions at annual conferences of the American Urological Association.
List of articles, broadcasts, radio shows, and podcasts that involve sexual experts who confirm the existence of porn-induced sexual dysfunctions (in chronological order):
The authors of this so-called review would have readers believe that self-identification as a porn addict is a function of religious shame/moral disapproval about porn. They only reviewed a small number of studies, which rely on the CPUI-9, an instrument developed by co-author Grubbs that produces skewed findings. The co-authors carefully omitted or misrepresented opposing research that has convincingly demonstrated that the studies they relied on in their review are misleading.
It is not “religiousness” or “moral disapproval” that predicts self-perception as a porn addict, as they imply, but rather porn use levels. Let’s look at the opposing evidence more closely (see 4 formal critiques by researchers).
Porn use levels are by far the strongest predictor of self-perceived porn addiction
The first study is the only study that directly correlated self-identification as a porn addict with hours of use, religiousness and moral disapproval of porn use. Its findings contradict the carefully constructed narrative about “perceived addiction” (that “porn addiction is just religious shame/moral disapproval”) – which is grounded in studies employing the flawed instrument called the CPUI-9. In this study, the strongest correlation with self-perception as an addict was with hours of porn use. Religiousness was irrelevant, and while there was predictably some correlation between self-perception as an addict and moral incongruence regarding porn use, it was roughly half the hours-of-use correlation.
In short, the porn users who thought they were addicted really were using more porn, just as one would expect of compulsive (or addicted) porn users.
To understand how this research undermines all of the CPUI-9 studies, more background is helpful. (A detailed discussion of the CPUI-9 appears at the bottom of this page.) The key insight is that the CPUI-9 includes 3 “guilt and shame/emotional distress” questions not normally found in addiction instruments – which skew its results, causing religious porn users to score higher and non-religious users to score lower than subjects do on standard addiction-assessment instruments. By itself this flawed instrument might have done little harm, but its creator then conflated the term “perceived addiction” with the total score on the CPUI-9. Thus, a new, very misleading meme was born, and it was immediately snapped up by anti-porn addiction advocates and plastered all over the media.
The term “perceived pornography addiction” is misleading in the extreme, because it’s just a meaningless score on an instrument that produces skewed results. But people assumed they understood what “perceived addiction” meant. They presumed it meant that the CPUI-9’s creator, Dr. Grubbs, had figured out a way to distinguish actual “addiction” from “belief in addiction.” He hadn’t. He had just given a deceptive label to his “porn use inventory,” the CPUI-9 (its 9 questions are reproduced at the bottom of the page). However, Dr. Grubbs made no effort to correct the misperceptions that rolled out into the media, pushed by anti-porn addiction sexologists and their media chums.
Misled journalists mistakenly summed up CPUI-9 findings as:
Believing in porn addiction is the source of your problems, not porn use itself.
Religious porn users are not really addicted to porn (even if they score high on the Grubbs CPUI-9) – they just have shame.
Even some sincere clinicians were duped, because some clients really do believe their porn use is more destructive and pathological than their therapists think it is. These therapists assumed the Grubbs test somehow isolated these mistaken clients when it didn’t, and they adopted (and repeated) the new meme uncritically.
As the saying goes, “The only cure for bad science is more science.” Faced with thoughtful skepticism about his assumptions, and the media’s unfounded claims that his CPUI-9 instrument could indeed distinguish “perceived pornography addiction” from genuine problematic porn use, Dr. Grubbs finally did the right thing as a scientist. He pre-registered a study to test his hypotheses/assumptions directly (not using the CPUI-9). Pre-registration is a sound scientific practice that prevents researchers from changing hypotheses after collecting data.
The results of Grubbs’s pre-registered study contradicted both his earlier conclusions and the meme (“porn addiction is just shame”) that the press helped to popularize.
Details: Dr. Grubbs set out to prove that religiosity was indeed the main predictor of “believing yourself addicted to porn.” He and his team of researchers surveyed 3 good-sized, diverse samples (male, female, etc.). He posted the results online, although his team’s paper has not yet been formally published.
As stated, this time he didn’t rely on his CPUI-9 instrument. Instead, the Grubbs team asked 2 direct ‘yes/no’ questions of porn users (“I believe that I am addicted to internet pornography.” “I would call myself an internet pornography addict.”), and compared results with variables such as hours of use, religiousness and scores on a “moral disapproval of porn” questionnaire.
Directly contradicting his earlier claims, Dr. Grubbs and his research team found that believing you are addicted to porn correlates most strongly withdaily hours of porn use, not with religiousness. As noted below, some of Dr. Grubbs’s earlier studiesalso found that hours of use was a stronger predictor of “perceived addiction” (total CPUI-9 score) than religiosity – findings that continually did not make it into the mainstream media (or Dr. Grubbs’s own summaries).
From the new study’s abstract:
In contrast to prior literature indicating that moral incongruence and religiousness are the best predictors of perceived addiction [CPUI-9 total score], results from all three samples indicated that male gender and pornography use behaviors were the most strongly associated with self-identification as a pornography addict.
Being male is also strongly predictive of self-labeling as “addicted.” According to Dr. Grubbs, rates of male porn users who answered “yes” to one of the “addicted” questions ranged from 8-20% in the new study’s samples. These rates are consistent with other 2017 research (19% of college males addicted).
In short, there is widespread distress among some of today’s porn users. High rates of problematic use suggest that the World Health Organization’s proposed diagnosis of “Compulsive sexual behavior disorder” is genuinely needed to insure that problematic porn use is properly studied and those suffering are properly treated.
Based on their results in the new pre-registered study, Dr. Grubbs and his co-authors concluded that, “mental and sexual health professionals should take the concerns of clients identifying as pornography addicts seriously.” (emphasis supplied)
“Moral incongruence” is not unique to porn users, as Grubbs et al. presume
It’s also important to note that Grubbs’s work in this area presumes that “moral incongruence” is unique to porn users – without offering a shred of support, formal or otherwise. In fact, this presumption is incorrect. As author Gene M. Heyman points out in a new chapter entitled “Deriving Addiction” (Routledge Handbook of Philosophy and Science of Addiction, 11 June 2018), it also exists in substance addicts:
Accounts of quitting drugs often include moral concerns. With some frequency, ex-addicts explain that they wanted to regain the respect of family members, to better meet their image of how a parent should behave, and to better approximate their image of a person who is competent and in control of their life (e.g., Biernacki 1986; Jorquez 1983; Premack 1970; Waldorf et al. 1991)., p.32
Thus, “moral incongruence” seems to be a protective factor, rather than a hindrance to quitting. For some addicts it’s not “sexual/religious shame,” but distress over loss of self-mastery that is most potent.
Put simply, the Joshua Grubbs “moral incongruence” model of porn addiction is based on the false premise that individuals with other kinds of addictions would NOT morally disapprove of their own behaviors.
Astonishingly, Grubbs, Perry, Wilt and Reid “review” portrays the CPUI-9-based narrative as alive and well. They ignore the research described above, which totally contradicts their conclusions. The “review” also inadequately describes the significance of Fernandez, Tee & Fernandez, a study that also powerfully undermines the narrative these authors present, as explained in the next section.
A peer-reviewed non-Grubbs studyalso questioned the CPUI-9’s ability to assess either perceived or actual porn addiction
The researchers measured actual compulsivity by asking participants to abstain from internet porn for 14 days. (Only a handful of studies have asked participants to abstain from porn use, which is one of the most unambiguous ways to reveal its effects.)
Study participants took the CPUI-9 before and after their 14-day attempt at porn abstinence. (Note: They did not abstain from masturbation or sex, only internet porn.) The researchers’ main objective was to compare ‘before’ and ‘after’ scores of the 3 sections of the CPUI-9 to several variables.
Among other findings (discussed in depth here), the inability to control use (failed abstinence attempts) correlated with the CPUI-9’s actual addiction questions 1-6, but not with the CPUI-9’s guilt and shame (emotional distress) questions 7-9. Similarly, “moral disapproval” of pornography use was only slightly related to CPUI-9 “Perceived Compulsivity” scores. These results suggest that the CPUI-9 guilt and shame questions (7-9) shouldn’t be part of a porn addiction (or even “perceived porn addiction”) assessment because they are unrelated to frequency of porn use.
To say it differently, the most addicted subjects did not score higher on religiosity. Moreover, no matter how it is measured, actual porn addiction/compulsivity is strongly correlated with higher levels of porn use, rather than with “emotional distress” questions (guilt and shame).
In summary Dr. Grubbs’s own pre-registered study and the Fernandez studies support the following:
Religiousness does not “cause” porn addiction. Religiosity is not related to believing you are addicted to porn.
The amount of porn viewed is the strongest predictor (by far) of actual porn addiction or belief that someone is addicted to porn.
The “perceived addiction” studies (or any study that uses the CPUI-9) does not, in fact, assess “perceived porn addiction” or “belief in porn addiction” or “self-labeling as an addict,” let alone distinguish “perceived” from actual addiction.
Background on the CPUI-9 and how it badly skews results
In the last few years Dr. Joshua Grubbs has authored a series of studies correlating porn users’ religiosity, hours of porn use, moral disapproval, and other variables with scores on his 9-item questionnaire “The Cyber Pornography Use Inventory” (CPUI-9). In an odd decision that has lead to much misunderstanding of his findings, Dr. Grubbs refers to his subjects’ total CPUI-9 score as “perceived pornography addiction.” This gives the false impression that his CPUI-9 instrument somehow indicates the degree to which a subject merely “perceives” he is addicted (rather than being actually addicted). But no instrument can do that, and certainly not this one.
To say it another way, the phrase “perceived pornography addiction” indicates nothing more than a number: the total score on the following 9-item pornography-use questionnaire with its three extraneous questions about guilt and shame. It doesn’t sort the wheat from the chaff in terms of perceived vs. genuine addiction. Nor does the CPUI-9 assess actual porn addiction.
Perceived Compulsivity Section
I believe I am addicted to Internet pornography.
I feel unable to stop my use of online pornography.
Even when I do not want to view pornography online, I feel drawn to it
Access Efforts Section
At times, I try to arrange my schedule so that I will be able to be alone in order to view pornography.
I have refused to go out with friends or attend certain social functions to have the opportunity to view pornography.
I have put off important priorities to view pornography.
Emotional Distress Section
I feel ashamed after viewing pornography online.
I feel depressed after viewing pornography online.
I feel sick after viewing pornography online.
As you can see, the CPUI-9 cannot distinguish between actual porn addiction and “belief” in porn addiction. Subjects never “labeled themselves as porn addicts” in any Grubbs study. They simply answered the 9 questions above, and earned a total score.
What correlations did the Grubbs studies actually report? Total CPUI-9 scores were related to religiosity (as explained above), but also related to “hours of porn viewed per week.” In some Grubbs studies a slightly stronger correlation occurred between religiosity and total CPUI-9 scores (“perceived porn addiction”) in others a stronger correlation occurred with hours of porn use and total CPUI-9 scores (“perceived porn addiction”).
The media ignored the latter findings and grabbed onto the correlation between religiosity and total CPUI-9 scores (now misleadingly labeled “perceived addiction”), and in the process journalists morphed the finding into “religious people only believe they’re addicted to porn.” The media ignored the just-as-strong correlation between CPUI-9 scores and hours of porn use, and pumped out hundreds of inaccurate articles like this blog post by David Ley: Your Belief in Porn Addiction Makes Things Worse: The label of “porn addict” causes depression but porn watching doesn’t. Here is Ley’s inaccurate description of a Grubbs CPUI-9 study:
If someone believed they were a sex addict, this belief predicted downstream psychological suffering, no matter how much, or how little, porn they were actually using.
Removing Ley’s misrepresentations, the above sentence would accurately read: “Higher scores on the CPUI-9 correlated with scores on a psychological distress questionnaire (anxiety, depression, anger).” Which is how it tends to be for any addiction questionnaire. For example, higher scores on an alcohol use questionnaire correlate with higher levels of psychological distress. Big surprise.
The key to all the dubious claims and questionable correlations:the Emotional Distress questions (7-9) cause religious porn users to score much higher and secular porn users to score far lower, as well as creating a strong correlation between “moral disapproval” and total CPUI-9 score (“perceived porn addiction”).
To put it another way, if you use only results from CPUI-9 questions 1-6 (which assess the signs and symptoms of an actual addiction), the correlations dramatically change – and all the dubious articles claiming shame is the “real” cause porn addiction would never have been written.
Tips for understanding the numbers in the table: zero means no correlation between two variables; 1.00 means a complete correlation between two variables. The bigger the number the stronger the correlation between the 2 variables.
In this first correlation we see how moral disapproval correlates powerfully with the 3 guilt and shame questions (Emotional Distress), yet weakly with the two other sections that assess actual addiction (questions 1-6). The Emotional Distress questions cause moral disapproval to be the strongest predictor of total CPUI-9 scores (“perceived addiction”).
But if we use only the actual porn addiction questions (1-6), the correlation is pretty weak with Moral Disapproval (in science-speak, Moral Disapproval is a weak predictor of porn addiction).
The second half of the story is how the same 3 Emotional Distress correlate very poorly with levels of porn use, while the actual porn addiction questions (1-6) correlate robustly with porn use levels.
This is how the 3 Emotional Distress questions skew results. They lead to reduced correlations between “hours of porn use” and total CPUI-9 scores (“perceived addiction”). Next, the sum total of all 3 sections of the CPUI-9 test is deceptively re-labeled as “perceived addiction” by Grubbs. Then, at the hands of determined anti-porn-addiction activists, “perceived addiction” morphs into “self identifying as a porn addict.” The activists have pounced on the strong correlation with moral disapproval, which the CPUI-9 always produces, and presto! they now claim that, “a belief in porn addiction is nothing more than shame!”
It’s a house of cards built on 3 guilt and shame question not found in any other addiction assessment, in combination with the misleading term the questionnaire’s creator uses to label his 9 questions (as a measure of “perceived porn addiction”).
Second, our findings cast doubts on the suitability of the inclusion of the Emotional Distress subscale as part of the CPUI-9. As consistently found across multiple studies (e.g., Grubbs et al., 2015a,c), our findings also showed that frequency of IP use had no relationship with Emotional Distress scores. More importantly, actual compulsivity as conceptualized in the present study (failed abstinence attempts x abstinence effort) had no relationship with Emotional Distress scores.
Emotional Distress scores were significantly predicted by moral disapproval, in line with previous studies which also found a substantial overlap between the two (Grubbs et al., 2015a; Wilt et al., 2016)…. As such, the inclusion of the Emotional Distress subscale as part of the CPUI-9 might skew results in such a way that it inflates the total perceived addiction scores of IP users who morally disapprove of pornography, and deflates the total perceived addiction scores of IP users who have high Perceived Compulsivity scores, but low moral disapproval of pornography.
This may be because the Emotional Distress subscale was based on an original “Guilt” scale which was developed for use particularly with religious populations (Grubbs et al., 2010), and its utility with non-religious populations remains uncertain in light of subsequent findings related to this scale.
Here’s is the core finding: The 3 “Emotional Distress” questions have no place in the CPUI-9, or any porn addiction questionnaire. These guilt and shame questions do not assess distress surrounding addictive porn use or “perception of addiction.” These 3 questions merely artificially inflate total CPUI-9 scores for religious individuals while deflating total CPUI-9 scores for nonreligious porn addicts.
Formal critiques (by porn researchers) of “Pornography Problems Due to Moral Incongruence: An Integrative Model with a Systematic Review and Meta-Analysis”
This critique has two parts: Part 1 exposes how Nicole Prause, Marty Klein and Taylor Kohut completely misrepresent their solitary bit of “evidence” to support the article’s core falsehood – that “compulsive pornography viewing” was excluded from the new ICD-11 “Compulsive Sexual Behavior Disorder” diagnosis. Part 2 exposes the startling omissions, false claims, research misrepresentations, and cherry-picked data littering the Prause/Klein/Kohut article. (Note: Most of the article’s cherry-picked data and misrepresentations are recycled from this 2016 Prause “Letter to the editor” that YBOP thoroughly dismantled 2 years ago: Critique of: Letter to the editor “Prause et al. (2015) the latest falsification of addiction predictions”, 2016.)
PART 1: Debunking claim ICD-11 excluded “pornography viewing” from “Compulsive Sexual Behavior Disorder” diagnosis
The deniers of porn addiction are agitated because the latest version of the World Health Organization’s medical diagnostic manual, The International Classification of Diseases (ICD-11), contains a new diagnosis suitable for diagnosing what is commonly referred to as ‘porn addiction’ or ‘sex addiction’. It’s called “Compulsive Sexual Behavior Disorder” (CSBD). Nonetheless, in a bizarre “We lost, but we won” propaganda campaign, the deniers have been pulling out all the stops to spin this new diagnosis as a rejection of both “sex addiction” and “porn addiction.”
Not satisfied with the false narrative claiming a “rejection of addiction,” veteran porn-addiction deniers Nicole Prause, Marty Klein and Taylor Kohut have taken their propaganda to new levels in this July 30, 2018 Slate article: “Why Are We Still So Worried About Watching Porn?” Without supplying any evidence beyond mere opinions, the Prause/Klein/Kohut triumvirate asserts that WHO has officially excluded pornography viewing from the “Compulsive Sexual Behavior Disorder” diagnosis:
With no support, and zero logic, Prause/Klein/Kohut would have us believe that the most common compulsive sexual behavior – compulsive pornography use – has been axed from the WHO’s new diagnostic manual edition (the ICD-11). The hollowness of the authors’ campaign is apparent for many reasons, some of the most obvious of which are:
CSBD does not describe (or exclude) any particular sexual activity.
Multiple studies show that at least 80% of people with compulsive sexual behaviour (hypersexuality) report compulsive internet pornography use.
Most of the recent 40 neuroscience-based studies (on which the WHO relied in its decision to include CSBD) have been done on internet pornography viewers – so it is silly to suggest that the WHO intended to exclude pornography viewing but forgot to specify it.
Before we get to a detailed evaluation of the deniers’ remarks, let’s be clear: There is neither proclamation nor vague allusion in any WHO literature that could be interpreted as excluding pornography users. Similarly, no WHO spokesperson has ever hinted that a CSBD diagnosis excludes pornography use. Here’s the CSBD diagnosis in its entirety taken directly from the ICD-11 manual:
Compulsive sexual behaviour disorder is characterized by a persistent pattern of failure to control intense, repetitive sexual impulses or urges resulting in repetitive sexual behaviour. Symptoms may include repetitive sexual activities becoming a central focus of the person’s life to the point of neglecting health and personal care or other interests, activities and responsibilities; numerous unsuccessful efforts to significantly reduce repetitive sexual behaviour; and continued repetitive sexual behaviour despite adverse consequences or deriving little or no satisfaction from it. The pattern of failure to control intense, sexual impulses or urges and resulting repetitive sexual behaviour is manifested over an extended period of time (e.g., 6 months or more), and causes marked distress or significant impairment in personal, family, social, educational, occupational, or other important areas of functioning. Distress that is entirely related to moral judgments and disapproval about sexual impulses, urges, or behaviours is not sufficient to meet this requirement.
Do you see anything about excluding pornography? What about excluding compulsively visiting prostitutes? Was any particular sexual behavior at all excluded? Of course not. The Prause/Klein/Kohut article cites no official WHO communication, and quotes no WHO spokesperson or working-group member. The article is little more than propaganda peppered with a handful of cherry-picked studies that are either misrepresented or not what they appear to be. (More below.)
If you have any doubts about the true nature of the Prause/Klein/Kohut press campaign, carefully read this responsible article about compulsive sexual behavior disorder (CSBD). Unlike their Slate article, this July 27, 2018 article in “SELF” goes straight to the source. It quotes official WHO spokesperson Christian Lindmeier. Lindmeier is one of only four officials WHO spokespersons listed on this page: Communications contacts in WHO headquarters – and the only WHO spokesperson to have formally commented about CSBD! The SELF article also interviewed Shane Kraus, who was at the center of the ICD-11’s Compulsive Sexual Behavior Disorder (CSBD) working group. Excerpt with Lindmeir quotes makes it clear that WHO did not reject “sex addiction”:
In regards to CSBD, the largest point of contention is whether or not the disorder should be categorized as an addiction. “There is ongoing scientific debate on whether or not the compulsive sexual behavior disorder constitutes the manifestation of a behavioral addiction,” WHO spokesperson Christian Lindmeier tells SELF. “WHO does not use the term sex addiction because we are not taking a position about whether it is physiologically an addiction or not.”
Who are the authors of this article?
Who are the authors of this article?
Before reviewing the details below, it would be well to consider the mouthpieces of the brazen serving of propaganda in Slate. Its authors are not impartial observers. Their pro-porn agenda is plain.
Marty Klein once boasted his very own webpage on the AVN’s Hall of Fame in recognition of his pro-porn advocacy serving the porn industry’s interests (since removed).
Prause/Klein/Kohut misrepresent their one and only piece of so-called “evidence”
In the following paragraph Prause/Klein/Kohut mislead the reader about “addiction” in diagnostic manuals and lie about their one and only bit of “evidence” for pornography use being excluded from the ICD-11 CSBD diagnosis:
We are also accustomed to the shock when journalists learn that “pornography addiction” is actually not recognized by any national or international diagnostic manual. With the publication of the latest International Classification of Diseases (version 11) in June, the World Health Organization once again decided not to recognize sex-film viewing as a disorder. “Pornography viewing” was considered for inclusion in the “problematic Internet use” category, but WHO decided against its inclusion because of the lack of available evidence for this disorder. (“Based on the limited current data, it would therefore seem premature to include it in the ICD-11,” the organization wrote.) The common American standard, the Diagnostic and Statistical Manual, made the same decision in their latest version as well; there is no listing for porn addiction in DSM-5.
First, neither the ICD-11 nor the APA’s DSM-5 ever uses the word “addiction” to describe an addiction – whether it be gambling addiction, heroin addiction, cigarette addiction, or you name it. Both diagnostic manuals use the word “disorder” instead of “addiction” (i.e. “gambling disorder,” “nicotine use disorder,” and so on). Thus, “sex addiction” and “porn addiction” could never have been rejected, because they were never under formal consideration in the major diagnostic manuals. Put simply, there will never be a “porn addiction” diagnosis, just as there will never be a “meth addiction” diagnosis. Yet individuals with the signs and symptoms of consistent with either a “porn addiction” or a “methamphetamine addiction” can be diagnosed using the ICD-11’s provisions.
(1) The Jon Grant paper is over 4 years old. In fact, 32 of the 39 neurological studies on CSB subjects listed on this page were published since the 2014 Jon Grant paper.
(2) It’s just Grant’s two cents, and not an official position paper by the World Health Organization or the CSBD work-group.
(3) Most importantly, nowhere in the paper does it say that pornography use should be excluded from CSBD.In fact, Grant says the opposite: pornography use on the internet is a form of CSB! The word “pornography” is used only once in paper and here is what Grant has to say about it:
A third key controversy in the field is whether problematic Internet use is an independent disorder. The Working Group noted that this is a heterogeneous condition, and that use of the Internet may in fact constitute a delivery system for various forms of impulse control dysfunction (e.g., pathological game playing or pornography viewing). Importantly, the descriptions of pathological gambling and of compulsive sexual behaviour disorder should note that such behaviours are increasingly seen using Internet forums, either in addition to more traditional settings, or exclusively 22, 23.
There you have it, Prause/Klein/Kohut blatantly misrepresented the only bit of “evidence” they could muster (fact-check Slate?).
However, the misrepresentation of Grant’s 2014 paper, by Prause, has been occurring for at least a year. Prause created the following image, which has been passed around pro-porn propagandists’ social media accounts. It’s a doctored screenshot of the Jon Grant paragraph I excerpted above. Counting on Twitter-induced short attention-spans, the propagandists expect you to read only what’s in the red boxes, hoping you will overlook what the paragraph actually states:
If you fell for the red-box illusion, you misread the above excerpt as:
…pornography viewing… questionable whether there is enough scientific evidence at this time to justify its inclusion as a disorder. Based on the limited current data, it would therefore seem premature to include it in the ICD-11.
Now read the entire paragraph, and you will see that Jon Grant is talking about “Internet gaming disorder,”not pornography. Grant believed it was questionable whether there was enough scientific evidence at that time to justify Internet Gaming Disorder’s inclusion as a disorder. (Incidentally, 4 years later Gaming disorder is in the ICD-11 and the scientific support for it is vast.)
A third key controversy in the field is whether problematic Internet use is an independent disorder. The Working Group noted that this is a heterogeneous condition, and that use of the Internet may in fact constitute a delivery system for various forms of impulse control dysfunction (e.g., pathological game playing or pornography viewing). Importantly, the descriptions of pathological gambling and of compulsive sexual behaviour disorder should note that such behaviours are increasingly seen using Internet forums, either in addition to more traditional settings, or exclusively 22,23. The DSM-5 has included Internet gaming disorder in the section “Conditions for further study”. Although potentially an important behaviour to understand, and one certainly with a high profile in some countries 12, it is questionable whether there is enough scientific evidence at this time to justify its inclusion as a disorder. Based on the limited current data, it would therefore seem premature to include it in the ICD-11.
Without reading only the red squares, the above excerpt reveals that Jon Grant believes that internet pornography viewing can be an impulse control disorder that would fall under the umbrella diagnosis of “Compulsive Sexual Behavior Disorder” (CSBD). This is the exact opposite of the “red square” illusion tweeted by the propagandists.
What is Jon Grant saying 4 years later? Grant was a co-author on this 2018 paper announcing (and agreeing with) the inclusion of CSBD in the upcoming ICD-11: Compulsive sexual behaviour disorder in the ICD‐11. In a second 2018 article, “Compulsive sexual behavior: A nonjudgmental approach,” Grant says that Compulsive Sexual Behavior is also called “sex addiction” or “hypersexuality” (which have always functioned in the peer-reviewed literature as synonymous terms for any compulsive sexual behavior, including compulsive porn use):
Compulsive sexual behavior (CSB), also referred to as sexual addiction or hypersexuality, is characterized by repetitive and intense preoccupations with sexual fantasies, urges, and behaviors that are distressing to the individual and/or result in psychosocial impairment.
Despite a few misleading rumors to the contrary, it is untrue that the WHO has rejected “porn addiction” or “sex addiction”. Compulsive sexual behavior has been called by a variety of names over the years: “hypersexuality”, “porn addiction”, “sex addiction”, “out-of-control sexual behavior” and so forth. In its latest catalogue of diseases the WHO takes a step towards legitimizing the disorder by acknowledging “Compulsive Sexual Behaviour Disorder” (CSBD) as a mental illness. According to WHO expert Geoffrey Reed, the new CSBD diagnosis “lets people know they have “a genuine condition” and can seek treatment.”
PART 2: Exposing false claims, misrepresentations, cherry-picked studies, and egregious omissions
The remainder of the Prause/Klein/Kohut article is devoted to persuading the reader that porn addiction is a myth and that internet porn use causes no problems. In addition, they imply that only the “sex negative” would dare to suggest that porn use could produce negative effects. In this section we furnish relevant Prause/Klein/Kohut excerpts followed by analysis of both the claim and references supplied to support the claim. Where appropriate we provide studies that counter their assertions.
A sample of the article’s numerous omissions:
Before we address each of the article’s major assertions, it’s important to reveal what Prause/Klein/Kohut chose to omit from their magnum opus. The lists of studies contain relevant excerpts and links to the original papers.
Porn addiction? This page lists 40 neuroscience-based studies (MRI, fMRI, EEG, neuropsychological, hormonal). They provide strong support for the addiction model as their findings mirror the neurological findings reported in substance addiction studies.
The real experts’ opinions on porn/sex addiction? This list contains 17 recent literature reviews & commentaries by some of the top neuroscientists in the world. All support the addiction model.
The goal of this review was to synthesize empirical investigations testing effects of media sexualization. The focus was on research published in peer-reviewed, English-language journals between 1995 and 2015. A total of 109 publications that contained 135 studies were reviewed. The findings provided consistent evidence that both laboratory exposure and regular, everyday exposure to this content are directly associated with a range of consequences, including higher levels of body dissatisfaction, greater self-objectification, greater support of sexist beliefs and of adversarial sexual beliefs, and greater tolerance of sexual violence toward women. Moreover, experimental exposure to this content leads both women and men to have a diminished view of women’s competence, morality, and humanity.
22 studies from 7 different countries were analyzed. Consumption was associated with sexual aggression in the United States and internationally, among males and females, and in cross-sectional and longitudinal studies. Associations were stronger for verbal than physical sexual aggression, although both were significant. The general pattern of results suggested that violent content may be an exacerbating factor.
Increased access to the Internet by adolescents has created unprecedented opportunities for sexual education, learning, and growth. Conversely, the risk of harm that is evident in the literature has led researchers to investigate adolescent exposure to online pornography in an effort to elucidate these relationships. Collectively, these studies suggest that youth who consume pornography may develop unrealistic sexual values and beliefs. Among the findings, higher levels of permissive sexual attitudes, sexual preoccupation, and earlier sexual experimentation have been correlated with more frequent consumption of pornography…. Nevertheless, consistent findings have emerged linking adolescent use of pornography that depicts violence with increased degrees of sexually aggressive behavior. The literature does indicate some correlation between adolescents’ use of pornography and self-concept. Girls report feeling physically inferior to the women they view in pornographic material, while boys fear they may not be as virile or able to perform as the men in these media. Adolescents also report that their use of pornography decreased as their self-confidence and social development increase. Additionally, research suggests that adolescents who use pornography, especially that found on the Internet, have lower degrees of social integration, increases in conduct problems, higher levels of delinquent behavior, higher incidence of depressive symptoms, and decreased emotional bonding with caregivers.
Prause, Ley and Klein have grossly misrepresented the current state of the research for the last few years. Now, they’ve conveniently bundled all the outlying, cherry-picked studies they regularly cite into this article. We expose the truth below. The relevant Prause/Klein/Kohut excerpts listed here are in the same sequence as in the article.
EXCERPT #1: Repeat after me: “Neither the DSM-5 nor the ICD-11 recognizes any addiction, only disorders”
SLATE EXCERPT: “We are also accustomed to the shock when journalists learn that “pornography addiction” is actually not recognized by any national or international diagnostic manual.”
Nice try at fooling the readers, but, again, neither the ICD-11 nor the APA’s DSM-5 ever uses the word “addiction” to describe an addiction – whether it be gambling addiction, heroin addiction, cigarette addiction or you name it. Both diagnostic manuals use the word “disorder” instead of “addiction” (i.e. “gambling disorder” “nicotine use disorder”, and so on). Thus, “sex addiction” and “porn addiction” could never have been rejected, because they were never under formal consideration in the major diagnostic manuals. Put simply, there will never be a “porn addiction” diagnosis, just as there will never be a “meth addiction” diagnosis. Yet individuals with the signs and symptoms of consistent with either a “porn addiction” or a “methamphetamine addiction” can be diagnosed using the ICD-11’s provisions.
The new definition resulted from an intensive, four‐year process with more than 80 experts actively working on it, including top addiction authorities, addiction medicine clinicians and leading neuroscience researchers from across the country. … Two decades of advancements in neurosciences convinced ASAM that addiction needed to be redefined by what’s going on in the brain.
The new definition leaves no doubt that all addictions—whether to alcohol, heroin or sex, say—are fundamentally the same. Dr. Raju Haleja, former president of the Canadian Society for Addiction Medicine and the chair of the ASAM committee that crafted the new definition, told The Fix, “We are looking at addiction as one disease, as opposed to those who see them as separate diseases. Addiction is addiction. It doesn’t matter what cranks your brain in that direction, once it has changed direction, you’re vulnerable to all addiction.” …Sex or gambling or food addiction [are] every bit as medically valid as addiction to alcohol or heroin or crystal meth.
For all practical purposes, the 2011 definition ends the debate over whether sex and porn addictions are “real addictions.” ASAM explicitly stated that sexual behavior addictions exist and must be caused by the same fundamental brain changes found in substance addictions. From the ASAM FAQs:
QUESTION: This new definition of addiction refers to addiction involving gambling, food, and sexual behaviors. Does ASAM really believe that food and sex are addicting?
ANSWER: The new ASAM definition makes a departure from equating addiction with just substance dependence, by describing how addiction is also related to behaviors that are rewarding. … This definition says that addiction is about functioning and brain circuitry and how the structure and function of the brains of persons with addiction differ from the structure and function of the brains of persons who do not have addiction. … Food and sexual behaviors and gambling behaviors can be associated with the ‘pathological pursuit of rewards’ described in this new definition of addiction.
As for the DSM, the American Psychiatric Association (APA) has so far dragged its feet on including compulsive sexual behaviors in its diagnostic manual. When it last updated the manual in 2013 (DSM-5), it didn’t formally consider “internet porn addiction,” opting instead to debate “hypersexual disorder.” The latter umbrella term for problematic sexual behavior was recommended for inclusion by the DSM-5’s own Sexuality Work Group after years of review. However, in an eleventh-hour “star chamber” session (according to a Work Group member), other DSM-5 officials unilaterally rejected hypersexuality, citing reasons that have been described as illogical.
In reaching this position, the DSM-5 disregarded formal evidence, widespread reports of the signs, symptoms and behaviors consistent with compulsion and addiction from sufferers and their clinicians, and the formal recommendation of thousands of medical and research experts at the American Society of Addiction Medicine.
Incidentally, the DSM has earned distinguished critics who object to its approach of ignoring underlying physiology and medical theory to ground its diagnoses solely in symptoms. The latter permits erratic, political decisions that defy reality. For example, the DSM once incorrectly classified homosexuality as a mental disorder.
Just prior to the DSM-5’s publication in 2013, Thomas Insel, then Director of the National Institute of Mental Health, warned that it was time for the mental health field to stop relying on the DSM. Its “weakness is its lack of validity,” he explained, and “we cannot succeed if we use DSM categories as the “gold standard.” He added, “That is why NIMH will be re-orienting its research away from DSM categories.” In other words, the NIMH would stop funding research based on DSM labels (and their absence).
It will be interesting to see what occurs with the next update of the DSM. (Note: DSM-5 did create a behavioral addiction category)
SLATE EXCERPT: Scientists and clinicians who present evidence that challenges these harm-focused narratives—and we count ourselves among that group—face serious social and political opposition to their research. It can be tough for this info to make it to the public too.
These authors spin the yarn that pro-porn advocates “face serious social and political opposition to their research” and that it can be “tough for this info to make it to the public.” Not so. In fact, pro-porn spokespersons are greatly over-represented in the press, and they have done much, often behind the scenes, to suppress opposing evidence of porn’s harms in both the popular and academic literature. (Examples)
Predictably, these authors offer no evidence of their supposed social and political difficulties. A few statistics will serve to reveal the true situation.
A Google search for “Nicole Prause” + pornography returns 16,600 results over relatively few years. Prause’s powerhouse media exposure includes quotations of her pro-porn/anti-porn addiction views in some of the most popular mainstream outlets, including Slate, Daily Beast, The Atlantic, Rolling Stone, CNN, NPR, Vice, The Sunday Times, and countless smaller outlets. Clearly Prause gets what she pays for from her glossy public relations firm. See http://media2x3.com/category/nikky-prause/
It should be noted that Prause’s close colleague David Ley receives similar, generous press treatment. A Google search for “David Ley” + pornography returns 18,000 results – mostly because he wrote a book entitled The Myth of Sex Addiction (without ever having studied addiction in depth). A Google search for “Marty Klein” + pornography returns 41,500 results over many years.
Not only do mainstream outlets feature the views of these 3 authors, they also typically adopt these spokespersons’ narrative at face value – without seeking out the opposing views of big name academics who have published multiple neurological studies on internet porn users demonstrating evidence of porn’s harmful effects. These include Marc Potenza, Matthias Brand, Valerie Voon, Christian Laier, Simone Kühn, Jürgen Gallinat, Rudolf Stark, Tim Klucken, Ji-Woo Seok, Jin-Hun Sohn, Mateusz Gola and others.
Clearly, it is the serious academic researchers who are discriminated against in the press. Consequently, readers are advised to take these pro-porn authors’ narrative about the hardships they face in publicizing their pro-porn views with a healthy degree of skepticism. Journalists should do more responsible, less biased due diligence in this fractious, fractured field.
EXCERPT #3: A blog post by Playboy staff writer is all you got?
SLATE EXCERPT: They are also told that there is an epidemic of erectile dysfunction emerging in young men and that porn is the cause (though actual evidence suggests that there’s not).
Prause/Klein/Kohut attempt unconvincingly to debunk the well documented rise in youthful erectile dysfunction with a blog post by Justin Lehmiller, a regular paid contributor to Playboy Magazine. It shouldn’t surprise anyone that Lehmiller is a close ally of Prause, having featured her in at least ten of his blog posts. These and many other Lehmiller blogs perpetuate the same false narratives: porn use causes no problems and porn addiction/porn-induced sexual dysfunctions do not exist. Before we address Lehmiller’s sleight of hand regarding porn-induced sexual dysfunction, let’s examine the evidence.
Historical ED rates: Erectile dysfunction was first assessed in 1940s when the Kinsey report concluded that the prevalence of ED was less than 1% in men younger than 30 years, less than 3% in those 30–45. While ED studies on young men are relatively sparse, this 2002 meta-analysis of 6 high-quality ED studies reported that 5 of the 6 reported ED rates for men under 40 of approximately2%. The 6th study reported figures of 7-9%, but the question used could not be compared to the 5 other studies, and did not assess chronic erectile dysfunction: “Did you have trouble maintaining or achieving an erection any time in the last year?” (Yet this anomalous study is the one that Lehmiller irresponsibly uses for comparison.)
At the end of 2006 free, streaming porn tube sites came on line and gained instant popularity. This changed the nature of porn consumption radically. For the first time in history, viewers could escalate with ease during a masturbation session without any wait.
Nine studies since 2010: Nine studies published since 2010 reveal a tremendous rise in erectile dysfunctions. This is documented in this lay article and in this peer-reviewed paper involving 7 US Navy doctors – Is Internet Pornography Causing Sexual Dysfunctions? A Review with Clinical Reports (2016). In the 9 studies, erectile dysfunction rates for men under 40 ranged from 14% to 37%, while rates for low libido ranged from 16% to 37%. Other than the advent of streaming porn (2006) no variable related to youthful ED has appreciably changed in the last 10-20 years (smoking rates are down, drug use is steady, obesity rates in males 20-40 up only 4% since 1999 – see this study).
The recent jump in sexual problems coincides with the publication of 26 studies linking porn use and “porn addiction” to sexual problems and lower arousal to sexual stimuli. It’s important to note that the first 5 studies in the list demonstrate causation, as participants eliminated porn use and healed chronic sexual dysfunctions (for some strange reason the Slate article failed to mention any of these 26 studies). In addition to the studies listed, this page contains articles and videos by over 120 experts (urology professors, urologists, psychiatrists, psychologists, sexologists, MDs) who acknowledge and have successfully treated porn-induced ED and porn-induced loss of sexual desire.
Lehmiller’s sleight of hand: Lehmiller carefully selected two mismatched studies, with data separated by 18 years, in an attempt to convince the reader that ED rates have always been around 8% for men under 40:
1) The “way things were study” from 1992 is the one that asked: “Did you have trouble maintaining or achieving an erection any timein the last year?” Rates of yes to this question were between 7-9%.
2) The “modern study” with 2010-12 data that asked whether men had trouble getting or keeping an erection for a period of three or more months during the last year.” This study reported the following rated of sexual functioning problems in 16-21 year old males:
Lacked interest in having sex: 10.5%
Difficulty reaching climax: 8.3%
Difficulty achieving or maintaining an erection: 7.8%
Lehmiller “summarized” these findings for the vision-impaired as he tried to mislead them:
“Although these data were collected in different Western countries and the question wording differed, it’s striking how similar the figures are considering that the data were collected 20 years apart. This suggests that perhaps rates of ED aren’t on the rise among young men after all.”
Sorry Justin, but the questions are not “worded differently”; they are completely different questions. The 1992 study asked whether over the course of the last year at any point you had trouble getting it up. This includes when you were drunk, sick, just wanked three times in a row, experienced performance anxiety, whatever. I’m surprised it’s only 7-9%. In contrast, the 2010 study asked whether you had a persistent problem of erectile dysfunction over a period of three months or more: this was for 16-21 year olds, not men 39 and under!
As one recovery-forum member observed, Justin Lehmiller’s “science analysis” is Buzzfeed level clickbait, not science journalism.
But you may ask: Why are the ED rates about 8% in the 2010-2012 study, yet 14-37% in the 9 other studies published since 2010?
First, 8% isn’t low, as that would translate in a 600%-800% increase for men under 40.
Second, it wasn’t men under 40 – it was 16 to 21 year olds, so virtually none of them should have chronic ED.
Third, unlike the other 9 studies that employed anonymous surveys, this study used face to face in-home interviews. (It’s quite possible that adolescents would be less than fully forthcoming under such circumstances.)
The study gathered its data between August, 2010 and September, 2012. Studies reporting a significant rise in under-25 ED first appeared in 2011. More recent studies on the 25 and under crowd report higher rates (see this 2014 study on Canadian adolescents).
Many of the other studies used the IIEF-5 or IIEF-6, which assess sexual problems on a scale, as opposed to the simple yes or no (in the past 3 months) employed in the Lehmiller’s chosen paper.
Before leaving this topic, it would be well to look at some of the most irrefutable research that demonstrates a radical rise in ED rates over a decade using very large samples (which increase reliability). All the men were assessed using the same (yes/no) question about ED, as part of the Global Study of Sexual Attitudes and Behavior (GSSAB), administered to 13,618 sexually active men in 29 countries. That occurred in 2001-2002.
A decade later, in 2011, the same “sexual difficulties” (yes/no) question from the GSSAB was administered to 2,737 sexually active men in Croatia, Norway and Portugal. The first group, in 2001-2002, wereaged 40-80. The second group, in 2011, were 40 and under.
Based on the findings of prior studies one would predict the older men would have far higher ED scores than the younger men, whose scores should have been negligible. Not so. In just a decade, things had changed radically. The 2001-2002 ED rates for men 40-80 were about 13% in Europe. By 2011, ED rates in Europeans, ages 18-40, ranged from 14-28%!
What changed in men’s sexual environment during this time? Well, major changes were internet penetration and access to porn videos (followed by access to streaming porn in 2006, and then smartphones on which to view it). In the 2011 study on Croatians, Norwegians and Portuguese, the Portuguese had the lowest rates of ED and the Norwegians had the highest. In 2013, internet penetration rates in Portugal were only 67%, compared with 95% in Norway.
However, pornography consumption was associated with lower interpersonal satisfaction outcomes in cross-sectional surveys, longitudinal surveys, and experiments. Associations between pornography consumption and reduced interpersonal satisfaction outcomes were not moderated by their year of release or their publication status.
1) The Dual Control Model – The Role Of Sexual Inhibition & Excitation In Sexual Arousal And Behavior (2007) – This was the first study on porn-induced sexual problems (by the Kinsey Institute). In an experiment employing standard video porn that had “worked” in the past, 50% of the young men now couldn’t become aroused or achieve erections with porn (average age was 29). The shocked researchers discovered that the men’s erectile dysfunction was,
related to high levels of exposure to and experience with sexually explicit materials.
The men experiencing erectile dysfunction had spent a considerable amount of time in bars and bathhouses where porn was “omnipresent” and “continuously playing.” The researchers stated:
Conversations with the subjects reinforced our idea that in some of them a high exposure to erotica seemed to have resulted in a lower responsivity to “vanilla sex” erotica and an increased need for novelty and variation, in some cases combined with a need for very specific types of stimuli in order to get aroused.
“We assume that subjects with a high porn consumption need increasing stimulation to receive the same amount of reward. That could mean that regular consumption of pornography more or less wears out your reward system. That would fit perfectly the hypothesis that their reward systems need growing stimulation.”
3) Adolescents and web porn: a new era of sexuality (2015) – This Italian study analyzed the effects of internet porn on high school seniors, co-authored by urology professor Carlo Foresta, president of the Italian Society of Reproductive Pathophysiology. The most interesting finding is that 16% of those who consume porn more than once a week report abnormally low sexual desire, as compared with 0% in non-consumers – which is exactly what you would expect for 18-year old men.
4) Patient Characteristics by Type of Hypersexuality Referral: A Quantitative Chart Review of 115 Consecutive Male Cases (2015) – A study on men (average age 41.5) with hypersexuality disorders, such as paraphilias, chronic masturbation or adultery. 27 of the men were classified as “avoidant masturbators,” meaning they masturbated to porn for one or more hours per day, or more than 7 hours per week. Findings: 71% of the men who chronically masturbated to porn reported sexual functioning problems, with 33% reporting delayed ejaculation (often a precursor to porn-induced ED).
“Among participants who responded to the open-ended question (n=718), problematic usage was self-identified by 88 respondents. Male participants who reported problematic usage of pornography highlighted effects in three areas: on sexual function, arousal and relationships.”
The theme of this section, repeated throughout the article, is Prause/Klein/Kohut making bold yet unsupported pronouncements in the face of overwhelming empirical evidence to the contrary.
EXCERPT #5: Another lesson in how to manipulate data and bury findings
SLATE EXCERPT: Amazingly, the first nationally representative peer-reviewed study on sex-film viewing was only just published in 2017 in Australia. This study found that 84 percent of men and 54 percent of women had ever viewed sexual material. Overall, 3.69 percent of men (144 of 3,923) and 0.65 percent of women (28 of 4,218) in the study believed that they were “addicted” to pornography, and only half of this group reported that using pornography had any negative impact on their lives.
With pro-porn researcher Alan McKee as an author of the study named here it’s not surprising the lead headline was buried away in the study’s tables, while a cleverly worded abstract leaves the reader with the impression that only a small percentage of porn users believe porn is having a bad effects. McKee has a long history of defending porn. He authored “The Porn Report”, which an ABC analysis said was “on an ideological mission to provide an apologia for the sex industry”.
In fact, ABC revealed that: “The project on which the book is based was funded by the Australian Research Council from 2002 to 2004, and was conducted in liaison with, and with support from, the peak Australian sex industry organisation, the Eros Association, along with pornography businesses such as Gallery Entertainment and Axis Entertainment.” (emphasis supplied)
So what key finding was buried in the Australian study? 17% of males and females aged 16-30 reported that using pornography had a bad effect on them. It’s important to note that the data is 6 years old (2012), and the questions are based purely upon self-perception. Keep in mind that addicts rarely see themselves as addicted. In fact, most internet porn users are unlikely to connect symptoms to porn use unless they quit for an extended period. Here’s a screenshot of Table 5 (results):
How different would the headlines from this study have been if the authors had emphasized their key finding that nearly 1 in 5 young people believed that porn use had a “bad effect on them”? Why did they attempt to downplay this finding by ignoring it and focusing on cross-sectional results – rather than the millennial group most at risk for internet problems?
Here are a few additional reasons to take the headlines with a grain of salt:
This was a cross-sectional representative study spanning age groups 16-69, males and females. It’s well established that young men are the primary users of internet porn. So, 25% of the men and 60% of the women had not viewed porn at least once in the last 12 months. Thus the statistics gathered minimize the problem by veiling the at-risk users.
The single question, which asked participants if they had used porn in the last 12 months, doesn’t meaningfully quantify porn use. For example, a person who bumped into a porn site pop-up is grouped with someone who masturbates 3 times a day to hardcore porn.
However, when the survey inquired of those who “had ever viewed porn” which ones had viewed porn in the past year, the highest percentage was the teen group. 93.4% of them had viewed in the last year, with 20-29 year olds just behind them at 88.6.
Data was gathered between October 2012 and November 2013. Things have changed a lot in the last 4 years thanks to smartphone penetration – especially in younger users.
Questions were asked in computer-assisted telephone interviews. It’s human nature to be more forthcoming in completely anonymous interviews, especially when interviews are about sensitive subjects such as porn use and porn-related problems.
The questions are based purely upon self-perception. Keep in mind that addicts rarely see themselves as addicted. In fact, most internet porn users are unlikely to connect their symptoms to porn use unless they first quit for an extended period.
The study did not employ standardized questionnaires (given anonymously), which would more accurately have assessed both porn addiction and porn’s effects on users.
What’s the data from recent studies where all participants intentionally viewed internet porn at least once in the last, say, 3-6 months, or even the last year?
Emotion Regulation and Sex Addiction among College Students (2017): The study utilized the SAST-R “Core Scale” to assess sexual addiction. Among a sample of 337 college students, 57 (16.9 %) scored in the clinical range of sexual addiction. Breaking this down by gender, 17.8% of males and 15.5% of females in the sample surpassed the clinical cutoff.
EXCERPT #6: Study reveals that self-delusion is widespread in Canada
SLATE EXCERPT: Interestingly, even among the minority of users who believe they are “addicted” to pornography, remission may be spontaneous: A study following people over time found that 100 percent of women and 95 percent of men concerned about their frequent sexual behaviors (again, not assessed clinically) no longer felt that they were addicted to sex within five years despite no documented intervention.
First spin: Contrary to the excerpt, the Canadian study did not ask participants if “they believed themselves to be addicted.” Instead, once a year (2006 to 2011) participants were asked “whether their over-involvement in the behavior had caused significant problems for them in the past 12 months”. The six behaviors were: exercise, shopping, online chat, video gaming, eating or sexual behaviors. The Slate excerpt is referring to the percentage of participants who thought they had a significant problem in ALL 5 years.
Second spin: Contrary to the excerpt all the problematic sexual behaviors were lumped together into one category – like the ICD-11 has done with CSBD. There was no “remission from porn addiction” as no participant was asked if they believed themselves to be addicted to pornography.
Third spin: Contrary to the spin, problematic sexual behaviors were the most stable excessive problem, which is remarkable as it is well established that for many libido tends to fall with age. Excerpt from study:
Our data suggested that in the vast majority of cases the reported problem behaviors were transient (Table 3). Within the subsample of respondents reporting a given problem behavior, most participants reported the given excessive behavior only once during the 5-year study period. Even the most stable problem behavior (excessive sexual behavior) was reported five times only by 5.4% of those males who reported having difficulties with this problem behavior.
The study also reveals that far more people actually have a problem than perceive they have a problem: In a clear example of self-delusion only 38 out of the 4,121 participants thought they had a problem with eating (answering ‘yes’ in 4 out of 5 years). In other words, less than 1%of Canadians believe their eating habits are causing them problems or are disordered. How could this be when 30% of adult Canadians are obese, while another 43% are overweight? Let’s not forgot the remaining 27% of Canadians who are not overweight, yet may be dealing with an eating disorder, such as anorexia nervosa or bulimia.
How could more than 99% of Canadians believe their eating habits are of no concern, when the majority of them appear to have a problem? And what does the finding really tell us about this type of study? Maybe it’s not that individuals rarely have problematic behaviors, or that troublesome behaviors fade away. Maybe, it’s exposing what is commonly acknowledged: we humans are really good at lying to ourselves.
In several places Prause/Klein/Kohut utilize various tactics to convince the reader that porn use has no effects of intimate relationships. They must be employing the tried and true political strategy of “attack your opponents strength,” but it won’t work. We will repeatedly cite the current state of the peer-reviewed literature and expose their subterfuge. In this excerpt suggesting that porn isn’t “bad for relationships” they cite only a single article, in Dutch, which is not peer-reviewed.
When evaluating the research, it’s important to know that coupled females who regularly use internet porn (and can thus report on its effects) make up a relatively small percentage of all porn users. Large, nationally representative data are scarce, but the General Social Survey reported that only 2.6% of all US women had visited a “pornographic website” in the last month. The question was only asked in 2002 and 2004 (see Pornography and Marriage, 2014). Sure, porn use by younger women may have increased since 2004. Still, however, studies reporting that more porn use is correlated to greater satisfaction in women are referring to a relatively small percentage of women (perhaps only 1-2% of the female population). For example, below is a graph from one the few studies to report that more porn use is related to greater satisfaction in females.
It’s important to note that “Full” refers to males and females combined. Since the “Full” and “Men” lines are nearly identical, this tells us that almost all the frequent porn users at the far end were males. In other words the women who use 2-3 times a month or more probably comprise only 1-2% of all females. This would align with the 2004 nationally representative study mentioned above where only 2.4% of women had visited a porn site in the last month.
This raises several unanswered questions: What characteristics do the 1%-2% of female porn users have that leads to greater use, yet greater satisfaction? Are they into BDSM or other kinks? Are they in polyamorous relationships? Do these women possess extremely high libidos or have an addiction to porn? Whatever the reason for high levels of porn use in a tiny fraction of women, does this really tell us anything about the effects of regular porn on the other 98-99% of adult women?
The 2 studies did not assess if compulsive porn users had trouble controlling their porn use – as the excerpt falsely implies. Instead, the two studies had subjects watch a bit of porn, instructing them to attempt reduce their sexual arousal. The studies compared subjects’ scores on a sex addiction test with subjects’ ability to control their sexual arousal while watching a short clip of vanilla porn. The results for both studies were all over the place, with no clear cut correlations between the sex addiction test and the ability to inhibit one’s arousal.
The Prause/Klein/Kohut assertion is that subjects scoring highest on the sex addiction test should score lowest on controlling their arousal. Since there was no clear cut correlation in the 2 studies then “porn addiction must not exist.” Here’s why this is nonsense:
1) As stated, the studies did not assess subject’s “ability to control porn use despite negative consequences,” only transient arousal in a lab setting with a bunch of strangers in white coats lurking about.
2) The studies did not assess which participants were or were not “porn addicts” – as the researchers only used “sex addiction” questionnaires. For example, Prause’s study relied upon the CBSOB, which has zero questions about internet porn use. It only asks about “sexual activities,” or if subjects are worried about their activities (e.g., “I am worried I am pregnant,” “I gave someone HIV,” “I experienced financial problems”). Thus any correlations between scores on the CBSOB and ability to regulate arousal are irrelevant for internet porn use.
3)Most importantly: Even though neither study identified which participants were porn addicts, Prause/Klein/Kohut seem to claim that actual “porn addicts” should be the least able to control their sexual arousal while viewing porn. Yet why would they think porn addicts should have “higher arousal’ when Prause et al., 2015 reported that more frequent porn users had less brain activation to vanilla porn than did controls? (Incidentally, another EEG study similarly found that greater porn use in women correlated with less brain activation to porn.) The findings of Prause et al. 2015 align with Kühn & Gallinat (2014), which found that more porn use correlated with less brain activation in response to pictures of vanilla porn, and with Banca et al. 2015, which found faster habituation to sexual images in porn addicts.
It is not uncommon for frequent porn users to develop tolerance, which is the need for greater stimulation in order to achieve the same level of arousal. Vanilla porn can become boring. A similar phenomenon occurs in substance abusers who require bigger “hits” to achieve the same high. With porn users, greater stimulation is often achieved by escalating to new or extreme genres of porn. A recent study found that such escalation is very common in today’s internet porn users. 49% of the men surveyed had viewed porn that “was not previously interesting to them or that they considered disgusting.” In fact, multiple studies have reported findings consistent habituation or escalation in frequent porn users – an effect entirely consistent with the addiction model.
Key point: The authors’ entire claim rests upon the unsupported prediction that “porn addicts” should experience greater sexual arousal to static images of vanilla porn, and thus less ability to control their arousal. Yet the prediction that compulsive porn users would experience greater arousal to vanilla porn and greater sexual desire has repeatedly been refuted by several lines of research:
25 studies refute the claim that sex and porn addicts “have high sexual desire.”
28 studies link porn use to lower sexual arousal or sexual dysfunctions with sex partners.
Relevant: In another example of agenda-driven bias, Prause claimed that her 2015 results of lower brain activation in response to vanilla porn had completely “debunked porn addiction.” Eight peer-reviewed papers disagree with Prause. All say that Prause et al., 2015 actually found desensitization/habituation in frequent porn users (which is consistent with the addiction model): 1, 2, 3,4,5, 6, 7, 8.
A single paper, co-authored by Nicole Prause, was cited to support the claim that porn use has no effects on sexual functioning (“…..nor with their erectile functioning.“) Before we address this heavily criticized paper (Prause & Pfaus), let’s review the evidence in support of porn-induced sexual dysfunctions.
As detailed in Excerpt #3 above, nine studies published since 2010 reveal a tremendous rise in erectile dysfunction. This is documented in this lay article and in this peer-reviewed paper involving 7 US Navy doctors: Is Internet Pornography Causing Sexual Dysfunctions? A Review with Clinical Reports (2016). Prior to 2001 erectile dysfunction rates for men under 40 hovered around 2-3%. Since 2010 ED rates range from 14% to 37%, while rates for low libido ranged from 16% to 37%. Other than the advent of streaming porn no variable related to youthful ED has appreciably changed in the last 10-20 years.
The recent jump in sexual problems coincides with the publication of 26 studies linking porn use and “porn addiction” to sexual problems and lower arousal to sexual stimuli. It’s important to note that the first 5 studies in the list demonstrate causation, as participants eliminated porn use and healed chronic sexual dysfunctions. For some strange reason the Slate article fails to mention any of these 26 studies.
Prause & Pfaus did not support its claims: I provide the formal critique by Richard Isenberg, MD and a very extensive lay critique, followed by my comments and excerpts from Dr. Isenberg’s critique:
Prause & Pfaus 2015 wasn’t a study on men with ED. It wasn’t a study at all. Instead, Prause claimed to have gathered data from four of her earlier studies, none of which addressed erectile dysfunction. It’s disturbing that this paper by Nicole Prause and Jim Pfaus passed peer-review as the data in their paper did not match the data in the underlying four studies on which the paper claimed to be based. The discrepancies are not minor gaps, but gaping holes that cannot be plugged. In addition, the paper made several claims that were false or not supported by their data.
We begin with false claims made by both Nicole Prause and Jim Pfaus. Many journalists’ articles about this study claimed that porn use led to better erections, yet that’s not what the paper found. In recorded interviews, both Nicole Prause and Jim Pfaus falsely claimed that they had measured erections in the lab, and that the men who used porn had better erections. In the Jim Pfaus TV interview Pfaus states:
We looked at the correlation of their ability to get an erection in the lab.
We found a liner correlation with the amount of porn they viewed at home, and the latencies which for example they get an erection is faster.
In this radio interview Nicole Prause claimed that erections were measured in the lab. The exact quote from the show:
The more people watch erotica at home they have stronger erectile responses in the lab, not reduced.
Yet this paper did not assess erection quality in the lab or “speed of erections.” The paper only claimed to have asked guys to rate their “arousal” after briefly viewing porn (and it’s not clear from the underlying papers that this simple self-report was even asked of all subjects). In any case, an excerpt from the paper itself admitted that:
No physiological genital response data were included to support men’s self-reported experience”
In other words, no actual erections were tested or measured in the lab, which means that no such data or conclusions were peer-reviewed!
In a second unsupported claim, lead author Nicole Prause tweeted several times about the study, letting the world know that 280 subjects were involved, and that they had “no problems at home.” However, the four underlying studies contained only 234 male subjects, so “280” is way off.
A third unsupported claim: Dr. Isenberg’s Letter to the Editor (linked to above), which raised multiple substantive concerns highlighting the flaws in Prause & Pfaus , wondered how it could be possible for Prause & Pfaus to have compared different subjects’ arousal levels when three different types of sexual stimuli were used in the 4 underlying studies. Two studies used a 3-minute film, one study used a 20-second film, and one study used still images. It’s well established that films are far more arousing than photos, so no legitimate research team would group these subjects together to make claims about their responses. What’s shocking is that in their paper authors Prause and Pfaus unaccountably claim that all 4 studies used sexual films:
“The VSS presented in the studies were all films.”
This statement is false, as clearly revealed in Prause’s own underlying studies. This is the first reason why Prause and Pfaus cannot claim that their paper assessed “arousal.” You must use the same stimulus for each subject to compare all subjects.
A fourth unsupported claim: Dr. Isenberg also asked how Prause & Pfaus 2015 could compare different subjects’ arousal levels when only 1 of the 4 underlying studies used a 1 to 9 scale. One used a 0 to 7 scale, one used a 1 to 7 scale, and one study did not report sexual arousal ratings. Once again Prause and Pfaus inexplicably claim that:
“Men were asked to indicate their level of “sexual arousal” ranging from 1 “not at all” to 9 “extremely.”
This statement, too, is false, as the underlying papers show. This is the second reason why Prause and Pfaus cannot claim that their paper assessed “arousal” ratings in men. A study must use the same rating scale for each subject to compare the subjects’ results. In summary, all the Prause-generated headlines and claims about porn use improving erections or arousal, or anything else, are unsupported by her research.
Authors Prause and Pfaus also claimed they found no relationship between erectile functioning scores and the amount of porn viewed in the last month. As Dr. Isenberg pointed out:
Even more disturbing is the total omission of statistical findings for the erectile function outcome measure. No statistical results whatsoever are provided. Instead the authors ask the reader to simply believe their unsubstantiated statement that there was no association between hours of pornography viewed and erectile function. Given the authors’ conflicting assertion that erectile function with a partner may actually be improved by viewing pornography the absence of statistical analysis is most egregious.
As is customary when a letter critical of a study is published, the study’s authors were given a chance to respond. Prause’s pretentious response entitled “Red Herring: Hook, Line, and Stinker” not only evades Isenberg’s points (and Gabe Deem’s), it contains several new misrepresentations and several transparently false statements. In fact, Prause’s reply is little more than smoke, mirrors, groundless insults, and falsehoods. This extensive critique by Gabe Deem exposes the Prause and Pfaus response for what it is: A critique of the Prause & Pfaus response to Richard Isenberg’s letter.
Summary: The 2 core claims made by Klein/Kohut/Prause remain unsupported:
Prause & Pfaus failed to provide data for its core claim that porn use was not related to scores on an erection questionnaire (IIEF).
Prause & Pfaus failed to explain how its authors could reliably assess “arousal” when the 4 underlying studies used different stimuli (still images vs. films), and use no scale or very different number scales (1-7, 1-9, 0-7, no scale).
If Prause and Pfaus had answers to the above concerns, they would have put them in their response to Dr. Isenberg. They didn’t.
EXCERPT #9: When confronted with hundreds of studies linking porn use to negative outcomes just shout “correlation is not causation”
SLATE EXCERPT: However, a core problem with this area of research is that the overwhelming majority of studies are cross-sectional, meaning they just ask about your life as it is now. This means that they cannot show causality. Remember the old “correlation is not causation” principle from science class? If your marriage is not going well or you stopped being intimate years ago, chances are good that someone in that relationship is masturbating to sate their unfulfilled sexual desire.
Translation: “You are getting very, very sleepy…your eyelids are getting heavy… no matter what 58 studies on porn use relationships reveal, it’s really masturbation…. You are now asleep.… it can’t be porn….porn is good for you…. it must be masturbation…. Go deeper asleep, deeper asleep.”
On to the “correlation doesn’t equal causation” mantra that any 7th grader can recite. When confronted with hundreds of studies linking porn use to negative outcomes, a common tactic by pro-porn PhDs is to claim that “no causation has been demonstrated.” The reality is that when it comes to psychological and medical studies, very little research reveals causationdirectly. For example, all studies on the relationship between lung cancer and cigarette smoking in humans are correlative. Yet cause and effect are now clear to everyone but the tobacco lobby.
For ethical reasons, researchers are usually precluded from constructing experimental research designs that would reveal definitively whether pornography causes certain harms. Therefore, they use correlational models. Over time, when a significant body of correlational studies is amassed in any given research area, there comes a point where the body of evidence can be said to demonstrate a point of theory, despite a lack of the ideal, but often unethical to conduct, experimental studies.
Put another way, no single correlation study may ever provide a “smoking gun” in an area of study, but the converging evidence of multiple correlational studies can establish cause and effect. When it comes to porn use, nearly every study published is correlative.
To “prove” that porn use is causing erectile dysfunction, relationship problems, emotional problems or addiction-related brain changes you would have to have two large groups of identical twins separated at birth. Make sure one group never watches porn. Make sure that every individual in the other group watches the exact same type of porn, for the exact same hours, at the exact same age. And continue the experiment for 30 years or so, followed by assessment of the differences.
Alternatively, research attempting to demonstrate causation could be done using the following 3 methods:
Eliminate the variable whose effects you wish to measure. Specifically, have porn users stop, and assess any changes weeks, months (years?) later. This is exactly what is occurring as thousands of young men stop porn as a way to alleviate chronic non-organic erectile dysfunction and other symptoms (caused by porn use).
Perform longitudinal studies, which means following subjects over a period of time to see how changes in porn use (or levels of porn use) relate to various outcomes. For example, correlate levels of porn use with rates of divorce over years (asking other questions to control for other possible variables).
Expose willing participants to pornography and measure various outcomes. For example, assess subjects’ ability to delay gratification both before and after exposure to porn in a lab setting.
Below we list studies that have employed these 3 methods: elimination porn use, longitudinal studies, exposure to pornography in a lab. All of the results strongly suggest that porn use leads to negative outcomes.
Section #1: Studies where participants eliminated porn use:
The first 5 studies in this section demonstrate porn use causing sexual problems as participants eliminated porn use and healed chronic sexual dysfunctions. Thus, the debate about whether porn-induced sexual dysfunctions exist has been settled for some time now.
1) Is Internet Pornography Causing Sexual Dysfunctions? A Review with Clinical Reports (2016): An extensive review of the literature related to porn-induced sexual problems. Co-authored by 7 US Navy doctors (urologists, psychiatrists, and an MD with PhD in neuroscience), the review provides the latest data revealing a tremendous rise in youthful sexual problems. It also reviews the neurological studies related to porn addiction and sexual conditioning via internet porn. The authors provide 3 clinical reports of men who developed porn-induced sexual dysfunctions. Two of the three men healed their sexual dysfunctions by eliminating porn use. The third man experienced little improvement as he was unable to abstain from porn use.
2) Male masturbation habits and sexual dysfunctions (2016): Authored by a French psychiatrist and president of the European Federation of Sexology. The paper revolves around his clinical experience with 35 men who developed erectile dysfunction and/or anorgasmia, and his therapeutic approaches for helping them. The author states that most of his patients used porn, with a quarter of them being addicted to porn. The abstract points to internet porn as the primary cause of patients’ problems. 19 of the 35 men saw significant improvements in sexual functioning. The other men either dropped out of treatment or were still trying to recover.
3) Unusual masturbatory practice as an etiological factor in the diagnosis and treatment of sexual dysfunction in young men (2014): One of the 4 case studies in this paper reports on a man with porn-induced sexual problems (low libido, fetishes, anorgasmia). The sexual intervention called for a 6-week abstinence from porn and masturbation. After 8 months the man reported increased sexual desire, successful sex and orgasm, and enjoying “good sexual practices. This is the first peer-reviewed chronicling of a recovery from porn-induced sexual dysfunctions.
4) How difficult is it to treat delayed ejaculation within a short-term psychosexual model? A case study comparison (2017): This is a report on two “composite cases” illustrating the etiology and treatments for delayed ejaculation (anorgasmia). “Patient B” represented multiple young men treated by the therapist. Patient B’s “porn use had escalated into harder material,” “as is often the case.” The paper says that porn-related delayed ejaculation is not uncommon, and on the rise. The author calls for more research on porn’s effects on sexual functioning. Patient B’s delayed ejaculation was healed after 10 weeks of no porn.
5) Situational Psychogenic Anejaculation: A Case Study (2014): The details reveal a case of porn-induced anejaculation. The husband’s only sexual experience prior to marriage was frequent masturbation to pornography (where he was able to ejaculate). He also reported sexual intercourse as less arousing than masturbation to porn. The key piece of information is that “re-training” and psychotherapy failed to heal his anejaculation. When those interventions failed, therapists suggested a complete ban on masturbation to porn. Eventually this ban resulted in successful sexual intercourse and ejaculation with a partner for the first time in his life.
8) Trading Later Rewards for Current Pleasure: Pornography Consumption and Delay Discounting (2015): The more pornography that participants consumed, the less able they were to delay gratification. This unique study also had porn users attempt to reduce porn use for 3 weeks. The study found that continued porn use was causally related to greater inability to delay gratification (note that the ability to delay gratification is a function of the brain’s prefrontal cortex).
Section #2: Longitudinal studies:
All but two of the longitudinal studies examined the effects of porn use on intimate relationships
3) Does Viewing Pornography Reduce Marital Quality Over Time? Evidence from Longitudinal Data (2016). Excerpt: This study is the first to draw on nationally representative, longitudinal data (2006-2012 Portraits of American Life Study) to test whether more frequent pornography use influences marital quality later on and whether this effect is moderated by gender. In general, married persons who more frequently viewed pornography in 2006 reported significantly lower levels of marital quality in 2012, net of controls for earlier marital quality and relevant correlates. Pornography’s effect was not simply a proxy for dissatisfaction with sex life or marital decision-making in 2006. In terms of substantive influence, frequency of pornography use in 2006 was the second strongest predictor of marital quality in 2012.
4) Till Porn Do Us Part? Longitudinal Effects of Pornography Use on Divorce, (2016). The study used nationally representative General Social Survey panel data collected from thousands of American adults. Excerpt: Beginning pornography use between survey waves nearly doubled one’s likelihood of being divorced by the next survey period, from 6 percent to 11 percent, and nearly tripled it for women, from 6 percent to 16 percent. Our results suggest that viewing pornography, under certain social conditions, may have negative effects on marital stability.
6) Pornography Use and Marital Separation: Evidence from Two-Wave Panel Data (2017). Excerpt: analyses showed that married Americans who viewed pornography at all in 2006 were more than twice as likely as those who did not view pornography to experience a separation by 2012, even after controlling for 2006 marital happiness and sexual satisfaction as well as relevant sociodemographic correlates. The relationship between pornography use frequency and marital separation, however, was technically curvilinear.
7) Are Pornography Users More Likely to Experience A Romantic Breakup? Evidence from Longitudinal Data (2017). Excerpt: analyses demonstrated that Americans who viewed pornography at all in 2006 were nearly twice as likely as those who never viewed pornography to report experiencing a romantic breakup by 2012, even after controlling for relevant factors such as 2006 relationship status and other sociodemographic correlates. Analyses also showed a linear relationship between how frequently Americans viewed pornography in 2006 and their odds of experiencing a breakup by 2012.
1) Effect of Erotica on Young Men’s Aesthetic Perception of Their Female Sexual Partners (1984). Excerpt: After exposure to beautiful females, mates’ aesthetic value fell significantly below assessments made after exposure to unattractive females; this value assumed an intermediate position after control exposure. Changes in mates’ aesthetic appeal did not correspond with changes in satisfaction with mates, however.
2) Effects of Prolonged Consumption of Pornography on Family Values (1988). Excerpt: Exposure prompted, among other things, greater acceptance of pre- and extramarital sex and greater tolerance of nonexclusive sexual access to intimate partners. Exposure lowered the evaluation of marriage, making this institution appear less significant and less viable in the future. Exposure also reduced the desire to have children and promoted the acceptance of male dominance and female servitude. With few exceptions, these effects were uniform for male and female respondents as well as for students and nonstudents.
3) Pornography’s Impact on Sexual Satisfaction (1988). Excerpt: Male and female students and nonstudents were exposed to videotapes featuring common, nonviolent pornography or innocuous content. Exposure was in hourly sessions in six consecutive weeks. In the seventh week, subjects participated in an ostensibly unrelated study on societal institutions and personal gratifications. [Porn use] strongly impacted self-assessment of sexual experience. After consumption of pornography, subjects reported less satisfaction with their intimate partners—specifically, with these partners’ affection, physical appearance, sexual curiosity, and sexual performance proper. In addition, subjects assigned increased importance to sex without emotional involvement. These effects were uniform across gender and populations.
4) Influence of popular erotica on judgments of strangers and mates (1989). Excerpt: In Experiment 2, male and female subjects were exposed to opposite sex erotica. In the second study, there was an interaction of subject sex with stimulus condition upon sexual attraction ratings. Decremental effects of centerfold exposure were found only for male subjects exposed to female nudes. Males who found the Playboy-type centerfolds more pleasant rated themselves as less in love with their wives.
5) Pornographic picture processing interferes with working memory performance (2013): German scientists have discovered that Internet erotica can diminish working memory. In this porn-imagery experiment, 28 healthy individuals performed working-memory tasks using 4 different sets of pictures, one of which was pornographic. Participants also rated the pornographic pictures with respect to sexual arousal and masturbation urges prior to, and after, pornographic picture presentation. Results showed that working memory was worst during the porn viewing and that greater arousal augmented the drop.
6) Sexual Picture Processing Interferes with Decision-Making Under Ambiguity (2013): Study found that viewing pornographic imagery interfered with decision making during a standardized cognitive test. This suggests porn might affect executive functioning, which is a set of mental skills that help you get things done. These skills are controlled by an area of the brain called the prefrontal cortex.
9) Exposure to Sexual Stimuli Induces Greater Discounting Leading to Increased Involvement in Cyber Delinquency Among Men (Cheng & Chiou, 2017): In two studies exposure to visual sexual stimuli resulted in: 1) greater delayed discounting (inability to delay gratification), 2) greater inclination to engage in cyber-delinquency, 3) greater inclination to purchase counterfeit goods and hack someone’s Facebook account. Taken together this indicates that porn use increases impulsivity and may reduce certain executive functions (self-control, judgment, foreseeing consequences, impulse control).
EXCERPT #10: Prause/Klein/Kohut cherry-pick 5% of subjects from 1 of the 58 studies linking porn use to poorer relationships
SLATE EXCERPT: Longitudinal studies following people over time at least show if sex-film viewing occurred before a proposed effect, which is necessary to suggest that sex films caused the effect. For example, one longitudinal study showed that, on average, sex-film viewing increased the risk of relationship loss later. Till Porn Do Us Part? A Longitudinal Examination of Pornography Use and Divorce. However, another study found that married Americans with the highest frequencies of sex-film use actually were at the lowest risk for losing their relationship (a nonlinear effect).
The tactic here is to fool the reader into thinking that the research investigating porn’s effects on relationships is conflicted. They do this by acknowledge the existence of one study linking porn to relationship troubles (out of the 58 studies linking porn use to poorer relationship), followed by cherry-picking the only study reporting an outlier result – for a small percentage of its subjects (5% of subjects).
Drawing on data from the 2006 and 2012 waves of the nationally representative Portraits of American Life Study, this article examined whether married Americans who viewed pornography in 2006, either at all or in greater frequencies, were more likely to experience a marital separation by 2012. Binary logistic regression analyses showed that married Americans who viewed pornography at all in 2006 were more than twice as likely as those who did not view pornography to experience a separation by 2012, even after controlling for 2006 marital happiness and sexual satisfaction as well as relevant sociodemographic correlates. The relationship between pornography use frequency and marital separation, however, was technically curvilinear. The likelihood of marital separation by 2012 increased with 2006 pornography use to a point and then declined at the highest frequencies of pornography use.
The actual results. Grouped together, the pornography users (either the men or the women) were more than twice as likely to experience a marital separation 6 years later. Specifically, for 95% of the subjects, porn use in 2006 was related with an increased likelihood of marital separation in 2012. However, once porn use frequency reached several times a week or more (only 5% of subjects) the likelihood of separation was about the same as for those who didn’t use porn.
As pointed out under excerpt #7 correlations at the far end of the bell curve may not predict results for the vast majority of porn users. In this mixed bag of 2-5% of frequent users we may find a much higher percentage of couples who identify as swingers or polyamorous. They may have open marriages. Maybe the couple has an understanding that the partner can use as much porn as desired, but divorce is never an option. Whatever the reason for high levels of porn use in one or both partners, it’s clear from this study and all the rest, that the outliers don’t line up with the vast majority of couples.
By the way, all the other longitudinal studies confirm that porn use is related poorer relationship outcomes.
Does Viewing Pornography Reduce Marital Quality Over Time? Evidence from Longitudinal Data (2016). Excerpt: This study is the first to draw on nationally representative, longitudinal data (2006-2012 Portraits of American Life Study) to test whether more frequent pornography use influences marital quality later on and whether this effect is moderated by gender. In general, married persons who more frequently viewed pornography in 2006 reported significantly lower levels of marital quality in 2012, net of controls for earlier marital quality and relevant correlates. Pornography’s effect was not simply a proxy for dissatisfaction with sex life or marital decision-making in 2006. In terms of substantive influence, frequency of pornography use in 2006 was the second strongest predictor of marital quality in 2012.
Are Pornography Users More Likely to Experience A Romantic Breakup? Evidence from Longitudinal Data (2017). Excerpt: analyses demonstrated that Americans who viewed pornography at all in 2006 were nearly twice as likely as those who never viewed pornography to report experiencing a romantic breakup by 2012, even after controlling for relevant factors such as 2006 relationship status and other sociodemographic correlates. Analyses also showed a linear relationship between how frequently Americans viewed pornography in 2006 and their odds of experiencing a breakup by 2012.
How the study linked to supports this talking point is anyone’s guess. Perhaps they think the reader will misread this as “porn viewing leads to greater desire for sex with a real person that is sustained for several months.” But that’s not what the study reported.
This was a study about mechanisms behind compulsive behaviors (overeating and compulsive sexual behaviors). The study found that greater cue-reactivity to porn correlated with greater cravings to have sex and masturbate six months later. The study did not assess “desire to be with a partner.” It only assessed cravings to masturbate and have sex, which wasn’t limited to a single partner. The study found similar results for food: subjects with greater cue-reactivity to images of enticing food gained the most weight over the next six months. From the study’s abstract:
These findings suggest that heightened reward responsivity in the brain to food and sexual cues is associated with indulgence in overeating and sexual activity, respectively, and provide evidence for a common neural mechanism associated with appetitive behaviors.
This study supports the addiction model, as subjects with the greatest cue-reactivity (reward center activity) in response to porn experienced greater cravings to act out six months later. It appears these individuals had become sensitized to pornography, which manifested as both cue-reactivity and cravings to use. Addiction researchers view sensitizationas the core brain change that leads to compulsive consumption and ultimately addiction. (See “The incentive sensitization theory of addiction”)
Sensitized pathways can be thought of as Pavlovian conditioning on turbos. When activated by thoughts or triggers, sensitized pathways blast the reward circuit, firing up hard-to-ignore cravings. Several recent brain studies on porn users assessed sensitization, and all reported the same brain response as seen in alcoholics and drug addicts. As of 2018 some 20 studies have reported findings consistent with sensitization (cue-reactivity or cravings) in porn users and porn addicts: 1,2,3,4, 5,6,7,8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20.
It’s important to note that sensitization is not a sign of true libido or desire to get close to a partner. Instead, it’s evidence of hyper-sensitivity to memories or cues related to the behavior. For example, cues – such as turning on the computer, seeing a pop-up, or being alone – may trigger intense, hard to ignore cravings to view porn. Studies reveal that compulsive porn users can have greater cue-reactivity or cravings for porn, and yet experience low sexual desire and erectile dysfunction with real partners. For example, in the Cambridge University brain scan studies on porn addicts the subjects had greater brain activation to porn, but many reported arousal/erectile problems with partners. From the 2014 Cambridge study:
[Compulsive sexual behaviour] subjects reported that as a result of excessive use of sexually explicit materials…..they experienced diminished libido or erectile function specifically in physical relationships with women (although not in relationship to the sexually explicit material).
“My mind still boggles at the Prause claim that her subjects’ brains did not respond to sexual images like drug addicts’ brains respond to their drug, given that she reports higher P300 readings for the sexual images. Just like addicts who show P300 spikes when presented with their drug of choice. How could she draw a conclusion that is the opposite of the actual results?”
In line with the Cambridge University brain scan studies, Steele et al. 2013 also reported greater cue-reactivity to porn correlating with less desire for partnered sex. To put it another way, individuals with greater brain activation to porn would rather masturbate to porn than have sex with a real person. Shockingly, study spokesperson Prause claimed that porn users merely had “high libido,” yet the results of the study say the exact opposite (subjects’ desire for partnered sex dropped in relation to their porn use). Five peer-reviewed papers explain the truth: 1, 2, 3,4, 5, 6. Also see this extensive YBOP critique.
In summary, a frequent porn user can experience higher subjective arousal (cravings) yet also experience erection problems with a partner. Arousal in response to porn is not evidence of “sexual responsiveness” or healthy erectile function with a partner.
EXCERPT #12: Even David Ley thinks your citation is questionable
SLATE EXCERPT: Experimental studies can demonstrate if porn viewing really causes negative relationship effects by including controls. The first large, preregistered experiment found that viewing sexual pictures did not diminish love or desire for the current romantic partner.
First, it’s absurd to claim that “Experimental studies can demonstrate if porn viewing really causes negative relationship effects.” Experiments where college-aged guys view a few Playboy centerfolds (as in the study linked to by the authors) can tell you nothing about the effects of your husband masturbating to hard-core videos clips day after day for years on end. The only relationship studies that can “demonstrate if porn viewing really causes negative relationship effects” are longitudinal studies that control for variables or studies where subjects abstain from porn. To date seven longitudinal relationship studies have been published that reveal the real-life consequences of ongoing porn use. All reported that porn use relates to poorer relationship/sexual outcomes:
The 2017 study attempted to replicate a 1989 study that exposed men and women in committed relationships to erotic images of the opposite sex. The 1989 study found that men who were exposed to the nude Playboy centerfolds rated their partners as less attractive and reported less love for their partner. As the 2017 failed to replicate the 1989 findings, we are told that the 1989 study got it wrong, and that porn use cannot diminish love or desire. Whoa! Not so fast.
The replication “failed” because our cultural environment has become “pornified.” The 2017 researchers didn’t recruit 1989 college students who grew up watching MTV after school. Instead their subjects grew up surfing PornHub for gang bang and orgy video clips.
In 1989 how many college students had seen an X-rated video? Not too many. How many 1989 college students spent every masturbation session, from puberty on, masturbating to multiple hard-core clips in one session? None. The reason for the 2017 results is evident: brief exposure to a still image of a Playboy centerfold is a big yawn compared to what college men in 2017 have been watching for years. Even the authors admitted the generational differences with their first caveat:
1) First, it is important to point out that the original study was published in 1989. At the time, exposure to sexual content may not have been as available, whereas today, exposure to nude images is relatively more pervasive, and thus being exposed to a nude centerfold may not be enough to elicit the contrast effect originally reported. Therefore, the results for the current replication studies may differ from the original study due to differences in exposure, access, and even acceptance of erotica then versus now.
In a rare instance of unbiased prose even David Ley felt compelled to point out the obvious:
It may be that the culture, men, and sexuality have substantially changed since 1989. Few adult men these days haven’t seen pornography or nude women—nudity and graphic sexuality are common in popular media, from Game of Thrones to perfume advertisements, and in many states, women are permitted to go topless. So it’s possible that men in the more recent study have learned to integrate the nudity and sexuality they see in porn and everyday media in a manner which doesn’t affect their attraction or love for their partners. Perhaps the men in the 1989 study had been less exposed to sexuality, nudity, and pornography.
Keep in mind that this experiment doesn’t mean internet porn use hasn’t affected men’s attraction for their lovers. It just means that looking at “centerfolds” has no immediate impact these days. Many men report radical increases in attraction to partners after giving up internet porn. And, of course, there is also the longitudinal evidence cited above demonstrating the deleterious effects of porn viewing on relationships.
Once again, Prause/Klein/Kohut provide a dubious, cherry-picked result in a feeble attempt to counter the preponderance of studies reporting porn use linked to divorce, breakups, and poorer sexual and relationship satisfaction.
Finally, it’s important to note that the authors of the paper linked to are colleagues of Taylor Kohut at the University of Western Ontario. This group of researchers, headed by William Fisher, has been publishing questionable studies, which consistently produce results that on the surface appear to counter the vast literature linking porn use to myriad negative outcomes. Moreover, both Kohut and Fisher played big roles in the defeat of Motion 47 in Canada.
Here are two recent studies from Kohut, Fisher and colleagues at Western Ontario that garnered widespread and misleading headlines:
In their 2017 study, Kohut, Fisher and Campbell appear to have skewed the sample to produce the results they were seeking. Whereas most studies show that a tiny minority of porn users’ female partners use porn, in this study 95% of the women used porn on their own (85% of the women had used porn since the beginning of the relationship). Those rates are higher than in college-aged men, and far higher than in any other porn study! In other words, the researchers appear to have skewed their sample to produce the results they were seeking. Reality: Cross-sectional data from the largest US survey (General Social Survey) reported that only 2.6% of women had visited a “pornographic website” in the last month.
In addition, Kohut’s study asked only “open ended” questions where subjects could ramble on about porn. The researchers read the ramblings and decided, after the fact, what answers were “important” (fit their desired narrative?). In other words, the study did not correlate porn use with any objective, scientific variable assessment of sexual or relationship satisfaction (as did the nearly 60 studies that show porn use in linked to negative effects on relationships). Everything reported in the paper was included (or excluded) at the unchallenged discretion of the authors.
Taylor Kohut co-authors framed egalitarianismas: Support for (1) Abortion, (2) Feminist identification, (3) Women holding positions of power, (4) Belief that family life suffers when the woman has a full-time job, and oddly enough (5) Holding more negative attitudes toward the traditional family. Secular populations, which tend to be more liberal, have far higher rates of porn use than religious populations. By choosing these criteria and ignoring endless other variables, lead author Kohut and his co-authors knew they would end up with porn users scoring higher on this study’s carefully chosen selection of what constitutes “egalitarianism.” Then the authors chose a title that spun it all. In reality, these findings are contradicted by nearly every other published study. (See this list of over 25 studies linking porn use to sexist attitudes, objectification and less egalitarianism.)
Note: This 2018 presentation exposes the truth behind 5 questionable and misleading studies, including the two studies just discussed: Porn Research: Fact or Fiction?
Another Nicole Prause paper. Viewing porn, becoming horny, and then wanting to get off, is hardly a remarkable finding. This “laboratory finding” tells us nothing about the long-term effects of porn use on relationships (again, almost 60 studies – and every study on men – link porn use to less sexual and relationship satisfaction). This experiment is akin to evaluating the effects of alcohol by asking bar patrons if they feel good after their first couple of beers. Does this onetime assessment tell us anything about their mood the next morning or the long-term effects of chronic alcohol use?
Not surprisingly, Dr. Prause omitted the rest of her study’s findings:
Viewing the erotic films also induced greater reports of negative affect, guilt, and anxiety
Negative affect means negative emotions. Prause has resorted to cherry-picking her own results.
EXCERPT #14: In order to protect porn, let’s blame masturbation for all the negative effects linked to porn
SLATE EXCERPT: While one study reported that reducing pornography consumption increased commitment to a partner, no study has yet shown that this was due to the sex films themselves and not some other confounding variable, such as differences in masturbation that resulted from adjusting viewing habits. In our view, there are not yet compelling data to confirm that sexual arousal via sex films always decreases desire for the regular sex partner; certainly, under some conditions, sex films appear to stoke the fire at home.
Actually, the vast preponderance of the evidence demonstrates convincingly that as pornography consumption increases, relationship and sexual satisfaction decline. This isn’t a case of some studies “say yes” and some studies “say no”, as every study on males and porn use (55 studies) links greater porn use to decreased sexual or relationship satisfaction. In fact, a recent study pointed out that for men, porn use that was more frequent than once per month correlated with reduced sexual satisfaction. (For women, the cut off was even lower. Use that was more frequent than “several times per year” was associated with reduced sexual satisfaction.)
Also, the porn-commitment study cited above actually did show that viewing porn was the most likely cause of reduced commitment in those who viewed more porn. It is one of the few studies to ask people to (attempt to) eliminate porn use (for 3 weeks) to compare the effects with a control group. Incidentally some of the same researchers published another study comparing delayed discounting in those who temporarily tried to quit porn as well. They found that the more porn participants viewed the less able they were to defer gratification. The
It’s ironic that sexologists like Klein, Prause and Kohut are so bent on defending porn use that they’re willing to imply that masturbation causes relationship problems! (Prause and colleague Ley have also claimed masturbation causes chronic ED in young men – without a shred of medical or other evidence)
Yet at the same time Prause has long insisted publicly that masturbation is an unqualified benefit. So, which is it? Here these authors point the finger at masturbation as the cause of relationship problems, but they offer no formal evidence supporting their hunch. It seems their claim that “it’s masturbation” is only a convenient red herring whenever actual scientific evidence demonstrates that more porn use correlates problems.
Take the example of pornography. Thinking about ways to gain access to it, or actively searching for it, and perhaps experiencing desire during the process, is considered sexual wanting. Watching selected pornographic material, even without masturbation, can be considered “having sex” when there is genital arousal.
Humanity urgently needs researchers who will use sound science (and neuroscience) to investigate human sexuality and the effects of today’s unique sexual environment. Not propagandists serving up red herrings.
SLATE EXCERPT: Speaking to the heart of the issue, one of the biggest problems for some porn users is shame. Shame about viewing sex films is heaped on the public by the sex-addiction treatment industry (for profit), by the media (for clickbait), and by religious groups (to regulate sexuality). Unfortunately, whether you believe porn viewing is appropriate or not, stigmatizing sex-film viewing may be contributing to the problem. In fact, anincreasing number of studiesshow that many people who identify as “porn addicted” do not actually view sex films more than other people. They simply feel more shame about their behaviors, which is associated with growing up in a religious or sexually restrictive society.
The response to excerpt #15 has been combined with the response to excerpt #19 below, as both deal with a single pornography questionnaire (CPUI-9) and the mythology surrounding it and the studies that employ it.
Note: The core claim in the above excerpt is false as there is only one study that directly correlated self-identification as a porn addict with hours of use, religiousness and moral disapproval of porn use. Its findings contradict the carefully constructed narrative about “perceived addiction” (that “porn addiction is just religious shame/moral disapproval”) – which is grounded in studies employing the flawed instrument called the CPUI-9. In the only direct-correlation study, the strongest correlation with self-perception as an addict was with hours of porn use. Religiousness was irrelevant, and while there was predictably some correlation between self-perception as an addict and moral incongruence regarding porn use, it was roughly half the hours-of-use correlation.
EXCERPT #16: Compulsivity is not synonymous with the “Compulsive Sexual Behavior Disorder” diagnosis in the ICD-11
SLATE EXCERPT: It is very important to note that compulsivity is not an umbrella term that includes addiction. Addiction, compulsivity, and impulsivity are all different models with different patterns of response that require different treatments. For example, addiction models predict withdrawal symptoms, but compulsivity models do not predict withdrawal. Impulsivity models predict a strong aversion to delaying decisions or delaying expected pleasure, whereas compulsivity models predict rigid, methodical perseverance.
Once again Prause/Klein/Kohut attempt a clever sleight of hand. They want you to believe that “compulsivity” is synonymous with the Compulsive Sexual Behavior Disorder diagnosis, and that therefore the ICD-11 intended to prevent healthcare givers from using it to diagnose those with porn and sex addiction. However, these terms are not synonymous, which means we could disregard excerpt #17 and its muddled attempts to confuse the reader.
Yet we want to unpack this excerpt further because addiction-deniers like Prause/Klein/Kohut and their colleagues seem to have a bit of a compulsion themselves. They insist on relabeling problematic porn use as a “compulsion” – thus implying that it can never be an “addiction.”
RE: “compulsivity is not an umbrella term that includes addiction.” Depends on whom you ask, but such a question is irrelevant to the ICD-11 Compulsive Sexual Behavior Disorder diagnosis. The use of “Compulsive” in the new ICD-11 diagnosis isn’t meant to denote the neurological underpinnings of CSBD: “continued repetitive sexual behaviour despite adverse consequences.” Instead “Compulsive,” as used in the ICD-11, is a descriptive term that’s been in use for years, and is often employed interchangeably with “addiction.” (For example a Google scholar search for compulsion + addiction returns 130,000 citations.)
Excerpt #17 preys on general ignorance of a well established fact: The ICD and DSM systems are descriptive, largely atheoretical classification systems. They rely on the presence or absence of specific signs and symptoms to establish diagnoses. In other words, the ICD and DSM stay away from endorsing any particular biological theory underlying a mental disorder, whether for depression, schizophrenia, alcoholism, or CSBD.
Thus, whatever you or your healthcare giver want to call it – “hypersexuality,” “porn addiction,” “sex addiction,” “out-of-control sexual behavior,” “cybersex addiction” – if the behaviors fall within the “Compulsive Sexual Behaviour Disorder” description, the condition can be diagnosed using the ICD-11 CSBD diagnosis.
Incidentally, as the press release of the Society for the Advancement of Sexual Health explained, the Compulsive Sexual Behavior Disorder is under “impulse control disorders” for now but that may change as it did for Gambling Disorder.
For now, the parent category of the new CSBD diagnosis is Impulse Control Disorders, which includes diagnoses such as Pyromania [6C70], Kleptomania [6C71] and Intermittent Explosive Disorder [6C73]. Yet doubts remain about the ideal category. As Yale neuroscientist Marc Potenza MD PhD and Mateusz Gola PhD, researcher at the Polish Academy of Sciences and the University of California San Diego point out, “The current proposal of classifying CSB disorder as an impulse-control disorder is controversial as alternate models have been proposed …There are data suggesting that CSB shares many features with addictions.” 7
It might be worth noting that ICD-11 includes diagnoses of Gambling Disorder under both Disorders Due to Addictive Behaviors and under Impulse Control Disorders. Thus, categorization of disorders need not always be mutually exclusive.5 Classification may also shift with time. Gambling Disorder was originally classified as an impulse disorder in both the DSM-IV and the ICD-10, but based on advances in empirical understanding, Gambling Disorder has been reclassified as a “Substance-Related and Addictive Disorder” (DSM-5) and a “Disorder Due to Addictive Behaviour” (ICD-11). It is possible that this new CSBD diagnosis may follow a similar developmental course as Gambling Disorder has.
While CSBD looks like an addiction and quacks like an addiction, it starts out in the “Impulse Control Disorders” for political reasons. Politics aside, neuroscientists who publish brain studies on CSB subjects strongly believe its rightful home is with other addictions. From the Lancet commentary, Is excessive sexual behaviour an addictive disorder? (2017):
Compulsive sexual behaviour disorder seems to fit well with non-substance addictive disorders proposed for ICD-11, consistent with the narrower term of sex addiction currently proposed for compulsive sexual behaviour disorder on the ICD-11 draft website. We believe that classification of compulsive sexual behaviour disorder as an addictive disorder is consistent with recent data and might benefit clinicians, researchers, and individuals suffering from and personally affected by this disorder.
By the way, even if “Compulsive Sexual Behaviour Disorder” is eventually moved to the “Disorder Due to Addictive Behaviour” section it will still likely be called “Compulsive Sexual Behaviour Disorder.” Again, “compulsivity” is not synonymous with the diagnosis of CSBD.
First, the link goes to a confused paper that proposes a theoretical “sex addiction” model that just happens to mirror normal sexual patterns of feeling horny, doing the deed, and not feeling longer horny. The model:
Specifically, the sexhavior cycle suggests that the cycle of sexual behavior comprises four distinct and sequential stages described as sexual urge, sexual behavior, sexual satiation, and post-sexual satiation.
That’s it. This inspires me to announce my theoretical model of food intake, with four sequential stages: feeling hungry, urge to eat, eating, feeling full and stopping. The journal solicited commentaries on this proposed “sexhavior cycle.” I recommend this one: Separating Models Obscures the Scientific Underpinnings of Sex Addiction as a Disorder.
Second, addiction studies repeatedly report that addiction features elements of both impulsivity and compulsivity. (A Google Scholar search for addiction + impulsivity + compulsivity returns 22,000 citations.) Here are simple definitions of impulsivity and compulsivity:
Impulsivity: Acting quickly and without adequate thought or planning in response to internal or external stimuli. A predisposition to accept smaller immediate rewards over larger delayed gratification and an inability to stop a behavior toward gratification once it’s set in motion.
Compulsivity: Refers to repetitive behaviors that are performed according to certain rules or in a stereotypical fashion. These behaviors persevere even in the face of adverse consequences.
Third, the concern about different treatment requirements for each model is a red herring as the ICD-11 doesn’t endorse any particular treatment for CSBD or any other mental or physical disorder. That’s up to the healthcare practitioner. In his 2018 paper, “Compulsive sexual behavior: A nonjudgmental approach, CSBD workgroup member Jon Grant (the same expert whom Prause/Klein/Kohut misrepresented earlier) covered misdiagnosis, differential diagnosis, co-morbidities and various treatments options related to the new CSBD diagnosis. Incidentally, Grant says that Compulsive Sexual Behavior is also called “sex addiction” in that paper!
“It’s not an addiction, it’s a compulsion.” This brings us to the ‘compulsion’ versus ‘addiction’ discussion. Addiction and compulsion are both terms that have entered our everyday language. Like many words that are in common use, they may be misused and misunderstood.
In arguing against the concept of behavioral addictions, especially porn addiction, skeptics often claim that pornography addiction is a ‘compulsion’ and not a true ‘addiction’. Some even insist that addiction is “like” Obsessive-Compulsive Disorder (OCD). When further pressed as to how a ‘compulsion to use X’ differs neurologically from an ‘addiction to X’, a common comeback by these uninformed skeptics is that “behavioral addictions are simply a form of OCD.” Not true.
Obsessive-compulsive spectrum disorders have been considered to conceptualize sexual compulsivity (40) because some studies have found individuals with hypersexual behavior are on the obsessive-compulsive disorder (OCD) spectrum. OCD for hypersexual behavior is not consistent with DSM-5 (1) diagnostic understandings of OCD, which exclude from the diagnosis those behaviors from which individuals derive pleasure. Although obsessive thoughts of the OCD type often have sexual content, the associated compulsions performed in response to the obsessions are not carried out for pleasure. Individuals with OCD report feelings of anxiety and disgust rather than sexual desire or arousal when confronted with situations triggering obsessions and compulsions, with the latter being performed only to quell uneasiness the obsessive thoughts arouse. (41)
Few studies have examined associations between compulsivity and hypersexuality. Among males with nonparaphilic hypersexual disorder [CSBD], the lifetime prevalence of obsessive-compulsive disorder—a psychiatric disorder characterized by compulsivity—ranges from 0% to 14%
Obsessiveness—which may be associated with compulsive behavior—in treatment-seeking men with hypersexuality has been found to be elevated relative to a comparison group, but the effect size of this difference was weak. When the association between the level of obsessive-compulsive behavior—assessed by a subscale of the Structured Clinical Interview for DSM-IV (SCID-II) —and the level of hypersexuality was examined among treatment-seeking males with hypersexual disorder, a trend toward a positive, weak association was found. On the basis of the aforementioned results, compulsivity appears to contribute in a relatively small manner to hypersexuality [CSBD].
In one study, general compulsivity was examined in relation to problematic pornography use among men, showing positive but weak associations. When investigated in a more complex model, the relationship between general compulsivity and problematic pornography use was mediated by sexual addiction and Internet addiction, as well as an addiction more generally. Taken together, the associations between compulsivity and hypersexuality and compulsivity and problematic use appear relatively weak.
There is a current debate regarding how best to consider problematic sexual behaviors (such as hypersexuality and problematic pornography use), with competing models proposing classifications as impulse-control disorders, obsessive-compulsive spectrum disorders, or behavioral addictions. Relationships between transdiagnostic features of impulsivity and compulsivity and problematic sexual behaviors should inform such considerations, although both impulsivity and compulsivity have been implicated in addictions.
The finding that impulsivity related moderately to hypersexuality provides support both for the classification of compulsive sexual behavior disorder (as proposed for ICD-11; World Health Organization as an impulse-control disorder or as a behavioral addiction. In considering the other disorders currently being proposed as impulse-control disorders (e.g., intermittent explosive disorder, pyromania, and kleptomania) and the central elements of compulsive sexual behavior disorder and proposed disorders due to addictive behaviors (e.g., gambling and gaming disorders), the classification of compulsive sexual behavior disorder in the latter category appears better supported. (Emphasis supplied)
Finally, all the physiological and neuropsychological studies published on porn users and porn addicts (often denoted as CSB) report findings consistent with the addiction model (as do studies reporting escalation or tolerance).
In 2016 George F. Koob and Nora D. Volkow published their landmark review in The New England Journal of Medicine: Neurobiologic Advances from the Brain Disease Model of Addiction. Koob is the Director of the National Institute on Alcohol Abuse and Alcoholism (NIAAA), and Volkow is the director of the National Institute on Drug Abuse (NIDA). The paper describes the major brain changes involved with both drug and behavioral addictions, while stating in its opening paragraph that sexual behavioral addictions exist:
We conclude that neuroscience continues to support the brain disease model of addiction. Neuroscience research in this area not only offers new opportunities for the prevention and treatment of substance addictions and related behavioral addictions (e.g., to food, sex, and gambling)….
EXCERPT #17: Porn users experience both withdrawal and tolerance
SLATE EXCERPT: For example, addiction models predictwithdrawal symptoms, but compulsivity models do not predict withdrawal. Impulsivity models predicta strong aversion to delaying decisions or delaying expected pleasure, whereas compulsivity models predict rigid, methodical perseverance.
RE: withdrawal symptoms. The fact is, withdrawal symptoms are not required to diagnose an addiction. First, you will find the language “neither tolerance nor withdrawal is necessary or sufficient for a diagnosis…” in both the DSM-IV-TR and DSM-5. Second, claiming that “real” addictions cause severe life-threatening withdrawal symptoms conflates physiological dependence with addiction-related brain changes. An excerpt from this 2015 review of literature provides a more technical explanation (Neuroscience of Internet Pornography Addiction: A Review and Update):
A key point of this stage is that withdrawal is not about the physiological effects from a specific substance. Rather, this model measures withdrawal via a negative affect resulting from the above process. Aversive emotions such as anxiety, depression, dysphoria, and irritability are indicators of withdrawal in this model of addiction [43,45]. Researchers opposed to the idea of behaviors being addictive often overlook or misunderstand this critical distinction, confusing withdrawal with detoxification [46,47].
That said, internet porn research and numerous self-reports demonstrate that some porn users experience withdrawal and/or tolerance – which are often characteristic of addiction. In fact, ex-porn users regularly report surprisingly severe withdrawal symptoms, which are reminiscent of drug withdrawals: insomnia, anxiety, irritability, mood swings, headaches, restlessness, poor concentration, fatigue, depression, social paralysis and the sudden loss of libido that guys call the ‘flatline’ (apparently unique to porn withdrawal).
As for recent studies, consider this graph from a 2017 study reporting the development and testing of a problematic porn use questionnaire. Note that substantial evidence of both “tolerance” and “withdrawal” was found in at-risk users and low-risk users.
Regarding the assertion that, “Sex addiction” was specifically excluded from the ICD-11 for insufficient evidence, actually, no, it wasn’t. As explained elsewhere, neither the ICD-11 nor the APA’s DSM-5 ever uses the word “addiction” to describe an addiction – whether it be gambling addiction, or heroin addiction. Both diagnostic manuals title such diagnoses as “disorders” instead. (Details about the peculiar last-minute exclusion of “Hypersexual Disorder” from the DSM-5 are found above under Excerpt #1.) Thus, “sex addiction” was never formally considered for inclusion in either manual (and consequently never “rejected” either).
As for the first link, it goes to a short Business Insider article, not to an official WHO statement. That’s right. Popular media is all the Slate article offers to support the authors’ wishful thinking. Even so, Prause/Klein/Kohut should have read the article before relying on it, as the only scientist quoted states that sexual behavior addictions exist:
Endocrinologist Robert Lustig told Business Insider earlier this year that many activities that can bring feelings of pleasure, like shopping, eating, playing video games, using porn, and even using social media all have addictive potential when taken to extremes. “It does the same thing to your central nervous system as all those drugs do,” he said. “It just doesn’t do the peripheral nervous system part. That doesn’t make it not addiction. It’s still addiction, it’s just that it’s addiction without the peripheral effects.”
Why didn’t the Slate article link to a scientific journal, such as this 2017 Lancet commentary, co-authored by CSBD work-group member Shane Kraus, Ph.D? Well, because the Lancet commentary says the empirical evidence supports CSBD being classified as an addictive disorder:
We believe that classification of compulsive sexual behaviour disorder as an addictive disorder is consistent with recent data and might benefit clinicians, researchers, and individuals suffering from and personally affected by this disorder.
The ICD-11’s Compulsive Sexual Behavior Disorder diagnosis is under “impulse control disorders” for now, but that may change in the future, just as it did for Gambling Disorder. In this responsible article quoting WHO representatives, Kraus leaves open the possibility that CSBD will eventually be placed in the “Disorders Due to Addictive Behaviour” section of the World Health Organization’s diagnostic manual.
And as Kraus puts it, “This is definitely not the final solution, but it’s a good starting place for more research and treatment for people.”
Whatever you or your healthcare giver want to call it – “hypersexuality,” “porn addiction,” “sex addiction,” “out-of-control sexual behavior,” “cybersex addiction” – if the behaviors fall within the “Compulsive Sexual Behaviour Disorder” description, the condition can be diagnosed using ICD-11 the CSBD code.
Re: “six professional organizations.” Actually, the Slate article provided 3 links to “professional organizations” and one link to a 2012 David Ley blog post about the DSM-5 omitting Hypersexual Disorder (which was discussed under excerpt #1). Let’s take a closer look at this impressive-sounding support.
Link #1: Link goes to the infamous 2016 AASECT proclamation. AASECT is not a scientific organization and cited nothing to support the assertions in its own press release – rendering its opinion meaningless.
Finding AASECT’s tolerance of the “sex addiction model” to be “deeply hypocritical,” in 2014 Dr. Aaron set out to eradicate support for the concept of “sex addiction” from AASECT’s ranks. To accomplish his goal, Dr. Aaron claims to have deliberately sowed controversy among AASECT members in order to expose those with viewpoints that disagreed with his own, and then to have explicitly silenced those viewpoints while steering the organization toward its rejection of the “sex addiction model.” Dr. Aaron justified using these “renegade, guerilla [sic] tactics” by reasoning that he was up against a “lucrative industry” of adherents to the “sex addiction model” whose financial incentives would prevent him from bringing them over to his side with logic and reason. Instead, to effect a “quick change” in AASECT’s “messaging,” he sought to ensure that pro-sex addiction voices were not materially included in the discussion of AASECT’s course change.
Dr. Aaron’s boast comes across as a little unseemly. People rarely take pride in, much less publicize, suppressing academic and scientific debate. And it seems odd that Dr. Aaron spent the time and money to become CST certified by an organization he deemed “deeply hypocritical” barely a year after joining it (if not before). If anything, it is Dr. Aaron who appears hypocritical when he criticizes pro-“sex addiction” therapists for having a financial investment in the “sex addiction model”, when, quite obviously, he has a similar investment in promoting his opposing viewpoint
Several commentaries and critiques expose AASECT’s proclamation for what it truly is: sexual politics:
Link #2: Link goes to a statement by the Association for the Treatment of Sexual Abusers (ATSA). Nowhere does the position statement suggest that sex addiction does not exist. Instead ATSA reminds us that non-consensual sexual activity is sexual abuse (e.g., Harvey Weinstein) and “likely … not the result of sexual addiction.” Absolutely true.
Incidentally, it appears that both AASECT and the 3 kink organizations produced their proclamations in a desperate effort to stop the new “CSBD” diagnosis from going into the ICD-11. Evidently, the experts at the World Health Organization were not taken in by this jointly created paper tiger, as the new diagnosis appears in the implementation version of the ICD-11.
Link #4: Link goes to Sex Addiction: Rejected Yet Again by APA. Hypersexual Disorder Will NOT be Included in the DSM5. This David Ley post is noteworthy because it exemplifies the circular tactic employed throughout the Slate article by Ley’s close allies. When the DSM-5 rejected the umbrella diagnosis of “Hypersexual Disorder” Ley and his chums painted it as rejection of “Sex Addiction.” Yet when the ICD-11 included the umbrella diagnosis of “Compulsive Sexual Behavior Disorder” they painted it as excluding “Sex Addiction.” Why worry about internal inconsistencies, right? Just say black is white, and repeat in tweets, on listserves and Facebook and articles like this one by Klein/Kohut/Prause.
Next, back your spin up using an expensive PR firm. It can get you and your propaganda placed in dozens of different mainstream media outlets, touting you as world experts. It matters not if you aren’t an academic, haven’t been affiliated with a university for years, or obtained your PhD from an unaccredited sexology institution.
SLATE EXCERPT: Speaking to the heart of the issue, one of the biggest problems for some porn users is shame. Shame about viewing sex films is heaped on the public by the sex-addiction treatment industry (for profit), by the media (for clickbait), and by religious groups (to regulate sexuality). Unfortunately, whether you believe porn viewing is appropriate or not, stigmatizing sex-film viewing may be contributing to the problem. In fact, an increasing number of studiesshow that many people who identify as “porn addicted” do not actually view sex films more than other people. They simply feel more shame about their behaviors, which is associated with growing up in a religious or sexually restrictive society.
SLATE EXCERPT: The decision to include sexual compulsivity in ICD-11 strikes us as odd because the exact diagnostic criteria that were chosen have never been tested. Specifically, the ICD-11 asserts that anyone distressed about their frequent sexual behaviors due purely to “moral judgments and disapproval about sexual impulses, urges, or behaviours” should be excluded from diagnosis. However, moral judgments and disapproval are the strongest predictors of someone believing that they are addicted to pornography in the first place.
The following is a combined response to excerpts 15 and 19 as both deal with a single pornography questionnaire (CPUI-9) and the studies that employ it.
Note: The core claim put forth in both excerpts is false as there is only one study that directly correlated self-identification as a porn addict with hours of use, religiousness and moral disapproval of porn use.Its findings contradict the carefully constructed narrative about “perceived addiction” (that “porn addiction is just religious shame/moral disapproval”) – which is grounded in studies employing the
flawed instrument called the CPUI-9. In the only direct-correlation study, the strongest correlation with self-perception as an addict was with hours of porn use. Religiousness was irrelevant, and while there was predictably some correlation between self-perception as an addict and moral incongruence regarding porn use, it was roughly half the hours-of-use correlation.
Here we present a relatively short synopsis of the Joshua Grubbs questionnaire (CPUI-9), the myth of “perceived pornography addiction,” and what the relevant data actually reveal. Since this involves a complex and tangled web with many layers, these three articles and a presentation were produced to fully explain the CPUI-9 studies:
To understand how the only direct-correlation research undermines all of the CPUI-9 studies, more background is helpful. The phrase “perceived pornography addiction” indicates nothing more than a number: the total score on the following 9-item pornography-use questionnaire with its three extraneous questions. The key insight is that the CPUI-9 includes 3 “guilt and shame/emotional distress” questions not normally found in addiction instruments. These skew its results, causing religious porn users to score higher and non-religious users to score lower than subjects do on standard addiction-assessment instruments. It doesn’t sort the wheat from the chaff in terms of perceived vs. genuine addiction. Nor does the CPUI-9 assess actual porn addiction accurately.
Perceived Compulsivity Section
I believe I am addicted to Internet pornography.
I feel unable to stop my use of online pornography.
Even when I do not want to view pornography online, I feel drawn to it
Access Efforts Section
At times, I try to arrange my schedule so that I will be able to be alone in order to view pornography.
I have refused to go out with friends or attend certain social functions to have the opportunity to view pornography.
I have put off important priorities to view pornography.
Emotional Distress Section
I feel ashamed after viewing pornography online.
I feel depressed after viewing pornography online.
I feel sick after viewing pornography online.
Subjects never “label themselves as porn addicts” in any Grubbs study: They simply answer the 9 questions above, and earn a total score.
The term “perceived pornography addiction” is misleading in the extreme, because it’s just a meaningless score on an instrument that produces skewed results. But people have assumed they understood what “perceived addiction” meant. They presumed it meant that the CPUI-9’s creator, Grubbs, had figured out a way to distinguish actual “addiction” from “belief in addiction.” He hadn’t. He had just given a deceptive label to his “porn use inventory,” the CPUI-9. Grubbs has made no effort to correct the misperceptions about his work that rolled out into the media, pushed by anti-porn addiction sexologists and their media chums.
Misled journalists mistakenly summed up CPUI-9 findings as:
Believing in porn addiction is the source of your problems, not porn use itself.
Religious porn users are not really addicted to porn (even if they score high on the Grubbs CPUI-9) – they just have shame.
The Key: the Emotional Distress questions (7-9) cause religious porn users to score much higher and secular porn users to score far lower, as well as creating a strong correlation between “moral disapproval” and total CPUI-9 score (“perceived addiction”). To put it another way, if you use only results from CPUI-9 questions 1-6 (which assess the signs and symptoms of an actual addiction), the correlations dramatically change – and all the dubious articles claiming shame is the “real” cause porn addiction would never have been written.
Tips for understanding the numbers in the table: zero means no correlation between two variables; 1.00 means a complete correlation between two variables. The bigger the number the stronger the correlation between the 2 variables.
In this first correlation we see how moral disapproval correlates powerfully with the 3 guilt and shame questions (Emotional Distress), yet weakly with the two other sections that assess actual addiction (questions 1-6). The Emotional Distress questions cause moral disapproval to be the strongest predictor of total CPUI-9 scores (“perceived addiction”).
But if we use only the actual porn addiction questions (1-6), the correlation is pretty weak with Moral Disapproval (in science-speak, Moral Disapproval is a weak predictor of porn addiction).
The second half of the story is how the same 3 Emotional Distress correlate very poorly with levels of porn use, while the actual porn addiction questions (1-6) correlate robustly with porn use levels.
This is how the 3 Emotional Distress questions skew results. They lead to reduced correlations between “hours of porn use” and total CPUI-9 scores (“perceived addiction”). Next, the sum total of all 3 sections of the CPUI-9 test is deceptively re-labeled as “perceived addiction” by Grubbs. Then, at the hands of determined anti-porn-addiction activists, “perceived addiction” morphs into “self identifying as a porn addict.” The activists have pounced on the strong correlation with moral disapproval, which the CPUI-9 always produces, and presto! they now claim that, “a belief in porn addiction is nothing more than shame!”
It’s a house of cards built on 3 guilt and shame question not found in any other addiction assessment, in combination with the misleading term the questionnaire’s creator uses to label his 9 questions (as a measure of “perceived porn addiction”).
Second, our findings cast doubts on the suitability of the inclusion of the Emotional Distress subscale as part of the CPUI-9. As consistently found across multiple studies (e.g., Grubbs et al., 2015a,c), our findings also showed that frequency of IP use had no relationship with Emotional Distress scores. More importantly, actual compulsivity as conceptualized in the present study (failed abstinence attempts x abstinence effort) had no relationship with Emotional Distress scores.
Emotional Distress scores were significantly predicted by moral disapproval, in line with previous studies which also found a substantial overlap between the two (Grubbs et al., 2015a; Wilt et al., 2016)…. As such, the inclusion of the Emotional Distress subscale as part of the CPUI-9 might skew results in such a way that it inflates the total perceived addiction scores of IP users who morally disapprove of pornography, and deflates the total perceived addiction scores of IP users who have high Perceived Compulsivity scores, but low moral disapproval of pornography.
This may be because the Emotional Distress subscale was based on an original “Guilt” scale which was developed for use particularly with religious populations (Grubbs et al., 2010), and its utility with non-religious populations remains uncertain in light of subsequent findings related to this scale.
Here’s is the core finding: The 3 “Emotional Distress” questions have no place in the CPUI-9, or any porn addiction questionnaire. These guilt and shame questions do not assess distress surrounding addictive porn use or “perception of addiction.” These 3 questions merely artificially inflate total CPUI-9 scores for religious individuals while deflating total CPUI-9 scores for nonreligious porn addicts.
EXCERPT #20: A study accused of using porn stars as its subjects and funded by a controversial for-profit company trying to legitimize its very expensive sexual technique…yeah, that will debunk porn addiction
SLATE EXCERPT: More importantly, we have no laboratory studies about actual sexual behaviors in those who relabport this difficulty. The first study of partnered sexual behaviors in the laboratory, which tests the compulsivity model, is currently under peer review at a scientific journal. (Disclosure: One of this article’s co-authors, Nicole Prause, is the lead author of that study.) The World Health Organization should wait to see if any science supports their novel diagnosis before risking pathologizing millions of healthy people.
“We have no laboratory studies?” Not so. There are plenty of laboratory studies published on porn’s immediate effects on the viewer (listed in Excerpt #9). More importantly, there are 39 “laboratory studies” assessing brain functions and structures in porn users and those with CSB.
We also have hundreds of studies on adults linking real-life porn use to various negative outcomes such as lower relationship satisfaction, lower sexual satisfaction, divorce, marital separation, relationship breakups, lower levels of commitment, more negative communication, less sex, erectile dysfunctions, anorgasmia, low libido, delayed ejaculation, poorer concentration, poorer working memory, loneliness, depression, anxiety, interpersonal sensitivity, depression, paranoid thinking, psychoticism, addiction, narcissism, reduced happiness, difficulties in intimacy, less relationship trust, devaluation of sexual communication, romantic attachment anxiety, negative body attitude, greater dissatisfaction with muscularity, body fat and height, greater stress, more sexual concerns, less enjoyment of intimate behaviors, increased sexual boredom, less positive communication for both partners, diminished view of women’s competence/morality/humanity, loss of compassion toward women as rape victims, greater belief that women are sex objects, less progressive gender role attitudes, more hostile sexism, opposition to affirmative action, callousness toward sexual violence, thinking of women as entities that exist for men’s sexual gratification, higher adherence to belief that power over women is desirable, lower responsivity to “vanilla sex” erotica, an increased need for novelty and variety…. and a whole lot more.
We have over 200 studies on adolescents reporting that porn use is related to such factors as poorer academics, more sexist attitudes, more aggression, poorer health, poorer relationships, lower life satisfaction, viewing people as objects, increased sexual risk taking, less condom use, greater sexual violence, unexplained anxiety, greater sexual coercion, less sexual satisfaction, lower libido, greater permissive attitudes, social maladjustment, lower self-worth, lower health status, sexually aggressive behavior, addiction, greater gender role conflict, more avoidant and anxious attachment styles, antisocial behaviours, heavy drinking, fighting, ADHD symptoms, cognitive deficits, greater acceptance of pre- and extramarital sex, lower evaluation of marriage, promotion of the acceptance of male dominance and female servitude, less gender egalitarianism, more likely to believe rape myths and prostitution myth…. and a whole lot more.
Will Prause’s upcoming “laboratory study” negate hundreds of studies performed over the last few decades? Highly unlikely as we already know a great deal about her upcoming research on “partnered sexual behaviors.” Both Prause and the lucrative commercial enterprise that funded this research have been crowing about it for years.
In fact, all existing indications are that her partnered subjects will not be doing anything relevant to this article by Prause/Kohut/Klein. Here’s what we know about this as yet unpublished work: Prause was commissioned by the California company that her website lists as her major source of income, Orgasmic Meditation (also called ‘OM’ and ‘OneTaste’), to study the benefits of clitoral stroking. From Prause’s Liberos website:
Neurological effects and health benefits of orgasmic meditation” Principal Investigator, Direct costs: $350,000, Duration: 2 years, OneTaste Foundation, co-Investigators: Greg Siegle, Ph.D.
OneTaste charges high fees to attend workshops where participants learn “orgasmic meditation” (how to stroke women’s clitorises). This enterprise has recently received some unflattering, revealing publicity. Here are the news items:
The OM/OneTaste company plans to use Prause’s upcoming studies to “scale” their marketing up to new heights. According to the Bloomberg article The Dark Side of the Orgasmic Meditation Company,
The newish CEO is betting that the study OneTaste has funded on the health benefits of OM, which has taken brain-activity readings from 130 pairs of strokers and strokees, will draw fresh crowds. Led by researchers from the University of Pittsburgh, the study is expected to yield the first of multiple papers later this year. “The science that’s coming out to back what this is and what the benefits are is going to be huge in terms of scaling,” Van Vleck says
Regardless of the fact that Prause’s OM research business is addressing partnered clitoral stroking, she is already hinting (as here) or openly claiming (elsewhere) that it invalidates the ICD-11’s new “Compulsive sexual behavior disorder” (CSBD) diagnosis. (Much as her diametrically opposed results in her 2013 and 2015 studies both somehow debunked sex addiction.) In short, whatever research this scientist is hired to perform, you can bet she will claim it debunks porn and sex addiction, as well as the new CSBD that will be used to diagnose both!
Incidentally, where did Prause obtain subjects for her clitoral-stroking investigation? According to tweets by an adult performer, Prause obtained porn performers as OM study subjects, via the most powerful lobbying arm of the porn industry, the Free Speech Coalition. See this Twitter exchange between Prause and adult performer, Ruby the Big Rubousky, who is vice president of the Adult Performers Actors Guild (Prause has since deleted this thread):
Prause has been quick to accuse others of bias without supplying any hard evidence whatsoever, but her OM research is a powerful example of an egregious conflict of interest: taking hundreds of thousands of dollars to find benefits of a dubious, commercially driven practice…and possibly obtaining subjects via the most powerful lobbying arm of the porn industry. All while conveniently serving the porn industry by also claiming this research invalidates the new CSBD diagnosis that will be used for those suffering from compulsive sexual behaviors (more than 80% of whom report problems with internet pornography use).
Over 40 studies reporting findings consistent with escalation of porn use (tolerance), habituation to porn, and even withdrawal symptoms.
All the neurological studies published on porn users/sex addicts: 45 neuroscience studies (MRI, fMRI, EEG, neurospychological, hormonal) provide strong support for the addiction model.
Articles, interviews and videos citing over 130 experts (urology professors, urologists, psychiatrists, psychologists, sexologists, MDs) who acknowledge and have successfully treated porn-induced ED and porn-induced loss of sexual desire.
The Men’s Health articles featured Dr. Nicole Prause, a non-academic who’s extensive history of actively campaigning against porn-induced ED and porn addiction is well documented. Let’s begin with Prause’s string of misinformation and false assertions:
Most men watch porn, so the thought of missing out on actual sex because you watched too many X-rated videos is, understandably, a pretty terrifying prospect. We were a bit hesitant to use the experiences of just two men to generalize about a world full of men who watch porn, so we talked to a few sex researchers with Ph.D.s to get a few more details on whether your habit can cause serious problems with your sex life.
The verdict? There’s no scientific evidence that supports the idea of “porn-induced erectile dysfunction.”
“There are three laboratory studies that have shown sex film viewing is unrelated to erectile functioning,” said Nicole Prause, Ph.D., founder of Liberos, a sex research and biotechnology company in Los Angeles. (You can find those studies here, here, and here.)
“No study has ever linked the two,” she says. “The therapists are literally manufacturing the idea that these are connected in their patients.”
Um…it is patently false to claim that no study has linked porn use to sexual problems. In reality, there are now 37 studies linking porn use/porn addiction to sexual problems and lower arousal to sexual stimuli. It’s not just correlation studies: the first 7 studies in the list demonstrate causation, as participants eliminated porn use and healed chronic sexual dysfunctions. Put simply, porn-induced sexual problems exist because medical professionals asked young men to refrain from porn – and they healed chronic sexual problems (ED, Anorgasmia, delayed ejaculation, low sexual desire). Fact check anyone?
What about Prause’s claim concerning the 3 studies she cited:
“There are three laboratory studies that have shown sex film viewing is unrelated to erectile functioning.” (You can find those studies here, here, and here.)
First, none of the studies were “laboratory studies”, so ignore that claim. The first study listed actually supports the hypothesis that porn use causes sexual problems as 71% of the heavy porn users in the study had developed chronic sexual problems! This is another example of a journalist failing to fact-check, as journalists writing articles about pornography so often fail to do. The second and third papers (one wasn’t a study) on the list were roundly criticized in the peer-reviewed literature, with many questioning both findings and methodologies. Below we examine the 3 papers separately:
PAPER #1: Sutton et al., 2015:
Patient Characteristics by Type of Hypersexuality Referral: A Quantitative Chart Review of 115 Consecutive Male Cases (2015) – A study on men (average age 41.5) with hypersexuality disorders, such as paraphilias, chronic masturbation or adultery. 27 of the men were classified as “avoidant masturbators,” meaning they masturbated (typically with porn use) one or more hours per day, or more than 7 hours per week. 71% of the men who chronically masturbated to porn reported sexual functioning problems, with 33% reporting delayed ejaculation (often a precursor to porn-induced ED).
What sexual dysfunction do 38% of the remaining men have? The study doesn’t say, and the authors have ignored repeated requests for details. Two primary choices for male sexual dysfunction are ‘erectile dysfunction’ and ‘low libido’. It should be noted that the men were not asked about their erectile functioning without porn. This, if all their sexual activity involved masturbating to porn, and not sex with a partner, many might be unaware they had porn-induced ED. (For reasons known only to her, Prause chronically cites this paper as debunking the existence of porn-induced sexual dysfunctions.)
PAPER #2: Prause & Pfaus, 2015.
I provide the formal critique by Richard Isenberg, MD and a very extensive lay critique, followed by my comments and excerpts from the paper co-authored by US Navy doctors:
The reality behind Prause & Pfaus 2015: This wasn’t a study on men with ED. It wasn’t a study at all. Instead, Prause claimed to have gathered data from four of her earlier studies, none of which addressed erectile dysfunction. It’s disturbing that this paper by Nicole Prause and Jim Pfaus passed peer-review as the data in their paper did not match the data in the underlying four studies on which the paper claimed to be based. The discrepancies are not minor gaps, but gaping holes that cannot be plugged. In addition, the paper made several claims that were false or not supported by their data.
We begin with false claims made by both Nicole Prause and Jim Pfaus. Many journalists’ articles about this study claimed that porn use led to better erections, yet that’s not what the paper found. In recorded interviews, both Nicole Prause and Jim Pfaus falsely claimed that they had measured erections in the lab, and that the men who used porn had better erections. In the Jim Pfaus TV interview Pfaus states:
“We looked at the correlation of their ability to get an erection in the lab.”
“We found a liner correlation with the amount of porn they viewed at home, and the latencies which for example they get an erection is faster.”
In this radio interview Nicole Prause claimed that erections were measured in the lab. The exact quote from the show:
“The more people watch erotica at home they have stronger erectile responses in the lab, not reduced.”
Yet this paper did not assess erection quality in the lab or “speed of erections.” The paper only claimed to have asked guys to rate their “arousal” after briefly viewing porn (and it’s even not clear from the underlying papers that this simple self-report was asked of all subjects). In any case, an excerpt from the paper itself admitted that:
“No physiological genital response data were included to support men’s self-reported experience.”
In other words, no actual erections were tested or measured in the lab!
In a second unsupported claim, lead author Nicole Prause tweeted several times about the study, letting the world know that 280 subjects were involved, and that they had “no problems at home.” However, the four underlying studies contained only 234 male subjects, so “280” is way off.
A third unsupported claim: Dr. Isenberg’s Letter to the Editor (linked to above), which raised multiple substantive concerns highlighting the flaws in the Prause & Pfaus paper, wondered how it could be possible for Prause & Pfaus 2015 to have compared different subjects’ arousal levels when three different types of sexual stimuli were used in the 4 underlying studies. Two studies used a 3-minute film, one study used a 20-second film, and one study used still images. It’s well established that films are far more arousing than photos, so no legitimate research team would group these subjects together to make claims about their responses. What’s shocking is that in their paper Prause & Pfaus unaccountably claim that all 4 studies used sexual films:
“The VSS presented in the studies were all films.”
This statement is false, as clearly revealed in Prause’s own underlying studies. This is the first reason why Prause & Pfaus cannot claim that their paper assessed “arousal.” You must use the same stimulus for each subject to compare all subjects.
A fourth unsupported claim: Dr. Isenberg also asked how Prause & Pfaus 2015 could compare different subjects’ arousal levels when only 1 of the 4 underlying studies used a 1 to 9 scale. One used a 0 to 7 scale, one used a 1 to 7 scale, and one study did not report sexual arousal ratings. Once again Prause & Pfaus inexplicably claim that:
“Men were asked to indicate their level of “sexual arousal” ranging from 1 “not at all” to 9 “extremely.”
This statement, too, is false, as the underlying papers show. This is the second reason why Prause & Pfaus cannot claim that their paper assessed “arousal” ratings in men. A study must use the same rating scale for each subject to compare the subjects’ results. In summary, all the Prause-generated headlines about porn use improving erections or arousal, or anything else, are unwarranted.
Prause & Pfaus 2015 also claimed they found no relationship between erectile functioning scores and the amount of porn viewed in the last month. As Dr. Isenberg pointed out:
Even more disturbing is the total omission of statistical findings for the erectile function outcome measure. No statistical results whatsoever are provided. Instead the authors ask the reader to simply believe their unsubstantiated statement that there was no association between hours of pornography viewed and erectile function. Given the authors’ conflicting assertion that erectile function with a partner may actually be improved by viewing pornography the absence of statistical analysis is most egregious.
In the Prause & Pfaus response to the Dr. Isenberg critique, the authors once again failed to provide any data to support their “unsubstantiated statement.” As this analysis documents, the Prause & Pfaus response not only evades Dr. Isenberg’s legitimate concerns, it contains several new misrepresentations and several transparently false statements. Finally, a review of the literature I wrote with 7 Navy doctors commented on Prause & Pfaus 2015:
Our review also included two 2015 papers claiming that Internet pornography use is unrelated to rising sexual difficulties in young men. However, such claims appear to be premature on closer examination of these papers and related formal criticism. The first paper contains useful insights about the potential role of sexual conditioning in youthful ED [50]. However, this publication has come under criticism for various discrepancies, omissions and methodological flaws. For example, it provides no statistical results for the erectile function outcome measure in relation to Internet pornography use. Further, as a research physician pointed out in a formal critique of the paper, the paper’s authors, “have not provided the reader with sufficient information about the population studied or the statistical analyses to justify their conclusion” [51]. Additionally, the researchers investigated only hours of Internet pornography use in the last month. Yet studies on Internet pornography addiction have found that the variable of hours of Internet pornography use alone is widely unrelated to “problems in daily life”, scores on the SAST-R (Sexual Addiction Screening Test), and scores on the IATsex (an instrument that assesses addiction to online sexual activity) [52, 53, 54, 55, 56]. A better predictor is subjective sexual arousal ratings while watching Internet pornography (cue reactivity), an established correlate of addictive behavior in all addictions [52, 53, 54]. There is also increasing evidence that the amount of time spent on Internet video-gaming does not predict addictive behavior. “Addiction can only be assessed properly if motives, consequences and contextual characteristics of the behavior are also part of the assessment” [57]. Three other research teams, using various criteria for “hypersexuality” (other than hours of use), have strongly correlated it with sexual difficulties [15, 30, 31]. Taken together, this research suggests that rather than simply “hours of use”, multiple variables are highly relevant in assessment of pornography addiction/hypersexuality, and likely also highly relevant in assessing pornography-related sexual dysfunctions.
This review also highlighted the weakness in correlating only “current hours of use” to predict porn-induced sexual dysfunctions. The amount of porn currently viewed is just one of many variables involved in the development of porn-induced ED. These may include:
Ratio of masturbation to porn versus masturbation without porn
Ratio of sexual activity with a person versus masturbation to porn
Gaps in partnered sex (where one relies only on porn)
Virgin or not
Total hours of use
Years of use
Age started using porn voluntarily
Escalation to new genres
Development of porn-induced fetishes (from escalating to new genres of porn)
Level of novelty per session (i.e. compilation videos, multiple tabs)
Addiction-related brain changes or not
Presence of hypersexuality/porn addiction
The better way to research this phenomenon, is to remove the variable of internet porn use and observe the outcome, which was done in the case studies in which men removed internet porn use and healed. Such research reveals causation instead of fuzzy correlations open to conflicting interpretation. My site has documented a few thousand men who removed porn and recovered from chronic sexual dysfunctions.
As for the claim that Landripet & Štulhofer, 2015 found no relationships between porn use and sexual problems. This is not true, as documented in both this YBOP critique and the this review of the literature. Furthermore, Landripet & Štulhofer’s paper omitted three significant correlations they presented to a European conference (more below). Let’s start with the first of three paragraphs from our paper that addressed Landripet & Štulhofer, 2015:
A second paper reported little correlation between frequency of Internet pornography use in the last year and ED rates in sexually active men from Norway, Portugal and Croatia [6]. These authors, unlike those of the previous paper, acknowledge the high prevalence of ED in men 40 and under, and indeed found ED and low sexual desire rates as high as 31% and 37%, respectively. In contrast, pre-streaming Internet pornography research done in 2004 by one of the paper’s authors reported ED rates of only 5.8% in men 35–39 [58]. Yet, based on a statistical comparison, the authors conclude that Internet pornography use does not seem to be a significant risk factor for youthful ED. That seems overly definitive, given that the Portuguese men they surveyed reported the lowest rates of sexual dysfunction compared with Norwegians and Croatians, and only 40% of Portuguese reported using Internet pornography “from several times a week to daily”, as compared with the Norwegians, 57%, and Croatians, 59%. This paper has been formally criticized for failing to employ comprehensive models able to encompass both direct and indirect relationships between variables known or hypothesized to be at work [59]. Incidentally, in a related paper on problematic low sexual desire involving many of the same survey participants from Portugal, Croatia and Norway, the men were asked which of numerous factors they believed contributed to their problematic lack of sexual interest. Among other factors, approximately 11%–22% chose “I use too much pornography” and 16%–26% chose “I masturbate too often” [60]
As my co-authors, the Navy doctors, and I described, this paper found a rather important correlation: Only 40% of the Portuguese men used porn “frequently,” while the 60% of the Norwegians used porn “frequently.” The Portuguese men had far less sexual dysfunction than the Norwegians. With respect to the Croat subjects, Landripet & Štulhofer, 2015 acknowledge a statistically significant association between more frequent porn use and ED, but claim the effect size was small. However, this claim may be misleading according to an MD who is a skilled statistician and has authored many studies:
Analyzed a different way (Chi Squared), … moderate use (vs. infrequent use) increased the odds (the likelihood) of having ED by about 50% in this Croatian population. That sounds meaningful to me, although it is curious that the finding was only identified among Croats.
In addition, Landripet & Štulhofer 2015 omitted three significant correlations, which one of the authors presented to a European conference. He reported a significant correlation between erectile dysfunction and “preference for certain pornographic genres”:
Reporting a preference for specific pornographic genres were [sic] significantly associated with erectile (but not ejaculatory or desire-related) male sexual dysfunction.
It’s telling that Landripet & Štulhofer chose to omit this significant correlation between erectile dysfunction and preferences for specific genres of porn from their paper. It’s quite common for porn users to escalate into genres (or fetishes) that do not match their original sexual tastes, and to experience ED when these conditioned porn preferences do not match real sexual encounters. As we pointed out above, it’s very important to assess the multiple variables associated with porn use – not just hours in the last month or frequency in the last year.
The second significant finding omitted by Landripet & Štulhofer 2015 involved female participants:
Increased pornography use was slightly but significantly associated with decreased interest for partnered sex and more prevalent sexual dysfunction among women.
A significant correlation between greater porn use and decreased libido and more sexual dysfunction seems pretty important. Why didn’t Landripet & Štulhofer 2015 report that they found significant correlations between porn use and sexual dysfunction in women, as well as a few in men? And why haven’t these findings been reported in any of Štulhofer’s many studies arising from these same data sets? His teams seem very quick to publish data they claim debunks porn-induced ED, yet very slow to inform users about the negative sexual ramifications of porn use.
Finally, Danish porn researcher Gert Martin Hald’s formal critical comments echoed the need to assess more variables (mediators, moderators) than just frequency per week in the last 12 months:
The study does not address possible moderators or mediators of the relationships studied nor is it able to determine causality. Increasingly, in research on pornography, attention is given to factors that may influence the magnitude or direction of the relationships studied (i.e., moderators) as well as the pathways through which such influence may come about (i.e., mediators). Future studies on pornography consumption and sexual difficulties may also benefit from an inclusion of such focuses.
Bottom line: All complex medical conditions involve multiple factors, which must be teased apart before far-reaching pronouncements in the press are appropriate. Landripet & Štulhofer’s statement that, “Pornography does not seem to be a significant risk factor for younger men’s desire, erectile, or orgasmic difficulties” goes too far, since it ignores all the other possible variables related to porn use that might be causing sexual performance problems in users, including escalation to specific genres, which they found, but omitted from the “Brief Communication.” Paragraphs 2 & 3 in our discussion of Landripet & Štulhofer, 2015:
Again, intervention studies would be the most instructive. However, with respect to correlation studies, it is likely that a complex set of variables needs to be investigated in order to elucidate the risk factors at work in unprecedented youthful sexual difficulties. First, it may be that low sexual desire, difficulty orgasming with a partner and erectile problems are part of the same spectrum of Internet pornography-related effects, and that all of these difficulties should be combined when investigating potentially illuminating correlations with Internet pornography use.
Second, although it is unclear exactly which combination of factors may best account for such difficulties, promising variables to investigate in combination with frequency of Internet pornography use might include (1) years of pornography-assisted versus pornography-free masturbation; (2) ratio of ejaculations with a partner to ejaculations with Internet pornography; (3) the presence of Internet pornography addiction/hypersexuality; (4) the number of years of streaming Internet pornography use; (5) at what age regular use of Internet pornography began and whether it began prior to puberty; (6) trend of increasing Internet pornography use; (7) escalation to more extreme genres of Internet pornography, and so forth.
A 500% – 1000% increase in youthful ED since 2010 cannot be explained away by the usual factors
Prior to the advent of free streaming porn (2006), cross-sectional studies and meta-analysis consistently reported erectile dysfunction rates of 2-5% in men under 40. Erectile dysfunction rates in 9 studies published since 2010 range from 14% to 35%, while rates for low libido (hypo-sexuality) range from 16% to 37%. Some studies involve teens and men 25 and under, while other studies involve men 40 and under. One of the most dramatic recent examples (2018) is a survey of ED in porn actors. Those under 30 had twice the rate of ED as the older ones (whose sexuality developed without access to highspeed Internet porn during adolescence). See Erectile Dysfunction Among Male Adult Entertainers: A Survey.
In short there has been a 500%-1000% increase in youthful ED rates in the last 10 years. What variable has changed in the last 15 years that could account for this astronomical rise? Before confidently claiming that today’s porn consumers have nothing to worry about from Internet porn use, researchers still need to account for the very recent, sharp rise in youthful ED and low sexual desire, the many studies linking porn use to sexual problem, the thousands of self reports and clinician reports of men healing ED by eliminating a single variable: porn.
Men’s Health quotes Ian Kerner, but in the past Kerner stated that porn causes sexual problems!
In the Men’s Health article Kerner (who is an AASECT spokesman) twists and turns to avoid blaming porn, asserting that masturbation causes chronic ED in health young men:
Though there may not be a direct connection between watching porn and erectile dysfunction, there is an indirect one in that in certain cases masturbation can lead to erection issues. “In my clinical experience I do not find porn to be a direct cause of [erectile disorder, premature ejaculation, and delayed ejaculation]” explains Ian Kerner, Ph.D. and licensed psychotherapist and sexuality counselor.
Notice that Kerner cited nothing, because no urologist would agree with his unsupported claim that masturbation causes chronic ED in young men. Kerner, Prause, and David Ley have all contrived to misdirect the public away from porn as the true cause. YBOP wrote about this smoke & mirrors tactic here: Sexologists deny porn-induced ED by claiming masturbation is the problem (2016).
Before Ian Kerner became the chair of public relations for AASECT, he had a different opinion on porn-induced sexual problems. See the following 2013 article by Kerner, which undercuts 2018 Kerner (Maybe by becoming AASECT’s official spokesperson he felt compelled to follow the company line.):
Easy access to internet porn and the sheer variety of novelty it contains have affected average guys who wouldn’t normally have a problem.
As a sex therapist and founder of Good in Bed, I’ve seen a sharp increase in men who suffer from a new syndrome I’ve dubbed “Sexual Attention Deficit Disorder,” or SADD. And the source of this problem is just a click away — too much internet porn.
Just as people with ADD are easily distracted, guys with SADD have become so accustomed to the high levels of visual novelty and stimulation that comes from internet porn that they’re unable to focus on real sex with a real woman. As a result, guys with SADD often find it difficult to maintain an erection during intercourse, or they experience delayed ejaculation and can only climax with manual or oral stimulation.
Bored in bed?
Men with SADD tend to find themselves getting bored or impatient during sex. They may be physiologically aroused and erect, but they’re not at peak mental arousal. Guys with SADD may also simply lack the mojo for real sex because they’re depleted from masturbation. They’re not running on a full tank, physically or mentally.
Believe it or not, I first became aware of SADD via the complaints of women who wondered why their guys couldn’t ejaculate (and were often faking it) or who noticed that their partners seemed disconnected or uninterested during sex. When I dug a little deeper, or talked to the guys themselves, I realized that these men were masturbating more than usual due to their easy access to internet porn. Sometimes, they were masturbating about the same as always, but hadn’t realized that their natural refractory period — the recovery time between erections — was increasing as they aged.
Don’t get me wrong, I’m a big fan of masturbation. It helps a guy blow off some steam and is like a 30-second spa day. But easy access to internet porn and the sheer variety of novelty it contains have affected average guys who wouldn’t normally have a problem. Because of this, these men have rewired their brains to crave the instant gratification of a porn-enabled orgasm. This means that they’re developing what’s clinically referred to as an idiosyncratic masturbatory style: They’ve accustomed themselves to an intense type of physical stimulation that’s not approximated during real sex. Their overall levels of sexual desire for their partners are down, and they need to fantasize during real sex in order to maintain a full erection.
Think you suffer from SADD? Here’s what to do…
What’s a guy with SADD to do?
First, give yourself a masturbation break. Save your mojo for your partner. If you’re single, decrease your frequency of masturbation. When you do masturbate, try using your non-dominant hand. For example, if you’re a righty, touch yourself with your left. You won’t be able to apply the same levels of physical intensity as you can with your dominant hand, so you won’t be as physically numbed to the sensations of intercourse.
Second, lay off the porn. When you masturbate, use your mind to create the pictures and try to recall single episodes of sex. Think of it as the difference between reading and watching TV. Use this opportunity to reconnect with your erotic history and your own catalog of sexy memories.
Increase the mental novelty with your partner: Share fantasies and experiment with role play. Before you have intercourse, get yourself to a point where you’re at peak physical and mental arousal. SADD doesn’t have to be sad for you or your partner. Step away from your computer and toward your bedroom, and you can put your attention back where it belongs — on your real sex life.
Gavin Evans may wish to update his article in Men’s Health… but I won’t hold my breath.
Since 2011, when urology professor Carl Foresta first described porn-induced sexual dysfunctions, over 120 sexual experts (urology professors, urologists, psychiatrists, psychologists, sexologists, MDs) have been quoted as saying that porn causes sexual problems. Below are published articles or radio and TV segments featuring these experts. Note – Urologists have twice presented evidence of porn-induced sexual dysfunctions at annual conferences of the American Urological Association:
Here we have yet another propaganda piece, this one attempting to deny the existence of widespread porn-induced sexual problems. This one is by The Daily Dot’s Claire Downs whose expertise is described as “A third-generation worker in the Chicago futures industry, she specializes in cryptocurrencies and altcoins.” Interestingly, none of the recent hit pieces attempting to debunk porn-induced ED are by science journalists, let alone academics or health professionals.
Like other such articles, Downs cites the same two studies (which did not, in fact, find what Downs asserts they did) while ignoring the preponderance of empirical and clinical evidence in the field.
Before I address specific sections of The Daily Dot article, here are studies that Claire Downs chose to neglect. (I say ‘chose’ because most of the following studies were cited in this 2016 review of literature, which Downs mentioned in her piece, yet disregarded because she wished to disparage one of its 8 authors):
Over 130 articles and videos quoting numerous experts (urology professors, urologists, psychiatrists, psychologists, sexologists, MDs) who acknowledge and have successfully treated porn-induced ED and porn-induced loss of sexual desire.
Also relevant: 44 neuroscience-based studies (MRI, fMRI, EEG, neuropsychological, hormonal) providing strong support for the addiction model. This list contains 23 recent literature reviews & commentaries by some of the top neuroscientists in the world, supporting the porn addiction model.
In her intro Downs claims that “we spoke to doctors and sexual health experts about this research“, but the article only quotes two so-called experts. Neither is a heath professional who sees males suffering from sexual problems:
Dr. Heather Berg, who is described as a teacher of gender studies at USC working on a book about the adult film industry.” The book? “Porn Work: Adult Film at the Point of Production, investigates porn performance, precarity, and worker organizing“
The article relies on two porn-friendly PhD’s, without a medical professional in sight, let alone an actual urologist. Perhaps Claire Downs should have perused this page containing articles and videos by over 130 experts (urology professors, urologists, psychiatrists, psychologists, sexologists, MDs) who acknowledge and have successfully treated porn-induced ED and porn-induced loss of sexual desire.
The rest of this response will consist of excerpts from the Claire Downs article followed by YBOP comments.
Tries to debunk urology professor Carlo Foresta, but mixes up two completely separate studies
In a failed attempt to “debunk” the Foresta findings, Downs cites a 2015 Foresta study, yet all her excerpts come from a 2011 Foresta press release that has nothing to do with the 2015 study. Sloppy.
CLAIRE DOWNS: Believers in the “epidemic” of PIED often cite one2015 study from the International Journal of Adolescent Medicine and Health. It surveyed 28,000 Italian men about pornography and masturbation tendencies. The study concluded that boys—first exposed to porn around age 14 on average—experienced a drop in libido and a decreased interest in IRL sexual partners later in life.
Here’s the catch, though: It didn’t. This conclusion is how websites like the Blazereported the study. Participants’ libido levels were never actually measured—the “study” was simply an opinion survey.
When Downs said “Believers in the “epidemic” of PIED often cite one 2015 study,” she linked to this study: Adolescents and web porn: a new era of sexuality (2015). This Foresta study analyzed the effects of internet porn on high school seniors (age 18). Incidentally, Dr. Foresta is the President (or past President) of the Italian Society of Reproductive Pathophysiology. His team’s most interesting finding is that 16% of those who consume porn more than once a week report abnormally low sexual desire, compared with 0% in non-consumers (and 6% for those who consume less than once a week).
This 2014 PDF of a Foresta lecture, contains more observations and statistics, including a dramatic rise in the percentage of teens reporting sexual problems and loss of libido. Foresta also mentions his upcoming study, “Sexuality media and new forms of sexual pathology sample 125 young males, 19-25 years.” Italian name: “Sessualità mediatica e nuove forme di patologia sessuale Campione 125 giovani maschi”
Because of her amateurish error, everything Downs says about “the 2015 study” is incorrect. This is just one of several glaring inaccuracies and omissions made by Claire Downs.
In the next paragraph Downs resorts of to false statements and ad hominem:
CLAIRE DOWNS: Another paper, “Is Internet Pornography Causing Sexual Dysfunction?” was cited in this Herald article warning about a generation who grew up on porn. Upon further investigation, one of the authors of that paper was Gary Wilson, the founder of YourBrainOnPorn.com, which leads political and religious campaigns against pornography.
For some strange reason Downs forgot to mention that the paper’s other authors are seven US Navy medical doctors, including 2 urologists, 2 psychiatrists, and an MD with a PhD in neuroscience from John Hopkins. Oops.
Downs also omitted the fact that our review of the literature provides recent data revealing a tremendous rise in youthful sexual problems. It also reviews the neurological studies related to porn addiction and sexual conditioning, both of which appear to be substantial risks for some of today’s Internet porn users. The doctors provide 3 clinical reports of men who developed porn-induced sexual dysfunctions. Two of the three men healed their sexual dysfunctions by eliminating Internet porn use. The third man experienced little improvement as he was unable to abstain from porn use.
The old adage is “Always try ad hominem when you cannot address the substance.” Or in Downs case, “Why bother to fact-check a ghost-written article?” I do not lead political or religious campaigns against porn. I’m an atheist, as were my parents, and my politics are far-left liberal. This widely known fact is stated on the About Us page. A lesser known fact is that my very liberal Seattle-raised father taught sex education.
I have explained in multiple interviews my history and how I ended up creating www.yourbrainonporn in 2011. (For more see this 2016 interview of me by Noah B. Church.) I had no opinion on porn. Through a fluke in search engine categorization, around 2007 (shortly after the advent of streaming tube porn), men complaining of porn-induced erectile dysfunction and low libido for real partners began posting on my wife’s rather obscure forum created for discussions around sexual relationships. Over the next few years many otherwise healthy men on that forum healed their sexual dysfunctions by giving up porn. Eventually we blogged about this phenomenon, because so many men found reading their peers’ experiences helpful. Soon my wife’s forum was overflowing with relatively young men seeking to heal the unexpected effects of their internet porn use. During this period, we cannot count how many times we asked academic sexologists to look into this phenomenon. They refused.
Sadly, many of the men suffering from porn-induced sexual dysfunctions had been suicidal when they arrived, fearing that they were broken for life. In the face of continued stonewalling by the experts who should have been investigating the sufferers’ circumstances, we felt a need make a cyberspace available that presented the relevant science and the stories of the men who recovered from a range of porn-induced sexual dysfunctions (chiefly delayed ejaculation, loss of attraction for real partners, and fleeting or unreliable erections). Www.yourbrainonporn.com was born. If it campaigns for anything, it would be sexual health.
Claire Downs cites two highly criticized papers while ignoring 2 dozen contradictory studies.
As stated above, Downs omitted 24 studies linking porn use/sex addiction to sexual problems and lower arousal to sexual stimuli. More importantly, Downs omitted 5 studies demonstrate porn use causing sexual problems (the first 5 studies in the list). In all 5 studies young patients with chronic sexual dysfunctions eliminated porn use and healed their sexual problems
Ignoring the 5 papers suggesting that cessation of Internet porn use reversed sexual dysfunctions, and 19 other studies that link internet porn use to sexual dysfunctions and low arousal, Claire Downs instead cited 2 papers as “reputable sources”: Prause & Pfaus, 2015 and Landripet & Stulhofer, 2015. First, neither paper was an actual study. Prause & Pfaus, 2015 cobbled together data from older papers that had nothing to do with erectile dysfunction. As you will see, none of the data from the 4 older papers came close to matching the number of subjects or claims made that composite paper. Landripet & Stulhofer, 2015 was a brief communication that omitted several relevant correlations that were reported at a conference. Both papers have been criticized in the peer-reviewed literature, and elsewhere. Relevant excerpts from the Downs article:
CLAIRE DOWNS: It’s much easier to find reputable sources that support and promote pornography’s virtues. For example, this 2015 study, conducted by researchers at the Sexual Psychophysiology and Affective Neuroscience Laboratory found no relationship between ED and the number of sex films men view. In one case, Dr. Nicole Prause found stronger sexual arousal in men who reported viewing more pornography at home.
Another 2015 cross-sectional online study of nearly 4,000 European men, published in the Journal of Sexual Medicine, found no significant risk factor related to ED and porn and even cited “greater sexual responsiveness” in porn viewers.
Both papers were discussed at length in the review of the literature co-authored by the 7 US Navy doctors and myself, which I will excerpt below. I have a lot to say about both papers, so I have created separate sections for each. Let’s get one thing out of the way: neither paper found that porn use was correlated with “greater sexual responsiveness,” despite what Downs has been told by her sources. I will start with the second paper because we addressed it first in our review of the literature.
PAPER 1: Prause & Pfaus, 2015.
I provide the formal critique by Richard Isenberg, MD and a very extensive lay critique, followed by my comments and excerpts from the paper co-authored by US Navy doctors:
The claim: Contrary to Downs’s claim (and Prause & Pfaus’s claim), the men who watched more porn did not have “stronger responses in the lab.” None of the 4 studies underlying the paper’s claims even assessed genital or sexual responses in the lab. What Prause & Pfaus claimed in their paper was that men who watched more porn rated their excitement slightly higher while watching porn. The key phrase is “while watching porn.” That is, not while having sex with an actual person.
Arousal ratings while viewing porn tell us nothing about one’s arousal or erections when not viewing porn (which is when most guys with porn-induced sexual dysfunctions show impaired sexual function). Such ratings also tell us nothing about porn-induced ED, which is the inability to become sufficiently aroused without using porn. That said, details from Prause & Pfaus, 2015 reveal that they could not have accurately assessed their subjects’ arousal ratings (much more below).
For argument’s sake let’s suppose that men viewing more porn rated their arousal a bit higher than men who viewed less. Another, more legitimate, way to interpret this arousal difference between the two porn-use groups is that men who watched the most porn experienced slightly greater cravings to use porn. This is quite possibly evidence of sensitization, which is greater reward circuit (brain) activation and craving when exposed to (porn) cues. Sensitization (cue-reactivity and cravings) is a prime addiction-related brain change.
Several recent Cambridge University brain studies demonstrated sensitization in compulsive porn users. Participants’ brains were hyper-aroused in response to porn video clips, even though they didn’t “like” some of the sexual stimuli more than control participants. In a dramatic example of how sensitization can affect sexual performance, 60% of the Cambridge subjects reported arousal/erectile problems with partners but not with porn. From the Cambridge study:
[Porn addicts] reported that as a result of excessive use of sexually explicit materials…..they experienced diminished libido or erectile function specifically in physical relationships with women (although not in relationship to the sexually explicit material).
Put simply, a heavy porn user can report higher subjective arousal (cravings) yet also experience arousal/erection problems with a partner. Certainly, his arousal in response to porn is not evidence of his “sexual responsiveness” or erectile functioning with a partner. See these studies reporting sensitization/cravings or cue-reactivity in porn users/sex addicts: 1,2,3,4, 5,6,7,8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20.
The reality behind Prause & Pfaus 2015: This wasn’t a study on men with ED. It wasn’t a study at all. Instead, Prause claimed to have gathered data from four of her earlier studies, none of which addressed erectile dysfunction. It’s disturbing that this paper by Nicole Prause and Jim Pfaus passed peer-review as none of the data in their paper matched the data in the underlying four studies on which the paper claimed to be based. The discrepancies are not minor gaps, but gaping holes that cannot be plugged. In addition, the paper made several claims that were patently false or not supported by their data.
We begin with false claims made by both Nicole Prause and Jim Pfaus. Many journalists’ articles about this study claimed that porn use led to better erections, yet that’s not what the paper found. In recorded interviews, both Nicole Prause and Jim Pfaus falsely claimed that they had measured erections in the lab, and that the men who used porn had better erections. In the Jim Pfaus TV interview Pfaus states:
“We looked at the correlation of their ability to get an erection in the lab.”
“We found a liner correlation with the amount of porn they viewed at home, and the latencies which for example they get an erection is faster.”
In this radio interview Nicole Prause claimed that erections were measured in the lab. The exact quote from the show:
“The more people watch erotica at home they have stronger erectile responses in the lab, not reduced.”
Yet this paper did not assess erection quality in the lab or “speed of erections.” The paper only claimed to have asked guys to rate their “arousal” after briefly viewing porn (and it’s even not clear from the underlying papers that this simple self-report was asked of all subjects). In any case, an excerpt from the paper itself admitted that:
“No physiological genital response data were included to support men’s self-reported experience.”
In other words, no actual erections were tested or measured in the lab!
In a second unsupported claim, lead author Nicole Prause tweeted several times about the study, letting the world know that 280 subjects were involved, and that they had “no problems at home.” However, the four underlying studies contained only 234 male subjects, so “280” is way off.
A third unsupported claim: Dr. Isenberg’s Letter to the Editor (linked to above), which raised multiple substantive concerns highlighting the flaws in the Prause & Pfaus paper, wondered how it could be possible for Prause & Pfaus 2015 to have compared different subjects’ arousal levels when three different types of sexual stimuli were used in the 4 underlying studies. Two studies used a 3-minute film, one study used a 20-second film, and one study used still images. It’s well established that films are far more arousing than photos, so no legitimate research team would group these subjects together to make claims about their responses. What’s shocking is that in their paper Prause & Pfaus unaccountably claim that all 4 studies used sexual films:
“The VSS presented in the studies were all films.”
This statement is false, as clearly revealed in Prause’s own underlying studies. This is the first reason why Prause & Pfaus cannot claim that their paper assessed “arousal.” You must use the same stimulus for each subject to compare all subjects.
A fourth unsupported claim: Dr. Isenberg also asked how Prause & Pfaus 2015 could compare different subjects’ arousal levels when only 1 of the 4 underlying studies used a 1 to 9 scale. One used a 0 to 7 scale, one used a 1 to 7 scale, and one study did not report sexual arousal ratings. Once again Prause & Pfaus inexplicably claim that:
“Men were asked to indicate their level of “sexual arousal” ranging from 1 “not at all” to 9 “extremely.”
This statement, too, is false, as the underlying papers show. This is the second reason why Prause & Pfaus cannot claim that their paper assessed “arousal” ratings in men. A study must use the same rating scale for each subject to compare the subjects’ results. In summary, all the Prause-generated headlines about porn use improving erections or arousal, or anything else, are unwarranted.
Prause & Pfaus 2015 also claimed they found no relationship between erectile functioning scores and the amount of porn viewed in the last month. As Dr. Isenberg pointed out:
“Even more disturbing is the total omission of statistical findings for the erectile function outcome measure. No statistical results whatsoever are provided. Instead the authors ask the reader to simply believe their unsubstantiated statement that there was no association between hours of pornography viewed and erectile function. Given the authors’ conflicting assertion that erectile function with a partner may actually be improved by viewing pornography the absence of statistical analysis is most egregious.”
In the Prause & Pfaus response to the Dr. Isenberg critique, the authors once again failed to provide any data to support their “unsubstantiated statement.” As this analysis documents, the Prause & Pfaus response not only evades Dr. Isenberg’s legitimate concerns, it contains several new misrepresentations and several transparently false statements. Finally, our review of the literature commented on Prause & Pfaus 2015:
“Our review also included two 2015 papers claiming that Internet pornography use is unrelated to rising sexual difficulties in young men. However, such claims appear to be premature on closer examination of these papers and related formal criticism. The first paper contains useful insights about the potential role of sexual conditioning in youthful ED [50]. However, this publication has come under criticism for various discrepancies, omissions and methodological flaws. For example, it provides no statistical results for the erectile function outcome measure in relation to Internet pornography use. Further, as a research physician pointed out in a formal critique of the paper, the paper’s authors, “have not provided the reader with sufficient information about the population studied or the statistical analyses to justify their conclusion” [51]. Additionally, the researchers investigated only hours of Internet pornography use in the last month. Yet studies on Internet pornography addiction have found that the variable of hours of Internet pornography use alone is widely unrelated to “problems in daily life”, scores on the SAST-R (Sexual Addiction Screening Test), and scores on the IATsex (an instrument that assesses addiction to online sexual activity) [52, 53, 54, 55, 56]. A better predictor is subjective sexual arousal ratings while watching Internet pornography (cue reactivity), an established correlate of addictive behavior in all addictions [52, 53, 54]. There is also increasing evidence that the amount of time spent on Internet video-gaming does not predict addictive behavior. “Addiction can only be assessed properly if motives, consequences and contextual characteristics of the behavior are also part of the assessment” [57]. Three other research teams, using various criteria for “hypersexuality” (other than hours of use), have strongly correlated it with sexual difficulties [15, 30, 31]. Taken together, this research suggests that rather than simply “hours of use”, multiple variables are highly relevant in assessment of pornography addiction/hypersexuality, and likely also highly relevant in assessing pornography-related sexual dysfunctions.”
This review also highlighted the weakness in correlating only “current hours of use” to predict porn-induced sexual dysfunctions. The amount of porn currently viewed is just one of many variables involved in the development of porn-induced ED. These may include:
Ratio of masturbation to porn versus masturbation without porn
Ratio of sexual activity with a person versus masturbation to porn
Gaps in partnered sex (where one relies only on porn)
Virgin or not
Total hours of use
Years of use
Age started using porn voluntarily
Escalation to new genres
Development of porn-induced fetishes (from escalating to new genres of porn)
Level of novelty per session (i.e. compilation videos, multiple tabs)
Addiction-related brain changes or not
Presence of hypersexuality/porn addiction
The better way to research this phenomenon, is to remove the variable of internet porn use and observe the outcome, which was done in the case studies in which men removed internet porn use and healed. Such research reveals causation instead of fuzzy correlations open to conflicting interpretation. My site has documented a few thousand men who removed porn and recovered from chronic sexual dysfunctions.
As for the claim that Landripet & Štulhofer, 2015 found no relationships between porn use and sexual problems. This is not true, as documented in both this YBOP critique and the US Navy review of the literature. Furthermore, Landripet & Štulhofer’s paper omitted three significant correlations they presented to a European conference (more below). Let’s start with the first of three paragraphs from our paper that addressed Landripet & Štulhofer, 2015:
A second paper reported little correlation between frequency of Internet pornography use in the last year and ED rates in sexually active men from Norway, Portugal and Croatia [6]. These authors, unlike those of the previous paper, acknowledge the high prevalence of ED in men 40 and under, and indeed found ED and low sexual desire rates as high as 31% and 37%, respectively. In contrast, pre-streaming Internet pornography research done in 2004 by one of the paper’s authors reported ED rates of only 5.8% in men 35–39 [58]. Yet, based on a statistical comparison, the authors conclude that Internet pornography use does not seem to be a significant risk factor for youthful ED. That seems overly definitive, given that the Portuguese men they surveyed reported the lowest rates of sexual dysfunction compared with Norwegians and Croatians, and only 40% of Portuguese reported using Internet pornography “from several times a week to daily”, as compared with the Norwegians, 57%, and Croatians, 59%. This paper has been formally criticized for failing to employ comprehensive models able to encompass both direct and indirect relationships between variables known or hypothesized to be at work [59]. Incidentally, in a related paper on problematic low sexual desire involving many of the same survey participants from Portugal, Croatia and Norway, the men were asked which of numerous factors they believed contributed to their problematic lack of sexual interest. Among other factors, approximately 11%–22% chose “I use too much pornography” and 16%–26% chose “I masturbate too often” [60]
As my co-authors, the Navy doctors, and I described, this paper found a rather important correlation: Only 40% of the Portuguese men used porn “frequently,” while the 60% of the Norwegians used porn “frequently.” The Portuguese men had far less sexual dysfunction than the Norwegians. With respect to the Croat subjects, Landripet & Štulhofer, 2015 acknowledge a statistically significant association between more frequent porn use and ED, but claim the effect size was small. However, this claim may be misleading according to an MD who is a skilled statistician and has authored many studies:
Analyzed a different way (Chi Squared), … moderate use (vs. infrequent use) increased the odds (the likelihood) of having ED by about 50% in this Croatian population. That sounds meaningful to me, although it is curious that the finding was only identified among Croats.
In addition, Landripet & Štulhofer 2015 omitted three significant correlations, which one of the authors presented to a European conference. He reported a significant correlation between erectile dysfunction and “preference for certain pornographic genres”:
“Reporting a preference for specific pornographic genres were [sic] significantly associated with erectile (but not ejaculatory or desire-related) male sexual dysfunction.”
It’s telling that Landripet & Štulhofer chose to omit this significant correlation between erectile dysfunction and preferences for specific genres of porn from their paper. It’s quite common for porn users to escalate into genres (or fetishes) that do not match their original sexual tastes, and to experience ED when these conditioned porn preferences do not match real sexual encounters. As we pointed out above, it’s very important to assess the multiple variables associated with porn use – not just hours in the last month or frequency in the last year.
The second significant finding omitted by Landripet & Štulhofer 2015 involved female participants:
“Increased pornography use was slightly but significantly associated with decreased interest for partnered sex and more prevalent sexual dysfunction among women.”
A significant correlation between greater porn use and decreased libido and more sexual dysfunction seems pretty important. Why didn’t Landripet & Štulhofer 2015 report that they found significant correlations between porn use and sexual dysfunction in women, as well as a few in men? And why hasn’t this finding been reported in any of Štulhofer’s many studies arising from these same data sets? His teams seem very quick to publish data they claim debunks porn-induced ED, yet very slow to inform women about the negative sexual ramifications of porn use.
Finally, Danish porn researcher Gert Martin Hald’s formal critical comments echoed the need to assess more variables (mediators, moderators) than just frequency per week in the last 12 months:
“The study does not address possible moderators or mediators of the relationships studied nor is it able to determine causality. Increasingly, in research on pornography, attention is given to factors that may influence the magnitude or direction of the relationships studied (i.e., moderators) as well as the pathways through which such influence may come about (i.e., mediators). Future studies on pornography consumption and sexual difficulties may also benefit from an inclusion of such focuses.
Bottom line: All complex medical conditions involve multiple factors, which must be teased apart before far reaching pronouncements are appropriate. Landripet & Štulhofer’s statement that, “Pornography does not seem to be a significant risk factor for younger men’s desire, erectile, or orgasmic difficulties” goes too far, since it ignores all the other possible variables related to porn use that might be causing sexual performance problems in users, including escalation to specific genres, which they found, but omitted from the “Brief Communication.” Paragraphs 2 & 3 in our discussion of Landripet & Štulhofer, 2015:
Again, intervention studies would be the most instructive. However, with respect to correlation studies, it is likely that a complex set of variables needs to be investigated in order to elucidate the risk factors at work in unprecedented youthful sexual difficulties. First, it may be that low sexual desire, difficulty orgasming with a partner and erectile problems are part of the same spectrum of Internet pornography-related effects, and that all of these difficulties should be combined when investigating potentially illuminating correlations with Internet pornography use.
Second, although it is unclear exactly which combination of factors may best account for such difficulties, promising variables to investigate in combination with frequency of Internet pornography use might include (1) years of pornography-assisted versus pornography-free masturbation; (2) ratio of ejaculations with a partner to ejaculations with Internet pornography; (3) the presence of Internet pornography addiction/hypersexuality; (4) the number of years of streaming Internet pornography use; (5) at what age regular use of Internet pornography began and whether it began prior to puberty; (6) trend of increasing Internet pornography use; (7) escalation to more extreme genres of Internet pornography, and so forth.
A 500% – 1000% increase in youthful ED since 2010 cannot be explained away by the usual factors
Prior to the advent of free streaming porn (2006), cross-sectional studies and meta-analysis consistently reported erectile dysfunction rates of 2-5% in men under 40. Erectile dysfunction rates in 9 studies published since 2010 range from 14% to 35%, while rates for low libido (hypo-sexuality) range from 16% to 37%. Some studies involve teens and men 25 and under, while other studies involve men 40 and under. That’s nearly a 500%-1000% increase in youthful ED rates in the last 10 years. What variable has changed in the last 15 years that could account for this astronomical rise? Downs implies that the same old variables related to youthful ED are to blame for this jump in sexual problems:
CLAIRE DOWNS: ED is unfortunately common, and it’s not just a result of getting old. Although age increases the likelihood of experiencing dysfunction, one in four men under the age of 40 will seek treatment for ED. Whether chronic or temporary, erectile dysfunction is caused by a myriad of things like drug use, medication side effects, mental issues, and relationship communication problems, as well as heart disease, sleep disorders, and nerve injuries.
As explained in our paper, smoking, diabetes and heart disease rarely cause ED in men under 40 (citation 16). It takes years of smoking or uncontrolled diabetes to manifest neuro-vascular damage severe enough to cause chronic ED. From our paper:
Traditionally, ED has been seen as an age-dependent problem [2],and studies investigating ED risk factors in men under 40 have often failed to identify the factors commonly associated with ED in older men, such as smoking, alcoholism, obesity, sedentary life, diabetes, hypertension, cardiovascular disease, and hyperlipidemia [16].
As for “medications, smoking, alcohol and drug use,” none of rates of these correlative factors have increased over the last 15 years (smoking has actually decreased). From the US Navy paper:
However, none of the familiar correlative factors suggested for psychogenic ED seem adequate to account for a rapid many-fold increase in youthful sexual difficulties. For example, some researchers hypothesize that rising youthful sexual problems must be the result of unhealthy lifestyles, such as obesity, substance abuse and smoking (factors historically correlated with organic ED). Yet these lifestyle risks have not changed proportionately, or have decreased, in the last 20 years: Obesity rates in U.S. men aged 20–40 increased only 4% between 1999 and 2008 [19]; rates of illicit drug use among US citizens aged 12 or older have been relatively stable over the last 15 years [20]; and smoking rates for US adults declined from 25% in 1993 to 19% in 2011 [21].
As for “mental issues:depression, anxiety, nervousness,” none of these cause erectile dysfunction, they are simply weakly correlative to ED. In fact, some studies report that depressed and anxious patients have higher sexual desire. Other studies suggest the obvious: depression doesn’t cause ED; having ED increases scores on depression tests. From the US Navy paper:
Other authors propose psychological factors. Yet, how likely is it that anxiety and depression account for the sharp rise in youthful sexual difficulties given the complex relationship between sexual desire and depression and anxiety? Some depressed and anxious patients report less desire for sex while others report increased sexual desire [22, 23, 24, 25]. Not only is the relationship between depression and ED likely bidirectional and co-occurring, it may also be the consequence of sexual dysfunction, particularly in young men [26].
As we said in our paper’s conclusion:
Traditional factors that once explained sexual difficulties in men appear insufficient to account for the sharp rise in sexual dysfunctions and low sexual desire in men under 40.
Overall, 229 (75%) and 78 (25%) patients had normal and impaired Erectile Function (EF); among patients with ED, 90 (29%) had an IIEF-EF score suggestive for severe ED. Patients with and without ED did not differ significantly in terms of median age, BMI, prevalence of hypertension, general health status, smoking history), alcohol use, and median IPSS score. Similarly, no differences were reported in terms of serum sex hormones and lipid profile between the two groups.
These findings showed that young men with ED do not differ in terms of baseline clinical characteristics from a comparable-age group with normal EF, but depicted lower sexual desire scores, clinically suggesting a more probable psychogenic cause of ED.
For some reason those with ED had low sexual desire (should’ve asked about porn!) To repeat, Claire Downs, like other porn-induced ED deniers, argue that young men’s ED is caused by the exact same risk factors that are related to ED in men over 40. These claims do not match the peer-reviewed literature.
As a species, we would be wise to steer for deeply fulfilling connection – and away from mindless stimulation, both chemical and behavioral. Second, drug addicts shouldn’t be treated like criminals. They should be trained on how best to manage what often proves to be a chronic disease – a disease of pathological learning, which is accompanied by physical changes in the brain that drive continued use despite negative consequences.
However, neither the benefits of connection nor Hari’s plea for compassionate treatment of addicts justifies his title implying that addiction science is off the mark, or has overlooked either of these points. Hari could have promoted his messages without ignoring or dismissing mountains of solid research published on addiction.
The video starts out with a straw-man argument. It claims that if “what we think we know about addiction” were true, everyone given heroin in the hospital would be hooked. Actually, no addiction expert believes this. Researchers report that only 10-20% of users offered addictive drugs become addicted, in both humans and animals. Hari’s false premise is the claim that every isolated caged rat becomes addicted if given access to heroin or cocaine. It’s more like 20% as this 2010 study reveals (with heroin rates somewhat higher):
“In a study published in the June 25th edition of Science, a team of researchers attached laboratory rats to a device that allowed the rodents to self-administer doses of cocaine—a coke IV of sorts. After a month, the researchers began identifying which rats had become hooked on the drug by looking for the hallmark signs of addiction: difficulty stopping or limiting drug use; high motivation to continue use; and continued use despite negative consequences. Only 20 percent of the rats exhibited all three signs of addiction, while 40 percent exhibited none.”
The difference between the addicted 20% and non-addicted 80% wasn’t lousy parenting or bad living conditions. Instead, it was how the rats’ brains adapted to drug use. Plain old genetics (or maybe epigenetics). The article continues:
“At first, drug use alters the physiology of every user’s brain as they go through a sort of reward-response learning: If you take the drug, you will feel better—certainly a dangerous mindset to be in when you’re wired to an unlimited supply of cocaine. Luckily, in most cases a brain eventually re-learns how to control its intake of the drug. Addict brains, not so much. Unlike their non-addict furry friends, the brains of addict rats lack sufficient “plasticity”—a property of the brain that allows it to adapt to changes over time—to get a handle on their habit. These rats are stuck in a reward-response frame of mind, and with it a downward spiral of addiction.”
Incidentally, 10 – 20% are the rates for situations where the user can self-administer a drug, thus reinforcing the connection between the “high” and using. Reinforcement of this type is different from hospitals, where pain medication is managed, and the presence of pain itself weakens reinforcement (because the body is already producing its own opioids so the drug “high” is less noticeable).
The exception to the 10-20% rate of addiction is nicotine, which is considered by many experts humanity’s most addictive drug. Its use is more socially acceptable and its immediate effects are less debilitating (characteristics it shares with internet porn use). There was a time when almost 50% of adult Americans were smokers. Did all nicotine addicts have attachment issues? Were all these smokers lonely? No. Even today we have millions of Americans who are quite happy and successful, yet cannot stop smoking. This alone refutes Hari’s premise.
While the 10-20% addiction rate may apply to substance use, we will see that supernormal versions of natural rewards (internet porn, junk food) can hook a higher percentage of users. For example, given a choice between sugar and cocaine, 85% of rats forgo cocaine to eat the sweet stuff. From this study:
“A retrospective analysis of all experiments over the past 5 years revealed that no matter how heavy was past cocaine use most rats readily give up cocaine use in favor of the non-drug alternative. Only a minority, fewer than 15% at the heaviest level of past cocaine use, continued to take cocaine, even when hungry and offered a natural sugar.”
If “In a Nutshell” viewers were told the truth, that only a minority of rats become drug addicts, Hari’s message would lose most of its impact.
Rat park experiment not replicated
Hari asks us to take the 1979 “Rat Park” experiment as gospel even though replication of the experiment failed. In doing so, Hari also asks us to ignore nearly 40 years of addiction neuroscience, which has identified cellular, molecular and epigenetic changes that account for the behaviors we recognize as addiction. For example, artificially increasing levels of a single molecule (DeltaFosB) makes rats compulsively crave drugs and junk food. Blocking this same reward-center molecule prevents addiction in lab animals. Similarly, in humans, active cocaine addicts (who died suddenly) had abnormally high levels of DeltaFosB in their brains’ reward centers.
Even more telling, an extensive body of brain-scan research reports that various addiction-induced brain changes are the best predictor of who will relapse (1, 2, 3, 4, 5, 6, 7, 8 ). In fact, in direct opposition to Hari’s claim, the only consistent factors related to either success or relapse were the magnitudes of certain addiction-related brain changes. From one of the studies:
“ER-fMRI data was compared with psychiatric, neuropsychological, demographic, personal- and family- history of drug use in order to form predictive models, and was found to predict abstinence with higher accuracy than any other single measure obtained in this study.”
How could brain changes predict relapse if the only cause of addiction were a lack of human connection?
There’s more to the Vietnam story
The author of this article “Vietnam Heroin Researcher May Have Disagreed With Johann Hari’s Take On The Causes of Addiction” further dismantles Hari’s claim (although he ultimately concludes addiction is a choice, a view we do not share). He points out that heroin was cheap and readily available in Vietnam, with more than 80% of servicemen offered it within the first week. However, the 1974 study reports that narcotic use wasn’t all that rampant:
“Approximately 13,760 Army enlisted men returned to the United States from Vietnam in September 1971. Within the population of 13,760, approximately 1,400 had been found to have urines positive for narcotics at time of departure.”
Only 10% of returning soldiers tested positive for opiates. It’s highly unlikely that all 1400 were heroin addicts, especially when we consider that some would have been given narcotics for pain relief. A ten percent addiction rate is far below the current addiction rate for drugs and alcohol in the US population.
Was widespread heroin use due to the stress of Vietnam or was it due to easy access to cheap heroin? A key finding was that most of the soldiers who eventually did become heroin addicts had prior histories of substance use, which suggests a strong genetic component for these soldiers’ addictions. Said the researcher,
“the greater the variety of drugs used before entering service, the greater the likelihood that narcotics would be used in Vietnam.”
If it was combat stress, why did the men who eventually became addicts generally start their heroin use early in their tours, before being exposed to combat? Why didn’t heroin use correlate with combat action? Said the researcher:
“Those who saw more active combat were not more likely to use than veterans who saw less, once one took into account their pre-service histories.”
Is it really surprising that most heroin-using soldiers stopped when they got back home? Heroin is costly, often hard to get, and interferes with civilian life: finding a job, working, renewing relationships, etc.
What about internet porn use?
Hari’s material has received an enthusiastic response on internet porn recovery forums where many users have been so glued to their screens that they feel socially isolated. Hari’s hypothesis encourages them to ascribe their addictive behavior to lack of human connection. However, Hari completely misses a key piece of information, which in turn leaves internet overconsumers with a major blind spot.
The relationship between human connection and addiction goes both ways, not one way. Many guys who quit discover that their inability to connect was due to their addiction, and that they become social magnets once they stop. That is, although isolation can drive self-medication via addiction, addiction itself impedes connection and mutes its benefits. An addicted brain is altered such that attachment doesn’t generally register normally or feel particularly good, compared with the drug or behavior the user has become “sensitized” to.
Over and over, we see that guys who quit report they become able to connect much more deeply with others, and with much greater satisfaction. Some even discover they were extroverts, not introverts. They are often amazed at how much more enjoyable they find social interaction, sexual activity with a partner, and even climax itself during sex. But they need a period of abstinence from overstimulation before they can fully benefit from the beneficial effects of connection. Their brain’s reward system needs time to rebalance. Hari does not address this need.
The power of supernormal versions of natural rewards
One implication of Hari’s message is that “as long as someone has a good social environment, he/she can engage in addictive behaviors without risk of becoming addicted.” This is just as misguided as a belief that addictive substances are equally dangerous for all users. We see lots of users struggling with internet porn’s effects who have had happy upbringings and plenty of social activity. We see happily married men struggling with it. Let’s look more closely at why internet porn is compelling even for those with good social connections.
Back up for a moment to reconsider drugs. The side effects of most drugs that offer a “high” are aversive. Many alter consciousness, interfere with ability to drive, cause debilitating hangovers, etc. Drugs are also risky to obtain or expensive (or both). Moreover, drugs are a poor substitute for natural rewards. Eons of evolution have tailored mammalian brains to light up for food, sex, bonding, achievement, play and novelty. While Hari informs us that connection is the true reward we are seeking, he ignores these other natural rewards. As psychologist Stanton Peele pointed out in this Psychology Today blog post:
“Rat Park is a classic experiment in which rats, once habituated to a morphine solution, preferred to continue drinking it over water in small isolated cages, but eschewed the morphine in favor of water in Rat Park, a spacious and enriched environment where there were many rats of both sexes. In such an environment the ability to compete for sex quickly took precedence over seeking narcosis – i.e., sex is better than drugs for rats.”
Nor does Hari explain to his viewers that supernormal versionsof natural rewards (modern junk food and internet porn, for example) are far more universally appealing and addictive than drugs or alcohol. Supernormal stimuli are exaggerated versions of normal stimuli, but we falsely perceive them as more valuable. This helps explain why 35% of adult Americans are obese and 70% are overweight, even though none of them want to be. With our brain’s reward circuit lighting up, we can easily slam down 1500 calories in burgers, fries and milkshakes. Try slamming down 1500 calories of dried chewy venison and boiled roots in one sitting (or in one day).
Several animal studies have shown that junk food is more addictive than cocaine, (rats prefer sugar to cocaine) and that overeating to obesity can bring about addiction-related brain changes. In fact, when rats are given unlimited access to “cafeteria food,” nearly 100% binge to obesity. The obese rats’ brains and behaviors mirror those of drug addicts. These same rats don’t overeat on regular rat chow, just as hunter-gathers don’t get fat on their native diets.
To say this another way, there are no innate circuits for seeking heroin, alcohol, or cocaine. Yet there are various brain circuits devoted to seeking out and consuming both food and sex. And, while we like a good meal, sexual arousal and orgasm release the highest levels of rewarding neurochemicals (dopamine and opioids). That’s as it should be: reproduction is our genes’ #1 job.
While only a minority of rats become drug addicts; 100% copulate to exhaustion
What happens when you drop a male rat into a cage with a receptive female rat? First, you see a frenzy of copulation. Then, progressively, the male tires of that particular female. Even if she wants more, he has had enough. However, replace the original female with a fresh one, and the male immediately revives and gallantly struggles to fertilize her. You can repeat this process with fresh females until he is completely wiped out.
This is called the Coolidge effect—the automatic response to novel mates. Here’s how the Coolidge effect works: The rat’s reward circuitry is producing less and less exciting neurochemicals (dopamine and opioids) with respect to the current female, but produces a big surge for a new female. His genes want to make sure he leaves no female unfertilized…or exhaust himself trying.
After 18 viewings—just as the test subjects were nodding off—researchers introduced novel erotica for the 19th and 20th viewings. Bingo! The subjects and their penises sprang to attention. (Yes, women showed similar effects.)
Of course, a sedentary mammal experiencing a endless parade of willing females would occur only in a lab and not in nature. Or would it?
Internet porn is especially enticing to the reward circuitry because it offers an endless parade of sexual novelty. It could be a novel “mate,” unusual scene, strange sexual act, or—you fill in the blank. With multiple tabs open and clicking for hours a viewer can experience more novel sex partners every session than our hunter-gatherer ancestors experienced in a lifetime.
With internet porn, it’s not just the unending sexual novelty that buzzes our reward circuit. Strong emotions such as anxiety, shock or surprise also light up our reward circuit. Unlike scoring heroin on the street corner, today’s porn is easy to access, available 24/7, free and private. Unlike food and drugs, for which there is a limit to consumption, there are no physical limitations to internet porn consumption. The brain’s natural satiation mechanisms are not activated unless one climaxes. Even then, a user can click to something more exciting to become aroused again.
Unlike addictive drug use, porn use is now widespread, and almost universal among adolescent males with internet access. Moreover, many under the age of 30 view porn use as “healthy” and a normal part of “sexual expression.” Young men today use porn because they like it, not necessarily because they lack connection or love. (All neuroscience-studies published to date support the porn addiction model.)
Elephant in the room: the adolescent brain
Hari – who is no addiction expert – does not acknowledge the heightened vulnerability of the adolescent brain to addictive substances and behaviors, which exists quite apart from degree of social connection. For example, studies show that for teen brains, using drugs is far more permanently damaging than for adult brains.
What we have now is adolescents chronically using a compelling supernormal stimulus during the time when their brains are rewiring to the sexual environment. One primary goal of adolescence is to learn everything possible about sex (consciously and subconsciously) in order to successfully reproduce later on. Internet porn can thus alter or sculpt our extensive brain circuitry for sexuality and reproduction – as well as distract us from learning the very social skills we need for connection.
Inadvertently or not, Hari’s animation leaves the impression that a good social environment prevents addiction. This simply isn’t true, especially for adolescents with their super-sensitive brains. As recovery forum host Gabe Deem points out:
Those rats in the Rat Park could have sex instead of heroin, but what they didn’t have is the option to “fertilize” millions of female rats on internet devices.
COMMENTS: Many claim this study supports the argument that Internet porn doesn’t really cause serious problems. For example, this pro-porn advocate falsely states that only 2% of participants felt that porn was leading to adverse effects. In reality, 17% of males & females aged 16-30 reported that using pornography had a bad effect on them.
There are several reasons to take the headlines with a grain of salt. First a few caveats about this study:
This was a cross-sectional representative study spanning age groups 16-69, males and females. It’s well established that young men are the primary users of internet porn. So, 25% of the men and 60% of the women had not viewed porn at least once in the last 12 months. Thus the statistics gathered minimize the problem by veiling the at-risk users.
The single question, which asked participants if they had used porn in the last 12 months, doesn’t meaningfully quantify porn use. For example, a person who bumped into a porn site pop-up is considered no different from someone who masturbates 3 times a day to hardcore porn.
However, when the survey inquired of those who “had ever viewed porn” which ones had viewed porn in the past year, the highest percentage was the teen group. 93.4% of them had viewed in the last year, with 20-29 year olds just behind them at 88.6.
Data was gathered between October 2012 and November 2013. Things have changed a lot in the last 4 years, thanks to smartphone penetration – especially in younger users.
Questions were asked in computer-assisted telephone interviews. It’s human nature to be more forthcoming in completely anonymous interviews, especially when interviews are about sensitive subjects such as porn use and porn addiction.
The questions are based purely upon self-perception. Keep in mind that addicts rarely see themselves as addicted. In fact, most internet porn users are unlikely to connect their symptoms to porn use unless they quit for an extended period.
The study did not employ standardized questionnaires (given anonymously), which would more accurately have assessed both porn addiction and porn’s effects on the users.
Check out the study’s conclusion:
Looking at pornographic material appears to be reasonably common in Australia, with adverse effects reported by a small minority.
However, for males & females aged 16-30, it’s not a small minority. According to Table 5 in the study, 17% of this age group reported that using pornography had a bad effect on them. (In contrast, among people 60-69, only 7.2% thought porn had a bad effect.)
How different would the headlines from this study have been if the authors had emphasized their finding that nearly 1 in 5 young people believed that porn use had a “bad effect on them”? Why did they attempt to downplay this finding by ignoring it and focusing on cross-sectional results – rather than the group most at risk for internet problems?
Once again, few regular porn users realize how porn has affected them until well after they cease using. Often ex-users need several months to fully recognize the negative effects. Thus, a study like this one has major limitations.
There are societal concerns that looking at pornography has adverse consequences among those exposed. However, looking at sexually explicit material could have educative and relationship benefits. This article identifies factors associated with looking at pornography ever or within the past 12 months for men and women in Australia, and the extent to which reporting an “addiction” to pornography is associated with reported bad effects. Data from the Second Australian Study of Health and Relationships (ASHR2) were used: computer-assisted telephone interviews (CASIs) completed by a representative sample of 9,963 men and 10,131 women aged 16 to 69 years from all Australian states and territories, with an overall participation rate of 66%. Most men (84%) and half of the women (54%) had ever looked at pornographic material. Three-quarters of these men (76%) and more than one-third of these women (41%) had looked at pornographic material in the past year. Very few respondents reported that they were addicted to pornography (men 4%, women 1%), and of those who said they were addicted about half also reported that using pornography had had a bad effect on them. Looking at pornographic material appears to be reasonably common in Australia, with adverse effects reported by a small minority.
The authors of this study framed egalitarianismas: (1) Support for abortion, (2) Feminist identification, (3) Women holding positions of power, (4) Belief that family life suffers when the woman has a full-time job., and oddly enough (5) Holding more negative attitudes toward the traditional family. Secular populations, which tend to be more liberal, have far higher rates of porn use than religious populations. By choosing these criteria and ignoring endless other variables, lead author Taylor Kohut knew he would end up with porn users scoring higher on his study’s carefully chosen selection of what constitutes “egalitarianism.” Then he chose a title that spun it all.
Update: In this 2018 presentation Gary Wilson exposes the truth behind 5 questionable and misleading studies, including this study (Kohut et al., 2016): Porn Research: Fact or Fiction?
Sexually objectifying portrayals of women are a frequent occurrence in mainstream media, raising questions about the potential impact of exposure to this content on others’ impressions of women and on women’s views of themselves. The goal of this review was to synthesize empirical investigations testing effects of media sexualization. The focus was on research published in peer-reviewed, English-language journals between 1995 and 2015. A total of 109 publications that contained135 studies were reviewed. The findings provided consistent evidence that both laboratory exposure and regular, everyday exposure to this content are directly associated with a range of consequences, including higher levels of body dissatisfaction, greater self-objectification, greater support of sexist beliefs and of adversarial sexual beliefs, and greater tolerance of sexual violence toward women. Moreover, experimental exposure to this content leads both women and men to have a diminished view of women’s competence, morality, and humanity.
Taylor Kohut has a history of publishing ‘creative’ studies designed to find little or no problems arising from the use of porn. In this 2017 study, Kohut appears to have skewed the sample to produce the results he was seeking. Whereas most studies show that a tiny minority of porn users’ female partners use porn, in this study 95% of the women used porn on their own (85% of the women had used porn since the beginning of the relationship)! Reality: Cross-sectional data from the largest US survey (General Social Survey) reported that only 2.6% of women had visited a “pornographic website” in the last month.
Kohut’s new website and his attempt at fundraising suggest that he just may have an agenda. Kohut’s bias is revealed in a recent brief written for the Standing Committee on Health Regarding Motion M-47 (Canada). In the brief Kohut and his coauthors are guilty of cherry-picking a few outlying studies while misrepresenting the current state of the research on porn’s effects. Their distorted and laughable description of the published neurological studies on porn users leaves no doubt as to their bias.
J Sex Res. 2016;53(1):1-11. doi: 10.1080/00224499.2015.1023427.
According to radical feminist theory, pornography serves to further the subordination of women by training its users, males and females alike, to view women as little more than sex objects over whom men should have complete control. Composite variables from the General Social Survey were used to test the hypothesis that pornography users would hold attitudes that were more supportive of gender nonegalitarianism than nonusers of pornography. Results did not support hypotheses derived from radical feminist theory. Pornography users held more egalitarian attitudes–toward women in positions of power, toward women working outside the home, and toward abortion–than nonusers of pornography. Further, pornography users and pornography nonusers did not differ significantly in their attitudes toward the traditional family and in their self-identification as feminist. The results of this study suggest that pornography use may not be associated with gender nonegalitarian attitudes in a manner that is consistent with radical feminist theory.
In early November, 2017 three non-profit kink organizations (Center for Positive Sexuality, National Coalition for Sexual Freedom, and The Alternative Sexualities Health Research Alliance) released a group position paper “opposing the addiction model in relation to frequent sexual behavior and pornography viewing.” The groups’ press release, Position statement opposing sex/porn addiction model, explained their motivations:
“These organizations cite AASECT’s statement as one of the reasons for their joint statement, as well as citing many scientific studies that reject the addiction model in relation to these sexual behaviors.”
Contrary to this PR statement, there are no “scientific studies that reject the addiction model,” and ASSECT’s proclamation provided no studies to support its own assertions. As for the 3 kink organizations’ proclamation, all their “evidence” (which we examine below) is packed into this handy PDF: Addiction to Porn/Sex Position Statement.
We suspect the primary reason for yet another public relations push (as it was with AASECT) is that the World Health Organization’s upcoming edition of its diagnostic manual, the ICD-11, includes a diagnosis for “Compulsive Sexual Behavior Disorder.” Due out in 2018, “Compulsive Sexual Behavior Disorder” (CSB) will function as an umbrella to diagnose both sex addiction and pornography addiction. And some sexual communities incorrectly perceive this as an attack on their behavior. It isn’t.
Let’s start with the proclamation’s opening paragraph, which omitted some 60 relevant neurological studies and reviews of the literature, while misrepresenting many of the studies it did cite.
“Although some academic and professional reports have supported the application of an addiction model to frequent sexual behavior and/or pornography viewing (i.e., Hilton & Watts, 2011; Kafka, 2010), others point out serious potential or actual problems with applying an addiction model to sexual behavior and pornography viewing (Ley, 2012; Ley, Prause, & Finn, 2014; Reid & Kafka, 2014; Giugliano, 2009; Hall, 2014; Karila et al., 2014; Moser, 2013; Kor, Fogel, Reid, & Potenza, 2013; Ley et al., 2014; Prause & Fong, 2015; Prause, Steele, Staley, Sabatinelli, & Hajcak, 2015).”
What this proclamation purposely omitted:
40 neuroscience-based studies (MRI, fMRI, EEG, neurospychological, hormonal, genetic) providing strong support for the addiction model.
Next, let’s look at the proclamation’s scientific support for its statement that “others point out serious potential or actual problems with applying an addiction model to sexual behavior and pornography viewing”:
1)Ley, 2012: Not peer-reviewed. It’s a book: The Myth of Sex Addiction by David Ley.
2) Ley, Prause, & Finn, 2014: An opinion piece commissioned by a minor journal (Current Sexual Health Reports). The lead author has never published any original research, yet was asked to give his opinion of pornography addiction and addiction in general. Virtually nothing in the opinion piece is backed up by the studies it cited. This extensive critique dismantles Ley et al., 2014 – claim by claim and documents dozens of misrepresentations of the research the authors cited. The most shocking aspect of the Ley paper is that it omitted ALL the many studies that reported negative effects related to porn use or found porn addiction. Also know that Current Sexual Health Reports has a short and rocky history. It started publishing in 2004, and then went on hiatus in 2008, only to be resurrected in 2014, just in time to feature Ley et al.’s “review.”
3) Reid & Kafka, 2014: This paper hypothesizes why hypersexuality didn’t make it into the DSM-5 (Diagnostic and Statistical Manual). However, both Reid & Kafka favored hypersexuality for inclusion in the DSM. See this 2012 UCLA press release by Rory Reid: Science supports sex addiction as a legitimate disorder.
4)Giugliano, 2009: This older paper, by a past president of SASH, set out to question sex addiction, but results didn’t support the author’s hypothesis. Nowhere does it suggest that sex addiction doesn’t exist. See the SASH position paper on sex and porn addiction.
5)Hall, 2014: This article by UK therapist Paula Hall supports the existence of sex addiction. See this TEDx talk by Paula Hall – We Need To Talk About Sex Addiction.
6)Karila et al., 2014: This paper supports the existence of sex addiction. From the abstract: “Sexual addiction, which is also known as hypersexual disorder, has largely been ignored by psychiatrists, even though the condition causes serious psychosocial problems for many people.”
7) Moser, 2013: Charles Moser is a known “sex addiction” skeptic. In fact, as the Section Editor of Current Sexual Health Reports, he is the one who invited Ley, Prause and Finn to do their pseudo-review discussed above, Ley et al., 2014.
8)Kor, Fogel, Reid, & Potenza, 2013: This paper supports the existence of sex addiction. From the conclusion: “Although many gaps exist in knowledge in our understanding of HD, available data suggest that considering hypersexuality disorder within an addiction framework may be appropriate and helpful.”
9)Ley et al., 2014: Same citation as #2.
10)Prause & Fong, 2015: This item was not peer-reviewed. It’s a short opinion piece in a lay volume, much of which is devoted to chronicling the mythology of Prause’s victimization.
11) Prause, Steele, Staley, Sabatinelli, & Hajcak, 2015: A single EEG study. No less than 8 peer-reviewed papers say that this paper, Prause et al., 2015, lends support to the addition model: 1, 2, 3, 4, 5, 6, 7, 8. The neuroscientists on these 8 papers state that Prause et al. actually found desensitization/habituation (consistent with the development of addiction), as less brain activation to vanilla porn (pictures) was related to greater porn use.
So, let’s summarize the evidence for the campaign by these 3 organizations: Five of the eleven references explicitly support the addiction model, two references aren’t peer-reviewed, and one is a repeat of an earlier reference.
The three remaining references arise from 3 individuals who have often teamed up to “debunk” porn and sex addiction: David Ley, Nicole Prause and Charles Moser. Ley and Prause wrote Ley et al., 2014 (which Moser commissioned), and at least two Psychology Today blog posts. Charles Moser also teamed up with Ley and Prause to “debunk” porn addiction at the February 2015 ISSWSH conference. They presented a 2-hour symposium: “Porn Addiction, Sex Addiction, or just another OCD?” The lone neurological study out of the remaining three (Prause et al., 2015) is regarded by six peer-reviewed papers as consistent with the addiction model.
Why didn’t the proclamation cite any of the 20 recent reviews of the literature and commentaries by some of the top neuroscientists working at Yale University, Cambridge University, University of Duisburg-Essen or the Max Planck Institute? Because the reviews lend support to the addiction model, contradicting the claims of these organizations.
The proclamation divides the rest of its claims into five sections: A, B, C, D, E.
The proclamation’s first main assertion (A)
A) The American Psychiatric Association (APA) does not identify sex/porn addiction as mental disorders. Similarly, the American Association of Sexuality Educators, Counselors, and Therapists (AASECT) does not recognize sex/porn addiction as mental disorders and has concluded that an addiction model “cannot be advanced as a standard of practice for sexuality education delivery, counseling, or therapy”.
Re AASECT: First, AASECT is not a scientific organization and cited nothing to support the assertions in its own press release – rendering its support meaningless.
Finding AASECT’s tolerance of the “sex addiction model” to be “deeply hypocritical”, in 2014 Dr. Aaron set out to eradicate support for the concept of “sex addiction” from AASECT’s ranks. To accomplish his goal, Dr. Aaron claims to have deliberately sowed controversy among AASECT members in order to expose those with viewpoints that disagreed with his own, and then to have explicitly silenced those viewpoints while steering the organization toward its rejection of the “sex addiction model.” Dr. Aaron justified using these “renegade, guerilla [sic] tactics” by reasoning that he was up against a “lucrative industry” of adherents to the “sex addiction model” whose financial incentives would prevent him from bringing them over to his side with logic and reason. Instead, to effect a “quick change” in AASECT’s “messaging,” he sought to ensure that pro-sex addiction voices were not materially included in the discussion of AASECT’s course change.
Dr. Aaron’s boast comes across as a little unseemly. People rarely take pride in, much less publicize, suppressing academic and scientific debate. And it seems odd that Dr. Aaron spent the time and money to become CST certified by an organization he deemed “deeply hypocritical” barely a year after joining it (if not before). If anything, it is Dr. Aaron who appears hypocritical when he criticizes pro-“sex addiction” therapists for having a financial investment in the “sex addiction model”, when, quite obviously, he has a similar investment in promoting his opposing viewpoint.
Several commentaries and critiques expose AASECT’s proclamation for what it truly is:
Re DSM-5 and ICD-11: Second, when the APA last updated its diagnostic manual in 2013 (DSM-5), it didn’t formally consider “internet porn addiction,” opting instead to debate “hypersexual disorder.” The latter umbrella term for problematic sexual behavior was recommended for inclusion by the DSM-5’s own Sexuality Work Group after years of review. However, in an eleventh-hour “star chamber” session (according to a Work Group member), other DSM-5 officials unilaterally rejected hypersexuality, citing reasons that have been described as illogical.
Moreover, just prior to the DSM-5’s publication in 2013, Thomas Insel, then Director of the National Institute of Mental Health, warned that it was time for the mental health field to stop relying on the DSM. Its “weakness is its lack of validity,” he explained, and “we cannot succeed if we use DSM categories as the “gold standard.” He added, “That is why NIMH will be re-orienting its research away from DSM categories.” In other words, the NIMH planned to stop funding research based on DSM labels (and their absence).
Major medical organizations are moving ahead of the APA. The medical doctors and addiction researchers of the American Society of Addiction Medicine (ASAM) hammered what should have been the final nail in the porn-addiction debate coffin in August, 2011 based on decades of addiction research. Top addiction experts at ASAM released their carefully crafted definition of addiction. Foremost, behavioral addictions affect the brain in the same fundamental ways as drugs do. In other words, addiction is essentially one disease (condition), not many. ASAM explicitly stated that “sexual behavior addiction” exists and must necessarily be caused by the same fundamental brain changes found in substance addictions.
B) “Existing studies supporting an addiction model lack precise definitions and methodological rigor, and rely on correlational data. Pre-existing psychological issues that could account for changes in sexual behavior and/or pornography viewing have not been considered. Studies are needed that utilize experimental designs and account for a range of potential extraneous variables (Ley et al., 2014). Although some people may incorrectly assume that increased dopaminergic activity during sex or pornography viewing (which is to be expected) is evidence for addiction, Prause, Steele, Staley, Sabatinelli, and Hajcak (2015) found in their controlled study that participants reporting hypersexual problems did not show the same neural response patterns consistent with other known addictions. There are many diverse reasons why people may engage in pornography viewing, and frequent and diverse sexual activities, which must be considered when assessing behavior (Ley, 2012; Ley et al., 2014).”
The neurological studies on sex and porn addiction are very rigorous, and many of them are done by some of the top addiction neuroscientists in the world. Here they are: 41 neuroscience-based studies.
The proclamation’s suggestion that “correlation” renders research useless, reveals remarkable ignorance (or spin), as it would be unethical to induce addiction of any type in human subjects. Besides, it is silly to suggest that porn addicts were all born with all the major addiction-caused brain changes that are showing up in rigorous brain research on porn/sex-addicted subjects. What are the odds? Zero. For example, the core addiction-caused brain change is sensitization, which can only occur with continuous and prolonged use.
The proclamation statement’s mischaracterizing the neurological research as investigations of “dopaminergic activity during sex or pornography viewing” reveal that the authors of this proclamation haven’t read any of the studies in question. None of the neurological studies assessed dopamine activity! Instead, the 3 dozen studies assessed the presence of one or more of the four major brain changes involved with both drug and behavioral addictions: 1) Sensitization, 2) Desensitization, 3) Dysfunctional prefrontal circuits (poorer exceutive functioning), and 4) Dysfunctional stress circuits. All 4 of these brain changes have been identified among the 40 neuroscience-based studies on frequent porn users & sex addicts:
Studies indicating a dysfunctional stress system in porn users/sex addicts: 1, 2, 3.
What about the proclamation’s claim concerning Prause et al., 2015?
“Prause, Steele, Staley, Sabatinelli, and Hajcak (2015) found in their controlled study that participants reporting hypersexual problems did not show the same neural response patterns consistent with other known addictions.”
“Neural response patterns” means “cue-reactivity,” which reveals the core addiction brain change – sensitization. As you can see above, there are now 21 studies on porn users/sex addicts reporting findings consistent with cue-reactivity, attentional bias, or cravings. Even if the proclamation were correct that Prause et al., 2015’s findings actually contradicted the existence of cue-reactivity (it doesn’t), it would take more than one anomalous (and flawed) study to “debunk” decades of behavioral addiction research!
And what were the actual results of Prause et al., 2015? Compared to controls “individuals experiencing problems regulating their porn viewing” had lower brain responses to one-second exposure to photos of vanilla porn. The authors claim these results “debunk porn addiction.” Yet, in reality, the findings of Prause et al. 2015 align perfectly with Kühn & Gallinat (2014), which found that more porn use correlated with less brain activation in response to pictures of vanilla porn – an addiction-related brain change.
Prauseet al. findings also align with Banca et al. 2015. Lower EEG readings mean that subjects are paying less attention to the pictures. Put simply, frequent porn users were desensitized to static images of vanilla porn, compared to a control group. They were bored (habituated or desensitized), which can be evidence of an addiction process at work. See this extensive YBOP critique. Eight peer-reviewed papers agree that this study actually found desensitization/habituation in frequent porn users (consistent with addiction): 1, 2, 3, 4, 5, 6, 7, 8.
The proclamation’s third main assertion (C)
C) “The sex/porn addiction model reflects significant sociocultural biases (Klein, 2002; Williams, 2016), including specific measures of clinical assessment Joannides, 2012). Socio-cultural biases include assumptions concerning normal sex drive, relationship styles, and erotic interests and practices. Thus, people with alternative sexual identities are likely to face further marginalization and discrimination by those who support a sex/porn addiction model.”
Only one of the above citations is peer-reviewed: Williams, 2016. It is in a minor social work journal that is not PubMed indexed. The only neurological study Williams cited was, you guessed it, Prause et al. 2015. Williams, 2016 is a biased opinion piece that depends on Prause et al. 2015 and David Ley’s books and articles for its empirical support. It ignores the 40 other neurological studies on porn users, 20 recent reviews & commentaries, and 90 studies linking porn to sexual problems and less sexual & relationship satisfaction. Wiiliams, 2016 is nothing more than empty rhetoric.
The proclamation’s fourth main assertion (D)
D) “Research has shown that religiosity and moral disapproval have a strong influence on perceived sex/porn addiction. For example, Grubbs and colleagues (2010, 2015) found that religiosity and moral disapproval were strong predictors of perceived pornography addiction, even when actual pornography use was controlled. Other researchers have reported similar findings (Abell, Steenbergh, & Boivin, 2006; Kwee, Dominguez, & Ferrell, 2007; Leonhardt, Willoughby, & Young-Petersen, 2017). Regarding pornography use, Thomas (2013, 2016) applied archival analysis to trace the creation and deployment of the addiction framework among evangelical Christians. Other scholars have reported that the concept of sex addiction emerged in the 1980s as a socially conservative response to cultural anxieties, and has gained acceptance through its reliance on medicalization and popular culture visibility (Reay, Attwood, & Gooder, 2013;Voros, 2009).”
Second, two studies that assessed treatment-seeking male sex addicts found no relationship with religiosity. For example, this 2016 study on treatment-seeking porn addicts found that religiosity did not correlate with negative symptoms or scores on a sex addiction questionnaire. This 2016 study on treatment-seeking hypersexuals found no relationship between religious commitment and self-reported levels of hypersexual behavior and related consequences.
Finally, this proclamation assertion combines 2 specious “straw man” arguments:
E) The sex/porn addiction model assumes that sexual behaviors as a coping mechanism are an indicator of addiction, but it does not consider the possibility that sex may be a positive coping mechanism.
The sex/porn addiction model makes no such assumption. It is concerned with people who cannot control their behavior despite serious negative consequences. This is the very opposite of “coping.”
As is customary when a letter critical of a study is published, the study’s authors were given a chance to respond. Prause’s pretentious response entitled “Red Herring: Hook, Line, and Stinker” not only evades Isenberg’s points (and mine), it contains several new misrepresentations and several transparently false statements. In fact, Prause’s reply is little more than smoke, mirrors, groundless insults, and falsehoods. On a side note, check out this twitter convo where Prause attempts to substitute insults about Isenberg for substantive replies to his many valid objections:
“@DrDavidLey definitely the most amusing letter I’ve had the chance to publish. Fun when the first writer cannot spell, math, or think!”
It’s unfortunate that she had “fun” instead of actually answering his concerns. She appears to be spinning a Big Fish Story littered with false statements and misrepresentations. I will address Prause’s claims in the order of her reply.
The Missing Subjects
Prause begins by boldly claiming that Isenberg was mistaken, and that she had already accounted for 280 participants:
“The author describes “discrepancies” in participant counts, but no discrepancies exist. Table 1 shows all 280 participants, including the subsample with International Index of Erectile Function (IIEF) scores.”
This is the first of several false statements by Prause. It is irrefutable that discrepancies existed in her original paper, and these still have not been explained. For example, guess how Prause now claims to get from the 234 subjects Dr. Isenberg counted in the 4 underlying studies to 280, the total subjects she claimed? Simple. She now asserts that a 5th study exists: Moholy and Prause (circled below). This is an unpublished study not mentioned in the original Prause & Pfaus ED paper. No one can see it, so no one can check it or challenge it!
This unpublished paper, which may never be accepted for publication, is now brazenly and improperly tacked onto the existing paper, which has already been published (and supposedly peer-reviewed). How can you publish a study and say it’s peer-reviewed, when data it contains and bases its claims on have not been peer-reviewed? Riddle me that.
The original P&P ED paper explicitly states (in error) that all the subjects and data were culled from these four studies (study 1, study 2, study 3, study 4):
“Two hundred eighty men participated over four different studies conducted by the first author. These data have been published or are under review [33–36],”
Either the original ED paper is inaccurate, or the current response tacking on a 5th, unaccepted study is a slight-of-hand.
Why doesn’t this mysterious 5th paper add subjects to any other categories in the table? Look below its title in her table (above) and you will see two big fat zeros. Very fishy indeed.
Anyhow, as explained in my original critique, 280 was an empty number, mentioned for headline purposes only. The P&P paper was supposedly about ED in 280 (sic) men, yet it reported erectile functioning scores for a mere 127 men (IIEF). And even that figure (already much lower than the 280 in the headlines) was unsupported by the 4 underlying studies on which the ED paper purports to rest. That is, P&P may have claimed that 127 (or 133) men took the IIEF, but the underlying studies reported only 47 subjects. This glaring discrepancy still has not been explained.
Her table reveals a second sleight-of-hand. Prause now claims that 92 men, from 1 of the 4 studies (Moholy et al), took the IIEF. First problem: that particular study makes no mention of the IIEF. Second, much bigger, problem: that study lists only 61 male subjects (table 1 pg 4). Uh oh, guess 31 fish got away.
Summary of Prause’s new assertions:
Prause conjures up a 5th unpublished study no one can check in an attempt to get her subject-count up to 280: Moholy and Prause (under review). This new development directly contradicts P&P ED paper. Suspiciously, the extra 52 men are nowhere else to be found in the original P&P ED paper.
To get to 127 men for the IIEF, Prause announces that 92 missing men were somehow present in Moholy et al. Unfortunately, that study made no mention of the IIEF, and lists only 61 male subjects.
I guess I’ll need to add these two additional discrepancies and misrepresentations to the eight in my original critique. By the way, 1 and 2 above render her paragraph that starts with “Secondary analysis…” meaningless.
Each Study Used a Different Arousal Scale
Headlines for the P&P ED paper consistently claimed that porn use increased sexual performance. Shockingly, Jim Pfaus falsely claimed in an TV interview that P&P assessed men’s ability to achieve a erection in the lab. Pfaus also falsely stated: “We found a liner correlation with the amount of porn they viewed at home, and the latencies which for example they get an erection is faster.”
In reality, the study only asked men to rate their arousal after viewing porn. No erections or latencies were tested. The finding: Men who watched more porn rated their arousal slightly higher than men who watched less porn. That’s called sensitization, not “better performance”. P&P’s claims that porn use leads to greater arousal are dependent upon all four studies using the same arousal scale and the same stimulus. Neither occurred.
Prause tries to explain away the fact that none of her four underlying studies used the same “arousal scale” for porn viewing. Here’s what the original P&P ED paper actually said:
“Men were asked to indicate their level of “sexual arousal” ranging from 1 “not at all” to 9 “extremely.”
As Isenberg and I pointed out, only 1 of the 4 underlying studies used a 1 to 9 scale. One used a 0 to 7 scale, one used a 1 to 7 scale, and one study did not report sexual arousal ratings. Even more confusing, the sexual arousal graph in the P&P paper used a 1 to 7 scale. Two glaring mistakes in the original paper.
Instead of apologizing for the original paper’s false statements and graph errors, Prause now offers Isenberg a lesson on what researchers might theoretically do with different number scales:
“The author of the letter also made a false statistical statement: “Results from different Likert scales are not poolable”. Of course they are! In fact, there are at least three different methods to pool them.”
That’s great to know, but there’s absolutely no indication that Prause pooled the four different arousal scales. I suspect she didn’t as 1) she would have said so, 2) one of the studies had no scale, so couldn’t be pooled using any method, and 3) she refused to acknowledge her earlier errors, so why would she acknowledge this one?
Studies Used Different Sexual Stimuli
Not only did the four underlying studies have different arousal scales (or none), they used different stimuli. Two of the studies used a 3-minute film; one study used a 20-second film; and one study used only photos. No researcher can do that and expect valid results. It’s well established that films are more arousing than photos. What’s shocking is that the original P&P ED paper falselyclaims that all 4 studies used sexual films:
“The VSS presented in the studies were all films.”
So how does Prause address this conspicuous methodological flaw and her study’s false statement? With another false statement, or two, in bold:
“The author also made a false statement that stimuli varied between studies and this was not “controlled”. We assessed and controlled the stimuli as stated in our original article (“sexual arousal reported did not differ by film length, so data were collapsed across studies for this analysis”, p. E4).”
First false statement: Nowhere did Dr. Isenberg say that the stimuli “[were] not controlled.”
Second false statement: The stimuli did vary among studies: 3-minute film, 20-second film, photos.
“Controlled for” is meaningless here, and Prause refuses to say how she magically managed to do the impossible: control for some guys viewing photos, while other watched 3-minute porn flicks.
Some of the Subjects Were Gay
Prause begins her next paragraph with yet another false statement:
“Finally, again contrary to the author’s claims, there were not “four gay” men in any study.
Dr. Isenberg’s only reference to “gay” was a listing of “including 4 gay” in his table under Prause’s study “Biases for Affective Versus Sexual Content in Multidimensional Scaling Analysis: An Individual Difference Perspective (2013, Prause, Moholy, Staley). From page 2 of that study.
“A total of 157 (N=47 male, 1 transgender) psychology students over age 18 years participated in exchange for course credit. Most reported being heterosexual. Four males reported being homosexual and four reported being bisexual.”
Four gay men, just as Dr. Isenberg stated. It seems Isenberg can “math” good enough to know that 4 means 4.
Why did Dr. Isenberg list 4 gay men in the table? It’s well established (and common sense) that gay and straight men have very different brain responses to heterosexual porn. Including gay men, as Prause did, skews the “sexual arousal” results and her resulting correlations. It calls into question her findings.
In brain studies on addiction, or compulsive behaviors, valid results depend upon homogeneous subjects. Put simply, subjects must be the same sex, similar ages, similar IQs and, generally, all right-handed to produce valid results. Prause ignores standard protocols by having males, females and non-heterosexuals all watch heterosexual porn. You can’t do that, as many studies confirm significant differences between males and females in response to sexual images (1, 2, 3, 4, 5).
This is one of various reasons why Prause’s 2013 EEG study on porn users was sharply criticized. The study’s subjects differed (women, men, heterosexuals, non-heterosexuals), yet they were all shown the same standard male+female porn. This alone invalidates the study’s claims that it “debunks porn addiction.” Please be aware that Prause has already announced that she has employed this same flaw (mixed subjects) in a study, which she maintains debunks porn addiction once again. From her SPAN Lab website:
What scientist announces on their twitter account and personal website that their single, unpublished study “debunks” an entire field of research?
Hours Per Week Not Defined
This section takes some explaining, but it leads us to another manifestly false statement by Prause. In the following paragraph, Dr. Isenberg explains that P&P failed to fully describe hours per week of porn use. In other words, Prause failed to say if hours per week referred to the previous week, or month, or year, or who knows.
ISENBERG: “The hours-viewed parameter itself is poorly defined. We are not told if the self-report of hours referenced the preceding week, the average over the last year, or was entirely left to subject interpretation. Were there subjects who were previously heavy users who had recently cut down or eliminated their pornography viewing? Absent a well-defined and consistent referent, the porn use data is uninterpretable.”
Prause responds by telling us what we already know – that she said “hours per week“:
“The author claims we did not adequately describe the sex film view variable. We described that variable at least 13 places in the manuscript. (“weekly average” in abstract; “reported the average number of hours they consumed VSS per week”…..
Again, Dr. Isenberg wanted to know: Are you asking subjects about the “previous week”, or “the last year”, maybe “since you started watching porn”, or some other time-frame? Prause ends her repetitive two-paragraph rant with yet another false statement:
“The question was exactly as described, “How much time per week did you spend using pornography during the past month?” with the response box including the descriptor “hours” for which they could indicate partial hour(s).”
Search the P&P ED paper and you will find no such question (mentioning the past month).
Prause follows up this false statement with two paragraphs arguing that hours per week is an appropriate measure. Dr. Isenberg wasn’t commenting on its “appropriateness.” He just pointed out that the data cannot be interpreted without knowing how the subjects understood the question. Since she had to make a false claim to respond to Isenberg’s point, perhaps Prause’s statement is the red herring she refers to in her pompous title.
Many More Variables Than Current Hours Per Week
One of the most common questions posed on recovery forums is, “Why did I develop PIED when my friends watch as much (or more) porn than I do?” Instead of onlycurrent hours per week, a combination of variables appears to be implicated in porn-induced ED. Dr. Isenberg highlights the importance of investigating many other variables before claiming, as the authors do, that porn-induced ED is a myth (and he doesn’t even mention novelty of watching internet porn, arguably the most important factor):
ISENBERG: “Furthermore, the authors do not report on relevant viewing parameters such as total pornography usage, age of onset, presence of escalation, and extent of sexual activity with partner which may have bearing on male sexual functioning [11,12].”
In the above sentence, Dr. Isenberg cites two studies as examples of research that examined two additional variables: citation 11 employed ‘years of porn use’, and citation 12 employed ‘age started porn use’. Prause spends the next paragraph attacking a straw man, namely, that Dr. Isenberg claimed both studies assessed every single variable he listed. Why didn’t she instead explain why she didn’t ask her subjects about important variables before drawing her unsubstantiated conclusion that porn isn’t the culprit in youthful ED?
Average Erectile Scores Actually Indicate ED
While Prause admits to only a single oversight, it’s fitting that she adds yet another misrepresentation to her apology (bold):
“We also recognize that we stated in one place that the IIEF was a “19-item” (p. E3) scale. The scale actually is a 15-item scale. We profusely apologize for this gross oversight, although the scores, results, and conclusions were accurate and indicative of normal erectile function“
As pointed out in my critique, P&P reported an average score of 21.4 out of 30 for the 6-item IIEF (average age 23). This is far from “normal erectile function” in 23-year olds. In fact, this score indicates “mild erectile dysfunction”, leaning towards “moderate erectile dysfunction”.
Still No Data Correlating IIEF Scores With Porn Use
Isenberg was also concerned that P&P offer inadequate data for their claim that no correlation existed between IIEF scores and hours viewed per week:
ISENBERG: Even more disturbing is the total omission of statistical findings for the erectile function outcome measure. No statistical results whatsoever are provided. Instead the authors ask the reader to simply believe their unsubstantiated statement that there was no association between hours of pornography viewed and erectile function. Given the authors’ conflicting assertion that erectile function with a partner may actually be improved by viewing pornography the absence of statistical analysis is most egregious.
Red Herring leaves us hanging on this critical point. We’re meant to swallow the authors’ conclusions “hook, line and stinker.”
Questions Were Raised About P&P’s “Strong” Finding
The following excerpt, taken from the second paragraph, claims that Isenberg failed to raise questions about P&P’s “strong” finding. Read carefully as Prause alters key words to give the reader a false impression:
“No questions were raised about the strong finding that the more men viewed sex films at home the stronger sexual desire they reported for their partner. In fact, this result was described as ‘hardly novel’.”
The actual finding? Guys who watched more porn scored higher in their desire to masturbate and have sex with a partner. In the above claim, Prause omitted greater desire to masturbate (presumably to porn), and leads us to believe that the questionnaire stated sexual desire for “their” partner. It didn’t. From P&P ED study:
“Men reported their desire for sex with apartner and desire for solitary sex“
Prause added “their” and removed “solitary sex”. Since the questionnaire’s phrasing was actually “sex with a partner”, these porn-loving subjects could have just as easily been fantasizing about sex with their favorite porn star. I suspect many were, as a large percentage of the subjects had no partners (50% in one underlying study).
In reality, higher “desire” to masturbate, or to have sex, might be evidence of sensitization, which is greater reward circuit activation and craving when exposed to porn cues. Sensitization can be a precursor to, or evidence of, addiction.
Two recent Cambridge University studies found that heavy porn users can experience higher desire (cravings), yet also experience erection problems with a partner. Participants’ brains lit up when exposed porn, yet 60% of them reported arousal/erectile problems with partners. From the Cambridge study:
“CSB subjects reported that as a result of excessive use of sexually explicit materials…..they experienced diminished libido or erectile function specifically in physical relationships with women (although not in relationship to the sexually explicit material)”
Put simply, there’s no basis for claiming that a porn user’s higher desire to masturbate and have sex predicts better performance in the bedroom. Remember, the average erection scores for P&P subjects indicated ED.
Prause Tweets & Posts About Her Reply
Here’s Prause initially tweeting about her reply to Isenberg’s critique:
“Red Herring: Hook, Line, and Stinker” Our fun, published response to the crazy claims made by anti-porn groups
The next day Prause posts this on her SPAN lab website:
Amazing. As you have read above, Isenberg’s claims are valid, while Prause makes false statement after false statement. Moreover, she attempts to add an unpublished study after the fact in a desperate ploy to meet her published claim of 280 subjects. She conjures up IIEF subjects who cannot exist by her own earlier admission. Then she calls uro-gynecologist Isenberg a “crazy anti-porn group.” Feel free to Google his name. You will see that he has published peer-reviewed studies, yet has never said a word that was anti-porn. Spin without addressing the content.
Why has Sexual Medicine Open Access allowed Prause to publish numerous false statements in both the original P&P paper and her reply to Isenberg? Why weren’t Isenberg’s questions taken seriously and answered professionally? Why is there no serious investigation into the cause of the sudden jump in ED rates in the last few years? Rates have skyrocketed to around 30% in young men.
I was surprised and somewhat baffled by grad student Kris Taylor’s recent VICE article on porn use and sexual dysfunctions. In his article Taylor not only misrepresented the content of a 2016 review of literature I co-authored with 7 US navy doctors, he chose to omit over 40 studies linking porn use to sexual problems and lower sexual arousal. Before I address specific sections of Kris Taylor’s article here are the studies and articles he was given, yet chose to neglect in his article:
Articles, interviews and videos citing over 150 experts (urology professors, urologists, psychiatrists, psychologists, sexologists, MDs) who acknowledge and have successfully treated porn-induced ED and porn-induced loss of sexual desire.
Over 60 studies reporting findings consistent with escalation of porn use (tolerance), habituation to porn, and even withdrawal symptoms.
All the neurological studies published on porn users/sex addicts: 55 neuroscience studies (MRI, fMRI, EEG, neurospychological, hormonal) provide strong support for the addiction model.
The truth behind current and historical sexual dysfunction rates in young men.
KRIS TAYLOR EXCERPT: “Hooked on porn: Prepare for a tsunami of damaged people,” warned the Herald last year. They quote Brisbane based sexologist Liz Walker, saying “before the internet appeared, erectile dysfunction in males under 40 was reported as being about 2-5 per cent, now that figure has jumped to between 27 and 33 per cent.“
KRIS TAYLOR EXCERPT: “But when you try to find the research she’s citing, thing get murkier. Her source is this paper, which in turn gives numbers sourced from twopapers – neither of which reference pornography as causative. Not to mention that the second author of the paper is Gary Wilson, a well-known fervent anti-pornography campaigner.”
Taylor cites the US Navy paper and proceeds to blatantly misrepresent its content (perhaps hoping no one would click on the link). Taylor “suggests” that our paper cited only 2 isolated studies to support the claim that ED rates in men under 40 have skyrocketed since the advent of streaming tube sites (2006). In reality, we examined every PubMed listed study previously published that provided sexual dysfunction rates for men under 40.
We also examined all PubMed sourced meta-studies and meta-analyses examining ED rates in both men over and under 40. A meta-analysis is a study that reviews all previous studies on a particular subject, and lists the pertinent data. (Taylor may not yet know what a meta-analysis is as he linked to one of meta-analysis we cited.)
What did our paper cite in the 2nd paragraph to support the claim that historical ED rates for men under have been between 2-5%? (The following citation numbers and their original links are provided.)
[2] – (2000) Meta-analysis that reviewed 93 studies from across the globe.
[5] – (2001) ED rates from 29 developed countries (13,000 subjects).
Not cited: The Kinsey report concluded that the prevalence of ED was less than 1% in men younger than 30 years, less than 3% in those 30–45.
Taylor failed to provide a single study to refute our claim that ED rates for men under 40 have been consistently reported as between 2-5%. Instead, he attempted to mislead the reader with a single 2013 study, implying that high rates of erectile dysfunction in young men were always normal. However, the paper also supports our claims. He said:
KRIS TAYLOR EXCERPT:“By some estimates erectile ‘dysfunction’ may occur for about half of all men, and 1 in 4 men seeking treatment for erectile dysfunction will be under 40.”
Further, what did our paper cite in the 3rd paragraph to support the claim that recent studies report much higher rates of sexual dysfunction for men under 40?
[9] – (2013). The above study. The rates of severe ED nearly 10% higher than in men over 40.
[6] – (2015). Europeans, 18–40, ED rates ranged from 14%–28%. Low libido as high as 37%.
[8] – (2012). ED rates of 30% in a cross-section of Swiss men aged 18–24.
[10] – (2014). Males aged 16-21: ED (27%), low sexual desire (24%), problems with orgasm (11%).
[11] – (2016). 2-year longitudinal study in which they found that, over several checkpoints during the 2 years, the following percentages of 16-21 year old males: low sexual satisfaction (47.9%), low desire (46.2%), problems in erectile function (45.3%).
[12] – (2014). New diagnoses of ED in active duty servicemen reported that rates had more than doubled between 2004 and 2013.
[13] – (2014). Cross-sectional study of active duty male military personnel aged 21–40 found an overall ED rate of 33.2%.
[16] – (2010). Brazilian study of men 18-40 reported ED rates of 35%.
The takeaway: The claims that historical rates of youthful ED have ranged from 1-5 percent, and that studies since 2010 have reported a tremendous increase in ED rates is supported by the peer-reviewed literature. All the above evidence (and more) was presented in the first 3 paragraphs of the US Navy paper. This fact indicates that Kris Taylor purposely misled VICE and its readers.
Over 40 studies link porn use/porn addiction to sexual problems & lower arousal (all omitted by Taylor)
KRIS TAYLOR EXCERPT:“While searching in vain for research that supported the position that pornography causes erectile dysfunction, I found a variety of the most common causes of erectile dysfunction. Pornography is not among them. These included depression, anxiety, nervousness, taking certain medications, smoking, alcohol and illicit drug use, as well as other health factors like diabetes and heart disease. Even riding a bike for too long can cause temporary erectile dysfunction if the bike seat compresses nerves in the perineum.”
First we will address Kris Taylor “searching in vain for research that supported the position that pornography causes erectile dysfunction.” This claim is rather hard to swallow as Taylor was earlier given this YBOP page by Liz Walker. It contains 37 studies linking porn use or porn addiction to sexual dysfunctions and lower arousal. The first 7 studies in the list demonstrate causation,as participants eliminated porn use and healed chronic sexual dysfunctions (one of the three being the US Navy paper, which included case reports). Sixteen of these studies made it into the 2016 US Navy paper, and they were introduced with this paragraph:
While such intervention studies would be the most illuminating, our review of the literature finds a number of studies that have correlated pornography use with arousal, attraction, and sexual performance problems [27, 31, 35, 36, 37, 38, 39, 40, 41, 42, 43], including difficulty orgasming, diminished libido or erectile function [27, 30, 31, 35, 43, 44], negative effects on partnered sex [37], decreased enjoyment of sexual intimacy [37, 41, 45], less sexual and relationship satisfaction [38, 39, 40, 43, 44, 45, 46, 47], a preference for using Internet pornography to achieve and maintain arousal over having sex with a partner [42], and greater brain activation in response to pornography in those reporting less desire for sex with partners [48].
The following very convincing study was published after the US Navy paper appeared: Male masturbation habits and sexual dysfunctions, 2016. Like our paper, it too demonstrated causation as 35 men who developed erectile dysfunction and/or anorgasmia attempted to quit porn and cut back on masturbation. The study reported that 19 men experienced significant improvement by the time the author wrote up the paper. The author is a French psychiatrist who is the current president of the European Federation of Sexology. He is hardly a “fervent anti-pornography campaigner,” yet he noted that many of the men he assessed were addicted to porn.
Conclusion:Addictive masturbation, often accompanied by a dependency on cyber-pornography, has been seen to play a role in the etiology of certain types of erectile dysfunction or coital anejaculation.
A 600% – 1000% increase in youthful ED in the last 7-12 years cannot be explained away by the usual factors
Kris Taylor claims that the recent tremendous rise in youthful ED must be caused by the variables usually correlated with ED in men over 40.
KRIS TAYLOR EXCERPT: While searching in vain for research that supported the position that pornography causes erectile dysfunction, I found a variety of the most common causes of erectile dysfunction. Pornography is not among them. These included depression, anxiety, nervousness, taking certain medications, smoking, alcohol and illicit drug use, as well as other health factors like diabetes and heart disease. Even riding a bike for too long can cause temporary erectile dysfunction if the bike seat compresses nerves in the perineum.
As explained in our paper, smoking, diabetes and heart disease rarely cause ED in men under 40 (citation 16). It takes years of smoking or uncontrolled diabetes to manifest neuro-vascular damage severe enough to cause chronic ED. From our paper:
Traditionally, ED has been seen as an age-dependent problem [2],and studies investigating ED risk factors in men under 40 have often failed to identify the factors commonly associated with ED in older men, such as smoking, alcoholism, obesity, sedentary life, diabetes, hypertension, cardiovascular disease, and hyperlipidemia [16].
As for “taking certain medications, smoking, alcohol and illicit drug use,” none of rates of these correlative factors have increased over the last 15 years (smoking has actually decreased). From the US Navy paper:
However, none of the familiar correlative factors suggested for psychogenic ED seem adequate to account for a rapid many-fold increase in youthful sexual difficulties. For example, some researchers hypothesize that rising youthful sexual problems must be the result of unhealthy lifestyles, such as obesity, substance abuse and smoking (factors historically correlated with organic ED). Yet these lifestyle risks have not changed proportionately, or have decreased, in the last 20 years: Obesity rates in U.S. men aged 20–40 increased only 4% between 1999 and 2008 [19]; rates of illicit drug use among US citizens aged 12 or older have been relatively stable over the last 15 years [20]; and smoking rates for US adults declined from 25% in 1993 to 19% in 2011 [21].
As for “depression, anxiety, nervousness,” none of these cause erectile dysfunction, they are simply weakly correlative to ED. In fact, some studies report that depressed and anxious patients have higher sexual desire. Other studies suggest the obvious: depression doesn’t cause ED; having ED increases scores on depression tests. From the US Navy paper:
Other authors propose psychological factors. Yet, how likely is it that anxiety and depression account for the sharp rise in youthful sexual difficulties given the complex relationship between sexual desire and depression and anxiety? Some depressed and anxious patients report less desire for sex while others report increased sexual desire [22, 23, 24, 25]. Not only is the relationship between depression and ED likely bidirectional and co-occurring, it may also be the consequence of sexual dysfunction, particularly in young men [26].
As we said in our paper’s conclusion:
Traditional factors that once explained sexual difficulties in men appear insufficient to account for the sharp rise in sexual dysfunctions and low sexual desire in men under 40.
Overall, 229 (75%) and 78 (25%) patients had normal and impaired Erectile Function (EF); among patients with ED, 90 (29%) had an IIEF-EF score suggestive for severe ED. Patients with and without ED did not differ significantly in terms of median age, BMI, prevalence of hypertension, general health status, smoking history), alcohol use, and median IPSS score. Similarly, no differences were reported in terms of serum sex hormones and lipid profile between the two groups.
These findings showed that young men with ED do not differ in terms of baseline clinical characteristics from a comparable-age group with normal EF, but depicted lower sexual desire scores, clinically suggesting a more probable psychogenic cause of ED.
For some reason those with ED had low sexual desire (should’ve asked about porn!) To repeat, Kris Taylor, like other porn-induced ED deniers, argue that young men’s ED is caused by the exact same risk factors that are related to ED in men over 40.
Finally, Taylor’s claim that bike-riding is associated with ED has recently been debunked. An excerpt from the article:
“As cycling gains in popularity, as both a hobby and a professional sport, it is important for the public to know that it has no credible link to urologic disease or sexual dysfunction,” said Dr. Kevin McVary, a spokesman for the American Urological Association.
Addressing the two papers Kris Taylor cited (both were extensively discussed in the US Navy review)
Ignoring the 7 papers demonstrating cessation of internet porn use reversing sexual dysfunctions, and 35 other studies that link internet porn use to sexual dysfunctions and low arousal, Taylor cited 2 papers as the “best available research”:
But the best research we have so far simply doesn’t support the claims. For example, a 2015 cross-sectional online study of 3,948 Croatian, Norwegian, and Portuguese men published in the Journal of Sexual Medicine indicated that “contrary to raising public concerns, pornography does not seem to be a significant risk factor for younger men’s desire, erectile, or orgasmic difficulties.” Another 2015 study, this time of 208 non-treatment seeking American men indicated that viewing pornography was “unlikely to negatively impact sexual functioning, given that responses actually were stronger in those who viewed more [pornography]”.
Neither paper was an actual study, and both have been formally criticized in the peer-reviewed literature. Both papers were discussed at length in the US Navy review of the literature – which I will excerpt below. I have a lot to say about both papers, so I have created separate sections for each. I will start with the second paper mentioned by Taylor, because we addressed it first in our review of the literature.
PAPER 2: Prause & Pfaus, 2015.
KRIS TAYLOR EXCERPT: Another 2015 study, this time of 208 non-treatment seeking American men indicated that viewing pornography was “unlikely to negatively impact sexual functioning, given that responses actually were stronger in those who viewed more [pornography]”.
I provide the formal critique by Richard Isenberg, MD and a very extensive lay critique, followed by my comments and excerpts from the US Navy paper:
The claim: Contrary to Taylor’s claim (and Prause & Pfaus claim), the men who watched more porn did not have “stronger responses.” None of the 4 studies underlying underlying the paper’s claims assessed genital or sexual responses in the lab. What Prause & Pfaus claimed in their paper was that men who watched more porn rated their excitement slightly higher while watching porn. The key phrase is while watching porn – not while having sex with an actual person. Arousal ratings while viewing porn tell us nothing about one’s arousal or erections when not viewing porn. It tells us nothing about porn-induced ED, which is the inability to become sufficiently aroused without using porn. That said, details from Prause & Pfaus, 2015 reveal that they could not have accurately assessed their subjects’ arousal ratings (much more below).
For argument’s sake let’s suppose that men viewing more porn rated their arousal a bit higher than men who viewed less. Another, more legitimate, way to interpret this arousal difference between the two porn-use groups is that men who watched the most porn experienced slightly greater cravings to use porn. This is quite possibly evidence of sensitization, which is greater reward circuit (brain) activation and craving when exposed to (porn) cues. Sensitization (cue-reactivity and cravings) is a primary addiction-related brain change.
Several recent Cambridge University brain studies demonstrated sensitization in compulsive porn users. Participants’ brains were hyper-aroused in response to porn video clips, even though they didn’t “like” some of the sexual stimuli more than control participants. In a dramatic example of how sensitization can affect sexual performance, 60% of the Cambridge subjects reported arousal/erectile problems with partners but not with porn. From the Cambridge study:
“[Porn addicts] reported that as a result of excessive use of sexually explicit materials…..they experienced diminished libido or erectile function specifically in physical relationships with women (although not in relationship to the sexually explicit material).”
Put simply, a heavy porn user can report higher subjective arousal (cravings) yet also experience erection problems with a partner. Certainly, his arousal in response to porn is not evidence of his “sexual responsiveness” or erectile functioning with a partner. Studies reporting sensitization/cravings or cue-reactivity in porn users/sex addicts: 1,2,3,4, 5,6,7,8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20.
The reality behind Prause & Pfaus 2015: This wasn’t a study on men with ED. It wasn’t a study at all. Instead, Prause claimed to have gathered data from four of her earlier studies, none of which addressed erectile dysfunction. It’s disturbing that this paper by Nicole Prause and Jim Pfaus passed peer-review as none of the data in their paper matched the data in the underlying four studies on which the paper claimed to be based. The discrepancies are not minor gaps, but gaping holes that cannot be plugged. In addition, the paper made several claims that were patently false or not supported by the data.
We begin with false claims made by both Nicole Prause & Jim Pfaus. Many journalists’ articles about this study claimed that porn use led to better erections, yet that’s not what the paper found. In recorded interviews, both Nicole Prause and Jim Pfaus falsely claimed that they had measured erections in the lab, and that the men who used porn had better erections. In the Jim Pfaus TV interview Pfaus states:
“We looked at the correlation of their ability to get an erection in the lab.”
“We found a liner correlation with the amount of porn they viewed at home, and the latencies which for example they get an erection is faster.”
In this radio interview Nicole Prause claimed that erections were measured in the lab. The exact quote from the show:
“The more people watch erotica at home they have stronger erectile responses in the lab, not reduced.”
Yet this paper did not assess erection quality in the lab or “speed of erections.” The paper only claimed to have asked guys to rate their “arousal” after briefly viewing porn (and it’s not clear from the underlying papers that this simple self-report was asked of all subjects). In any case, an excerpt from the paper itself admitted that:
“No physiological genital response data were included to support men’s self-reported experience.”
In a second unsupported claim, lead author Nicole Prause tweeted several times about the study, letting the world know that 280 subjects were involved, and that they had “no problems at home.” However, the four underlying studies contained only 234 male subjects, so “280” is way off.
A third unsupported claim: Author of the critical Letter to the Editor linked to above, Dr. Isenberg, wondered how it could be possible for Prause & Pfaus 2015 to have compared different subjects’ arousal levels when three different types of sexual stimuli were used in the 4 underlying studies. Two studies used a 3-minute film, one study used a 20-second film, and one study used still images. It’s well established that films are far more arousing than photos, so no legitimate research team would group these subjects together to make claims about their responses. What’s shocking is that in their paper Prause & Pfaus unaccountably claim that all 4 studies used sexual films:
“The VSS presented in the studies were all films.”
This statement is false, as clearly revealed in Prause’s own underlying studies. This the first reason why Prause & Pfaus cannot claim that their paper assessed “arousal.” You must use the same stimulus for each person to compare all the subjects.
A fourth unsupported claim: Dr. Isenberg also asked how Prause & Pfaus 2015 could compare different subjects’ arousal levels when only 1 of the 4 underlying studies used a 1 to 9 scale. One used a 0 to 7 scale, one used a 1 to 7 scale, and one study did not report sexual arousal ratings. Once again Prause & Pfaus inexplicably claim that:
“Men were asked to indicate their level of “sexual arousal” ranging from 1 “not at all” to 9 “extremely.”
This too is false as the underlying papers show. This is the second reason why Prause & Pfaus cannot claim that their paper assessed “arousal” ratings in men. A study must use the exact same rating scale for each person to compare the subjects’ results. In summary, all the Prause-generated headlines about porn use improving erections or arousal, or anything else, are unwarranted.
Prause & Pfaus 2015 also claimed they found no relationship between erectile functioning scores and the amount of porn viewed in the last month. As Dr. Isenberg pointed out:
“Even more disturbing is the total omission of statistical findings for the erectile function outcome measure. No statistical results whatsoever are provided. Instead the authors ask the reader to simply believe their unsubstantiated statement that there was no association between hours of pornography viewed and erectile function. Given the authors’ conflicting assertion that erectile function with a partner may actually be improved by viewing pornography the absence of statistical analysis is most egregious.”
In the Prause & Pfaus response to the Dr. Isenberg critique, they once again failed to provide any data to support their “unsubstantiated statement.” As this analysis documents, the Prause & Pfaus response not only evades Dr. Isenberg’s legitimate concerns, it contains several new misrepresentations and several transparently false statements. Finally, our review of the literature commented on Prause & Pfaus 2015:
“Our review also included two 2015 papers claiming that Internet pornography use is unrelated to rising sexual difficulties in young men. However, such claims appear to be premature on closer examination of these papers and related formal criticism. The first paper contains useful insights about the potential role of sexual conditioning in youthful ED [50]. However, this publication has come under criticism for various discrepancies, omissions and methodological flaws. For example, it provides no statistical results for the erectile function outcome measure in relation to Internet pornography use. Further, as a research physician pointed out in a formal critique of the paper, the papers’ authors, “have not provided the reader with sufficient information about the population studied or the statistical analyses to justify their conclusion” [51]. Additionally, the researchers investigated only hours of Internet pornography use in the last month. Yet studies on Internet pornography addiction have found that the variable of hours of Internet pornography use alone is widely unrelated to “problems in daily life”, scores on the SAST-R (Sexual Addiction Screening Test), and scores on the IATsex (an instrument that assesses addiction to online sexual activity) [52, 53, 54, 55, 56]. A better predictor is subjective sexual arousal ratings while watching Internet pornography (cue reactivity), an established correlate of addictive behavior in all addictions [52, 53, 54]. There is also increasing evidence that the amount of time spent on Internet video-gaming does not predict addictive behavior. “Addiction can only be assessed properly if motives, consequences and contextual characteristics of the behavior are also part of the assessment” [57]. Three other research teams, using various criteria for “hypersexuality” (other than hours of use), have strongly correlated it with sexual difficulties [15, 30, 31]. Taken together, this research suggests that rather than simply “hours of use”, multiple variables are highly relevant in assessment of pornography addiction/hypersexuality, and likely also highly relevant in assessing pornography-related sexual dysfunctions.”
The US Navy paper highlighted the weakness in correlating only “current hours of use” to predict porn-induced sexual dysfunctions. The amount of porn currently viewed is just one of many variables involved in the development of porn-induced ED. These may include:
Ratio of masturbation to porn versus masturbation without porn
Ratio of sexual activity with a person versus masturbation to porn
Gaps in partnered sex (where one relies only on porn)
Virgin or not
Total hours of use
Years of use
Age started using porn
Escalation to new genres
Development of porn-induced fetishes (from escalating to new genres of porn)
Level of novelty per session (i.e. compilation videos, multiple tabs)
Addiction-related brain changes or not
Presence of hypersexuality/porn addiction
The better way to research this phenomenon, is to remove the variable of internet porn use and observe the outcome, which was done in the Navy paper and in two other studies. Such research reveals causation instead of fuzzy correlations open to varying interpretation. My site has documented a few thousand men who removed porn and recovered from chronic sexual dysfunctions.
KRIS TAYLOR EXCERPT: For example, a 2015 cross-sectional online study of 3,948 Croatian, Norwegian, and Portuguese men published in the Journal of Sexual Medicine indicated that “contrary to raising public concerns, pornography does not seem to be a significant risk factor for younger men’s desire, erectile, or orgasmic difficulties.”
As for the claim that Landripet & Štulhofer, 2015 found no relationships between porn use and sexual problems. This is not true, as documented in both this YBOP critique and the US Navy review of the literature. Furthermore, Landripet & Stulhofer’s paper omitted three significant correlations they presented to a European conference (more below). Let’s start with the first of three paragraphs from our paper that addressed Landripet & Štulhofer, 2015:
A second paper reported little correlation between frequency of Internet pornography use in the last year and ED rates in sexually active men from Norway, Portugal and Croatia [6]. These authors, unlike those of the previous paper, acknowledge the high prevalence of ED in men 40 and under, and indeed found ED and low sexual desire rates as high as 31% and 37%, respectively. In contrast, pre-streaming Internet pornography research done in 2004 by one of the paper’s authors reported ED rates of only 5.8% in men 35–39 [58]. Yet, based on a statistical comparison, the authors conclude that Internet pornography use does not seem to be a significant risk factor for youthful ED. That seems overly definitive, given that the Portuguese men they surveyed reported the lowest rates of sexual dysfunction compared with Norwegians and Croatians, and only 40% of Portuguese reported using Internet pornography “from several times a week to daily”, as compared with the Norwegians, 57%, and Croatians, 59%. This paper has been formally criticized for failing to employ comprehensive models able to encompass both direct and indirect relationships between variables known or hypothesized to be at work [59]. Incidentally, in a related paper on problematic low sexual desire involving many of the same survey participants from Portugal, Croatia and Norway, the men were asked which of numerous factors they believed contributed to their problematic lack of sexual interest. Among other factors, approximately 11%–22% chose “I use too much pornography” and 16%–26% chose “I masturbate too often” [60]
As I and the Navy doctors described, this paper found a pretty important correlation: Only 40% of the Portuguese men used porn “frequently,” while the 60% of the Norwegians used porn “frequently.” The Portuguese men had far less sexual dysfunction than the Norwegians. With respect to the Croats, Landripet & Štulhofer, 2015 acknowledge a statistically significant association between more frequent porn use and ED, but claim the effect size was small. However, this claim may be misleading according to an MD who is a skilled statistician and has authored many studies:
Analyzed a different way (Chi Squared), … moderate use (vs. infrequent use) increased the odds (the likelihood) of having ED by about 50% in this Croatian population. That sounds meaningful to me, although it is curious that the finding was only identified among Croats.
In addition, Landripet & Stulhofer 2015 omitted three significant correlations, which one of the authors presented to a European conference. He reported a significant correlation between erectile dysfunction and “preference for certain pornographic genres”:
“Reporting a preference for specific pornographic genres were significantly associated with erectile (but not ejaculatory or desire-related) male sexual dysfunction.”
It’s telling that Landripet & Stulhofer chose to omit this significant correlation between erectile dysfunction and preferences for specific genres of porn from their paper. It’s quite common for porn users to escalate into genres that do not match their original sexual tastes, and to experience ED when these conditioned porn preferences do not match real sexual encounters. As we pointed out above, it’s very important to assess the multiple variables associated with porn use – not just hours in the last month or frequency in the last year.
The second significant finding omitted by Landripet & Stulhofer 2015 involved female participants:
“Increased pornography use was slightly but significantly associated with decreased interest for partnered sex and more prevalent sexual dysfunction among women.”
A significant correlation between greater porn use and decreased libido and more sexual dysfunction seems pretty important. Why didn’t Landripet & Stulhofer 2015 report that they found significant correlations between porn use and sexual dysfunction in women, as well as a few in men? And why hasn’t this finding been reported in any of Stulhofer’s many studies arising from these same data sets? His teams seem very quick to publish data they claim debunks porn-induced ED, yet very slow to inform women about the negative sexual ramifications of porn use.
Finally, Danish porn researcher Gert Martin Hald’s formal critical comments echoed the need to assess more variables (mediators, moderators) than just frequency per week in the last 12 months:
“The study does not address possible moderators or mediators of the relationships studied nor is it able to determine causality. Increasingly, in research on pornography, attention is given to factors that may influence the magnitude or direction of the relationships studied (i.e., moderators) as well as the pathways through which such influence may come about (i.e., mediators). Future studies on pornography consumption and sexual difficulties may also benefit from an inclusion of such focuses.
Bottom line: All complex medical conditions involve multiple factors, which must be teased apart before far reaching pronouncements are appropriate. Landripet & Stulhofer’s statement that, “Pornography does not seem to be a significant risk factor for younger men’s desire, erectile, or orgasmic difficulties” goes too far, since it ignores all the other possible variables related to porn use that might be causing sexual performance problems in users – including escalation to specific genres, which they found, but omitted in the “Brief Communication.” Paragraphs 2 & 3 in our discussion of Landripet & Stulhofer, 2015:
Again, intervention studies would be the most instructive. However, with respect to correlation studies, it is likely that a complex set of variables needs to be investigated in order to elucidate the risk factors at work in unprecedented youthful sexual difficulties. First, it may be that low sexual desire, difficulty orgasming with a partner and erectile problems are part of the same spectrum of Internet pornography-related effects, and that all of these difficulties should be combined when investigating potentially illuminating correlations with Internet pornography use.
Second, although it is unclear exactly which combination of factors may best account for such difficulties, promising variables to investigate in combination with frequency of Internet pornography use might include (1) years of pornography-assisted versus pornography-free masturbation; (2) ratio of ejaculations with a partner to ejaculations with Internet pornography; (3) the presence of Internet pornography addiction/hypersexuality; (4) the number of years of streaming Internet pornography use; (5) at what age regular use of Internet pornography began and whether it began prior to puberty; (6) trend of increasing Internet pornography use; (7) escalation to more extreme genres of Internet pornography, and so forth.
Kris Taylor resorts to ad hominem and misrepresentation. I respond.
KRIS TAYLOR EXCERPT: Her source is this paper, which in turn gives numbers sourced from twopapers – neither of which reference pornography as causative. Not to mention that the second author of the paper is Gary Wilson, a well-known fervent anti-pornography campaigner.
I was going to ignore Taylor’s ad hominem attack, but the above two sentences expose his tactics and bias. The first sentence misrepresents the content of our review of the literature, while the second attempts to dismiss it by mislabeling me “a fervent anti-pornography campaigner.”
As described earlier my co-authors included 7 US Navy doctors, among them 2 psychiatrists, 2 urologists, and an MD with a PhD in neuroscience from John Hopkins. My co-authors have spent much of their careers treating (primarily) young men. The paper provided 3 clinical case reports of servicemen, who had developed porn-induced sexual dysfunctions. Has Taylor ever seen patients for sexual dysfunctions? Has he ever performed a medical examination? It’s clear that Taylor’s goal was to encourage his reader to ignore the paper, the medical doctors who authored it, and just take his word for the paper’s content and merit.
As for Taylor’s branding me “a fervent anti-porn campaigner,” I have explained in multiple interviews my history and how I ended up creating www.yourbrainonporn in 2011. (For more see this 2016 interview of me by Noah B. Church.) As stated on the site’s “About” page, I am an atheist (as were my parents and grandparents), and my politics are far-left liberal. I had no opinion on porn.
Details: Through a fluke in search engine categorization, around 2007 (shortly after the advent of streaming tube porn), men complaining of porn-induced erectile dysfunction and low libido for real partners began posting on my wife’s rather obscure forum created for discussions around sexual relationships. Over the next few years many otherwise healthy men on that forum healed their sexual dysfunctions by giving up porn. Eventually we blogged about this phenomenon, because so many men found reading their peers’ experiences helpful. Soon my wife’s forum was overflowing with relatively young men seeking to heal the unexpected effects of their internet porn use. During this period, we cannot count how many times we asked academic sexologists to look into this phenomenon. They refused.
Sadly, many of the men suffering from porn-induced sexual dysfunctions had been suicidal when they arrived, fearing that they were broken for life. In the face of continued stonewalling by the experts who should have been investigating the sufferers’ circumstances, we felt a need make a cyberspace available that presented the relevant science and the stories of the men who recovered from a range of porn-induced sexual dysfunctions (chiefly delayed ejaculation, loss of attraction for real partners, and fleeting or unreliable erections). Www.yourbrainonporn.com was born. If it campaigns for anything, it would be sexual health.
Would Taylor’s professors approve of his tactics? If they would, he has spent too much on his tuition.
UPDATE: The points made below have now been affirmed in peer-reviewed research. In Social Desirability Bias in Pornography-Related Self-Reports: The Role of Religion (2017), Dr. Joshua Grubbs tested his hypothesis that religious individuals are more likely to lie about their porn use (in anonymous surveys studies or to researchers). The “religious people are lying” hypothesis rested on a few state-wide studies, which suggested that conservative or religious states might use more porn. The problem with such claims is that nearly every study that employed anonymous surveys had found lower rates of porn use in religious individuals.
Grubbs found no evidence for religious individuals lying about their porn use. In fact, religious people may be more honest than secular individuals about porn use. This suggests that the state-wide comparisons may be less reliable than anonymous surveys in which each subject’s level of religiosity is identified. Religion appears to be protective against porn use.
From the conclusion:
“However, contrary to popular sentiment-and our own hypotheses-we found no evidence for and much evidence against the suggestion that religious individuals have a more pronounced social desirability bias against the reporting of pornography consumption than the irreligious. Interaction terms assessing that possibility were either nonsignificant or significant in the reverse direction.”
ARTICLE
Utah is not #1 in porn use. Not even close. That often-repeated meme arose from Benjamin Edelman’s 2009 economics paper “Red Light States: Who Buys Online Adult Entertainment?” He relied entirely on subscription data from a single top-ten provider of pay-to-view content when he ranked states on porn consumption – ignoring hundreds of other such websites. Why did he choose that one to analyze?
We do know that Edelman’s analysis was conducted circa 2007, after free, streaming “tube sites” were operational, and porn viewers were increasingly turning to them. So, Edelman’s single data point out of thousands (of free and subscription sites) cannot be presumed to be representative of all US porn users.
Turns out it’s not. In fact, other studies and available data rank Utah porn use between 40th and 50th among the states. See:
Per capita page views, taken from Pornhub in 2014 (graph below).
The oft-repeated, but unsupported “Utah as number 1” myth often bolsters another spurious meme, namely, that ‘religious individuals use more porn than nonreligious individuals.’ In fact, the opposite is true. Religiosity predicts far lower rates of porn use.
The preponderance of studies report far lower rates of porn use in religious individuals compared with non-religious individuals. Consider these studies:
65% of religious young men reported viewing no pornography in the past 12 months
8.6% reported viewing two or three days per month
8.6% reported viewing daily or every other day
In contrast, cross-sectional studies of college-age men report relatively high rates of porn viewing (US – 2008: 87%, China – 2012: 86%, Netherlands – 2013 (age 16) – 73%).
Finally, consider two recent studies investigating religiosity in treatment-seeking sex and porn addicts:
The “Utah Is #1” talking point lingers in mainstream journalism and sexology spin long after the science has proven otherwise. Why?
Finally, recent articles about the Joshua Grubbs studies (“perceived addiction studies”) have tried to paint a very misleading picture of what these studies actually reported and what these findings mean. In essence, bloggers, and sometimes Grubbs himself, have claimed that religiosity is strongly related to porn addiction. It’s not. In response to these spurious articles, YBOP published this extensive critique of the claims made in the perceived addiction studies and in the related misleading articles.
Page Views Per Capita on Pornhub (2014): Utah is 40th
While a handful of studies report little effect of women’s porn use on women’s sexual and relationship satisfaction, the vast maturity do report negative effects. This page contains studies linking female porn use to lower sexual or relationship satisfaction.
When evaluating the research, it’s important to know that a relatively small percentage of all coupled females regularly consumes internet porn. Large, nationally representative data are scarce, but the General Social Survey reported that only 2.6% of all US women had visited a “pornographic website” in the last month. The question was only asked in 2002 and 2004 (see Pornography and Marriage, 2014). While rates of porn use by some age groups of adult women have increased since 2004, be careful when comparing rates from other studies. Very few studies are nationally representative (all age groups), and often ask if the subject has seen pornography in the last 12 months. The takeaway is that studies reporting positive or neutral effects on relationship or sexual satisfaction for female porn users are generally taking their data from a small percentage of regular porn users who are not representative of women generally.
Also, It may be that coupled use is less detrimental to users, and coupled use of porn is more common in women (as compared with men).
In any case, in contrast with the few studies reporting no decreased sexual/relationship dissatisfaction in female porn users, below are the many studies linking porn use in women to poorer relationship and sexual satisfaction outcomes in women.
Guided by sexual script theory, social comparison theory, and informed by prior research on pornography, socialization, and sexual satisfaction, the present survey study of heterosexual adults tested a conceptual model linking more frequent pornography consumption to reduced sexual satisfaction via the perception that pornography is a primary source of sexual information, a preference for pornographic over partnered sexual excitement, and the devaluation of sexual communication. The model was supported by the data for both men and women.
Pornography consumption frequency was associated with perceiving pornography as a primary source of sexual information, which was associated with a preference for pornographic over partnered sexual excitement and the devaluation of sexual communication. Preferring pornographic to partnered sexual excitement and devaluing sexual communication were both associated with less sexual satisfaction.
Finally, we found that frequency of pornography consumption was also directly related to a relative preference for pornographic rather than partnered sexual excitement. Participants in the present study primarily consumed pornography for masturbation. Thus, this finding could be indicative of a masturbatory conditioning effect (Cline, 1994; Malamuth, 1981; Wright, 2011). The more frequently pornography is used as an arousal tool for masturbation, the more an individual may become conditioned to pornographic as opposed to other sources of sexual arousal.
Till Porn Do Us Part? Longitudinal Effects of Pornography Use on Divorce (2017) – This longitudinal study used nationally representative General Social Survey panel data collected from thousands of American adults. Respondents were interviewed three times about their pornography use and marital status — every two years from 2006-2010, 2008-2012, or 2010-2014. Excerpts:
Our study is the first to examine how viewing pornography could be associated with marital stability using data that are nationally representative and longitudinal. Using a doubly robust approach that allows us to isolate the longitudinal association between viewing pornography and likelihood of divorce, we find that the likelihood of divorce roughly doubles for those who begin pornography use between waves. While this association looks slightly stronger for women in terms of predicted probabilities, men and women did not differ significantly from one another. Conversely, we found that ending porn use was associated with a lower likelihood of divorce, but only for women
Beginning pornography use between survey waves nearly doubled one’s likelihood of being divorced by the next survey period, from 6 percent to 11 percent, and nearly tripled it for women, from 6 percent to 16 percent. Our results suggest that viewing pornography, under certain social conditions, may have negative effects on marital stability. Conversely, discontinuing pornography use between survey waves was associated with a lower probability of divorce, but only for women.
Additional analyses also showed that the association between beginning pornography use and the probability of divorce was particularly strong among younger Americans, those who were less religious, and those who reported greater initial marital happiness
This study examined whether Americans who use pornography, either at all or more frequently, are more prone to report experiencing a romantic breakup over time. Longitudinal data were taken from the 2006 and 2012 waves of the nationally representative Portraits of American Life Study. Binary logistic regression analyses demonstrated that Americans who viewed pornography at all in 2006 were nearly twice as likely as those who never viewed pornography to report experiencing a romantic breakup by 2012, even after controlling for relevant factors such as 2006 relationship status and other sociodemographic correlates. This association was considerably stronger for men than for women and for unmarried Americans than for married Americans. Analyses also showed a linear relationship between how frequently Americans viewed pornography in 2006 and their odds of experiencing a breakup by 2012.
While the likelihood of women experiencing a breakup only rose about 34 percent with earlier porn viewing (from 15.4 percent to 23.5 percent), the likelihood of male porn users experiencing a breakup was over 3.5 times that of non-porn users (22.5 percent compared to 6.3 percent).
The Development of the Problematic Pornography Consumption Scale (PPCS) (2017) – This paper’s goal was the creation of a problematic porn use questionnaire. In the process of validating the instruments, the researchers found that higher scores on the porn use questionnaire were related to lower sexual satisfaction. Gender differences in relationship satisfaction were not mentioned. An excerpt:
Therefore, a total of 772 participants (females = 390, 50.5%; males = 382, 45.5%) were retained for further analyses who were between ages 18 and 54
Satisfaction with sexual life was weakly and negatively correlated with PPCS scores
Three hundred and forty-four participants with steady partners (i.e., dating or married) in China volunteered to take part in the study, including 178 men and 166 women from 29 provinces/regions in China. In this study, we examined the online sexual activities (OSAs) of Chinese men and women in committed relationships, with a focus on the characteristics of OSAs and the factors prompting men and women with steady partners to engage in OSAs. Almost 89% of the participants reported OSA experiences in the past 12 months even when they had a real-life partner.
As predicted, individuals with lower relationship quality in real life, including low relationship satisfaction, insecure attachment, and negative communication patterns, engaged in OSAs more frequently. Additionally, dyadic satisfaction significantly predicted OSAs among both men and women. Overall, our results suggest that variables influencing offline infidelity may also influence online infidelity.
Sexually explicit media use and relationship satisfaction a moderating role of emotional intimacy? (2016)– The authors attempt to obfuscate their findings in the abstract by stating that once sexual and relationship variables were “controlled for”, they found no link between between porn use and relationship satisfaction. Reality: The study found significant correlations between porn use and poorer relationship & sexual satisfaction in both males and females. Excerpt from discussion section:
For both men and women, significant, yet modest negative zero-order correlations between SEM use and relationship satisfaction were found, indicating that increased SEM use was associated with lower relationship satisfaction across gender.
This is a cross-sectional study in which 200 sexually active married women were administered a self-filling questionnaire covering different aspects of female sexuality. All participants were free from any disease known to affect sexual function. In total 52% of the participants and 59.5% of their husbands were positive watchers.
An overall 51.6% of participants who were aware that their husbands were positive watchers reported experiencing negative emotions (depression, jealous), whereas 77% reported changes in their husbands’ attitude.Non-watchers watchers were more satisfied with their sexual life compared with their counterparts. Although watching soft-core pornography had a statistically significant effect on sexual desire, vaginal lubrication, ability to reach orgasm, and masturbation, it had no statistically significant effect on coital frequency. Watching soft-core pornography affects female sexual life by increasing sexual boredom in both men and women, causing relational difficulties.
A self-administered survey was distributed to 400 selected Filipino married individuals who were married individuals that are watching pornography on the Internet who are living in Quezon City.
Internet pornography has many adverse effects, especially to the relationship commitment. The use of pornography directly correlates to a decrease in sexual intimacy. Hence, this might lead to weakening of the relationship of their partner. To find out the relevance of the claim, the researchers aimed to explore the relationship of Internet pornography consumption to the relationship commitment of married individuals in the Philippines. It is revealed that Internet pornography consumption has an adverse effect on the relationship commitment of married Filipino couples. Furthermore, watching porn online weakened the relationship commitment that leads to an unstable relationship. This investigation found out that internet pornography consumption has a nominal negative effect on the relationship commitment of Filipino married individuals.
First, even when controlling for perceived addiction to cyberpornography and overall sexual functioning, cyberpornography use remained directly associated with sexual dissatisfaction. Even though this negative direct association was of small magnitude, time spent viewing cyberpornography seems to be a robust predictor of lower sexual satisfaction.
Our results highlight that psychosexual outcomes are similar for men and women. Thus, we observed negative psychosexual functioning in both women and men.
Participants included 75 males (25%) and 221 females (75%) aged 18–87 years
More specifically, couples, where no one used, reported more relationship satisfaction than those couples that had individual users. This is consistent with the previous research (Cooper et al., 1999; Manning, 2006), demonstrating that the solitary use of sexually explicit material results in negative consequences.
With gender effects held constant, individual users reported significantly less intimacy and commitment in their relationships than non-users and shared users.
Overall, how frequently someone views sexually explicit material can have an impact on users’ consequences. Our study found that high frequency users are more likely to have lower relationship satisfaction and intimacy in their romantic relationships.
This study used the Cybersex addiction test, Craving for pornography questionnaire, and a Questionnaire on intimacy among 267 participants (192 males and 75 females) mean age for males 28 and for females 25, who were recruited from special sites that are dedicated to pornography and cybersex on the Internet. Results of regression analysis indicated that pornography, gender, and cybersex significantly predicted difficulties in intimacy and it accounted for 66.1% of the variance of rating on the intimacy questionnaire.
Second, regression analysis also indicated that craving for pornography, gender, and difficulties in forming intimate relationships significantly predicted frequency of cybersex use and it accounted for 83.7% of the variance in ratings of cybersex use.
Third, men had higher scores of frequency of using cybersex than women and higher scores of craving for pornography than women andno higher scores on the questionnaire measuring difficulties in forming intimate relationship than women.
This descriptive-correlation study was conducted on 310 married students studying at private and public universities in Birjand, in 2012-2013 academic year using random quota sampling method.
Conclusion: It appears that pornography has a negative impact on love and marital satisfaction….. There was no significant gender-difference in overall mean scores of marital satisfaction.
We used data on 20,000 ever-married adults in the General Social Survey to examine the relationship between watching pornographic films and various measures of marital well-being. We found that adults who had watched an X-rated movie in the past year were more likely to be divorced, more likely to have had an extramarital affair, and less likely to report being happy with their marriage or happy overall. We also found that, for men, pornography use reduced the positive relationship between frequency of sex and happiness. Finally, we found that the negative relationship between pornography use and marital well-being has, if anything, grown stronger over time, during a period in which pornography has become both more explicit and more easily available.
Our results were similar when we control for gender, age, race, education, and number of children, and they shrank by about one third when we included controls for frequency of religious attendance.
For women, all of the coefficients have the same sign but were generally smaller in magnitude than those of men. Women who reported using pornography had 10% higher odds of being divorced, 95 % higher odds of having had an extramarital affair, 8% lower odds of reporting having a very happy marriage, and about 2% lower odds of being very happy with their life overall
Using a sample of 792 emerging adults, the present study explored how the combined examination of pornography use, acceptance, and sexual behaviour within a relationship might offer insight into emerging adults’ development. Results suggested clear gender differences in both pornography use and acceptance patterns. High male pornography use tended to be associated with high engagement in sex within a relationship and was associated with elevated risk-taking behaviours. High female pornography use was not associated with engagement in sexual behaviours within a relationship and was general associated with negative mental health outcomes.
This exploratory study assessed the association between adult U.S. women’s exposure to Internet pornography and attitude towards extramarital sex using data provided by the General Social Survey (GSS). A positive association between Internet pornography viewing and more positive extramarital sex attitudes was found.
The purpose of this study was to examine the relationships between men’s pornography use, both frequency and problematic use, on their heterosexual female partner’s psychological and relational well-being among 308 young adult college women. Results revealed women’s reports of their male partner’s frequency of pornography use were negatively associated with their relationship quality. More perceptions of problematic use of pornography was negatively correlated with self-esteem, relationship quality, and sexual satisfaction.
Participants were 367 undergraduates (300 female) from a Southeastern university who participated in the study for partial course credit in a family development course. Participants ranged in age from 17 to 26 with a median age of 19 and reported being in a heterosexual, romantic relationship.
Study 1 found that higher pornography consumption was related to lower commitment
Study 3 participants were randomly assigned to either refrain from viewing pornography or to a self-control task. Those who continued using pornography reported lower levels of commitment than control participants.
Study 5 found that pornography consumption was positively related to infidelity and this association was mediated by commitment. Overall, a consistent pattern of results was found using a variety of approaches including cross-sectional (Study 1), observational (Study 2), experimental (Study 3), and behavioral (Studies 4 and 5) data.
In this study, 92% of young men and 50% of young women reported having ever used a variety of types of SEM.
Higher frequencies of sexual explicit material (SEM) use were associated with less sexual and relationship satisfaction. The frequency of SEM use and number of SEM types viewed were both associated with higher sexual preferences for the types of sexual practices typically presented in SEM. These findings suggest that SEM use can play a significant role in a variety of aspects of young adults’ sexual development processes. Specifically, higher viewing frequency was associated with less sexual and relationship satisfaction when controlling for gender, religiosity, dating status and the number of SEM types viewed.
It appears as though SEM use is associated with specific sexual preferences in addition to being associated with earlier and greater sexual experiences, as well as lower sexual and relationship satisfaction. This combination reveals that, despite having a well-defined set of preferences and experiences, individuals frequently using SEM are nonetheless less satisfied with these experiences.
For women, SEM viewing frequency was not correlated with sexual satisfaction and was onlymarginally negatively correlated with relationship satisfaction.
Finally, regression analyses revealed that both SEM viewing frequency and the number of SEM types viewed uniquely predicted all three sexual preference variables. These robust relationships (particularly with the ‘‘kinky sex’’ subscale) indicate that heavy consumers of SEM hold similar sexual preferences to those frequently portrayed in SEM (e.g., Jensen & Dines, 1998; Krassas et al., 2003; Menard & Kleinplatz, 2008).
This study investigated associations between viewing sexually-explicit material (SEM) and relationship functioning in a random sample of 1291 unmarried individuals in romantic relationships.
Those who viewed SEM only with their partners reported more dedication and higher sexual satisfaction than those who viewed SEM alone. Individuals who never viewed SEM reported higher relationship quality on all indices than those who viewed SEM alone. The only difference between those who never viewed SEM and those who viewed it only with their partners was that those who never viewed it had lower rates of infidelity.
Using the Interpersonal Exchange Model of Sexual Satisfaction, we consider how infidelity, pornography consumption, marital satisfaction, sexual frequency, premarital sex, and cohabitation are associated with married couples’ sexual satisfaction. Data from 433 couples are analyzed with structural equation models to determine the contributions. Finally, some evidence suggests that pornography consumption is costly for own and spouse’s sexual satisfaction, especially when pornography is used by only one spouse.
Between May 2006 and May 2007, we conducted a three-wave panel survey among 1,052 Dutch adolescents aged 13–20.Structural equation modeling revealed that exposure to SEIM consistently reduced adolescents’ sexual satisfaction. Lower sexual satisfaction (in Wave 2) also increased the use of SEIM (in Wave 3). The effect of exposure to SEIM on sexual satisfaction did not differ among male and female adolescents.
In couples where only one partner used pornography, we found more problems related to arousal (male) and negative (female) self-perception.
In those couples whereone partner used pornography there was a permissive erotic climate. At the same time, these couples seemed to have more dysfunctions.
The couples who did not use pornography... may be considered more traditional in relation to the theory of sexual scripts. At the same time, they did not seem to have any dysfunctions.
Couples who both reported pornography use grouped to the positive pole on the ‘‘Erotic climate’’ function and somewhat to the negative pole on the ‘‘Dysfunctions’’ function.
This was an exploratory study of sex and relationship seeking on the Internet, based on a survey of 15,246 respondents in the United States Seventy-five percent of men and 41% of women had intentionally viewed or downloaded porn. Men and gays/lesbians were more likely to access porn or engage in other sex-seeking behaviors online compared with straights or women. A symmetrical relationship was revealed between men and women as a result of viewing pornography, with women reporting more negative consequences, including lowered body image, partner critical of their body, increased pressure to perform acts seen in pornographic films, and less actual sex, while men reported being more critical of their partners’ body and less interested in actual sex.
Complete data on 531 Internet users are taken from the General Social Surveys for 2000. Social bonds measures include religious, marital, and political ties. Measures of participation in sexual and drug-related deviant lifestyles, and demographic controls are included. The results of a logistic regression analysis found that among the strongest predictors of use of cyberporn were weak ties to religion and lack of a happy marriage.
Male and female students and nonstudents were exposed to videotapes featuring common, nonviolent pornography or innocuous content. Exposure was in hourly sessions in six consecutive weeks. In the seventh week, subjects participated in an ostensibly unrelated study on societal institutions and personal gratifications. [Porn use] strongly impacted self-assessment of sexual experience. After consumption of pornography, subjects reported less satisfaction with their intimate partners—specifically, with these partners’ affection, physical appearance, sexual curiosity, and sexual performance proper. In addition, subjects assigned increased importance to sex without emotional involvement. These effects were uniform across gender and populations.
Male and female students and nonstudents were exposed to videotapes featuring common, nonviolent pornography or innocuous content. Exposure was in hourly sessions in six consecutive weeks. In the seventh week, subjects participated in an ostensibly unrelated study on societal institutions and personal gratifications. Marriage, cohabitational relationships, and related issues were judged on an especially created Value-of-Marriage questionnaire. The findings showed a consistent impact of pornography consumption. Exposure prompted, among other things, greater acceptance of pre- and extramarital sex and greater tolerance of nonexclusive sexual access to intimate partners. It enhanced the belief that male and female promiscuity are natural and that the repression of sexual inclinations poses a health risk. Exposure lowered the evaluation of marriage, making this institution appear less significant and less viable in the future. Exposure also reduced the desire to have children and promoted the acceptance of male dominance and female servitude. With few exceptions, these effects were uniform for male and female respondents as well as for students and nonstudents.
IASR Fortieth Annual Meeting Book of AbstractsDubrovnik
Pornography Use; Pornography Addiction; Sexual Difficulties and Dysfunctions; Hypoactive Sexual Desire; Erectile Dysfunction
Dubrovnik, Hrvatska, 25.-28. lipnja 2014.
A couple of recent large-scale epidemiological studies pointed to a surprisingly high prevalence of erectile dysfunction among young men (Mialon et al., 2012 ; Martins, 2010). It has been suggested that this “epidemic” is explained by excessive online pornography use. Similar concerns have been raised in response to anecdotal evidence of partnered sexual desire deficit. To empirically assess these claims, which reverberate in recent calls for systematic regulation of pornography, we explored: if pornography use is associated with male and female sexual dysfunctions (SD) ; if an increased frequency of pornography use is associated with SD ; and if the association between pornography use and sexual functioning is moderated by pornography genre (mainstream vs. specific/paraphilic contents).
Participants were recruited through Facebook and banners posted on several news and dating websites. In total, 4, 597 were included in the analyses (18-60 yrs ; mean age=31.1 ; 56.5% women). 56.3% reported college education and 38.4% were married/cohabitating. Frequency of pornography use in the past 12 months, the time spent on pornography use in a typical day within that period, and their interaction indicated the intensity of pornography use.
Finding related to females:
However, increased pornography use was slightly but significantly associated with decreased interest for partnered sex (and more prevalent sexual dysfunction) among women.
One of the factors affecting the incidence of divorce and relationship problems between couples is the sexual and marital behaviors. There are several different reasons to suspect that pornography might affect divorce in either a positive or a negative way. Therefore this study evaluated the sexual health of divorce-asking in Urmia, Iran.
Conclusions: The results of the study indicated that who had low sexual satisfaction score, had higher rate of watching pornography clips. Based on current study, paying attention to family education and counseling programs especially in the sexual field will be more fruitful.
This article presents results from a survey of approximately 1,500 U.S. adults. Quadratic analyses indicated a curvilinear relationship between personal pornography viewing and sexual satisfaction in the form of a predominately negative, concave downward curve. The nature of the curvilinearity did not differ as a function of participants’ gender, relationship status, or religiosity.
For all groups, negative simple slopes were present when viewing reached once a month or more. These results are correlational only. However, if an effects perspective were adopted, they would suggest that consuming pornography less than once a month has little or no impact on satisfaction, that reductions in satisfaction tend to initiate once viewing reaches once a month, and that additional increases in the frequency of viewing lead to disproportionately larger decrements in satisfaction.
In the present study, the association between sexual satisfaction and frequency of pornography use was examined, as well as the effect of marital status and its interaction with frequency of pornography use. A sample of 204 people completed an online survey. Results suggest that sexual satisfaction is negatively associated with frequency of pornography use. Marital status also correlated significantly with sexual satisfaction, but the effect of the interaction between both independent variables was not significant.
This research report assessed pornography consumption and sexual satisfaction in a heterosexual sample of Korean adults. Consistent with prior studies, the linear association between pornography consumption and satisfaction was negative and significant. However, the addition of a quadratic term to the equation increased model fit. Interaction effect analyses revealed an inverted U relationship for both men and women, such that occasional pornography consumption was associated with higher satisfaction, while consumption with any degree of regularity was associated with lower satisfaction. Further assessments showed that the negative relationship between more regular pornography consumption and lower satisfaction was slightly more marked for women, while the positive relationship between intermittent pornography consumption and higher satisfaction was slightly more marked for men. The nature of the relationship between pornography consumption and satisfaction was similar for religious and nonreligious people and for people in a relationship and not in a relationship.
We specifically examined the relationships between viewing frequency and problematic viewing constructs on body image and relationship satisfaction in women….. Also regarding H1, viewing frequency was significantly negatively associated with women’s relationship satisfaction at the bivariate level.
We surveyed 706 heterosexual women (18-29 years of age) in the United States, associating consumption of pornography with sexual preferences, experiences, and concerns. Among female consumers who were sexually active, higher rates of consumption for masturbation were associated with increased mental activation of the pornographic script during sex-heightened recall of pornographic images during sex with a partner, heightened reliance on pornography for achieving and maintaining arousal, and a preference for pornography consumption over sex with a partner. Furthermore, higher activation of the pornographic script during sex, rather than simply viewing pornographic material, was also associated with higher rates of insecurities about their appearance and diminished enjoyment of intimate acts such as kissing or caressing during sex with a partner.
In the context of Internet addiction, cybersex is considered to be an Internet application in which users are at risk for developing addictive usage behavior. Regarding males, experimental research has shown that indicators of sexual arousal and craving in response to Internet pornographic cues are related to severity of cybersex addiction in Internet pornography users (IPU). Since comparable investigations on females do not exist, the aim of this study is to investigate predictors of cybersex addiction in heterosexual women.
We examined 51 female IPU and 51 female non-Internet pornography users (NIPU). Using questionnaires, we assessed the severity of cybersex addiction in general, as well as propensity for sexual excitation, general problematic sexual behavior, and severity of psychological symptoms. Additionally, an experimental paradigm, including a subjective arousal rating of 100 pornographic pictures, as well as indicators of craving, was conducted.
Results indicated that IPU rated pornographic pictures as more arousing and reported greater craving due to pornographic picture presentation compared with NIPU. Moreover, craving, sexual arousal rating of pictures, sensitivity to sexual excitation, problematic sexual behavior, and severity of psychological symptoms predicted tendencies toward cybersex addiction in IPU. Being in a relationship, number of sexual contacts, satisfaction with sexual contacts, and use of interactive cybersex were not associated with cybersex addiction. These results are in line with those reported for heterosexual males in previous studies.
Findings regarding the reinforcing nature of sexual arousal, the mechanisms of learning, and the role of cue reactivity and craving in the development of cybersex addiction in IPU need to be discussed.
This study replicates the findings of this 2014 Cambridge University study that compared the attentional bias of porn addicts to healthy controls. The new study differs: rather than comparing porn addicts to controls, the new study correlated scores on a sex addiction questionnaire to the results of a task assessing attentional bias (explanation of attentional bias). The study described two key results:
Higher sexual compulsivity scores correlated with greater interference (increased distraction) during the attentional bias task. This aligns with substance abuse studies.
Among those scoring high on sexual addiction, fewer years of sexual experience were related to greater attentional bias.
The authors concluded that this result could indicate that more years of “compulsive sexual activity” lead to greater habituation or a general numbing of the pleasure response (desensitization). An excerpt from the conclusion section:
“One possible explanation for these results is that as a sexually compulsive individual engages in more compulsive behaviour, an associated arousal template develops and that over time, more extreme behaviour is required for the same level of arousal to be realised. It is further argued that as an individual engages in more compulsive behaviour, neuropathways become desensitized to more ‘normalised’ sexual stimuli or images and individuals turn to more ‘extreme’ stimuli to realise the arousal desired.”
No differences seen between male and female participants:
No effects of age or gender (males: M = 20.75, SD 46.61; females: M = 19.30, SD 52.46) on interference scores were shown and are not considered in subsequent analyses.
From this characterization, it is be possible to trace the problems evident in PSB and additional clinical features, such as emotional dysregulation, to particular cognitive deficits…. If the cognitive problems identified in this analysis are actually the core feature of PSB, this may have notable clinical implications.
Sexual Desire, not Hypersexuality, is Related to Neurophysiological Responses Elicited by Sexual Images (2013) – Subjects included males & females. EEG study was touted in the media as evidence against the existence of porn/sex addiction. Not so. This SPAN Lab study, like the one below, actually lends support to the existence of both porn addiction and porn use down-regulating sexual desire. In line with the Cambridge University brain scan studies, this EEG study also reported greater cue-reactivity to porn correlating with less desire for partnered sex.To put another way – individuals with greater brain activation to porn would rather masturbate to porn than have sex with a real person. Shockingly, study spokesman Nicole Prause claimed that porn users merely had “high libido”, yet the results of the study say something quite different .Five peer-reviewed papers expose the truth: 1, 2, 3, 4, 5. Also see the extensive YBOP critique.
Modulation of Late Positive Potentials by Sexual Images in Problem Users and Controls Inconsistent with “Porn Addiction” (2015) – Subjects included males & females. Another SPAN Lab EEG (brain-wave) study comparing the 2013 subjects from the above study to an actual control group (yet it suffered from the same methodological flaws named above). The results: compared to controls “individuals experiencing problems regulating their porn viewing” had lower brain responses to one-second exposure to photos of vanilla porn. The lead author, Nicole Prause, claims these results “debunk porn addiction”.
In reality, the findings of Prause et al. 2015 align perfectly with Kühn & Gallinat (2014), which found that more porn use correlated with less brain activation in response to pictures of vanilla porn. Prause’s findings also align with Banca et al. 2015. Lower EEG readings mean that subjects are paying less attention to the pictures. Put simply, frequent porn users were desensitized to static images of vanilla porn. They were bored (habituated or desensitized). These findings are consistent with tolerance, a sign of addiction. Tolerance is defined as a person’s diminished response to a drug or stimulus that is the result of repeated use. See this extensive YBOP critique. Five peer-reviewed papers agree that this study actually found desensitization/habituation in frequent porn users: 1, 2, 3, 4, 5, 6.
This page was created to counter the ongoing harassment and false claims made by former UCLA researcher Nicole Prause as part of an ongoing “astroturf” campaign to persuade people that anyone who disagrees with her conclusions deserves to be reviled. User friendly versions of this overlong page:
Since this page was first created Prause has targeted others, including researchers, medical doctors, therapists, psychologists, colleagues from her short stint at UCLA, a UK charity, men in recovery, a TIME magazine editor, several professors, IITAP, SASH, Fight The New Drug, Exodus Cry, the academic journal Behavioral Sciences, its parent company MDPI, the head of the academic journal CUREUS, and the journal Sexual Addiction & Compulsivity. These incidents are in the “OTHERS” sections. Several additional incidents have occurred that we are not at liberty to divulge – as Prause’s victims fear further retribution. This page is arranged roughly in chronological order.
Important point: While Prause continues to falsely claim she is “the victim,” it is Prause who initiated all contact and harassment towards the individuals and organizations listed on this page. No one on this list has harassed Nicole Prause. Her fabricated claims about being a victim of “stalking” or misogyny from “anti-porn activists” lack one iota of documentation. All the evidence she provides is self-generated: a single info-graphic, a few emails from her to others describing harassment, and five spurious cease and desist letters containing false allegations. You will also see evidence of a number of formal complaints Prause has filed with various regulatory agencies – which have been summarily dismissed or investigated and dismissed. She seems to file these bogus complaints so she can then go on to claim her targets are all “under investigation.” See: PDF Documenting Nicole Prause’s Malicious Reporting and Malicious Use of Process.
Update (January, 2020): Alex Rhodes filed an amended complaint against Prause which also names the RealYBOP twitter account (@BrainOnPorn) as engaging in defamation. RealYBOP’s lies, harassment, defamation, and cyberstalking have caught up with it. The @BrainOnPorn twitter is now named in two defamation lawsuits.
Update (August, 2020): Serial defamer & harasser Nicole Pause loses lawsuits to Gary Wilson; court rulings expose Prause the perpetrator, not the victim. In August of 2020 court rulings fully exposed Nicole Prause as the perpetrator, not the victim. In March of 2020, Prause sought a groundless temporary restraining order (TRO) against me using fabricated “evidence” and her usual lies (falsely accusing me of stalking). In Prause’s request for the restraining order she perjured herself, saying I posted her address on YBOP and Twitter (perjury is nothing new with Prause). I filed an anti-SLAPP lawsuit against Prause for misusing the legal system (TRO) to silence and harass me. On August 6, the Los Angeles County Superior Court ruled that Prause’s attempt to obtain a restraining order against me constituted a frivolous and illegal “strategic lawsuit against public participation” (commonly called a “SLAPP suit”). Prause lied throughout her fraudulent TRO, providing zero verifiable evidence to support her outlandish claims that I stalked or harassed her. In essence, the Court found that Prause abused the restraining order process to bully me into silence and undercut his rights to free speech. By law, the SLAPP ruling obligates Prause to pay my attorney fees.
Update (January, 2021): Prause filed a second frivolous legal proceeding against me in December, 2020 for alleged defamation. At a hearing on January 22, 2021 an Oregon court ruled in my favor and charged Prause with costs and an additional penalty. This failed effort was one of a dozen lawsuits Prause publicly threatened and/or filed in the previous months. After years of malicious reporting, she has escalated to threats of actual lawsuits to try to silence those who reveal her close ties to the porn industry and her malicious conduct, or who have made sworn statements in the 3 defamation suits currently active against her.
Overview: Prause’s fabrications of victim-hood exposed as groundless: she is the perpetrator, not the victim. (created in 2019)
Since many of the Prause and Ley assertions revolve around their mythology of being victimized by “anti-porn activists,” I debunk their fabrications in this very first section (and supply additional evidence under each specific claim):
1) Gary Wilson “physically stalked” Prause in Los Angeles.
Reality: I haven’t been in Los Angeles in years. Prause provides no documentation for this claim, which she initiated in April, 2013 (see below), and began publicizing in July, 2013 (a few days after I critiqued her EEG study). The only police report made public by Prause (April, 2018) says nothing about me stalking her; it didn’t report any crime. Instead, Prause me reported to the LAPD for attending a German conference, which Prause falsely claimed she wanted to attend (screenshot). It’s true that I traveled to Germany and attended the 2018 5th International Conference on Behavioral Addictions, which ran from April 23-25 (note that Prause filed her police report on April 25th), and features experts on behavioral addictions from all over the world. The untrue part is Prause’s claim that she ever had any intention of attending the ICBA conference in Germany. Prause has never attended or been invited to present at an ICBA conference. Prause doesn’t believe in behavioral addictions. Throughout her entire career, Prause has waged a war against the concept of behavioral addiction, especially sex and porn addiction. Prause thus filed a false police report.
Important to note that her false accusations of stalking began almost as soon as our paths crossed. In fact, she accused my wife and myself of stalking in an April, 2013 email exchange that occurred a few weeks after I published a response to David Ley’s Psychology Today blog post where Prause and he targeted my website: “Your Brain on Porn – It’s NOT Addictive.” Ley’s blog was about Nicole Prause’s unpublished, yet to be peer-reviewed EEG study (this was the first I had heard of Prause).
Prause initiated her only contact with me in 2 emails and a comment under my Psychology Today response. Simultaneously, she contacted Psychology Today editors, who forwarded her second email. The following 2 emails are from the end of our brief exchange (screenshots of Prause & Wilson’s entire email exchange):
As you can see, Prause is accusing us of stalking her, although all I did was respond to two emails she sent my way. This is where Prause’s fabricated “stalking” claims began.
Question: Did I drive 800 miles to Los Angeles on the same day I published my detailed critique to hover around UCLA, or did Prause initiate a fabricated campaign of being stalked on the day after my critique? Let’s go to trial and expose the truth.
2) Dr. Prause requires “armed guards at talks” because Gary Wilson has threatened to attend
3) Dr. Prause has filed numerous “police & FBI reports” on Gary Wilson
Reality: Starting in July, 2013 (a few days after I published a careful critique of Prause’s first EEG study), various usernames began posting defamatory comments wherever my name appeared. The comments were very similar in content and tone, falsely claiming that “Wilson has a police report filed on him,” “Wilson is charged with stalking a poor woman,” and “Wilson stole a woman’s pictures and placed them on a porn site,” and “Wilson has been reported to LAPD (which agrees that he’s dangerous) and the UCLA campus police.”
By 2016, as Prause was no longer employed by UCLA or any other institution that could rein in her cyber-harassment, she finally began to identify Gary Wilson as the “person” she had reported to the LAPD and the UCLA campus police. I haven’t been to LA in years. It’s almost 2020, and no law enforcement agency has ever contacted me. (Any harasser can file a fake police report, or misuse the courts)
I presumed that Prause had, in fact, filed fraudulent, groundless reports (which were subsequently disregarded), but it turned out Prause was lying – again. In late 2017 a call to the Los Angeles Police Department and the UCLA campus police revealed no report in their systems on a “Gary Wilson,” nor any report filed by a “Nicole Prause.” I created this section to report my findings: Los Angeles Police Department and UCLA campus police confirm that Prause lied about filing police reports on Gary Wilson.
As chronicled above, I discovered in March of 2019 that Prause had finally filed a fraudulent police report on April 25, 2018. Note that I did not learn of this empty police report from the police. I learned of it a year later, when student journalists (and misinformed Prause devotees) publicly reproduced it online in a university newspaper. It has since been removed by University of Wisconsin authorities.
Prause’s LAPD report was categorized as “cyberstalking”, not physical stalking (I’ve done neither). She didn’t (dare) report any actual crime. Instead, Prause had reported me to the LAPD for:
attending a German conference, which Prause falsely claimed she wanted to attend (but didn’t dare because she claimed to be frightened of me). Important to note that Prause could not have known that I was planning to attend (and she filed her police report the day after the conference was over).
If I have been physically stalking her, why doesn’t any police report describe me as doing so? It’s simple: Prause is afraid of being arrested for knowingly filing a police report falsely accusing me of an actual crime.
In 2019, Diana Davison became the first journalist to do an investigation into Prause’s claims of victim-hood. During their week of communications Prause was unable to provide any evidence other than Prause’s silly LAPD of me attending a German conference Prause lied about wanting to attend. Davison’s expose’ is here: The Post Millennial expose’ on Nicole Prause. Diana Davison also produced this 6-minute video about Prause’s fake victim-hood and the defamation lawsuits filed against Prause.
Reality: No such order exists. Prause is trying to trick the public into believing that a court has formally sanctioned me, i.e., that she has obtained a restraining order or an injunction. She hasn’t. But that doesn’t stop her from publicly and falsely accusing me and other victims of her malice of “violating no contact orders” and of “harassment.” The clear, and clearly false, implication of her statements is to suggest I and others are acting illegally. Her aggressive tactics and knowingly false accusations are calculated to bully and intimidate the victims of her online cyber-harassment into fear and silence. Two defamation suits have been filed against her. Enough said.
I have only responded to a handful of Prause’s defamatory online attacks, ignoring countless “contacts” from her. For example, in a single 24-hr period Prause posted 10 Quora comments about me – which resulted in her permanent suspension. In another example Prause (using RealYBOP Twitter) posted over 120 tweets about me in a 4-day period (PDF of tweets). A few examples of Prause initiating harassment and defamation followed by claiming victim-hood and ending with claims about her fictitious “no-contact orders”:
5) Gary Wilson has employed misogynistic language to denigrate Dr. Prause
Reality: Absolutely false. Prause and Ley provide only a solitary non-example. I accidentally typed “Miss” Prause in a reply to Dr. Prause asking about the size of my penis. That’s the extent of her evidence of my supposed misogyny. Not kidding.
Link to my full answer. Portion of my comment where I used “Miss” Prause:
Prause is certainly being sexist when she demands details about the size of my penis. Nevertheless, she has transformed my inadvertently typing “Miss” in my reply to her questions about my manhood into part of her never ending baseless campaign to paint me and others as misogynists. In this section are just a few examples of how Prause has weaponized her bizarre interest in my penis size and my response.
Over the last few years, Dr. Prause appears to have taken great pains to position herself as a “woman being subjected to misogynistic oppression when she tells truth to power.” She frequently tweets the following infographic that she apparently also shares at her public lectures, suggesting she is being victimized “as a woman scientist,” and painting herself as a trailblazer forging ahead to prove porn’s harmlessness despite prejudiced attacks.
It accuses me, my wife, Don Hilton MD, and nofap founder Alexander Rhodes of misogyny with utterly unconvincing “evidence.” Any suggestion that I (or my wife), Hilton, or Rhodes are motivated by misogyny is fabricated, as our objections have nothing to do with Dr. Prause as a person or as a woman, and only to do with her untrue statements and inadequately supported claims about her research.
Put simply, anyone who exposes Prause’s falsehoods or misrepresentations of the research is automatically labeled “a misogynist,” in hopes that gullible people might believe her defamatory statements. She does this to shut down actual debate on Twitter and other social media platforms, to prevent her falsehoods from being exposed.
It’s ironic that her info-graphic contains four instances of misogyny taken from anonymous YouTube comments under her TEDx talk. In 2013, TED closed comments under Gary Wilson’s TEDx talk in response to Nicole Prause’s many hateful and defamatory comments (see this section).
I look forward to the two defamation lawsuits (Donald Hilton, MD & Nofap founder Alexander Rhodes) going to a jury trial, and to being on the stand to present evidence. I especially look forward to Prause and Ley being forced to provide actual evidence or documentation, rather than the few pieces self-generated bogus “evidence”. I look forward to their cross examination and the two harassers being exposed as the perpetrators, not the victims.
March & April 2013: The beginning of Nicole Prause’s libel, threats and harassment (after she & David Ley target Wilson in a Psychology Today blog post)
First Key point: Prause initiated all direct contacts with Gary Wilson. Prause continues to publicly harass and libel Wilson while simultaneously (falsely) claiming he is under a court’s “no contact” order. No such order exists. Prause is trying to trick the public into believing that a court has formally sanctioned me, i.e., that she has obtained a restraining order or an injunction. She hasn’t. But that doesn’t stop her from publicly and falsely accusing me and other victims of her malice of “violating no contact orders” and of “harassment.” The clear, and clearly false, implication of her statements is to suggest I and others are acting illegally. Her aggressive tactics and knowingly false accusations are calculated to bully and intimidate the victims of her online cyber-harassment into fear and silence. Two defamation suits have been filed against her. Enough said.
March 5, 2013
Author of “The Myth of Sex Addiction,” David Ley, and Nicole Prause team up to write a Psychology Today blog post with the strategic title: “Your Brain on Porn – It’s NOT Addictive.” (Your Brain On Porn is a website founded by Wilson.) It was about Nicole Prause’s unpublished, yet to be peer-reviewed EEG study (“Sexual desire, not hypersexuality, is related to neurophysiological responses elicited by sexual images”).
It’s important to note that only Ley received access to Prause’s unpublished study (it was published 5 months later). The blog post linked to Wilson’s ‘Your Brain on Porn’ website and suggested that YBOP was in favor of banning porn (untrue).
Second key point: Five months before Prause’s EEG study (Steele et al., 2013) was published, both Prause and Ley were targeting Gary Wilson and his website.
March 7, 2013
Wilson published a Psychology Today blog post responding to the content in the David Ley post. Ley’s blog post and Wilson’s response were eventually removed by Psychology Today editors, as the underlying study wasn’t yet available. You can find the original Ley and Wilson blog posts archived here. It’s important to note that Wilson’s blog post clearly states it was only responding to Ley’s description of the Prause study. Later Nicole Prause would falsely accuse Wilson of misrepresenting her study (that only she and Ley had seen, and were making public claims about – which were later shown to be unfounded).
Wilson posts under David Ley’s article requesting the study:
“Hey David – I’m wondering how you got your hands on a study that has yet to published, or mentioned anywhere else. Are you willing to send me a copy?”
In response to the above comment, Prause contacted the Psychology Today editors, commented under my PT article, and emailed Wilson the following. In the email, Prause attacks Wilson personally, and mistakenly states that he did not ask for the study. He had, in fact, asked David Ley for it. The email:
From: Nicole Prause <nprause@________>
Dear Mr. Wilson,
It is illegal for you to misrepresent our science having never even requested a copy of the manuscript. It will be treated as such. Our article actually is very balanced. Unlike you, I have peer-reviewed publications on both sides of this issue. You have attempted to discredit it by describing things that were not done. I am pursuing this with Psychology Today now, but I would advise you to remove the post yourself before I am forced to pursue further action.
You also do not have permission to quote any portion of this email. It is private communication.
Sell your books on your own merit. Don’t try to make money off the backs of scientists doing their jobs. I can tell this study clearly panics you because the design and data are strong, but it is egregious to have not even asked for a copy of the manuscript and just make up content. Shame on you.
Nicole Prause, PhD
Research faculty
UCLA
In addition, Psychology Today editors forwarded a second email from Prause:
Date: April 10, 2013 5:13:30 PM EDT
Topic: Comment on the Blogs
From: Nicole Prause, PhD <nprause@_____________
To whom it may concern:
I was surprised to see an article written about a study of mine by Gary Wilson on Psychology Today.
I have no problem with him representing his own views and interpretations of studies, but he does not and could not have had access to mine. It is under review and he never requested a copy from any of the authors. I notified him that it should be removed. He has not yet done so. Of course, once it is public record, he will have access to it and be able to represent it (hopefully) more accurately.
Of course, knowingly misrepresenting a person to denigrate them is illegal. I hope Psychology Today will take this matter seriously. I will contact other board members as well, in case your cue is full and may take longer to respond.
Submitted by Nicole Prause, PhD on April 10, 2013 – 1:54pm.
Unfortunately, these authors never requested access to our manuscript, so they actually did not review it. They have made a number of egregious errors misrepresenting the science in this article. I am investigating who to contact to remove this article given the lack of due diligence by the authors.
We are now using this as our course example of the misrepresentation of science in the media now, though, so thank you for that opportunity.
The groundless legal threats, false claims, and playing the victim begin in her very first contact with Wilson. Nothing Prause says is true:
Wilson did not describe Prause’s study or misrepresent it in any way. He only responded to Ley’s description of the study. Read Ley’s and Wilson’s blog posts and judge for yourself.
Wilson asked for a copy of the study (Prause refused to supply it).
Prause initiated all contact with Wilson.
Wilson’s email response to Nicole Prause:
On Wed, Apr 10, 2013 at 3:14 PM, gary wilson <> wrote:
Hi Nicole,
I commented under your comment. Have a look.
We make no money on this. My website has no advertising and we accept no donations. We have no services to sell. I have no book to sell. My wife’s book, which appears on PT, is not about porn.
If you want to be truly fair, please send us the full study and give us permission to blog about it – as you did with Dr. Ley.
I’ll be anticipating your study,
Gary Wilson
April 12, 2013
Two days later Prause contacted Wilson again threatening further legal action. She somehow tracked down one of Wilson’s comments on the porn-recovery site Your Brain Rebalanced. It was posted on a long thread about David Ley’s original blog post. Wilson’s comment was meant to explain why both Ley’s and Wilson’s Psychology Today posts had been removed by Psychology Today. This signaled Prause’s pattern of cyberstalking, as a not even a Google search could locate that post. How did Prause know about this thread on a porn recovery forum?
This is libel. Please remove this post or I will follow up with legal action.
Nicole Prause
Wilson responds:
On Fri, Apr 12, 2013 at 11:09 AM, gary wilson <> wrote:
Dear Nicole Prause,
Maybe you didn’t know that my wife is a graduate of Yale law school. I said nothing libelous. In fact, my statements are quite accurate.
1) You have refused to hand over your unpublished study.
2) You were nasty and threatening, as you are now.
3) In addition, you falsely stated that I make money from guys struggling to recover from porn addiction.
4) You also mischaracterized my PT post, as it was a clear response to David Ley’s description of your unpublished study. You chose not correct Ley’s description or make the full study available to me, even when I asked about it in the comment section one month ago.
You have yet to answer my original questions (posed in the comments section):
1) Why did you release your study to only David Ley? As the author of the “Myth of Sex Addiction,” and someone who claims porn addiction cannot exist, why was only he the only Chosen One?
2) Why haven’t you corrected David Ley’s interpretation of your study? It has been up for over a month, and you’ve commented twice on it in the last month.
3) You commented under Ley’s post one month ago. I immediately posted a comment under you comment, with several specific questions directed to you about your study. That was your chance to both respond and offer the study. You did neither. Why?
I’m fine with making our exchange public. Won’t it be interesting when you file a lawsuit against a couple of PT bloggers who dare to take on your research?
Best,
Gary Wilson
Prause emails again with more crazy claims & legal threats [Note: Neither Wilson nor his wife ever initiated contact with Prause. She is the one who repeatedly contacted them and threatened them with groundless legal action.]
This is to notify both you and your wife that your (both you and your wife’s) contact is unwanted. Per stalking statutes in your home state (http://courts.oregon.gov/Lane/Restraining.page), any additional harassing contact will be interpreted as actionable harassment.
You do not have my permission to share this private communication in any forum.
Nicole Prause
Wilson sends his final email to Prause, to set the record straight: that she is the one initiating all contact and the only person making threats (and false claims):
To: nprause Subject: RE: [PT] Inquiry via Psychology Today
Date: Fri, 12 Apr 2013 15:44:12 -0700
Dear Nicole Prause,
Harassment? I have not initiated one email exchange with you, including this one.
The first, initiated by you on 4/10/13, where you had the last email. And the one below, where you are trying to create a false impression that someone is harassing you, when in fact you are threatening me for the second time.
You are also the one who contacted Psychology Today’s editor to interfere with my blog post. My wife has had no contact with you whatsover.
We do not need your permission.
Gary Wilson
The end of the beginning with Nicole Prause.
Note: The above email exchange has been touted by Prause as as “a no-contact order”. It’s not. Prause continues to harass Wilson on social media and behind the scenes, while simultaneously claiming that Wilson has been barred from responding to her lies. While Prause ends many of her targeted social media attacks by asserting a “no-contact request”, there is no such thing. A “no-contact request” is as legally binding as requesting someone “stop and smell the roses”. Prause is trying to trick the public (her twitter followers) into believing she has obtained a restraining order or an injunction. She hasn’t. Its just a tweet. A garbage pile of fabricated fake victim-hood by the actual perpetrator, Prause.
Late July, 2013: Prause publishes her EEG study (Steele et al., 2013). Wilson critiques it. Prause employs multiple usernames to post lies around the Web
In late July 2013 Prause’s EEG study (Steele et al., 2013) was finally published. It arrived with much press coverage, including this Prause Interview by a Psychology Today blogger: New Brain Study Questions Existence of “Sexual Addiction.” A few days later Gary Wilson published his detailed analysis of Steele et al., 2013 and Prause’s claims put forth in the above interview and elsewhere. Wilson posted it on his Psychology Today blog as Nothing Correlates With Nothing In SPAN Lab’s New Porn Study. Incidentally, Psychology Today, apparently in response to Prause’s threats, ultimately unpublished not only Wilson’s critique of this study, but also the critiques of two professional experts in the field who wrote about the study’s weaknesses.
Ultimately, Prause’s findings and claims in the media were re-analyzed and critiqued repeatedly by various other experts and by eight peer-reviewed papers: Peer-reviewed critiques of Steele et al., 2013
All the peer-reviewed papers agree with Gary Wilson’s analysis that Steele et al. actually supports the porn addiction model, and that Prause misrepresented her findings to the press. Prause’s two claims versus the study’s actual findings:
1) Prause claimed that subjects “brains did not respond like other addicts”.
Reality: The study had no control group for comparison. More importantly, the study reported higher EEG readings (relative to neutral pictures) when subjects were briefly exposed to pornographic photos. Studies consistently show that an elevated P300 occurs when addicts are exposed to cues (such as images) related to their addiction (see more).
2) Prause suggested that her subjects simply had “high sexual desire”.
Reality: In line with the Cambridge University brain scan studies, Steele et al. reported greater cue-reactivity (higher EEG readings) to porn correlating with less desire for partnered sex. To put another way – individuals with greater brain activation to porn would rather masturbate to porn than have sex with a real person. Prause claimed that porn users merely had “high libido”, yet the results of the study say the exact opposite: their desire for partnered sex was dropping in relation to their porn use (see more).
With her unsupported claims exposed by Gary Wilson, John A. Johnson PhD and Don Hilton MD, Prause then resorted to behind the scenes maneuvering at Psychology Today, cyberstalking, and various forms of intimidation. To this day Prause and others continue to cite her work as “debunking the field,” without mentioning or offering any response to any of the formal criticism apart from ad hominem attacks on some of the authors.
Within a few days of publishing Wilson’s critique, various usernames began posting comments wherever Gary Wilson’s name appeared. The comments are very similar in content and tone, falsely claiming that 1) Wilson had never taught anatomy, physiology, pathology or attended college, 2) Wilson stole a woman’s pictures and placed them on a porn site, 3) Wilson has a police report filed on him, 4) Wilson is an unemployed massage therapist, 5) Wilson is charged with stalking a poor woman, 6) Wilson has been reported to LAPD, UCLAPD and the FBI. These same false assertions are made by no other Wilson critic and continue to this day in tweets and comments by Prause and by her many sockpuppets.
The above claims are ludicrous, but the lies about stolen “pictures on a porn site“, “a police report has been filed“, “stalking a poor woman/scientist” and “unemployed massage therapist” incriminate Prause as the cyberstalker posting the 2013 comments and the dozens of fake usernames with hundreds of comments over the next 5 years. (Note – A call to the Los Angeles police and the UCLA campus police revealed no such report in their systems.) Below is an example taken from Wilson’s YouTube inbox (7/26/13):
From a second YouTube channel for Wilson’s radio show:
Another example:
Another example:
Another example:
Another example:
Another example:
Another example:
Another example:
Another example:
More by Nikky:
More. “RunningBiker” comments (Prause is a runner, who also rides a motorcycle):
A Key point: Both the cyberstalker and Nicole Prause have stated that Wilson “stole photos of a woman” and “had a police report on file for stealing these photos.” One in the same person.
1) “Photos stolen” “on a porn site”
Here’s the reality: Gary Wilson wrote this Psychology Today blog post about this Nicole Prause Psychology Today Interview (which contains a picture of Prause). Psychology Today required at least one picture (all of Wilson’s Psychology Today articles contained several pictures). Since this blog post was about Nicole Prause’s interview and her EEG study, it seemed appropriate to use a picture of Prause from a UCLA website. The picture that accompanied Wilson’s Psychology Today blog post was also used with this same article on YBOP.
The photo of Prause came from what Wilson reasonably assumed was a UCLA website – SPAN Lab – and it was apparently the photo Prause had chosen to represent herself. Everything about SPAN Lab’s website gave the impression it was owned and run by UCLA. At the bottom each SPAN Lab page was the following (Prause has recently forbidden the “Internet WayBack Machine” from showing SPAN Lab’s archive pages, so as to conceal this fact):
A screenshot of the SPAN Lab front page from August, 2013:
It was unclear how Prause could be claiming copyright to a photo that was on a website that claimed its copyright was owned by UCLA. UCLA is a California state school answering to taxpayers. Presumably, its images are public. Many months later when Wilson wrote UCLA concerning Prause’s libelous PDF (below), UCLA stated that SPAN Lab was Prause’s site, and not on UCLA servers(!). Why did Prause misrepresent her website as being owned by UCLA? That was the first time Wilson learned this. Undisputed fact: Prause never contacted Wilson to request that her picture be removed from the blog post. Wilson knew nothing until Prause filed a DMCA request (below) and Wilson found the picture missing from the article critiquing Prause’s interview and study.
So, that’s the “stolen photo’s” claim: A single picture, selected by Prause herself, from (what appeared to be) a UCLA lab website was used in an article about a study published and promoted by UCLA & Nicole Prause. The “porn site” was YBOP, a claim that is laughable, as it is a porn recovery support website without x-rated content.
Addendum: Prause is now claiming in an AmazonAWS PDF that Wilson migrated the picture of Prause (and the associated article) to other servers. This is completely false. The picture of Prause accompanied a single critique that appeared on two separate websites, PornStudySkeptics and YourBrainOnPorn.com. These two identical articles have remained on those two websites since July, 2013: Article 1, Article 2. In her PDF Prause also claims that Wilson’s ISP told him that they would “close his website if he did it a fourth time.” This is fabricated nonsense.
2) “police report filed”
It’s been over 6 years and Wilson has never been contacted by the police (a call to the Los Angeles police department and the UCLA campus police revealed no such report in their systems). Although Prause has repeated this undocumented claim dozens of times, she has also failed to divulge what law Wilson supposedly violated. In 2018, she added the tall-tale that Wilson was twice reported to the FBI. What’s next, the CIA, ICE, Homeland Security… maybe a mall cop? (Addendum: Gary Wilson filed a freedom of information request with the FBI and the FBI confirmed that Prause was lying: no report has ever been filed on Wilson. See – November, 2018: FBI affirms Nicole Prause’s fraud surrounding defamatory claims)
Evidence directly connecting Prause to these many groundless comments about “stolen pictures” and “a police report.”
Prause filed a DMCA take down of her SPAN Lab picture on July 21, 2013 – http://www.chillingeffects.org/dmca512c/notice.cgi?NoticeID=1091617 and the server removed it before Wilson saw the related email notices. Wilson removed the photo from its other location when asked via a second DMCA filing, even though UCLA, not Prause, appeared (as far as he could tell) to be the copyright owner.
Prause has tweeted that she filed a police report on Wilson (see details below under “Prause & Ley attack NoFap founder Alexander Rhodes“). A call to the LAPD and UCLA campus police revealed no such report in their system.
Nicole Prause published a PDF on her SPAN Lab website (more on this in the next section) with all the usual claims and lies echoing all the preceding comments. It also lied that:
“Wilson has been found guilty of stealing other people’s images”
Again, this was apparently a reference to the same picture that accompanied the Psychology Today post, and the Psychology Today post was about Prause’s interview on Psychology Today. It was the same picture she had chosen for the top of her SPAN Lab website (which falsely proclaimed it was a UCLA site).
Most of these comments claimed that Wilson “stole” and placed Prause’s picture on a pornographic website.
Prause never contacted Wilson about the picture.
Prause filed a DMCA take down of her picture, which forced the company hosting YBOP to remove the picture without first contacting Gary Wilson.
Similar groundless comments continue to be posted to this day by Prause sockpuppets and by Prause on her twitter and Facebook accounts. The comments are often identical to the July, 2013 “anonymous” comments (many more examples below and on page 2). PDF of Nicole Prause aliases she used to harass & defame
Others – August, 2013: John A. Johnson PhD debunks Prause’s claims about Steele et al., 2013; Prause retaliates.
At the same time that Prause was engaging in cyberstalking and threatening groundless legal action against Wilson, she went after senior psychology professor emeritus John A. Johnson. Prause was enraged by Johnson’s saying that spokesperson Prause made claims that did match her actual results (as Wilson had also said). Commenting under the Psychology Today interview of Nicole Prause, Professor John A. Johnson commented twice:
Mustanski asks, “What was the purpose of the study?” And Prause replies, “Our study tested whether people who report such problems [problems with regulating their viewing of online erotica] look like other addicts from their brain responses to sexual images.”
But the study did not compare brain recordings from persons having problems regulating their viewing of online erotica to brain recordings from drug addicts and brain recordings from a non-addict control group, which would have been the obvious way to see if brain responses from the troubled group look more like the brain responses of addicts or non-addicts.
Instead, Prause claims that their within-subject design was a better method, where research subjects serve as their own control group. With this design, they found that the EEG response of their subjects (as a group) to erotic pictures was stronger than their EEG responses to other kinds of pictures. This is shown in the inline waveform graph (although for some reason the graph differs considerably from the actual graph in the published article).
So this group who reports having trouble regulating their viewing of online erotica has a stronger EEG response to erotic pictures than other kinds of pictures. Do addicts show a similarly strong EEG response when presented with their drug of choice? We don’t know. Do normal, non-addicts show a response as strong as the troubled group to erotica? Again, we do not know. We don’t know whether this EEG pattern is more similar to the brain patterns of addicts or non-addicts.
The Prause research team claims to be able to demonstrate whether the elevated EEG response of their subjects to erotica is an addictive brain response or just a high-libido brain response by correlating a set of questionnaire scores with individual differences in EEG response. But explaining differences in EEG response is a different question from exploring whether the overall group’s response looks addictive or not. The Prause group reported that the only statistically significant correlation with the EEG response was a negative correlation (r=-.33) with desire for sex with a partner. In other words, there was a slight tendency for subjects with strong EEG responses to erotica to have lower desire for sex with a partner. How does that say anything about whether the brain responses of people who have trouble regulating their viewing of erotica are similar to addicts or non-addicts with a high libido?
Two months later John Johnson published this psychology Today blog post which he linked to in a comment under the same Prause interview.
My mind still boggles at the Prause claim that her subjects’ brains did not respond to sexual images like drug addicts’ brains respond to their drug, given that she reports higher P300 readings for the sexual images. Just like addicts who show P300 spikes when presented with their drug of choice.
How could she draw a conclusion that is the opposite of the actual results? I think it could be due to her preconceptions–what she expected to find. I wrote about this elsewhere. http://www.psychologytoday.com/blog/cui-bono/201308/preconceptions-may-color-conclusions-about-sex-addiction
When I first conceived this blog post and began to compose it about a month ago, my original intention was to describe in exquisite detail the specific ways in which I saw the proponents of opposite sides of the debate exaggerating or overextending their arguments beyond the actual data in the study. I subsequently changed my mind when I observed a firestorm of emotionally-charged rhetoric erupting among the debate participants. Not arguments about what the data logically implied, but ad hominem threats, including threats of legal action. I saw a PT blog post disappear, apparently because one of the parties demanded that it be taken down. I even received a couple of angry emails myself because one of the parties had heard that I had raised questions about the proper interpretation of the research in question in a scientific forum.
So, I have decided to quietly tip-toe out of the room. I have also decided to go ahead and post here what I had already composed a month ago, simply to present an example of my empirical claim that science is not a purely objective enterprise, and that actual scientists can become very personally and emotionally involved in their work. The controversy in question is also an excellent example of a common trend among U.S. researchers to overestimate soft-science results.
November 2013: Prause places a libelous PDF on her SPAN Lab website. Content mirrors “anonymous” comments around the Web
In November 2013, Nicole Prause placed a PDF on her SPAN Lab website attacking Gary Wilson (screenshot below). It contained several instances of libel. The PDF’s contents are very similar to hundreds of other comments that were posted by various usernames. Posts were written by GaryWilson Stalker, GaryWilson IsAFraud and other sock puppets. Such comments continue to this day on various recovery forums and other venues, posted with other usernames (PDF of Nicole Prause aliases she used to harass & defame).
If there was ever any doubt as to who was actually behind these comments, the PDF puts an end to it. Gary Wilson contacted UCLA to report the PDF’s defamatory statements, as he still believed SPAN Lab was a UCLA website (at the time, SPAN Lab’s copyright was owned by UCLA and its address was within a UCLA building). UCLA acknowledged the existence of the PDF, and its subsequent removal in a letter. Its URL was – http://www.span-lab.com/WilsonIsAFraud.pdf.
How did Gary Wilson discover the above PDF? His Internet browser was redirected to the PDF when he visited the SPAN lab website (representing itself as a UCLA website). Knowing Wilson’s IP address, Prause made a habit of redirecting Wilson’s Internet browser to other URLs, such as porn sites or pictures of mutilated penises. This started before the PDF appeared, and continued after the PDF was removed. More evidence that Prause is likely the one responsible for cyberstalking events (only a small portion of which are detailed on this page). For example, two PDFs containing material nearly identical to Prause’s libelous PDF were uploaded onto DocStoc a few days after Wilson published his critique of Prause’s 2013 EEG study:
Contrary to claims the “documents” show nothing, except that Prause is the person who published both PDFs. Wilson complained to UCLA about Prause’s libelous PDF. The UCLA reply:
UPDATE: In the beginning Prause employed dozens of fake usernames to post on porn recovery forums, Quora, Wikipedia, and in the comment sections under articles. Prause rarely used her real name or her own social media accounts. That all changed after UCLA chose not to renew Prause’s contract (around January, 2015).
Prause began to put her name to falsehoods, openly cyber-harassing multiple individuals and organizations on social media and elsewhere. Since Prause’s primary target was Gary Wilson (hundreds of social media comments along with behind the scenes email campaigns), it became necessary to monitor and document Prause’s tweets and posts. This was done for her victims’ protection, and crucial for any future legal actions.
It soon became apparent that Prause’s tweets and comments were rarely about sex research, neuroscience, or any other subject related to her claimed expertise. In fact, the vast majority of Prause’s posts could be divided into two overlapping categories:
Defamatory & ad hominem comments targeting individuals and organizations that she labeled as “anti-porn activists” (often claiming to be a victim of these individuals and organizations).
Support of the porn industry:
direct support of the FSC (Free Speech Coalition), AVN (Adult Video Network), porn producers, performers, and their agendas
countless misrepresentations of the state of pornography research and attacks on porn studies or porn researchers
This page contains a sampling of tweets and comments related to #2 – her vigorous support of the porn industry and its chosen positions. After years of sitting on the evidence, YBOP is of the view that Prause’s unilateral aggression has escalated to such frequent and reckless defamation (falsely accusing her many victims of “physically stalking her,” “misogyny,” “encouraging others to rape her,” and “being neo-nazis”), that we are compelled to examine her possible motives. The page is divided into 4 main sections:
December, 2013: Prause’s initial tweet is about Wilson & the CBC: “RealScience” posts same false claims on same day on multiple websites
On December 18, 2013 Nicole Prause’s maiden tweet for her new Twitter account was about Gary Wilson and a CBC interview. We can’t link to the tweet as Prause’s original Twitter account was permanently suspended for harassing Todd Love, PsyD, JD, whose review of the literature dared to criticize her work (more below). Prause’s original Twitter URL was https://twitter.com/NicolePrause/. If interested you can read Wilson’s response to the CBC here.
On December 18th & 19th “RealScience” or “RealScientist” posted several similar, equally misleading comments on sites that mentioned Gary Wilson.(PDF of Nicole Prause aliases she used to harass & defame). Who else but Prause could be responsible for these posts, which entirely misrepresent the exchange with the CBC and its response to Wilson? A few examples, where Prause lies not only about the CBC, but also my credentials, my education, and the courses I have taught:
Prause posting on porn-recovery forum YourBrainRebalanced (YBR), using a name other than “RealScience”(Prause often posts on YBR, harassing men in recovery and defaming Gary Wilson, Gabe Deem and former UCLA colleague Rory Reid)
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Tweeting about CBC (using her new twitter account) in 2016 falsely claiming that Wilson threatened the CBC.
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In the next section Prause (“RealScience”) posts her CBC drivel on porn recovery forum YourBrainRebalanced, and asks Gary Wilson about the size of his penis. Prause transforms Wilson’s reply to her penis question (where he accidentally typed “Miss” Prause) into a campaign defaming Wilson and his wife as misogynists. Not kidding.
Here’s an enlarged version of the image she included in the above tweet. Link to Wilson’s full answer. It is Prause who is being sexist as Prause asks Gary Wilson about the size of his penis:
Nevertheless, Prause has transformed Wilson’s inadvertently typing “Miss” in his reply to her questions about his manhood into her never ending campaign to paint Wilson, and others as misogynists. Below are just a few examples of how Prause has weaponized her bizarre interest in Gary Wilson’s penis and his response.
Over the last few years, Dr. Prause appears to have taken great pains to position herself as a “woman being subjected to misogynistic oppression when she tells truth to power.” She frequently tweets the following infographic that she apparently also shares at her public lectures, suggesting she is being victimized “as a woman scientist,” and painting herself as a trailblazer forging ahead to prove porn’s harmlessness despite prejudiced attacks.
It accuses Wilson, Marnia Robinson, Don Hilton MD, and nofap founder Alexander Rhodes of misogyny. Any suggestion that Wilson (or his wife), Hilton, or Rhodes are motivated by misogyny is fabricated, as their objections have nothing to do with Dr. Prause as a person or as a woman, and only to do with her untrue statements and inadequately supported claims about her research.
Put simply, anyone who exposes Prause falsehoods or misrepresentations of the research is a misogynist. She does this to shut down actual debate on twitter and other social media platforms, to prevent her falsehoods from being exposed. It has worked, so she continues the defamation.
It’s ironic that her infographic contains four instances of misogyny taken from anonymous YouTube comments under her TEDx talk. In 2013, TED closed comments under Gary Wilson’s TEDx talk in response to Nicole Prause’s many hateful and defamatory comments (see this section). Prause used the following two YouTube usernames to post her comments:
The following tweets are examples of Prause obsessively playing the misogyny card and tweeting her “everyone is a misogynist infographic”. Note: Prause has never provided a single verifiable example of her being a victim of personal attacks or misogyny (certainly not by the person’s she names). It’s all propaganda. Unfortunately many believe her falsehoods.
Prause looks for any opportunity to tweet her infographic:
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She has never provided a single documented incident of anything arising from FTND. on the other hand Prause has engaged in about 100 separate instances of defamation and harassment targeting FTND. See these sections for a whole lot more:
Claims that “sexist stalker Gary Wilson” threatened her, but has never provided a singe example.
Prause falsely claims that there are “hundreds of studies” contradicting harms of porn – but can only cite the same 5 cherry-picked, outlier studies described here.
How did Taylor Kohut manage to achieve his anomalous results? His study framed egalitarianism as: (1) Support for abortion, (2) Feminist identification, (3) Women holding positions of power, (4) Belief that family life suffers when the woman has a full-time job., and oddly enough (5) Holding more negative attitudes toward the traditional family. Secular populations, which tend to be more liberal, have far higher rates of porn use than religious populations. By choosing these criteria and ignoring endless other variables, lead author Taylor Kohut knew he would end up with porn users scoring higher on his study’s carefully chosen criteria of what constitutes “egalitarianism.” Then he chose a title that spun it all.
The goal of this review was to synthesize empirical investigations testing effects of media sexualization. The focus was on research published in peer-reviewed, English-language journals between 1995 and 2015. A total of 109 publications that contained 135 studies were reviewed. The findings provided consistent evidence that both laboratory exposure and regular, everyday exposure to this content are directly associated with a range of consequences, including higher levels of body dissatisfaction, greater self-objectification, greater support of sexist beliefs and of adversarial sexual beliefs, and greater tolerance of sexual violence toward women. Moreover, experimental exposure to this content leads both women and men to have a diminished view of women’s competence, morality, and humanity.
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Calls PornHelp.org a harasser for publishing a blog post:
The goal of this review was to synthesize empirical investigations testing effects of media sexualization. The focus was on research published in peer-reviewed, English-language journals between 1995 and 2015. A total of 109 publications that contained 135 studies were reviewed. The findings provided consistent evidence that both laboratory exposure and regular, everyday exposure to this content are directly associated with a range of consequences, including higher levels of body dissatisfaction, greater self-objectification, greater support of sexist beliefs and of adversarial sexual beliefs, and greater tolerance of sexual violence toward women. Moreover, experimental exposure to this content leads both women and men to have a diminished view of women’s competence, morality, and humanity.
She then implies that Wilson has threatened to kill her.
Absolutely nuts. Again, if she had an actual example, she would provide it. If it were true she would have reported Wilson to the police. But the LAPD and FBI said she never has:
Again, dirty deeds by “activists”. But the deeds are never named and she never provides evidence for a single deed:
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Spreading her myths
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Prause ally spreads her lie that she had a restraining order on Gary Wilson. This nonsense is covered in many sections of this page.
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The preceding tweets represents the tip of the Prause iceberg of her faux victim-hood.
May 2014: Multiple sock puppets post information on YourBrainRebalanced.com that only Prause would know (many more examples)
The day the Max Planck study on porn users was published (suggesting that porn use may have measurable effects on the brain), four aliases including, “txfba”, “touif” and “TrickyPaladin” posted approximately 100 comments on YourBrainRebalanced.com. (PDF of Nicole Prause aliases she used to harass & defame). What’s left of their comments is in this thread, as the troll deleted her comments within a few hours. Most of the touif and TrickyPaladin comments were either attacks on Wilson or meticulously detailed ‘defenses’ of Prause’s 2013 EEG study. Below are few examples caught by a YBR member’s cell phone where TrickyPaladin and touif make detailed assertions about Steele et al., 2013 that only a handful of people could produce (and only Prause would care about):
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I’ll ask, who (other than Prause herself) would know details of a complex EEG study well enough to attempt defense of it, or want to post 100 times on a porn recovery forum to defend it? (If you bothered to read the above comments, know that any and all such claims have been dismantled by this extensive critique, and 8 peer-reviewed papers: Peer-reviewed critiques of Steele et al., 2013)
While Tricky (and other sock puppets) deleted most of her comments, she left a few describing a “yet to be published chapter by Prause” supposedly chronicling Gary Wilson’s evil deeds:
Who but Prause would know details of an unpublished chapter by Prause? The above comment is from May, 2014. The “upcoming” Prause chapter was in fact published 8 months later in this book – “New Views on Pornography: Sexuality, Politics, and the Law.“ Of course, Prause did not identify Wilson in the chapter, as her claims of “horrible things” are fabricated nonsense.
A few additional Prause aliases used on YourBrainRebalanced.com (others were quickly deleted by the moderators).
As mentioned, sock puppets posting Prause-like comments continue to this day on porn recovery sites such as reddit/pornfree and reddit/nofap. Right from the beginning Prause had an odd habit of frequently creating usernames from 2-4 capitalized words (i.e. GaryWilsonStalker). While the usernames and comments are often deleted by the sock puppet, a few examples with content remain (all were created for only Prause-like comments, then immediately abandoned):
Examples of Prause sockpuppets on Quora, where Gary Wilson occasionally answered questions about porn addiction. The sockpuppets only commented under Wilson’s answers. Quora requires members to use their actual names. Mods ban trolls who use fake names (as they did with Prause’s fake names):
Others – Summer, 2014: Prause urges patients to report sex addiction therapists to state boards
Prause makes it no secret that she vehemently opposes the concepts of sex and porn addiction. In the summer of 2014 Prause placed the following notice on her SPAN Lab website. You can read for yourself that Prause is encouraging all individuals being treated for sex addiction to report their therapists to the state board (it contains a handy hyperlink):
A month later Prause reminds us all again to report our local sex addiction therapist. It’s free and easy!
Prause doesn’t stop with tweets directed at a profession. She ups her game, falsely accusing psychotherapists of fraudulent therapy. Isn’t this rather reckless for a psychologist, especially given that (1) diagnoses of compulsive sexual behavior can be made using the World Health Organization’s ICD-10 and (2) Section F52.8 of the DSM itself recognizes the diagnostic validity of excessive sex drive as a valid, reimbursable disorder? In short, Prause is mistaken and behaving unethically.
Prause employs her alias account RealYBOP to tell stories, suggesting porn addiction therapist should be reported. We have Prause tweeting with Prause (RealYBOP)
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Fall 2014: Documentation of Prause lying to film producers about Gary Wilson and Donald L. Hilton Jr., MD
Documentary producers forwarded the following email to Gary Wilson:
Re: Documentary on porn
Hi **********
I am open to chatting with you, but I should probably clarify two items.
First, I do believe, and have published, some negative effects of sex films. It is fair to say that I do not believe it is addicting. If it is useful to you to have a scientist who can talk about both the benefits and possible problems with sex films, I am probably best-suited to that type of role.
Second, I am not willing to be placed in opposition to Gary Wilson, Marnia Robinson, or Don Hilton. None of these individuals are scientists, and all have attacked me personally, making it unsafe for me to be put in a direct confrontation with them. For example, they claimed that I was secretly funded by pornography, falsified my data, and wrote me and my university chancellor many times trying to harass me at home and work. If you were considering these individuals, I would be happy to get you in touch with some actual scientists who support that sex films can lead to addiction. These individuals, in my opinion, would be scraping the bottom of the barrel for a film.
I realize this information may be in direct opposition to your desire to have free artistic reign, so I understand if I might not be useful to your film given this information. Regardless, best of luck with your project!
Nikky
Nicole Prause, Ph.D.
Associate Research Scientist
University of California, Los Angeles
www.span-lab.com
Prause is once again lying. As addressed below, Wilson never said that Prause had “falsified her data” or that she was “funded by pornography.” While Gary Wilson wrote UCLA chronicling Prause’s harassment and cyberbullying (see below), he never attempted to contact Prause directly at home or at work. (In reality, it is Prause who initiated all direct contact with Gary Wilson as documented in the first section.) Donald Hilton Jr. MD confirmed that he has never attempted to contact Nicole Prause or UCLA, nor did he say what Prause claims in the above email.
Key point: There is reason to believe that this behind-the-scenes defamation of Wilson and others is standard procedure for Prause. See further example relating to TIME magazine and Gabe Deem below. Note how Prause tries to control who is being interviewed by stating that she is not willing “to be placed in opposition to Gary Wilson or Don Hilton.”
Others – December, 2014: Prause employs an alias to attack and defame UCLA colleague Rory Reid PhD (on a porn-recovery forum). Concurrently, UCLA decides not to renew Prause’s contract.
A little background on Rory Reid and former UCLA researcher Nicole Prause is useful here. Rory Reid has been a research psychologist at the David Geffen School of Medicine, UCLA since before Nicole Prause’s brief stint at UCLA began in late 2012. Reid’s research areas are hypersexuality and gambling addiction.
Reid, like Prause, has often argued against the existence of “sex addiction.” Reid stated in a 2013 article that his office was right next door to Prause’s at UCLA. In 2013 Nicole Prause listed Rory Reid as a member of her now defunct “SPAN Lab.” But in 2014 everything changed: she began attacking her former colleague Reid.
On December 5th, 2014 a new member of the porn recovery site YourBrainRebalanced (TellTheTruth) posted 4 comments attacking Rory Reid urging readers to report Reid to California authorities. A screenshot of the comment of this Prause alias:
As documented in the above sections, Prause made a habit of commenting on YBR using various aliases. Moreover, Prause regularly use aliases with 2-4 capitalized words as usernames.
In her first comment TellTheTruth posted 2 links. One link went to a PDF on Scribd with supposed evidence supporting TellTheTruth’s claims and a link to the California.gov website search for psychology license.
Two more comments by TellTheTruth:
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Below are a few screenshots of the PDF that TellTheTruth placed on Scribd:
Note the same “2013 copyright State of California” description of Prause’s current screenshot and TellTheTruth’s 2-year old screenshot.
Key takeaway: The TellTheTruth comments and PDF from December, 2014 incriminate Nicole Prause as cyberstalking Rory Reid at about the same time that UCLA chose not renew Prause’s contract. Merely a coincidence? Or was Prause retaliating against Reid when UCLA did not renew her contract? Or did they not renew her contract due to her unprofessional behavior?
While Prause claims that she was compelled to leave a dream job at UCLA to pursue “groundbreaking research,” certain facts cannot be denied: Prause harassed and defamed UCLA colleague Rory Reid. UCLA did not renew her contract. Rory Reid remains a researcher at UCLA.
January, 2015: “The Prause Chapter” described 9 months earlier by a YourBrainRebalanced.com troll is finally published
[To recap, a YourBrainRebalanced troll (TrickyPaladin) posted 50 comments or more on the same day the JAMA fMRI study on porn users was published (affirming that porn users’ brains show measurable changes correlating with time/years of use). Most of TrickyPaladin’s comments were either attacks on Wilson or meticulously detailed (attempted) defenses of Prause’s 2013 EEG study. While Tricky deleted most of her comments, she left a few saying a chapter in an upcoming book would detail horrible things done by Wilson.]
The book and chapter now arrive: “New Views on Pornography: Sexuality, Politics, and the Law.” The chapter in question (“The Science and Politics of Sex Addiction Research.”) is authored by Nicole Prause and Timothy Fong. It consists mostly of a discussion of the appropriate “model” for understanding compulsive pornography use. Only two paragraphs are devoted to Prause’s undocumented and unsupported claims of being harassed. The most outlandish claim is that “individuals mapped routes to the laboratory address.” In other words, Prause is claiming that Google maps told her when people were searching for her lab’s address. Of course Prause did not name Wilson or anyone else in her chapter.
Key point: Knowing the details of an unpublished chapter 9 months before it is published incriminates Prause as TrickyPaladin. As do the meticulously detailed comments defending Prause’s flawed 2013 EEG study.
“Some individuals repeatedly emailed her after we had requested contact to stop… resulting in a police report”
Both claims are aimed at Wilson, and both are false.
[As explained above, here’s the reality behind each claim:
1) “Photos stolen”
A single picture, selected by Prause herself, from (what appeared to be) a UCLA lab website was used in an article about a study published and promoted by UCLA & Nicole Prause. The “porn site” was YBOP, a preposterous claim, as it is a porn recovery support website without x-rated content.
Police Report: Wilson has never been contacted by the police. A call to the Los Angeles police department and UCLA campus police revealed no such report in their system.
Email Claim: It was Prause who initiated all contact with Wilson after he wrote a Psychology Today blog post. Prause’s harassing emails contained threats and false statements, and it was Prause who continued to harass Wilson. (screenshots of our entire email exchange)
In the chapter Prause also stated:
“Noticeably absent from these attacks are published critiques from any scientist.”
Contrary to Prause’s claim 18 peer-reviewed critiques of her studies have been published:
“The research was never stopped by these attempts.”
As for Prause’s research at UCLA never stopping, it’s important to note that UCLA chose not to renew Prause’s employment contract (although she continued to claim publicly that she was still a UCLA researcher employed at the medical school). Prause hasn’t been employed by UCLA or any other university since late 2014 or early 2015.
Others – 2015 & 2016: Prause falsely accuses sex addiction therapists of reparative therapy
David Ley and Nicole Prause team up again. This time falsely accusing sex addiction therapists of practicing reparative therapy or conversion therapy. It started with Ley publishing “Homosexuality is Not an Addiction” which not so subtly, falsely accused members of IITAP and SASH of trying to turn their gay clients straight. (In response to complaints, Ley was later forced to alter the post and Psychology Today eventually deleted the comments.)
Prause was the first to comment, falsely accusing IITAP of harboring reparative therapists, and claiming to have emailed IITAP the names of the accused. While Prause’s comments were later deleted, she commented a few weeks later groundlessly accusing (gay!!) therapist Michael J. Salas of practicing reparative therapy as follows:
Having received no response to her groundless accusations, Prause “outed” Salas as a reparative therapist. She took a sentence out of context, hoping no one would actually visit his website. On his website, however, readers discover that Salas specializes in therapy for the Gay/Lesbian/Bisexual/Transgender community. He is a member the “Texas Association for Lesbian, Gay, Bisexual and Transgender Issues in Counseling”, Salas also states:
“For clients who are gay, lesbian, or bisexual, I provide LGBT Affirming Therapy. There is no such thing as changing someone’s sexual orientation”
It doesn’t end there. On November 22, 2015 Psychology Today blogger Joe Kort published “Why I Am No Longer a Sex-Addiction Therapist,” which created a brouhaha on all fronts. Nicole Prause immediately commented about her email exchanges with IITAP (Prause mistakenly called the organization CSAT, which is IITAP’s certification):
Submitted by Nicole prause on November 23, 2015 – 6:21pm
On submitting specific names and concerns, CSAT did not respond. After pressed with three queries and by other professionals they responded that te allegations were false. They provided no investigative process. For this writer to inquire would change nothing and make him yet another target of that community. I would discourage anyone from tangling with a group with no intention of addressing its problems.
I am happy to share the emails with you privately. They were disgusting to me as a licensed psychologist too.
Actually, any investigation shows her claims were completely false. Click on the link to Prause’s comment and you see no replies. That’s because Joe Kort deleted all comments challenging Prause, leaving her fabrications unchallenged. We have reproduced those (now) deleted comments below. The first 2 comments have CSAT Michelle Saffier asking Prause for data, and Prause responding:
The 3 Prause “complaints” were nothing more than cyberstalking. Michelle Saffier received no data or emails from Prause. The next comment challenging Prause was posted by anonymous:
Again, Joe Kort deleted the comments challenging Prause, while allowing Prause’s defamatory claims to remain. Kort’s actions drew a Twitter response, and an unsatisfactory response (Joe Kort later deleted his Twitter replies to Michelle and others). Joe Kort’s deletion of comments drew yet another comment under his blog post (since deleted).
Joe Kort closed all comments and deleted the above comment. Prause’s comment remains unchallenged to this day. Prause continues her unsupported and libelous claims concerning CSAT therapists. For example, this March, 2016 Tweet with compatriot David Ley.
Another CSAT therapist using “sex addiction” as a justification for reparative therapy. #IITAP stop supporting now.
It is, predictably, entirely untrue.
Prause and Ley go to twitter to cyber-stalk & harass therapists and IITAP (most of the therapists they wrongfully target were gay!). A few examples:
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Has nothing to do with IITAP:
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Prause hears things…..
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Article has nothing to with IITAP:
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The next 3 tweets have since been deleted by Prause. In fact, scroll Prause’s entire twitter thread and you will find no CSAT named as a reparative therapist.
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David Ley continues his defamation of CSAT’s (2019)
Prause and Ley exposed as sick cyberstalkers.
April, 2019 – Playing the victim, while providing zero evidence for claim that there are “therapists directly supporting people sending her death threats”.
Others – March, 2015 (ongoing): Prause and her sock puppets (including “PornHelps“) go after Gabe Deem (numerous additional instances of defamation)
Gabe Deem recovered from severe porn-induced ED by quitting internet porn use. He now runs Reboot Nation and occasionally appears on TV and radio to discuss his and other men’s experiences with porn-induced sexual dysfunctions. In March of 2015 Gabe published a detailed critique of the Nicole Prause and Jim Pfaus paper, “Viewing Sexual Stimuli Associated with Greater Sexual Responsiveness, Not Erectile Dysfunction.” Everything in Gabe’s page is accurate, documented, and unassailable. Gabe’s critique aligns with a Letter to the Editor of the journal where the paper appeared, by Richard A. Isenberg MD, though it provides more details about the Prause paper’s glaring discrepancies and unsupported statements.
A long debate ensued when user “FapSlap” posted the Prause & Pfaus paper on reddit/nofap. Prause-apologist “FapSlap” (who appears to be a researcher) eventually claimed to contact Nicole Prause looking for ammunition to defend the Prause paper. Here’s FapSlap’s comment confirming not only his/her email exchanges with Prause, but a future response to her critics:
Of course you will probably say ‘fake is fake.’ But believe me it’s not. Out of respect I am not posting the conversation. You will have proof soon enough for the journal, trust me And I will be quite happy to see your ‘bullet in the barrel’ critique be thrown out the window.
Actually, he did just write me and he is correct. We collected the full IIEF in many studies in which we do not ultimately publish the data. Sometimes we choose not to, sometimes reviewers tell us to remove them because they are not relevant.
We are publishing a follow-up letter in the journal to show all the counts remain correct. All the analyses remain correct. The conclusions stand.
I will not be responding to any follow-up posts. I posted here only out of compassion, because you are lying to this poor person. Wait for the letter. It is to appear in April and will dispel all the myths RebootNation is propagating to the poor people they are using to fund their speaking travel and fees and false “counselor” titles.
The promised response did not address any of Isenberg’s concerns (as pointed out subsequently by Deem) and merely added new unsupported claims and untrue statements. Prause also falsely states that Gabe (RebootNation) is lying and that he makes money from RebootNation and speaking fees. While none of this is true, these same exact claims soon appear again via “PornHelps” and several r/pornfree sock puppet user names.
On March 31, 2016, the TIME cover story featuring Gabe, and other men who had recovered from porn-induced sexual problems, was published. On April 1 the following post by TruthWithOut appeared on reddit/pornfree: Gabe Deem admits profiting of NoFAP Reboot Nation. The original post, the “TruthWithOut” username, and a few of her comments, were later deleted (though most of her comments remained). The original post, claiming TIME had “outed” the nefarious Deem:
The reddit/pornfree moderator “Iguanaforhire” recognizes the sock puppet has previously posted the same false content:
It doesn’t. Person made a new account just to bother us. Again.
You can read TruthWithOut’s remaining comments and see the same false claims repeated over and over: 1) Gabe is lying about everything, 2) he never had ED, 3) he makes money from both RebootNation and speaking fees, and, 4) he’s unemployed. All untrue. One example:
And I’m waiting on that evidence Gabe. ANY shred of evidence that you are not just lying. No one has seen anything validating any part of your story. Not your supposed girlfriend, no doctor, no one. You could easily provide it, but you haven’t.
You are just taking trips and money from guys you stir into a panic with your made up tales.
The facts? The TIME Magazine article incorrectly stated that Gabe Deem made money through speaking fees. While this is not true (and was later publicly corrected by TIME), TruthWithOut used this journalistic error to launch an attack, claiming a series of lies. A few days later Deem tweeted the correction from the print version of TIME Magazine. (TIME formally acknowledged that it had erred in saying that Deem makes money from his activities connected with RebootNation.) End of story. Nonetheless, several other Prause sock puppets posted similar allegations (that “Deem lied about everything“) on Reddit/pornfree and elsewhere. A few examples:
We have yet another Prause sock puppet (AskingForProof) posting this:
Another Prause sockpuppet with her usual 3 capitalized words, harassing Gabe Deem on reddit/pornfree (https://www.reddit.com/user/TruthWithOut) – with the exact same calims of Gabe faking his porn-induced ED. Prause starts with this post, and is followed by almost 20 comments:
Thing is, Gabe makes no money off his porn-recovery forum and had never taken any money for speaking fees. Prause/TruthWithOut just keep ranting:
Just for fun, yet another r/pornfree thread started by another Prause sock puppet: DontDoDallas – https://www.reddit.com/user/DontDoDallas (Deem resides in Dallas):
Speaking of lies, the above Newsweek article never mentioned Gary Wilson or YBOP.
As outlined later, evidence suggests that Prause shares the @pornhelps twitter account with others and created the PornHelps Disqus username.(@pornhelps later deleted their twitter account when outed as Prause). Below is a PornHelps Disqus comment published around the same time as the r/pornfree lie “Gabe Deem admits profiting”:
Look everybody! It’s Gabe Deem back again reposting anti-sex rants again and puppeting his own upvoted post! You might remember him from the Reason post where he was shredded for posting this anti-science message with links back to his own website. He has no college degree, no job, and is paid (see Time article) for speaking about his erectile problems he claims (with no doctors’ evidence) were “due” to porn.
I know I know, you are going to repost a long list of links hoping no one actually follows them and knows the truth, but this is it. And I’m not engaging further. Hopefully the folks form the previous time you did this will find your posts again Gabe Deem.
PornHelps references the TIME article, making the same false claims as the many Reddit sock puppets. This is no coincidence. Below you will see that Prause as Prause (i.e., using her own name) called TIME journalist Luscombe and NoFap.com founder Alexander Rhodes ‘liars’ and ‘fakers’.
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UPDATES: Using her @BrainOnPorn account, Prause continues to defame and harass Gabe (even though Gabe blocked her). A few exmaples:
As mentioned numerous, because porn-induced sexual problems are the biggest threat to the porn industry agenda, RealYBOP (created April, 2019) is obsessed with debunking porn-induced ED. In this tweet RealYBOP insinuates that Gabe deem and Alex Rhodes are lying about PIED (and are doing so for profit):
RealYBOP claims are untrue and disgusting.
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September 30, 2019 tweet about Alex Rhodes. In it RealYBOP falsely sates that NoFap tried to silence the actual science, but they lost (linking to the WIPO decision in favor of RealYBOP)
In this tweet, RealYBOP said Gabe Deem “Tried to have our website taken down bc he cannot answer science”:
RealYBOP continues, defaming Deem, and stating that he tried to silence scientists (linking to WIPO decision).
RealYBOP falsely states that Deem was involved in a lawsuit. That is defamation per se.
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The next day, RealYBOP trolls Gabe (whom she has blocked):
More of the same, falsely claiming Gabe was involved in the Burgess legal action – it was not a lawsuit.
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More trolling by the blocked RealYBOP account
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RealYBOP and sidekick NerdyKinkyCommie, troll Gabe Deem (note that Gabe had blocked both, but that doesn’t stop cyberstalkers):
First, the links posted by trolls Nerdy and James F. were given to them by RealYBOP/Prause.
Second, Nerdy’s screenshot has been tweeted dozens of times by Prause & RealYBOP. It had nothing to do anything in thread, but it matters not, because RealYBOP/Prause are obsessed with MDPI (parent company of the journal Behavioral Sciences). Behavioral Sciences published Is Internet Pornography Causing Sexual Dysfunctions? A Review with Clinical Reports(Park et al., 2016). Nerdy is lying about MDPI’s rating. Here are examples of Prause (as Sciencearousal) inserting the above clerical error by the Norwegian Register, who accidentally downgraded MDPI’s rating from the normal “1” to a “0”. The downgraded rating had long been resolved on the MDPI Wikipedia page. Prause knows the zero rating was a clerical error, yet she and RealYBOP tweet that MDPI was downgraded and that MDPI is a predatory journal (both are false and both are in Sciencearousal’s/Prause Wikipedia edit).
Third, the 5-year video has nothing to do with China, or internet addiction boot camps. It was about porn.
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More trolling Gabe (who RealYBOP has blocked):
Nope what?
RealYBOP trolling Gabe Deem, again:
Reality: Gabe was accurate for a drawing. The other 2 comments are red herrings. However, RealYBOP’s comments are irrelevant. Instead, this twitter account claims represent 20 experts, yet its trolling accounts it has blocked, with inane, spurious tweets. How embarrassing. How mentally deranged.
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In a disgusting tweet, RealYBOP calls Gabe Deem a white supremacist (RealYBOP regularly defames and harasses individuals and organizations who say porn use might cause problems).
So liking a tweet of someone you don’t know makes you a white supremacist? All this does is expose RealYBOP as a cyberstalker.
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RealYBOP trolls Gabe Deem again: She lies about the research an attacks him personally.
RE: Cameron Staley’s TEDx Talk. He was a grad student of Prause when he gathered data for Steele et al. 2013. Just a few his falsehoods in his TEDx talk where he cited zero studies to support his propaganda:
Staley says his “mentor was a renowned sex researcher!” What? No one had heard of Prause before Steele et al. was published in July of 2013 (Prause misrepresented its findings).
Staley lies about about the actual results of Steele et al, 2013. He states that “the subjects brains didn’t look like brains of addicts” – but he never tells us how their brains differed from addicts (because they did not). 8 peer-reviewed papers disagree with Staley, and point out that the subjects brains looked exactly like an addict- Peer-reviewed critiques of Steele et al., 2013 (greater cue reactivity correlated with less desire for sex with a partner). Note: Steele et al., did NOT have a control group!
Bottom line according to Staley – believe porn use is just fine and you will be just fine using porn. Unsupported propaganda refuted by hundreds of studies.
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Even though RealYBOP has blocked Gabe Deem she still cyberstalks him:
Disgusting how a “Psychologist” is allowed to say that a young man faked erectile dysfunction (RealYBOP is a liar – Gabe makes no money off of this).
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On January 30, 2020 – Gabe Deem posted the following tweet with snippets from urologist Tarek Pacha’s Porn-Induced ED presention givenat the American Urologialc Association Conference, May 6-10, 2016 (Part 1,Part 2,Part 3, Part 4)
i wake up every morning baffled this isn’t being talked about more.
Here we have a urologist, Dr. Tarek Pacha, presenting at the American Urological Association on the rise in porn-induced sexual dysfunction in young, otherwise healthy men. pic.twitter.com/lk9ymqoFgj
Right after @gabedeem tweeted Dr. Tarek Pacha’s presentation on PIED, RealYBOP twitter (thought to be run by Prause) defamed Dr. Pacha by falsely stating he is NOT a urologist and that he is somehow profiting through suggesting guys quit porn. Reality:
Pacha received only free meals and some lodging from medical companies in an amount far below the average for physicians. More to the point, medical companies would prefer Pacha refrain from telling guys that to achieve sexual health all they have to do is quit porn. Can’t sell any medical devices that way!
RealYBOP begins by posting 4 malicious and defamtory tweets:
No RealYBOP, your “critique” is defamatory, as you falsely stated that Tarek Pacha is not a urologist. You also falsely claim a conflict of interest when there was none: no medical supply company is buying Pacha lunch to encourage him to tell young men to eliminate porn to cure their ED
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February, 2020 – Even though Gabe Deem has blocked RealYBOP, she trolls and defames Gabe. RealYBOP also lies about current state of research.
Immediately after Prause’s Twitter account was suspended, this defamatory post appeared on reddit/pornfree, disparaging and defaming Gary Wilson, Gabe Deem, the author of the above paper (Todd Love), and others. Three newly created usernames commented most (PDF of Nicole Prause aliases she used to harass & defame):
Two usernames were later deleted, but EvidenceForYou remained. Several comments leave no doubt its Nicole Prause – most notably by stating that lawyers are now involved, or that Wilson is about to be sued:
Link – Gary Wilson, they have your IP and all the records courtesy of a subpoena. We’re not chasing these new lies too, just going to stop the one’s you have already been telling. Prepare to file for bankruptcy again.
Link – When they cannot fight the science, they fight the person. They fail, so they spread false rumors that are currently the subject of a lawsuit. This proves it.
Link – For example, in reviewing a (non-existent) critique, they claim the scientist is no longer employed: https://www.yourbrainonporn.com/our-response-rory-reids-critique-nicole-prause-study This, by the way, is a recent update (seeing these posts and panicking Gary? Too late, we already sent her attorney the screen shots.) watered down from the earlier “fired”.
A week or two later (October 15, 2015) Gary Wilson received a ‘cease and desist’ letter from a lawyer representing Nicole Prause. It stated that Gary Wilson had made four false and misleading statements about Prause. Of course, all four were untrue (such as Wilson saying that “Prause starred in porn films”….unbelievable!). Wilson responded with a letter stating all were false, and asked for proof of these claims (reproduced later on this page). There was no response by the lawyer or Prause. Yet another example of Prause’s continued pattern of harassment while simultaneously playing the victim.
Others – November, 2015: John Adler, MD blogs about Nicole Prause & David Ley harassment
John Adler, MD, who is Co-Editor-in-Chief of Cureus, wrote a blog post about his harassment at the hands of Nicole Prause and David Ley and their cronies: Intellectual Fascism. In it Adler describes behaviors we have come to expect from Prause & Ley:
Two individuals, whose specialty overlapped the erroneous article [Prause and Ley], attacked the article for its political misstatement, and by extension, Cureus’ journalistic integrity for missing this error during our pre-publication review process.
I immediately invited these critics to set the record straight via our liberal comment and scoring processes, but in a series of personal (and necessarily confidential) emails, the critics refused, insisting on remaining anonymous. Over the next several days they recruited a chorus of similarly-minded colleagues who insisted that the article in question represented serious scientific misconduct and demanded it be retracted… period!
… In parallel, I stumbled upon the existence of a listserv community of likeminded researchers including the two critics, whose major modus operandi is to fiercely act en-mass, hyena-like, oftentimes via social media, when certain partisan political issues arise, such as the article Cureus had unwittingly published.
If ever I witnessed intellectual fascism, this was it; the only thing missing was a goose-stepping mustached man….
By the way, we know he is talking about Ley and Prause because 1) both Ley and Prause engaged in a Twitter storm against Adler prior to his post appearing (we have tweets by Adler, but Prause’s tweets are unavailable because her @NicolePrause account was eventually permanently suspended due to her misconduct). 2) David Ley posted all about this on a sexology listserve.
As part of the storm Adler wrote about, former porn star and current radio show host Melissa Hill, tweeted that Dr. Adlers son “managed to get @NicolePrause PhD’s account suspended!”:
The above is entirely false as Prause’s Twitter account was permanently suspended for posting the personal information of one of the authors of this paper “Neuroscience of Internet Pornography Addiction: A Review and Update” (2015). Trip Adler had nothing to do with it, as Prause caused it herself. The logical conclusion is that Prause fed Melissa Hill this false story. It seems they are friends. Prause has appeared on Melissa Hill’s radio show several times, and Prause re-tweeted a photo of her and Hill together on the red carpet of the Adult Video awards. A few days later, the Free Speech Coalition (the lobbying organization for the porn industry) offered Prause assistance, suggesting she contact Diane, the CEO of the Free Speech Coalition (FSC).
Question: Why is the porn industry offering high-level assistance to Nicole Prause? Whatever the reason, Melissa Hill and the FSC join up to harass Adler’s son (Trip Adler) – all because Prause told Hill and the FSC her fabricated accusation that Trip Adler got her thrown off twitter:
The promised story has yet to appear, and Prause has given no formal (or truthful) explanation for her permanent Twitter suspension. Three years later, Prause is still dishonestly blaming Adler’s son for the permanent suspension of her first Twitter account:
Prause has never provided a single iota of evidence for her tall tale that the CEO of Twitter personally deleted her first twitter account. The truth about Prause’s permanent suspension is right here.
Others – March, 2016: Prause (falsely) tells TIME Magazine that Gabe Deem impersonated a doctor to write a formal critique of her study (letter to the editor) in an academic journal (and the letter was traced to Gabe’s computer).
On March 31, 2016, the TIME cover story (“Porn and the Threat to Virility”), by Belinda Luscombe, featuring Gabe Deem, Nicole Prause and many others, was published. It was a year in the making and TIME had the author and other TIME employees (fact checkers) follow-up on claims made by each person interviewed. In the process, TIME fact-checkers presented Gabe Deem with a final set of questions for him to confirm or to deny.
One fact to confirm or to deny was an allegation put forth by Nicole Prause. Prause had told TIME that Gabe Deem had impersonated a medical doctor to write the letter to the editor of an academic journal (described above) critiquing a paper the journal had published by Prause & Pfaus. Below are snapshots from TIME‘s email to Gabe. They include the email intro and the allegation from Prause, but omit other, unrelated questions:
The Intro to the email:
The last of many questions in the email:
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Richard A. Isenberg, a medical doctor and author of multiple academic papers, specializing in Uro-Gynecology, is the one who wrote the critique (A letter to the editor), which was published in “Sexual Medicine Open Access,” the same journal that published Nicole Prause and Jim Pfaus’s paper, “Viewing Sexual Stimuli Associated with Greater Sexual Responsiveness, Not Erectile Dysfunction.” Since Gabe also wrote a critique of the same paper, Prause appears to be accusing Gabe of writing Isenberg’s critique as well! More astonishing still, Prause claimed that UCLA had traced the Isenberg critique to Gabe Deem’s computer. Of course, no evidence was supplied to back up any of these unbelievable assertions.
How likely is it that UCLA would hack the computers of men recovering from porn-induced ED? The thing that makes Prause’s claim about UCLA particularly unstable is that Isenberg’s Letter to the Editor was published 6 months after UCLA did not renew Prause’s employment contract – and yet she claims UCLA was engaging in cyber-espionage on her behalf! All this reveals just how far Prause is willing to go. And unlike much of her unscrupulous behavior this attempt at defamation is documented by a third party (TIME magazine’s staff).
Others – June, 2016: Prause and her sock puppet PornHelps claim respected neuroscientists are members of “anti-porn groups” and “their science is bad”
As usual her claims are preposterous. First, it’s an excellent study, now formally published despite all the incomprehensible resistance. Second, its authors received first prize for this very research at the European Society for Sexual Medicine conference in 2016. Third, the authors have no affiliation with Prause’s imaginary “anti-porn groups” (which Prause never names).
For example, the lead author is Dr. Mateusz Gola, who is visiting scholar at UC San Diego, and has 71 publications to his name. Another author is Marc Potenza MD, PhD, of Yale University, who is considered by many to be one of the world’s preeminent addiction researchers (way out of Prause’s league). A PubMed search returns over 460 studies by Dr. Potenza.
As Matuesz Gola explained to “PornHelps” in the comments section, BioRxiv (where Prause found it) exists for pre-publication papers, and functions to elicit feedback from researchers in order to improve papers. It should be noted that the “pornhelps” comments and Prause’s tweet appeared at the same time. Do the following pornhelps comments sound like porn industry shill or a researcher:
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It’s clear that Prause as herself, and as pornhelps, is disturbed by any neurological study lending scientific support to the porn addiction model (all do). But there’s more to this story. Matuesz Gola also published a formal critique of Prause et al., 2015, which explained that Prause’s findings align with two established addiction models (8 peer-reviewed papers agree with Gola) – contradicting Prause’s claim (that she had disproved (or, as she likes to say publicly, “falsified”) the addiction model with her single paper).
Update – Prause confirms what we already knew – that she is pornhelps. @pornhelps later states “I have 15 years studying as neuroscientist”:
Prause, a Kinsey grad, calls herself a neuroscientist, and appears to have started college about 15 years before this tweet. More on @pornhelps here. (Update – @pornhelps later deleted its twitter account and website when it became apparent to others that Prause often tweeted with this account, commented as pornhelps, and helped with the website)
Others – July, 2016: Prause & David Ley attack NoFap founder Alexander Rhodes.
Prause did not name Wilson, so she may be off the hook, legally speaking. All claims are false as Wilson has 1) never been contacted by the police, 2) never threatened her lab, 3) is not under any “no-contact order” except threats from Prause herself after Prause harassed him. This tweet once again incriminates Prause as the individual responsible for the many defamatory comments described in the first section. Prause ended it all as she usually does: citing no evidence and tweeting Rhodes “I sent you documentation. Do not contact me again.” That’s Nicole Prause’s MO: Initiate a personal attack, follow it up with lies, then end it all by playing the victim. By the way, Prause sent no such documentation. Yet another lie. Others were watching the Twitter storm, which led to an article detailing it, and more Prause tweets attacking yet another person (below). Meanwhile, consider the fact that it is a violation of APA (American Psychological Association) principles for psychologists to attack those trying to recover.
July 2016 wasn’t the first time Prause defamed and harassed Alex Rhodes. On May 30, 2016 Prause went so far as to falsely accuse an anonymous quora account of being Alexander Rhodes and thus holding a “trademark”. The Quora account was not Rhodes. Here she posts 3 bizarre comments:
Over the next few months Prause takes every opportunity to belittle and attack Alexander, NoFap.com, and men recovering from porn addiction:
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Prause and Ley referring to the TIME article, thus Gabe Deem and Alex Rhodes
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In this out of the blue May, 2018 tweet attacking Nofap, Prause cited an opinion piece in the journal “Sexualities” falsely stating that the article had “shown by science to denigrate women”.
Others – July, 2016: Prause falsely accuses @PornHelp.org of harassment, libel, and promoting hate
The day after the above Alexander Rhodes/Nicole Prause dustup, @PornHelpdotorg published a blog post detailing the events: “Reflections on a Twitter Skirmish,” and tweeted it to Rhodes, Prause, and David Ley. This set off another Twitter conversation, which you can read in entirety here (prause has delted all herPrause’s first response once again claims documentation:
Once again, Prause performs her usual dance: Start with false unsupported claims. When asked to support the claims, she cannot. Finally, Prause resorts to legal threats, instead of the requested documentation or examples (because she has nothing). As always, she end with “do not contact me” – then later falsely states that she has a “no-contact order”, even though there is no such thing.
Others – July, 2016: Prause & her alias “PornHelps” attack Alexander Rhodes, falsely claiming he faked porn-induced sexual problems
Evidence points to Prause sharing the @pornhelps twitter account and using the PornHelps disqus username. As described above, Prause published (then deleted) a bizarre tweet about this Matuesz Gola study. PornHelps simultaneously commented under the Gola study using the jargon of a researcher. In addition, the following @pornhelps tweets arise from Los Angeles, where Prause lives. (Update – @pornhelps later deleted their twitter account and website as it became apparent that Prause often tweeted with this account)
This was followed by @pornhelps calling both Alexander and Belinda liars. @NicoleRPrause eventually chimed in to call TIME journalist Luscombe a liar (more in the next section). The back and forth contains too many tweets to post here, but most can be found in these threads: Thread 1, Thread 2, Thread 3. Below is a sampling of @pornhelps’s unstable-sounding tweets falsely claiming that Alexander faked his story of porn-induced sexual problems:
@luscombeland @nytimes “Brave”? Faking a problem to promote his business? You failed to verify any part of his story
@GoodGuypervert @luscombeland exaggerating makes them money, esp in his case. These guys are mostly unemployed, no college…got $$$ somehow
@AlexanderRhodes & @luscombeland are creating fake panic to sell their wares. Disgusting.
@AlexanderRhodes @luscombeland @GoodGuypervert uh-oh, he’s gone full ad-hominem BC he got caught faking to make money off young scared men.
@AlexanderRhodes @luscombeland @GoodGuypervert then I await your proof that any of your claims actually happened to you, fake profiteer.
Pornhelps responds, seeing if a lie will stick: “I heard you got blackballed for false reporting”. Eventually Prause’s “NicoleRPrause” Twitter account chimes in calling Luscombe a liar (below). Hmm…how did @NicoleRPrause know about this Twitter thread? Another bit of evidence suggesting Nicole Prause masqueraded as @pornhelps.
In the Ley interview Prause claims to have unpublished data falsifying any connection between “porn addiction” and penile injures (Prause also said she will never publish the data). It’s important to know that both Prause and Pornhelps had been saying that Alexander lied about his masturbation-induced penile injury and porn-induced sexual problems.
Is it any coincidence that 3 days after multiple @pornhelps tweets called Alexander a liar, Ley and Prause publish a Psychology Today blog post directed at one of Alexander’s complaints (that he injured his penis from excessive masturbation)? Interestingly, their own data apparently showed that a fifth of those surveyed had experienced similar injuries. But again, Prause refuses to publish the data, while claiming her data somehow (inexplicably) prove that Alexander must be a liar. In any case Prause’s blog claims remain unsupported as she did not assess “porn addiction” or compulsive porn use in her subjects (read the comments section of Ley’s post).
Others – July, 2016: Nicole Prause & “PornHelps” falsely accuse TIME editor Belinda Luscombe of lying and misquoting
Luscombe has been with TIME Magazine since 1995, becoming a senior editor in 1999. (See her Wikipedia page and her TIME page.) Luscombe spent a year investigating porn-induced sexual problems in young men, which resulted in the March, 31, 2016 TIME cover story “Porn and the Threat to Virility.” Both Prause and Ley have attacked the TIME article, even though both were featured in it and quoted (minimally).
Unfortunately for the public, usually Prause and Ley are the only “experts” featured in most mainstream porn-addiction articles, while the true addiction neuroscientists and their work are not even acknowledged to exist. Not this time. Two world renowned neuroscientists, who have published fMRI studies on porn users, were interviewed for the TIME article. So was a urologist, as well as several young men who have recovered from porn-induced erectile dysfunction. Put simply, the TIME article was more carefully researched than any other article on this subject, and its content reflected both reality and the (then) current state of the science. Since then, even more support for the possible link between internet porn use and sexual dysfunctions has come out in the peer-reviewed literature.
In response to Belinda’s earlier tweet (pictured above) about working the story for a year, we have @pornhelps, tweeting the following:
Pornhelps is psychic: she knows “for fact” how long Belinda worked on the story. Ten minutes later Prause tweets claiming Belinda misquoted her and “lied about her sources”:
As always, Prause provides no examples and no documentation. Not being tagged, how did Prause know about Belinda’s tweet or @pornhelp’s reply? Maybe Prause is psychic too?
Reality Check: It is Prause and @Pornhelps who are lying. As many can verify, Luscombe contacted Gary Wilson, Gabe Deem, Alexander Rhodes, Noah Church, David Ley, and others, during the year before the TIME cover story was published. In addition, Luscombe and several TIME Magazine fact-checkers contacted each individual several times to corroborate each interviewee’s claims.
We know that Wilson’s former employers were contacted, as were the girlfriends of the men with porn-induced sexual problems. Interviewees were also asked to deny or confirm claims given to TIME by David Ley and Nicole Prause. This was done in writing, often 2-3 times for each claim.
For example, Nicole Prause falsely claimed to TIME magazine that Gabe Deem masqueraded as a medical doctor to write this peer-reviewed critique of Prause & Pfaus 2015 (in fact written by a medical doctor/researcher). Even more astonishingly, Prause told TIME that UCLA had traced the “Richard A. Isenberg MD” critique (Letter to the Editor) to the young man’s computer. This outlandish attempt to defame Deem is all documented above.
No one responds to feed the troll. More examples of Prause’s acknowledged twitter account continuing to attack TIME and Belinda:
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Update (April, 2019): Prause and David Ley attack & libel Luscombe (and Wilson)
On April 1, 2019, both Gary Wilson and Belinda Luscombe weighed in on a long twitter thread discussing validity of the General Social Survey (which claimed that only 45% of men, aged 18-29, had viewed an X-rated movie in the last year). Within a few minutes Prause joined the tread to attack and libel Luscombe and Wilson (long-time Prause ally David Ley also libeled Wilson). In her first of 8 tweets, Prause repeats the same lies documented on this page. She also calls Belinda a fake journalist, engaging fraud.
Since Prause has blocked Belinda, Ley jumps in to “paraphrase” (but omits Prause’s attacks on Belinda). Belinda responds:
David Ley joins in with 2 of his own lies: That Wilson was a TA (teacher assistant) and he was fired.
Truth doesn’t stop Ley or Prause from continuing their Twitter libel-fest, attacking Belinda Luscombe and Wilson.
All provable libel:
Wilson did not drop out of college.
Wilson did not default on his student loans.
Wilson was not a TA. He was ‘Adjunct Faculty.’ (How could Wilson be a TA if he was not attending SOU as a student?)
On December 15, 2019 the most comprehensive, research-based article yet on porn’s effects was published by Pascal Gobry: A Science-Based Case for Ending the Porn Epidemic. RealYBOP and Nicole Prause responded with 90 rambling tweets consisting of personal attacks, ad hominem, false accusations – yet nothing specific about the article. Belinda Luscombe can relate:
Despite claiming that she is “not a science writer,” she continues to try to cover scientific topics. This often results in required retractions by the scientists then forced to clean up her poor writing.
The above comment was reversed the next day by another Wikipedia editor. Without checking this user’s other comments, it’s evident that this was likely done by Nicole Prause. Moreover, an investigation of this user’s only other 3 Wikipedia edits erases all doubt that this is Prause’s handiwork:
Only Nicole Prause would have made theses edits, especially the last 3:
“Largest neuro study mysteriously left off previous edits.” This is referring to Prause et al., 2015, which is the study that only Prause boasts (inaccurately) is the largest neurological study on porn addicts. No one else calls her EEG study the “largest study” because: 1) Many of Prause’s subjects were not really porn addicts; 2) two other neurological studies assessed greater numbers of subjects.
“Removing pseudoscience by Gary Wilson.” Who else would (falsely) accuse Gary Wilson in a Wikipedia edit? In the section below we reveal other Prause Wikipedia sock puppets who attack Gary Wilson, including a sock puppet with the user name “NotGaryWilson.”
This vicious failed attack on veteran TIME editor Belinda Luscombe for doing her job well (and giving short shrift to Prause’s “alternative facts”) is classic Prause vindictiveness. (PDF of Nicole Prause aliases she used to harass & defame).
Others – September 2016: Prause attacks and libels former UCLA colleague Rory C. Reid PhD. 2 years earlier “TellTheTruth” posted the exact same claims & documents on a porn recovery site frequented by Prause’s sock puppets.
On September 15th, 2016 Nicole Prause posted a fake press release on the website PROLOG. Prause’s “press release” attacked and libeled several individuals including Gary Wilson, Donald Hilton MD, Utah state senator Todd Weiler, and Dr. Todd Love. This is what remains of the press release, as ProLog removed the content 2 days later because it violated their policies. Not to be denied, Prause placed the press release’s content on her AmazonAWS account. Links to the Rory Reid related documents Prause uploaded to her AmazonAWS site:
“Psychologist” and “LCSW” are both regulated titles licensed with the state of California that Rory Reid was using to advertise his services to patients but did not actually possess. Rory Reid also has falsely described that he attended and is on faculty at Harvard University and is an “assistant professor” at UCLA. Reid was never faculty at Harvard University and is an adjunct, not tenure track faculty, at UCLA. Reid is listed as a full-time employee of the State of California’s Office of Problem Gambling at UCLA, so it is unclear how Reid would be able to study sex films and contact politicians about sex films without violating his state contract.
A little background on Rory Reid and former UCLA researcher Nicole Prause is useful here. Rory Reid has been a research psychologist at the David Geffen School of Medicine, UCLA since before Nicole Prause’s brief stint at UCLA began in 2013. Reid’s research areas are hypersexuality and gambling addiction.
Reid, like Prause, has often argued against the existence of “sex addiction.” Reid stated in a 2013 article that his office was right next door to Prause’s at UCLA. In 2013 Nicole Prause listed Rory Reid as a member of her “SPAN Lab.” As stated, Prause’s UCLA contract was not renewed while Reid remains a researcher at UCLA. Whatever he did to displease her, Prause is now attacking a former colleague publicly and brutally.
But there’s more to the story. Twenty months earlier, in December 5th, 2014 several comments mirroring Prause’s “press release” (urging readers to report Rory Reid to California authorities) were posted on the porn recovery site YourBrainRebalanced by a brand new member. As we saw above, Prause made a habit of commenting on YBR using various aliases. (PDF of Nicole Prause aliases she used to harass & defame). The first of these comments, by TellTheTruth, contained 2 links. One link went to a PDF on Scribd with supposed evidence supporting TellTheTruth’s claims (Prause regularly use aliases with 2-4 capitalized words as usernames).
Two more comments by TellTheTruth that mirror Nicole Prause’s “press release” (now) published nearly 2 years later.
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The TellTheTruth comments and PDF from December, 2014 along with the Prause’s press release incriminate Nicole Prause as cyberstalking Rory Reid at about the time that UCLA chose not renew her contract! Coincidence?
Key point: The documents that Prause placed on her AmazonAWS account about Reid are the same documents that TellTheTruth placed on YourBrainRebalanced 2 years earlier. Note the same “2013 copyright State of California” for Prause’s current screenshot and TellTheTruth’s 2-year old screenshot:
Prause’s current document: https://s3-us-west-1.amazonaws.com/weilerdefamation/NoLicenseInCalifornia.png (note the URL in this screenshot & the 2013 copyright)
TellTheTruth’s document she posted 2 years earlier on the porn recovery forum YourBrainRebalanced. Notice the 2013 copyright and how TellThe Truth pasted Reid’s picture into her PDF:
Here’s why we know TellTheTruth was Nicole Prause: The current license search has a 2016 copyright notice! Prause was harassing and cyberbullying her UCLA colleague Rory Reid in December, 2014 (about the time she was leaving UCLA), and she’s still using the same screen shots to do it.
Here’s another another example of duplicate documents by Prause-2016 and TellTheTruth-2014. Prause’s current AmazonAWS document – https://s3-us-west-1.amazonaws.com/weilerdefamation/BevHillsClinicalPractice_ClaimsLCSW.png
Incidentally, it looks like Nicole Prause “stole” Rory Reid’s picture and placed on a website without his permission. Should he file a police report? And here’s TellTheTruth’s document from December, 2014. You can see from the URL stamp and heading that this was a PDF on SCRIBD:
Same documents, same claims, same spinning of the truth by both Prause and TellTheTruth. Here’s the Key point: Rory Reid is still a researcher at UCLA while Prause’s contract at UCLA was not renewed.
One has to ask why UCLA would willingly part with an up-and-coming researcher able to (1) debunk entire fields of science with a single study (in this case, the field of porn addiction research), and (2) persuade the media she has done so. Things are not always what they seem.
September, 2016: Prause libels Gary Wilson and others with Amazon AWS documents (which Prause tweeted dozens of times)
Back to the September 15th, 2016 fake press release Nicole Prause posted on the website PROLOG. Prause’s “press release” also attacked and libeled several individuals including Gary Wilson, Donald Hilton MD, Utah state senator Todd Weiler, and Dr. Todd Love. Again, this is what remains of the press release, as ProLog removed the content 2 days later because it violated their policies. Not to be denied, Prause placed the press release’s content on her AmazonAWS account (Amazon refuses to arbitrate content disputes). Since September 15, Prause has tweeted dozens of times about her document. Here we examine Prause’s comments about Gary Wilson.
Prause said: Dr. Prause had to file a police report and close and hide her UCLA laboratory under threat from this blogger and now requires physical protection at all her public talks from him. He has since been spotted in Los Angeles near the scientist’s home and LAPD threat management has been alerted.
Closed her Lab? Armed guards? Spotted near her home? All this because YBOP critiqued her 2013 EEG study? All these claims are untrue, and the claim that “Wilson has been spotted seen near the scientist’s home” is also fiction. Wilson hasn’t been to LA in years. A call to the Los Angeles police and the UCLA campus police revealed no police report about Wilson in either system. That is the only fact here.
Prause said: He wrote the UCLA chancellor over a dozen times claiming Prause had faked her data, faked her title, and more, all of which UCLA refuted.
False. Wilson wrote (or copied) the chancellor 3 times in late 2013 and early 2014 to complain about Prause’s ongoing harassment. The first letter informed UCLA about Prause’s multiple instances of harassment, frivolous legal threats and libel targeting Wilson and two others. This letter also documented Prause’s intimidation of Psychology Today editors (who acquiesced and removed Wilson’s critique and a critique by two other Psychology Today bloggers (both experts)). In one paragraph Wilson described how Prause misrepresented the finding of Steele et al., 2013 to the press. Eight peer-reviewed papers have since supported Wilson’s assertion: Peer-reviewed critiques of Steele et al., 2013. Nowhere did Wilson say that Prause had “faked her data” or “faked her title.” Both Wilson and UCLA possess the original letters. Their content proves that Prause is libeling Wilson.
Wilson sent a second letter to UCLA (December 2, 2013) to complain about Prause placing a document libeling Wilson on the SPAN lab website (as described above). It was assumed that UCLA controlled the content as each SPAN Lab page contained the following:
Reproduced below are the first several paragraphs of Wilson’s letter to UCLA Chancellor Block:
Two weeks later a letter was sent to Vice Dean Jonathan R. Hiatt to inform him that Prause’s libelous PDF remained. Shortly thereafter the PDF was removed, although no official response was received until March, 2014. The Vice Dean informed Wilson that the SPAN Lab website was Prause’s own site, and not a UCLA website at all(!). Reproduced below is a portion of UCLA’s response to Gary Wilson’s letter:
So Wilson did not “write the UCLA chancellor over a dozen times.” This can be confirmed by UCLA. We must state again that Prause not only personally attacked Wilson, but attacked UCLA colleague Rory Reid PhD (see above section). UCLA did not renew Prause’s contract.
Prause said: He also broke into her private online account to stalk her after receiving a no-contact order. He stole her personal photos from that account, posted them to his porn website, then migrated them to try to evade DMCA take downs until his ISP threatened to shutter his website.
Addendum: Prause is now claiming in an AmazonAWS PDF that Wilson migrated the picture of Prause (and the associated article) to other servers. This is false. The picture of Prause accompanied a single critique that appeared on two separate websites, PornStudySkeptics and YourBrainOnPorn.com. These two identical articles have remained on those two websites since July, 2013: Article 1, Article 2. In her PDF Prause also claims that Wilson’s ISP told him that they “would close his website if he did it a fourth time”. This did not occur.
Prause said: Her name appears over 1,350 times on one website alone of an obsessed blogger.
This claim may actually be true. The website Prause is referring to is this one: YourBrainOnPorn.com. Approximately 700 of the 1,350 mentions are on this page alone. Why would YourBrainOnPorn.com contain an alleged additional 650 instances of “Prause”? YBOP contains about 13,000 pages, and it’s a clearinghouse for nearly everything associated with Internet porn use and its effects on the user. Nicole Prause has published multiple studies about porn use and hypersexuality, and by her own admission, is a professional debunker of porn addiction and porn-induced sexual problems.
A Google search for “Nicole Prause” + pornography returns about 13,000 pages. She’s quoted in hundreds of journalistic articles about porn use and porn addiction. She has published several papers related to pornography use. She’s on TV, radio, podcasts, and YouTube channels claiming to have debunked porn addiction with a single (heavily criticized) study. So Prause’s name inevitably shows up a lot on a site functioning as a clearinghouse for research and news associated with Internet porn’s effects.
Not only are Prause’s studies on YBOP, so are hundreds of other studies, many of which cite Prause in their reference sections. YBOP also has published very long critiques of 8 Prause papers. YBOP contains at least 18 peer-reviewed critiques of Prause’s studies. YBOP contains at least a dozen lay critiques of Prause’s work. YBOP contains many journalistic articles that quote Nicole Prause, and YBOP often responds to Prause’s claims in these articles. YBOP also debunks many of the talking points put forth by Prause and her close ally David Ley. Finally, YBOP members comment here asking about Prause’s studies or her claims in the media. However, YBOP also critiques other questionable research on porn and related subjects. These critiques are not personal, but rather substantive (see update).
Over the last few years, Dr. Prause appears to have taken great pains to position herself as a “woman being subjected to misogynistic oppression when she tells truth to power.” She frequently tweets this infographic that she apparently also shares at her public lectures, suggesting she is being victimized “as a woman scientist,” and painting herself as a trailblazer forging ahead to prove porn’s harmlessness despite prejudiced attacks. She has even been known to tweet combinations of misogyny claims and claims that (legitimate, peer-reviewed) science with which she disagrees is “fake.” Any suggestion that Wilson, Deem or Rhodes are motivated by misogyny is fabricated, as their objections have nothing to do with Dr. Prause as a person or as a woman, and only to do with her untrue statements and inadequately supported claims about her research.
The info-graphic also claims that Alexander Rhodes is sexist because he defended Wilson against Prause’s libelous claims that “Wilson was recently seen outside Prause’s residence.” When did the refutation of lies become misogyny? (Update: NoFap founder Alexander Rhodes defamation lawsuit against Nicole Prause)
If YBOP is truly sexist why are the majority of the authors we critique men? This page lists the studies and papers YBOP has critiqued.
The total number of authors listed on all the papers: 56
Male authors: 42
Female authors: 14
Once again, facts debunk propaganda.
Finally, no one named on this page – whom Prause has accused of sexism and misogyny – endorses, or encourages, either. Speak with them and you will discover that the very opposite is true. All support the respectful treatment of women. Their issue with Prause is with her tactics and her unsupported claims about her research, not with her as a woman or a woman scientist.
Others – Prause falsely accuses Donald Hilton Jr., MD
Curious about Prause’s claim that Don Hilton, MD, “called her a child molester,” we contacted Dr. Hilton. Here is his response:
With regard to Prause’s claim, the facts are presented here. I did not call her a child molester.
About 6 or 7 years ago I spoke in 3 Idaho cities in one day for a group called Citizens for Decency. I spoke on evidence supporting an addictive model related to problematic porn use, which was mainly molecular biology at that point. This model has since been substantiated by structural and functional MRI studies.
At the end of my talk a young woman came up and basically said that she did not think there was any evidence supporting the addiction model. I only learned later that it was Nicole Prause, who was then employed in Idaho. Next, she said she had trained at the Kinsey Institute, implying that she was an expert on sexuality.
I asked her if she supported the research and methodology of the namesake of her institution, Alfred Kinsey. I explained to her that Kinsey had collaborated with pedophiles, and trained and instructed them to time with stopwatches how long it took children they molested to reach orgasm. I asked her if she supported Kinsey and his methodology. At that point she became hostile.
Her claim that I said she was a child molester is untrue; I didn’t know her, her name, or anything about her other than that she admired Kinsey. My point was that the person she considered her philosophical mentor had knowingly collaborated with child molesters. This is perfectly true. Attached is attached a copy of Table 34 from the Kinsey book on male sexuality published in 1948 [reproduced below]. The youngest child is 5 months old, and is described as having 3 orgasms. Note that most sessions are timed.
Incidentally, Paul Gebhard (coauthor of Kinsey’s female sexuality book published a few years after the male book), was interviewed by J.Gordon Muir years later. This is an excerpt from the interview:
Muir: “So, do pedophiles normally go around with stopwatches?”
Gebhard: “Ah, they do if we tell them we’re interested in it!”
Kinsey, Pomeroy (an early president of AASECT), Gebhard, and others worked with 2 child molesters, Rex King and a Nazi named Fritz Ballusek. Ballusek’s trial is well documented, but King was never caught. An example of the collaboration is from a letter on Nov 24, 1944 from Kinsey to King:
“I rejoice at everything you send, for I am then assured that that much more of your material is saved for scientific publication.”
Kinsey also warned his pedophiles to be careful not to be caught. For documentation, see Kinsey: Crimes and Consequences, whose author confirmed to me that she has the original tapes of the phone interview in her archives.
Although I did not call Nicole Prause a child molester, I did ask her then, and I ask her now, if she condones or refutes the collaboration of Kinsey, his coauthors, and the Kinsey Institute with child molesters. I am still waiting for her answer.
In 2019, leading sexology journal Archives of Sexual Behavior published a rare open-access piece about sexual harassment in the field of sexology, acknowledging Kinsey’s misdeeds:
Some of Kinsey’s biographies also included accounts of sexual behavior occurring between members of the research team (and their spouses) and highlight how some may have at times felt maneuvered into such sexual behaviors (Gathorne-Hardy, 1998; Jones, 1997). We feel that the Kinsey team’s inclusion of reports about infant and child genital response provided by one or more adults is especially egregious and concerning, for its time and ours. (emphasis supplied)
YBOP comments: Once again Nicole Prause has been caught in a lie.
Dr. Prause is obsessed with Dr. Hilton because he dared to critique the claims she made about her 2013 EEG study (Steele et al., 2013). Prause touted in the media that her study provided evidence against the existence of porn/sex addiction. Not so. Steele et al. 2013 actually lent support to the existence of both porn addiction and porn use down-regulating sexual desire. How so? The study reported higher EEG readings (relative to neutral pictures) when subjects were briefly exposed to pornographic photos. Studies consistently show that an elevated P300 occurs when addicts are exposed to cues (such as images) related to their addiction.
In line with the Cambridge University brain scan studies, this EEG study also reported greater cue-reactivity to porn correlating with less desire for partnered sex. To put it another way – individuals with greater brain activation to porn would rather masturbate to porn than have sex with a real person. Shockingly, study spokesperson Prause claimed that porn users merely had “high libido,” yet the results of the study say the exact opposite (subjects’ desire for partnered sex was dropping in relation to their porn use). Eight peer-reviewed papers expose the truth: Peer-reviewed critiques of Steele et al., 2013
Key point: Prause was given full opportunity by the journal to formally respond to Hilton’s critique. She declined. Instead, Prause attacked Hilton on social media and defamed him in emails.
Below are a few examples of Prause posting her lies on social media. Prause created a slide (naming Hilton, Gary Wilson, Marnia Robinson, Nofap, Alexander Rhodes) “proving” everyone she doesn’t like is “misogynist,” and continues to tweet it repeatedly to this day (maybe 40-50 times… so far):
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Notice how Prause tagged her friends at AVN (Adult Video Network, a porn producers interest group) in her tweet where she claimed that Dr. Hilton “screamed that she experimented on children”:
If Hilton screamed at Prause, why are Prause & Hilton pictured having a friendly discussion after the talk Prause attended?
In 2017 Prause tweeted the following about Dr. Hilton’s 2013 critique, while falsely stating that her Lancet commentary addressed criticisms put forth in the 5 peer-reviewed papers:
Dr. Prause even resorted to posting on IMDB to attack Dr. Hilton:
While Prause claims the film contained “misrepresentations and falsehoods about the science”, she couldn’t name any. Not one. She never does. Look at all of Prause’s tweets, Quora posts, Facebook comments, or even her two op-ed’s. She never provides any specific examples of misrepresentations. No excerpts from a study. No quote from the offender. Prause’s prime tactics are ad hominem and other defamation.
As always, Prause lied in the above comment. The journal in question is not predatory – and it’s the same journal that published her own 2013 EEG study – Socioaffective Neuroscience & Psychology:
June 1, 2019: Ley disparages Don Hilton. Ley links to an unprofessional and scientifically inacurate article by Daniel Burgess, a close ally of Prause and Ley:
Burgess has also defamed and harassed Gary Wilson on social media – regurgitating Prause’s usual set of lies. Burgess was kicked off the “Marriage and Family Therapists” Facebook group for defaming Wilson in this thread – also see the 15 replies to Burgess by Staci Sprout and Forest Benedict.By the way, the Burgess commentary on a few out-of-context excerpts from a 2010 Hilton book for the lay public is laughable. For example, Burgess attacks Hilton for saying there are two major sources of dopamine in the brain: one that is affected by Parkinson’s disease; the other is primarily affected by addiction. Revealing his ignorance, Burgess says Hilton is mistaken!
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June 3, 2019: Prause’s alter ego and very active pro-porn twitter account, RealYBOP joins Ley in a weak attempt at disparaging Hilton. RealYBOP tweets 3 screenshots from a 2011 reply to a February 2011, Hilton & Watts paper: Pornography addiction: A neuroscience perspective.
Commentary on the above:
First, Rory Reid’s snarky commentary and the Hilton & Watts reply to Reid are on this same page.
Second, Rory Reid was Nicole Prause’s (RealYBOP) roommate in LA, and played a role in her being hired by UCLA.
November 14, 2019: On the same day, Prause alias @BrainOnPorn tweets about Hilton’s appearance on a CBS show about pornography:
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November 19, 2019: RealYBOP disparages Don Hilton, MD. (He was the so-called “religious physician” in the CBS segment about porn, but he sticks to the science and never makes religiosity part of his public talks. Only his critics do.)
December 31, 2019: Cyberstalking Gabe Deem (who has blocked RealYBOP) on New Years Eve, RealYBOP tweets defamation and PDF’s of her defamatory motion to dismiss:
December 31, 2019: RealYBOP trolls under Gary Wilson (even though I blocked her and she blocked me), tweeting about Hilton & Watts, 2011 – again, and completely out of context:
December 31, 2019: In a truly bizarre event, @BrainOnPorn twitter (apparently managed Prause) changed its home page to superimpose Rory Reid’s unpersuasive commentary on Hilton & Watts, 2011:
All the above expose Prause as a relentless harasser/cyberstalker
2020 – Using her RealYBOP twitter account she attcks a metaphor by sex addiction therapist Paula Hall. Just more cybertsalking.
Ley and RealYBOP again:
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Others – October, 2016: Prause commits perjury attempting to silence Alexander Rhodes of NoFap
As described above Prause has a history of personally attacking Alexander Rhodes (it is always Prause who initiates the harassment with her tweets). For example, (again) here’s Prause (on a thread she initiated) claiming that Alexander Rhodes lied about experiencing porn-induced sexual problems:
@YourBrainOnPorn@JamesTherapy How did you get to another state so quickly to stalk? You also behind all of the mysterious clown sightings?
Key point: The above tweet no longer contains this picture of a man hiding in the bushes, which was used under the copyright “fair use” exclusion because it is evident the image’s purpose was for meme/parody:
As Alexander Rhodes describes in subsequent tweets, Nicole Prause falsely claimed ownership of the “man in the bush” picture and filed a bogus DMCA takedown request via Twitter. In doing so Prause committed perjury.Rhodes tweets the evidence:
UPDATE – January, 2018: In response, Alexander Rhodes eventually sent in a counter notice, explaining to Twitter Inc. that as Dr. Nicole Prause is not the copyright holder or an authorized representative of the copyright holder, inconsistent with what she falsely asserted in the DMCA take-down notice sent to Twitter, the copyright infringement notice was baseless. In response, Twitter gave Dr. Prause a window of opportunity to respond to Rhodes’s counter-notice, in which she did not. While Twitter Inc. said that they would reinstate the censored tweet, the image has yet to reappear as of January 2018, despite the copyright decision being reversed. This demonstrates that while Alexander Rhodes and NoFap LLC successfully provided a legal argument against Prause’s censorship, she still was successfully able to permanently remove an image posted on Twitter through perjury without any tangible repercussions for breaking the law.
An earlier and significantly different version of this paper was first submitted in March, 2015 to the Yale Journal of Biology and Medicine for possible inclusion in its “Addiction” issue. Normal procedure is for the journal to have two academics review a paper to provide commentary and criticism. Key point #2: This paper was the only place Wilson’s affiliation with the Reward Foundation could be found outside of Foundation personnel. In other words, only the Yale Journal of Biology and Medicine editor and the two reviewers knew about this affiliation.
In April, 2015 an email by someone using a fake name (“Janey Wilson”) was sent to The Reward Foundation and to the organization housing several charities, including The Reward Foundation:
On Wed, Apr 22, 2015 at 9:21 AM, Janey Wilson <[email protected]> wrote:
I now have documentation that Gary Wilson himself is claiming to be a member of the Reward Foundation. While he is not listed on the new website page, this represents a rather worse transgression…. [Reward Foundation personnel] may not even be aware he is making these claims, I am not sure, but he has now made them publicly.
Key Point #3: Only one of two reviewers of the Yale Journal of Biology and Medicine submission could have sent this email (Prause later self-identified as one of the two reviewers). The information was not public, but only made available to the journal.
Around the time that “Janey” (1) wrote The Reward Foundation to tell it about my “false” claim of affiliation, and (2) reported the charity itself to the Scottish Charity Regulator, “Janey” also wrote the Edinburgh organization where the charity is domiciled with false claims about me and The Reward Foundation. The Edinburgh entity is called “The Melting Pot.” It’s an umbrella organization that hosts various small enterprises. They contained the now familiar personal attacks on Wilson (described above), and even threats of legal action. No one took the bizarre rantings and unsupported claims seriously and “Janey” would not supply proof of her identity. “Janey” apparently simultaneously posted about this on the redddit/pornfree porn recovery forum – Gary Wilson is profiting from YBOP:
The above is hardly surprising as Prause has employed many sock-puppet identities to post, primarily on porn-recovery forums, about Wilson. For example hundreds of comments by Prause’s apparent avatars can be found at the links below. And, they are but an incomplete collection:
Another reddit/pornfree post that appeared about the same time (Prause deleted her sockpuppet’s username, as she often did after posting):
Janey/Prause made the irrational claim that I was “paying off” The Reward Foundation for a TEDx talk opportunity that occurred years earlier, in 2012. It had been arranged in 2011, years before the charity was conceived of or organized. Obviously, no such subterfuge was needed. I had the right to give my book proceeds to anyone at any point, or put them in my pocket. I chose the Reward Foundation because I respect its balanced, educational objective.
Neither organization (the Scottish Charity Regulator nor the Melting Pot) responded to “Janey,” as she offered no evidence, and wouldn’t identify herself, claiming “whistleblower status” (although, of course, she wasn’t an employee of either, and was not under threat). Had the charity not had a strong, respected relationship with the Melting Pot, and had it already been required to file financial statements with the Scottish Charity Regulator, “Janey’s” malicious claims might have done a lot of damage to the charity’s reputation and initiated a time-consuming, costly audit, etc.
In late 2016, Prause outed herself as “Janey Wilson” when she demanded (repeatedly and unsuccessfully) that Dan Hind of Commonwealth Publishing confirm my connection with the Scottish charity called The Reward Foundation to Prause in writing. Copying both MDPI (the ultimate publisher of the paper discussed earlier) and a publication ethics organization (COPE), Prause told Commonwealth’s Hind that he had already written her to this effect.
However, the only correspondence Hind had with anyone on the subject of Wilson and The Reward Foundation was with “Janey,” and he has stated this in writing. Thus, Prause has now outed herself as the former “Janey.” When Hind didn’t respond to Prause’s repeated demands, she then demanded the information via Commonwealth’s web designer – accompanied, as usual, by defamation and threat:
You may wish to encourage the site content owner that you designed to clarify that his author was caught claiming to “donate” proceeds from a book that actually went into his own pocket. Mr. Hind has failed to respond to inquiries with the Committee on Publication Ethics. I assume you would not want your name entangled in fraud like this in any way.
Prause seems to believe that the fact that my share of book proceeds goes to a Scottish registered charity, which I listed as my affiliation for purposes of two academic papers published in 2016, means that I am somehow pocketing the proceeds (from my own book) – and thus have a conflict of interest, which is purportedly grounds, in her mind, for my paper being retracted. Does any of this make any sense in light of the facts?
In fact, I am not on the Board of the charity, and certainly have no say over the book proceeds it receives as a consequence of my irrevocable donation. Incidentally, my affiliation is now public, as it is mentioned in both papers I published in 2016. In short, there is nothing hidden or improper going on, and no conflict of interest whatsoever – despite Prause’s claims behind the scenes and publicly.
The following sections of this page provide examples of Prause and “pornhelps” simultaneously attacking and defaming some of Prause’s favorites targets (men who run porn-recovery forums, porn addiction researchers, TIME editor Belinda Luscombe, who wrote a cover story Prause didn’t approve of):
The Yale Journal of Biology and Medicine was informed of this behavior (apparently engaged in by one of their two reviewers). When it was suggested that Prause might be behind these bizarre emails and the paper’s initial rejection, the editor didn’t deny it. The paper was promptly accepted…and then not published after all, based on a claim that it was too late to meet the print deadline for YJBM’s “Addiction” issue.
A different, substantially updated version of the paper was then submitted to the journal Behavioral Sciences. After a few rounds of reviews and rewriting it was accepted as a review of the literature. Its final form was quite different from the original YJBM submission. During this process, the paper was reviewed by no fewer than 6 reviewers. Five passed it, some with some suggested revisions, and one harshly rejected it (Prause, again). As part of this process, the authors were given all of the comments by the reviewers (but not their identities). The reviewers’ concerns were thoroughly addressed, point by point.
From these comments, it became evident that the “harsh reviewer” of the Behavioral Sciences paper had also reviewed the paper at YJBM.About a third of the 77 points raised did not relate to the Behavioral Sciences submission at all.They referred to material that was only present in the earlier version of the paper, the one that had been submitted to YJBM. At a much later date, Prause submitted the original YJBM version to a regulatory board (in an effort to have the published paper retracted), thus confirming she was the person behind the many harassing “Janey Wilson” emails.
In the course of her attacks on the paper’s authors, Nicole Prause has violated the Committee on Publication Ethics (COPE) code of ethics for academic reviewers multiple times. Section 5, in the “Guidelines on Good Publication Practice” PDF (on this page) outlines eight rules for peer reviewers. Nicole Prause has violated at least three COPE’s rules:
(2) The duty of confidentiality in the assessment of a manuscript must be maintained by expert reviewers, and this extends to reviewers’ colleagues who may be asked (with the editor’s permission) to give opinions on specific sections.
Prause broke confidentiality. She used Wilson’s affiliation with The Reward Foundation to harass the officers of the Reward Foundation and to pepper the Scottish Charity Register with false allegations about Wilson.
(3) The submitted manuscript should not be retained or copied.
Prause kept the manuscript and later submitted it to regulatory boards as part of a frivolous demand for retraction. (Apparently, she never realized the paper had been accepted by YJBM once her review was disqualified.)
(4) Reviewers and editors should not make any use of the data, arguments, or interpretations, unless they have the authors’ permission.
Prause used specific content of the YJBM submission as a part her bogus claim to regulatory boards without the authors’ permission.
Update: In May, 2018 Prause falsely claimed to journal publisher MDPI (and others) that, based on the charity’s recent public filing (with a name redacted, as is standard), expense reimbursements paid to a charity officer were in fact paid to me. I forwarded Prause’s claim to Darryl Mead, Chair of The Reward Foundation, who debunked Prause’s claims: See for the documentation.
October, 2016 – Prause publishes her spurious October, 2015 “cease and desist” letter. Wilson responds by publishing his letter to Prause’s lawyer.
On October 15, 2015 Gary Wilson received a cease and desist letter from a lawyer representing Nicole Prause. A year later Prause published her cease and desist letter on AmazonAWS, and linked to it under a petition to Psychology Today (asking the organization to reconsider its editorial policy). Prause commented under the petition multiple times saying that members of two organizations (IITAP & SASH) were all “openly sexist and assaultive to scientists.” In a strange disconnect, the main evidence Prause supplied for this blanket statement was the cease and desist letter sent only to Wilson, reproduced below. Wilson is not a member of SASH or IITAP.
There is no other way to say this: All four claims in the above cease & desist letter are bogus. The most absurd claim is that Wilson said that Prause appeared in porn. Gary Wilson wrote the following letter asking both Prause and the lawyer to provide evidence to support their allegations. Wilson’s letter in full:
In the intervening 6 years neither Prause nor the lawyer have responded. Neither has provided any evidence to support Prause’s allegations – because the allegations are false. It’s clear that Prause’s motivation was threefold:
to intimidate Wilson so that he might remove his critiques of Prause’s studies,
to create a letter she could show her allies as “proof positive” that Wilson is harassing her (even though it is proof of nothing and merely made up),
to produce an “official letter” to show journalists so as to discourage them from contacting Wilson.
October, 2016 – Prause had co-presenter Susan Stiritz “warn campus police” that Gary Wilson might fly 2000 miles to listen to Prause say porn addiction isn’t real
Prause continues to spin a fable that Gary Wilson has threatened to “show up” at one of her talks. This is poppycock. Prause has provided no evidence to support this claim, and Wilson has no desire to hear Prause speak (let alone pay to hear her speak). In mid-October, 2016 Nicole Prause placed the following PDF on AmazonAWS. Prause posted a link to the PDF under a petition to Psychology Today (which was gathering support to ask the organization to reconsider its editorial policy).
While nothing in this message (below) can be verified, it appears to be written by Susan Stiritz. It also appears to be describing Stiritz relaying Prause’s fabricated claim to WU campus patrolman Tim Dennis to the effect that Gary Wilson was planning to attend the AASECT summer institute. Put simply, Wilson was claimed to be planning to fly 2000 miles, pay for 4 nights in a St Louis hotel, and pay over $1000 to AASECT, just to hear Prause and David Ley explain how porn addiction has been “debunked.” Prause even provided a picture of Wilson, which she must have “stolen,” because he didn’t send it to her (reproduced below).
So this is the “proof” that Gary Wilson is dangerous: a made-up tale by Prause, told to a friend, who relayed it to a campus cop 2000 miles from where Wilson lives via message, which Prause now offers as “proof” of Wilson’s evil actions. What’s missing from all of this claptrap is one iota of evidence that hints that Wilson ever indicated that he intended to attend a Prause lecture – or threaten her in any way whatsoever.
While Prause claims Wilson is “dangerous,” the only danger of having Wilson in the audience is that he might, with awkward questions, debunk Prause’s claims by citing more than 3 dozen neurological papers that support the porn addiction model, and 110 studies that link porn use to sexual dysfunctions and lower sexual & relationship satisfaction. That’s the real reason she doesn’t want Wilson attending her lectures. Update: Gary Wilson includes these incidents in an affidavit filed in the Alexander Rhodes defamation lawsuit against Nicole Prause: Exhibit #11: Gary Wilson affidavit (123 pages)
Ongoing – Prause silencing people with fake “no contact” demands and spurious cease & desist letters
Prause has a history of sending cease and desist (C&D) letters to people who question her unsupported assertions. She claims to have sent (at least) seven such letters, which she has repeatedly mischaracterized on social media as “no contact orders.” Only courts and regulatory bodies issue “orders,” as that word is commonly understood, and only then after giving both parties the chance to be heard. Prause’s C&D letters to anyone who questions her come from her lawyer, not a judge, and seem expressly intended to stifle criticism and honest debate.
Worse, on the basis of merely sending these unsubstantiated letters, Prause insists she has the legal right to prevent anyone who has received such a letter from defending against, or replying to, her demeaning online statements about them or others – even if they simply wish to supply evidence that counters her untrue statements. When those letter recipients try to speak out, she publicly and falsely accuses them of “violating no contact orders” and of “harassment.” The clear, and clearly false, implication of her statements is to suggest these people are acting illegally.
To our knowledge, Prause has never obtained a court or regulatory order against any C&D letter recipient. Her aggressive tactics and knowingly false accusations instead appear calculated to bully and intimidate her detractors into silence.
Prause has also used a modified version of this tactic against Rhodes and PornHelp.org, among others by attacking them and their speech online, then if they dare to correct or defend, publicly demanding they “not contact [her] by any means.” If they subsequently dare to correct a falsehood or call her out, she accuses them of violating a “no contact” and threatens to sue. And then, despite her demand, she continues to attack them online in the future.
A number of the C&D letters Prause has posted online or sent are reproduced as images below. Prause placed links to three of her C&D letters on her Amazon AWS pages (C&D 1, C&D 2, C&D 3), presumably so that she could easily link to each in tweets, on Facebook, and in the comment sections under online articles. To repeat: we are not aware of Prause ever acting on any of the aggressive, albeit empty, threats in these letters. We believe they are intimidation tactics, pure and simple. Finally, the recipients of the C&D letters emphatically state that Prause’s lists of wrongdoings were manufactured lies. Anyone can pay an internet-based lawyer to write spurious C&D letters.
Four of the five C&D letters are reproduced below. The 5th C&D letter, and Wilson’s reply to Prause’s lawyer, are in this section.
Linda Hatch PhD
Prause addressed Linda Hatch as “Ms.” instead of “Dr.” in the letter, (an error that Prause has repeatedly insisted is incontrovertible proof of “misogyny”). Note that Prause had her lawyer cruelly copy the editor of a site where Dr. Hatch regularly blogs. Prause posted 4 of the cease & desist letters publicly on amazonaws.com. It’s clear that the bogus C&D letters were meant to “punish” the recipients for thoughtfully critiquing Prause’s flawed studies and challenging Prause’s unsupported claims.
In the above C&D letter Prause claims that Weiss misleadingly stated that Prause no longer has a university affiliation. While there is no evidence that Weiss said this – Prause isn’t affiliated with any university.
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Marnia Robinson, JD
It’s entertaining that Prause accused Robinson of saying that Prause is no longer employed by a university and that her contract with UCLA was not renewed – when both are true. The reality behind Prause’s so-called no-contact request is exposed in the very first section of this page. Since Prause’s April, 2013, no-contact request Prause and her sockpuppets have posted hundreds of libelous comments on social media and elsewhere. In Prause’s twisted world it’s OK for her defame and harass others, but no one is allowed to defend themselves from her abuse.
Ongoing – Prause creates inane “infographics” to disparage & defame numerous individuals and organzations
Prause created two “infographics” in 2016, naming Gary Wilson and YBOP, which she has tweeted dozens of times and posted on Quora and other outlets. The first infographic, kept at the ready on Prause’s Amazon website, is named “Sexism In Neuroscience”. It defames Gary Wilson, Don Hilton, Alex Rhodes and Marnia Robinson by calling all misogynists (It could alos be interperted as calling Don Hilton a child molestor). As already chronicled in an earlier section, above, Prause’s only “proof” is Gary Wilson inadvertently typing “Miss” in his reply to her questions about the size of Wilson’s penis! Prause’s interest in Wilson’s genitals and her creating and several examples of her posting the inane “sexism” infographic are all documented here: December 2013: Prause posts on YourBrainRebalanced & asks Gary Wilson about the size of his penis (kicking off Prause’s campaign of calling Wilson, and many others, misogynists).
The second Prause infographic purports to be a primer on “how to evaluate sex films” (Prause euphemism for pornography). A closer look reveals that Prause is guilty of breaking most of her rules for evaluating sources of information. At the bottom of the infographic she lists 15 websites she wants the reader to believe are sources of “bad information” (sites run by the many individuals and organizations she regularly defames or harasses, as documented on these pages). She also lists two “good” websites and one “good” article. The bottom of Prause’s inane infographic:
Her two “good” websites are AASECT and Justin Lehmillers blog. AASECT is a organization for sex therapists and cites no research on the AASECT website. Justin Lehmiller, a regular paid contributor to Playboy Magazine, and a close ally of Nicole Prause, having featured her in at least ten of his blog posts.
The third “website” is a short article from early 2014 in a magazine, quoting Prause. The article cites only one neurological paper: Prause’s 2013 EEG study, Steele et al., 2013. Prause claimed that she had debunked porn addiction because her porn using subjects’ (1) “brains did not respond like other addicts,” and (2) they really just had “high desire.” Both claims are without support. Neither is reported in Steele et al., 2013. Truth? Eight peer-reviewed analyses of Steele et al. 2013 describe how the Steele et al. findings lend support to the porn addiction model. The 2014 article omitted 43 neuroscience-based studies on porn users and sex addicts (all support the addiction model).
Here we provide examples of Prause posting her”sex films” infographic. She did so multiple times on Quora (before she was permanently banned for harassing Gary Wilson). For example:
As Prause and her twitter alias RealYBOP often do, both troll threads to post their propaganda (this time Matt Fradd):
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In this tweet Prause can’t control her fabricated hyperbole:
Reality: not a single “science group” has ever attempted to debunk www.yourbrainonporn.com. Notice how Prause never provides a single example of so-called “debunking” of YBOP.
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Evan Elliot calls out Prause for bullying and her inability to address substance
Her defamatory tweet linked to grad student Kris Taylor’s dissertation on 15 comments from reddit/nofap: I want that power back: Discourses of masculinity within an online pornography abstinence forum (2018). That’s right, a PhD analyzing 15 reddit comments! Taylor is decidedly pro-porn and anti-Nofap. He has a history of blatantly misrepresenting studies and the state of the research, as chronicled in the YBOP critique: Debunking Kris Taylor’s “A Few Hard Truths about Porn and Erectile Dysfunction” (2017). Under a David Ley hit-piece on porn recovery forums, Prause and “bart” debate the merits of Taylor’s sociological gibberish masquerading as “deep thought.” Bart exposes Prause as misrepresenting Taylor’s paper.
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Trolling other’s twitter accounts:
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Never provides concrete examples of “twisting our science”…. never:
Others – October, 2016: Prause states falsely that SASH and IITAP “board members and practitioners are openly sexist and assaultive to scientists“
On October 12, 2016 a petition to Psychology Today (asking the organization to reconsider its editorial policy) was published on “petitionbuzz.com” The next day Nicole Prause & Jim Pfaus posted four comments under the petition. Prause & Pfaus co-authored this paper (it’s not an actual study), that they claim debunked porn-induced ED. Two peer-reviewed papers (paper 1, paper 2) and three lay critiques say otherwise (1, 2, 3). As do 35 studies linking porn use to sexual problems or lower arousal. Under the petition, Jim Pfaus calls SASH and IITAP “addiction cults” and “snake oil salesmen” (Pfaus is not a therapist). He also falsely claims that there’s “no empirically-based clinical or biological science supporting porn addiction or the negative effects of porn use.”
Update (2019):News reports paint Jim Pfaus as having spent years engaging in inappropriate sexual behaviors with young female students. Excerpts:
The sources paint a picture of a professor they believe repeatedly crossed appropriate boundaries with his students.
a group of graduate students approached several of Concordia’s psychology professors who were in charge of the department’s management. They filed a written complaint about Pfaus’s alleged sexual relationships with undergraduate students in classes he taught.
Pfaus was placed on administrative leave, then mysteriously departed the university. The irony of Pfaus lecturing licensed therspists on sexuality.
On to Nikky. In a reply comment, Prause echoed fellow troll Pfaus calling “IITAP/CSAT’s” snake oil salesmen. Now that’s an unbiased researcher.
Nicole Prause posted 3 more comments, including this one where she claims that all members of IITAP and SASH are “openly sexist” and “assaultive to scientists”:
What evidence does Prause provide to incriminate all the members in these two very large and diverse organizations, accusing them all of “sexism and assaults on scientists?” Prause posts links to her fabricated claims about Gary Wilson (described above). Since Wilson is not a member of either organization, it’s baffling how Prause’s ramblings about Wilson incriminate over a thousand therapists, PhDs, medical doctors and psychologists belonging to these two organizations. Once again, we have inflammatory and defamatory claims without a shred of evidence.
A few examples Prause harassing SASH on twitter:
Her silly little inforgraphic, which includes the entirety of her evidence:
Working as one, Prause tweets a David Ley blog post libeling IITAP. The blog post was removed by Psychology Today:
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Tags IITAP in a article that has nothing to with sex or porn addiction. Typical mischaracterization, combined with cyber-stalking:
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Prause creates a logo to harass IITAP members on twitter: “I FAP (masturbation) before IITAP”
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No Fraud, but Prause did file a spurious claim (as Prause so often does) with a journal, claiming the data wasn’t quite right. The Journal and publisher were forced to look into Prause assertions – and found nothing to her claims. No one ever does. Anyhow, Prause’s twitter falsehoods related to this manufactured incident:
David Ley joins in with his blog post that was removed from Psychology Today:
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More harassment over a 2 year old critique of Prause & Pfaus, 2015:
Another:
Prause & Pfaus 2015? It wasn’t a study on men with ED. It wasn’t a study at all. Instead, Prause claimed to have gathered data from four of her earlier studies, none of which addressed erectile dysfunction. It’s disturbing that this paper by Nicole Prause and Jim Pfaus passed peer-review as the data in their paper did not match the data in the underlying four studies on which the paper claimed to be based. The discrepancies are not minor gaps, but gaping holes that cannot be plugged. In addition, the paper made several claims that were false or not supported by their data. Prause & Pfaus 2015 as these 2 critiques expose, it cannot support a single claim it made, including Prause’s claim that they measured sexual response:
Prause post a screenshot of a Stefanie Carnes comment on on the Compulsive sexual behaviour disorder section (CSBD) of the ICD-11 (you can’t read the comments unless you create a username)
The above comment was made in a general response to dozens of Nicole Prause comments where Prause personally attacked therapists and organizations (IITAP, SASH, ASAM) for supposedly “profiting from sex and porn addiction.” Prause has spent the last 4 years obsessively posting on the ICD-11 beta draft, doing her best to prevent the CSBD diagnosis from making it into the final manual. In fact, Prause posted more comments than everyone else combined. (Her attempt failed, as “Compulsive Sexual Behavior Disorder.” is now in the ICD-11)
Who’s the cyber-stalker when Prause tweets over 1oo times about IITAP or Carnes, while IITAP & Carnes never tweet about Prause?
Updates – Three sex addiction therapists (IITAP members), and a professor who has co-authored papers with IITAP members, filed affidavits in Don Hilton’s defamation lawsuit against Nicole Prause:
Others – November, 2016: Prause asks VICE magazine to fire infectious disease specialist Keren Landman, MD for supporting Prop 60 (condoms in porn)
California Proposition 60 would have mandated condom use in porn films. It was supported by AIDS Healthcare Foundation (AHF), a nonprofit HIV/AIDS care and advocacy organization, and vehemently opposed by porn producers and interestingly enough, Nicole Prause and colleague David Ley. In the run up to the 2016 election, Prause and Ley seemed obsessed with defeating Prop 60, while relatively unconcerned about graver issues such as health care, immigration, or jobs. Both Prause and Ley spent considerable effort tweeting and re-tweeting attacks on Prop 60, and support for the Free Speech Coalition, the lobbying arm for the porn industry (tweet1, tweet2, tweet3, tweet4, tweet5, tweet6, tweet7, tweet8, tweet9, tweet10, tweet11 – NOTE: Prause deleted many of these tweets in April, 2016). One such example of Prause supporting the porn industry:
In a series of tweets, Prause joins an “adult actor” in attacking a Keren Landman, a medical doctor specializing in infectious disease.
In Prause’s esteemed opinion, VICE magazine should have fired expert Dr. Landman for writing an article supporting Prop 60:
Freelancer? While Prause’s degree is in statistics, Keren Landman MD is a researcher, medical epidemiologist, and infectious disease specialist who once worked for the U.S. Centers for Disease Control and Prevention. HIV infection is one of her specialties, having published several papers in the field. Once again, we have Prause personally attacking experts in a field, while simultaneously failing to support her position with empirical evidence. (Does anyone believe Prause’s claim that “every independent scientist supports prop 60″?) Whatever anyone thinks about Prop 60, Dr. Landman’s position is supported by research, and Nicole Prause’s is not.
The question remains: Why are both Prause and Ley such outspoken supporters of the porn industry, and so eager to attack anyone and everyone who suggests porn use or sex without a condom may pose problems? Insight in these 2 links:
Others – November, 2016: Prause falsely claims to have sent cease & desist letters to the 4 panelists on the Mormon Matters podcast (Don Hilton, Stefanie Carnes, Alexandra Katehakis, Jackie Pack)
On November 10, 2016 “Mormon Matters” published the following podcast: 353–354: Championing the “Addiction” Paradigm with Regard to Pornography/Sex Addiction. It was a response to an earlier Mormon Matters podcast (episodes 347–348) where Prause and three therapists tried their very best to debunk porn addiction and sex addiction. In Podcast 353–354, Mormon Matters host Dan Wotherspoon was joined by four panelists: Jackie Pack (LCSW, CSAT–S, CMAT), Alexandra Katehakis (MFT, CSAT-S, CST-S), Stefanie Carnes (Ph.D., CSAT-S), and Donald Hilton (M.D.).
Within a few minutes of the podcast going live, Nicole Prause and, apparently, her sock puppets (“Skeptic”, “Lack of expertise on panel”, “Danny”) posted a dozen comments attacking the four panelists. Prause & sock puppets was joined in her ad hominem fest by Jay Blevins and Natasha Helfer-Parker (two of the therapists who collaborated with Prause on episodes 347-348). Over the next few days, Prause, Jay Blevins, and Natasha Helfer-Parker posted dozens more ad hominem comments. Nicole Prause posted her typical lies about Gary Wilson stealing photos, having to lock down her lab, and “fortifying her home” (maybe she installed a bomb-shelter to protect her from unfavorable blog posts). Also, in one of her numerous comments, Prause claimed that:
She had sent Cease & Desist letters to members of the panel
Two of the panelists are currently under APA investigation
Prause’s comment:
We contacted the panelists, and it was confirmed that:
No panelist has received a cease and desist letter from Dr. Prause, and
No panelist has been contacted by the APA (the American Psychological Association).
Once again, we have evidence that Nicole Prause is making false statements. And suppose Prause had actually sent cease and desist letters? It would be evidence of nothing, as anyone can pay a lawyer to send a spurious cease and desist letter (as Prause is wont to do).
Update: All of the many comments under podcast: 353–354, including several libelous ones by Prause, have mysteriously disappeared. Is this another instance of Prause trying to cleanup her public image?
Nicole Prause as “PornHelps” (on Twitter, website, comment sections). Accounts deleted once Prause was outed as “PornHelps”
Nicole Prause created a username called “PornHelps”, which had its own twitter account (@pornhelps) and a website promoting the porn industry and cherry-picked studies reporting the “positive” effects of porn. Prause’s “PornHelps” chronically badgered the same people and organizations that Prause often attacked. In fact, Prause would team up with her alias PornHelps to attack individuals on Twitter and elsewhere in tandem with her other identities. Some of the Prause/PornHelps coordinated attacks are documented in these Prause-page sections:
The @pornhelps twitter account and PornHelps website were suddenly deleted when it became apparent to that Prause was the individual behind both. While many of us being attacked knew “PornHelps” was really Nicole Prause, the following @pornhelps tweet left no doubt:
Prause, a Kinsey grad, calls herself a neuroscientist, and appears to have started college about 15 years earlier than the above 2016 tweet. In response to several ad hominem attacks by “PornHelps”, which perfectly mirrored many of Prause’s usual comments, “PornHelps” was confronted in the comments section of Psychology Today with this and other evidence: https://www.psychologytoday.com/us/comment/887468#comment-887468
Want more confirmation that PornHelps was really Prause? The following comments, tweets, and coincidences make it apparent.
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Here Prause and Russell J. Stambaugh simultaneously comment under an article about porn. Prause & Stambaugh are close allies and often comment together in pre-planned assaults in comment sections.
At the same time that Prause tweeted the above, “PornHelps” began posting in the comments section below the paper. A few of PornHelps’ comments below. How does PornHelps know so much about research methodology and statistics? (Prause’s PhD was in stats):
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And here’s more confirmation that PornHelps is Prause. The PornHelps comments under an NPR interview of Prause are nearly identical to Prause’s usual spin about the claimed benefits of porn:
Now a taste of Prause (as PornHelps) attacking Wilson on various websites: promoting porn and misrepresenting the current state of the research. (Note: PornHelps was very busy attacking others on PT and other websites, and of course, via Twitter).
Pornhelps going after Wilson mirrors Prause’s language in many comments (“stalker,” “massage therapist,” “fake,” etc.)
Look familiar? Prause is the only commentor who calls Wilson a cyberstalker and a massage therapist (other than her sidekick David Ley):
The following are some of the over 20 comments under the Prause op-ed by PornHelps. Prause’s #2 obsession after Gary Wilson is FTND, which Prause has tweeted about over 100 times. The comments perfectly mirror Prause tweets misrepresenting the research and attacking FTND.
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PornHelps mentions the same Australian study that Prause tweets all the time:
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Here PornHelps mirrors dozens of Prause tweets or comments – both naming the exact same findings from outlier studies.
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Another example of Prause/PornHelps attacking Wilson (while teaming up with David Ley). Many more examples can be found on this page.
Again, Prause deleted “PornHelps” twitter and website, but later resurrected the porn-industry shill account as RealYourBrainOnPorn
Prause’s tweet linked to a radio show about Jehovah Witnesses and sex abuse, which contained a segment about a 14-year old gay teen whose mom found his stash of porn magazines. Since being gay is against JW doctrine, the church insisted the gay teen no longer masturbate to images of men. The gay teen was driven to thoughts of suicide because he was a homosexual stuck in the JW facing the very real prospect of being tossed out of the church and shunned by his family and friends. The radio segment did not mention NoFap. Here’s Prause’s tweet (notice that only David Ley liked it):
Prause’s twisted and libelous tweet attempting to smear NoFap in connection with an entirely unrelated event demonstrates just how far she is willing to stretch the truth in pursuit of her agenda. The NoFapTeam responded with 3 tweets:
Not so coincidentally, a rambling hit piece about NoFap, featuring Nicole Prause, was published a few days later by Medical Daily. Of course Prause tweeted it, saying “claims busted by scientists.” By “scientists” Prause means herself. This goes to show that Prause has many contacts in the media, and uses them to her advantage. Prause also called NoFap “woo woo and cult-like.” Medical Daily author Lizette Borreli went so far as to label NoFap an “anti-sex group.” Anyone who has visited Nofap knows that nothing could be further from the truth. Many experiment with NoFap to regain their sexual function. NoFap decided to set the record straight with a few tweets of its own (1, 2, 3, 4), including this one:
Once again, Prause teams up with David Ley to defame Alexander Rhodes, Nofap (along with Gary Wilson’s website and RebootNation). Revealing her long-time obsession with over Rhodes, Prause tweets 4 screenshots from the last 3 years:
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It sure seems that Prause tweets more about NoFap and Alexander Rhodes than she does about her own research. Prause claims to be licensed psychologist. What ethical psychologist would go out of the way to call a young man recovering from compulsive porn use a liar, especially without evidence? Ethics violation? Violation of APA principles?
December, 2016: In a Quora answer Prause tells a porn addict to visit a prostitute (a violation of APA ethics and California law)
Below is a screenshot of Prause’s original answer posted in response to this Quora question: How can I overcome masturbation and/or porn addiction? What are the best methods? While Prause’s post was written in September, 2016, its existence was further publicized in this December 14th IITAP blog post that responded to AASECT’s proclamation that porn and sex addiction are myths. (Thereafter the original Prause response was deleted.) Here is the paragraph from IITAP’s response that linked to the Prause Quora post. (Keep in mind that Prause was an instrumental figure in misleading a small band of AASECT therapists that porn and sex addiction had been debunked – not the case).
On the other side, many clinicians are expressing worry that people who truly are sexual addicts are harmed by well-meaning sex therapists who without insight or full understanding of these issues discount the problematic nature of these symptoms, thus writing off a client’s compulsive sexual behavior patterns as normal and non-consequential, even suggesting that clients’ issues are related more to their attitude about sex than the sex itself. This stance is clearly harmful to those clients who are getting and sharing STD’s with unwitting partners and/or losing marriages, jobs and educational opportunities due to self-described excessive porn use, online hook-ups and the like. Consider, for instance, the recently published blog from a well-known researcher, and AASECT faculty member that recommended that someone with a porn addiction should go see a sex worker instead of masturbating to porn (since the posting of this article this blog has been removed). From the IITAP educational perspective, such blatant disregard of compulsive behavior can without question be harmful to the client and those close to him or her.
Below is a screenshot of Prause’s original answer posted in response to this Quora question (Prause has since deleted her answer). Prause’s suggestion to visit a prostitute is in the last paragraph:
While this is not defamation or harassment, it’s relevant because it shows a complete disregard for professional ethics, ethical and social norms, and the rule of law. This theme permeates everything revealed about Nicole Prause on this page. Prause perjured herself in court filings, falsely claiming she never posted the above answer.
Others – December, 2016: Prause reports Fight the New Drug (FTND) to the State of Utah
Nicole Prause seems to tweet more about Fight The New Drug (FTND) than she does about her or others’ research. A quick look reveals that Prause tweeted 35 times about FTND in November & December 2016.
On December 19, 2016, Prause wrote an e-mail to the Utah State Division of Child and Family Services (DCFS), in which she accused Fight the New Drug in its online Fortify program (an online educational curriculum for teens and adults seeking to overcome compulsive pornography use) of both “soliciting sexual stories from children” without parental consent and “coercing” children to provide these stories. While underscoring that she was a “licensed psychologist in California (CA #27778)” and a “mandated reporter” the single reference she provided to support her initial claim was a hit-piece from an online website called “Harlot Magazine.”
Nicole CC’d the CEO of Fight the New Drug (FTND), Clay Olsen, on her complaint to DCFS. Subsequent phone calls from FTND to DCFS revealed that (while they could officially neither confirm nor deny whether an investigation was taking place) (1) the accusation from Prause meets none of the criteria for something DCFS investigates, and (2) it was not necessary for FTND to meet with DCFS since there was “nothing to investigate” and “nothing to explain.”
Despite all this, Prause continued publicly tweeting her concerns about “@FightTheNewDrug child victims” and posted the following request to all her twitter followers, “if your child completed @FightTheNewDrug Fortify program, asking sexual hx, Utah DCFS wants to talk to you. This how to get heard.”
Several more related tweets, containing factually incorrect & inflammatory drivel, which the state of Utah determined to be empty rhetoric:
Prause went so far as to produce short YouTube videos to harass FTND and researchers:
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Prause escalates the rhetoric, accusing FTND of coercion and ultimately of pedophilia!
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In the following tweets Prause inudates @delmonater with her unsupported propagand (which the state of Utah rightfully ignored)
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Below is Prause’s ever-present info-graphic, calling everyone she harrases a misogynist, while providing zero evidence to support her falsehoods. Over the last few years, Dr. Prause appears to have taken great pains to position herself as a “woman being subjected to misogynistic oppression when she tells truth to power.” She frequently tweets this infographic that she apparently also shares at her public lectures, suggesting she is being victimized “as a woman scientist,” and painting herself as a trailblazer forging ahead to prove porn’s harmlessness despite prejudiced attacks. She has even been known to tweet combinations of misogyny claims and claims that (legitimate, peer-reviewed) science with which she disagrees is “fake.” Any suggestion that FTND, Don Hilton, Wilson, Gabe Deem or Alexander Rhodes are motivated by misogyny is fabricated, as their objections have nothing to do with Dr. Prause as a person or as a woman, and only to do with her untrue statements and inadequately supported claims about her research.
This next tweet contains Prause’s second “info-graphic” she regularly tweets. It lists FTND, SASH, IITAP, YBOP, NoFap.com, RebootNation, PornAddiction.com, and others as “fake news” websites” while listing only two websites as having accaurate information about pornography’s effects: 1) Justin Lemillers website (a paid writer for Playboy); 2) AASECT, which is not a sceintific organization (debunking of AASECT’s proclamation that porn/sex addiction doesn’t exist).
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RealYBOP/Prause attacking FTND with Prause’s long since debunked 600-word op-ed:
Prause’s Op-Ed is chock full of unsupported assertions meant to fool the lay public. It fails to support a single assertion as it cites only 4 papers – none of which have anything to do with porn addiction, porn’s effects on relationships, or porn-induced sexual problems. Several experts in this field and I debunked its assertions and empty rhetoric in this relatively short response – Op-ed: Who exactly is misrepresenting the science on pornography? (2016). Unlike the “neuroscientists of the Op-Ed,” we cited several hundred studies and multiple reviews of the literature.
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The preceding tweets are but a small sample of Prause’s tweets and Facebook comments defaming and disparaging FTND. Prause’s claims she is victim, yet she is the perpetrator.
Thus Prause continues her pattern of misusing regulatory bodies for unwarranted complaints – partly as a way to intimidate individuals and organizations and partly as a way for her to subsequently use her own specious and defamatory accusations in broader media opportunities.
Others – January, 2017: Nicole Prause tweets that Noah B. Church is a scientifically inaccurate non-expert and religious profiteer
Once again, Prause launches an unprovoked, defamatory twitter attack on a man who recovered from porn-induced ED. The following Prause tweet seems to be related to Noah’s appearance on the DearSugarRadio segment “My Fiancé Is Addicted To Porn“.
Was Noah scientifically inaccurate? Nope. As is usual, Prause fails to describe the supposed inaccuracies.
provided one-on-one coaching and advice to those recovering from porn addiction and porn-induced ED
Is Noah religious? Nope. He is an atheist, which he has stated many times in past.
Is Noah a profiteer? His book, videos and website are all given freely. Noah only charges for one-on-one coaching because it’s so time-consuming.
We assume that Dr. Prause doesn’t treat clients for free (if she sees clients). We know that Prause offered (for a fee) her “expert” testimony against sex addiction and porn addiction. She also receives payment for speaking engagements where she debunks porn and sex addiction.
Finally, consider the fact that it is a violation of APA (American Psychological Association) principles for psychologists to attack those trying to recover.
Others – January, 2017: Prause smears professor Frederick M. Toates with a bogus claim
Prior to the publication “The Routledge International Handbook of Sexual Addiction” Prause tweets that the book’s “only neuroscience chapter was written by a person with no neuroscience training”:
The chapter in question is 3.2 – “The Neuroscience of Sexual Addiction” and was written by Frederick M. Toates DPhil DSc.
The 73-year old Toates is Emeritus Professor of Biological Psychology at The Open University and Vice-President of the Open University Psychology Society. He is not only trained in neuroscience, he is a professor of biological psychology (neuroscience).
With two doctoral degrees, Frederick Toates is a pioneer in the study of motivational systems (the reward system), especially in relationship to sexual desire and motivation. His latest book: How Sexual Desire Works: The Enigmatic Urge. Professor Toates was publishing biological research and authoring neuroscience books before Nikky Prause was a gleam in her parents’ eyes. While Professor Toates is still actively publishing and working in academia, non-academic Prause hasn’t been associated with a university for over 2 years.
With Prause’s targets expanding, it appears that there is no lie too outrageous to tell nor target too unassailable to smear. Welcome to the club, Professor Toates.
Two years later when Fred Toates points out David Ley’s hypocrisy and Ley loses it, calling Gary Wilson names and babbles about neurobabble:
David Ley lecturing Toates (or anyone else) on neuroscience or dopamine? Hilarious.
Ongoing: Prause uses social media to harass & defame publisher MDPI, researchers who publish in MDPI, and anyone citing Park et al., 2016
MDPI is the Swiss parent company of numerous academic journals, including Behavioral Sciences. Prause is obsessed with MDPI because (1) Behavioral Sciences published two articles that Prause disagrees with (because they discussed papers by her, among hundreds of papers by other authors), and, (2) Gary Wilson is a co-author of Park et al., 2016. The two paper:
The second paper (Park et al.) didn’t analyze Prause’s research. It cited findings in 3 of her papers. At the request of a reviewer during the peer-review process, it addressed the third, a 2015 paper by Prause & Pfaus, by citing a scholarly piece in a journal that heavily criticized the paper. (There was not enough space in Park et al. to address all the flaws and unsupported claims found in Prause & Pfaus.)
A few days after Park et al.‘s publication Prause insisted that MDPI retract it. The professional response to scholarly articles one disapproves of is to publish a comment outlining any objections. Behavioral Sciences’s parent company, MDPI, invited Prause to do this. Prause declined the offer and demanded (unwarranted) retraction instead. Since Park et al.’s publication Prause has been trying every weapon in her arsenal to have the paper retracted (including sending bogus complaints to the medical boards of all 7 physicians who co-authored the paper). Her emails to MDPI officials, filled with spurious claims and easily debunked allegations, have failed to achieve her goal. No one on the receiving end of her invective had ever witnessed such bizarre behavior by a researcher.
Most unprofessionally, she has turned to threats and social media (and most recently the Retraction Watch blog) to bully MDPI into retracting Park et al. In addition, she informed MDPI that she had filed complaints with the American Psychological Association and the doctors’ medical boards. She also pressured the doctors’ medical center and Institutional Review Board, causing a lengthy, thorough investigation, which found no evidence of wrongdoing on the part of the paper’s authors.
Having failed to bring about an unmerited retraction, Dr. Prause has continued to make untrue statements about the journal itself, claiming that Behavioral Sciences is a predatory journal (it isn’t – it’s PubMed indexed), and that Park et al. was never reviewed (normally a journal sends a paper to 2 reviewers for comments and criticisms). In reality, the paper was reviewed at least 6 times that we know of (for Behvavioral Sciences alone), including one very antagonistic review from Dr. Prause – who later indirectly identified herself as the person who reviewed not only the Behavioral Sciences submission, but an earlier, much shorter version of the paper, submitted to Yale Journal of Biology and Medicine (YJBM).
In many of her emails to MDPI (and others), Prause mentioned her “77 criticisms” and falsely claimed that they had not been addressed. In reality, many of the 77 so-called problems were carelessly copied and pasted from Prause’s review of the YJBM submission; 25 of them had nothing to do with the Behavioral Sciences submission. In other words, the only reviewer to condemn the paper had cut and pasted dozens of criticisms from a review done at another journal (YJBM), which no longer had any relevance to the paper submitted to Behavioral Sciences. This is highly unprofessional.
Even apart from that glaring irregularity, few of the 77 problems could be considered legitimate. Yet, we carefully combed through each comment mining for useful insights, and wrote a comprehensive response to all comments for Behavioral Sciences and its editors. Almost all of the remaining 50 critical comments were either scientifically inaccurate, groundless, or were simply false statements. Some were repetitive. The authors provided MDPI with a point by point response to each so-called problem.
Prause is claiming that publisher MDPI is on predatory journal list cataloged by librarian Jeffrey Beall. This assertion is false, and there’s no list associated with the link Prause tweeted. MDPI does not publish predatory journals. In fact, it was investigated years ago after it was mistakenly placed on a predatory list, and formally determined to be a legitimate publisher. See: http://www.mdpi.com/about/announcements/534. The man (Jeffrey Beall) who made the error eventually deleted his entire operation
MDPI responds:
Prause Twitter rampage has continued (a few of her tweets below):
MDPI responds to Prause:
CEO of MDPI Franck Vazquez, Ph.D, also responds, as does Prause:
Prause keeps going (MDPI eventually ignores her Twitter tagging):
Has Prause been trying to have MDPI thrown out of PubMed and other indices based on her untruths? Three tweets from August, 2016 – just a few weeks after Park et al., 2016 was published:
From a hit piece containing several false statements by Prause: http://www.patheos.com/blogs/mormontherapist/2016/12/op-ed.html. One article referred to is Park et al., the review co-authored by 7 Navy doctors and me. The other is co-authored by other experts, including Todd Love PsyD – whom Prause has also harassed. (Again, MDPI was formally exonerated and removed even before Beall took his list down.)
Prause has also tried to interfere with other MDPI journal issues by defaming MDPI:
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Here are examples of Prause unprofessionally shaming others for collaborating/publishing with/receiving awards from MDPI:
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Here Prause plays her favorite card – accusing others of misogyny – without a shred of evidence (just as she has done with me and multiple others).
More false accusations of misogyny:
Prause falsely claims the Behavioral Sciences paper she attacked was retracted. This is both defamatory and unprofessional.
The Twitter conversation continues:
After a lengthy, thorough, time-consuming investigation, MDPI decided not to retract the paper, and circulated a draft editorial criticizing Prause’s unprofessional behavior. As soon as Prause was informed, she initiated an unprofessional, untruthful email exchange with MDPI – copying bloggers David Ley (her close colleague) and Retraction Watch among others. On the same day of this email barrage harrasing and threatening MDPI, Prause employed multiple Wikipedia usernames (which violates Wikipedia rules) to edit Wikipedia, inserting false information about MDPI and attacking the authors of Park et al., the MDPI president, and two others in the organization.
While Prause’ email threats are not on social media (yet), she has copied bloggers who are positioned to damage the reputations of MDPI in the media, if they choose. Ley blogs on Psychology Today and has often served as the Mouth of Prause. Neuro Skeptic has a popular blog that disparages legitimate (and sometimes dubious) research. Adam Marcus writes for Retraction Watch. Prause also copied Iratxe Puebla, who works for COPE, an organization that addresses publication ethics.
Update: On June 13, Retraction Watch (RW) published an inaccurate and biased account of events surrounding Behavioral Sciences paper Park et al., 2016. Prause contacted RW personnel and fed them the particulars she wanted in print – and RW swallowed them whole and duly published them. My response appears underneath the Retraction Watch article. However, RW edited my comment substantially before it would post it. I supply various missing details in this section: “Who’s watching Retraction Watch?” – an update on events. Among other distortions, the RW piece omitted material details about Nicole Prause’s unsuccessful (and unseemly) 4-year campaign to have the paper retracted (documented in 8 sections on this page: Prause’s efforts to have Behavioral Sciences review paper (Park et al., 2016) retracted). RetractionWatch refused to interview Gary Wilson, deliberately ignored dozens of saved emails proving Prause was lying, and carefully chose out-of-context excerpts from emails to paint a false picture of events. On to additional examples of Prause’s obsessive social media campaign attacking Park et al., 2016:
“Pornaddiction recovery” tweets two YBOP lists, which causes Prause to tweet a paper by Gary Wilson and Navy doctors. Prause falsely claims that she badgered COPE into suggesting a retraction. It’s all bullshit.
On February 16, 2019, a sexual medicine specialist presented a talk at the 21st Congress of the European Society for Sexual Medicine on the Internet’s impact on sexuality. A few slides describing porn-induced sexual problems, citing Park et al., 2016, were tweeted. The tweets caused Nicole Prause, David Ley, Joshua Grubbs and their allies to Twitter-rage on Park et al., 2016.
Update: Joshua Grubbs confirmed hsi extreme agenda-driven bias when they joined their allies Nicole Prause and David Ley in trying to silence YourBrainOnPorn.com. Grubbs, and other pro-porn “experts” at www.realyourbrainonporn.com are engaged in illegal trademark infringement and squatting.
On social media, Prause has stated that she got my talk cancelled because I presented “fake credentials.” For example, Prause’s tweet attacking the ESSM talk, and her claiming that Gary Wilson was uninvited because he “gave false credentials”:
More tweets attacking the 2019 ESSM talk and Park et al., 2016:
No, COPE did not suggest retraction, even though Prause harassed them for 3 straight years. As soon as COPE understood that all Navy consent rules had been complied with, all talk of retraction ended.
Another falsehood about “addiction being ruled out.” Diagnostic manuals such as the DSM and ICD do not use the word “addiction” to describe any addiction: they use “disorder.” In reality, the latest version of the World Health Organization’s medical diagnostic manual, The International Classification of Diseases (ICD-11), contains a new diagnosis suitable for diagnosing what is commonly referred to as ‘porn addiction’ or ‘sex addiction.’ It’s called “Compulsive Sexual Behavior Disorder” (CSBD).
Out of the blue, Prause tweets an attack on MDPI: The following downgraded rating by Norwegian Register was a clerical error, that was later corrected. See the explanation of the MDPI Wikipedia page: https://en.wikipedia.org/wiki/Talk:MDPI#Reply_1-APR-2019
A link to the corrected version showing that MDPI was not downgraded in 2019 (it was clerical error that was eventually corrected). While the 2020 rating may also be an error, the Norwegian register does show “0’ – but it’s “not again”. Notice that Prause is attempting to fool the public by tweeting 2 screenshots of the ratings; one with only 2020, and a screenshot of the 2019 error that was later corrected. Prause’s screenshots:
First showing only 2020
Second showing the uncorrected error:
Prause is lying about MDPI’s 2019 rating (and later lies about 2020 ratings) as seen in a screenshot of the 2020 ratings:
It appears that the 2020 rating will be adjusted at the beginning of the year (it was).
In response, Prause trolls a 3-month old Frank Vasquez tweet:
Prause caught in another lie about the Norwegian ratings. The correct link to ratings page for each journal: https://dbh.nsd.uib.no/publiseringskanaler/VedtakNiva1. Search for MDPI and you will see that all its journals have a “1” rating, including Behavioral Sciences, where Park et al., 2016 was published.
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August, 2019: Prause and David Ley team up to lie about Park et al., 2016. The paper is posted in a thread were Ley misrepresents the state research, claiming porn addiction doesn’t exist. Immediately Ley responds with defamation – claiming the authors paid to have Park et al., 2016 published:
Prause and Ley comment under an August, 2016 Psychology Today blog post by Mark Castleman. Castleman’s post is laden with falsehoods about Park et al., 2016 and Grubbs and Gola, 2016. Castleman lies about yourbrainonporn.com, claiming we misrepresent studies or list junk studiesl Like every other nayasayer but he fails to provide a single example of misrepresention. He also lies in his intro about what YBOP said about porn-induced ED. Everything he claimed about Park et al. is a lie: the content, its claims, its focus, the cases studies, the citations, you name it. This should not be a surprise as Castleman’s published many articles in support of the porn industry (all biased and scientifically inaccurate). He is not a researcher or therapist, only a journalist with an agenda. Castleman’s articles also promoted realyourbrainonporn.com as the source of truth concerning porn’s effects. There is little doubt of Prause and Ley’s involvement in his current hit-piece.
First the comment by Ley:
A few comments on Ley’s lies and spin.
LEY – Published in a very poor journal under strange circumstances.
Behavioral Sciences is PubMed indexed, unlike the journals that have accepted Ley’s 2 opinion pieces (e.g. Porn Studies Journal, Current Sexual Health Reports).
LEY – None of the authors appear to have any training in sexual health, or sex therapy and several are apparently ophthalmologist?
Typical Ley. Among the eight authors were seven physicians with the following expertise: two urologists, a neuroscientist, and two psychiatrists, and a general medical physician.” One author, Dr. Klam, is Director of Mental Health at the Naval Medical Center – San Diego. As for the ophthalmologist, Dr. Doan is both an MD and a PhD (Neuroscience – Johns Hopkins), is the former of Head of “Addictions and Resilience Research” in the Department of Mental Health at the Naval Medical Center. In addition to the papers on internet pornography, Doan has authored multiple papers on behavioral addiction/pathologies relating to technologies, (he published peer-reviewed studies before he evengraduating from high school).
LEY – The described medical assessments and treatments in the Park article are very troubling. In the first case study, the authors describe that they informed the patient that “use of a sex toy had potentially desensitized his penile nerves,” an extraordinary and unsupported statement to publish, without a urological examination.
Ley thinks it was egregious for the doctors to suggest giving up the sex toy and porn (even though the sailor was severely distress about his toy/porn induced sexual problems). An excerpt from the case-report exposing Ley’s advice as malpractice:
A 20-year old active duty enlisted Caucasian serviceman presented with difficulties achieving orgasm during intercourse for the previous six months. It first happened while he was deployed overseas. He was masturbating for about an hour without an orgasm, and his penis went flaccid. His difficulties maintaining erection and achieving orgasm continued throughout his deployment. Since his return, he had not been able to ejaculate during intercourse with his fiancée. He could achieve an erection but could not orgasm, and after 10–15 min he would lose his erection, which was not the case prior to his having ED issues. This was causing problems in his relationship with his fiancée.
Patient endorsed masturbating frequently for “years”, and once or twice almost daily for the past couple of years. He endorsed viewing Internet pornography for stimulation. Since he gained access to high-speed Internet, he relied solely on Internet pornography. Initially, “soft porn”, where the content does not necessarily involve actual intercourse, “did the trick”. However, gradually he needed more graphic or fetish material to orgasm. He reported opening multiple videos simultaneously and watching the most stimulating parts. When preparing for deployment about a year ago, he was worried about being away from partnered sex. So, he purchased a sex toy, which he described as a “fake vagina”. This device was initially so stimulating that he reached orgasm within minutes.
Medically, he had no history of major illness, surgery, or mental health diagnoses. He was not taking any medications or supplements. He denied using tobacco products but drank a few drinks at parties once or twice a month. He had never blacked out from alcohol intoxication. He reported multiple sexual partners in the past, but since his engagement a year ago his fiancée had been his sole sexual partner. He denied a history of sexually transmitted diseases. On physical examination, his vital signs were all normal, and his genital exam was normal appearing without lesions or masses.
At the conclusion of the visit, it was explained to him that use of a sex toy had potentially desensitized his penile nerves and watching hardcore Internet pornography had altered his threshold for sexual stimulation. He was advised to stop using the toy and watching hardcore Internet pornography. He was referred to urology for further evaluation.
By the time he was seen by the urologist a few weeks later, he had cut down on Internet pornography use significantly, although he said he could not completely stop. He ceased using the toy. He was having orgasms again through intercourse with his fiancée, and their relationship had improved.
More evidence that Ley should handing out sexual advice.
A comment by a Prause alias (she dares not comment as herself as she is involved in 2 lawsuits as of August, 2016):
An idiotic comment as Park et al., 2016 was not a study, but a review. As exposed on the current page, Prause is lying about ethics problems and the case reports. But what do you expect from MDPI’s cyberstalker?
Another comment by a Prause alias:
As above, Park was a review, so it did not present experimental data. However, it contained massive data throughout and 200 references.
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January, 2017 (and earlier): Prause employs multiple sock puppets (including “NotGaryWilson“) to edit Wikipedia pages
· 19:06, 19 January 2015 (diff | hist) . . (-9,453) . . Pornography addiction (This section talked only about delta fos-B, which has never been investigated with respect to erotica. Gary Wilson, a known porn blogger who makes money from porn “addiction” added this section, as he is the only one promoting it. It should be removed.) (Tag: section blanking)
Naming “Gary Wilson” is a dead give-away that the above user account is Nicole Prause. Reality Check: Gary Wilson makes no money related to this endeavor, and he did not add the DeltaFosB section to the “Pornography Addiction” Wiki page. As time passed, Prause fell back into her usual pattern of creating usernames with 3-4 capitalized words. For example:
While the above edits suggest that all are Prause as they consistently attack IITAP, Carnes, the addiction model, and falsely claim there’s no science supporting either porn or sex addiction. If there was any doubt, two of them once again comment about Gary Wilson and DeltaFosB. First, a telling “PatriotsAllTheWay” comment:
04:55, 21 January 2015 (diff | hist) . . (-9,433) . . Pornography addiction (Delata fos B has never been linked to sexual behaviors in humans, not once. This section was added by Gary Wilson, promoting his book for profit of the same idea.) (Tag: section blanking)
A few comments: 1) All of Gary Wilson’s profits from the sales of his book go to charity, and his website is otherwise entirely non-commercial; 2) Contrary to Prause’s claim, DeltaFosB is present in humans and all neuroscientists studying its mechanisms agree that DeltaFosb is involved with multiple physiological functions, including sensitization to sexual activity and addiction.
A Wikipedia “user-page” is automatically created for every username that edits a Wikipedia article. “NotGaryWilson” is the only Prause sock puppet to have made a comment on its user page. Here’s what “NotGaryWilson” wrote about the “Sex Addiction” article:
As you are probably aware, anti-porn groups repeatedly sabatoge these pages for profit. Delta FOSb has no direct support, but is a pet idea from Gary Wilson, paid anti-porn activist. So, yes, I did mean to remove the text and will go ahead and remove it again. I will add the justification back. There is no evidence supporting the connections Wilson makes, which is why it is so easy to spot his writing.
As with the “Pornography Addiction” Wikipedia page, Gary Wilson in fact added none of the DeltaFosB material to the “Sexual Addiction” Wikipedia page. As stated, Wilson is paid by no one, and makes no money on this endeavor. Finally, only non-academics David Ley and Nicole Prause ever assert that DeltaFosB is not involved with initiating addiction-related brain changes. (Prause is particularly obsessed discrediting with DeltaFosB.) Contrary to their unsupported rantings, DeltaFosB’s role in addiction and sensitization is well established in both animal and human studies (see list 1 and list 2 for DeltaFosB studies). A veteran Wikipedia editor responds to the above comments by “NotGaryWilson”:
I’m C.Fred. I noticed that you recently removed some content from Sexual addiction without adequately explaining why. In the future, it would be helpful to others if you described your changes to Wikipedia with an accurate edit summary. If this was a mistake, don’t worry; the removed content has been restored.
And,
It’s pretty clear from your username that you have an axe to grind with the topic. Chopping broad sections from the article is not a constructive way to go about this. You need to discuss your changes on the talk page and get broad support for them. —C.Fred (talk) 00:48, 16 January 2017 (UTC)
Don’t hold your breath for broad (legitimate) support for unsupported claims about Wilson or DeltaFosB. Sometimes Prause uses an IP address as a username. This Wikipedia user only edited “Sex Addiction” blabbering on about “FosB” and CSATs & IITAP – two of Prause’s favorite targets:
It appears that Nicole Prause employed two additional usernames to edit the Fight The New Drug Wikipedia page (FTND is one of Prause’s favorites targets):
What makes us suspect that both usernames are Nicole Prause? Not only did both usernames edit only the FTND Wikipedia page, both created the section featuring Prause’s often-tweeted op-ed that appeared in the Salt Lake City Tribune. Prause wrote the critique of Fight the New Drug’s previous op-ed, then persuaded 7 of her PhD buddies to sign off on it. Prause’s op-ed cited only a few irrelevant citations, while offering no neuroscience-based studies. It also made several false statements about the content and references in the earlier FTND op-ed. Several experts responded with this dismantling of the Prause op-ed: Op-ed: Who exactly is misrepresenting the science on pornography? (2016).
In a rare turn of events, the Nicole Prause Wikipedia page was created by a Wikipedia employee. Whatever this employee’s motivation, there is little doubt that two primary usernames editing thsi page are Prause herself:
Prause, who has not been affiliated with any academic institution since early 2015, attacks Professor Dines in a Tweet:
This public insult was part of a thread where Prause scathingly assailed a university student in Sweden for endeavoring to study abuse of porn performers (later deleted by Prause).
Another tweet calling both Gail Dines and Fight The New Drug (FTND) liars and “anti-LGBT” and “anti-woman”:
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The @BrainOnPorn twitter is believed to be Prause. who uses it to disparage the same people Prause does, while promoting the porn industry’s agenda. Here, RealYBOP trolls an account that quotes Gail Dines (April 22, 2019).
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More trolling by porn-industry shill RealYBOP (May, 2019)
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Out of nowhere, RealYBOP trolls Dines:
RealYBOP claims to have wrote the research, but Prause has never published a study on porn use and sexism.
Others – May, 2017: Prause attacks SASH (Society for the Advancement of Sexual Health)
Background: Prause has asserted that she has “debunked” and “falsified” the work of dozens of expert addiction neuroscientists with a single flawed study. That study has been formally critiqued repeatedly in the academic literature, as explained below.
Perhaps upset that SASH’s new Position Paper dared to look to the preponderance of neuroscientific evidence on the subject of sexual behavior addiction instead of looking to Prause’s assertions, Prause tweeted the following unjustifed, retaliatory claims. SASH has never commented on Prause.
Others – May, 2017: In response to paper presented at a urology conference Prause calls US Navy urologists “activists, not scientists.”
Prause’s typical tactics are two-fold: 1) disparage every study that links porn use to negative outcomes, 2) personally attack those involved with the study. These behaviors serve her goal, which is to “prove” that porn use is rarely harmful, and almost always beneficial. In this tweet she disparages a study by US navy urologists, saying they are “activists, not scientists.”
Prause follows this attack with her own “official” press release attacking the study, which Prause has never seen. A second Prause tweet asserts that the medical doctors “ducked from reporters due to shame.” This is found nowhere in the article Prause tweeted and Prause did not attend the urology conference where the paper was presented:
It must be noted that Prause’s own “ED paper,” Prause & Pfaus 2015, wasn’t a study at all. Instead, Prause claimed to have gathered data from four of her earlier studies, none of which addressed erectile dysfunction. Additional problem: The data in the Prause & Pfaus (2015) paper do not match the data in the four earlier studies. The discrepancies are not small and have not been explained.
Many journalists’ articles about this study claimed that porn use led to better erections, yet that’s not what the paper found. In recorded interviews, both Prause and Pfaus falsely claimed that they had measured erections in the lab, and that the men who used porn had better erections. In this Jim Pfaus TV interview Pfaus states:
“We looked at the correlation of their ability to get an erection in the lab.”
“We found a liner correlation with the amount of porn they viewed at home, and the latencies which for example they get an erection is faster.”
In this radio interview Prause claimed that erections were measured in the lab. The exact quote from the show:
“The more people watch erotica at home they have stronger erectile responses in the lab, not reduced.”
Yet this paper did not assess erection quality in the lab or “speed of erections.” The paper only claimed to have asked guys to rate their “arousal” after briefly viewing porn (and it’s not clear from the underlying papers that even that actually happened in the case of all subjects). In any case, an excerpt from the paper itself admitted that:
“No physiological genital response data were included to support men’s self-reported experience.”
Nowhere in Prause & Pfaus 2015, or the 4 underlying papers, were lab measures of erectile functioning mentioned or reported. Truth? What’s that?
Others – September 14, 2017: Prause claims all who believe porn can be harmful and addictive are “science-illiterate & misogynistic”
Others – January 24, 2018: Prause files groundless complaints against therapist Staci Sprout
Continuing her behind-the-scenes pattern of filing baseless, harassing complaints against anyone whose views Prause disagrees with, Prause filed two unfounded complaints against therapist Staci Sprout, accusing Sprout of “conspiracy theories.” This was after falsely accusing her on a Facebook post comment of practicing without a license. Note that Prause tried to persuade the State of Washington to hide Prause’s bogus complaint from Sprout. Because the complaint was baseless, Prause was not considered a whistleblower, and identity was not protected – despite a second complaint by Prause insisting she had whistleblower status.
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According to the records, Washington received Prause’s complaint on January 24th, and the case was opened on January 30th. Two days later (February 1st) the State of Washington dismissed the empty complaint (without an investigation) and closed the case, declaring that even if the allegations were true, no violation of law would have occurred.
To understand Prause’s dishonesty and irrational action look at her “complaint” to the State of Washington. Prause targeted the following Sprout post, which is found on the Compulsive sexual behaviour disorder section (CSBD) of the ICD-11 (you can’t read the comments unless you create a username):
Again let us not neglect to consider the financial interests of those who benefit by the billions from unidentified, untreated compulsive sexual behavior. Two easy examples: “free” pornography sites who are paid for advertising, and drug manufacturers of ED drugs. They might even have lobbyists.
Context: The above comment was made in a general response to dozens of Nicole Prause comments where Prause personally attacked therapists and organizations (IITAP, SASH, ASAM) for supposedly “profiting from sex and porn addiction.” Prause has spent the last 2 years obsessively posting on the ICD-11 beta draft, doing her best to prevent the CSBD diagnosis from making it into the final manual. (Her attempt failed, and CSBD is now in the ICD-11 – see below.) In fact, Prause posted more comments than everyone else combined.
When Sprout dared to point out the more likely profiteers, Prause reported her to Washington State! Here’s Prause complaint to the Board:
Violation: Stated that we had “lobbyists” and that “pornography sites who are paid for advertising, and drug manufactures of ED drugs”. None of this is true. Neither I nor any of my colleagues who publish peer-reviewed science have any “lobbyist” efforts. These conspiracy theories appear promoted to support her own books and profit her therapy practice.
Notice how Prause lied, saying that Sprout’s comment was about Prause and unnamed colleagues – and not, as Sprout actually wrote, about the billions made by “free pornography sites” (most owned by wealthy Mindgeek) and “drug manufacturers of ED drugs”. In short, this is not a legitimate complaint; it’s simply harassment.
Prause’s second complaint to Washington
Unsatisfied with Washington’s dismissive response, and angry that her duplicity in filing a groundless complaint against Sprout was made public on this page, Prause filed a second complaint against Sprout. Prause falsely claimed she had “whistleblower status.” The State again disagreed, and Washington again released the related correspondence to Sprout:
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Update (5-14-18): Prause harasses and defames Staci Sprout on her Facebook page – falsely claiming Sprout was not licensed:
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Update (6-8-18): The “implementation version” of the ICD-11 (the World Health Organization’s International Classification of Diseases – the world’s most widely used medical diagnostic manual) is now out (as of June, 2018). Its mental-health-expert authors have included a diagnosis that can be used to diagnose anyone suffering from compulsive sexual behavior (including sexual behavior addictions) called “Compulsive Sexual Behavior Disorder.”
Prior to the release of the “implementation version, ” a beta draft of the ICD-11 was also put online, and made available for interested parties to comment on. (A simple sign-up is needed to view and participate.) Note: Prause has posted more comments in the beta-draft comment section than everyone else combined. In the comments section under this new proposal, Prause attacks Staci Sprout, falsely claiming that Sprout “is under continued investigation” by the State of Washington. In fact, as explained and documented above, Washington summarily dismissed both of Prause’s baseless complaints.
May, 2019: David Ley and RealYBOP (Prause alias account) misrepresenting Staci Sprout’s tweet. Sprout said nothing about “sex addiction”:
RealYBOP (Prause) tweets a link to an excerpt from Prause’s Geoffrey Reed email (on RealYBOP). Geoffrey Reed isn’t an official WHO spokesperson, and this was only a private email to Prause to get her off of his back. In truth only one official WHO spokesperson has commented on CSBD – Christian Lindmeier. If you have any doubts about the true nature of the Prause/RealYBOP campaign, carefully read this responsible article about compulsive sexual behavior disorder (CSBD). It quotes official WHO spokesperson Christian Lindmeier. Lindmeier is one of only four officials WHO spokespersons listed on this page: Communications contacts in WHO headquarters – and the only WHO spokesperson to have formally commented about CSBD! The SELF article also interviewed Shane Kraus, who was at the center of the ICD-11’s Compulsive Sexual Behavior Disorder (CSBD) working group. Excerpt with Lindmeir quotes makes it clear that WHO did not reject “sex addiction”:
In regards to CSBD, the largest point of contention is whether or not the disorder should be categorized as an addiction. “There is ongoing scientific debate on whether or not the compulsive sexual behavior disorder constitutes the manifestation of a behavioral addiction,” WHO spokesperson Christian Lindmeier tells SELF. “WHO does not use the term sex addiction because we are not taking a position about whether it is physiologically an addiction or not.
Compulsive sexual behaviour disorder is characterized by a persistent pattern of failure to control intense repetitive sexual impulses or urges, resulting in repetitive sexual behaviour over an extended period (e.g., six months or more) that causes marked distress or impairment in personal, family, social, educational, occupational or other important areas of functioning.
Although this category phenomenologically resembles substance dependence, it is included in the ICD‐11 impulse control disorders section in recognition of the lack of definitive information on whether the processes involved in the development and maintenance of the disorder are equivalent to those observed in substance use disorders and behavioural addictions.
The new WHO paper linked to by sprout (Geoffrey Reed is one of the authors) calls out Prause’s behavior on ICD-11 comment section: Public stakeholders’ comments on ICD‐11 chapters related to mental and sexual health (2019). WHO discusses public comments made on proposed ICD-11 mental disorders, incuding “compulsive sexual behavior disorder” where Nicole Prause posted more comments than everyone else combined (22), disparaging individuals and organizations, making false accusations and engaging in libel. Bold type describes Prause comments:
Compulsive sexual behaviour disorder received the highest number of submissions of all mental disorders (N=47), but often from the same individuals (N=14). The introduction of this diagnostic category has been passionately debated3 and comments on the ICD‐11 definition recapitulated ongoing polarization in the field. Submissions included antagonistic comments among commenters, such as accusations of a conflict of interest or incompetence (48%) or claims that certain organizations or people would profit from inclusion or exclusion in ICD‐11 (43%).
Click here if you want to read the public comments on the ICD-11 CSBD sections (including the hostile/defamatory/disparaging ones). You will need to sign up with a username to view comments.
Prause joins the defamation as herself (instead of RealYBOP):
Inaccuracies by Prause: 1) Everything Sprout tweeted was accurate, 2) WHO never communicated with Sprout (that’s a crazy claim).
RealYBOP (an alias account of Nicole Prause) disparages Staci Sprout.
In reality, hundreds of Twitter accounts made fun of Prause’s inane and factually incorrect tweet claiming that a study had busted “the myth that men watch more porn than women”. For example, in this thread RealYBOP several scientists make fun of RealYBOP (in reponse she argues that being drunk does not impair driving!):
Others – January 29, 2018: Prause threatens therapists who would diagnose sexual behavior addicts using the upcoming “Compulsive sexual behavior disorder” diagnosis in the ICD-11
Her aggression is absurd given the fact that experts who serve on the ICD-11 wrote, in the world’s top psychiatry journal that,
Currently, there is an active scientific discussion about whether compulsive sexual behaviour disorder can constitute the manifestation of a behavioural addiction[5]. For ICD-11, a relatively conservative position has been recommended, recognizing that we do not yet have definitive information on whether the processes involved in the development and maintenance of the disorder are equivalent to those observed in substance use disorders, gambling and gaming[6]. For this reason, compulsive sexual behaviour disorder is not included in the ICD-11 grouping of disorders due to substance use and addictive behaviours, but rather in that of impulse control disorders. The understanding of compulsive sexual behaviour disorder will evolve as research elucidates the phenomenology and neurobiological underpinnings of the condition[7].
Anyone who considers the proposed disorder itself can see that it is intended to encompass sexual behavior addicts by whatever label.
Not so, but before we get to the truth it’s worth noting that her claim is very bold indeed, as 3 Prause studies on porn users failed to control for much of anything, including screening to establish that they were addicted to porn (Prause et al., 2013, Steele et al., 2013, Prause et al., 2015). In fact, these 3 Prause studies chose to ignore numerous standard exclusion criteria normally employed in addiction studies, such as psychiatric conditions, other addictions, psychotropic medications, drug use, other compulsions, depression, religiosity, age, sexuality, gender, etc.
In reality, Seok & Sohn, 2018 carefully screened subjects for “sex addiction” (PHB). PHB was defined by two qualified clinicians based on clinical interviews using PHB diagnostic criteria set in previous studies, Table S1. Seok & Sohn also controlled for multiple variables. From Seok & Sohn, 2018:
We used the following exclusion criteria for PHB and control participants: age over 35 or under 18; other addictions such as alcoholism or gambling addiction, previous or current psychiatric, neurological, and medical disorders, homosexuality, currently using medication, a history of serious head injury, and general MRI contraindications (i.e., having a metal in the body, severe astigmatism, or claustrophobia).
In addition, Seok & Sohn 2018 assessed (controlled for) multiple psychological variables, including depression. From their study:
To identify comorbid tendencies among subjects with PHB, the Beck Depression Inventory (BDI) (Beck et al., 1996), Beck Anxiety Inventory (BAI) (Beck and Steer, 1990), and Barrett’s Impulsiveness Scale II (BIS-II), as adapted by Lee (1992) were administered. The score of BIS-II was used as a covariate to remove the effects of impulsivity. The BIS-II consists of 35 questions with dichotomized ‘‘yes” (1) or ‘‘no” (0) answers. The total score ranges from 0 to 35, with higher scores indicating greater levels of impulsivity. Information about the demographic and clinical characteristics of all participants is presented in Table 1.
Put simply, Prause lied.
March, 2018 – Libelous claim that Gary Wilson was fired from Southern Oregon University
Gary Wilson’s cyberstalker, Dr. Nicole Prause, prepared a libelous blog piece, which she posted on an adult industry website. It was removed after Wilson tweeted this. (Original url: http://mikesouth.com/scumbags/dr-nicole-prause-destroys-yourbrainonporn-dont-fall-22064/).
The site containing Prause’s libelous blog piece describes itself as follows:
Mike South adult industry blog, the premier destination for adult industry news since 1998. Mike South was a small-time porn producer, who won two AVN awards, turned adult news blog pioneer. South was cited on a host of major news sites, and Gawker.com acknowledged him as “the gonzo king of porn gossip”.
Prause working with Mike South provides clear evidence of Prause’s porn-industry connections:
In her defamatory piece, Prause knowingly, falsely stated that,
[Gary Wilson] claims to have been a “professor in Biology”. In reality, he was supposed to be an undergrad instructor, not a professor, for a lab section at Southern Oregon University. He was fired without pay immediately before completing even a quarter.
In truth, Gary was an Adjunct Instructor at Southern Oregon University and has never claimed to be a professor – although careless journalists and websites have assigned him an array of titles in error over the years – including a now-defunct page on a website that pirates many TEDx talks and describes the speakers carelessly without contacting them. Below is the screenshot Prause posts to “prove” that Gary Wilson has misrepresented his credentials (again, the Gary Wilson page no longer exists). Note: Until Prause produced her “proof,” Gary had never seen this site and has never communicated with its hosts. Thus he never provided a bio, or claims of “professorship” for it. Gary does not seek speaking engagements and has never accepted fees for speaking. Moreover, YBOP accepts no ads, and the proceeds from Gary Wilson’s book go to a registered charity.
On the about page the Keynotes.org website said that it is not an agency and that anyone could upload a video and speaker bio: Keynotes.org is not an agency, but rather, a media site…. Keynotes.org is crowdsourced and fueled by TrendHunter.com, the world’s largest trend spotting website. Thus, it is even possible that Prause uploaded Gary’s TEDx talk with a purposely inaccurate bio in order to fabricate her desired “proof” of misrepresentation. After 5 years of continuous harassment and cyber-stalking, faked documents, libelous assertions, hundreds of tweets, and dozens of usernames with hundreds of comments, nothing would surprise us.
Gary taught at Southern Oregon University on two occasions. He was never “fired,” as can be seen from the employment documents beneath this paragraph. Gary also taught anatomy, physiology and pathology at a number of other schools over a period of two decades, and was certified to teach these subjects by the education departments of both Oregon and California (YBOP About us page). Gary has never said he had a PhD or was a professor.
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Below is the “un-redacted” copy of the document Prause posted on several websites. Prause claimed it meant that Gary was fired, when it actually meant “terminate paychecks” as Gary had to resign due to a medical emergency. The Prause version redacted the COMMENTS section, where SOU stated that Gary resigned due to a health crisis.
Incidentally, Gary receives no compensation from the charity to which his proceeds from his book go. His position as Research Officer is an honorary (volunteer) one. Nor does he serve on the Board of the charity or otherwise determine how it disburses its funds.
He hopes that one day TED will remove the unmerited warning that his critics (headed by Prause) lobbied long and hard to have placed on his very popular TEDx talk. Not only was there comprehensive empirical support for “The Great Porn Experiment” (2012), hundreds of additional studies have been published since 2012 that fully support Gary Wilson’s claims. These 2 pages provide slide by slide support for TGPE:
In addition to placing the redacted employment document and associated libelous statements on a porn industry site, Prause used Quora and Twitter to spread her lies. In doing so, Prause was banned from Quora, and suspend by Twitter. See these two sections from the “Prause page”:
Gary also hopes that Dr. Prause will quit libeling and harassing him and others. Although this new instance of libel (her false claim that Gary was fired) isn’t as shocking as her libelous claim that she has a no-contact court order against Gary, it is equally untrue.
Perhaps it is time for Dr. Prause to grow up and behave like the professional she claims to be.
PS: Southern Oregon University has confirmed that Nicole Prause was the only one who sought his employment records. Email below:
Prause’s usual partner in targeted harassment, David Ley, also falsely stated that Gary Wilson was fired from Southern Oregon university:
Another libelous tweet by Ley, promoting the Mike South article (that was later deleted):
Not only is Tammy Johnson Ellis lying about Wilson being terminated she is also lying about “cherry-picking pieces of research”. In all the hundreds of defamatory posts and tweets Ley, Prause, Ellis, and their allies have never once provided an example of Wilson “cherry-picking” (see YBOP’s main research page for the current state of the research).
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Continuing into 2019: Prause continues to post defamatory tweets claiming that Wilson was “terminated” from SOU, or was a TA (teaching assistant) at Souther Oregon University. In addition, she continues to lie about Wilson misrepresenting his credentials.
April 1, 2019: Prause and David Ley once again lie about about Gary Wilson’s SOU employment.
Background: On March 31, 2016, the TIME cover story (“Porn and the Threat to Virility”), by Belinda Luscombe, featuring Gabe Deem, Nicole Prause, David Ley, Gary Wilson, and many others, was published. It was a year in the making and TIME had the author and other TIME employees (fact checkers) follow-up on claims made by each person interviewed. Once published Prause and her alias “PornHelps” viciously attacked and libeled its author Belinda Luscombe:
On April 1, 2019, both Gary Wilson and Belinda Luscombe weighed in on a long twitter thread discussing validity of the General Social Survey (which claimed that only 45% of men, aged 18-29, had viewed an X-rated movie in the last year). Within a few minutes Prause joined the tread to attack and libel Luscombe and Wilson (long-time Prause ally David Ley also libeled Wilson). In her first of 8 tweets, Prause repeats the same lies documented on this page. She also calls Belinda a fake journalist, engaging fraud.
Since Prause has blocked Belinda, Ley jumps in to “paraphrase” (but omits Prause’s attacks on Belinda). Belinda responds:
David Ley joins in with 2 of his own lies: That Wilson was a TA (teacher assistant) and he was fired.
Truth doesn’t stop Ley or Prause from continuing their Twitter libel-fest, attacking Belinda Luscombe and Wilson.
All provable libel:
Wilson did not drop out of college.
Wilson did not default on his student loans.
Wilson was not a TA. He was ‘Adjunct Faculty.’ (How could Wilson be a TA if he was not attending SOU as a student?)
March 5, 2018 – Prause permanently banned from Quora for harassing Gary Wilson
On March 3rd 2018, Nicole Prause posted a defamatory article on Quora: https://www.quora.com/What-do-you-think-about-your-brain-on-porn-movement/answer/Nicole-Prause. In her lie-filled hit-piece, Prause posted redacted copies of Gary Wilson employment records and knowingly, falsely stated that Southern Oregon University had fired Wilson. On March 3rd & 4th Prause posted ten more demeaning and untruthful comments about Wilson and his work, all containing a link to her defamatory piece:
Wilson reported Prause to both Quora and Twitter for violation of terms of service and harassment. Both acted upon Wilson’s complaints, removing his employment document and Prause’s false interpretation of it. Confirmation of Quora acting on Wilson’s complaint (not the first violation for harassing Gary Wilson):
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Quora permanently bans Nicole Prause for harassment:
Ongoing – Prause falsely claims that Gary Wilson has misrepresented his credentials
In her defamatory articles, tweets, and Quora posts Prause has knowingly and falsely stated that I claimed to be “professor in biology” or a “neuroscientist”. I was an Adjunct Instructor at Southern Oregon University and taught human anatomy, physiology & pathology at other venues. Although careless journalists and websites have assigned him an array of titles in error over the years (including a now-defunct page on a website that pirates many TEDx talks and describes the speakers carelessly without contacting them) he has always stated that he taught anatomy & physiology. He has never said he had a PhD or was a professor.
Below is the screenshot Prause posts to “prove” that Gary Wilson has misrepresented his credentials (again, the Gary Wilson page no longer exists). Note: Until Prause produced her “proof,” I had never seen this site and had never communicated with its hosts, never uploaded the page in question and never removed it. Thus I certainly never provided a bio, or claims of “professorship.”
On the about page the Keynotes.org website said that it is not an agency and that anyone could upload a video and speaker bio: Keynotes.org is not an agency, but rather, a media site…. Keynotes.org is crowdsourced and fueled by TrendHunter.com, the world’s largest trend spotting website. Thus, it is even possible that Prause uploaded Gary’s TEDx talk with a purposely inaccurate bio in order to fabricate her desired “proof” of misrepresentation. After 7 years of continuous harassment and cyber-stalking, faked documents, libelous assertions, hundreds of tweets, and dozens of usernames with hundreds of comments, nothing would surprise us.
I taught at Southern Oregon University on two occasions. Gary also taught anatomy, physiology and pathology at a number of other schools over a period of two decades, and was certified to teach these subjects by the education departments of both Oregon and California. Gary does not seek speaking engagements and has never accepted fees for speaking. Moreover, YBOP accepts no ads, and the proceeds from Gary Wilson’s book go to a registered charity.
Both Prause & David Ley continue to directly or indirectly claim that I have misrepresented my credentials. Of course, they never provide a single example, but truth is irrelevant to these two. Examples of their cyber harassment:
On social media, Prause has stated that she got my talk cancelled because I presented “fake credentials.” For example, Prause’s tweet attacking the ESSM talk, and her claiming that Gary Wilson was uninvited because he “gave false credentials”:
Continuing into 2019, Prause continues to post defamatory tweets claiming that I was “terminated” from SOU, or was a TA (teaching assistant) at Southern Oregon University. In addition, she continues to lie about me misrepresenting my credentials.
Names Gary Wilson as “The Cyberstalker” on Quora. Prause was ultimately banned from Quora for harassing me. The claims about me misrepresenting myself are lies and based on a web page that no longer exists, and was most likely created by Prause:
Employing a new tactic with a new Twitter account:
August, 2019: The RealYourBrainOnPorn Twitter account (apparently tied to the website currently in Daniel Burgess’s name) posted multiple defamatory tweets stating that I misrepresented my credentials. As with Prause, this Twitter account failed to link to any evidence produced by me (a dead-give away that they fabricated their claim). Instead, RealYBOP pulled a fast one: it posted a screenshot of YBOP Google search, which returned a few media articles copied and posted on YBOP mistakenly describing me as a “professor” (which I have never claimed to be).
A screenshot from the above tweet. Again, the article is reproduced on YBOP, but not authored by YBOP. It incorrectly refers to me as “adjunct professor” (rather than “adjunct faculty”):
RealYBOP used this kind of Google search to capture YBOP’s URL, to make it appear as if I were saying I was a professor. RealYBOP could capture the YBOP URL because a 100 or more articles mentioning Gary Wilson and YBOP are located on YBOP. Most of the YBOP articles are here: ‘Your Brain On Porn’ in the News. Using key words, a Google search returned the same item RealYBOP tweeted. (In fact, almost all the search returns were about Prause falsely claiming I faked my credentials.)
The excerpt where TIME incorrectly refers to me as a “professor”:
The young porn abstainers do have an unlikely guru: Gary Wilson, 59, a former part-time adjunct biologyprofessorat Southern Oregon University and various vocational schools and the author of Your Brain on Porn: Internet Pornography and the Emerging Science of Addiction. His website, yourbrainonporn.com, or more commonly YBOP, is a clearinghouse for information that supports the link between heavy adolescent pornography use and sexual dysfunction. Many people find him through his 2012 TEDx talk, which has more than 6 million views.
The above, and a second article on YBOP (Will quitting porn improve your life?), are the only evidence RealYBOP and Prause provide that I claimed I was a former professor – even though it was a journalistic error, not mine at all. The journalists replaced “adjunct faculty” with “adjunct professor” (oh, the horror!):
That talk was followed by an independent TEDx Talk video last year by Gary Wilson, a past adjunct professor in anatomy at an Oregon university.
Both articles got it wrong. I have never once claimed to a professor or PhD. I taught anatomy and physiology for years, including a few A&P labs at Southern Oregon University. When asked about my time at SOU, I explicitly state I was categorized as “adjunct faculty,” not a professor. In 10 years of giving interviews, I have yet to see even a single article convey my statements entirely accurately in an interview. In reality, many articles are little more than cobbled together copy-and-pastes from other websites, which inevitably propagates errors as well as truth.
Since this minor “former part-time adjunct professor” blunder can be traced the 2016 TIME magazine cover story, let’s look at what I actually emailed to TIME editor Belinda Luscombe.
Where in the chain of communications “adjunct faculty” transformed into “adjunct professor” is anyone’s guess. But clearly it did not come from me.
As documented in other sections (1, 2), Prause and her alias account “PornHelps” had previously harassed and defamed Belinda Luscombe for daring to author the TIME cover story on porn-induced ED. In a 2019 Twitter thread Prause once again claims that I misrepresented my credentials to TIME. Since Prause has blocked Belinda, Ley jumps in to “paraphrase” (but omits Prause’s personal attacks on Belinda). Belinda responds:
TIME fact-checked with Southern Oregon University. Are they the ones who got it (slightly) wrong?
David Ley continues the convo inserting 2 of his own lies: (1) I was a TA (teacher assistant), and (2) I was fired. Belinda Luscombe sets him straight:
August/September, 2019: Realyourbrainonporn (Daniel Burgess? Nicole Prause?) obsessively tweeting that Gary Wilson misrepresented his credentials. RealYBOP even went after Belinda Luscomble – like Prause and her alias (PornHelps) often did:
November, 2019 – RealYBOP: Follower “Abby” inadvertently called me a neuroscientist (English is not Abby’s native language). Prause/RealYBOP immediately jumped on this to lie again:
Note that Prause/RealYBOP asserted that an expose’ will be published within months
I had enough of Prause/RealYBOP lies, and responded with several tweets (even RealYBOP has blocked me). For example, a few of my tweets:
RealYBOP went nuts, creating numerous bogus graphs “showing” that I was harassing their twitter. RealYBOP fails to mention that it has tweeted over 300 times at me, or about me, and is trying to steal my trademark. One of RealYBOP graphs falsely claims I have threatened to sue in 170 tweets posted over the last 12 months:
In reality, I have only threatened to sue in a solitary tweet (the tweet targeting RealYBOP’s initial defmatory tweet:
RealYBOP is a pathological liar and cyberstalker, who’s about to pulled into 3 Federal lawsuits.
March, April, October, 2018: Nicole Prause files bogus DMCA takedown requests in an attempt to hide her harassment and defamation (all were dismissed)
As you can see in the 3 preceding sections, Prause posted Gary Wilson’s Southern Oregon University employment records on Twitter, Quora, and an adult website. In her defamatory posts, Prause knowingly and falsely stated that Gary Wilson was fired and had never previously taught at Southern Oregon University. Wilson was not fired and had previously taught at SOU. These violations resulted in Prause being permanently banned from Quora and suspended from Twitter, with a warning. Wilson sent the adult website (MikeSouth) a DMCA takedown notice, which resulted in the Prause “article” being deleted. (deleted url: http://mikesouth.com/scumbags/dr-nicole-prause-destroys-yourbrainonporn-dont-fall-22064/).
In a clear reprisal for having had her impulsive plans foiled, Prause filed her first DMCA takedown request with my website host on 3/29/2018. For those who may not know, DMCA stands for Digital Millennium Copyright Act. A DMCA takedown notice is used to have copyrighted materials removed from a website. Prause filed a DMCA takedown as a backdoor way to have this page chronicling her harassment and defamation removed or gutted. Prause is claiming that screenshots of her tweets are copyrighted material. Tweets are generally not copyrightable, and hers are not. Every day thousands of websites and countless Twitter users post screenshots of tweets. A portion of Prause’s first DMCA complaint:
Identification of material that is infringing and which you wish to have taken down or blocked and enough information to allow the OSP to locate the material, e.g., an URL to the offending page;
URL: www.yourbrainonporn.com containing 3,040 references to me. Examples are attached and include pages like: https://www.yourbrainonporn.com/nicole-prauses-pdf-her-span-lab-website
A portion of Gary Wilson’s response to Prause’s DMCA takedown request:
It’s disturbing that Prause claims to be a victim here, as I have documented multiple instances of her harassing myself and others – including researchers, medical doctors, therapists, psychologists, former UCLA colleagues, a UK charity, men in recovery, a TIME magazine editor, several professors, IITAP, SASH, Fight The New Drug, the academic journal Behavioral Sciences, and the head of the academic journal CUREUS: https://www.yourbrainonporn.com/nicole-prauses-pdf-her-span-lab-website
As for other places where Prause name appears, YBOP contains about 10,000 pages, and it’s a clearinghouse for nearly everything associated with Internet porn use and its effects on the user. Nicole Prause has published multiple studies about porn use and hypersexuality, and by her own admission, is a professional “debunker” of porn addiction and porn-induced sexual problems.
A Google search for “Nicole Prause” + pornography” returns about 11,000 pages. She’s quoted in hundreds of journalistic articles about porn use and porn addiction, in addition to her research related to pornography use. She’s on TV, radio, podcasts, and YouTube channels claiming to have debunked porn addiction with a single (heavily criticized) study. So Prause’s name is inevitable on a site like mine, which functions as a clearinghouse for research and news associated with Internet porn’s effects. YBOP also critiques other questionable research on porn and related subjects. These critiques are not personal, but rather substantive.
This DMCA take-down request is just the latest in a long string of harassment incidents by Prause. Dr. Prause has tweeted about me nearly 100 times, while I never tweet about her (other than correcting a few of her lies). Prause has used dozens of fake usernames to post comments about me on porn recovery forums (https://www.yourbrainonporn.com/nicole-prauses-pdf-her-span-lab-website#ybr). Prause has created an amazon AWS page to libel and harass me and many others (https://s3-us-west-1.amazonaws.com/weilerdefamation/PressRelease_DefamationBySenatorWeiler.txt).
Thank you for your attention.
Gary Wilson
After a few back and forths with Wilson the website host suggested, “that the two of you can work out whatever it is that is going on here“. Gary Wilson responded:
Dear ______
Thank you for your message. Dr. Prause already has my contact information, which you are welcome to provide her again. However, she has demanded that I not contact her directly (even though I have never initiated direct contact with her). Unfortunately, therefore, I’m not sure how it would be possible for us to exchange views or reach an accord in the way you propose.
My website is a clearing house for news related to claims about porn’s effects. It is my understanding, based on legal advice, that Tweets are generally not copyrightable, nor are images of them protected by the DMCA. There are no other images relating to Dr. Prause that I’m aware of on YBOP.
Dr. Prause’s behavior and biases, as documented by her Tweets, are essential reading for anyone trying to understand the politics currently influencing the study and reporting of internet porn’s effects. Thus, without solid reason for their removal, they need to remain on YBOP.
I regret that Dr. Prause has tried to involve [you] in her latest harassment efforts.
Best regards,
Gary
The YBOP hosting service responded by “closing the ticket”:
Greetings,
Thank you for the update on this issue. We’ll pass along your contact email address. I hope this leads to an amicable solution for both of you.
At this time we consider this Copyright Infringement matter resolved. I have set this ticket to automatically close in 96 hours while we continue to monitor for additional complaints.
If you have any questions please let me know.
Not to be deterred, Prause acquired the services of DMCA Defender.com, who filed a second DMCA takedown request on April 17th, 2018. Once again, DMCA Defender claimed that screenshots of tweets are somehow copyrighted. They provided no authority to support the assertion, but did provide the urls of each screenshot. Gary Wilson, once again, responded to Prause’s harassment:
Dear _______
In case you need details for your records, I see that my harasser, Nicole Prause, has now hired a company to assist her in spurious DMCA takedown requests. Prause is falsely claiming that screenshots of her tweets and Facebook comments are copyrighted material. Nearly all of the screenshots the company complains of can be found on the YBOP page that documents Prause’s harassment of myself and others – including researchers, medical doctors, therapists, psychologists, former UCLA colleagues, a UK charity, men in recovery, a TIME magazine editor, several professors, IITAP, SASH, Fight The New Drug, the academic journal Behavioral Sciences, and the head of the academic journal CUREUS. See – https://www.yourbrainonporn.com/nicole-prauses-pdf-her-span-lab-website
As stated in response to Prause’s previous DMCA attempt, my website is a clearing house for news related to claims about porn’s effects. It is my understanding, based on legal advice, that Tweets are not copyrightable, nor are images of them protected by the DMCA. With this request, Prause is attempting to remove evidence of her harassment, cyber-stalking and defamation. Unless the law itself changes, the screenshots need to remain.
This DMCA take-down request appears to be the latest in a long string of harassment incidents. Dr. Prause has tweeted about me nearly 100 times, while I never tweet about her (other than correcting a few of her lies). In fact, Prause attacked me yet again on twitter yesterday.
Prause has used dozens of fake usernames to post comments about me on porn recovery forums
Just prior to Prause‘s first DMCA takedown attempt, she placed my employment records from Southern Oregon University on several venues, including Twitter, Quora, and an adult industry website. Prause falsely claimed that I was fired (I wasn’t), and that I had never before taught at SOU (I had). All explained here:
The outcome was that Prause was permanently banned from Quora, was temporarily banned from Twitter. In response to my request, the adult industry website (http://mikesouth.com/scumbags/dr-nicole-prause-destroys-yourbrainonporn-dont-fall-22064/) subsequently deleted Prause’s libelous “article.” This incident apparently spurred Prause to attempt to her two specious DMCA takedown requests.
Again, I regret that she is wasting your time in this way.
Gary Wilson
In the end Wilson’s website host closed both cases, finding no merit in Prause’s DMCA take-down requests. Note: At the same time Prause was attempting her bogus DMCA takedowns, she also deleted hundreds of the tweets were she harassed, libeled, or bullied many individuals and organizations named on this page.
UPDATE: October, 2018 – Prause attempts a third DMCA takedown
On October 10th, 2018 an agent representing Nicole Prause filed a 3rd DMCA takedown request with my website host. The agent requested that several screenshots of Prause tweets be removed from this page. Below is Gary Wilson’s email to his web-host
The current complaint is by an agent for Nicole Prause and has been dealt with before. See this Linode ticket from 6 months ago: ————————————————–
Please re-visit that ticket. This is Dr. Prause’s third unfounded attempt to have evidence of her tweets removed from my website. After she wrote you the first time and failed to achieve her objective, she hired a company to make a request. Now, she has second company attempting a spurious DMCA takedown.
As explained in two previous Linode tickets, Nicole Prause has been harassing and defaming many people, including me, for the past 6 years. In response to Dr. Prause’s widespread harassment I have created the following page to catalog (and refute) her libelous statements and false assertions: https://www.yourbrainonporn.com/nicole-prauses-pdf-her-span-lab-website
The current ticket submitted by Dr. Prause, or her agent, is once again claiming that screenshots of her defamatory tweets are covered by the DMCA. As stated 6 months ago, it is my understanding, based on legal advice, that tweets are not copyrightable; nor are images of them protected by the DMCA. Dr. Prause’s behavior and biases, as documented by her tweets, are essential reading for anyone attempting to understand the politics currently skewing the study and reporting of internet porn’s effects. Thus, without solid reason for their removal, they need to remain on YBOP.
Sincerely,
Gary Wilson
In the end Wilson’s website host closed this 3rd case, finding no merit in the agent’s DMCA take-down requests.
Political language … is designed to make lies sound truthful and murder respectable, and to give an appearance of solidity to pure wind. ~George Orwell
A true academic will be willing to engage in discussion without defaulting to ad hominem insults or ascribing negative intentions to the other side.~ Dr. Debra Soh
Others – April 11, 2018: Prause falsely claims medical journal Cureus is a predatory journal and engages in fraud
Nicole Prause attacked Cureus on Twitter over a paper that it had merely corrected (slightly). Prause claimed that Cureus is a predatory journal which engages in fraud. Both claims are false as predatory journals always charge for publication and are not PubMed indexed. Cureus does not charge authors for publishing, and it is PubMed indexed. Prause, as expected, provided no examples of Cureus engaging in fraud.
Next, John Adler, MD stepped in to refute Prause’s claims. She then falsely accused him of violating a non-existent no-contact order, blocked him on Twitter, and phoned in a spurious complaint of harassment to the Stanford’s Dean’s Office.
John Adler’s final response, before being blocked by Prause:
As Adler pointed out, Prause was given a chance to publish a comment in his Journal but chose instead harass him and his journal on social media and with emails to Stanford University.
May 20, 2018: Ley & Prause falsely claim that Gary Wilson & Don Hilton gave evidence in a case by Chris Sevier
As they often do, Ley and Prause team up to defame and harass those they disagree with. This time they play twitter tag in a pre-planned attack on Gary Wilson, Don Hilton, and Mary Ann Layden. We know it was a pre-planned event as the “evidence” they both tweeted was in a concurrent email with other untruths about Wilson sent from Prause to MDPI (Ley was cc’d on the email).
In Ley’s first tweet he sets things up for Prause by falsely stating that Chris Sevier was the “creator of porn is public health crisis legislation.” In reality, Utah was the first state to pass a resolution about porn and Sevier had nothing to do with it. Ley’s so-called proof is screenshot from this incredibly long page containing four years of court filings full of allegations in the case, Sevier v. Apple inc.
Anyhow, Ley’s chosen excerpt, from 4 years of Sevier’s unhinged rantings in court filings, surrounds Sevier’s belief that “all Gay people are sex addicts”:
Why did David Ley choose this random excerpt about gays from Sevier’s January, 2014 court filing? So he and Prause could falsely assert that Wilson, Hilton, and Layden are anti-gay crazies.
Before we go any further, it must be mentioned that Chris Sevier seems to be universally believed by all who experience a brush with him to be a mentally unstable attention-seeker who chronically lies and harasses individuals and organizations associated with the so-called “anti-pornography movement.” Incidentally, “crazy” supporters are a time-honored strategy for tarnishing and impeding a cause.
Regardless of who his true masters may be, Sevier “makes shit up.” It has grown so bad that organizations (those genuinely behind the “porn as a public health crisis” movement) have been forced to take legal action against Chris Sevier. For example, the National Center on Sexual Exploitation (NCOSE) sent Sevier a cease and desist letter and published a statement denouncing Sevier’s actions. An excerpt:
The second matter relates to the author of the HTPA. The bill (sans resolution language) was developed by Chris Sevier, also known as Chris Severe. We have had a difficult relationship with Mr. Sevier over the last several years, to say the least. We have not found him trustworthy in our past dealings and therefore cannot rely on his assertions that those groups and those legislators that he claims are supporters of HTPA are actually in support. That is because, in the past, Sevier has falsely represented that our organization and NCOSE President Patrick Trueman and NCOSE Executive Director Dawn Hawkins are in support of his work. We have demanded that Sevier stop using our names.
In 2015, the office of a United States Senator alerted us to the fact that Sevier was promoting a version of the HTPA at the U. S. Capitol and was representing to U. S. Senate offices that Patrick Trueman was an author of the bill. This was false. A key legal assistant with that senator’s office also said that Sevier was visiting other senate offices claiming that his boss, the senator, was supporting the legislation, which was also false.
Several organizations have contacted us over the past couple years to complain that Sevier was also using their names without authorization and some of those organizations have complained that he was threatening them with legal sanctions when they refused to support him and his work. Several organizations have contacted us over the past couple years to complain that Sevier was also using their names without authorization and some of those organizations have complained that he was threatening them with legal sanctions when they refused to support him and his work.
In 2014, our general counsel had to write a cease and desist letter to Sevier demanding that he cease threatening our organization on various matters and reminding him that as a lawyer he is bound be definitive rules of professional responsibility.
In 2016 Sevier sued the state of Utah following the passage of the above-mentioned resolution developed by our office which declares pornography to be a public health crisis. The lawsuit was ostensibly over the issue of filters (a copy of the complaint is here). It included an extended footnote, part of which we are including here, which attacks NCOSE’s President Patrick Trueman and Executive Director Dawn Hawkins in bizarre terms…..
Very important set of facts: Don Hilton and Mary Ann Layden are on the board of directors of NCOSE and both regularly present at NCOSE conventions and NCOSE-related gatherings. How likely is it that they would be furthering Sevier’s “cause” by contradicting the position taken by NCOSE against Sevier?
With Ley’s set-up, Prause next tweets that Sevier claimed Gary Wilson and “these experts” were ready to testify:
No way! Hilton, Layden and Wilson never agreed to testify for Sevier, and certainly never agreed to testify that “all gay people are sex addicts.” It’s true that “Severe” emailed Gary Wilson in 2014. In Wilson’s response he suggested Severe visit his website for information. Wilson never agreed to testify, and did not respond to further emails from Severe. Don Hilton was asked if he had ever communicated with Sevier/Severe. He said he had not. Put simply, Sevier, and the Prause-Ley tag team, are lying.
With nothing but lies to back him up, Ley caps off the tag-team twitter like this:
Both Prause and Ley are obsessed cyberstalkers, with 300 tweets or more about Gary Wilson alone. Their assertions here are reprehensible and disgusting, yet fully in character.
May 24-27, 2018: Prause creates multiple sock-puppets to edit the MDPI Wikipedia page (and is banned for sock-puppetry & defamation)
In an earlier section we recounted Prause’s harassment of MDPI and its journal Behavioral Sciences. We also chronicled Prause’s long history of employing multiple fake usernames on Wikipedia (which violates its rules) to harass many of the individuals or organizations listed on this page. For example:
Prause’s latest Wikipedia barrage occurred from May 24th to the 27th and involved at least 6 fake usernames (called “sock-puppets” in Wikipedia jargon). The following links take you to all the edits by these particular usernames (“user contributions”):
The first four usernames edited the MDPI Wikipedia page, while 3 of the 6 edited the Nofap Wikipedia page, the Sex Addiction page and the Pornography Addiction page. All 3 pages are obsessions of Prause. Even Wikipedia recognized the usernames as belonging to the same person because all the names were banned for “sock-puppetry.” We can be sure it was Prause editing the MDPI page because:
1) The most recent batch of emails between MDPI and Nicole Prause started on May 22, with MDPI notifying all involved that one minor technical correction and an editorial would be forthcoming. This enraged Prause who responded with a string of demands and threats, followed by false accusations and personal attacks.
Welcome to Wikipedia. Although everyone is welcome to contribute constructively to the encyclopedia, your addition of one or more external links to the page Nicole Prause has been reverted.
I have images that verify each of the claims (e.g., email from the publisher, email from the listed editor, etc.). RetractionWatch and other outlets are considering writing reviews of it as well, but I cannot be sure those will materialize. How is best to provide such evidence that verifies the claims? As embedded image? Written elsewhere with images and linked?
Note: In her concurrent emails to MDPI, Prause cc’d RetractionWatch, apparently to threaten MDPI with public retaliation. Another “NeuroSex” edit (lies) related to Gary Wilson and to Park et al., 2016:
In 2016, another MDPI journal, Behavioral Sciences, published a review paper claiming pornography caused erectile dysfunction. Six scientists independently contacted MDPI concerned about fraud and other issues in the article, initiating an independent review by the Committee on Publication Ethics (COPE). COPE recommended retracting the article.[31] The listed paper editor, Scott Lane, denied having served as the editor. Thus, the paper appears not to have undergone peer-review. Further, two authors had undisclosed conflicts of interest. Gary Wilson’s association with The Reward Foundation did not properly identify it as an activist, anti-pornography organization. Wilson also had posted extensively in social media that the study was “by the US Navy”, although the original paper stated that it did not reflect the views of the US Navy. The other author, Dr. Andrew Doan, was an ophthalmologist who ran an anti-pornography ministry Real Battlefield Ministries, soliciting donations for their speaking.[32] Further, the Committee on Publication Ethics determined that the cases were not properly, ethically consented for inclusion. MDPI issued a correction for some of these issues,[33] but has refused to post corrections for others to date as described by Retraction Watch.[31]
Several of the above lies debunked:
There were not 6 scientists – only Prause contacted MDPI.
My association with The Reward Foundation was fully disclosed from the beginning. As explained earlier, my affiliation with The Reward Foundation (TRF) was always clearly stated, both in the initial Behavioral Sciences article and in the recent correction (the original PubMed version). The purpose of the newly published correction was to counter Dr. Prause’s incessant defamatory claims that I receive money from TRF, and that I make money from my book (my proceeds for which, in fact, go to the charity)
I posted that the paper involved 7 US Navy doctors. The Navy had no problems with my comments.
Dr. Andrew Doan is both an MD and a PhD (Neuroscience – Johns Hopkins), is the former of Head of “Addictions and Resilience Research” in the Department of Mental Health at the Naval Medical Center. (He has since been transferred and promoted, and has different responsibilities.) Doan has authored multiple papers on behavioral addiction/pathologies relating to technologies (in some cases with a co-author of the paper you have written about here). In short, he is a qualified senior author. Those other papers can be found here: https://www.ncbi.nlm.nih.gov/pubmed/?term=doan+klam. His non-profit, Real Battlefield Ministries (RBM), did not discuss pornography prior to publication of the paper. Even if RBM had presented on pornography it would not have been a conflict of interest.
As described above, COPE’s decision was hypothetical and did not apply to our paper as the US Navy doctors more than complied with their Naval Medical Center – San Diego’s IRB consent rules. The Naval Medical Center San Diego’s IRB policy does not consider case reports of less than four patients in a single article to be human subject research and does not require the patients to consent to inclusion in an article. Although the researchers were not required to obtain consent, for two cases, verbal and written consents were obtained. In the third case where anonymity was unlikely to be compromised, no written consent was obtained. Incidentally, at Dr. Prause’s insistence, after the paper was published, the actions of the Navy co-authors with respect to this paper were thoroughly reviewed in an independent Navy investigation. Result? I have a copy of the official report by a Navy lawyer affirming that the co-authors complied with all the IRB’s rules.
——————————————
NeuroSex edit #2: In 2015, the MDPI journal ”[[Behavioral Sciences (journal)|Behavioral Sciences ]]” published a paper ”Is Internet Pornography Causing Sexual Dysfunctions? A Review with Clinical Reports”. It was widely promoted during political attempts in the USA to define pornography as a public health hazard. However, it was soon discovered that many fraudulent statements appeared in the paper, often claiming the opposite of what a cited study had described
Gary Wilson comment:
To begin with, NeuroSex (Prause) got the publication date wrong: our paper was published in August, 2016, not in 2015. Second, our paper was not widely promoted. Third, no fraudulent statements were made and we cited all references correctly. A bit of background is in order.
Pre-MDPI history
The story of Prause’s efforts relating to the paper that was ultimately published as Park et a l., 2016 actually begins before the involvement of MDPI and Behavioral Sciences. An earlier, much shorter version of the paper, with the same authors and author affiliations as it had when later submitted to Behavioral Sciences, was first submitted to Yale Journal of Biology and Medicine (YJBM). It’s worth reviewing certain conduct in connection with this paper when it was under consideration by YJBM.
One of the 2 reviewers of the paper gave it a scathing review with 70+ criticisms, and it was duly rejected. Around the time that YJBM rejected the paper, a “Janey Wilson” began harassing my book publisher, Commonwealth Publishing, and the registered charity to which I donate all of my share of my book’s proceeds (recounted in this section). I am the author of Internet Pornography and the Emerging Science of Addiction.
Note: The submission to YJBM was the only place my affiliation with the charity, The Reward Foundation (TRF), could be found, as it was nowhere public. In other words, apart from the Board of TRF and myself, only the YJBM editor and its two reviewers knew about this affiliation. And yet, “Janey” claimed to have evidence of this affiliation, and used my affiliation to fabricate various allegations of wrongdoing by TRF and me.
Later, Dr. Prause submitted her scathing YJBM review with 70+ criticisms to a regulatory board (as part of an effort to have the published paper retracted), thus confirming she had indeed provided the YJBM with an unfavorable review of the paper. (Further evidence that she was a YJBM reviewer turned up during the Behavioral Sciences submission process, as recounted below.) Incidentally, Prause’s actions are a clear violation of COPE’s rules for peer reviewers (Section 5 of the “Guidelines on Good Publication Practice”), which require reviewers to keep confidential anything they learn through the review process.
YJBM was informed of (1) the harassing behavior engaged in by “Janey,” (2) “Janey’s” possible true identity, and (3) the fact that “Janey” may have violated COPE’s rules for peer reviewers by making public confidential information about me.
The paper was promptly accepted by YJBM…and then not published in that journal after all, due to the journal’s decision that it was too late to make the requested revisions and still meet the print deadline for YJBM’s special “Addiction” issue.
Behavioral Sciences
A revised and updated version of the paper was then submitted to the journal Behavioral Sciences. After a few rounds of reviews and further restructuring it was accepted as a review of the literature, with case studies. Its final form was quite different from the original YJBM submission.
During this process, the paper was reviewed by no fewer than 6 reviewers. Five passed it, some with some suggested revisions, and one harshly rejected it (It was Prause again, as she later revealed).
Phase one of this process unfolded as follows: The paper was reviewed twice, one of them a harsh rejection, one favorable. Puzzled by the harsh rejection, Behavioral Sciences sent the paper out for review to 2 other reviewers. These reviewers passed the paper. Behavioral Sciences cautiously rejected the paper but allowed the authors to “revise and resubmit.” As part of this process, the authors were given all of the comments by the reviewers (but not their identities). The reviewers’ concerns were thoroughly addressed, point by point (available upon request).
From these comments, it became evident that the “harsh reviewer” of the Behavioral Sciences paper had also reviewed the paper at YJBM.About a third of the 77 points raised did not relate to the Behavioral Sciences submission at all.They referred to material that was only present in the earlier version of the paper, the one that had been submitted to YJBM.
In other words, the harsh reviewer had cut and pasted dozens of criticisms from a review done of an earlier iteration of the paper at another journal (YJBM), which no longer had any relevance to the paper submitted to Behavioral Sciences! This is highly unprofessional. Moreover, Prause eventually revealed herself as the author of these criticisms in her complaint to the medical boards (see above), in which she shared her YJBM review of the obsolete version of the paper. (Apparently, she never realized the YJBM paper had been accepted by YJBM once her review was disqualified.)
Incidentally, when Prause was asked to review the paper at Behavioral Sciences she apparently did not reveal that she had already reviewed the paper at another journal. It would have been standard reviewer etiquette to reveal her earlier review effort.
Let me summarize Prause’s multiple objections to our paper. Again, 25 or so of them had nothing whatsoever to do with the Behavioral Sciences paper Prause had been asked by Behavioral Sciences to review. These items referred to its first submission at YJBM. This alone should disqualify the entire review from further consideration.
Yet, we carefully combed through each comment looking for any useful insights, and wrote a comprehensive response to all 77 comments for Behavioral Sciences and its editors. Almost all of the remaining 50 critical comments were either scientifically inaccurate, groundless, or were simply false statements. Some were repetitive. In short, while reviewers’ comments always improve any paper to some degree, there really wasn’t the need to “fix” much of the paper itself in light of Prause’s comments. What we did do was strengthen the paper itself with 50 more citations, lest other readers make any of the same errors she had.
The paper was rewritten and revised. Next, two more reviewers reviewed and passed it with various suggestions, including a suggestion to restructure it as a “review with case studies.” Satisfied that all legitimate concerns had been addressed, Behavioral Sciences published the paper.
Immediately after publication in August, 2016 Prause insisted that MDPI retract Park et al., 2016. The professional response to scholarly articles one disapproves of is to publish a comment outlining any objections. Behavioral Sciences’s parent company, MDPI, invited Prause to do this. She declined. That’s right, Prause was given full opportunity to critique the paper in Behavioral Sciences – and she ran the other way.
Instead she unprofessionally turned to threats and social media (and most recently the Retraction Watch blog) to bully MDPI into retracting Park et al. In addition, she informed MDPI that she had filed complaints with the American Psychological Association and the doctors’ medical boards. She also pressured the doctors’ medical center and Institutional Review Board, causing a lengthy, thorough investigation, which found no evidence of wrongdoing on the part of the paper’s authors.
Prause concurrently complained repeatedly to COPE (Committee on Publication Ethics). COPE finally wrote MDPI with a hypothetical observation relating to (Prause’s narrative about) consents obtained for the case studies in the paper, and a question about retraction. MDPI thoroughly re-investigated the consents obtained by the doctors who authored the papers, as well as US Navy policy around obtaining consents. Written consents had been obtained for the two extensive case studies, and the third case study involved so little identifying information that a written consent was deemed unnecessary. On this basis, MDPI declined to retract the paper.
May, 2018: Prause lies about Gary Wilson in emails to MDPI, David Ley, Neuro Skeptic, Adam Marcus of Retraction Watch, and COPE
In the May, 2018 email exchanges with MDPI & COPE, Prause copied bloggers who are positioned to damage the reputations of MDPI in the media, if they choose. Ley blogs on Psychology Today and has often served as the Mouth of Prause. Neuro Skeptic has a popular blog that disparages legitimate (and sometimes dubious) research. Adam Marcus writes for Retraction Watch. Prause also copied Iratxe Puebla, who works for COPE, an organization that addresses publication ethics. Already, Adam Marcus of Retraction Watch has taken the bait without adequate investigation.
In her defamatory articles, tweets, and Quora posts Prause has knowingly and falsely stated that I (Gary Wilson) claimed to be “professor in biology” “doctor” or a “neuroscientist.” I was an Adjunct Instructor at Southern Oregon University and taught human anatomy, physiology & pathology at other venues. Although careless journalists and websites have assigned me an array of titles in error over the years (including a now-defunct page on a website that pirates many TEDx talks and describes the speakers carelessly without contacting them) I have always stated that I taught anatomy & physiology. I have never said I had a PhD or was a professor. Prause told the same lie to the email recipients:
PRAUSE EMAIL #1 (5-1-2018)
On Tue, May 1, 2018 at 10:11 PM, Nicole Prause >
Additionally, Mr. Wilson is now using this publication to claim to be a doctor online to unsuspecting patients (attached).
Below is the screenshot Prause uses to “prove” that I have misrepresented my credentials (again, this Gary Wilson page no longer exists). Note: Until Prause produced her “proof,” I had never seen this site and had never communicated with its hosts, never uploaded the page in question and never removed it. Thus I certainly never provided a bio, or claims of “professorship.”
I taught at Southern Oregon University on two occasions. I also taught anatomy, physiology and pathology at a number of other schools over a period of two decades, and was certified to teach these subjects by the education departments of both Oregon and California. I do not seek speaking engagements and have never accepted fees for speaking. Moreover, YBOP accepts no ads, and the proceeds from my book go to a registered charity.
On the “about” page the Keynotes.org website said that it is not an agency and that anyone could upload a video and speaker bio: Keynotes.org is not an agency, but rather, a media site…. Keynotes.org is crowdsourced and fueled by TrendHunter.com, the world’s largest trend spotting website. Again, I’ve never uploaded anything to the site, and I have no idea who uploaded this page (or ordered it removed).
The above screen-shot was part of a larger article by Prause where she falsely claimed that I was fired from Southern Oregon University: March, 2018 – Libelous Claim that Gary Wilson Was Fired. In her article, which was posted on a pornography-related site and Quora, Prause published redacted versions of my Southern Oregon University employment records, falsely stating I was fired and had never before taught at SOU. As with her claims surrounding The Reward Foundation, Prause lied about the true content of what’s in the redacted documents. By the way, David Ley also tweeted the Prause article several times, saying I was fired from SOU (screenshots on the page).
In an email to MDPI, COPE, Ley, Neuroskeptic, Adam Marcus of Retraction Watch and others Prause falsely claimed that I had received money from The Reward Foundation.
It appears Wilson did receive money from The Reward Foundation. Attached is The Reward Foundation Annual Report. Per item C6 referring to travel that describes Gary Wilson’s travel totaling 9,027 pounds.
I request that any correction include this financial COI, or time be allotted to properly demonstrate that this was not a financial conflict of interest.
Nicole Prause, Ph.D. Liberos
Prause is lying. I have never received any money from The Reward Foundation. I forwarded Prause’s claim to Darryl Mead, Chair of The Reward Foundation, who debunked Prause’s claims here. As thoroughly explained in that section Gary Wilson donates the proceeds of his book to The Reward Foundation. Wilson accepts no money, and has never received a dime for any of his efforts. YBOP accepts no ads and Wilson has accepted no fees for speaking.
Well, it’s 2019 and Prause is finally being for defamation. In a sworn affidavit filed in Federal Court, Gary Wilson stated (under penalty of perjury) that (1) Nicole Prause used a false identity (Janey Wilson) to defame and harass Wilson, his publisher, and The Reward Foundation, (2) that Prause lied in emails, on Wikipedia and in public comments when stating that Gary Wilson received financial compensation from The Reward Foundation.
In many of her emails to MDPI (and others), Prause mentioned her “77 criticisms” and falsely claimed that they had not been addressed. This was just the latest:
On Tue, May 22, 2018 at 9:36 AM, Nicole Prause>
I provided a 77 point critique prior to publication that was, true to the predatory journal lists MDPI appeared on, was ignored.
This means Prause was one of two reviewers of the Yale Journal of Biology and Medicine submission – and thus “Janey Wilson.” As explained, many of the 77 so-called problems were carelessly copied and pasted from Prause’s review of the YJBM submission; 25 of them had nothing to do with the Behavioral Sciences submission. In other words, the only reviewer to condemn the paper had cut and pasted dozens of criticisms from a review done at another journal (YJBM), which no longer had any relevance to the paper submitted to Behavioral Sciences. This is highly unprofessional.
Even apart from that glaring irregularity, few of the 77 problems could be considered legitimate. Yet, we carefully combed through each comment mining for useful insights, and wrote a comprehensive response to all comments for Behavioral Sciences and its editors. Almost all of the remaining 50 critical comments were either scientifically inaccurate, groundless, or were simply false statements. Some were repetitive. The authors provided MDPI with a point by point response to each so-called problem.
May, June 2018: In emails to Retraction Watch, in the ICD-11 comments section, and on Wikipedia, Prause and her sockpuppets falsely claim that Wilson received 9,000 pounds from The Reward Foundation
Starting in May, 2018 Prause added a new wrinkle to her claims, namely that, “The Reward Foundation (RF) paid Wilson 9,027 pounds.” This is completely false, even though there’s absolutely nothing wrong with Wilson being paid by anyone for anything. The crazy part is that Wilson donates the proceeds from his book to the RF. In other words, Prause is claiming that Wilson gives money to the RF so they can give it back to him at a later date. Why Wilson would choose to play trans-Atlantic ping pong with his money in this way, Prause has yet to explain. Bottom line: Prause is lying.
This all started with Prause’s email to journal publisher MDPI, COPE, David Ley, Neuroskeptic, Adam Marcus & Ivan Oransky of Retraction Watch (and others) that, based on the charity’s recent public filing (with a name redacted, as is standard), expense reimbursements paid to a charity officer were in fact paid to Wilson. Prause, wrongfully assumed (and publicized) that Wilson’s name was behind the redaction when it wasn’t!
It appears Wilson did receive money from The Reward Foundation. Attached is The Reward Foundation Annual Report. Per item C6 referring to travel that describes Gary Wilson’s travel totaling 9,027 pounds.
I request that any correction include this financial COI, or time be allotted to properly demonstrate that this was not a financial conflict of interest.
Nicole Prause, Ph.D. Liberos
Two days later, one of Prause’s seven wikipedia sockpuppets attempted the following edit on MDPI Wikipedia page, assigning Wilson a fabricated, defamatory reason for receiving the money (that he had never, in fact, received):
NeuroSex linked to a redacted document, claiming that Gary Wilson was paid 9,000 pounds by Scotish charity The Reward Foundation. Two days earlier Prause falsely claimed to journal publisher MDPI (and others) that, based on the charity’s recent public filing (with a name redacted, as is standard), expense reimbursements paid to a charity officer were in fact paid to Wilson. Prause has not checked her facts, and she is mistaken (again). Wilson has never received any money from The Reward Foundation. Gary Wilson forwarded Prause’s claim to Darryl Mead, Chair of The Reward Foundation. His response is above:
From: Foundation Reward <[email protected]> Sent: Thursday, May 24, 2018 8:17 AM
To: gary wilson
Subject: Re: Concerns raised to the attention of COPE by Nicole Prause. Manuscript ID behavsci-133116
Dear Gary:
I have looked into this. Prause said:
On 22/05/2018 20:48, Nicole Prause wrote: It appears Wilson did receive money from The Reward Foundation. Attached is The Reward Foundation Annual Report. Per item C6 referring to travel that describes Gary Wilson’s travel totaling 9,027 pounds.
I request that any correction include this financial COI, or time be allotted to properly demonstrate that this was not a financial conflict of interest.
This is a reference to our 2016-17 Annual Accounts. A version of the accounts with identity redaction was published by the Office of the Scottish Charity Regulator and can be downloaded at https://www.oscr.org.uk/search/charity-details?number=SC044948#results, copy attached. This redaction process is done by OSCR without input from the named charity.
The relevant section with redaction reads as per this screen shot.
The individual referred to in C6 is Darryl Mead, the Chair of the Reward Foundation. I am that person and I made the claim for reimbursement of travel and other costs.
The original document reads as follows:
There is no reference to Gary Wilson in any part of the expenditure for the Reward Foundation because there were no payments to him.
With best wishes,
Darryl
In summary, Prause falsely accused Wilson of receiving funds from The Reward Foundation for a fabricated purpose. She then publicized this falsehood to MDPI, COPE, RetractionWatch, and others, using the redacted document she submitted. Then sockpuppet NeuroSex attempted to post these lies to Wikipedia, which failed.
Update, 6-7-2018:
For no reason in particular, Prause posted a comment on the ICD-11 about Gary Wilson. [Would be readers must create a username to view comments.] In this comment Prause repeats the above lies:
Prause not only repeated her original lie, she added several more of her usual lies about Wilson (all debunked on this very page). Prause also says that she has filed a second complaint against Staci Sprout with Washington. This part is true, as second harassing complaint was filed against Sprout and immediately dismissed.
In the 6 years since Prause’s cyber-aliases started claiming that Wilson was reported to the police, Prause has failed to provide any documentation of her purported police reports. As for the LAPD & UCLAPD, both have said that Prause never filed anything with their departments. In October, 2018 Gary Wilson filed a freedom of information request with the FBI and the FBI confirmed that Prause was lying: no report has ever been filed on Wilson. See – November, 2018: FBI affirms Nicole Prause’s fraud surrounding defamatory claims. Gary Wilson has been patiently waiting since July, 2013 (1) to discover what exactly he was reported for, (2) to be contacted by “the authorities.” Neither has occurred because Prause is lying.
Over the next few days Nicole Prause posted 3 more libelous comments on the ICD-11 attacking Gary Wilson and continuing to assert falsely that he is a paid employee of The Reward Foundation. Darryl Mead, the Chair of The Reward Foundation, eventually responded (see above).
Update:In a sworn affidavit filed in Federal Court, Gary Wilson stated (under penalty of perjury) that (1) Nicole Prause used a false identity (Janey Wilson) to defame and harass Wilson, his publisher, and The Reward Foundation, (2) that Prause lied in emails, on Wikipedia and in public comments when stating that Gary Wilson received financial compensation from The Reward Foundation.
Put simply, Nicole Prause is engaged in provable defamation (see you in the upcoming defamation lawsuits: 1, 2).
————————–
March 3, 2020: Cyberstalker RealYBOP has posted about 300 tweets about me. In this exmaple she lies about the Reward Foundation. Her defamatory tweet appears to be claiming that The Reward Foundation “paid” to have an article placed in The Sunday Times. That’s a lie. In reality, The Times paid TRF to write an article. TRF did not solicit The Times – The Times solicited TRF. I gues Nikky is mad because The Times isn’t interested in her opinions on porn.
In my 2 sworn affidavits filed in federal defamation suits I chronicle Prause libelous claims and ongoing cyberstalking of The Reward Foundation, my publisher, the Scottish Charity register, and MDPI:
Others – May 24-27, 2018: Prause creates multiple sock-puppets to edit the Nofap Wikipedia page
As described above, from May 24th to the 27th, 2018 Prause employed six fake usernames to edit the Wikipedia pages of her ongoing obsessions: MDPI, Nofap, Sexual Addiction, and Pornography Addiction. Even though Prause’s main target was MDPI, two of her sock-puppets took the time to attack Nofap, with edits and defamatory comments. As she has done in Twitter comments and in personal attacks on Alexander Rhodes, Prause called members of Nofap dangerous misogynists.
20:16, 25 May 2018 (diff | hist) . . (+367) . . NoFap (→Reception: Added peer-reviewed study about the verified dangers of NoFap)
20:14, 25 May 2018 (diff | hist) . . (-492) . . NoFap (→Reception: Removed a reference to an unpublished “study” only in a German newspaper and not published anywhere.)
03:28, 24 May 2018 (diff | hist) . . (+379) . . Pornography addiction (→Support groups: NoFap community has recently raised security concerns paralleling Incels and due to this paper discovering considerable misogynist attacks in NoFap. I suggest removal, but at least should warn people community is not safe.)
Another Prause edit involved deletion of a yet to be published paper by researcher Alec Sproten – How Abstinence Affects Preferences (2016). Sproten’s preliminary results, like a handful of other studies, reported significant benefits by participants who ceased using porn. Excerpts from Sproten’s article:
Results of the First Wave – Main Findings
The length of the longest streak participants performed before taking part in the survey correlates with time preferences. The second survey will answer the question if longer periods of abstinence render participants more able to delay rewards, or if more patient participants are more likely to perform longer streaks.
Longer periods of abstinence most likely cause less risk aversion (which is good). The second survey will provide the final proof.
Personality correlates with length of streaks. The second wave will reveal if abstinence influences personality or if personality can explain variation in the length of streaks.
Results of the Second Wave – Main Findings
Abstaining from pornography and masturbation increases the ability to delay rewards
Participating in a period of abstinence renders people more willing to take risks
Abstinence renders people more altruistic
Abstinence renders people more extroverted, more conscientious, and less neurotic
Unfortunately, Prause’s deletion of the Sproten study has not yet been reversed, and the Kris Taylor paper remains. More evidence that Wikipedia editors game the system, and sockpuppets rule.
Others – May 24-27, 2018: Prause creates multiple sock-puppets to edit “Sex Addiction” & “Porn Addiction” Wikipedia pages
The previous two sections chronicle Prause’s Wikipedia-based attacks on two of her favorite targets: MDPI and Nofap. In Prause’s recent 4-day Wikipedia blitz three of her sockpuppets edited two other objects of her disdain: the Wikipedia pages on “Sexual Addiction” and “Pornography Addiction” (which her numerous sockpuppets had previously edited over the years). In her many edits Prause attacks familiar targets such as Dr. Todd Love, Fight The New Drug, therapist Staci Sprout, Dr. Patrick Carnes, CEO of MDPI, the American Society for Addiction Medicine, and a protein – DeltaFosB.
Here we present selected edits and remarks from three sockpuppets, followed by our comments:
Comment: Once again, Prause is attacking therapist Staci Sprout, who Prause harassed and defamed in a groundless complaint filed with Washington State Dept. of Health. The State of Washington dismissed the empty complaint (without an investigation) and closed the case. Prause has also attacked Staci Sprout on Twitter and on the ICD-11 comment page for “Compulsive sexual behaviour disorder.”
02:16, 25 May 2018 (diff | hist) . . (-172) . . Sexual addiction (→Controversy: info-graphic was created by Mormon group Fight The New Drug, an anti-pornography organization. Not neutral and does not accurately reflect history, such as including individuals with no field influence
02:20, 25 May 2018 (diff | hist) . . (-3,460) . . Sexual addiction (→Mechanisms: Large section about FOSB made no mention of link to sex and had about 7 broken links (numbers clearly pasted from some other source, not properly attributed))
02:01, 25 May 2018 (diff | hist) . . (-356) . . m Sexual addiction (→Mechanisms: Lead claim of “wide acceptance” as addiction in humans linking to only animal studies is more activism on this entry. False
Comment: The above two edits and comments involve DeltaFosB, which Prause sockpuppets have been complaining about for over 3 years now (see 2 of Prause’s earlier posting about DeltaFosB: “PatriotsAllTheWay” & “NotGaryWilson”). This is nothing new as Prause and David Ley’s 2014 opinion piece on porn addiction railed against DeltaFosB – with the foremost DeltaFosB researcher saying that Ley & Prause’s commentary sounded like a “bad Saturday Night Live parody.”
03:16, 24 May 2018 (diff | hist) . . (-1,180) . . Pornography addiction (→Diagnostic status: Todd Love is described as an “addiction researcher”. He has zero research training and no data publications. He represents another false appeal to authority to create a false narrative. The reference describing him falsely as a scientist is removed.) (Tag: references removed)
03:11, 24 May 2018 (diff | hist) . . (+106) . . Pornography addiction (→Symptoms and diagnosis: ASAM is a fringe group that also advocates “tanning” addiction. Requires recognition that, just below, no other org shares ASAM view)
Comment: Here Prause’s sockpuppets told 2 (more) bare-faced lies. First, the American Society for Addiction Medicine is hardly a fringe group as its members include 3,000 medical doctors who specialize in addiction treatment. ASAM has been around longer than the DSM. Second, ASAM never stated that “tanning addiction” exists. Just another lie. What angers Prause is that America’s top addiction experts at ASAM released their sweeping new definition of addiction in 2011. ASAM’s definition of addiction explicitly stated that sexual behavior addictions exist and must be caused by the same fundamental brain changes found in substance addictions. From the ASAM FAQs:
QUESTION: This new definition of addiction refers to addiction involving gambling, food, and sexual behaviors. Does ASAM really believe that food and sex are addicting?
ANSWER: The new ASAM definition makes a departure from equating addiction with just substance dependence, by describing how addiction is also related to behaviors that are rewarding. … This definition says that addiction is about functioning and brain circuitry and how the structure and function of the brains of persons with addiction differ from the structure and function of the brains of persons who do not have addiction. …Food and sexual behaviors and gambling behaviors can be associated with the ‘pathological pursuit of rewards’ described in this new definition of addiction.
Update: On June 5th yet another Prause sockpuppet appeared and attempted to edit the Sexual Addiction Wikipedia page – User contributions: 71.196.154.4
The sockpuppet’s comments on the Sexual Addiction Talk Page perfectly mirror Prause’s usual baseless drivel about “sex addiction” being rejected, and that sex/porn addiction can be explained away by either high libido or shame:
Add first line to “is a proposed model” or “is an hypothesized model”. “Addiction” is a scientific model that has not been agreed on by any scientific body, so presenting “sex addiction” as “a state” misrepresents the state of the science, which largely has rejected this model (relative to, for example, impulsivity model, high drive model, social shame model, etc.). 71.196.154.4 (talk) 15:33, 5 June 2018 (UTC)
A Wikipedia editor asks Prause for reputable sources to support her claims:
Please provide a WP:VERIFIABLE source to support your claim.–DBigXray 19:16, 6 June 2018 (UTC)
Update: On September 3rd yet another Prause sockpuppet edited the Sexual Addiction Wikipedia page – User Contributions: HighFlyer1976. The only edit by the sockpuppet:
Calling it “fake news” HighFlyer1976 deleted an edit that sated that the ICD-11 had overtaken the ICD-10. Prause often mimics Donald Trump’s behavior and verbiage.
———-
Update: On November 26th yet another Prause sockpuppet edited the Sexual Addiction Wikipedia page – User Contributions: TestAccount2018abc. The only 2 edits by the sockpuppet:
In addition, TestAccount2018abc posts on the Sexual Addiction Talk Page, once again raging againts the new ICD-11 diagnosis of “Compulsive Sexual Behavior Disorder”. The Prause sockpuppet argues with regular editor Tgeorgescu (who is actually quite anti porn and sex addiction – but not extreme enough for Nikky): https://en.wikipedia.org/wiki/Talk:Sexual_addiction
Semi-protected edit request on 26 November 2018
Information about the ICD-11 draft was added, but did not include that (1) The ICD cannot be accepted as a diagnosis anywhere yet, and the earliest in the USA is 2022 and (2) the World Health Organization specifically stated that they did not find evidence that sex was addictive. Given that this article is “sex addiction”, that must be included for this to be accurate, otherwise it is misleading to people who do not know the differences between a compulsion and an addiction (there are many). “But the UN health body stops short of lumping the condition together with addictive behaviours like substance abuse or gambling, insisting more research is needed before describing the disorder as an addiction.” Dr. Geoffrey Reed, WHO [1]TestAccount2018abc (talk) 20:44, 26 November 2018 (UTC)
Sexual addiction is an umbrella concept, which people use in different meanings. The point you’re making is explained under Sexual addiction#ICD. Tgeorgescu (talk) 21:16, 26 November 2018 (UTC)
Addiction is not an “umbrella” concept. The article quote shows the head of the World Health Organization disagreeing with you too. Here neuroscientists describe the differences neurologically (https://onlinelibrary.wiley.com/doi/abs/10.1111/add.13297) and here by symptom (https://link.springer.com/article/10.1007/s10508-017-0991-8). You are an anti-sex activist who should not be editing this page, there is literally no science supporting your claim. Addiction and compulsivity are different models, and sex addiction appears nowhere in the ICD-11 intentionally, by WHO’s own statement. — Preceding unsigned comment added by TestAccount2018abc(talk • contribs) 23:50, 26 November 2018 (UTC)</small
Cool down buddy, I’m not an anti-sex activist, through my edits I have decidedly opposed sexual pseudoscience, but I am also prepared to give the other side the benefit of the doubt when the matters aren’t settled yet. You have read too few of what I wrote inside Wikipedia and you’re jumping to conclusions. If that’s the way to treat your allies I wonder how you treat your enemies. So, yeah, I know that compulsion is different from addiction. However, this article is not only about sexual addiction, but about a lot of stuff. Instead of having ten different articles with roughly the same content, we have one article which covers them all. This is not hard to get from reading it. Tgeorgescu (talk) 17:01, 28 November 2018 (UTC)
This impression was based on a review of your bio, which has extensive commentary about your biblical beliefs, not your scientific background in this area. So the critique of the article and the likely source of the bias seems fair. The article already states in one place exactly what I suggest, your addition reverts back to mischaracterize again. I did not request a separate entry at any time, only that this entry be scientifically accurate. With your last addition, it is no longer scientifically accurate by my, or the World Health Organization’s, estimation. — Preceding unsigned comment added by 209.194.90.6 (talk)17:12, 28 November 2018 (UTC)
First, Wikipedia does not require editors to be experts/scientists, that’s a thing for Citizendium. Wikipedia requires editors to WP:CITEWP:SOURCES, that’s all: you have sources, you have everything, don’t have sources, don’t have anything. Second, editing Wikipedia is a cooperative enterprise. If I were the only one to write this article, I would write it differently, but since everybody can edit, I have to make allowance for their doubt. Third, the matter of sexual addiction vs. CSBD is not settled yet: ICD is not a diagnosis manual, it is a manual of codes, so that a French MD understands the diagnosis of a Mexican MD. There has been a discussion about adding TCM codes to ICD, but in fact WHO does not say that a specific code is a thing, so if TCM would be included in the ICD it would not mean that TCM got scientifically validated. Fourth, I have quoted a source (Ley), which says that ICD does not include sexual addiction, and I tried to briefly explain his point. Perhaps you might try to suggest a different wording, I’m all ears. Fifth, don’t cast aspersions based on insufficient data. More precisely, you did not bother to read my opinions, e.g. that in respect to mental health insurance money, DSM is king, not ICD, and since addictions got purged out of DSM there is unlikely to be a diagnosis of porn addiction (or sex addiction, for that matter). Tgeorgescu (talk) 21:10, 28 November 2018 (UTC)
Notice: in the above exchange a second Prause sockpuppet enters into the fray – “Preceding unsigned comment added by 209.194.90.6“. With so many puppets she can’t keep track of which sockpuppet is editing Wikipedia!
May 30, 2018: Prause falsely accuses Fight The New Drug (FTND) of science fraud, and implies that she has reported Gary to the FBI twice.
This screenhot of a rant by non-academic Prause is self-explanatory. For the record, Gary has never received notice of any of Prause’s fictitious FBI or police reports, or done anything to merit them, and FTND relies on an array of respected academic scientists and peer-reviewed research. (Addendum: Gary Wilson filed a freedom of information request with the FBI and the FBI confirmed that Prause was lying: no report has ever been filed on Wilson. See – November, 2018: FBI affirms Nicole Prause’s fraud surrounding defamatory claims)
Prause’s claim that “their neuroscience is simply false” is just more fiction from a practiced liar. Prause provides no examples of ‘false neuroscience,” while a reading of a FTND article such as “How Porn Can Become Addictive,” reveals peer-reviewed studies supporting every claim. Another example, found in the FTND FAQs (Is Porn Addiction Even A Real Thing?), contains links to about 200 supporting peer-reviewed papers.
Prause’s falsehoods concerning FTND are exposed in her Salt Lake Tribune Op-Ed attacking FTND. On the surface it appears legitimate as 7 PhD buddies of Prause signed off on it. However, upon closer examination we find that:
It provides no examples of misrepresentation by “Fight The New Drug”, or anyone else.
None of the claims are supported by citations.
The 8 neuroscientists cited zero neuroscience-based studies.
Some who signed the Op-Ed have histories of fervently attacking the concept of porn and sex addiction (thus demonstrating stark bias).
Most had collaborated with the lead author of the Op-Ed (Prause) or her colleague (Pfaus).
This 600-word Op-Ed is chock full of unsupported assertions meant to fool the lay public. It fails to support a single assertion as it cites only 4 papers – none of which have anything to do with porn addiction, porn’s effects on relationships, or porn-induced sexual problems.
I and several other experts in this field debunked its assertions and empty rhetoric in this relatively short response – Op-ed: Who exactly is misrepresenting the science on pornography? (2016). Unlike the “neuroscientists of the Op-Ed,” we cited several hundred studies and multiple reviews of the literature, including many of the following:
44 neuroscience-based studies (MRI, fMRI, EEG, neuropsychological, hormonal) providing strong support for the addiction model.
Realizing she’s been exposed, Prause searches SB’s twitter feed for anything she can use, settling for this bizarre personal attack. YBOP has been waiting over 3 years for Prause to name a single study that FTND or Gary Wilson has misrepresented. Still waiting.
The Demise of Guys?: Philip Zimbardo: Excellent TED talk on (as the title says) the “demise” of young men. Zimbardo speaks of excessive Internet use (porn and video games) as “arousal addiction.”
Publisher of Skeptic magazine, Michael Shermer, calls out an article about Zimbardo’s famous “Stanford Prison experiment” as a fraud. Prause trolls him, lying about Zimbardo “misrepresenting the science”:
Note – Prause has never provided a single example of Zimbardo misrepresenting science or research. She can’t, because he hasn’t. In fact, the concerns Zimbardo raised about the ill effects of problematic internet porn use and excessive internet gaming have both since been codified as disorders in the upcoming ICD-11, which is the diagnostic manual of the World Health Organization.
Unlike Prause, Zimbardo backed up his claims with citations. What’s missing from all the above tweets? A single example of a Zimbardo misrepresentation. Nada.
As chronicled here and elsewhere Dr. Prause has a long history of misrepresenting her own and others’ research. In addition, she chronically mischaracterizes the current state of porn research, while repeatedly tweeting a few cherry-picked (and often flawed) outlier studies. If you want to judge for yourself, this page contains links to hundreds of studies and several reviews of the literature: current state of the research on Internet porn addiction and porn’s effects.
—————————
September, 2019: RealYBOP twitter (run by Prause & Daniel Burgess), pins the following tweet to its profile:
October, 2019: David Ley and Prause/Daniel Burgess (RealYBOP twitter) are at it again. RealYBOP disparages Phil Zimbardo, yet again. As porn industry shills Ley, Prause & RealYBOP often disparage Zimbardo because he has exposed porn’s negative effects on young people.
Non-academics Ley & Prause are also jealous of Zimbardo’s fame, success and influence.
July 6, 2018: “Someone” reports Gary Wilson to the Oregon Psychology Board, which dismisses the complaint as unfounded
This malicious reporting effort appears to be part of a larger, concerning pattern of filing baseless regulatory complaints about actual therapists, as documented elsewhere on this page. Fortunately regulators are not easily taken in by such spiteful tactics.
October, 2018: Ley & Prause devise an article purporting to connect Gary Wilson, Alexander Rhodes, Gabe Deem to white supremacists/fascists (Prause attacks & libels Alexander Rhodes & Nofap in the comments section).
The term “fascist” when misused as it is here, is “hate speech.” The post implies that all of the people named in it are both “fascists” and anti-masturbation. While this may constitute clever public relations spin in light of the immediately preceding reprehensible attack on a temple in Pittsburgh, it is shocking that Ley apparently used the tragedy to promote his well known pro-porn agenda by attempting to tie “fascism” and “anti-masturbation” to a range of people who have addressed the risks of overuse of internet pornography and related concerns. Ley’s proposed associations bear no relation to the facts. For example, Wilson is the author of a book entitled Your Brain On Porn, and the host of this website with the same name. The focus of both is on the risks of internet porn overuse, not on masturbation. A few excerpts from Ley’s article targeting Gary Wilson (yourbrainonporn.com) and Gabe Deem (RebootNation):
Another excerpt where Ley tries to connect Gary Wilson to David Duke (so sickening):
Ironically, Ley has, when it suited him, claimed masturbation, not internet pornography, is the true cause of young men’s rising problems with sexual performance and sexual attraction to real partners. Thus, it is especially disingenuous for him to now claim that those who oppose his views are “anti-masturbation.” See this piece about the absurdity of the sexology claim that the cause of rising sexual dysfunctions in millennials is masturbation. See Sexologists Deny PIED by Claiming Masturbation Is the Problem.
Let’s start with Prause’s admission that she helped David Ley with his defamatory blog post.
The pattern for Psychology Today blog posts co-created by Prause & Ley is for Ley to open the comments section (which he often doesn’t) and for Prause (and her aliases) to police the comments, which usually entails Prause attacking detractors and mischaracterizing the state of the research.
We have reproduced Prause’s comments below. Where appropriate we included the comments of her targets. As you can see, Prause employs her usual mix of personal attacks, falsehoods, faux victim-hood and misrepresentations of studies:
Submitted by PornHelp Team on October 28, 2018 – 12:43pm
This is disgraceful. Of all of the weekends to publish a conspiracy theory equating wanting to quit porn to fascism and Antisemitism, this isn’t the one (really, there’s never a good time for this kind of half-baked nonsense, but especially not now).
Let’s be clear. People seek help with out-of-control porn use for lots and lots of different reasons. Many have no religious motivation at all, but rather look for help because of tangible impacts porn use is having on their lives. For others, religious belief (including, for some, the teachings of Judaism, fwiw) does play a role.
Implying porn skepticism amounts to a Nazi plot is not only morally abhorrent, it’s also demonstrably false. Dr. Ley should know better than to make such irresponsible claims.
Submitted by Nicole Prause on October 28, 2018 – 3:29pm
His timing is perfect. Hate speech results in hateful acts. NoFap has been promoting hate speech for years, including against specific women. There are scientific papers published about the misogyny in NoFap groups. Incel’s have murdered. I fully expect one of these murders will someday be from these anti-masturbation anti-porn groups. HLey is calling attention to their hate speech while they still have time to try to correct. It is past time to stop promoting hate speech on your platforms…or this is what one of your followers will do next. Stop promoting fascism, misogyny, and antisemitism.
Submitted by Nicole Prause on October 29, 2018 – 1:59pm
There is a peer-reviewed article on some of the misogyny in the NoFap community. Search: “‘I want that power back’: Discourses of masculinity within an online pornography abstinence forum”
This means it was reviewed by independent scientists confidentially. There is nothing wrong with choosing for yourself not to masturbate, but they spread intentionally fake news and are a for-profit. For example, I study the effects of porn on the brain and have some of the largest samples in this area in high-impact journals. If they mention my research at all, it’s usually stating we found the opposite of what we actually found. These are not trustworthy sources and are promoting discrimination against protected groups.
Submitted by Nicole Prause on October 28, 2018 – 5:34pm
Geoffrey Goodman is the provider kicked off a listserv for his misogynist comments. Specifically, “Let’s discuss the merits and flaws of the actual research, rather than hide behind Prause’s apron strings.” As far as I know, he still has the title IX complaint with his university.
The “actual research” is quite clear. You and NoFap are openly misogynist and promoting hate speech. Birds of a feather.
Also, it’s cute that you thought EEG was “old” technology and fMRI was “better”. Please, do get to know an actual neuroscientist before spouting fake information.
Note: A communication revealed that Dr. Goodman was not kicked off the AASECT listserv and Prause’s spurious complaint – as usual – was ignored.
all nofap is trying to do is provide a support group for people who have the same goal- not masturbating. I can see why you might think there is discrimination against women there, as the population is predominantly men, but there are places for women to accomplish exactly the same things. when women post in nofap some people see it as a trigger. I personally don’t but from my perspective theres a big difference between unjustified discrimination and keeping order. You can’t make everyone happy 100% of the time.
Note the following back and forth between Prause and bart revolves around grad student Kris Taylor’s dissertation on 15 comments from reddit/nofap: I want that power back: Discourses of masculinity within an online pornography abstinence forum (2018). That’s right, a PhD analyzing 15 reddit comments! Taylor is decidedly pro-porn and anti-Nofap. He has a history of blatantly misrepresenting studies and the state of the research, as chronicled in the YBOP critique: Debunking Kris Taylor’s “A Few Hard Truths about Porn and Erectile Dysfunction” (2017). As bart points out, Taylor carefully selected 15 out-of-context comments from among millions of reddit/nofap comments in order to support his preordained agenda. Interspersed among the 15 reddit comments we find Taylor’s sociological gibberish masquerading as “deep thought.” This are the type of biased, lightweight reflections that sexology journals love to publish.
Submitted by Nicole Prause on October 29, 2018 – 2:05pm
“‘I want that power back’: Discourses of masculinity within an online pornography abstinence forum”
This was a systematic review of the content in those forums. I believe Ley’s point is not to say everyone must masturbate at some regular schedule. If you choose not to masturbate, just don’t promote for-profit groups that support misogyny and advertise Proud Boys and other antisemitic groups. As far as I am aware, the only celebrity fan of YourBrainOnPorn is David Duke, which he described as preventing race mixing.
There are many ways to reach your goals that don’t line the pockets of hate groups.
of anything. Dr. Prause must be referring to the agenda-driven paper by a grad student who chose a few random quotes from Reddit/nofap to push a false narrative (‘I want that power back’: Discourses of masculinity within an online pornography abstinence forum)
The opinion paper was qualitative, not quantitative – and everything excerpted was at the discretion of the grad student (Kris Taylor) – who has a history of pro-porn advocacy
Reddit/nofap has 370,000 members and millions upon millions of comments since its inception 8 years ago. It’s reddit for god sake. You can peruse a single post from reddit and find a thousand divergent and sometimes crazy comments. It’s reddit!!!.
Taylor excerpted 15 comments, writing a skewed narrative to match his predetermined wants. That’s right, 14 comments. That’s not a “study”. A 9th grader could hang out for 30 minutes on reddit (any sub-reddit), grab a few comments and write it up – and it would be comparable. What a joke.
Try citing a quantitative study by someone with PhD.
Submitted by Nicole Prause on October 29, 2018 – 4:47pm
The fake-name account appears to want some of the quotes from the systematic-review paper posted. These will make very clear that extensive content on the NoFap website is misogynist. If you visit this website, you will be supporting and furthering misogyny, above and beyond the antisemitism evidenced from Dr. Ley’s original piece.
“… what in the world is masculine about jerking off to porn in front of a screen? If you got caught you would feel rightfully ashamed. There’s nothing shameful about fucking a hot young girl, you feel like the king of the jungle afterwards that’s what we are meant to do! Fuck girls. Not jerk off like lonely losers to pixels on a screen. He makes some good points in the book, doesn’t mean I became a feminist and grew a vagina after reading it. If anything it made me want to fap less and fuck more. Is that not
masculine for you?”
“You think it’s a coincidence homeless guys don’t get laid? We’re animals… it’s natural to be attracted to what’s best for you and the species.”
“Rarely has it ever been that women chase the man.
That makes no sense. If you are truly masculine, then YOU go after the woman.”
“Think about what feminine means to you. Are you doing those things? Are you seeking approval, laughing nervously, and being indecisive? You shouldn’t be… And by the way, you can laugh, but laugh only if you want to. Laughing because you are nervous is feminine. Let the girls do that around you. Think about what masculine means to you. Are you doing those things? You should be. Are you decisive? Do you know what you stand for? Do you know what you want, and can you find a way to get it? These are the traits you need to be cultivating… Pay deep attention to your internal monologue. Don’t do or say things to people unless you want to… Don’t use 7 words when 4 will do. Speak in a deep, controlled voice.”
“The thing about power, at least in the modern world we live in today, is that a man simply has to respect himself and not heel to being a beta (bitch) to be considered masculine”
They provide many more exact misogynist quotes like this. What an awful group to support.
of a grad student who says porn never causes any problems. Qualitative clap-trap from an non-PhD. Let me grab a few comments out millions, and write a bunch of filler…..
I’ll go to reddit now and grab a few comments:
Delayed ejaculation: GONE! Thank you nofap! ‘
And from there things got even better. ALL and I literally mean ALL my social anxiety went away. On the second week I had cute girls talking to me everyday and I have even started “dating” (we had sex) this girl who was literally the girl of my dreams in high school (still is tbh). I even remember her saying to me “Wow you’re really good at making eye contact” and I received that same complement from others girls too.
I realized how bad I used to be when talking to people and its crazy to look back on. When I go to parties I am able to talk and hold conversations with anyone and it the best thing ever.
I totally agree with the benefits!
Used to have to think of porn in order to orgasm with wife. I have had regular sex through all my marriage (6 years now), but have always found that unless the sex is especially good I had to think of P in order to O in my wife, and found that about 5% of the time that I couldn’t finish at all. Now though I don’t think about this at all, just enjoy the time with her. It’s almost like starting over and learning sex again, it can be such a different with a clear mind not clouded by P.
26days = some of best sex ever!
Well I’ve gone 26 days now after going just a week at a time for ages, I’ve had some amazing sex with my gf of 8 months, not amazing in a porn style way, but very loving very emotional and feeling great. We’d sex 4 times this week, 2 of them were amazing, 2 were more the normal just felt good. It seemed to come out of nowhere the amazing sex. But really it was the lack of porn I’m sure. I wondered did I just think it was very different and gf didn’t, but nope, gf that it was very different and amazing too, which makes it all the better. So keep up the kicking porn in the nuts folks!
I’d always heard about surveys where they’d say that men who don’t watch porn are “more satisfied” with their sex lives. I never really knew what that was, or I thought I was “satisfied” enough. But now, on this streak, I’ve seen the difference. It’s like night and day! It’s better in sooo many ways. More satisfying, it’s a better experience physically, mentally it’s better as well. Can’t even explain. Sex is soooo much better without porn
A little bit different from Kris Taylor’s carefully chosen 15 out of over 10 million. And Taylor didn’t go to the nofap.com forum – which has millions more.
Submitted by Nicole Prause on October 29, 2018 – 5:24pm
Scientist every time
There’s was a peer-reviewed article. You probably wrote all of those yourself. I just discovered that the NoFap company account actually was being run by Alexander Rhodes himself, in violation of his no-contact request. So your actual founder is stalking women online in violation of no-contact orders.
You provide no evidence that their review was not balanced. As your cannot pass peer-review, I think it’s clear where the problem is.
You don’t even know what a review entails, do you? Again, it was 15 carefully selected comments out of tens of millions comments published on reddit/nofap since its inception 8 years ago.
How about detailing for us what a “review” of Reddit comments would entail. How would it be structured? Tell us about the methodology of a “review” of millions of comments over an 8 year period on a platform that allows everyone on the internet to post and say whatever they please.
From the paper itself we can see that it wasn’t a review at all:
Given this approach to data collection, we wish to highlight that the data presented is not intended to be read as representative of NoFap as a whole, but to present how some users express a particular investment in masculinity and its constitution (Edley, 2001; Edley and Wetherell, 1997). That is, as opposed to an analysis in which users’ posts are understood as oblique references to masculinity (through their talk about video games, pornography, exercise and diet, etc.), our study presents the ways in which users actively constitute masculine positions. Our search term ‘masculinity’ rendered numerous pages of ‘original posts’ which pertained specifically to defining masculinity.
So grad student Taylor selected 15 comments from a search for “masculinity” to support his predetermined goal, while ignoring %99.9999999999999 of all other comments. Is that what you call a “review”?
Taylor then interjected mind-numbing commentary on each of the carefully selected comments. For example, this load of gibberish about comment #11:
In the original post (Extract 11) the concept of a man that is both ‘who you are’ and ‘who you strive to be’ is introduced with an appeal to ‘embrace your masculinity’, again in the manner of a motivational call to arms to rally a general NoFap audience. However, the text indicates that it has been necessary for the author to hide aspects of his masculinity in the past to ‘not offend’. This disclosure positions certain expressions of masculinity as naturally offensive, or masculinity as a construct that has been vilified and judged to be problematic in its ‘natural’ form.
And this is what you, Dr. Prause, cite as a “review” of the entirety of reddit/nofap? LOL.
Submitted by Nicole Prause on October 30, 2018 – 10:38pm
They reported their systematic approach, a point you proved yourself by posting their method. You disclose nothing, were subject to no standards, made no attempt to observe in any systematic way…that is the difference between peer-review.
So yes, get it published or stick to your blogs, but there’s a reason you’ll never be able to publish your ramblings: They are poorly reasoned. I suspect this is because you have a conflict of interest. NoFap is a for-profit site; they make money by scaring people into having a problem they don’t actually have.
There was no “systematic approach” and it wasn’t a review. The paper wasn’t even a random sample of reddit/nofap posts. For the 4th time, grad student Taylor carefully selected excerpts from 15 out of context reddit comments (out of tens of millions) to match the narrative he already decided upon- and probably already transcribed (Taylor didn’t even provide full comments!).
As expected, you failed to respond to my very simple request to detail for us what a “review” of Reddit comments would entail. How would it be structured? Tell us about the methodology of a “review” of millions of comments over an 8 year period on a platform that allows everyone on the internet to post and say whatever they please.
It’s clear from your many comments here that you are obsessed with nofap (which is pretty strange). Waving around a grad student’s qualitative paper with 15 carefully selected, out-of-context excerpts from comments, while falsely asserting that it was “systematic review” of reddit/nofap comments is bad look. LOL
Submitted by Nicole Prause on October 30, 2018 – 11:47pm
There actually is no such thing as just a “review”, there are many different types. Each have different criteria. This review fulfilled the requirements for what they were required to meet criteria for publication.
Yours has not. Hurling personal insults at a woman with a doctorate appears consistent with the NoFap community.
Get your ideas through peer-review, or you have nothing to contribute at this point.
Playing the victim, when you are the one attacking members of nofap in every comment, is also a very bad look.
How do you know that I am not a women or transgender?
How do you know that I do not have a doctorate?
You assumptions offend me, as do your personal attacks, your put-downs, and your inability to stay on subject: the Kris Taylor 15-comment opinion piece, that didn’t review anything.
Disappointing. I excepted more civility and better presentation of empirical evidence.
Submitted by Nicole Prause on October 31, 2018 – 12:22am
They passed a scientific bar in peer-review at a reputable journal. You can try to pass that bar. As-is, anecdotes likely written by you are not good counter-points to a peer-reviewed paper.
I am not coming here to be called names. Women can be misogynist the same as anyone else, unfortunately. I expect nothing less from a group with a documented history of misogyny. The comments from their paper are all still present on the website, so it seems NoFap is happy to support the misogyny, even when it’s been identified by independent third parties with no conflict of interest.
You continue to falsely state that Kris Taylor’s paper (an opinion piece by a grad student) was a review. It was not a review of the literature. It did not review the peer-reviewed literature related to anything, including anything to do with porn use.
You continue to falsely claim that the 15 comments were was magically representative of tens of millions of comments posted on reddit/nofap over the last 8 years. The paper clearly states that the 15 bits from carefully selected comments were not representative of reddit/nofap. From the paper:
“Given this approach to data collection, we wish to highlight that the data presented is not intended to be read as representative of NoFap as a whole”
I suggest reading a study before making claims about that study.
You continue to falsely claim that nofap has a “documented history of misogyny”. Not so. There is no “documented” history of anything related to reddit/nofap. To begin to document any pattern of attitudes or beliefs a quantitative, systematic assessment of comments by members of nofap would need to be done. It hasn’s been done. The Taylor paper did not do this as it was not quantitative and was not representative…. it wasn’t anything but 15 carefully selected comments to further the authors predetermined agenda
In addition, Kris Taylor failed to confirm if any of the comments were by members of npfap. Anyone can comment on reddit/nofap. Without confirmation of membership, your assertion, based on only 15 comments, is without support. No documentation exists for misogyny or anything else, and that includes Taylor’s paper.
Below are some of the 15 excerpts from Kris Taylor’s paper that Dr. Prause says documents the misogyny of all of reddit/nofap’s 370,000 members. Judge for yourself if these comments are misogyny at its very worse:
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No Fap is not only about overcoming our addiction over porn and masturbation, it is also about reconnecting with our inner masculinity. So lets come out of our fantasies and begin to connect with real women. Lets love them and have meaningful sex with them
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Real women, real life, real respect.
—–
My no Fap journey began when i couldn’t stay erect for a real life woman! That was 44 long hard days ago. Today i had sex for the first time.
—–
I hate how it makes me feel like a creep. I hate how it makes me feel like I am unworthy of love. I hate how it makes me feel weak when I finish. I hate how it makes me feel deprived of my core masculinity. I hate how it keeps me in my head, afraid of the challenges of the real world. I hate everything about porn, other than the fact that it seems pleasurable in the moment. So I will be finding my pleasure in real things from now on, because fuck porn and how it makes me feel.
—–
Good on you man. Remember this feeling, let it drive you and keep away from porn. There’s so many great real things to find pleasure in. The pleasure of connecting with people, the pleasure of exercise, the pleasure of reading, the pleasure of finding a girl you really like without seeing her as a sex object or worrying about sexual problems. All the best in your journey!
——
But I am beginning to realize I am only hurting myself by not constantly striving to be masculine and increase my masculine nature. It will affect some people, but it’s who I am at the core. So embrace your masculinity. For you and your (potential) lover.
—–
Think about what masculine means to you. Are you doing those things? You should be. Are you decisive? Do you know what you stand for? Do you know what you want, and can you find a way to get it? These are the traits you need to be cultivating. . . Pay deep attention to your internal monologue.
—-
Being a man means you are passionate, creative, you focus on solution and fixing. Don’t allow toxic shame to talk away that pride. Learn to self-affirm.
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You don’t have to be Heisman winner or national wrestler or something, just respect yourself and your own opinions
—–
As you should know, most fapstronauts partake for several different reasons. My reason for being a fapstronaut is to increase my masculinity, become stronger as a man, and learn who i really am.
—–
What in the world is masculine about jerking off to porn in front of a screen?
—-
That’s it folks. The above is the entirety of Dr. Prause’s empirical evidence that nofap is a “documented” to be a stronghold of misogyny. A handful of non-representative, out-of-context comments found through a search for the term “masculinity”, selected without any discernible criteria, by a grad student with an agenda. A handful of comments, posted on the 5th largest website in the US, by a few guys, who may or may not be nofap members – out of tens of millions possible comments. So devastatingly convincing.
Submitted by Nicole Prause on October 31, 2018 – 10:51am
As the misogynist, misrepresentations of this anonymous troll make clear, this is why I get rape threats and am stalked by NoFap followers.
I do not owe anyone an education on published science they refuse to publish themselves, so would encourage you to stop threatening female scientists online.
Wow. When confronted with study excerpts that refute your claims about the study you devolve into character assassination, name calling, ad hominem and playing the victim (even though you are no victim in this thread).
It has been very enlightening to observe your tactics and internet demeanor.
As Bart and others saw, Prause always engages in personal attacks and outlandish assertions, while simultaneously misrepresenting studies and fabricating tales of her own victimization.
Bart learned, as everyone eventually does, that if you engage Prause in a substantive debate she very quickly resorts to name calling, unsupported accusations, and misrepresentation of the research. Once again we see a licensed psychologist co-authoring an article and trolling the comments section to smear individuals who are trying to quit porn.
Ley’s Psychology Today blog post targeted Alexander Rhodes and Gary Wilson, both of whom are atheists and politically liberal. As is often the case, Ley’s claims are the exact opposite of reality. That’s how propagandists roll.
Others –October, 2018: Prause follows-up the “fascist” article by attacking & libeling Alexander Rhodes and Nofap.com on Twitter
Its important to keep in mind that Nofap isn’t an organization, or movement, or anything other than the practice of abstaining from porn and masturbation for a period of time. While the Nofap subreddit was started in 2011, the “NoFap” concept can be traced back the “No Fap Ironman Competition” (October 20th, 2006 on the North American Subaru Owners Club Forums). Nofap months, and abstaining-from-porn contests subsequently occurred on many internet forum, long before reddit/nofap was born (see a collection of such forums on this page). Even an 8-week militarily boot camp could be considered “nofap.” To claim that nofappers are X or Y is like claiming that all Dallas Cowboy fans are X or Y. Any attempt to label those who abstain from porn or masturbation as a unified group is pure agenda-driven propaganda. Which leads us to the Ley & Prause “nofappers are fascist” blog post.
While policing comments under her and Ley’s Psychology Today blog post, Prause simultaneously went on a Twitter tirade attacking and defaming Nofap, Alexander Rhodes, and Gary Wilson. A reminder: Prause and Ley have a long, documented history of harassing and libeling Alexander Rhodes and Nofap (The current examples are just the tip of the Prause/Ley iceberg.):
Prause’s Twitter storm started with baiting NoFap by misrepresenting tweets from over 3 years ago. (Note how Prause has collected tweets, comments, random posts, for years from various accounts and from porn recovery forums which she has trolled with dozens of fake accounts.)
Prause follows up her targeted harassment and falsehoods with more tweets.
Tweet #2 – About a biased paper by a anti-nofap.com, pro-porn grad student, Kris Taylor (described above)
As described, Kris Taylor carefully selected 15 comments (out of millions available) to advance his predetermined agenda-driven narrative.
In Tweet #3 Prause provides a screenshot of an account that is not associated with NoFap. An account that NoFap lawyers had already served with a cease and desist letter for using their name and for cyberstalking:
The official Nofap account responding to Prause’s harassment and defamation with this tweet:
Caught in blatant misrepresentation, Prause goes on the attack, suggesting that Nofap should police the entire internet for her benefit. Nofap replies with undeserved calmness:
With no provocation, Prause injects Gary Wilson into her Twitter tirade – saying that Wilson has physically stalked her and had been reported to the LAPD and UCLA. All of these familiar lies are covered in several other places on the Prause page. Here, Prause provides a screenshot of a 2016 Alexander Rhodes tweet defending Wilson from Prause’s lies. The entire incident, with screenshots, is documented in this section: Others – October, 2016: Prause commits perjury attempting to silence Nofap’s Alexander Rhodes.
Prause is steeped in the ways of propaganda: When someone calls you out on your lies and harassment (as Rhodes did), Prause turns it into her faux-victimization. Nofap responds and links to this page chronicling her behaviors.
Their Twitter conversation about Gary Wilson continues in this section:
——————————
Prause continues her tirade by posting screenshots from the right-wing site “Gab.” The Gab nutcases have no association with Nofap, yet Prause claims they are Nofap members (as if Nofap issues membership cards):
Nofap calmly responds to Prause as if she were a sincere individual with a legitimate concern. Yet imagine all the time Prause spent scouring internet forums and Twitter for any random comment she could misuse and misrepresent. Impressive.
David Ley, Prause’s companion in cyber-harassment, feels compelled to join in the attack, with his usual unsupported claims about the mighty and powerful “sex addiction industry” (no mention of the actual industry here – the truly mighty and powerful porn industry and the FSC):
Note: The mass shooting of Jews occurred in Pittsburgh, Pennsylvania, the home of NoFap.com founder, Alexander Rhodes.
Prause continues, promoting Kris Taylor’s PhD pathetic dissertation and saying that if her assertions weren’t true NoFap would sue her (knowing very well that a lawsuit might cost a few hundred thousand dollars, drag on for years – and that Nofap.com could not afford such an endeavor. Few could).
Nofap.com also responds to Prause’s assertions related to Kris Taylor’s paper containing 15 carefully selected out-of context comments from reddit/nofap (not NoFap.com):
Prause blatantly lies about Kris Taylor’s 15-comment hit piece, claiming it was a “representative sample” of the millions of reddit/nofap comments posted over the last 8 years:
No Dr. Prause, it wasn’t a “representative sample” – as Taylor clearly stated in his paper:
“Given this approach to data collection, we wish to highlight that the data presented is not intended to be read as representative of NoFap as a whole“
Claims about police reports are lies (see below). Claims about Antisemitism, sexism and other discrimination” are equally without support – Prause never links to examples of such posts on NoFap.com. Note: Nofap.com is not the same as reddit/nofap. Reddit is truly the Wild West where anyone on the internet can post anything. Prause well knows this as she has created at least 20 fake usernames to post on reddit/pornfree and reddit/nofap. A few sections documenting Prause many aliases she has used:
As always, Prause accuses anyone who engages with her falsehoods and misrepresentations of being a misogynist. The attacker playing the victim. Propaganda in its purest form.
After 8 edits, Prause created another fake account – Suuperon – to delete a study showing the benefits of abstaining from porn, while adding more context to her other sock-puppets edits:
All the above Wikipedia edits mirror everything Prause said on twitter and in the comments section under the Prause/Ley Psychology Today article. The cybertsalker caught in the act….. again.
Tweet #1 – Prause scours NoFap.com to produce a random comment by an excessively polite Middle Eastern man referring to Gary Wilson as “professor.” In Prause’s bizzaro world, this comment constitutes “proof positive” that Gary Wilson claimed to be a professor! For more on Prause’s ongoing, evidence-free campaign, see Ongoing – Prause falsely claims that Wilson has misrepresented his credentials.
———
1) It’s been over 5 years and Wilson has never been contacted by any police department or agency (a call to the Los Angeles police department and the UCLA campus police revealed no such report in their systems). Although Prause has repeated this undocumented claim dozens of times, she has also failed to divulge what law Wilson supposedly violated. In early 2018, Prause added the tall-tale that Wilson was twice reported to the FBI. Wilson has never been contacted by the FBI. What’s next, the CIA, ICE, Homeland Security… maybe a mall cop?
No, LAPD records are not public. That is why Prause did not link to her “police report.” No, Wilson has never stalked Nicole Prause and hasn’t been in LA for years. No, there was no LAPD police report – as confirmed by a call with a kind-hearted policewoman at the LAPD.
UPDATES – law enforcement agencies expose Prause as a pathological liar:
If Prause keeps up her defamation and harassment of Gary Wilson, Alexander Rhodes and others, her name may soon appear 35,00 times on YBOP, as almost all instances are found on the pages chronicling her obsessive, unrelenting cyber-harassment:
All joking aside, Prause didn’t search Gary Wilson’s website, YourBrainOnPorn.com. She performed a purposely incorrect Google search for “prause site: yourbrainonporn.com” (leaving a space after the colon). Leaving the space tells Google to search the entire internet, not just YBOP! Her incorrect search did return 35,000 items, but the vast majority are not YBOP.
The proper syntax for such a Google search is to not have a space between “site:” and a URL, so “site:yourbrainonporn.com” is fine, but “site: yourbrainonporn.com” would search across the internet for either yourbrainonporn.com or the keyboard before it. On October 28, 2018 (the time of the above tweet) the proper results for “Prause” on yourbrainonporn.com is 565 mentions:
Frankly 565 seems too low for “Prause” on YBOP. Why does YourBrainOnPorn.com contain so many instances of “Prause”? First, the pages chronicling Prause’s behaviors alone contain hundreds of instances of “Prause.” Second, YBOP contains over 13,000 pages, and it’s a clearinghouse for nearly everything associated with Internet porn use and its effects on the user. Prause has published multiple studies about porn use and hypersexuality, and by her own admission, is a professional debunker of porn addiction and porn-induced sexual problems.
A Google search for “Nicole Prause” + pornography returns about 31,000 pages. Perhaps thanks to her costly public relations firm, she’s quoted in hundreds of journalistic articles about porn use and porn addiction. She has published several papers related to pornography use. She’s on TV, radio, podcasts, and YouTube channels claiming to have debunked porn addiction with a single (heavily criticized) study. So Prause’s name inevitably shows up a lot on a site that functions as a clearinghouse for research and news associated with Internet porn’s effects.
Not only do Prause’s studies appear on YBOP, so do hundreds of other studies, many of which cite “Prause” in their reference sections. YBOP also has published very long critiques of six Prause papers. YBOP also hosts at least 18 peer-reviewed critiques of Prause’s studies. Further, YBOP contains at least a dozen lay critiques of Prause’s work. YBOP also hosts many journalistic articles that quote Nicole Prause, and YBOP often responds to Prause’s claims in these articles. YBOP also debunks many of the talking points put forth by Prause and her close ally David Ley. To be sure, YBOP also critiques other questionable research on porn and related subjects. These critiques are not personal, but rather substantive.
As for the 82,000 instances of “Prause” on my website (www.yourbrainonporn.com), this is absolutely false. As explained above, Prause cleverly employed the improper syntax to achieve 82,000. The proper syntax for such a Google search is to not have a space between “site:” and a URL, so “site:www.yourbrainonporn.com” is fine, but “site: wwwyourbrainonporn.com” would search across the internet for either wwwyourbrainonporn.com or the or Prause or both. Put simply, a proper search for my website – prause site:www.yourbrainonporn.com – returns only 871 instances. Most instances of “Prause” are on found the above pages documenting Dr. Prause’s defamation and harassment.
As for the other claims, Dr. Prause never reported me to the FBI, LAPD or UCLAPD, as documented in these 2 sections. She is lying and has been for years:
UPDATE 2: Trolling the twitter thread of anti-sex trafficking, radical feminist Laila Mickelwait, Prause repeats the same old lies in her two tweets (FBI reports, name on YBOP 82,000 times, stalking, sexual harassment, etc.).
Below: actual returns (2-25-19) using the proper syntax for a Google search for instances of “prause” on yourbrainonporn.com. Notice that the top returned pages are documenting Prause’s harassment or critiquing her peer-reviewed papers. The rise in instances of “Prause” is caused by YBOP adding more examples of her harassment and defamation to the Prause pages, and the creation of a page that exposes her close relationship with the pornography industry (Is Nicole Prause Influenced by the Porn Industry?).
Both David Ley and Prause falsely claim that the person tweeting a few studies is a fake account account by Gary Wilson. It’s not.
Everything Ley and Prause said in the above tweets are lies.
Prause contiunes her rampage with this tweet about the TEDx talk:
We know that Prause harassed TED for 5 straight years… until their very biased “science curator” gave in (the curator only has a bachelor’s degree in writing, not science) and placed a bogus note on the talk. In reality everything in the TEDX talk is fully supported, with hundreds of additional studies supporting its assertion having been published since the talk was given (March, 2012). See these 2 extensive pages:
More of the same (March 29, 2019). First, Pause trolls a thread to support the porn industry agenda by misrepresenting the research, falsely stating the WE found that more porn use, in a few selected countries, was related to fewer reported rapes:
UPDATE (December, 2019): Adding Google Translate to YBOP multplies search returns by a factor of 100! (Prause commits perjury)
In court filings for Don Hilton’s defamation lawsuit against her, Prause commited numerous instances of perjury. One such instance was her falsely stating that her name appered 103,000 times on YBOP
As explained above, Prause did not search my website, YourBrainOnPorn.com. Instead, she performed a purposely incorrect Google search for “prause site: yourbrainonporn.com” (leaving a space after the colon). Leaving the space tells Google to search the entire internet, not just YBOP! Prause’s search trick does return about 29,000 items (not 103,000), but the vast majority are not on YBOP:
The proper syntax for such a Google search is to omit the space between “site:” and a URL Thus, “site:yourbrainonporn.com” works fine, but “site: yourbrainonporn.com” searches across the internet for either yourbrainonporn.com or “Prause”.
In December, 2019, the proper result for Prause and yourbrainonporn.com was 8,300 Google returns. However, the vast majority of these 8,300 google returns were duplicates of YBOP pages, because YBOP is translated by G-Translate into multiple other languages (and so each mention of Prause’s name is counted multiple times leading to vastly exaggerated numbers).
Let me explain: Because Google translates each YBOP page into 100 languages, a solitary mention on a single YBOP page can lead to a Google search returning 100 pages! In other words, you might need to divide Prause’s number by 100. For example, by the 10th page of a proper Google search for Prause on YBOP, 8 out of the 10 returns are duplicate pages in a foreign language:
In October, 2018,before YBOP was redesigned to employ Google Translate,the true result for “Prause” on yourbrainonporn.com was 565 mentions:
As explained above, 565 seemed low for “Prause” in October of 2018, as I was forced to create several pages to document and counter Prause’s relentless defamation and harassment of me and many others (which rapidly grew as Prause’s intensified and expanded:
Imporantt to note that mentions of “Prause” have increased significantly since October 2018, as Prause’s defamation and cyberstalking have risen exponentially. For example, on January 29, 2019, Prause filed a trademark application to obtain YOURBRAINONPORN and YOURBRAINONPORN.COM. In April 2019, Prause created a trademark infringing website “RealYourBrainOnPorn,” and a Twitter account (https://twitter.com/BrainOnPorn), a YouTube channel, and a Facebook page, all employing the words “Your Brain On Porn.” Prause also created a reddit account (user/sciencearousal) to spam porn recovery forums reddit/pornfree and reddit/NoFap with promotional drivel, claiming porn use is harmless, and disparaging YourBrainOnPorn.com and myself. Put simply, Prause has used her new alias (“RealYourBrainOnPorn”) to wage a full scale war on all her victims. As a result, I was forced to create these new YBOP pages:
Within a few months of creating RealYBOP, two defamation lawsuits were filed against Prause. The related documents for both defamation lawsuits (Donald Hilton, MD & Nofap founder Alexander Rhodes), were placed on YBOP, resulting is these pages:
While I get tired of documenting Prause’s activity, I know that YBOP is the one site willing to document Prause’s unbelievable behaviors. I have done this for the protection of her many victims, as a resource for the public to know the truth, and as a source of evidence for potential lawsuits (there are currently 3 lawsuits involving Prause). An ugly job, but unfortunately necessary.
Ongoing – David Ley & Nicole Prause’s ongoing attempts to smear YBOP/Gary Wilson & Nofap/Alexander Rhodes by claiming links with neo-Nazi sympathizers
The answer to “who knew?” is “Prause & Ley” because they were the only ones cultivating a fictitious “connection” between porn recovery forums and fascists. Starting in 2016 defamers Ley and Prause hatched this previously non-existent association. Apart from Prause & Ley’s Twitter pages no connection existed between Nazi sympathizers and Wilson or Rhodes. Ley & Prause initiated their fraudulent campaign with this tweet:
Scouring the internet for anything Ley can use to smear Wilson, he pounced upon an obscure (and disgusting) David Duke blog post containing a link to Gary Wilson’s TEDx talk. Wilson’s TEDx talk has some 11 million views, so thousands of folks of all stripes have linked to (and recommended) Wilson’s talk, “The Great Porn Experiment.”
How does this implicate Gary Wilson as a “white supremacist?” It doesn’t, of course. This ridiculous assertion is like suggesting all dog lovers are Nazi’s because Hitler loved his dogs. It’s the equivalent of claiming that the producers of “The Matrix” are neo-Nazis because David Duke liked their movie. Pure BS. (Reminder: one of Ley & Prause’s closest allies (therapist Joe Kort) linked to and recommended Gary Wilson’s TEDx talk. Consider his words:
Does recommending “The Great Porn Experiment” make Joe Kort a neo-Nazi? It must, according the Ley/Prause doctrine of: if you like X, and a Nazi likes X, you are a Nazi.
Here’s Prause attempting to connect “racist pseudo-science” with anyone who says porn might be a problem, including Pamela Anderson (Prause later deleted her tweet):
In a disgusting tweet she later deleted, Prause tried to make a connection between the tragedies in Charlottesville and Gary Wilson:
The sickening Prause and Ley propaganda machine kept rolling with this David Ley tweet tagging an unrelated NYTimes article about neo-Nazi’s:
With no factual evidence, psychologist Ley tries yet again to connect far-left liberal/atheist Gary Wilson and far-right, former KKK Grand Wizard, David Duke.
What Ley doesn’t know is that Wilson grew up in a black neighborhood and he has African-American relatives. Ley is without scruples.
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Not to be outdone, Prause scours the net for anything she can mischaracterize and implies a non-existent connection between “anti-porn activism” and neo-Nazis.
In this next tweet, Ley takes the laughable stance that there’s no racism in porn, but says those who claim porn is addictive are racist, misogynist and anti-Semites. It’s part of the ongoing strategy to paint anyone who disagrees with them as racist and misogynistic perpetrators – and themselves and the porn industry as the victims:
As these pages reveal, it’s Dr. Prause who regularly attacks those “who claim porn is addictive” (Prause has zero evidence of anyone named on these pages having engaged in misogyny). For much more on this ongoing smear campaign by Prause and David Ley see these sections:
Prause & Ley search twitter for anything they can use to claim that anyone who quits using porn is a misogynist/fascist. Here Ley retweets Prause, and adds his spin:
This person, who is not affiliated with nofap or any other organization, appears to be reporting Instagram users for violating rules related to pornographic content. This appears to have drawn the attention of porn stars and Prause was notified. Whatever the case, Prause and Ley are working hard to keep their fabricated meme going.
Others –October, 2018: Prause tweets that she has reported “serial misogynist harasser” Alexander Rhodes to the FBI
As is clearly evident from the above sections, and several other sections on the 2 Prause pages, the only serial harasser here is Nicole Prause. There are no misogynists among the many Prause targets listed on these pages. While Prause regularly accuses her victims of being misogynists, she never provides a single example of such behavior.
The following day, Prause tweets that she reported Alexander Rhodes to the FBI because he is serial misogynist who “violated” a clear no-contact request:
On the same day (in response to one bart’s comments) Prause posts this in the comment section under her and Ley’s “fascist” Psychology Today blog post:
While Prause ends many of her targeted social media attacks by asserting a “no-contact request”, there is no such thing. A “no-contact request” is as legally binding as requesting someone “stop and smell the roses”.
Prause is trying to trick the public (her twitter followers) into believing she has obtained a restraining order or an injunction. She hasn’t. Its just a tweet. But that doesn’t stop her from publicly and falsely accusing her victims of “violating no contact orders” and of “harassment.” The clear, and clearly false, implication of her statements is to suggest these people are acting illegally. Her aggressive tactics and knowingly false accusations are calculated to bully and intimidate the victims of her online cyber-harassment into silence.
A few examples of Prause initiating harassment and defamation followed by claiming victim-hood and ending with so-called “no-contact orders”:
Update: Both Gary Wilson and Alexander Rhodes filed FOIA requests with the FBI to find out if Prause had ever filed a report. She had not. See the following two sections:
Others – October, 2018: Prause claims that Fight The New Drug told its “followers” that Dr. Prause should be raped (section contains numerous additional defamatory & disparaging tweets by cyberstalker Prause)
Just when you think Prause’s assertions can’t get any more outlandish and defamatory she hits a new low. In the following two tweets Prause spreads the lie that Fight The New Drug (FTND) has told its followers that Prause should be raped. As is always the case, Prause provides zero evidence for this libelous and absurd assertion.
If there’s one thing we know about Prause, it’s that if she had so much as a single smidgen of innuendo she would post it as “evidence.” She doesn’t, and so this is a bare-faced, hateful lie. But it continues Prause’s obsessive pattern of spreading vicious falsehoods about FTND. Other such attacks are described in these sections:
Below is a small sampling of Prause’s many tweets defaming and disparaging FTND (Prause has since deleted almost all earlier tweets targeting FTND and others). Keep in mind that FTND never mentions Nicole Prause or engages with her hate speech on its social media platforms.
Afraid not. Prause is referring to her critique of Fight the New Drug’s previous op-ed, that she persuaded 7 of her PhD buddies to sign off on it. The 600-word Op-Ed is chock full of unsupported assertions meant to fool the lay public. It fails to support a single assertion as it cites only 4 papers – none of which have anything to do with porn addiction, porn’s effects on relationships, or porn-induced sexual problems. It also made several false statements about the content and references in the earlier FTND op-ed. Several experts responded with this dismantling of the Prause op-ed: Op-ed: Who exactly is misrepresenting the science on pornography? (2016). Unlike the “neuroscientists of the Op-Ed,” the response cited several hundred studies and multiple reviews of the literature. Nevertheless Prause obsessively touts her 600 word, citation free opinion piece as on par with Darwin’s The Origin of Species.
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We musn’t forget openly sexist and anti-science……..
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Prause can’t even get the number right – it was 8 PhD’s – but not all were neuroscientists, and none of them had ever published a study involving verified “pornography addicts.”
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What?
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Prause claims there’s article behind her quote, but it never materializes.
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Pure BS – nothing article remotely related to claim (no wonder only one person retweeted it)
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Gibberish, and playing a victim with her info-graphic….while being the perpetrator
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Ley joins Prause, as he often does:
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Prause attacks Matt Fradd and FTND. Fradd is honored and takes her to school:
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More false allegation, yet never any evidence:
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Prause tweeting her porn producer friends about her op-ed:
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Again, Prause tweeting as if there was an article covering this – but there wasn’t:
Prause is citing her own flawed study, Prause et al., 2015, which debunked nothing. The results: Compared to controls “individuals experiencing problems regulating their porn viewing” had lower brain responses to one-second exposure to photos of vanilla porn. The lead author claims these results “debunk porn addiction.” What legitimate scientist would claim that their lone anomalous study has debunked a well established field of study? In reality, the findings of Prause et al. 2015 align perfectly with Kühn & Gallinat (2014), which found that more porn use correlated with less brain activation in response to pictures of vanilla porn. Lower EEG readings mean that subjects are paying less attention to the pictures. Put simply, frequent porn users were desensitized to static images of vanilla porn. They were bored (habituated or desensitized). See this extensive YBOP critique. Nine peer-reviewed papers agree that this study actually found desensitization/habituation in frequent porn users (consistent with addiction): Peer-reviewed critiques of Prause et al., 2015
Prause continues her tweets tagging and attacking FTND:
The above tweet has nothing do with what FTND has actually said (Prause never links to any examples), but it takes us back to Prause’s unsupported claims surrounding her 2013 EEG study (Steele et al., 2013): 1) Prause claimed that her subject’s brains did look like cocaine addicts, even though they were never compared to cocaine addicts; 2) Prause misrepresented her findings to the media, claiming her subject’s brains didn’t look like addicts, when they looked exactly like addicts. Eight peer-reviewed papers explain the truth: Peer-reviewed critiques of Steele et al., 2013 Also see this extensive YBOP critique for all the details.
The bits about “cocaine” that expose Prause attacking (in 2018) the very behavior Prause-2013 engaged in, while simultaneously misrepresenting her findings:
Prause: Our study tested whether people who report such problems look like other addicts from their brain responses to sexual images. Studies of drug addictions, such as cocaine, have shown a consistent pattern of brain response to images of the drug of abuse, so we predicted that we should see the same pattern in people who report problems with sex if it was, in fact, an addiction.
Does this prove sex addiction is a myth?
Prause: If our study is replicated, these findings would represent a major challenge to existing theories of sex “addiction”. The reason these findings present a challenge is that it shows their brains did not respond to the images like other addicts to their drug of addiction.
The above claims that subjects brains did not “respond like other addicts” is without support. This assertion is nowhere to be found in the actual paper. It’s only found in Prause’s PR interviews. In Prause’s study subjects had higher EEG (P300) readings when viewing sexual images – which is exactly what occurs when addicts view images related to their addiction (as in this study on cocaine addicts). Commenting under the Psychology Today interview of Prause, senior psychology professor emeritus John A. Johnson said:
“My mind still boggles at the Prause claim that her subjects’ brains did not respond to sexual images like drug addicts’ brains respond to their drug, given that she reports higher P300 readings for the sexual images. Just like addicts who show P300 spikes when presented with their drug of choice. How could she draw a conclusion that is the opposite of the actual results? I think it could be due to her preconceptions–what she expected to find.”
A month later John A. Johnson PhD published a Psychology Today blog post about Prause’s EEG study and what he perceived as biases on both sides of the issue. Nicole Prause (as anonymous) commented underneath his post taking Johnson to task for linking to this YBOP critique. Johnson replied with the following comment for which Prause had no response:
If the point of the study was to show that “all people” (not just alleged sex addicts) show a spike in P300 amplitude when viewing sexual images, you are correct–I do not get the point, because the study employed only alleged sex addicts. If the study *had* employed a non-addict comparison group and found that they also showed the P300 spike, then the researchers would have had a case for their claim that the brains of so-called sex addicts react that same as non-addicts, so maybe there is no difference between alleged addicts and non-addicts. Instead, the study showed that the self-described addicts showed the P300 spike in response to their self-described addictive “substance” (sexual images), just like cocaine addicts show a P300 spike when presented with cocaine, alcoholics show a P300 spike when presented with alcohol, etc.
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Prause adds to the above tweet, with more false statements (as always, Prause links to no examples of misrepresentations – because there are none):
Prause’s falsehoods concerning FTND are exposed in her Salt Lake Tribune Op-Ed attacking FTND. This 600-word Op-Ed is chock full of unsupported assertions meant to fool the lay public. It fails to support a single assertion as it cites only 4 papers – none of which have anything to do with porn addiction, porn’s effects on relationships, or porn-induced sexual problems.
I and several other experts in this field debunked its assertions and empty rhetoric in this relatively short response – Op-ed: Who exactly is misrepresenting the science on pornography? (2016). Unlike the “neuroscientists of the Op-Ed,” we cited support for our views in the form of several hundred studies and multiple reviews of the literature.
Follows up with free t-shirts to the other twitter trolls:
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A few examples of David Ley cyber-stalking FTND
Ley going out of his way to troll FTND:
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Over the years we have seen FTND state that it has received no funding from the Mormon Church. Not surprising, Politico provided no documentation for this assertion (not even a link to another hit piece). Was it simply fabricated, or fed to Politico?
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Notice how Ley can give no examples.
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Again, never an example of “pseudoscience”. Ley has never once excerpted an example from the FTND website.
Through FOI requests, Prause obtained Senator Weiler’s emails. She has excerpted one email, mischaracterized what it said and has tweeted it multiple times. Once again in 2019:
Email said that they should focus on protecting children, and not tell adults what they can or cannot do. Who would disagree with that?
RealYBOP (Prause aliases) cites an article by the Adult Video News (AVN) to disparage FTND. Sounds like someone is back tracking as no amount of editing could put words in the former porn star’s mouth (and he hasn’t asked FTND to take down the interview). Interview: Most Successful Male Porn Star Of All Time Speaks Out On Porn
While Prause and RealYBOP have posted countless times that FTND misrepresents studies, they never link to an example of misrepresentation. Never.
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A RealYBOP (Prause) tweet that is unrelated to Fight The New Drug, cites Prause’s debunked op-ed disparaging FTND:
RealYBOP going to bat for the porn industry, while simultaneously attacking Fight The New Drug:
Data? RealYBOP failed to cite a single study. Here are six studies confirming mental and physical health problems of female performers.
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November, 2019: RealYBOP randomly disparaging Fight The New Drug:
Tweet #1: The panelists for the Mormon Matters podcast lied about most everything.
Tweet #2: Several experts in this field and I debunked its assertions and empty rhetoric in this relatively short response – Op-ed: Who exactly is misrepresenting the science on pornography? (2016). Unlike the “neuroscientists of the Op-Ed,” we cited several hundred studies and multiple reviews of the literature.
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RealYBOP randomly disparaging Fight The New Drug:
Tweet #1: The panelists lied about most everything.
Tweet #2: Several experts in this field and I debunked its assertions and empty rhetoric in this relatively short response – Op-ed: Who exactly is misrepresenting the science on pornography? (2016). Unlike the “neuroscientists of the Op-Ed,” we cited several hundred studies and multiple reviews of the literature.
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December, 2019: RealYBOP uses 4 tweets to misrepresent a FTND article about a study:
The third opportunity for prevention identified by the young people related to the trouble they had managing pornography. Out of the 14 young people, 12 talked about being exposed to pornography and three talked about how pornography was one of the factors that triggered their harmful sexual behavior. They implied the likelihood of their harmful sexual behavior occurring could have been reduced if pornography had not been present.
The study’s authors:
“We can’t, on the one hand, say we don’t want to talk with young children about sexuality, while on the other hand do nothing about the multi-billion-dollar pornography industry and the telecommunications industry that is enabling access,” McKibbin added.
“It may be that government needs to intervene at this point. Pornography can’t be seen as the sole responsibility of parents or schools because it has gone way beyond that. We probably need to engage directly with the pornography industry and the telecommunications industry,” she said.
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Cyberstalker and porn industry shill RealYBOP tweets in FTND thread under a porn star (RealYBOP has blocked FTND, but still trolls their threads). The tweet has nothing to do with FTND or its tweet. Instead, RealYBOP is once again defaming NoFap (NoFap founder Alexander Rhodes has filed a defamation lawsuit against Nicole Prause – who is thought to be RealYBOP)
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RealYBOP uses 4 tweets to misrepresent a FTND article about a study:
The third opportunity for prevention identified by the young people related to the trouble they had managing pornography. Out of the 14 young people, 12 talked about being exposed to pornography and three talked about how pornography was one of the factors that triggered their harmful sexual behavior. They implied the likelihood of their harmful sexual behavior occurring could have been reduced if pornography had not been present.
The study’s authors:
“We can’t, on the one hand, say we don’t want to talk with young children about sexuality, while on the other hand do nothing about the multi-billion-dollar pornography industry and the telecommunications industry that is enabling access,” McKibbin added.
“It may be that government needs to intervene at this point. Pornography can’t be seen as the sole responsibility of parents or schools because it has gone way beyond that. We probably need to engage directly with the pornography industry and the telecommunications industry,” she said.
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Porn industry shill RealYBOP/Prause tweeting propaganda by porn industry representative XBIZ while attacking FTND:
Original news segment: https://wset.com/news/local/pornography-the-new-gateway-drug
RealYBOP Cyberstalking FTND with her usual falsehoods and unsupported claims. First, RealYBOP has no idea who FTND “works with”. Second, strengthening pathways is called sensitization (cue-reactivity & cravings). Sensitization alters numerous synapses connecting various aspects of the reward system, which results in increased “wanting” or craving while liking or pleasure diminishes. As of 2020 there 24 neuroscience-based studies reporting sensitization or cue-reactivity in porn users/sex addicts: 1,2,3,4, 5,6,7,8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24.
There are more tweets, but this will suffice to expose Prause as an obsessive cyberstalker.
Ongoing – Prause falsely states that FTND said her research was funded by the porn industry (attempting to divert attention from her own documented porn-industry associations)
Several 2018 tweets attacking FTND contain the same text and two screenshots: 1) an excerpt from a Politico article asserting that FTND was “seeded with millions of dollars from the Mormon Church”; 2) an excerpt from an email that may or may not have been sent by FTND:
Again, the same tweet (November, 2018):
Over the years we have seen FTND state that it has received no funding from the Mormon Church. Not surprising, Politico provided no documentation for this assertion (not even a link to another hit piece). Was it simply fabricated, or fed to Politico?
Apart from offering no support for her Mormon-funding assertion, Prause’s screenshots of the purported email are a bit curious. Instead of providing a screenshot of an entire email, Prause provides a screenshot of a letterhead, and a second screenshot of an out-of-context paragraph.
The letterhead:
The out-of-context paragraph, which did not, in fact, claim that Prause’s research was funded by the porn industry:
Instead of saying Prause’s research was funded by the porn industry, the email wondered if Prause had been “influenced by someone within the porn industry.” Mind you, this email is dated April, 2016, before Nicole Prause exponentially increased her harassment and libel (as documented on these pages).
While there’s no evidence of any of Prause’s victims stating that Prause receives funding from the porn industry, anyone might be forgiven for wondering if she is indeed influenced by the porn industry. The Prause pages on this website are just the tip of a very large Prause Iceberg. She has posted thousands of times, attacking everyone and anyone who suggests porn might cause problems. (Prause recently purged her twitter account of 3,000 or more incriminating tweets.) She has defended the industry at every turn, much as a paid industry thought-leader could be expected to do.
“The XRCO Awards are given by the American X-Rated Critics Organization annually to people working in adult entertainment and it is the only adult industry awards show reserved exclusively for industry members.[1]“
In addition, the FSC (which has spent millions on lawsuits that benefit the porn industry) offered Prause assistance with respect to her so-called “bullies.”
\
The real bully was Prause, who had her Twitter account permanently banned for harassment and cyber-stalking. Instead of revealing the facts, Prause fabricated a tall-tale that John Adler MD (Stanford) somehow got her kicked off Twitter. Adler had nothing to with this. Lies upon lies.
In October, 2015 Prause emailed the FSC to accept their “help” with her imaginary bullies. Prause then promptly begins to discuss with another industry account why condoms in porn are a bad idea (the porn industry’s position):
Prause then offers help to the FSC (is this the beginnings of a mutually beneficial relationship?):
Since then, Prause has publicly assisted the FSC multiple times, including for example, supporting the FSC’s campaign against California’s ill-fated Proposition 60 (calling for condom use in porn):
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Here she retweets FSC propaganda. (Note: dozens of Prause’s incriminating pro-FSC tweets have since been deleted.):
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Smearing the AIDS Healthcare Foundation, while taking the side of porn industry reps:
FYI – During the initial broadcast of NBC’s Tomorrow Coast-to-Coast with Tom Snyder, Marigold said he would consider performing a sex scene with his own daughter. When asked if he would allow his daughter to enter the porn business, Margold replied, “Not until she’s eighteen. And then I might even work with her myself.”
Prause retweets XBIZm celebrating the demise of The Pink Cross Foundation (hated by the porn industry)
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Once again, Prause enters threads of porn performers to bolster their arguments:
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Prause provides advice to a porn performer:
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Prause tweet attacking studies reporting greater trauma in porn performers:
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Once again retweeting the FSC, and lending her spin to the mix. As usual, any science Prause disputes is disreputable, while her own heavily criticized research is indisputable, even when it opposes the preponderance of expert evidence:
Prause re-tweeting AVN, who was complaining about Dallas rejecting their convention:
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Prause posing with two well known porn stars:
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In this tweet, Prause attacks a grad student who is trying to gather data about porn performers:
Prause reported him to his university.
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Yet another tweet in which Prause promotes AVN’s position on Prop 60:
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Retweeting AVN news:
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Prause describing her experiences “at AVN”:
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Prause describing her time spent with another pornography legend:
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Again, citing a single outlier study, with a very small sample, to support the porn industry’s contention that performers are doing fine:
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Retweeting porn industry propaganda, telling the world that there is no sexism in the porn industry:
Prause contends that porn-recovery sites are sexist – as is everyone who disagrees with her or anyone who critiques her studies or assertions.
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Prause tagged by PornHub. Very buddy-buddy convo:
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More direct support for porn industry views:
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Why would a supposedly impartial researcher be tweeting about a porn performer union?
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Again interacting with performers, as if she has inside connections:
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Major porn producer calling Prause “our superheroine,” which Prause acknowledges:
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Retweets XBIZ propaganda, attacks AIDS Healthcare Foundation: https://twitter.com/AIDSHealthcare
In support of the porn industry, Prause retweets porn-producer propaganda. Prause attacks AIDS Healthcare Foundation:
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Convo with porn performer/producer claiming that “anti-porn” is misogynist, yet porn performers are not:
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Promoting AVN/porn show:
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Tagging FSC, retweeting porn industry propaganda:
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Tagging FSC while attacking a UCLA medical doctor who supported the use of condoms for porn performers:
Here she answers again as if she is an expert on the porn industry. Prause’s propaganda is that porn industry is poor, and that many “harassers” say her research is funded by the porn industry:
Prause has never provided any documentation of anyone saying she is funded by the porn industry. The claim that her science has not been challenged is laughable as there are 12 peer-reviewed critiques of her flawed studies and her unsupported claims about them:Questionable & Misleading Studies.
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Add to the above examples hundreds of social media attacks and behind the scenes harassment of any researcher, person, or organization reporting less than stellar effects of porn use or performing in porn. Just a few examples of 2,000 or more similar tweets (most of which have since been deleted):
And on and on it goes with Nicole Prause and the porn industry. For many more exmaples of Prause’s intimate relationships with members of the porn industry and her support of porn industry agendas see – Is Nicole Prause Influenced by the Porn Industry?.
Is it any surprise that FTND, or anyone else, might wonder if Prause, a former academic with a long history of harassing authors, researchers, therapists, reporters and others who dare to report evidence of harms from internet porn use, who lives in LA, who has obtained study subjects through the FSC, who hangs out with big names in the industry, who attends porn industry award ceremonies, and who has publicly been offered (and accepted) support by the FSC, might be influenced by the porn industry?
Again, no one has claimed Prause receives direct funding from the FSC. In fact, it seems most unlikely that the FSC would make any such arrangements directly, let alone make them public, even if they did exist. Nor has anyone stated that Prause is “in the porn industry” or “has, herself appeared in pornograpy“, as she falsely asserted in her bogus cease and desist letters, and in her response to Don Hilton, MD’s defamation lawsuit. See:
Beginning in July, 2013 (a few days after Wilson published his careful critique of Prause’s first EEG study) various usernames began posting defamatory comments wherever Gary Wilson’s name appeared. The comments were very similar in content and tone, falsely claiming that “Wilson has a police report filed on him,” “Wilson is charged with stalking a poor woman,” and that “Wilson has been reported to LAPD (which agrees that he’s dangerous) and the UCLA campus police.”
Very shortly, Prause, as herself, began to claim that a “person” had been reported to the police for physically stalking her, threatening her lab, mapping a route to her lab (whatever that means), and other vague fabrications.
By 2016, as Prause was no longer employed by UCLA or any other institution that could rein in her cyber-harassment, she finally began to identify Gary Wilson as the “person” she had reported to the LAPD and the UCLA campus police.
The facts? It has been over 5 years since her harassment began, and Wilson has never been contacted by a police department. Wilson had always presumed that Prause had, in fact, filed fraudulent, groundless reports (which were subsequently disregarded), but it turned out Prause was lying – again. In late 2017 a call to the Los Angeles Police Department and the UCLA campus police revealed no report in their systems on a Gary Wilson, nor any report filed by a Nicole Prause. Apparently Prause knows better than to waste authorities’ time with baseless complaints.
In 2018, Prause upped her game, claiming on social media (and probably in emails to journalists, conference organizers, and colleagues) that she had reported Wilson to the FBI for “physically stalking” her. This is absurd as Wilson hasn’t been in Los angles for years. Prause has even claimed that Wilson was seen outside her window.
In late October, 2018 Prause added yet another victim to her list of defamation targets. She claimed to have reported NoFap.com founder Alexander Rhodes to the FBI for calmly responding to her defamatory barrage of sickening tweets (see above).
In late October, Gary Wilson filed an FOIA request with the FBI to find out if Prause had ever filed a report naming him. She had not. Below you will find:
1) A copy of an FOIA request regarding Nicole R. Prause,
2) A letter from the FBI stating that no such report exists, and
3) Several screenshots documenting Prause falsely claiming to have reported Gary Wilson to the FBI.
Sadly, social media comments by Prause’s colleagues indicate that some actually believe she has been stalked and threatened. The facts are that she has been entirely dishonest, unprofessional and unethical in her relentless efforts to defame the blameless.
FOIA request regarding Nicole R. Prause (screenshot of email sent from FBI)
The “additional information” section asks if an FBI report has been filed on Gary Wilson (naming Prause). As you can see from the letter below, there is no FBI report.
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Letter from FBI confirming that Prause never filed an FBI report on Gary Wilson:
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Prause has been lying for years about reporting Gary Wilson to the “police” or FBI – and she continues her lies to this day. Below is a sampling of Prause tweets and comments asserting that she reported Wilson to the FBI.
The following is taken from the comments section under ICD-11 new proposal for “Compulsive Sexual Behavior Disorder.” Prior to the release of the “implementation version, ” a beta draft of the ICD-11 was put online, and made available for interested parties to comment on. (A simple sign-up is needed to view and participate.) Note: Prause has posted more comments in the beta-draft comment section than everyone else combined. Several Prause comments mention Gary Wilson, even though he never posted a comment. In this comment Prause falsely states that anyone is welcome to review the FBI, UCLPD, and LAPD files on Gary Wilson.
Prause never provides a link to, or a screenshot of, her many “public police and FBI reports” because they do not exist.
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Again, Prause offers the world her non-existent police and FBI reports:
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In a sad and disgusting ploy, Prause convinced a site devoted to battered women that she too was a victim, and had reported the man from Oregon (where Wilson lives) to the police and FBI. They featured Prause’s tale of victim-hood in an article about social media safety. Relevant excerpt:
While the article did not name Wilson, various tweets and Prause’s Amazon pages reveal that Prause is referring to Wilson.
Wilson: “Needless to say, I have never mapped out a route to her location, or even been in LA since I have known of her existence. Nor are there FBI or police reports naming me. All her claims are fiction except for the part about her name being on my website multiple times, which are primarily on the pages chronicling her defamation and harassment.”
Prause tweeting about her “frightening cyber-stalker”:
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In her 25 tweet tirade against NoFap (chronicled in this section), Prause directs gratuitous insults toward Gary Wilson and the multiple police and FBI reports she supposedly filed (Wilson was never mentioned by Nofap.com):
Prause scoured NoFap.com to produce a random comment by an excessively polite Middle Eastern man who referred to Gary Wilson as “professor.” In Prause’s bizzaro world, this comment constitutes “proof positive” that Gary Wilson claimed to be a professor (Prause’s false claims debunked here: Ongoing – Prause falsely claims that Wilson has misrepresented his credentials).
This is one of 20 comments about Gary Wilson (or Wilson’s wife) that Prause posted under a “Mormon Matters” podcast: 353–354: Championing the “Addiction” Paradigm with Regard to Pornography/Sex Addiction. In Podcast 353–354, Mormon Matters host Dan Wotherspoon was joined by four panelists: Jackie Pack (LCSW, CSAT–S, CMAT), Alexandra Katehakis (MFT, CSAT-S, CST-S), Stefanie Carnes (Ph.D., CSAT-S), and Donald Hilton (M.D.). Within a few minutes of the podcast going live, Nicole Prause and, apparently, her sock puppets (“Skeptic”, “Lack of expertise on panel”, “Danny”) posted a dozen comments attacking the four panelists and Gary Wilson.
All of the many comments under podcast: 353–354, including several libelous ones by Prause, have mysteriously disappeared.
Even after the above documentation from the FBI proving that Prause is lying about reporting either Gary Wilson or Alexander Rhodes to the FBI, Prause continues to spread her lies. On a Sunday she Trolls the twitter thread of anti-sex trafficking, radical feminist Laila Mickelwait, repeating the same old lies in her two tweets (FBI reports, name on YBOP 82,000 times, stalking, sexual harassment, etc.).
December, 2018: Gary Wilson files an FBI report on Nicole Prause
As documented on these two pages, Nicole Prause has been claiming since 2013 that she reported me to the LAPD. In the last few years Prause has tweeted dozens of times that she has also reported me (and others) to the FBI (for what, it was never clear). In the beginning Prause employed dozens of fake usernames to post on porn recovery forums, Quora, Wikipedia, and in the comment sections under articles. Prause rarely used her real name or her own social media accounts. That all changed after UCLA chose not to renew Prause’s contract (around January, 2015).
Freed from any oversight and now self-employed, Prause began tweeting she had reported me to the FBI and LAPD. Just know that I have screenshots of about 500 Prause tweets defaming me. It is Prause who is the cyber-stalker. While I wouldn’t have put it past Prause to file false police and FBI reports, it wasn’t until 2016 that I contacted the LAPD. In a phone conversation I asked if a police report by a Nicole Prause, or on Gary Wilson, was in their database. None were. This is documented in this section: Ongoing – Los Angeles Police Department and UCLA campus police confirm that Prause lied about filing police reports on Gary Wilson
Note: while Prause claimed to have filed a police report all the way back in 2013, she provided you with an April, 2018 LAPD report. Put simply, Prause had been lying for 5 years. While the LAPD will not provide written documentation of police reports, the FBI will. In October, 2018 I filed an FOIA request with the FBI to find out if Prause had ever filed a report naming me. As expected the FOIA revealed that Prause has never filed a FBI report, even though she has tweeted this multiple times and posted this same claim on the FTND Facebook page (see this section May 30, 2018: Prause falsely accuses FTND of science fraud, and implies that she has reported Gary to the FBI twice).
In talking to FBI agents on the phone I was encouraged to file an official FBI report on Nicole Prause. Which I did. Put simply, while Prause filed a silly police report (its not a crime to screenshot defamatory tweets), I was encouraged by an FBI agent to report Prause to both the FBI and the LAPD. My FBI report, which I have yet to place on the Prause pages, is below in a series of screenshots. The last screenshot is my signature confirming that I am aware that lying to the FBI is serious crime:
Ongoing – Los Angeles Police Department and UCLA campus police confirm that Prause lied about filing a police report on Gary Wilson
As recounted in the preceding section, starting in July, 2013 (a few days after Wilson published his careful critique of Prause’s first EEG study) various usernames began posting defamatory comments wherever Gary Wilson’s name appeared. The comments were very similar in content and tone, falsely claiming that “Wilson has a police report filed on him,” “Wilson is charged with stalking a poor woman,” and “Wilson stole a woman’s pictures and placed them on a porn site”,a nd that “Wilson has been reported to LAPD (which agrees that he’s dangerous) and the UCLA campus police.” Very shortly, Prause, as herself, began to claim that a “person” had been reported to the police for physically stalking her, threatening her lab, mapping a route to her lab (whatever that means), and other vague fabrications.
Prause: Dr. Prause had to file a police report and close and hide her UCLA laboratory under threat from this blogger and now requires physical protection at all her public talks from him. He has since been spotted in Los Angeles near the scientist’s home and LAPD threat management has been alerted.
Closed her Lab? Armed guards? Spotted near her home? All this because YBOP critiqued her 2013 EEG study?The facts? All these claims are untrue, and the claim that “Wilson has been spotted seen near the scientist’s home” is also fiction. Wilson hasn’t been to LA in years.
It has been over 5 years since Prause’s harassment began, and Wilson has never been contacted by a police department. Wilson had always presumed that Prause had, in fact, filed fraudulent, groundless reports (which were subsequently disregarded), but it turned out Prause was lying – again.In late 2017 a call to the Los Angeles Police Department and the UCLA campus police revealed no report in their systems on a Gary Wilson, nor any report filed by a Nicole Prause. Apparently Prause knows better than to waste authorities’ time with baseless complaints.
Below we provide a sampling of Prause and her many internet aliases posting that Gary Wilson had been reported to the police for “stalking”, “stealing photos” or over-all badness (PDF of Nicole Prause aliases she used to harass & defame).
Prause also posted PDF’s – with all her lies – on document sites in late July, 2013.
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After 3 years of hiding behind fake usernames, and freed of any employer, Prause starts tweeting the same lies that as her many aliases – Gary Wilson’s been reported to the police, and has a no-contact order, etc:
No, Wilson did not contact Prause.
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Tweeting her talk about her (non-existent) victim-hood:
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Tweeting her colleagues that she has been threatened, yet Prause never provides documentation.
Once again, using any opportunity to claim victimhood:
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Prause’s presentations at major conferences include her false tales of being stalked and needing to file police reports:
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Another talk, at her alma mater (Kinsey Institute) detailing fabricated attacks and nonexistent misogyny:
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After her UCLA contract was “not renewed” (early 2015), Prause escalated into naming Wilson as “the stalker” she had reported to police.
Let’s start the “info-graphic” that Prause has tweeted about 40 times in the last two years. Link to Prause’s amazon page – https://s3-us-west-1.amazonaws.com/weilerdefamation/SexismInNeuroscience.jpg
Over the last few years, Dr. Prause appears to have taken great pains to position herself as a “woman being subjected to misogynistic oppression when she tells truth to power.” She frequently tweets this infographic that she apparently also shares at her public lectures, suggesting she is being victimized “as a woman scientist,” and painting herself as a trailblazer forging ahead to prove porn’s harmlessness despite prejudiced attacks. She has even been known to tweet combinations of misogyny claims and claims that (legitimate, peer-reviewed) science with which she disagrees is “fake.” Any suggestion that Wilson, Deem or Rhodes, Don Hilton, or Marnia Robinson are motivated by misogyny is fabricated, as their objections have nothing to do with Dr. Prause as a person or as a woman, and only to do with her untrue statements and inadequately supported claims about her research.
NOTE:
1) Not a single Prause claim is supported by documentation. The only bits of evidence she provides are her spurious cease and desist letters with their false allegations.
2) Nearly every tweet below (and hundreds more of a similar nature) HAVE SINCE BEEN DELETED BY PRAUSE. If Prause were truly a victim of Wilson and others, why did she purge her twitter feed?
Here Prause accuses everyone of stalking:
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Names Wilson as “The Cyberstalker” on Quora. Prause was ultimately banned from Quora for harassing Wilson. The claims about Wilson misrepresenting himself are lies and based on a web page that no longer exists, and was most likely created by Prause:
Who’s doing the stalking when Wilson never tweets about Prause yet she has tweeted about Wilson over 500 times as herself, and commented about Wilson with over 100 internet aliases (PDF of Nicole Prause aliases she used to harass & defame).
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More lies about police reports:
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Armed guards:
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Just like the earlier aliases, Prause claims stolen photos, stalking, and armed guards:
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The twitter convo is about Wilson:
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More lies about threats and non-existent police reports:
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Tagging researchers with her false tale of being ‘physically stalked”
As explained elsewhere most instances of “Prause” occur on the pages chronicling Prause’s harassment and libel.
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Prause is a regular commentator under Psychology Today blog posts. Sometimes she uses her name, often she does not. Either way, Prause cannot engage in substantive debate. She usually responds with personal attacks and unsupported claims of victim-hood.
A sampling of 20 comments about Gary Wilson (or Marnia Robinson) that Prause posted under a “Mormon Matters” podcast: 353–354: Championing the “Addiction” Paradigm with Regard to Pornography/Sex Addiction. In Podcast 353–354, Mormon Matters host Dan Wotherspoon was joined by four panelists: Jackie Pack (LCSW, CSAT–S, CMAT), Alexandra Katehakis (MFT, CSAT-S, CST-S), Stefanie Carnes (Ph.D., CSAT-S), and Donald Hilton (M.D.). Within a few minutes of the podcast going live, Nicole Prause and, apparently, her sock puppets (“Skeptic”, “Lack of expertise on panel”, “Danny”) posted a dozen comments attacking the four panelists and Gary Wilson.
Over and over Prause falsely claims that Wilson has a “no-contact order” (she doesn’t, and there is no such thing). Prause always asserts she has a imaginary no-contact order, or FBI report, or police report, because she cannot engage in actual debate.
Here lies about “police reports”, stalking, that Wilson said she papered in porn (LOL), etc:
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More of the same falsehoods, incuding stalking, no-contact orders, etc.
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Prause falsely claims that Gary Wilson is a stalker legally prohibited from commenting anywhere on the internet.
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Once again Prause points out that her name appears on YBOP over 2,000 times, failing to mention that most instances occur on the 5 pages chronicling Prause’s behaviors:
Others – November, 2018: Prause resumes her unprovoked, libelous attacks on NoFap.com & Alexander Rhodes
Nicole Prause’s obsessive cyber-harassment of Nofap.com and founder Alexander Rhodes (and men trying to quit porn) resumed even after her multiple unmerited attacks in October, 2018. Right after Thanksgiving Prause tweeted Huffpost journalist Andy Campbell with her usual concoction of falsehoods and guilt-by-association ad hominem fallacies:
As described above, Alexander Rhodes debunked Prause’s malicious attempts to assert guilt-by-association by citing Twitter users who do not represent Nofap.com and are not members of Nofap.com. (In fact, Nofap.com had sent the Twitter account cited by Prause (“NoFap ResistanceArmy”) a cease and desist letter.)
Once again we have the cyber-stalker and harasser playing the victim. Propaganda in its purest form.
Others – December, 2018: Prause joins Xhamster to smear NoFap & Alexander Rhodes; induces Fatherly.com to publish a hit-piece where Prause is the “expert”
Prause’s obsessive cyber-stalking and defamation of Alexander Rhodes and Nofap continue. Apparently, Prause’s expensive PR firm and query bombardment of media outlets resulted in yet another hit piece, published by Fatherly.com (written by Lauren Vinopal). The “journalist” did little more than copy and paste Prause’s Twitter threads, quoting her as the world’s expert on everything related to Nofap.com, reddit/nofap, and men trying to quit porn.
First, here’s the barrage of unprovoked tweets, which mirrors previous unsupported drivel in this same “quitting porn causes fascism” (huh?) press campaign. Prause’s first tweet is on the Xhamster thread smearing Nofap. Prause falsely states that Rhodes “worked with” VICE founder Gavin McGinnes:
On the other hand, Prause joined Xhamster’s thread with the above tweet. Does this mean she is “working with” a major porn site to attack a porn-recovery forum (again)? This occurred after Xhamster complained to the world that NoNut November was affecting its bottom line:
Here’s a second Prause tweet in the Xhamster thread, where she spreads more of her toxic misinformation and tells Xhamster to Direct Message her:
What is true? Nicole Prause appears to be “working with” Xhamster to spread falsehoods about Nofap, Alex Rhodes, and Gary Wilson. For much more on Prause’s very cozy relationship with the porn industry, see: Is Nicole Prause Influenced by the Porn Industry?
On the same day Prause repeats her lies on a Sarah Manavis thread promoting the Manavis article attacking Nofap, supporting Xhamster, and parroting everything Prause has tweeted in the previous 3 weeks:
It’s highly suspicious that Sarah Manavis somehow knew about a random xHamster Twitter thread, that her hit piece closely mirrors Prause talking points, and that Manavis did not contact Alexander Rhodes for comment. Did Prause “work with” Sara Manavis behind the scenes?
A few days later Prause crows about the Fatherly.com piece she helped with:
“I think ‘No Nut November’ is largely anti-science,” psychophysiologist and neuroscientist Nicole Prause, told Fatherly. “The new designation, and it is hardly a tradition, appears supported most by the for-profit NoFap company, some religious organizations, and groups like Proud Boys. These are largely known for their very young male members and misogyny.”
More lies as NoFap.com had nothing to do with NoNutNovember, and claims that there’s a link between quitting porn and misogyny are the exact opposite of what the research shows and what men on the forums report.
The truth? The origins of NoNutNovember, and other “no fap” months, can be traced to a 2006 Subaru Imprezza thread. This was going on long before r/nofap was created on June 20th, 2011. Note that NoFap’s guidelines say porn is forbidden, but sex is just great. Not exactly a trend that XHamster, or its supporters, want to see. After all, it hurts their bottom line…by their own public admission.
Just for the fun of it, Prause adds another tweet (with the same lies) into the mix:
Gotta give it up to Prause. It appears that with the aid of her PR firm, and apparently Xhamster, her tireless work paid off. It all started with Ley’s (and her) inflammatory Psychology Today blog post… and eventually mushroomed into a propaganda meme that “the little ol’ porn industry is the victim of evil younguns who no longer watch porn.” Sadly, this fabricated meme has now been recklessly pumped up by irresponsible “journalists” who are able to disregard facts, common sense, and peer-reviewed studies.
April 25, 2019 – Ley retweets a Xhamster tweet of his fascist PT blog post:
Update: This section is now part of two defamation lawsuits:
Conflicts of interest (COI) are nothing new for David Ley. Lawyers pay him good money to “debunk” sex & porn addiction; he sells books “debunking” sex & porn addiction; he collects speaking fees for “debunking” sex & porn addiction. All this while harassing and defaming individuals and organizations who speak up about the possible negative effects of internet porn.
However, Ley officially has now crossed the line. In a blatant financial conflict of interest, David Ley is being compensated by porn industry giant xHamster to promote their websites and to convince users that porn addiction and sex addiction are myths! Notice how Ley is going to tell xHamster customers what “medical studies truly say about porn, camming and sexuality”:
The fledgling Sexual health Alliance (SHA) advisory board includes David Ley and two other RealYourBrainOnPorn.com “experts” (Justin Lehmiller and Chris Donaghue). RealYBOP is a group of openly pro-porn, self-proclaimed “experts” headed by Nicole Prause. This group is currently engaged in illegal trademark infringement and squatting directed toward the legitimate YBOP. Put simply, those trying to silence YBOP are also being paid by the porn industry to promote its/their businesses, and assure users that porn and cam sites cause no problems. (Note: Nicole Prause has close, public ties to the porn industry as documented on this page.)
In this article, Ley dismisses his compensated promotion of the porn industry:
Granted, sexual health professionals partnering directly with commercial porn platforms face some potential downsides, particularly for those who’d like to present themselves as completely unbiased. “I fully anticipate [anti-porn advocates] to all scream, ‘Oh, look, see, David Ley is working for porn,’” says Ley, whose name is routinely mentioned with disdain in anti-masturbation communities like NoFap.
But even if his work with Stripchat will undoubtedly provide fodder to anyone eager to write him off as biased or in the pocket of the porn lobby, for Ley, that tradeoff is worth it. “If we want to help [anxious porn consumers], we have to go to them,” he says. “And this is how we do that.”
David J. Ley, Ph.D., is a clinical psychologist and AASECT-certified supervisor of sex therapy, based in Albuquerque, NM. He has provided expert witness and forensic testimony in a number of cases around the United States. Dr. Ley is regarded as an expert in debunking claims of sexual addiction, and has been certified as an expert witness on this topic. He has testified in state and federal courts.
Contact him to obtain his fee schedule and arrange an appointment to discuss your interest.
Conflict of Interest #3: Ley makes money selling two books that deny sex and porn addiction (“The Myth of Sex Addiction,” 2012 and “Ethical Porn for Dicks,” 2016). Pornhub (which is owned by porn giant MindGeek) is one of the five back-cover endorsements listed for Ley’s 2016 book about porn:
Conflict of Interest #4: Finally, David Ley makes money via CEU seminars, where he promotes the addiction-deniers’ ideology set forth in his two books (which recklessly(?) ignore dozens of studies and the significance of the new Compulsive Sexual Behavior Disorder diagnosis in the World Health Organization’s diagnostic manual). Ley is compensated for his many talks featuring his biased views on porn use. In this 2019 presentation Ley appears to support and promote adolescent porn use: Developing Positive Sexuality and Responsible Pornography Use in Adolescents.
Others – December, 2018: FBI confirms that Nicole Prause lied about filing a report on Alexander Rhodes
As is clearly evident from the above sections, and several other sections on the 2 Prause pages, the only serial harasser here is Nicole Prause. There are no misogynists among the many Prause targets listed on these pages.
Backstory: Prause has a long history of claiming to have reported Gary Wilson to the LAPD, the UCLAPD, and the FBI, for “stalking” or “misogyny” or who knows what (as have Prause’s many sockpuppets). To convince the world that she filed police and FBI reports, Prause even offers “case numbers” to those who DM or email her. Here’s one of her many tweets claiming FBI reports:
While Prause is plainly capable of filing false police reports, the FBI, LAPD and UCLAPD have all confirmed that she hasn’t dared. She must realize that filing bogus reports could land her in a lot of trouble.
Back to Alexander Rhodes and Nofap. After her October 29 tweet claiming she had filed an FBI report, Prause escalated her harassment and defamation of Rhodes on Twitter and in the press. As seen below, she began by contacting a journalist and a popular porn site to let them know that Alexander Rhodes was (purportedly) under investigation by the FBI because of a report that she had submitted about him. Prause’s assorted tweets suggest the FBI report was for cyber-harassment or cyber-stalking or some other nonsense, after @NoFap refuted her lies about Rhodes being affiliated with an extremist group on Twitter. (He’s not.)
Prause tweets on a Sarah Manavis thread promoting the Manavis article attacking Nofap, supporting Xhamster, and parroting everything Prause had tweeted on the subject during the previous 3 weeks:
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On the same day, Prause tweeted in an XHamster thread, where she spread more of her toxic defamation and told XHamster to Direct Message her:
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Another Prause tweet on the XHamster thread smearing Nofap. Prause falsely states that Rhodes “worked with” VICE founder Gavin McGinnes.
Given the seriousness of Prause’s allegations against him, Alexander Rhodes submitted a Freedom of Information request to the FBI to inquire about possible reports about himself.He submitted the following request on November 27:
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And….. the verdict is in. Rhodes got word back from the FBI. Prause was lying about his FBI report, too.
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Prause has been lying for years about reporting Gary Wilson to “the police” and the FBI – and she continues her lies to this day, defaming yet another victim. As it did with Wilson, the FBI confirmed that Prause is lying about filing an FBI report on Alexander Rhodes (for defending himself against Prause’s obsessive, and suspiciously persistent, defamation).
It’s 2019 and Prause is back at it with false accusation of reparative therapy. As in all previous instances Prause falsely accuses a gay man of performing conversion therapy. In the following string of bizarre tweets, Prause suggests that gay therapist Daniel P Caldwell is a reparative therapist:
Even avid fan Tony D is a bit confused by Prause’s bizarre tweet. Prause replies:
A few days later Daniel Caldwell confronts Prause. She tweets he’s a fake account:
Coming out is a very personal process. I am experienced in helping individuals face their sexuality in a way that will respect their personal goals and beliefs and help them find a path that will make them the happiest and help them to find the healthiest way to do that.
How can Prause continue to hold a license while engaging in targeted defamation of fellow therapists?
Update: Prause & allies continue their libelous campaign
Two lies in one tweet: 1) No Nikky, treating porn addiction is not analogous to conversion therapy. 2) Wrong, The world’s most widely used medical diagnostic manual, The International Classification of Diseases (ICD-11), contains a new diagnosis suitable for porn addiction: “Compulsive Sexual Behavior Disorder.”
What’s fake is Prause alluding to seeing patients. Prause has stated multiple times that she sees no patients.
February, 2019: Confirmation that Prause lied to the organizers of the European Society for Sexual Medicine conference, causing the ESSM to cancel Gary Wilson’s keynote address
In the Fall of 2017, the Scientific Chairs of the World Meeting on Sexual Medicine, organized by the International Society for Sexual Medicine (ISSM) and the European Society for Sexual Medicine (ESSM), invited Gary Wilson to speak at their combined conference in Lisbon, Portugal. Unlike sexology conferences, the speakers and attendees at this one are primarily medically oriented urologists. The conference committee wanted Gary Wilson to present about porn-induced sexual dysfunctions. Wilson was, after all, the second author on the highly cited “Is Internet Pornography Causing Sexual Dysfunctions? A Review with Clinical Reports” and had given a very popular TEDx talk, “The Great Porn Experiment”, which touched on porn-induced ED. A screenshot of the formal invitation:
The committee wanted Wilson to be a keynote speaker, and proposed a talk entitled “The Great Porn Experiment (Revisited).” It was ultimately decided that the talk would be entitled, “Porn-Induced Sexual Dysfunctions.” It would be modeled on Wilson’s July, 2017, Mexico City presentation to urologists.
In relation to Prause’s later online assertions it’s important to point out that Wilson reminded the organizing committee that he did not have a PhD or MD.The committee assured him this was not a problem, and insisted Wilson present. Here’s the email confirming this account:
As you read Prause comments below, note that she falsely claims in multiple tweets that Wilson gave “false credentials” to the ESSM committee. This is clearly not true.
Here’s a screenshot, taken from the 2018 ISSM/ESSM conference website, of Gary Wilson’s scheduled talk. This was placed on their conference website in late October, for everyone to see, including Nicole Prause.
On January 12th, 2018, Wilson’s talk was cancelled, without explanation. The ISSM reimbursed Wilson for travel expenses already incurred, which it certainly would not have done had actual fraud been involved.
Although an explanation would have been interesting, Wilson didn’t really need one. Prause’s 6 years of harassment and behind the scenes maneuvering left no doubt as to who was behind the cancellation. Not only Prause, but most likely with the help of her chum and co-author Jim Pfaus (ISSM member), a sexologist who appears to have been a long-time influence at the ISSM.
As Wilson engaged in no wrongdoing, Prause apparently fabricated some crazy lies to scare off the ISSM (in keeping with her pattern of behavior documented on this page). Conjecture about two of these below.
Twelve days later (January 24, 2018) Prause admits to David Ley that Gary Wilson was “removed for an actual good reason from a conference.” (She’s the only one who seems to “know” this.)
This is a double lie. He was not removed for “an actual good reason.” As an aside, Prause’s claim that Wilson posted on Quora more “than a hundred times in the last month” is also false. In his 4 years on Quora, Gary Wilson only posted 122 times:
Between the time that Wilson received the email from the ISSM committee (1-12-2018), and Prause’s Facebook comment above (1-24-18), Wilson posted exactly zero times on Quora. A screenshot of Gary Wilson’s timeline of Quora posts (available here):
A few months later a Prause tweet alludes to having Wilson removed (“no-platformed”) from the ISSM conference (for supposedly presenting fake credentials. More on that below).
On February 16, 2019, a sexual medicine specialist presented a talk at the 21st Congress of the European Society for Sexual Medicine on the Internet’s impact on sexuality. (This is the same conference to which Wilson was (un)invited a year earlier.) A few slides describing porn-induced sexual problems, citing Park et al., 2016, were tweeted. The tweets caused Nicole Prause, David Ley, Joshua Grubbs and their allies to initiate a Twitter-rage on Park et al., 2016.
Several of Prause’s tweets allude to a keynote address by Gary Wilson scheduled for the 2018 ESSM conference. Let’s start With Josh Grubbs and Prause teaming up to attacking Park et al., 2016. Once again Prause says that Wilson “gave false credentials” to the ESSM conference (accompanied by a picture of Gary Wilson):
Here, Prause specifically states that a talk was “removed for fraud” and the “speaker giving false credentials” (with a picture of Wilson):
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On March 1, 2019, Prause tweets a double lie, clearly alluding to the ISSM. Not only did she lie about Wilson “giving fake credentials” to the ISSM, she says there was a second conference where “he already tried again”. No there wasn’t.
As we saw above, Wilson did not misrepresent his credentials. He communicated in writing with the ISSM that he is neither an MD or a PhD, and the ESSM/ISSM committee was completely fine with this.
So, what did Prause (and Pfaus) tell the committee? It’s likely that Prause fed the ISSM conference organizers her usual collection of falsehoods. For example, we suspect she pointed out that Wilson had been reported to the Oregon Board of Psychology (without cause) for “practicing psychology without a license.” We say this because, not long after the conference, Wilson received a letter from the Board exonerating him of doing so. (They were not permitted to reveal who had filed the malicious complaint.)
Around this time, Prause prepared a libelous blog piece, which she posted on an adult industry website. Prause’s “article” contained a redacted copy of Wilson’s employment records, which Prause falsely claimed were “proof” that Wilson had been fired from Southern Oregon University. Wilson had not been fired, as this page, with Wilson’s un-redacted employment records, and 2 letters from Southern Oregon University, make clear: Libelous Claim that Gary Wilson Was Fired (March, 2018. But it is likely that Prause’s behind-the-scenes reporting of her interpretation of this evidence to the conference organizers would have added to their uneasiness about featuring Wilson as a speaker.
Dr. Prause also regularly claims to people, including perhaps the conference organizers, that Wilson holds himself out as a professor. This is also untrue. (See this link for details: Ongoing – Prause falsely claims that Wilson has misrepresented his credentials.) She may also have told the organizers her oft-repeated lies that Wilson has a restraining order against him for her safety, and that he has have been reported to the FBI. There is no such “no contact” order, and Wilson has already made public a report from the FBI clearing him and confirming Prause as lying.
This conference incident was simply one of the more malicious such actions. More important, it has left key healthcare-givers and their patients ignorant of an apparent cause of sexual performance problems in young men. This serves the porn industry, the makers of sexual enhancement drugs (and their paid “thought leaders”), as well as serving the makers of penis implant devices and penile-revascularization surgery equipment.
March, 2018, Prause tweets a combination of her usual lies about “fake credentials” and sneaking into conferences, and her needing armed guards:
The lies:
1) Prause is lying about reporting Wilson to FBI. Prause also lied about reporting Alexander Rhodes:
(Wilson was eventually banned as several big names continued to make false reports about Wilson). For example, here’s two top Quora users saying their goal is to get Wilson banned:
In addition, the top Quora poster and moderator worked for 2 years to get Wilson banned – https://www.quora.com/profile/Franklin-Veaux (he made several false reports on Wilson, accumulating “evidence” for the ban, while he simultaneously broke Quora rules by chronically naming Wilson in his comments and defaming Wilson).
Others – February, 2019: Prause falsely accuses Exodus Cry of fraud. Asks twitter followers to report the non-profit to the Missouri attorney general (for spurious reasons). Appears to have edited the CEO’s Wikipedia page.
This appears to start with Prause trolling the Twitter thread of anti-sex trafficking, radical feminist Laila Mickelwait, who is associated with Exodus Cry. Prause attempts to persuade the Twitter-sphere that her new orgasmic-meditation study debunks anything and everything one might claim about porn’s negative effects:
The irony is that it appears Prause may have obtained porn performers as subjects through the most prominent porn industry interest group, the Free Speech Coalition. FSC-obtained subjects were allegedly used for a study she was hired to perform in order to bolster the commercial interests of the heavily tainted, and very commercial “Orgasmic Meditation” scheme (which is now being investigated by the FBI). Moreover, it’s likely that none of Prause’s subjects (all females) were actual porn addicts. In addition, self-reported strength of orgasm while being masturbated by a guy (that’s orgasmic meditation) tells us nothing about porn addiction.
The next day Prause attacks anti-sex trafficking non-profit Exodus Cry. Prause lies about the CEO’s salary calling it “six-figure,” when what she tweeted shows it’s really a five-figure salary. This glaring error from a person who claims to be an expert statistician.
Prause ask her followers “to contact the attorney general for fraud.” As always Prause never describes the so-called “fraud” perpetrated on the public. In fact, Prause has never provided one iota of documentation to support her chronic allegations of fraud by the many victims she harasses and defames. It is Prause who is engaging in fraud… as always.
Prause then asks her followers to file spurious complaints against Exodus Cry. Even providing a link for convenience.
The next day she tweets again. Funny how Prause supports the multi-billion dollar porn industry while attacking an anti-sex trafficking organization for paying their CEO a reasonable salary.
You have ask yourself why the majority of a researcher’s tweets consist of libelous attacks on those who suggest that porn may have negative effects. For much more documentation, see: Is Nicole Prause Influenced by the Porn Industry?
On the same day (February 26, 2019) that Prause posted the tweet claiming “CEO Nolon takes *far* in excess of non-profit standards from the donations given” a new user individual edited Benjamin Nolot Wikipedia page to match Prause’s tweet. The edit:
How the edit appeared on the Wikipedia page
As you can see, this solitary edit in the only one by user 67.129.129.52 (probably a fake IP address)
Since Prause has a very long history of employing multiple sockpuppets to edit Wikipedia pages, it takes very little imagination to ascertain the identity of user 67.129.129.52. A few more sections featuring Prause’s Wikipedia sock-puppets:
Prause with more lies, accusing Laila of promoting stalking and sexual harrasment
Reality: I haven’t been in Los Angeles in years. Prause provides no documentation for this claim, which she began publicizing in July, 2013 (a few days after I critiqued her EEG study). Important to note that Prause initiated her “Gary Wilson is a stalker” campaign immediately after I published my critique of Steele et al., 2013, which exposed her as misrepresenting Steele’s actual findings. Prause created numerous aliases to defame me, including this YouTube channel, GaryWilson Stalker (PDF of Nicole Prause aliases she used to harass & defame). A screenshot of my YouTube inbox from July 26, 2013 reveals Prause’s incessant cyberstalking:
Question: Did I drive 800 miles to Los Angeles on the same day I published my detailed critique to hover around UCLA, or did Prause initiate a fabricated campaign of being physically stalked on the day after my critique? Two defamation lawsuits have been filed against Prause for similar liee (Donald Hilton, MD & Nofap founder Alexander Rhodes). Let’s go to trial and expose the truth.
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Others – Nicole Prause & David Ley go on a cyber-harrasment & defamation rampage in response to this article in The Guardian: Is porn making young men impotent?
Prause and Ley were upset because the Guardian Article accurately portrayed porn-induced ED. As explained on these pages, Prause & Ley are obsessed with debunking PIED having waged a 3-year war against this academic paper, while simultaneously harassing and libeling young men who have recovered from porn-induced sexual dysfunctions
All the above is fiction, and a disgusting attempt to misinform the public. The following sections chronicle Prause and ally David Ley’s long history of cyberstalking Alexander Rhodes, including Prause lying about filing FBI reports on Gary Wilson and Alex Rhodes (and David Ley retweeting her lies):
In her tweets, Prause linked to 3 dubious papers (not actual studies). Two papers are Prause’s own propaganda, which have already been extensively dismantled. The third paper is a hit piece on Nofap by a grad student from NZ. Here are Prause’s links, each followed by debunking:
3 – https://journals.sagepub.com/doi/abs/10.1177/1363460717740248 – “‘I want that power back’: Discourses of masculinity within an online pornography abstinence forum”. This link goes to an exchange about the paper between Bart and Prause, on Psychology Today, where Prause defamed Alexander Rhodes. It reveals that Prause is misrepresenting the paper:
In addition to the studies below, this page contains articles and videos by over 130 experts (urology professors, urologists, psychiatrists, psychologists, sexologists, MDs) who acknowledge, and have successfully treated, porn-induced ED and porn-induced loss of sexual desire.
David Ley joins Prause in the harassment of the journalist with unprofessional comments.
Kinsey grad Brian Watson joins Ley & Prause in the direct harassment of Guardian reporter Amy Fleming. Watson lies that the article cited NCOSE (it didn’t). In this tweet, Watson continues his harassment.
In reality, Fleming quoted from Alexander Rhodes’s talk given at a NCOSE event (hundreds of individuals have given talks at NCOSE). Watson is feebly attempting an ad hominem by association (in truth, Rhodes is an atheist and politically liberal), because Watson is incapable of addressing the content of Fleming’s article.
More harassment by Watson, who is obsessed with a NCOSE talk given by Rhodes:
Nope, the Guardian article didn’t “cite” NCOSE. It quoted one sentence from a NCOSE talk by Rhodes who has been featured at multiple conferences, on TV & radio, on podcasts, and in over a hundred different media outlets.
March, 2019: Prause urges journalist Jennings Brown (Senior editor & reporter at Gizmodo) to write a defamatory hit piece on Gary Wilson (she also defames former UCLA colleague Rory C. Reid)
The Jennings Brown article featured Prause ally David Ley as one of its “experts.” David Ley posted the Gizmodo article on his Facebook page. Nicole Prause and Tammy Ellis posted the following comments under Ley’s post, revealing that Prause sent “info” on Gary Wilson to journalist Jennings Brown (in the hope that he would write a defamatory hit-piece):
In her defamatory articles, tweets, and Quora posts Prause has knowingly and falsely stated that Gary Wilson claimed to be “professor in biology” or a “neuroscientist,” or otherwise “faked” his credentials. These 2 sections have already exposed Prause’s claims as lies:
In short, Gary was an Adjunct Instructor at Southern Oregon University and taught human anatomy, physiology and pathology at other venues. Although careless journalists and websites have assigned him an array of titles in error over the years (including a now-defunct page on a website that pirates many TEDx talks where anyone can describe a speaker without contacting them first) he has always stated that he taught anatomy, pathology and physiology (YBOP About us page). He has never said he had a PhD or was a professor.
This incident is just one of many that expose Prause as manipulating the press and governing agencies to defame and harass anyone she disagrees with. Prause also employs a PR firm to contact media outlets as avenues of her fabrications and personal attacks.
NOTE: Prause also refers to her UCLA colleague, who just happens to be Rory Reid PhD. As documented in this section, Prause (using an alias) placed several defamatory comments on the porn recovery site YourBrainRebalanced (December 5th, 2014), urging readers to report Rory Reid to California authorities. As we saw in earlier sections, Prause made a habit of commenting on YBR using various aliases. The first of these comments, by TellTheTruth, contained 2 links. One link went to a PDF on Scribd with supposed evidence supporting TellTheTruth’s claims (Prause regularly use aliases with 2-4 capitalized words as usernames).
Key #1 – The PDF contained the same Rory Reid documents that Prause placed on her AmazonAWS account two years later (confirming Prause as TellTheTruth):
Key # 2 – Not long after Prause (as TellTheTruth) placed her defamatory documents on YBR, UCLA decided to not renew her contract. On the other hand, Rory Reid is still at UCLA.
March 17, 2019: Article by University of Wisconsin-Lacrosse student newspaper (The Racquet) posts false police report by Nicole Prause
This extensive section concerns an article published in the University of Wisconsin-Lacrosse student newspaper: The Racquet Investigates: Fight the New Drug. This March, 17th 2019 hit-piece, masquerading as investigative journalism, targeted Fight The New Drug. Inexplicably, it gratuitously contained a section about Gary Wilson, which featured a baseless April 25, 2018 Los Angeles police report filed almost a year earlier, and supplied to The Racquet, by Nicole Prause.
In the days following publication of The Racquet hit-piece, the section about Wilson was first removed, followed by removal of the entire article. We provide background, details on the bogus police report report, and email exchanges between Wilson and The Racquet and University of Wisconsin administrators. Relevant links:
Original URL for the March 17th article, “The Racquet Investigates: Fight the New Drug” – http://theracquet.org/5838/showcase/the-racquet-investigates-fight-the-new-drug
Since 2013 Nicole Prause has repeatedly proclaimed that she reported Gary Wilson to the LAPD and UCLAP. This defamatory assertion was addressed in several sections of the two extensive pages chronicling Prause’s defamation and harassment of Gary Wilson and others (page 1, page 2).
While police departments do not provide written documentation confirming or denying the existence of a report (to anyone but the person who files them), the FBI does. In late 2018, Wilson filed a Freedom Of Information request with the FBI and the FBI confirmed that Prause was lying: no report had ever been filed on Wilson. See this section for the FOIA request and other documentation exposing Prause as a liar: November, 2018: FBI affirms Nicole Prause’s fraud surrounding defamatory claims.
As part of her full-service pro-porn campaign, Prause has publicly accused almost everyone who has spoken out about the risks of internet porn of serious offenses and crimes – all without one iota of objective evidence. Thus, she has repeatedly lied about reporting others to governing bodies, the police, and also the FBI.
In response to the University of Wisconsin-La Crosse’s chapter of CRU (Campus Crusade for Christ) hosting Fight the New Drug, Samantha Strooza published her first FTND hit-piece: Viewpoint: Fight the New Drug, what exactly are you fighting?Stroozas employed multiple logical fallacies in an attempt to discredit FTND. Yet she failed to cite a single peer-reviewed paper to support various “opinions.”
Dismayed by Stroozas’s biased, factually incorrect propaganda piece, Wilson engaged The Racquet on this Twitter thread, with several tweets linking to hundreds of studies and literature reviews falsifying claims put forth in the article. Strooazs responded with three non-substantive tweets, and Wilson replied:
Faced with overwhelming empirical evidence, student editors Karley Betzler and Samantha Stroozas blocked Wilson on Twitter. This was a critical event as Betzler and Stroozas later authored the March 17th “investigative” article, using it as a vehicle for retaliation against Wilson.
The March 17th Betzler & Stroozas Fight The New Drug article contains a fraudulent police report by Nicole Prause.
As stated, the Karley Betzler and Samantha Stroozas article (“The Racquet Investigates: Fight the New Drug”) was so egregious that University of Wisconsin officials forced the student editors first to remove any mention of Wilson, and, a few days later, to delete the entire article.
Like Stroozas’s first hit-piece, the March 7th article was devoid of peer-reviewed citations or statements from academics. Instead, it featured three non-academics who regularly team up on social media to harass and defame both Wilson & Fight the New Drug: Nicole Prause, David Ley, and Daniel Burgess. These links provide examples of Prause, Ley and Burgess engaging in provable defamation and targeted harassment of FTND and Wilson:
So it’s no surprise that the Betzler & Stroozas hit-piece was little more than cobbled together Prause/Ley/Burgess tweets and Facebook comments interspersed with narrative taken from this 2015 Daily Beast article by yet another “ex-Mormon.” All the signs point to Betzler and Stroozas regurgitating whatever Prause/Ley/Burgess furnished.
In apparent retaliation for Wilson’s February Twitter comments Betzler & Stroozas created a section about Wilson, which featured a baseless April 25, 2018 (i.e., a year earlier) Los Angeles police report filed, and supplied to The Racquet, by Nicole Prause. (Screenshot of section & police report to the right.)
The purported editorial justification for the defamation of Wilson was an malicious email Prause sent to UWL’s Chapter of Cru. Prause told Cru that they were “promoting sexual harassment in your selection of Fight The New Drug for a presentation.” Prause moves on to defame Wilson, feigning concern (“I was just floored“) that FTND contained a few links to www.yourbrainonporn.com, run by Gary Wilson. Prause tells Cru that “FTND is promoting a person who is stalking and threatening scientists. Like, that is not a joke.”
Actually it is joke, a bad joke. Because Prause is the perpetrator, not the victim here. These extensive pages (1, 2, 3, 4, 5) document hundreds of incidents where Prause has defamed and harassed Wilson and many others, including Fight The New Drug, researchers, medical doctors, therapists, psychologists, colleagues from her brief stint at UCLA, a UK charity, men in recovery, a TIME magazine editor, several professors, IITAP, SASH, the academic journal Behavioral Sciences, its parent company MDPI, US Navy medical doctors, the head of the academic journal CUREUS, and the journal Sexual Addiction & Compulsivity.
Did Prause provide any documentation for her spurious assertions? Nope. Did Betzler or Stroozas ask Wilson or FTND about Prause’s suspect allegations? Nope. Did Betzler or Stroozas even bother to do a Google search? Apparently not, as the top two Google returns for “Gary Wilson Nicole Prause” are two of the four primary pages documenting Prause’s harassment and defamation of Wilson and others (including FTND):
The two “investigative journalists” hadn’t bothered to investigate.
Prause’s baseless police report didn’t report any crime, including “stalking”
As explained, Prause had been claiming since 2013 that “a police report has been filed” on Gary Wilson. However, the police never bothered to contact Wilson, and a call in 2017 to the Los Angeles police and the UCLA campus police revealed no such report in their systems. This was not surprising as Prause is a pathological liar and filing a false police report is a crime.
Perhaps motivated by YBOP exposing her lies, Prause brazenly filed her bizarre police police report on April 25, 2018 – almost a year before The Racquet published it. Wilson was unaware of the malicious report until Betzler & Stroozas posted one page of it in their March 17th hit-piece. In a classic example of yellow journalism Betzler & Stroozas mischaracterized it as a “Stalking report filed by Dr. Nicole Prause.” It was not a stalking report as Prause’s never stated that Wilson was in Los Angeles, stalking her. Nor was it a cyberstalking report as the “Suspects Actions” section contained two incidents that were neither stalking nor a crime. A screenshot of the two alleged “crimes”:
What Prause alleges, followed by reality:
“Suspect posted victim name and pic on his website. Suspect refused to remove pictures.”
While screenshots of Prause’s defamatory tweets and her name appear on YBOP, this is not a crime. To the contrary, the pages with screenshots chronicling her ongoing harassment (1, 2, 3, 4, 5) are documenting her misdeeds: libel and cyberstalking. As documented here, Prause has attempted to hide her egregious behavior by filing 3 unjustified, and unsuccessful, DMCA take-downs to have the screenshots of her incriminating tweets removed.
For those who may not know, DMCA stands for Digital Millennium Copyright Act. A DMCA take-down notice is used to have copyrighted materials removed from a website. Prause filed a DMCA take-down as a backdoor way to have this page chronicling her harassment and defamation removed or gutted. Prause is claiming that screenshots of her defamatory tweets are copyrighted material. Tweets are generally not copyrightable, and hers are not.
“Suspect traveled to Germany to victim’s conference. Suspect was not invited.”
Apart form the fact that attending a conference is not a crime, Prause is lying.
It’s true that Wilson traveled to Germany and attended the 5th International Conference on Behavioral Addictions, which ran from April 23-25 (note that Prause filed her police report on April 25th). The untrue part is that Prause had no intentions of attending the ICBA conference in Germany. Prause has never attended or given a presentation at an ICBA conference. Prause doesn’t believe in behavioral addictions. Throughout her entire career Prause has waged a war against the concept of behavioral addiction, especially sex and porn addiction. She’s an “addiction-denier.”
There’s no better example of this than Prause spending the last 4 years obsessively posting in the comments section of ICD-11 beta draft, for Compulsive sexual behaviour disorder section (CSBD) – the World Health Organization’s new diagnosis suitable for diagnosing porn addiction. Prause posted about 40 comments, more than everyone else combined, doing her best to prevent the CSBD diagnosis from making it into the final manual (you can’t read the comments unless you create a username). Her attempt failed, as “Compulsive Sexual Behavior Disorder” is now slated for inclusion in the ICD-11.
There is no way in hell that Prause would attend the ICBA as she would run into several members of the ICD-11 CSBD work-group and multiple other researchers who publish high-quality studies supporting the porn addiction model. In fact, several big name researchers who have formally criticized Prause’s flawed EEG studies and were scheduled to present (i.e. Valerie Voon, Marc Potenza, Matuesz Gola, Matthias Brand, Christian Laier). Put simply, Prause would have been surrounded by many of the people she deplores and attacks on social media and behind the scenes (links to these researcher’s critiques of the two Prause EEG studies: 1, 2, 3, 4, 5, 6, 7, 8). Many of these researchers are keenly aware of Prause’s ongoing unprofessional behavior and behind the scenes machinations.
Then we have the obvious: there is no way for Prause to have known in advance that Gary Wilson was attending the ICBA conference. As noted, Prause filed her police report on April 25th, the last day of the ICBA conference. This means that Prause was told of Wilson’s attendance by another conference attendee (Prause’s former UCLA colleague/roommate also attended).
Moving on, the second part of the Prause police report is equally factually incorrect, yet downright hilarious:
Even though Prause never claimed that Wilson was seen in LA, she describes his “personal oddity” as “wearing sleeping bag” and his weapon of choice as a “long sleave (sic) sweater.” Sounds like a SNL skit. It’s hard not to imagine the police officer biting her lip, trying not to crack-up, as she jots down Prause’s drivel. In any case, Gary Wilson hasn’t been in either Los Angeles or a sleeping bag in years.
In addition to wrongly describing his attire, Prause’s description of Wilson contains multiple inaccuracies: he’s not 65 years old, nor 5’6″, nor 120 pounds.
Did Betzler & Stroozas fact-check a single word in Prause’s bogus police report. Of course not. They had an agenda to fulfill.
The email exchanges between Gary Wilson and Betzler, Stroozas, University of Wisconsin-Lacrosse representatives
Reproduced below are the emails exchanged between Gary Wilson and Betzler & Stroozas or University of Wisconsin representatives. Relevant commentary is provided. Note: Wilson suspected that Betzler & Stroozas were forwarding his emails to David Ley and Nicole Prause. This was confirmed in the very last email and in David Ley’s rage-tweeting about The Racquet article being deleted, before all the parties were notified.
Gary Wilson’s initial email to editor-in-chief Betzler and the University of Wisconsin-Lacrosse counsel, chancellor, and vice-chancellor (Sunday, March 17th):
From: gary wilson Sent: Sunday, March 17, 2019 3:43 PM To: Noah Finco; Karley Betzler Cc:[email protected]; Joe Gow; Bob Hetzel Subject: Article in The Raquet contains a false police report naming me
I was alarmed to read in the above article that a false police report may have been filed about me with the LAPD. I have never heard anything about such a report, which makes me doubt it was actually filed. Do you have any evidence suggesting that it was? My guess is that Nicole Prause is too clever to waste police resources by filing a false report such as this, as that is a crime.
On the other hand, if indeed Prause did file this report, nothing in it is true. The police evidently did not believe the report was worth investigating (dated 4-22-18). I certainly have heard nothing about it.
Please be aware that Prause has, for years, been harassing me (and many others who raise concerns about the risks of internet porn over-use). She has made multiple false claims of reporting me to the police and the FBI, as well as claiming that she has a “no-contact order” against me. See:
Distressed by such reports, which I knew about solely via Prause’s ongoing defamatory social media campaign, I called the LAPD a couple of years ago. They explained that they do not supply formal evidence that no reports have been filed, but the woman I spoke with took pity on me and assured me that no report existed. Again, if this latest effort on Prause’s part had indeed been filed, I believe I would have heard from the LAPD by now.
As I have never stalked Prause or attended any conference where she was present, there is no way this can be a legitimate report. Kindly remove the report from your publication, so I don’t have to take legal action.
Please let me know that you have removed the defamatory police report.
Best regards,
Gary Wilson
Co-author Karley Betzler replied on the same day (UWL is on Central Time)
From: Karley Betzler Sent: Sunday, March 17, 2019 3:24 PM
To: gary wilson
Cc: [email protected]; Joe Gow; Bob Hetzel; Samantha Stroozas
Subject: Re: Article in The Raquet contains a false police report naming me
Good evening,
Thank you for reaching out to us. I have attached the full report we received from Nicole Prause above.
Gary, we will gladly update the article to include a quote from you stating the report is fake.
Gary Wilson replied saying he would soon follow-up with a more extensive response:
From: gary wilson Sent: Sunday, March 17, 2019 3:51 PM
To: Karley Betzler
Cc: [email protected]; Joe Gow; Bob Hetzel; Samantha Stroozas
Subject: Re: Article in The Raquet contains a false police report naming me
Thanks Karley. The report certainly looks genuine. The issue is that the allegations are false, and were not even investigated by the police. Yet they still appear in your paper. I will send you a more thorough response shortly.
Had you performed an actual investigation you would quickly have found the carefully documented pages I linked to earlier, and this page where Nicole Prause placed my redacted employment documents (Southern Oregon University) on multiple social media outlets and on porn-industry website (falsely claiming that I was fired). See – Libelous Claim that Gary Wilson Was Fired (March, 2018).
Southern Oregon University lawyers were forced to get involved to respond to Prause’s falsehoods. Documentation and the lawyer letters are posted on the above page documenting Prause’s libelous claim that I was fired.
I will email soon with much more.
Best regards
Gary
A few hours later Gary Wilson provided more documentation of Prause’s long history of harassment and defamation, including Prause chronically lying about having filed FBI reports, and copies of Gary Wilson’s FBI report he filed on Prause:
From: gary wilson <[email protected]> Sent: Sunday, March 17, 2019 8:40:05 PM
Dear Karley,
It is disturbing that your paper would publish a police report about someone, endorsing its content, without contacting the person named in it for comment, and without doing a more thorough investigation of the person from whom you received such a defamatory item. I would like you to remove the report.
With respect to the allegations in the report (about which I had heard nothing until your paper published it), here are my comments:
I haven’t stalked Dr. Prause or ever considered it. In fact, I haven’t been in LA, or in a sleeping bag, for many years.
It is true that Dr. Prause’s name appears on my website many times, mostly on the two extensive pages carefully documenting her defamation and unending attacks on others and myself. Again, have a look at them so you understand more fully whom you are dealing with when you print content from Dr. Prause.
The pictures she complains of (and wants removed from my website) are screenshots of her tweets, not photographs of her. They document her ongoing campaign of malicious harassment of people who call attention to the harms associated with overuse of internet pornography, myself included. Screenshots of tweets are not copyrightable images, and are therefore not subject to DMCA take-down demands (which she has repeatedly made to my internet provider unsuccessfully). Her trip to tell the police about it doesn’t surprise me. Nor does it surprise me that they did not follow up on her baseless accusations.
The only conference I attended in Germany is one that Dr. Prause would never have been interested in: the International Conference on Behavioral Addictions. Prause is an avid addiction-denier, who regularly fails to cite any of the research by addiction research experts of the type who attended that conference. I registered and attended as an interested member of the public, not as a gate-crasher as she claims. Nor did I announce my attendance publicly, so how would she even know I attended? I have never attempted to attend any conference where Prause was presenting. Nor would I want to.
For your information, I am the author and co-author of two peer-reviewed papers on the subject of internet pornography, and also the author of a very highly regarded lay book on internet pornography and the emerging science of addiction, so my decision to attend such a conference is hardly surprising. If you would like a copy of my book, I’ll send you one.
Karley, contrary to your claims your paper’s article was not an investigative piece concerning the current state of the research related to porn’s effects (which can found on this page: The Main Research Page). There’s abundant academic research highlighting the risks of internet porn overuse, and that’s a very interesting story indeed.
Instead your journalists attempted to smear Fight The New Drug – in part by smearing me, then connecting me to FTND. But it makes no sense to smear me without considering the pages upon pages of peer-reviewed research linked to on my 11,000-page website: https://www.yourbrainonporn.com/. I must assume FTND linked to my site because the links to all that research are available there.
I would like you to remove the police report smearing me, and any mention on me. It is baseless and malicious, and part of a long line of such activities engaged in by Dr. Prause and her pro-porn colleagues. Please know that Dr. Prause has been under investigation by the California Board of Psychology for more than 2 years for her harassment of others (while posing as the victim). Your paper appears to be helping her with her defamatory campaign. This is unacceptable.
More on police and FBI reports.
As documented on the two pages, Nicole Prause has been claiming since 2013 that she reported me to the LAPD. In the last few years Prause has tweeted dozens of times that she has also reported me (and others) to the FBI (for what, it was never clear). In the beginning Prause employed dozens of fake usernames to post on porn recovery forums, Quora, Wikipedia, and in the comment sections under articles. Prause rarely used her real name or her own social media accounts. That all changed after UCLA chose not to renew Prause’s contract (around January, 2015).
Freed from any oversight and now self-employed, Prause began tweeting she had reported me to the FBI and LAPD. Just know that I have screenshots of about 500 Prause tweets defaming me. It is Prause who is the cyber-stalker. While I wouldn’t have put it past Prause to file false police and FBI reports, it wasn’t until 2016 that I contacted the LAPD. In a phone conversation I asked if a police report by a Nicole Prause, or on Gary Wilson, was in their database. None were. This is documented in this section: Ongoing – Los Angeles Police Department and UCLA campus police confirm that Prause lied about filing police reports on Gary Wilson
Note: while Prause claimed to have filed a police report all the way back in 2013, she provided you with an April, 2018 LAPD report. Put simply, Prause had been lying for 5 years. While the LAPD will not provide written documentation of police reports, the FBI will. In October, 2018 I filed an FOIA request with the FBI to find out if Prause had ever filed a report naming me. As expected the FOIA revealed that Prause has never filed a FBI report, even though she has tweeted this multiple times and posted this same claim on the FTND Facebook page (see this section May 30, 2018: Prause falsely accuses FTND of science fraud, and implies that she has reported Gary to the FBI twice).
In talking to FBI agents on the phone I was encouraged to file an official FBI report on Nicole Prause. Which I did. Put simply, while Prause filed a silly police report (its not a crime to screenshot defamatory tweets), I was encouraged by an FBI agent to report Prause to both the FBI and the LAPD. My FBI report, which I have yet to place on the Prause pages, is below in a series of screenshots. The last screenshot is my signature confirming that I am aware that lying to the FBI is serious crime:
———-
———-
————–
——————
———————
Again, I request removal of the spurious Prause “police report,” and any mention of me. Otherwise, I will seek legal counsel in this matter.
Sincerely,
Gary Wilson
Author of the first FTND hit-piece, and managing editor, Samantha Stroozas immediately replied and retaliated by placing all 3 pages of Prause’s malicious LAPD police report into the published article:
From: Samantha Stroozas <[email protected]> Sent: Sunday, March 17, 2019 7:01 PM
To: gary wilson; Karley Betzler
Cc: [email protected]; Joe Gow; Bob Hetzel
Dear Gary,
The article is being updated to include the full police report. We understand your claims, but it is not The Racquet’s job to engage in politics between businesses, but more so, to prove further description to publicly accessed information. That is what the police report serves as – a representation of a publicly assessed document that aided in our research. If there is a true problem with this, that is not in regard to politics of institutions that do not involve us, the Office of General Counsel will contact us and we will take care of it. Until then, we appreciate your concerns, but we stand by our piece.
On Wednesday, March 20th Gary Wilson directly emails the 3 senior counsels for the University of Wisconsin system. The University of Wisconsin-Lacrosse counsel, chancellor, and vice-chancellor are once again copied. Student editors Betzler & Stroozas are omitted from this and all later emails sent by Wilson.
RE: Baseless, defamatory police report reproduced in The Racquet
This email concerns a highly defamatory article that appeared in La Crosse’s school newspaper, The Racquet: https://theracquet.org/5838/showcase/the-racquet-investigates-fight-the-new-drug/. This is another request to remove the groundless and maliciously filed police report about me that appears in it, along with the defamatory and disproven allegations the editors gratuitously included in the article. (The piece is purportedly an expose about a quite different organization that is critical of pornography, Fight the New Drug, or “FTND.”) See email thread below current email.
As explained to The Racquet editors (with much supportive documentation), the person who filed the police report (and who supplied it to the editors in full) is a known harasser who is under investigation by the State of California for similar attacks against myself and many others: Nicole Prause, a former UCLA researcher whose suspect coziness with the porn industry has been documented. For at least 6 years she has been claiming to have filed police and FBI reports against me. When (in 2017) I finally confirmed with the LAPD that she had not, in fact, done so, and made that fact public, she filed this report.
I first learned of this police report, which says it was filed almost a year ago, a few days ago, when I saw it being tweeted twice in one day by Dr. Prause (as well as her colleague Dr. Ley) with a link to The Racquet. This was extremely distressing. Apparently, the police correctly identified the report as unwarranted last year, as their investigation had not extended to even informing me of its existence. A quick examination of what the report contains reveals that it doesn’t actually allege any illegal behavior, but appears to have been submitted solely with the malicious intention of furthering Prause’s ongoing campaign of defamation (and “no platforming”).
The Racquet editors, however, imply in their very biased article that this defamatory report is legitimate – despite the extensive documentation calling into question Prause’s motives and willingness to exploit bureaucracies for her own ends. For example, Prause has made claims for years that she has (also) filed FBI reports about me. Via a FOIA request, I recently verified that she has not dared misuse FBI resources in this way, as filing fraudulent FBI reports could result in criminal repercussions. In light of The Racquet piece, I have now written the LAPD to find out what remedies they offer for malicious misuse of their resources.
The editors of The Racquet did not seek my comment before publishing the defamatory police report, which they falsely characterized as accusing me of “stalking and threatening” Prause. They have apparently made no effort to confirm with the LAPD that this report is in any way merited. They have also refused to remove the image of the report and refused to include my corrective input in their article, implying instead that I believe the police report is fake, as opposed to baseless and malicious. They ignored the years of evidence that Dr. Prause consistently works in the best interest of the porn industry and has repeatedly defamed (and endeavored to “no platform”) various people and organizations who raise questions about the effects of internet pornography use. In fact, the editors’ response to my concerns was to put up all three pages of the report(!), in place of the screenshot of the first page that was originally published.
In short, given their evident pro-porn stance and previous communications with me on Twitter.com where I commented upon their first article, The Racquet editors appear to be acting with malice and recklessness and without attention to basic journalistic standards. I am conferring with legal counsel and intend to pursue all available remedies to address this defamation. I sincerely hope this will be unnecessary, but if the report, and all mentions of me, are not promptly removed from the article, I will have little choice.
On February 7thThe Racquet editor Samantha Stroozas published a supposed investigatory piece attacking FTND. It was devoid of peer-reviewed references to support its few substantive assertions, and like the current piece, most of the article consisted of ad hominem attacks. On Twitter, I politely responded to Stroozas’s February 7th article with several tweets containing substantial research that corrected her article’s research-related claims. My tweets: https://twitter.com/YourBrainOnPorn/status/1093585735381176320. Stroozas and her coauthor blocked me, refusing to address the content of my tweets or the numerous studies I cited. This was their prerogative, although responsible journalistic ethics might have suggested another course of action, such as correcting or addending the article to factually represent the current state of research, the preponderance of which supports the existence of porn-related problems, as well as the addiction model.
On March 17th, Stroozas and Betzler published their second hit piece on FTND. I am not employed by FTND. I run an independent website (About Us page) with more than 11,000 pages, most of them abstracts and links related to peer-reviewed research on behavioral addiction, and self-reports taken from those who experiment with giving up internet porn. In the interest of furthering the scientific debate, I critique some of the sketchier research about porn, as well as unsubstantiated claims made by pro-porn advocates/researchers. I am also the author or co-author of two peer-reviewed papers, and the author of a popular, highly regarded book on pornography’s effects.
For reasons that are entirely unclear, The Racquet editors “enhanced” their second smear of FTND by including defamatory remarks about me and reproducing Prause’s baseless police report. I can think of no reason to include me in an article about FTND, other than malicious retaliation for my unwanted tweets in February, 2018.
As explained, when I saw the piece with the groundless report, Stroozas and Betzler were informed of Prause’s long and carefully documented history of defaming and harassing me and others (most of it available here and here), including:
documentation of Prause’s false claims about FBI reports (and years of baseless claims about non-existent police records),
my own FBI report on Prause’s defamatory use of bogus “claims to have filed with the FBI,”
information about a California Board of Psychology investigation into Prause’s harassment (in progress), and
documentation of multiple Prause attacks on others and myself (essentially targeting anyone who dares to inform the public about the risks of internet porn overuse to some users).
Further information
Stroozas made false statements in her email response to me, incorrectly claiming that Prause’s spurious police report is “publicly accessed information”:
“The article is being updated to include the full police report. We understand your claims, but it is not The Racquet’s job to engage in politics between businesses, but more so, to prove further description to publicly accessed information. That is what the police report serves as – a representation of a publicly assessed document that aided in our research”.
The LPAD police report is not public. In fact, it cannot be retrieved by any member of the public other than the person who filed it. It was supplied to the editors by Prause.
The Racquet editors did not contact me to confirm or deny Prause’s assertions. If they had actually performed an investigation (as claimed), or even bothered to Google-search ‘Gary Wilson and Nicole Prause’, the top returns would have been the three extensive pages documenting Prause’s harassment of me and many others (1, 2, 3).
Why didn’t the editors interview independent researchers or mental health professionals doing work with porn addiction and problematic porn use? Why did they only talk to porn-addiction deniers who are not academics and not affiliated with any university? Why did these editors choose to feature Prause, who appears to have a cozy relationship with porn producers and performers; has asked for and apparently received “assistance” from the lobbying arm of the porn industry, the Free Speech Coalition (including possibly obtaining subjects for some of her research via the FSC); has been photographed attending porn industry awards shows (including an exclusive industry-member-only event), and much more.
Why didn’t Stroozas and Betzler discover in their so-called investigation that Prause’s most infamous papers and controversial studies have been critiqued by experts in the peer-reviewed literature no less than 16 times?
Prause & Pfaus, 2015. Letter to the editor by Richard A. Isenberg MD (2015)It appears that Prause also furnished the editors with her friends/allies to be featured in the The Racquet article. Specifically, Nicole Prause, David Ley, and Daniel Burgess often work together to defame porn skeptics in social media attacks. I have documentation of all three working together to post defamatory comments about me and FTND, among others.
Why were the editors contacted to write these pieces in the first place? Have they considered why Prause’s tiny company is heavily staffed with press experts, and why so much of her focus appears to be on generating positive press about pornography? Have they asked Prause why she is attempting to trademark my site’s URL and the name of my book, almost 9 years after I started using the name? Have they asked Prause why she has falsely accused almost every major porn skeptic of very serious offenses and crimes?
If the editors were eager to investigate FTND and its purported ties to the Mormons, were they equally eager to ask Prause about her potential ties to the porn industry? If the editors are concerned about free speech, have they asked Prause why she repeatedly attempts fraudulent use of the DMCA law to censor the screenshots of evidence about her tweets from the pages where they appear? Finally, why am I gratuitously included in an article that’s supposed to be about FTND?
On a more personal note, given this article remains published virtually as-is, I am disappointed that your university appears to sanction its journalism students not actually conducting investigative journalism, but merely acting as a platform for allies of the pornography industry to publish defamation. I would hope that given this extensive documentation, the editors will be appropriately reprimanded for not following basic journalistic principles, and trying instead to push a particular view while deliberately publishing defamation, opting not to make corrections when presented with documentation, and excluding the preponderance of research which supports the existence of porn-related problems, possibly with the motivation of retaliating because I factually criticized their earlier article about pornography.
I would like a response to this letter within a week. In the meantime, I will continue the initial steps of acquiring legal counsel to represent me in this matter.
Thank you for your anticipated prompt attention.
Best regards,
Gary Wilson
Faculty advisor Lei Zhang replies on the same day, informing Wilson that that story had been removed. In reality, Prause’s baseless police report and any mention of Wilson was removed, but the rest of the article remained. Notice Lei Zhang stating that she hopes we “can move on to more important matters” – implying that destroying a person’s reputation is of little significance.
From: Lei Zhang <> Sent: Wednesday, March 20, 2019 3:35 PM
To: [email protected]
Cc: Vitaliano Figueroa; Samantha Stroozas; Karley Betzler; Betsy Morgan
Subject: The story published on the Racquet
Dear Gary,
I am the faculty advisor for the student newspaper, The Racquet. I heard about your complaint during the spring break. I have advised the editors to remove the story from the website.
My sincere apologies. I hope we can put this behind us and move on to more important matters.
Best,
Lei
Wilson replies the following day, Thursday, March 21st:
From: gary wilson <> Date: Thursday, March 21, 2019 at 2:58 PM
To: Lei Zhang <>
Subject: Re: The story published on the Racquet
Dear Lei,
I appreciate your kind apology.
Are you aware that the story has not been removed as you apparently believed when you wrote me? It is still quite misleading, although it no longer defames me personally.
Incidentally, I suspect that most people would consider the publication of a baseless, malicious police report a highly “important matter.”
Best regards,
Gary Wilson
Faculty advisor Lei Zhang replies on the next day, Friday, March 22nd:
From: Lei Zhang <> Sent: Friday, March 22, 2019 10:06 AM
To: gary wilson
Cc: Vitaliano Figueroa; Samantha Stroozas; Karley Betzler
Subject: Re: The story published on the Racquet
Dear Gary,
The student newspaper is an independent organization. The editors decided to publish the story after removing the section about the police report. If the story contains any more false or defamatory information, please let me know. The editors will remove this type of information. The writers spent a lot of time working on the story. I agree with their decision to publish it.
The story was written in the third-person voice. The views expressed in the story belong to the interviewees, for example, the psychology professor at UWL. If you disagree with the views expressed in the story, you are welcome to contribute an opinion piece. The Racquet welcomes diverse views.
At our next advisory meeting, I will discuss with the editors how to produce a more balanced story and double check information for accuracy.
I would suggest you contact Fight The New Drug about the accuracy of your editors’ claims concerning its organization.
As chronicled in earlier emails, both this article and the February 7th Stroozas article appear to violate The Racquet’s own guidelines as outlined on the letter to the editor page (“The Racquet reserves the right to deny publication if the story does not address all sides of the issues with accuracy and clarity”). Both articles by Stroozas were one-sided and evidently meant to smear their target (and others), while simultaneously ignoring the preponderance the empirical evidence establishing the risks of internet porn overuse.
My complaint to UW is supported by my Twitter exchange with Sroozas where I countered her incorrect statements and unsupported claims with peer-reviewed studies. In response to empirical research, Stroozas blocked me and then retaliated in the March 17th, 2019 article by reproducing a malicious police report and Dr. Prause’s falsehoods in an article that had nothing to do with me.
When Stroozas and Betzler were informed on March 17th of Dr Prause’s long, documented history of harassing and libeling me, and the falseness of Prause’s police report, Stroozas retaliated a second time, spitefully publishing all 3 pages of the report. Despite CC’s to university officials on all emails, the defamatory police report remained online for 4 days.
The internet is forever, and the police report and associated text were likely captured for later defamatory use by some of the unethical people your editors continue to validate in their (still) published hit pieces.
My legal advisors assure me that the University of Wisconsin’s students’ actions have already defamed me irreparably. I’ll have to give further thought to next steps.
Best regards,
Gary Wilson
On Wednesday, March 27th student editor emails the following short note announcing the removal of the entire article. In a break from protocol Karley Beltzer cc’s Gary Wilson’s harassers, David Ley, Nicole Prause and Daniel Burgess (along with several lawyers and university officials):
Karley Betzler <>
Wed 3/27/2019 2:34 PM
Good afternoon,
I hope you’re all having a good day. Sam Stroozas and I have made the decision to remove our article from The Racquet’s website. This was not an ideal situation for us, but we felt as if we had no other choice due to lack of support.
We stand by our commitment to providing a necessary conversation to the UWL public and beyond. The Racquet has forever been changed for the better by this experience.
Addendum: Evidence that Betzler and Stroozas had been forwarding Gary Wilson’s emails to Nicole Prause and David Ley. First, Dr. Ley quickly retorted with the sole response, ranting about Wilson:
David Ley <>
Wed 3/27/2019 3:44 PM
indeed. I warned you that wilson regularly intimidates journalists through threats and bully tactics.
He should run for president
As neither Prause nor Ley were included in any of the earlier emails, Ley’s retort indicates that they were kept apprised of Wilson’s correspondence (or bullying as Ley calls it) with The Racquet and its ultimate decision to cease its targeted defamation. More telling is that the following unhinged tweet wasposted 3 hours before the final Karley Betzler email to everyone:
It’s important to keep in mind that Prause and Ley often work together on social media, attacking and defaming anyone they disagree with. For example Ley has tweeted several times the lie that Wilson was fired from Southern Oregon University. This is libel and cyberstalking, and Ley’s involvement is documented on this page: Libelous Claim that Gary Wilson Was Fired (March, 2018).
Others – March 17, 2019: Prause employs multiple sock-puppets to edit the Fight The New Drug Wikipedia page, as Prause simultaneously tweets content from her sock-puppets’ edits
One of the Prause tweets containing the same material as the above Wikipedia edits:
The following sockpuppet, who made only 3 edits on March 15th, appears to be Prause: https://en.wikipedia.org/wiki/Special:Contributions/204.2.36.41. We suggest this because the 3 edits were identical to the edits by NewsYouCanUse2018, and only Prause tries to insert info about FTND financials (which no other editor does):
Prause seems to “own” Wikipedia, having employed over 30 aliases to post her lies and propaganda, despite the fact that aliases are strictly forbidden on Wikipedia (PDF of Nicole Prause aliases she used to harass & defame). Even though Wikipedia finally took some disciplinary action (below), much of her propaganda remains on Wikipedia. See these sections for documentation of many of Prause’s other Wikipedia sock-puppets:
Clerk endorsed – Please confirm & check for sleepers. The behavioral evidence (fixation on Fight the New Drug) indicates they’re puppets of the stale NeuroSex20:11, 4 May 2019:
Group 1 – the following accounts are Confirmed to each other and Unrelated to NeuroSex:
How many sock puppets remain? Knowing the truth, why doesn’t Wikipedia reverse all of her biased handiwork on its platform and replace the editors who acquiesced to her edits in the first place?
Others – April, 2019: Prause harasses and threatens therapist D.J. Burr, then maliciously reports him to the State of Washington Department of Health
Prause initiates her defamation by accusing anyone who treats porn addiction of also being a “reparative therapist” (practice of trying to change an individual’s sexual orientation from homosexual or bisexual to heterosexual).
In her assault, Prause publishes two lies in one tweet:
The lies: 1) No Nikky, treating porn addiction is not analogous to conversion therapy. 2) Wrong, The world’s most widely used medical diagnostic manual, The International Classification of Diseases (ICD-11), contains a new diagnosis suitable for porn addiction: “Compulsive Sexual Behavior Disorder.”
Nikky continues on the Joe Kort thread responding to licensed therapist D.J. Burr with false allegations and threats. Prause asserts that Burr is engaged in malpractice (for treating porn addiction), and that his patients should be report him to state boards. Prause says she would “support” his patients in their reports.
Prause blocks D.J. Burr and adds this bizarre tweet to the thread. It’s 3 random pictures snatched from internet. The screenshots fail to support her continued lies that CSAT’s treating porn addiction are masquerading as reparative therapists.
Prause never links to the page of an actual CSAT or members of SASH or IITAP. She just makes stuff up, as is her M.O.:
A few months later D.J. Burr receives a letter from State of Washington Department of Health informing him that the disciplinary board dismissed a complaint alleging unprofessional conduct. The alleged unprofessional (“using racist language”) occurred April 7, 2019 – the same day as the last of the above tweets.
Prause reporting DJ Burr was no secret as he exposed her malicious reporting in response to Ley’s propaganda piece claiming that he and Prause (not named, but described) were victims of malicious reporting (if they were reported, it was for good reason).
First, David Ley provides zero documentation for claims of victim-hood. Second, Prause does not comment on Burr’s tweet (which is out of character). Ley replies, strategically avoiding the facts presented to him:
The above organizations found no merit in Prause’s fraudulent allegations.
Note – Numerous individuals maliciously reported to universities of governing boards by Prause have filed sworn affidavits in the Don Hilton defamation lawsuit against Prause:
Prause long history of misusing regulatory bodies to harass innocent victims has finally caught up with her. Karma.
April, 2019: Prause, Daniel Burgess and associates engage in unlawful trademark infringement of YourBrainOnPorn.com, by creating “RealYourBrainOnPorn” website & social media accounts
As Your Brain on Porn has been continuously engaged in vigorous debate around the subject of compulsive pornography consumption since before 2011, our website certainly doesn’t take issue with, or fear, opposing views. Sexual health experts are welcome to offer views about internet pornography’s effects that differ from our views.
We thrive on debate as we believe that the facts surrounding the issue, along with the research, support that problems often emerge when people use too much internet pornography. But to this day, not many pro-porn activists have been willing to engage in substantive debate with us, resorting instead to unsavory tactics such as straw-men, lies, personal attacks, harassment, and defamation – and now, trademark infringement, impersonation, and domain-name squatting.
While we encourage these intellectual opponents to share their pro-porn views for us to continue to refute with facts and citations, they are not legally permitted to impersonate us.
Why not revert to ScienceOfArousal.com?
Why did these self-proclaimed experts change their site name to mirror our website’s name, when their first-choice URL was “ScienceOfArousal.com?” Proof: copy & paste that URL into your browser. It will redirect you to “realyourbrainonporn” – https://www.scienceofarousal.com. Why do they claim that they have been censored by a request to cease their trademark infringement, when they could simply revert to their erstwhile brand name “ScienceOfArousal.com” and continue to operate both freely and legally?
SCREENSHOT FROM APRIL 16, 2019, when SOA first appeared
We have never attempted to censor opposing views and critiques, unlike one of their “experts,” Dr. Prause, who has repeatedly tried to remove evidence of her behavior with groundless DMCA takedown requests. We simply ask that that these vocal spokespersons hold forth from their original pulpit, the URL and brand name “Science of Arousal” (ScienceOfArousal.com). And that they relinquish the subsequent name they employed along with the corresponding trademark application (for a name that YBOP has operated under for almost 10 years ). Why do they engage in these apparent attempts to suppress traffic to our website and confuse the public?
Trademark infringement and targeted harassment: Details
The URL for this website (YourBrainOnPorn.com) was registered in 2010, has some 20,000 unique visitors a day, more than 11,000 pages of content, and has long functioned as a well-known clearinghouse for information related to internet porn’s effects. For almost a decade it has been linked to by thousands of other websites, and mentioned in numerous news articles or podcasts, as well as being cited in several peer-review studies. The host of the site is also the author of a highly regarded book entitled Your Brain OnPorn, first published in 2014.
In April, 2019, a blatant trademark infringement campaign was launched targeting YourBrainOnPorn.com. A new website with the URL realyourbrainonporn.com appeared, just a few days after the website ScienceOfArousal.com (see above) had appeared. As explained above, the later URL, featuring much the same cast of self-proclaimed “experts,” replaced the earlier ScienceOfArousal.com. Use of the URL for the latter redirected its visitors to the second (infringing) site’s URL.
The imposter site attempts to trick the visitor, with the center of each page declaring “Welcome to the REAL Your Brain On Porn,” as the tab falsely proclaims “Your Brain On Porn.”
When the link for the imposter site is emailed it appears as “Your Brain on Porn”:
When a RealYourBrainOnPorn (@BrainOnPorn) tweet is retweeted it appears as “Your Brain on Porn” and “YBOP (our most frequently used nickname)”:
Although the Whois Record withholds the identity of the registrant, those apparently responsible for this unlawful trademark infringement can presumably be found among the site’s so-called “Experts”: https://www.realyourbrainonporn.com/experts.
This collection of porn-science deniers and their friends is well known to YBOP and other porn skeptics, as some of these deniers’ outlier studies and inadequately unsupported talking points are regularly featured in the mainstream media. These deniers frequently mislead journalists and academic journal editors about the true state of internet porn research. On social media and in lay articles they promote their cherry-picked, outlier papers, and/or misrepresent the true implications of their data. Visit this page to see critiques of some of their most dubious progeny.
The two most vocal and best known deniers, Nicole Prause and David Ley, have engaged in overt and covert defamation, harassment and cyberstalking, targeting groups and individuals who believe, based on the objective evidence, that today’s porn might be causing significant problems for some users. (Hundreds of harassment incidents are documented on these extensive pages page 1, page 2.) The current trademark infringement campaign is merely the latest crusade.
To promote their new site, while maliciously disparaging Gary Wilson and the legitimate YourBrainOnPorn, the creators of the imposter site created a Twitter account (https://twitter.com/BrainOnPorn), YouTube channel, Facebook page, and published a press release. In a further attempt to confuse the public, the press release falsely claims to originate from Gary Wilson’s home town – Ashland, Oregon. (None of the imposter site’s “experts” live in Oregon, let alone Ashland.)
Judge for yourself whether the imposter site and its “experts” further the interests of the porn industry or the authentic search for scientific truth by perusing this collection of RealYBOP tweets. Written in Dr. Nicole Prause’s distinctive, misleading style, the tweets extol the benefits of porn, misrepresent the current state of the research, and troll individuals and organizations Prause has previously harassed.
On April 25th, the Sciencearousal username appeared on Wikipedia, inserting links and deleting legitimate material about pornography’s effects. (On April 17 one of Sciencearousal’s aliases tried to do the same: SecondaryEd2020). See the scienceofarousal Wikipedia edits below. This campaign of misinformation is business-as-usual, as these 2 pages have documented over 20 apparent, illicit sock-puppets of Prause (one of the new site’s “experts”), which she has created to insert her propaganda and defame individuals and organizations: page 1, page 2. (Wikipedia’s rules prohibit sock-puppets.)
The legitimate YBOP, this website, stands by its brand, services and resources and is taking steps to address the infringing and unfair activities of the “Real Your Brain On Porn” site.
April, 2019: On January 29, 2019: Prause filed a trademark application to obtain YourBrainOnPorn & YourBrainOnPorn. Prause is sent a Cease & Desist letter for trademark squatting and trademark infringement (RealYBOP).
The URL for this website (YourBrainOnPorn.com) was registered in 2010, has some 10-20,000 unique visitors a day, more than 12,000 pages of content, and has long functioned as a well-known clearinghouse for information related to internet porn’s effects. For almost a decade it has been linked to by thousands of other websites, and mentioned in numerous news articles or podcasts, as well as being cited in several peer-review studies. The host of the site is also the author of a highly regarded book entitled Your Brain OnPorn, first published in 2014.
On January 29, 2019, Prause filed a trademark application to obtain YOURBRAINONPORN and YOURBRAINONPORN.COM. These marks have been used by the popular website www.YourBrainOnPorn.com and its host Gary Wilson for nearly a decade – facts well known to Prause, who has frequently disparaged the latter website and its host since 2013.
On May 1, 2019 the attorneys for the common-law owner of the trademarks “Your Brain On Born” and “YourBrainOnPorn.com” (this website) sent a cease and desist letter to all of those who appeared to be behind the infringing site (the so-called “Experts”): Marty Klein, Lynn Comella, David J. Ley, Emily F. Rothman, Samuel Perry, Taylor Kohut, William Fisher, Peter Finn, Janniko Georgiadis, Erick Janssen, Aleksandar Štulhofer, Joshua Grubbs, James Cantor, Michael Seto, Justin Lehmiller, Victoria Hartmann, Julia Velten, Roger Libby, Doug Braun-Harvey, David Hersh, Jennifer Valli.
UPDATE: Knowing she would lose a federal lawsuit (which was about to go forward), Nicole Prause withdrew her illegal attempt to trademark YOURBRAINONPORN and YOURBRAINONPORN.COM. On October 18, 2019 the United States Patent and Trademark Office entered a judgement against Prause (the applicant):
The legitimate YBOP, this website, stands by its brand, services and resources and is taking legal steps to address the infringing and unfair activities of Nicole R. Prause and Daniel Burgess. Next up, “RealYourBrainOnPorn” and its twitter account.
April, 2019: RealYBOP Twitter account (@BrainOnPorn) – In an attempted trademark grab Daniel Burgess, Prause & allies create a twitter account which supports a pro-porn industry agenda.
Prause and some of her pro-porn sexology chums are collaborating in a glossy reincarnation of the now-defunct “PornHelps” effort. This one, “RealYourBrainOnPorn,” was founded on an illegal trademark squatting effort. Lawyers are now involved. Update: legal actions revealed that Daniel Burgess is the current owner of the realyourbrainonporn.com URL.
On January 29, 2019, Prause filed a trademark application to obtain YOURBRAINONPORN and YOURBRAINONPORN.COM. These marks have been used by the popular website www.YourBrainOnPorn.com and its host Gary Wilson for nearly a decade – facts well known to Prause, who has frequently disparaged the latter website and its host since 2013.
The organizers of the imposter site employed many tactics calculated to confuse the public. For example, the new site attempted to trick visitors, with the center of each page declaring “Welcome to the REAL Your Brain On Porn,” while the tab falsely proclaimed “Your Brain On Porn.” Also, to advertise their illegitimate site, the “experts” created a Twitter account (https://twitter.com/BrainOnPorn), YouTube channel, Facebook page, all employing the words “Your Brain On Porn.”
In addition, the “experts” created a reddit account (user/sciencearousal) to spam porn recovery forums reddit/pornfree and reddit/NoFap with promotional drivel, claiming porn use is harmless, and disparaging YourBrainOnPorn.com and Gary Wilson. It’s important to note that Prause has a long documented history of employing numerous aliases to post on porn recovery forums. Comments in her easily recognizable style promote her studies, attack the concept of porn addiction, disparage Wilson and YBOP, belittle men in recovery, and defame porn skeptics (PDF of Nicole Prause aliases she used to harass & defame).
We start with the very first tweet by Real YBOP. Notice that about half of the retweets were by accounts associated with the porn industry. Note: As the RealYBOP account had no followers at that point, it means these accounts were likely notified via email. In fact, PornHub was the first account to retweet this, indicating a coordinated effort between PornHub and the RealYBOP account!
PornHub was the first account to retweet the above.
Evidence that RealYBOP Twitter and website are in cahoots with the porn industry?
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Just as Prause often does, RealYBOP trolls an account that claims porn use may cause problems:
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Trolling another porn skeptic:
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Just like Prause, RealYBOP attacks state resolutions about porn:
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RealYBOP tweeting under a Ley tweet libeling Gary Wilson (Prause & Ley’s top targets are Wilson and YBOP). Who else but Prause would do this?
——————
Just as Prause often does, RealYBOP cites Taylor Kohut’s oulier non-quantitative study on relationships:
RealYBOP mimics all of Prause’s favorite talking points in this second tweet.
————————
Next up: Promoting a new study on female porn stars, which reported an expected finding: lower rates of sexual dysfunction than the general population. BUT RealYBOP did not tweet a study by the same research group, which found much higher rates of ED in male performers! The research survey of male adult film actors published in 2018 reported 37% of male porn stars, ages 20-29, had moderate to severe erectile dysfunction (the IIEF, which measures performance during partnered sex, is the standard urology test for erectile function).
Real YBOP lies about replication, as Park et al., 2016 was review of the literature, and the new study was survey data from a naval urology clinic. (You can’t “replicate” a review.)
The authors of the new paper believe it supports the existence of porn-induced ED.
In the following 4-tweet series, RealYBOP posts on Gary Wilson’s thread. Both Prause and RealYBOP blocked Wilson so they could sneak tweets onto his threads. Are they afraid that Wilson will debunk their misinformation?
There are many more RealYBOP tweets on this page (which were collected for legal reasons). Now we turn to RealYBOP and Prause’s responses to receiving a well founded cease and desist letter.
On May 1, 2019 the attorneys for the common-law owner of the trademarks “Your Brain On Born” and “YourBrainOnPorn.com” (this website) sent a cease and desist letter to all of those who appeared to be behind the infringing site (the “Experts”). Prause’s letter also demands that she abandon her trademark-squatting application for the marks “Your Brain On Porn” and “YourBrainOnPorn.com.”
Instead of complying with the letters’ reasonable, well documented demands, a number of the Experts responded with a derisory Twitter rage storm, baseless accusations that their “free speech rights” were being violated, and indications of malicious intent, such as threats to go to the press to have their infringing activities mischaracterized as “free speech.”
Here’s a Twitter response to the C&D letter by one of the experts, Lynn Comella, who incorrectly spins this as squelching her freedom of speech. PornHelp.org educates Comella. Eventually RealYBOP responds with a link that only Prause ever posts:
The old CBC link is mischaracterized by RealYBOP, as it has always been by Prause. It’s part of a very long saga, other highlights of which include Prause’s Twitter account being permanently banned, Prause publicly asking Gary Wilson about the size of penis…and so much more. See:
On the same Lynn Comella thread PornHelp.org educates a confused PhD:
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Prause & RealYBOP mirror each other’s tweets:
RealYBOP continues her rampage against Wilson:
Above tweet is nearly identical to 2 earlier tweets by Prause.
RealYBOP comes back with a bizarre tweet under a 2-week old libelous tweet by David Ley, who actually (falsely) stated that the “folks at YBOP threatened his life.” (This false felony-accusation is grounds for a “defamation per se” a lawsuit).
RealYBOP claims Wilson has a puppet account (he doesn’t) and of course fails to link to this imaginary puppet account.
Playing tag-team, Prause provides her legal expertise to the Twitterverse:
April, 2019: Daniel Burgess? Nicole Prause? As “Sciencearousal” – Reddit account promotes “RealYourBrainOnPorn.com” while disparaging Gary Wilson & the legitimate “Your Brain On Porn”
user/sciencearousaltrolled and spammed reddit porn recovery forums, usually posting wherever Gary Wilson’s name or “Your Brain On Porn” appeared. Until otherwise informed, we must assume that user/sciencearousal speaks (defames?) for all the “experts” listed on their collective website: https://www.realyourbrainonporn.com/experts.
Sciencearousal’s first post boldly references to the imposter site “Your Brain On Porn”:
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More trolling/spamming:
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Trolling a 2-month old post about Gary Wilson, disparaging him:
The above comments mirror those made by both Nicole Prause (and her many aliases) and David Ley. The defamatory and malicious comments began appearing in July, 2013, a few days after Wilson published a critique of Prause ‘s first EEG study. The comments are very similar in content and tone. In the beginning Prause employed dozens of fake usernames to post on porn recovery forums, Quora, Wikipedia, and in the comment sections under articles. Prause rarely used her real name or her own social media accounts.
That all changed after UCLA chose not to renew Prause’s contract (around January, 2015). Freed from any oversight and now self-employed, Prause began to put her name to falsehoods, openly cyber-harassing multiple individuals and organizations on social media and elsewhere. As Prause’s primary target was Wilson (hundreds of social media comments along with behind-the-scenes email campaigns), it became necessary to monitor and document Prause’s tweets and posts. This was done for her victims’ protection, and crucial for any future legal actions. These 2 pages document hundreds of incidents of harassment and documented defamation:
Once again, comments mirror those made by Prause (and her many aliases), disparaging Wilson. In addition, Sciencearousal misrepresents the state of the research, promotes the porn industry’s agenda, and informs a r/pornfree member that porn use is positive for 99% of the population:
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Sciencearousal trolls another thread mentioning “Your Brain On Porn”:
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Sciencearousal trolls another thread mentioning “Your Brain On Porn”. She posts a comment in a one-person subreddit that spams NoFap. The pots is a 2012 rant about Gary Wilson’s TEDx talk, by ReaYBOP “expert” Jason Winters:
Jason Winters rant was thoroughly debunked on these 2 extensive pages:
As Prause and her internet aliases have done countless times, Sciencearousal disparages Wilson’s TEDx talk:
There’s evidence that Prause (and some of the other “experts” listed on “RealYBOP”) harassed TED for 5 straight years… until its biased “science curator” gave in (the curator only has a bachelor’s degree in writing, not science) and placed an unmerited note on the talk. In reality everything in the TEDx talk is fully supported, with hundreds of new studies supporting its assertions since the talk was given (March, 2012). See these 2 extensive pages for scientific support for Wilson’s talk:
Sciencearousal continues to disparage Wilson while try to persuade the world that RealYBOP accurately represents the current state of the research (it doesn’t):
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More inaccurate, unsupported claims by Sciencearousal. Continued attacks on Wilson:
Incidentally, the imposter site features cherry-picked studies, while excluding nearly every study linking porn use to negative outcomes (that is, the majority of porn studies). In those few RealYBOP studies listed that did report negative outcomes, RealYBOP omits such findings from its descriptions. Thanks to YBOP’s curated lists of relevant studies anyone can easily identify RealYBOP’s bias:
Sciencearousal posts 17 comments under the above post. Many comments involve defamation and disparagement of Wilson and this website.
This comment is identical to emails, social media posts, and Wikipedia edits by Prause. Prause fabricates a story that Wilson is being paid off by a charity. Not so, as documented.
For documentation of Prause’s lies and harassment related to the charity see:
Sciencearousal’s “expert” continues with defamation of Wilson and a Scottish charity:
More falsehoods and disparagement of Wilson and YBOP:
When called out for blatant trademark infringement, Sciencearousal accuses a r/pornfree member of “libel”:
Note: everyone on r/pornfree is aware of the legitimate YBOP, as a link to YourBrainOnPorn.com has been in the right-hand sidebar there for years.
When called out Sciencearousal responds by accusing the pornfree member of “misrepresenting the science”:
Sciencearousal escalates:
Pointing out blatant trademark infringement by RealYBOP is mischaracterized as “attacking scientists.”
Sciencearousal’s comments become increasingly bizarre:
No one accused anyone of “being in porn.” However, a few r/pornfree members wondered in comments if Sciencearousal might just be Prause. They, and the r/pornfree moderator, were obviously aware of Prause’s past history of employing various aliases to spread her propaganda on r/pornfree (PDF of Nicole Prause aliases she used to harass & defame). Prause has long had an odd habit of creating most of her usernames from 2-4 capitalized words (i.e. GaryWilsonStalker). See list of her apparent aliases below. While many of the usernames and comment were deleted, a few examples with content remain:
Sciencearousal tunes up a few days later on r/NoFap, telling us that masturbation, not porn is the real problem. (Apparently, porn must be protected at all costs, even if it means throwing masturbation under the bus.)
Sciencearousal on r/NoFap once again trying to convince men with problematic porn use that masturbation, not porn, is the real culprit. Also falsely claims that 7 labs have independently confirmed her assertion (simply untrue).
On April 24th, the Sciencearousal username appeared on Wikipedia, inserting links to RealYourBrainOnporn.com and deleting legitimate material about pornography’s effects. This wasn’t Sciencearousal’s first attempt, as an alias (SecondaryEd2020) tried to do the same on April 17th. (Wikipedia’s rules prohibit sock-puppets, but pro-porn posters seem immune from its rules.) Screenshot of the Pornography Wikipedia talk page with SecondaryEd2020 and Sciencearousal, trying to convince other Wikipedia editors to allow her to cite “RealYourBrainOnPorn.com”:
Eventually Wikipedia banned both Sciencearousal and SecondaryEd2020 as sockpuppets of NeuroSex/Prause (several more sockpuppets are still being investigated): wikipedia.org/wiki/Category:Wikipedia_sockpuppets_of_NeuroSex. (These 2 pages document over 20 apparent illicit sock-puppets of Nicole Prause, created to insert her propaganda and defame individuals and organizations: page 1, page 2.)
We present further evidence that Sciencearousal and SecondaryEd2020 and NeuroSex all are Prause.
Sciencearousal inserts the infamous 2016 AASECT proclamation (asserting sex addiction doesn’t exist) and disparages America’s top addiction experts at The American Society of Addiction Medicine (ASAM). Numerous Prause sockpuppets have inserted the same edits.
Sciencearousal went on to edit Prause’s other obsession, the Wikipedia page of academic publisher MDPI. As explained in other elsewhere, Prause is obsessed with MDPI because (1) Behavioral Sciences published two articles that Prause disagrees with (because they discussed papers by her, among hundreds of papers by other authors), and (2) Gary Wilson is a co-author of Park et al., 2016. Prause has a long history of cyberstalking and defaming Wilson, chronicled in this very extensive page. The two papers:
Prause immediately insisted that MDPI retract Park et al., 2016. The professional response to scholarly articles one disapproves of is to publish a comment outlining any objections. Behavioral Sciences’s parent company, MDPI, invited Prause to do this. She declined. Instead of publishing a formal comment, she unprofessionally turned to threats and social media (and most recently the Retraction Watch blog) to bully MDPI into retracting Park et al., of which I am a co-author with 7 US Navy physicians (including two urologists, two psychiatrists and a neuroscientist). In addition, she informed MDPI that she had filed complaints with the American Psychological Association. She then filed complaints with all the doctors’ medical boards. She also pressured the doctors’ medical center and Institutional Review Board, causing a lengthy, thorough investigation, which found no evidence of wrongdoing on the part of the paper’s authors. Prause also complained repeatedly to COPE (Committee on Publication Ethics). COPE finally wrote MDPI with a hypothetical inquiry about retraction, based on Prause’s narrative that the “patients weren’t consented.” MDPI thoroughly re-investigated the consents obtained by the doctors who authored the paper, as well as US Navy policy around obtaining consents. On and on Prause went, including employing multiple aliases to edit MDPI Wikipedia pages inserting falsehoods about Wilson, his coauthors. and the paper. For much more, see: From 2015 through 2019: Prause’s efforts to have Behavioral Sciences review paper (Park et al., 2016) retracted.
Below are examples of Prause (as Sciencearousal) inserting her usual drivel. First, she tried to insert a mistake by the Norwegian Register, who accidentally downgraded MDPI’s rating from the normal “1” to a “0”.
The downgraded rating was a clerical error, and had long been resolved on the MDPI Wikipedia page. Prause knows the zero rating was a clerical error, yet she tweeted last month that MDPI was downgraded and that MDPI is a predatory journal (both are false and both are in Sciencearousal’s Wikipedia edit):
Prause caught in another lie about the Norwegian ratings. The correct link to ratings page for each journal: https://dbh.nsd.uib.no/publiseringskanaler/VedtakNiva1. Search for MDPI and you will see that all its journals have a “1” rating, including Behavioral Sciences, where Park et al., 2016 was published.
May 9, 2019: Prause’s (Wayne Giampietro) reply to Gary Wilson’s cease and desist for trademark infringement contains numerous lies and false allegations
On May 1, 2019 the attorneys for the common-law owner (Gary Wilson) of the trademarks “Your Brain On Born” and “YourBrainOnPorn.com” (this website) sent a cease and desist letter to all of those who appeared to be behind a trademark-infringing site – www.realyourbrainonporn.com (the so-called “Experts”). The letter to Nicole Prause demanded, in addition, that she abandon her trademark-squatting application for the marks “Your Brain On Porn” and “YourBrainOnPorn.com.” See PDF of the 8-page cease and desist letter to Nicole Prause (May 1, 2019).
On May 9, 2019 we received a reply from former BackPage (sex trade) attorney Wyane Giampietro who was now representing Nicole Prause. The letter falsely asserted that Dr. Prause was not involved with realyourbrainonporn.com. A few paragraphs of Wayne Giampietro’s 3-page (reply) letter repeated Prause’s lies that my pages documenting her ongoing defamation and harassment constitute “untrue defamatory attacks upon Dr. Prause.“
Giampietro’s letter listed a few of the same Prause falsehoods documented on the “Prause pages.” He also demanded that I immediately remove all the pages documenting Prause’s unethical and illegal behaviors, and that I refrain from adding any “similar accusations” to YBOP:
Giampietro – “These statements made by your client are false, defamatory and actionable. He must remove them from his web site immediately, and refrain from posting any similar accusations in the future. “
Since May 9th I’ve added several new pages related to the trademark infringement/trademark squatting and harassment/defamation by RealYBOP Twitter (an apparent Prause alias), two related to the Hilton and Rhodes defamation lawsuits, an extensive page documenting Prause’s defamation and harassment of Alex Rhodes and some 30 new sections on Prause page #2, and Prause page #3, which document her escalating harassment and defamation. So no, Mr. Giampietro, I will not refrain from exposing your client as a serial defamer, harasser and cyberstalker. Nor, it seems, will Hilton, Rhodes, or the many Prause victims who have filed sworn affidavits about her in Federal court.
Because Prause often tweets or emails her lawyers’ letters, misrepresenting her fairy tales as factual, I am forced to expose Mr. Giampietro’s falsehoods below (the typos remain). As in her spurious 2015 cease and desist letter, Giampietro’s May 9th letter, and all subsequent letters from Giampietro, Prause provides no evidence to support her fabricated allegations of victim-hood or untruths about me. Here I repond to Giampietro (whose statements are in maroon):
Giampietro – “Finally, despite having been warned in 2015 by counsel for Dr. Prause, Mr. Wilson has continued his barrage of untrue defamatory attacks upon Dr. Prause. Apparently he has embarked upon a vendetta against Dr. Praise and others with whom she is associated. Dr. Prause name alone appears on more than 4000 pages of Wilson’s web site, and over 108,000 times with his link online.”
Everything I have chronicled concerning Prause is true, and nothing Prause’s 2015 attorney (pre-Giampietro) alleged in his C&D was true. These are simply Prause talking points, calculated to shape public opinion. First, as you can see from this search, Prause’s name appears on only 110 out of YBOP 13,000 pages – not 4,000 pages as Prause falsely asserted. The vast majority of these mentions are links to other pages containing my and other’s critiques of Prause’s dubious papers and articles (I purposely do a lot of internal linking).
Prause is not the only researcher whose work I analyze. For example, YBOP contains critiques of multiple Josh Grubbs papers, which results in his name appearing 70 times in a YBOP search.
As for her claim that there are 108,000 mentions of “Prause” on YBOP, this falsehood was already debunked in this section.
Giampietro – “While a dispute regarding issues of public interest is one thing, making false and defamatory allegations against Dr. Prause is indefensible. Among the false allegations Wilson has made against Dr. Prause are: she has engaged in “obsessive, unrelenting cybcr-harassment” against Wilson”…
In fact, she is engaged in “obsessive, unrelenting cybcr-harassment” against me. Extensive documentation: page 1, page 2, page 3.
“she tells a porn addict to visit a prostitute (a violation of APA ethics and Calfornia law)”….
Prause’s quora answer shows a complete disregard for professional APA ethics, ethical and social norms, and the rule of law in California. This theme permeates everything revealed about Nicole Prause on this page.
she is “unprofessional and unethical”…
Most definitely. Also a serial defamer and harasser.
she was fired, terminated and/or reprimanded by the University of California,…
Never said that she was. However, UCLA did not renew Prause’s contract (late 2014 or early 2015). This coincided with Prause harassing and defaming UCLA colleague Rory Reid (Dr. Reid is still at UCLA). I hope a court, in the defamation suits against Prause, investigates the actual events surrounding Prause’s departure from UCLA, her harassment of Rory Reid, and any legal threats made by Prause towards UCLA personnel.
she falsified or utilized “bogus” data in her studies…
May, 2019: The World Health Organization publishes a paper describing Nicole Prause’s numerous ICD-11 comments (“antagonistic comments, such as accusations of a conflict of interest or incompetence”)
The World Health Organization publishes its own diagnostic manual known as the International Classification of Diseases (ICD), which includes diagnostic codes for all known diseases, including mental health disorders. The next edition of the ICD, the ICD-11, has now officially been adopted (2019). The beta version of ICD-11 has allowed comments since 2014 on proposed diagnoses, such as “Compulsive sexual behaviour disorder” (CSBD). Here’s where most of the comments are located for CSBD. Additional comments can be found in the “proposal section” for compulsive sexual behaviour disorder. To view the comments you must sign up and create a username.
Beginning in March, 2015 Nicole Prause has compulsively posted in all the comment sections related to CSBD. Her goal was to prevent the inclusion of CSBD in the ICD-11. Prause failed, as CSBD has now been adopted. The majority of Prause’s comments constitute personal attacks and defamation. The “substantive” portions of her comments often involve misrepresentation of both the science and the current state of the research on CSBD.
On May 6, 2019, WHO officials published the following paper in the eminent journal World Psychiatry –Public stakeholders’ comments on ICD‐11 chapters related to mental and sexual health. The paper summarized the nature of the comments with some quantatative data. WHO starts by detailing the number of comments and proposals. Note the large number of comments for compulsive sexual behaviour disorder:
Between January 1, 2012 and December 31, 2017, 402 comments and 162 proposals were submitted on mental, behavioural and neurodevelopmental disorders, sleep‐wake disorders, and conditions related to sexual health. The largest number of submissions related to mental, behavioural and neurodevelopmental disorders focused on compulsive sexual behaviour disorder (N=47), complex post‐traumatic stress disorder (N=26), bodily distress disorder (N=23), autism spectrum disorder (N=17), and gaming disorder (N=11). Submissions on conditions related to sexual health mainly addressed gender incongruence of adolescence and adulthood (N=151) and gender incongruence of childhood (N=39). Few submissions were related to sleep‐wake disorders (N=18).
Of the 47 comments under the main CSBD proposal 26 were by Nicole Prause! Prause also posted 2 proposals to delete CSBD, with an additional 10 comments. WHO is clearly describing Prause and her allies (David Ley, Roger Libby, Luke Adams, Tammy Ellis Johnson) in this excerpt:
Compulsive sexual behaviour disorder received the highest number of submissions of all mental disorders (N=47), but often from the same individuals (N=14).
WHO goes on, portraying the nature of the CSBD comments as polarized and describing Prause’s comments in which she personally attacked individuals and organizations, including numerous incidents of defamation (some of which have already been documented on the Prause pages):
The introduction of this diagnostic category has been passionately debated3 and comments on the ICD‐11 definition recapitulated ongoing polarization in the field. Submissions included antagonistic comments among commenters, such as accusations of a conflict of interest or incompetence (48%; κ=0.78) or claims that certain organizations or people would profit from inclusion or exclusion in ICD‐11 (43%; κ=0.82). One group expressed support (20%; κ=0.66) and considered that there is sufficient evidence (20%; κ=0.76) for inclusion, whereas the other strongly opposed inclusion (28%; κ=0.69), stressing poor conceptualization (33%; κ=0.61), insufficient evidence (28%; κ=0.62), and detrimental outcomes (22%; κ=0.86). Both groups cited neuroscientific evidence (35%; κ=0.74) to support their arguments. Few commenters proposed actual changes to the definition (4%; κ=1). Instead, both sides discussed nosological questions such as conceptualization of the condition as impulsivity, compulsivity, behavioural addiction or expression of normal behavior (65%; κ=0.62). The WHO believes that the inclusion of this new category is important for a legitimate clinical population to receive services4. Concerns about overpathologizing are addressed in the CDDG, but this guidance does not appear in the brief definitions available to beta platform commenters.
Next, a few exmaples of Prause’s “antagonistic comments.” We begin with Prause’s numerous unprovoked and often libelous attacks on Gary Wilson (who never posted in the ICD-11 comments section). Prause accuses Wilson of commenting on the ICD-11, and lies about Wilson being “employed by The Reward Foundation.” (He is not. Nor has he ever received funds from TRF.) The following comment was Prause’s ad hominem response to commenter Monte Burris’s debunking of her usual assertions:
Staci replied one more time, providing links that expose Prause as lying:
Prause continued with the now familiar falsehoods, while disparaging Staci Sprout:
Hmmm.. bankruptcy, just as dozens of fake names on porn recovery sites have been saying since 2013. As for the LAPD and UCLAPD, both said in 2016 that Prause never filed anything with their departments. An FOIA from the FBI exposed Prause as lying about reporting Wilson. As for Prause claiming Wilson never challenged her claims, he has clearly done so on these extensive pages:
Darryl Mead, PhD, the Chair of The Reward Foundation, eventually responded:
Prause becomes even more irrational and vituperative:
Prause’s many lies are specifically addressed and debunked in these sections. (We are amazed at how many lies Prause can fit into a paragraph – impressive.)
More examples of Prause’s inaccurate, aggressive and defamatory comments. Here Prause misrepresents the research on PIED, while disparaging Stefanie Carnes:
Disparaging Stefanie Carnes:
As we recently outlined in our chapter (Prause & Williams, 2018), this is a common mistake specific to Marriage and Family Therapists like Stephanie Carnes. They misperceive their own clinical efficacy regularly, in a manner financially beneficial to them, and refuse to use treatments supported by research.
Prause cites her opinion piece, as she had nothing else to cite. More:
There are zero clinical data supporting the false claim that a treatment of “abstinence” reduces ED. Indeed, there are zero randomized controlled trials from which such a claim could even possibly be made. This is a fabrication by Stephanie Carnes.
False. See below.
Misrepresenting the research:
There are zero clinical data supporting the false claim that a treatment of “abstinence” reduces ED…
In reality, multiple laboratory studies and a representative survey have found sex film viewing is associated with less sexual dysfunction and erectile problems…
Prause lecturing no one in particular, falsely accusing all involved of “misrepresenting actual neuroscientists,” and “the intention to value profit over patients at any cost of course“:
Prause claims – “I also have cited multiple neuroscientists explicit conclusions (as above)“. In reality, Prause cited only one neuroscience paper “above” – her own 2015 EEG study – Prause et al., 2015. As with many of the studies she cites, that study, Prause et al., 2015, isn’t what it appears to be. While Prause boldly asserted that her lone, deeply flawed EEG study had debunked porn addiction, nine peer-reviewed papers disagree. All nine papers do agree that Prause et al., 2015 actually found desensitization or habituation in the more frequent porn users (a phenomenon consistent with addiction): Peer-reviewed critiques of Prause et al., 2015.
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Staci Sprout said nothing about Prause or research, yet Prause is compelled to disparage Sprout, claiming that Staci is “spamming” the ICD-11. Let’s do the math: Prause – 38 comments/posts; Staci Sprout – 4 comments (2 of which were defending Gary Wilson). As you can see, pure bile:
It’s important to know that the enterprising Prause offered (for a fee) her “expert” testimony against sex addiction and porn addiction. It seems as though Prause is attempting to sell her services to profit from the unsupportable anti-porn addiction conclusions of her two EEG studies (1, 2), even though 17 peer-reviewed analyses say both studies actually lend support to the addiction model! Prause has since deleted the following from her Liberos website:
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After Stefanie Carnes PhD (who has published several studies) cites multiple studies and reviews in support of the addiction model, Prause responds with personal attacks (because Prause cannot address the studies cited):
Comments: Yes, Carnes did send Prause a cease and desist letter for her numerous defamatory statements about IITAP and IITAP therapists, which are documented in these sections:
On the other hand, Prause sent at least 10 bogus cease and desist letters, which were meant to intimidate, yet contained nothing but fabricated assertions. See:
Prause falsehood – “SASH board of directors has religious faith healers.”
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In response to Candice Christiansen’s extensive comment, citing numerous studies and ASAM, Prause tells Candice that she doesn’t understand science, and is profiting from treating “these behaviors”:
Prause is omitting one tiny detail: her Liberos company was founded to “profit from treating these behaviors” (compulsive sexual behaviors)! Prause uses “direct current stimulation” (DCS) to alter sex drive, including to treat compulsive sexual behaviors as long as her clients refer to their porn addiction and sex addiction as “higher sex drive.” Screenshot from Liberos DCS page:
DCS is not free:
DCS is not FDA approved. Ironic that Prause attacks sex and porn addiction therapists for using unproven methods (according to Prause), yet she uses a completely unproven, novel method.
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In reponse to no one, Prause’s goes off, disparaging Don Hilton, Stef Carnes, Debra Kaplan, Candice Christiansen with the same tired litanny of personal attacks and propaganda:
Debunking this Prause claim:
The largest neuroscience study to date falsified a core tenet of the addiction model, the cue reactivity biomarker. No one has published data failing to replicate these studies.
In reality, the findings of Prause et al. 2015 align perfectly with Kühn & Gallinat (2014), which found that more porn use correlated with less brain activation in response to pictures of vanilla porn. Put simply, frequent porn users were desensitized to static images of vanilla porn. They were bored (habituated or desensitized). Nine peer-reviewed papers agree that this study actually found desensitization/habituation in frequent porn users (consistent with addiction): Peer-reviewed critiques of Prause et al., 2015. Even if Prause were correct she conveniently ignores the gaping hole in her “falsification” assertion: 24 other neurological studies have reported cue-reactivity or cravings (sensitization) in compulsive porn users: 1,2,3,4, 5,6,7,8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24. Science doesn’t go with the lone anomalous study hampered by serious methodological flaws; science goes with the preponderance of evidence (unless you are agenda-driven).
And this Prause claim:
There are also a series of behavioral studies replicated by independent laboratories falsifying other predictions of the addiction model (reviewed in Prause et al., 2016)
Prause disparages David House with the same vile, accusatory language (while she sells clients non-approved brain stimulation for their “high sexual desire”):
Re AASECT: First, AASECT is not a scientific organization and cited nothing to support the assertions in its press release – rendering its support meaningless.
Finding AASECT’s tolerance of the “sex addiction model” to be “deeply hypocritical”, in 2014 Dr. Aaron set out to eradicate support for the concept of “sex addiction” from AASECT’s ranks. To accomplish his goal, Dr. Aaron claims to have deliberately sowed controversy among AASECT members in order to expose those with viewpoints that disagreed with his own, and then to have explicitly silenced those viewpoints while steering the organization toward its rejection of the “sex addiction model.” Dr. Aaron justified using these “renegade, guerilla [sic] tactics” by reasoning that he was up against a “lucrative industry” of adherents to the “sex addiction model” whose financial incentives would prevent him from bringing them over to his side with logic and reason. Instead, to effect a “quick change” in AASECT’s “messaging,” he sought to ensure that pro-sex addiction voices were not materially included in the discussion of AASECT’s course change.
Dr. Aaron’s boast comes across as a little unseemly. People rarely take pride in, much less publicize, suppressing academic and scientific debate. And it seems odd that Dr. Aaron spent the time and money to become CST certified by an organization he deemed “deeply hypocritical” barely a year after joining it (if not before). If anything, it is Dr. Aaron who appears hypocritical when he criticizes pro-“sex addiction” therapists for having a financial investment in the “sex addiction model”, when, quite obviously, he has a similar investment in promoting his opposing viewpoint
Several commentaries and critiques expose AASECT’s proclamation for what it truly is:
Replying to no one, Prause disparages the 3,000 medical doctors at the American Society for Addiction Medicine:
Prause hates ASAM because in 2011, the American Society for Addiction Medicine (ASAM) came out with a public statement clarifying that behavioral addictions (sexual, food, gambling) are fundamentally like substance addictions in terms of brain changes. Said ASAM:
We all have the brain reward circuitry that makes food and sex rewarding. In fact, this is a survival mechanism. In a healthy brain, these rewards have feedback mechanisms for satiety or ‘enough.’ In someone with addiction, the circuitry becomes dysfunctional such that the message to the individual becomes ‘more’, which leads to the pathological pursuit of rewards and/or relief through the use of substances and behaviors.
ASAM specifically addressed sexual behavior addictions:
QUESTION: This new definition of addiction refers to addiction involving gambling, food, and sexual behaviours. Does ASAM really believe that food and sex are addicting?
ANSWER: The new ASAM definition makes a departure from equating addiction with just substance dependence, by describing how addiction is also related to behaviours that are rewarding. … This definition says that addiction is about functioning and brain circuitry and how the structure and function of the brains of persons with addiction differ from the structure and function of the brains of persons who do not have addiction. … Food and sexual behaviours and gambling behaviours can be associated with the “pathological pursuit of rewards” described in this new definition of addiction.
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More victimhood combined with personal attacks and misrepresentation of the research:
Actually there is scientific consensus: The ICD-11 accepted CSBD, and that was partially due to the fact that there are now 44 neuroscience-based studies (MRI, fMRI, EEG, neuropsychological, hormonal), providing strong support for the addiction model as their findings mirror the neurological findings reported in substance addiction studies.
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Geoffrey Goodman, whom Prause later maliciously reported to his university for calling her out, comments. Prause responds with her usual ad hominem:
Compulsive sexual behaviour disorder seems to fit well with non-substance addictive disorders proposed for ICD-11, consistent with the narrower term of sex addiction currently proposed for compulsive sexual behaviour disorder on the ICD-11 draft website.3 We believe that classification of compulsive sexual behaviour disorder as an addictive disorder is consistent with recent data and might benefit clinicians, researchers, and individuals suffering from and personally affected by this disorder.
Stefanie Carnes on her AASECT blog post, with a Prause reply spewing her usual array of disparaging remarks and unsupported assertions:
Prause claim:
The vast majority of neuroscientists, of which I speak with regularly and extensively, because it is my field, do not believe sex or porn are addictive.
Reality: First CSBD was accepted by the world’s health experts. Second, and most important, there have been 44 neuroscience-based studies (MRI, fMRI, EEG, neuropsychological, hormonal) published on porn users and CSBD subjects. Out of all the neuroscientists on those 44 papers, Prause is the ONLY one to publicly state that porn/sex addiction does not exist. Note – all 44 studies provide strong support for the addiction model as their findings (including her own) mirror the neurological findings reported in substance addiction studies.
Prause drivel:
The division between profiteering therapists with no science training asserting to interpret neuroscience data differently than the actual scientists themselves interpret it has been a longstanding strategy to line their pockets.
Reality: The real experts’ opinions on porn/sex addiction? This list contains 23 recent literature reviews & commentaries by some of the top neuroscientists in the world. All support the addiction model.
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Prause reponding to Geoff Goodman, PhD with her usual disparaging remarks, citing her and David Ley’s unsupported opinion piece – Ley et al., 2014 (not 2015 as Prause wrote).
The following is a very long analysis of Ley et al., 2014, which goes line-by-line, citation by citation, exposing all the shenanigans Ley and Prause incorporated in their “review”: The Emperor Has No Clothes: A Fractured Fairytale Posing As A Review. It completely dismantles the so-called review, and documents dozens of misrepresentations of the research they cited. The most shocking aspect of the Ley review is that it omitted any study that reported negative effects related to porn use or found porn addiction! Yes, you read that right. While purporting to write an “objective” review, these two sexologists justified omitting hundreds of studies on the grounds that these were correlational studies. Guess what? Virtually all studies on porn are correlational.
Since Ley et al., was published, over 20 legitimate reviews have come out. The real experts’ opinions on porn/sex addiction? This list contains 23 recent literature reviews & commentaries by some of the top neuroscientists in the world. All support the addiction model.
Next, Prause responds to no one, posting her short commentary, and fabricating nonsense about imaginary attempts to silence her (from the person who posted more comments than everyone else combined!), and “profiteers”:
Prause’s paper falsified nothing as it addressed one person masturbating to porn – who wasn’t a porn or sex addict.
Prause cites a sloppy, scientifically inaccurate PDF from 3 kink organizations (notice how she rarely cites actual studies – and if she does, they are usually her own studies).
Perhaps you are wondering how YBOP can produce so many critiques of reviews or articles purporting to debunk sex and porn addiction? It’s mostly cut and paste for YBOP as all the addiction opponents cite the same often-irrelevant studies (or each other’s drivel), while ignoring the vast preponderance of evidence. These extensive critiques debunk all the usual often-repeated talking points and cherry-picked studies:
Prause posted her upcoming study 3-4 times on ICD-11. As of July, 2019 it still hasn’t been published. The facts surrounding this paper are very, very interesting.
This paper was funded by “Orgasmic Meditation” (to legitimize their very shaky reputation), was not about porn or sex addiction, and may have used subjects supplied by the porn industry! Let’s expand on this.
The study (or studies) in question is said to be funded by OneTaste, a for-profit company charging $4,300.00 for a 3-day workshop to learn clitoral manipulation. As described in this Bloomberg.com expose, OneTaste offers several different packages:
Currently, students pay $499 for a weekend course, $4,000 for a retreat, $12,000 for the coaching program, and $16,000 for an “intensive.” In 2014, OneTaste started selling a yearlong $60,000 membership, which lets buyers take all the courses they want and sit in the front row.
The official description of the OM study:
“Neurological effects and health benefits of orgasmic meditation” Principal Investigator, Direct costs: $350,000, Duration: 2 years, OneTaste Foundation, co-Investigators: Greg Siegle, Ph.D.
In the Bloomberg article Chief Executive Officer Joanna Van Vleck pretty much says that OneTaste is now dependent on Prause’s upcoming EEG studies to legitimize OM (which is now being investigated by the FBI):
The newish CEO is betting that the study OneTaste has funded on the health benefits of OM, which has taken brain-activity readings from 130 pairs of strokers and strokees, will draw fresh crowds. Led by researchers from the University of Pittsburgh, the study is expected to yield the first of multiple papers…eventually. “The science that’s coming out to back what this is and what the benefits are is going to be huge in terms of scaling,” Van Vleck says.
To perform the OM study Prause needed willing participants comfortable with being hooked up to machines, having their genitals exposed, and being masturbated by a man as researchers observe their responses. It’s not hard to imagine that it was challenging to locate females willing to act as sexual guinea pigs in Prause’s Hollywood Boulevard office. Whatever the reasons, Ruby insisted that Prause obtained subjects for her OM study via the FSC, and that Prause had an ongoing relationship with the FSC:
If the above is true it reveals a very cozy working relationship between Prause and the FSC. A relationship that may have started in 2015, when with Prause publicly accepted assistance from the deep-pocketed FSC. This was immediately followed by Prause throwing her scientific weight behind some the FSC’s major agendas (rejection of Proposition 60 [condoms in porn], porn stars are not damaged goods, porn addiction is a myth, porn is not public health crisis, watching porn is mostly beneficial, etc.)
The plot thickens. Originally funded to explore only the benefits of “Orgasmic Meditation,” Prause began crowing that her yet to be published OM study “falsified” porn and sex addiction. In her tweets and comments Prause revealed that she showed her clitoris stroking couples “sex films” and the results (in her opinion) debunked the porn addiction model. Prause’s OM study has magically morphed from a “partnered sex” investigation into an anti-porn addiction, pro-porn industry paper. How could this happen?
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David Ley falsely asserting that OCD is probably synonymous with CSBD.
Ley suggests to WHO – “this category should only be supported if there is extant research showing effective differential diagnosis from individuals experiencing OCD.” Those studies you’re demanding have already been published, David.
In arguing against the concept of behavioral addictions, including porn addiction, skeptics like Ley & Prause often claim that that addiction is really just a form of OCD. Research demonstrates that addictions differ from OCD in many substantive ways. In fact, the DSM-5 has separate categories for OCD and behavioral addictions, so its experts realize that the two conditions are physiologically different. An excerpt from this 2016 review sums it up:
Obsessive-compulsive spectrum disorders have been considered to conceptualize sexual compulsivity (40) because some studies have found individuals with hypersexual behavior are on the obsessive-compulsive disorder (OCD) spectrum. OCD for hypersexual behavior is not consistent with DSM-5 (1) diagnostic understandings of OCD, which exclude from the diagnosis those behaviors from which individuals derive pleasure. Although obsessive thoughts of the OCD type often have sexual content, the associated compulsions performed in response to the obsessions are not carried out for pleasure. Individuals with OCD report feelings of anxiety and disgust rather than sexual desire or arousal when confronted with situations triggering obsessions and compulsions, with the latter being performed only to quell uneasiness the obsessive thoughts arouse. (41)
Few studies have examined associations between compulsivity and hypersexuality. Among males with nonparaphilic hypersexual disorder, the lifetime prevalence of obsessive compulsive disorder—a psychiatric disorder characterized by compulsivity—ranges from 0% to 14% (Kafka, 2015). Obsessiveness—which may be associated with compulsive behavior (Minnesota Multiphasic Personality Inventory 2 (MMPI-2); Butcher, Dahlstrom, Graham, Tellegen, & Kaemmer, 1989)—in treatment-seeking men with hypersexuality has been found to be elevated relative to a comparison group, but the effect size of this difference was weak (Reid & Carpenter, 2009). When the association between the level of obsessive-compulsive behavior—assessed by a subscale of the Structured Clinical Interview for DSM-IV (SCID-II) (First, Gibbon, Spitzer, Williams, & Benjamin, 1997)—and the level of hypersexuality was examined among treatment-seeking males with hypersexual disorder, a trend toward a positive, weak association was found (Carpenter, Reid, Garos, & Najavits, 2013). On the basis of the aforementioned results, compulsivity appears to contribute in a relatively small manner to hypersexuality.
While there are definite overlaps between hypersexuality and conditions such as obsessive-compulsive disorder (OCD) and other impulse control disorders [61], there are also some notable differences pointed out: for example, OCD behaviors do not involve reward, unlike sexual behavior. Moreover, while engaging in compulsions might result in temporary relief for OCD patients [62], hypersexual behavior is usually associated by guilt and regret after committing the act [63]. Also, the impulsivity that can sometimes dominate the patient’s behavior is incompatible with the careful planning that is sometimes required in CSB (for example, in regards to a sexual encounter) [64]. Goodman thinks that addiction disorders lie at the intersection of compulsive disorders (which involve anxiety reduction) and impulsive disorders (which involve gratification), with the symptoms being underpinned by neurobiological mechanisms (serotoninergic, dopaminergic, noradrenergic, and opioid systems) [65]. Stein agrees with a model combining several ethiopathogenical mechanisms and proposes an A-B-C model (affective dysregulation, behavioral addiction, and cognitive dyscontrol) to study this entity [61].
From an addictive behavior standpoint, hypersexual behavior relies on sharing core aspects of addiction. These aspects, according to the DSM-5 [1], refer to the mentioned problematic consumption model applied to hypersexual behavior, both offline and online [6,66,67]. Evidence of tolerance and withdrawal in these patients might probably be key in characterizing this entity as an addictive disorder [45]. Problematic use of cybersex is also often conceptualized as a behavioral addiction [13,68].
In this study, we were interested in the prevalence and the associated sociodemographic and clinical features of CSBD in patients with OCD. First, we found that 3.3% of patients with OCD had current CSBD and 5.6% had lifetime CSBD, with a significantly higher prevalence in men than in women. Second, we found that other conditions, particularly mood, obsessive–compulsive, and impulse-control disorders, were more common in OCD patients with CSBD than in those without CSBD, but not disorders due to substance use or addictive behaviors.
The early estimations of prevalence rates of CSBD provided by Carnes (1991) and Coleman (1992) suggested that up to 6% of people from the general population suffer from compulsive sexual behavior. Although it is unclear how these estimates were obtained (Black, 2000), subsequent epidemiological research confirmed that compulsive sexuality, which may include increased masturbation frequency, pornography use, number of sexual partners, and extramarital affairs, is common in the general population (Dickenson et al., 2018). Our findings on prevalence rates of CSBD in OCD seem roughly comparable to those in the general population (Langstrom & Hanson, 2006; Odlaug et al., 2013; Skegg, Nada-Raja, Dickson, & Paul, 2010).
In conclusion, our data indicate that prevalence rates of CSBD in OCD are comparable to those in the general population and in other diagnostic cohorts. Moreover, we found that CSBD in OCD was more likely comorbid with other impulsive, compulsive, and mood disorders, but not with behavioral- or substance-related addictions. This finding supports the conceptualization of CSBD as a compulsive–impulsive disorder. Going forward, standardized measures with sound psychometric properties are needed to assess presence and severity of CSBD. Future research should continue to consolidate the conceptualization of this disorder and to gather additional empirical data, in order to ultimately improve clinical care.
While these incidents might have been sufficient to warrant legal action, it wasn’t until Prause sank to accusing Dr. Hilton of sexual harassment that a suit was filed. The court filings are here.
On July 24, 2019 Don Hilton amended his lawsuit to include:
Affidavits from 9 other victims of Prause,
Prause’s malicious complaint to the Texas Board of Medical Examiners containing false and defamatory statements,
Prause’s accusations with two different professional journals in which Dr. Hilton has published, incorrectly accusing Dr. Hilton of falsifying and exaggerating his credentials.
UPDATE: Nicole R. Prause filed a motion to dismiss Donald Hilton’s defamation lawsuit against her. Prause’s motion contained false statements and myriad unsupported allegations. Don Hilton responded with a 21-page opposition to dismiss and .
June, 2019: David Ley and Prause (as RealYBOP Twitter & “sciencearousal”) continue their campaign to connect porn recovery forums to white supremacists/Nazis
It’s 2019 and not much has changed. David Ley and Prause (as RealYBOP Twitter & “sciencearousal”) are still campaigning to connect porn recovery forums and anti-porn activists to anti-Semitism and fascism. This is just the latest, as we have already documented Prause and Ley’s previous attempts in other sections:
It appears that David Ley collaborated again with journalist Rob Kuznia to produce the following June, 2019 NY Times piece: “Among Some Hate Groups, Porn Is Viewed as a Conspiracy.” Back in 2017 Kuznia collaborated with Prause and Ley to produce a factually inaccurate hit-piece for The Daily Beast. The 2017 article painted Prause as a victim of Gary Wilson’s supposed stalking, while promoting Prause’s two high profile EEG studies as landing, “like PR torpedoes on the controversial notion that sex or porn can be addictive like booze and drugs.” They were bombs all right.
In fact, the opposite of Kuznia’s statement is true as Prause is the perpetrator (not the victim), and her two EEG studies were critiqued an unbelievable total of 17 times in the peer-reviewed literature. In fact, experts stated that that the results of these flawed studies actually appear to support the porn-addiction model:
Kuznia’s 2017 hit-piece purposely omitted all the other neurological studies on this list of 44 neuroscience-based studies. Taken together, these studies provide strong support for a porn-addiction model. We say “purposely,” because Kuznia was given the list of research by Wilson, along with hundreds of other studies on this list. He ignored them all – unlike the World Health Organization, which has adopted a diagnosis for “Compulsive sexual behavior disorder” that is plenty broad enough to encompass “porn addicts.”
As was cleverly done in his 2017 Daily Beast article, Kuznia tricks the reader into presuming connections that don’t really exist. For example, in this new piece he places two unconnected sentences into a single paragraph to fool the reader into thinking that reddit/nofap is populated by white nationalists and somehow connected to the Proud Boys.
For example, a forum on Reddit is a support group of sorts for 440,000 members who take breaks from masturbation and porn for what they believe to be mental, physical and sexual-health reasons. The Proud Boys, a self-professed “western chauvinist” group, encouraged a similar message.
Neither is the case, and Kuznia provides no evidence. But hey, that’s what you can expect from agenda-driven journalists.
Concurrently with the latest Kuznia smear, Prause tunes up with two apparent aliases representing her new website (which illegally infringes on YBOP’s trademarks): realyourbrainonporn twitter account and reddit user scienceofarousal. First, here are the targeted tweets (which both Ley and Prause retweet):
RealYBOP falsely claims the “anti-porn” movement is rooted in hate groups.
RealYBOP trolls another thread with Prause’s standard allegations about being stalked or receiving rape threats. Prause has yet to provide documentation of these incidents. On the other hand, the page you’re reading, and its sister page, document Prause lying numerous times by making false claims that Gary Wilson, Alex Rhodes, and Clay Olsen have threatened or stalked her physically.
As RealYBOP was tweeting, the RealYBOP Reddit account (user/sciencearousal) was spamming r/nofap with the Kuznia article, implying that r/nofap is a hate group:
Sciencearousal (Prause) followed up her post with what on the surface appears to be an uncharacteristically sincere answer:
However, closer examination reveals a link to one of Prause & Ley’s all time favorite propaganda articles: a 2016 David Duke article with a link to Gary Wilson’s TEDx talk. Ley and Prause have used this over and over to suggest (falsely) that Wilson is allied with Duke. That’s what sciencearousal is trying to do with her oh-so-reasonable comment (hoping not to be deleted). Disgusting ploy.
Wilson’s TEDx talk has 12+ million views, so thousands of folks of all stripes have linked to (and recommended) Wilson’s talk, “The Great Porn Experiment.” How does this implicate Gary Wilson as a “white supremacist?” It doesn’t, of course. This ridiculous assertion is like suggesting all dog lovers are Nazis because Hitler loved his dogs.
In the Kuznia article Ley asserts that he has received “death threats.” Whether he has or not, Ley has certainly lied about receiving death threats from YBOP. In April, 2019. David Ley tweeted that the folks at YBOP had threatened his life.
David Ley is lying about YBOP death threats. Nor have the “folks at YBOP” censored, stalked, or deplatformed David Ley. Simply ridiculous.
Ley was asked several times on Twitter to supply evidence to support his claims. He provided none, as can be seen in the above thread. Ley has engaged in several instances of documented defamation. This latest defamatory assertion that YBOP “folks” threatened his life falls into a special category of defamation per se. YBOP is still weighing the options of a defamation per se lawsuit against Ley.
Missing from Kuznia’s NY Times article: the list of harassment, defamation, and threats, which many individuals documented on these 2 pages experience from Ley and Prause and their troupe of flying monkeys.
RealYBOP/Prause continues to tweet the NYTimes article in her propaganda.
As herself, for a change, falsely claiming to have recieved death & rape threats:
As they intended, Prause & Ley’s fabrications incite unstable Twitter trolls to harass Gary Wilson, Alexander Rhodes, and Nofap. A few of Prause’s allies join in here. (Even though nerdykinkycommie was long ago blocked, he joins the thread):
As soon as kinkycommie retweets Wilson’s tweet (the above tweet), Prause joins her friend in the defamation (Wilson’s tweet reads “unavailable” because kinkycommie is blocked).
Prause is claiming that: (1) she is receiving death threats, 2) Wilson is somehow behind these death threats because he is posting libel directed at “us.” As for Wilson posting libel, Prause provides no example, because she is lying and engaging in libel herself. While the posted threat may be legitimate (and that would be terrible), we are given no documentation as to the source. While this may seem harsh, we have documentation of several instances of Prause lying about having received rape threats from specific individuals. In one instance, Dr. Prause called the office of a doctor she had been harassing, telling office workers that threats to her (Prause) had been traced back to that office’s IP address, and must have come from the doctor. Unbeknownst to Prause the doctor hadn’t worked there for over a year. Prause busted in another lie.
Prause has also falsely asserted that she was sexually harassed by Don Hilton, MD and John Adler, MD. (Dr. Hilton was obliged to file a lawsuit in response to Prause defamatory statements in order to defend his professional reputation.)
Back story: This page documents much of Prause’s unethical behavior surrounding Park et al., 2016 – Prause’s efforts to have Behavioral Sciences review paper (Park et al., 2016) retracted – including, lying in emails to MDPI and COPE; using fake names to harass The Reward Foundation (a Scottish charity); threatening Gary Wilson’s publisher and his website manager; inserting false information about Wilson and The Reward Foundation into Wikipedia; harassing numerous individuals who published articles in MDPI journals; mischaracterizing her “review” of Park et al.; hiding the fact she had reviewed Park et al. at a previous journal; being banned from Wikipedia for employing multiple sockpuppets to edit the MDPI page; maliciously reporting US Navy doctors to medical boards; lying to Retraction Watch; using aliases to contact the US Navy; falsely accusing a US Navy doctor of harassment, when she was the perpetrator; and on and on and on. All this because Prause is obsessed with attempting to deny porn-induced sexual dysfunctions.
In August 2017, Behavioral Sciences published the article [1], which includes a case study of three individuals in the US Navy. The paper underwent our usual editorial process, including peer review, and was accepted for publication. Since then, we have received a number of complaints from a single individual claiming that the paper is seriously flawed and calling for withdrawal of the article. In this comment we wish to reiterate that the correct procedures were followed in the handling of the manuscript and to publicly counter some of the claims. The Committee for Publication Ethics (COPE) considered some of these issues and we are grateful for their advice and cooperation. We also wish to thank the authors for their cooperation.
One serious claim leveled against the paper was that the required consent was not sought from the three individuals featured in the case studies presented. According to the instructions for authors posted on the Behavioral Sciences website, informed consent should be obtained for case studies where there is any risk that individuals could be identified. When asked to confirm this point, the authors verified that consent had been obtained for two individuals and that for the third not enough details were shared in the paper to require consent. The editorial office has seen redacted copies of the consent form used and is satisfied with the authors’ explanation.
Another issue was that the academic editor of the article was not aware that he was making a final decision to accept article [1] for publication. Behavioral Sciences uses a standard template to invite editors to make the final decision to accept manuscripts, which was also done in this case. Since the complaint, the original academic editor has informed us that he was not aware that this was his role for the paper. We re-evaluated the peer review process with the (now former) Editor-in-Chief John Coverdale and made the decision that the manuscript should not be removed for this reason. In the published Correction [2], the academic editor information has been amended.
Numerous claims about conflicts of interest of the authors were made in relation to [1]. Only one non-financial conflict of interest was found to be substantiated and the paper has been updated [2].
Consequently, MDPI has updated its instructions for authors to provide more clarity about informed consent issues and to better guide authors in this area. Our requirements and policies have not changed and we continue to follow the guidelines provided by COPE.
We believe that the dispute surrounding this paper arose from a difference of opinion in terms of the treatment of individuals using high levels of pornography, and was not motivated by genuine concerns about the editorial work around the paper [3]. Our view is that the correct way to deal with such a dispute is by presenting arguments and counter-arguments in a peer-reviewed, scientific context where all conflicts of interest from both parties are properly disclosed. Personal criticism does not have a place in this context and attempts to shut down those with opposing views by removing their work from the literature is not the correct approach. We know that the majority of authors and readers approach research in a constructive and engaged way and we wish to advocate this approach for the benefit of the research community as a whole.
References
[1] Park, B.Y.; Wilson, G.; Berger, J.; Christman, M.; Reina, B.; Bishop, F.; Klam, W.P.; Doan, A.P. Is Internet Pornography Causing Sexual Dysfunctions? A Review with Clinical Reports. Sci.2016, 6, 17.
[2] Park, B.Y. et al.; Correction: Park, B.Y., et al. Is Internet Pornography Causing Sexual Dysfunctions? A Review with Clinical Reports Sci. 2016, 6, 17. Behav. Sci.2018, 8, 55.
What’s not clear in this article is that my (Wilson’s) affiliation with The Reward Foundation was disclosed from the start (see the original PubMed version, published in August, 2016 – https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5039517/). The correction was published for my protection, in an attempt to stop Dr. Prause from continuing to claim that I was being paid by The Reward Foundation as a lobbyist, or just being “paid off.” (She has publicly advanced several baseless theories about my imagined corruption.) In the journal’s correction, only the title of my book (“Your Brain On Porn: Internet Pornography and the Emerging Science of Addiction”) and a clear indication of my unremunerated role at The Reward Foundation were added. Again, this was to prevent further assertions of any possible financial conflict of interest. Corrected version: http://www.mdpi.com/2076-328X/8/6/55/htm
Put simply, the correction was meant to protect me from Prause and her littany of falsehoods surrounding this paper.
Backstory: MDPI is the Swiss parent company of over 100 academic journals, including Behavioral Sciences. Prause is obsessed with MDPI because Behavioral Sciences published two highly cited reviews that Prause despises because they (1) critiqued 3 papers by her, and (2) the two papers lend support to the existence of porn addiction and porn-induced sexual problems. The 2 reviews:
Not long after Park et al., 2016 was published, Prause went on the warpath against MDPI, Behavioral Sciences, and the authors of Park et al., employing multiple avenues of overt and covert attack (documented on this extensive page – Prause’s efforts to have Behavioral Sciences review paper (Park et al., 2016) retracted ). One avenue of attack was to edit the MDPI Wikipedia page using multiple aliases (sockpuppets), which violates Wikipedia rules. To date we have indentified at least 30 likely Prause sockpuppets.
Let’s begin with Wikipedia user NeuroSex, who had a least 8 other aliases – all of which were banned as Wikipedia sockpuppets of NeuroSex. Neurosex, her sockpuppets, and other Prause sockpuppets have edited Wikipedia, inserting false information about Gary Wilson, Park et al. and MDPI.
I have images that verify each of the claims (e.g., email from the publisher, email from the listed editor, etc.). RetractionWatch and other outlets are considering writing reviews of it as well, but I cannot be sure those will materialize. How is best to provide such evidence that verifies the claims? As embedded image? Written elsewhere with images and linked?
Let’s provide a few examples of the “NeuroSex” edits (lies) related to Wilson and to Park et al., 2016 – followed by Wilson’s comments:
Wilson comment: NeuroSex linked to a redacted document, claiming that Gary Wilson was paid 9,000 pounds by Scottish charity The Reward Foundation. Two days earlier, Prause falsely claimed to journal publisher MDPI (and others) that, based on the charity’s recent public filing (with a name redacted, as is standard), expense reimbursements paid to a charity officer were in fact paid to Wilson. Prause had not checked her facts, and she was mistaken (again). Wilson has never received any money from The Reward Foundation. Prause has repeated this same lie elsewhere.
Three sockpuppets of NeuroSex who edited the MDPI Wikpedia page (links show list of edits for each sockpuppet):
Wikipedia is an important source of community-based knowledge and MDPI supports the endeavor to openly disseminate knowledge, which closely matches the goals of MDPI. Unfortunately, some editors of the Wikipedia page about MDPI lack objectivity. This leaves the article heavily biased and uninformative about the majority of MDPI’s activities. Any potential improvements added to the page are quickly removed. We have made a number of attempts to discuss with Wikipedia editors to improve the quality of the article, but without success. Thus, for the time being, we do not recommend Wikipedia as a reliable source of information about MDPI.
Almost three quarters of the Wikipedia article covers controversial topics, mentioning 4 out of over 200,000 published papers, one instance where 10 editorial board members resigned (in 2018 we had over 43,000 Editorial Board Members and Guest Editors), and inclusion on Jeffrey Beall’s list, known as a source biased against open access and from which MDPI was removed (see our response here). While we do not object to these topics being mentioned, the way in which they are presented is misleading.
Responses to some of the topics covered can be found at:
Comment on Park, B., et al. Is Internet Pornography Causing Sexual Dysfunctions? A Review with Clinical Reports Behav. Sci. 2016, 6, 17: https://www.mdpi.com/about/announcements/1616.
A large parent company posting two official statements related to the unethical behavior by a rogue PhD may be without precedent.
Others – July, 2019: Donald Hilton amends defamation lawsuit to include affidavits from 9 other victims of Prause, Texas Board of Medical Examiners complaint, incorrectly accusing Dr. Hilton of falsifying his credentials.
Prause’s malicious complaint to the Texas Board of Medical Examiners containing false and defamatory statements,
Prause’s accusations with two different professional journals in which Dr. Hilton has published, incorrectly accusing Dr. Hilton of falsifying and exaggerating his credentials.
UPDATE: Nicole R. Prause filed a motion to dismiss Donald Hilton’s defamation lawsuit against her. Prause’s motion contained false statements and myriad unsupported allegations. Don Hilton responded with a 21-page opposition to dismiss and 57 pages of exhibits:
We provide screenshots of only the narrative portion of the affidavit (omitting the exhibit portions which are in the full PDF).
You can see the rest of the affidavit here – Gary Wilson of YBOP (affidavit #2). These pagaes conatin hundreds more of documented incidents involving Prause harassing, defaming or cyberstalking Wilson:
As usual, Prause is lying: Geoff Goodman is still on the AASECT listserve, posting whenever he pleases. His university ultimately dismissed Prause’s malicious attempt to punish Goodman for challenging one of Prause’s minions.
July, 2019: Laila Haddad affidavit: Donald Hilton defamation lawsuit against Nicole R Prause & Liberos LLC.
Prause’s history of intentionally mischaracterizing porn related research (including her own)
Over the last few years Nicole Prause has not only mischaracterized the current state of porn research, she has misrepresented the findings of her own studies. What’s going on here? By her own admission, Prause rejects the concept of porn addiction. For example, a quote from this Martin Daubney article about sex/porn addictions:
Dr Nicole Prause, principal investigator at the Sexual Psychophysiology and Affective Neuroscience (Span) Laboratory in Los Angeles, calls herself a “professional debunker” of sex addiction.
In addition, Nicole Prause’s former Twitter slogan suggests she may lack the impartiality required for scientific research:
“Studying why people choose to engage in sexual behaviors without invoking addiction nonsense”
We will start with Prause’s consistent claims to the media that no studies have been published that support either porn addiction or porn-induced sexual problems. Prause said this in the Congressional Quarterly Researcher (2016, October 21):
Moreover, says Nicole Prause, a neuroscientist and CEO of Liberos, a company that researches sexuality in Los Angeles, there is no proof that pornography is causing a rising rate of erectile dysfunction nor that it is addictive.
This Salt Lake Tribune Op-Ed (debunking an earlier Op-Ed) contained 100 peer-reviewed studies found on these two lists: 1, 2. Within a few days Nicole Prause and 3 therapists appeared on a Mormon Matters podcast to offer a “rebuttal” to the Salt Lake Tribune Op-Ed. When the show’s host asked Prause to address the many studies cited in support of the Op-Ed, Prause said the following:
“Not one of the studies the cited asked about the positive effects of sex films”
False. Most of these 110 studies simply correlated porn use with sexual or relationship satisfaction. A few even reported porn use sexual satisfaction. She also said,
“They were probably not peer-reviewed.”
False. All were peer-reviewed.
“A lot of the studies they cited were in predatory journals.”
False. None were in predatory journals. Many of the papers were authored by some of the top neuroscientists at Yale University, Cambridge University, University of Duisburg-Essen, and the Max Planck Institute.
“So what they are citing is not respected by any scientist.”
False. No scientist has come forth to officially critique any of the papers in those lists of peer-reviewed literature.
It’s telling that Prause failed to provide the name of a single study from those lists that was not peer-reviewed, or that was published in a predatory journal. Once again Prause makes outlandish claims, yet never provides an iota of evidence to support them. It seems as though Dr. Prause is unaware of the Americal Psychological Association’s “General Principles,” one of which is “Integrity.” Excerpt:
Psychologists do notsteal, cheat orengage in fraud, subterfuge or intentional misrepresentation of fact.
Prause has also misrepresented the findings of her own studies to the media (which is the primary reason this website has been obliged to critique Prause’s studies/claims). As examples, we examine a few of the claims surrounding Prause’s three most publicized papers, which she repeatedly claims debunk either porn addiction or porn-induced erectile dysfunction.
Prause, as the Steele et al. spoesperson, claimed that her subjects’ brain response differered from other types of addicts (cocaine was the example). A few interviews of Prause:
Reporter: “They were shown various erotic images, and their brain activity monitored.”
Prause: “If you think sexual problems are an addiction, we would have expected to see an enhanced response, maybe, to those sexual images. If you think it’s a problem of impulsivity, we would have expected to see decreased responses to those sexual images. And the fact that we didn’t see any of those relationships suggests that there’s not great support for looking at these problem sexual behaviors as an addiction.”
Prause: Our study tested whether people who report such problems look like other addicts from their brain responses to sexual images. Studies of drug addictions, such as cocaine, have shown a consistent pattern of brain response to images of the drug of abuse, so we predicted that we should see the same pattern in people who report problems with sex if it was, in fact, an addiction.
Does this prove sex addiction is a myth?
Prause: If our study is replicated, these findings would represent a major challenge to existing theories of sex “addiction.” The reason these findings present a challenge is that it shows their brains did not respond to the images like other addicts to their drug of addiction.
The above claims that subjects’ “brains did not respond like other addicts” is without support, and is nowhere to be found in the actual study. It’s only found in Prause’s interviews. In Steele et al., 2013, the subjects had higher EEG (P300) readings when viewing sexual images, which is exactly what occurs when addicts view images related to their addiction (as in this study on cocaine addicts). Commenting under the Psychology Today interview of Prause, senior psychology professor emeritus John A. Johnson said:
“My mind still boggles at the Prause claim that her subjects’ brains did not respond to sexual images like drug addicts’ brains respond to their drug, given that she reports higher P300 readings for the sexual images. Just like addicts who show P300 spikes when presented with their drug of choice. How could she draw a conclusion that is the opposite of the actual results?
Mustanski asks, “What was the purpose of the study?” And Prause replies, “Our study tested whether people who report such problems [problems with regulating their viewing of online erotica] look like other addicts from their brain responses to sexual images.”
(Said Johnson) But the study did not compare brain recordings from persons having problems regulating their viewing of online erotica to brain recordings from drug addicts and brain recordings from a non-addict control group, which would have been the obvious way to see if brain responses from the troubled group look more like the brain responses of addicts or non-addicts…
Nicole Prause also claimed her study contained 122 subjects (N). In reality, the study had only 55 “compulsive porn users.” The other 67 participants were controls.
In a third dubious claim, Prause, et al. stated in both the abstract and in the body of the study:
“These are the first functional physiological data of persons reporting VSS regulation problems.”
This is clearly not the case, as the Cambridge fMRI study was published nearly a year earlier.
Nine peer-reviewed papers disagree with Nicole Prause’s interpretation of her study: Peer-reviewed critiques of Prause et al., 2015. The author of the fourth critique, neuroscientist Mateusz Gola, summed up it up nicely:
“Unfortunately the bold title of Prause et al. (2015) article has already had an impact on mass media, thus popularizing a scientifically unjustified conclusion.”
Finally, for Prause’s claims of falsification and the resulting dubious headlines to be legitimate, all of Prause’s 55 subjects would have to have been actual porn addicts. Not some, not most, but every single subject. All signs point to a good number of the 55 Prause subjects being non-addicts.
The subjects were recruited from Pocatello Idaho via online advertisements requesting people who were “experiencing problems regulating their viewing of sexual images”. Pocatello Idaho is over 50% Mormon, so many of the subjects may feel that any amount of porn use is a serious problem. In a serious methodological flaw, none of the subjects were screened for porn addiction.
Make no mistake, neither Steele et al., 2013 nor Prause et al., 2015 described these 55 subjects as porn addicts or compulsive porn users. The subjects only admitted to feeling “distressed” by their porn use. Confirming the mixed nature of her subjects, Prause admitted in 2013 interview that some of the 55 subjects experienced only minor problems (which means they were not porn addicts):
“This study only included people who reported problems, ranging from relatively minor to overwhelming problems, controlling their viewing of visual sexual stimuli.”
Key point: How can you debunk the porn addiction model if many of your “porn addicts” are not really porn addicts?
This paper wasn’t a study at all. Instead, Prause claimed to have gathered data from four of her earlier studies, none of which had anything to do with erectile dysfunction. None of the data from the Prause & Pfaus (2015) paper matched the four earlier studies. The discrepancies were not small and have not been explained. A comment by researcher Richard A. Isenberg MD, published in Sexual Medicine Open Access, points out several (but not all) of the discrepancies, errors, and unsupported claims (a lay critique describes more discrepancies). Prause made a number of false or unsupported claims associated with this paper:
Many of the articles about this study claimed that porn use lead to better erections, yet that’s not what the paper found. In recorded interviews both Prause and Pfaus falsely claimed that they had measured erections in the lab, and the men who used porn had better erections. The Jim Pfaus TV interview Jim Pfaus he states:
“We looked at the correlation of their ability to get an erection in the lab,”
“We found a liner correlation with the amount of porn they viewed at home, and the latencies which for example they get an erection is faster.”
In this radio interview Nicole Prause claimed that erections were measured in the lab. The exact quote from the show:
“The more people watch erotica at home they have stronger erectile responses in the lab, not reduced.”
Yet this paper did not assess erection quality in the lab nor “speed of erections.” The paper only claimed to have asked guys to rate their “arousal” after briefly viewing porn (and it’s not clear from the underlying papers that even that actually happened in the case of all subjects). In any case, an excerpt from the paper itself admitted that:
“No physiological genital response data were included to support men’s self-reported experience.”
In a second unsupported claim, lead author Prause tweeted several times about the study, letting the world know that 280 subjects were involved, and that they had “no problems at home.” However, the four underlying studies contained only 234 male subjects, so “280” is way off.
A third unsuported claim: Dr. Isenberg wondered, how is it possible for Prause & Pfaus to have compared different subjects’ arousal levels when three different types of sexual stimuli were used in the 4 underlying studies? Two studies used a 3-minute film, one study used a 20-second film, and one study used still images. It’s well established that films are far more arousing than photos, so no legitimate research would group these subjects together to make claims about their responses. What’s shocking is that in this paper Prause & Pfaus unaccountably claim that all 4 studies used sexual films:
“The VSS presented in the studies were all films.”
This statement is absoluely false and clearly shown in Prause’s own underlying studies.
A fourth unsupported claim: Dr. Isenberg also asked how Prause & Pfaus compared different subjects’ arousal levels when only 1 of the 4 underlying studies used a 1 to 9 scale. One used a 0 to 7 scale, one used a 1 to 7 scale, and one study did not report sexual arousal ratings. Once again Prause & Pfaus inexplicably claim that:
“men were asked to indicate their level of “sexual arousal” ranging from 1 “not at all” to 9 “extremely.”
This too is false as the underlying papers prove.
In summary, all the Prause-generated headlines about porn improving erections or arousal, or anything else, are completely unsupported. Claims in the Prause & Pfaus paper are falsified by Prause’s own studies underlying the paper.
Why the extreme bias and libelous attacks on anyone who suggests that internet porn might cause problems in some users?
It’s important to note that UCLA chose not to renew Prause’s contract (around January, 2015), and she has not been employed by an academic institution ever since.
This article aligns perfectly with what we have seen and experienced. A few excerpts:
Often individuals who engage in scientific fraud are high achievers. They are prominent in their disciplines but seek to be even more recognised for the pre-eminence of their scholarly contributions. Along with their drive for recognition can come charisma and grandiosity, as well as a craving for the limelight. Their productivity can border on the manic. Their narcissism will often result in a refusal to accept the manifest dishonesty and culpability of their conduct. The rationalising and self-justifying books of Stapel and Obokata are examples of this phenomenon.
When criticism is made or doubts are expressed about their work, these scientists often react aggressively. They may threaten whistleblowers or attempt to displace responsibility for their conduct onto others. Such cases can generate persistent challenges in the courts, as the scientists in question deny any form of impropriety.
These fraudulent scientists often use the collaboration of others, including across institutions, to blur the lines of responsibility and make it difficult to identify who has generated particular components of research and whether there has been proper authorisation by relevant ethics committees….
Research misconduct often has multiple elements: data fraud, plagiarism and the exploitation of the work of others. People rarely engage in such conduct as a one-off and frequently engage in multiple forms of such dishonesty, until finally they are exposed.
This intellectual dishonesty damages colleagues, institutions, patients who receive suspect treatments, trajectories of research and confidence in scholarship.
It challenges institutions because those responsible for scientific fraud are often stars in the scholarly firmament and high earners of research funding. They put institutions, be they university departments or research laboratories, on the scholarly map and keep them there.
Exposing their misconduct risks the status of the whole institution and its commercial viability. It’s hardly surprising then that accusations and revelations of such misconduct are often unwelcome, and that too many times the blowtorch of scrutiny is turned on the whistleblower rather than the perpetrator.
Research misconduct generally matters most when it reaches the point of publication. Multiple instances of research fraud have been revealed in recent years, resulting in an unparalleled number of retractions in high profile and reputable journals.
The unpalatable truth is that the check and balance of peer review has repeatedly been shown to be ineffectual, and has been subverted and circumvented. We need to do better if we are to reduce the extent of the phenomenon of fraudulent research.
A single scientist might be publishing papers, peer-reviewing other peoples’ papers, submitting grants, serving on review committees for other peoples’ grants, editing a journal, applying for a job and serving on a hiring committee — all at the same time. And so the standards for scientific integrity, for rigorous methods, do not reside with the institutions or the funders or the journals. Those standards are within the scientists themselves. The inmates really do run the scientific asylum.
A relevant study: “Need for Drama” is a maladaptive personality trait.
Scientists have begun to investigate a personality trait in which, “people impulsively manipulate others from a position of perceived victimhood.” They have confirmed a three factor model of “Need For Drama” (NFD) consisting of, “interpersonal manipulation, impulsive outspokenness, and persistent perceived victimhood.”
The Need for Drama (NFD) personality can be defined as a compound personality trait in which individuals impulsively manipulate others from a position of perceived victimization. …
We expect individuals with greater NFD to share some characteristics with those who exhibit BPD and HPD features, namely susceptibility to interpersonal conflict, manipulative behaviors, impulsive decision-making, and pervasive perceived victimization. …
Political language … is designed to make lies sound truthful and murder respectable, and to give an appearance of solidity to pure wind. ~George Orwell
A true academic will be willing to engage in discussion without defaulting to ad hominem insults or ascribing negative intentions to the other side.~ Dr. Debra Soh
July 4, 2019: Prause escalates her stalking and harassment by delivering a bogus Cease and Desist letter to my home at about 10:00 pm (her lawyer, Giampierto, also represented BackPage.com)
Nicole Prause and the lawyer she employs to threaten people, Wayne Giampietro (Prause has other lawyers defending her in defamation suits) cobbled together her usual spate of falsehoods, fairy tales, and empty threats in a hand delivered cease and desist letter.
On to the July 4th, 2019 C&D letter. Prause’s lawyer states that I continue to make false allegations, statements and publications, yet he fails to provide an example of a single one. Giampietro does allude to “eight new posts attacking and defaming Dr. Prause,” yet provides no links or screenshots. Standard Giampierto/Prause. Nevertheless, I assumed Prause was upset that I debunked her factually-inaccurate July 2, Daily Beast article in this series of tweets (which remain):
1/ Debunking the new Daily Beast article "Porn Didn’t Break Your Penis” (by RealYBOP "expert" Nicole Prause): https://t.co/mRYk7kRrXw It links to RealYBOP research & falsely states that 7 labs found no relationship between porn use & ED. Debunked here: https://t.co/0oSsPrE5xK
I was also told on July 4th, 2019 that “Dr. Prause has reached the end of her patience with Mr. Wilson”. These threats were not only unfounded, but also empty. Not only does the above Twitter thread remain, Prause’s continued harassment means that I have since added 30 new sections to Prause page #2, and Prause page #3, and these extensive pages chronicling Prause’s ever increasing defamation and cyberstalking:
Prause may be at the end of her patience with me, but I chose to disregard the above threat. The next communication I received was not a summons or complaint, but yet another full-of-lies cease and desist letter.
July, 2019: Prause supplies troll NerdyKinkyCommie with a YBOP trademark lawsuit document; NerdyKinkyCommie lies about a document; & RealYBOP experts spread his libelous tweets, adding their own lies
Background: NerdyKinkyCommie, whose Twitter handle is @SexualSocialist, appears to be a prolific troll. He freely admits to being obsessed with porn and sex and revels in harassing and defaming anyone who suggests that internet porn might cause problems. Among his favorite targets are Alexander Rhodes, NoFap, Fight The New Drug, Gary Wilson, and men in recovery from porn-related difficulties. Nerdy’s original Twitter account was permanently banned for relentless harassment of Fight The New Drug (Prause’s original account was also banned for harassment). In violation of Twitter rules, and just like Prause, Nerdy created a new Twitter account for trolling: https://twitter.com/SexualSocialist
NerdyKinkyCommie often re-tweets Ley, RealYBOP and Prause propaganda. Prause, Ley and Nerdy regularly engage in friendly banter, expressing their disdain for the aforementioned targets. In June and July, NerdyKinkyCommie trolled Gary Wilson threads posting material mirroring Prause & Ley’s disgusting tweets and screenshots struggling in vain to connect Gary Wilson, YBOP and Nofap with Nazis and white nationalists. One example of many such tweets:
Wilson reported NerdyKinkyCommie, who was eventually banned for a week by Twitter.
After the ban, NerdyKinkyCommie continued where he left off, this time aided by Prause, the RealYBOP Twitter account, and RealYBOP “experts.”
On July 21 David Ley tweets in Nerdy’s thread that defamed Wilson:
The next day NerdyKinkyCommie produced a tweet that was most certainly constructed by Nicole Prause.
It falsely accused Wilson of being funded by The Reward Foundation (Prause concocted this lie in 2016, repeating it on social media and on Wikipedia)
The screenshot is of a the YourBrainOnPorn UK trademark provided to Prause’s lawyers, by Wilson, in trademark infringement case made necessary because Prause had filed an application for an infringing trademark.
What the above screenshot actually shows: Acting as Gary Wilson’s UK representative and using Wilson’s money, The Reward Foundation (a UK charity) paid the UK government to trademark YourBrainOnPorn in the UK. The UK trademark was a response to Prause trying to shut down YBOP by:
publicizing a new website with the trademark-infringing URL realyourbrainonporn.com in April of 2019.
As thoroughly explained elsewhere Wilson donates the proceeds of his book to The Reward Foundation. Wilson accepts no money, and has never received a dime for any of his efforts. YBOP accepts no ads and Wilson has accepted no fees for speaking. As documented in these sections, Prause has constructed a libelous fairy tale that Wilson is being paid by the same charity he donates his book proceeds to:
In fact, this is not true. The above two sections are addressed in Gary Wilson’s sworn affidavit, which is part of the Dr. Hilton’s defamation lawsuit filed against Dr. Prause. Here are the relevant sections of Wilson’s sworn affidavit filed in Federal Court: Gary Wilson of YBOP (affidavit #2 in Hilton defamation lawsuit):
Put simply, Nikky and Nerdy are collaborating in provable defamation (to repeat, Prause provided Nerdy with the “evidence” for his misleading tweet). Then RealYBOP, RealYBOP “experts” and good old PornHub jumped aboard. First we have RealYBOP (Prause) immediately retweeting Nerdy’s lies, and adding her own (RealYBOP “expert” Roger Libby also comments):
All lies. RealYBOP isn’t a registered non-profit. In fact, all the experts advertise their services on RealYBOP. Moreover, David Ley and two other RealYourBrainOnPorn.com “experts” (Justin Lehmiller and Chris Donaghue) are being paid to promote xHamster websites! If you believe that RealYBOP isn’s biased, check out their tweets, or their so-called “research page”. Other RealYBOP “experts” joined NerdyKinkCommie in defaming the legitimate YBOP, Wilson, and The Reward Foundation. First, “expert” Victoria Hartmann:
Finally we have PornHub, a RealYBOP ally, “liking” the defamatory tweet (PornHub’s was the first Twitter account to tweet about RealYBOp’s new Twitter account and website when it appeared):
Hmmm… PornHub, Prause, Ley and Hartmann all “liking” the tweet of an obscure Twitter troll who had recently completed a 7-day ban for harassing Gary Wilson. Go figure.
The cherry on top of RealYBOP’s targeted defamatory cyberstalking: As described here, RealYBOP’s reddit account, sciencearousal trolled and spammed reddit porn recovery forums, usually posting wherever Gary Wilson’s name or “Your Brain On Porn” appeared. In her recent reddit posts, sciencearousal spammed a nofap subreddit with the same Rob Kuznia article frequently tweeted by RealYBOP and Nikky (Kuznia is pals with Nikky). Nofap deleted her post:
RealYBOP/sciencearousal comment where she links to her fav – David Duke’s article about porn, which conatins a link to Gary Wilson’s TEDx Talk (Sciencearousal comment was deleted):
Scouring the internet for anything Ley can use to smear Wilson, he pounced upon an obscure (and disgusting) David Duke blog post containing a link to Gary Wilson’s TEDx talk. Wilson’s TEDx talk has some 12 million views, so thousands of folks of all stripes have linked to (and recommended) Wilson’s talk, “The Great Porn Experiment.”
Update August 20, 2019: Nerdykinky, Prause, David Ley and Ron Swanson (Daniel Burgess alias) form a twitter thread surrounding the above section. Since Nerdy is unaware of the Prause pages, it’s highly likely this twitter orgy was orchestrated by Prause.
Wilson suspected Ron was Burgess because the account was 3 years old, dormant, had only a dozen or so tweets – yet it contained a tweet to Instagram pictures of Daniel Burgess and his wife doing CrossFit training (Burgess is a cross-fit nut: even has a Facebook page called “CrossFit Dan“, which he used to post numerous libelous comments about Gary Wilson). A dead give-away.
The minute the legally irrelevant ACLU letter was tweeted by RealYBOP, Prause and Ley, Ron Swanson awoke – tweeting it 4 times @ the YBOP twitter account.
Suspicions confirmed.
“Ron Swanson” hasn’t tweeted since the above 4 tweets – until August 2oth, when Ron went after Gary Wilson again with bizarre tweets claiming that YBOP contained porn (a screw-up on the Wayback Machine – all the links are bogus and go nowhere):
The cyberstalkers join forces again: Burgess, Ley, Prause and Nerdykinkycommie. It’s almost comical.
August, 2019: In the wake of two mass shootings (El Paso & Dayton), Nicole Prause & David Ley try to connect Gary Wilson, YBOP and Nofap to white nationalists & Nazis
In a new low (which is saying something), Nicole Prause used the tragic deaths of innocent people once again to defame Gary Wilson and NoFap while promoting the porn industry agenda. On the Monday following two mass shootings (Dayton and El Paso) Prause posted tweets and screenshots vainly trying to connect Gary Wilson, YBOP and Nofap to Nazis and white nationalists.
As chronicled in many other sections, when such tragedies occur, Prause and Ley appear to scour the internet for any comments mentioning Gary Wilson’s TEDx talk, YBOP, or NoFap – all in the hope that a few are posted by white nationalists. (Alternatively, Prause or Ley may be using aliases to post their own fabricated comments – to use in their propaganda campaign. We have documented over 60 Prause aliases on these pages: page 1, page 2.)
Here are other sections of the “Prause pages” documenting Prause and Ley’s repugnant campaign to falsely characterize YBOP and porn recovery communities as Nazi sympathizers.
Prause/Ley capture (or produce) the posts, store them, and wait for the next racist-fueled tragedy. Then they grab meaningless screenshots and “explain” them with defamatory assertions. Is it a surprise that Prause is now being sued for defamation? Gary Wilson and Alex Rhodes of Nofap have provided sworn affidavits in connection with that suit, which include among numerous incidents, Prause’s lies that both are Nazi sympathizers. See:
Even if Prause’s screenshots are real, a white nationalist linking to Wilson’s TEDx Talk tells us nothing about Wilson or anyone else who believes viewing porn may cause problems. If a Nazi links to a Motor Trend review of the Ford F150 does that mean that everyone who drives a Ford, or is employed by Ford is a Nazi? This type of malicious propaganda is simply how Prause and Ley roll.
On to the current set of Prause/Ley revolting tweets. (tweet #1)
Below we provide the two screenshots Prause featured with the above tweet (picture #1, picture #2). Notice how Gary Wilson’s name is highlighted, which means that Prause searched these sites for Wilson’s name, his TED Talk, or his website. Given her preoccupation with fabricating dirt, how does Prause find time to do research? (Such as completing her upcoming study that allegedly acquired subjects via the Free Speech Coalition – the lobbying arm for the porn industry!)
Also note that “anonymous” posted Philip Zimbardo’s famous TED talk, The Demise of Guys?, a Buzzfeed article, a Max Planck Institute fMRI study on porn users, and an article by aidshealth.org. Is Prause suggesting that Zimbardo, everyone at BuzzFeed, everyone the Max Planck Institute, and all associated with aidshealth.org are Nazi sympathizers? Absurd.
In this second screenshot, Gary Wilson’s obsessed cyberstalker (Prause) once again highlights his name:
As before, the list includes links to other well known Nazi sympathizers (joke) such as Phil Zimbardo, Buzzfeed, Brown University, Cambridge University researchers, PlosOne, InternetSafety.org, and Scribd.
Once again, Prause is searching only for Gary Wilson or his website. How this screenshot implicates Wilson as a Nazi is anyone’s guess:
This second Prause screenshot mentions a growing body of research, which is quite solid, even if “Sentinel” turns out to be a white nationalist rather than her own cyber progeny. (Prause provides no evidence of who Sentinel might be.)
August 9, 2019: Don Hilton’s 21-page response (with 57 pages of exhibits) to the Nicole Prause motion to dismiss his defamation lawsuit
Nicole R. Prause filed a motion to dismiss Donald Hilton’s defamation lawsuit against her. Prause’s motion contained false statements and myriad unsupported allegations. Don Hilton responded with a 21-page opposition to dismiss (screenshots below) and 57 pages of supporting exhibits.
August 27, 2019: In response to Wilson exposing Prause & Burgess’s lies & defamation surrounding fake porn URLs they discovered on the Wayback Archive, their lawyer sends another bogus Cease & Desist letter with more false accusations.
During this 4-day rampage @BrainOnPorn posted over 110 tweets targeting me. Nearly every @BrainOnPorn tweet contained at least one defamatory statement (most contained several). Rather than posting 100+ tweets here, including tweets RealYBOP posted under other comments out of context, I’ve created this link. There you can see all the @BrainOnPorn tweets targeting me between August 22-26: PDF of over 100 RealYBOP tweets targeting Gary Wilson from August 22-26. Most contain defamation by RealYBOP.
In addition to the baseless character-impugning campaign conducted by the “Brain On Porn” Twitter account, the Twitter account also explicitly accused me of at least 3 felonies (screenshots below):
Stalking women in person
Making death threats, and
Hacking into websites.
Publicly accusing people of sexual/professional misconduct and felonies is actionable. In fact, if a tribunal deems RealYBOP’s (Burgess’s) actions “defamation per se,” I need not show any commercial damages in order to recover. I am investigating the remedies open to me to seek redress for RealYBOP’s (Burgess’s) actions.
In addition to approximately 150 tweets in 4 days by “Brain On Porn” Twitter and its allies (@RonSwansonTime -Burgess alias, Nicole Prause, NerdyKinkyCommie, and David Ley), on August 22 this email by the realyourbrainonporn website admin was forwarded to Gary Wilson (is it Burgess who owns the URL, or Prause?):
As the organization forwarding the email knows me, and is keenly aware of both RealYBOP’s trademark infringement and Prause’s long history of defaming and harassing those in the porn-skeptic movement, its personnel knew it was all lies.
On August 27th Prause & Burgess’s lawyer, Wayne Giampierto, sent me another one of his lie-filled Cease and Desist letters:
Nothing but untruths by Prause/Burgess/Giampierto. While I strongly suspect that Prause, or Prause colleagues, were behind the fake Mormon porn URLs placed on the Internet WayBack Machine, I never stated that she or any of the RealYBOP “experts” inserted the fake “Mormon porn” URLs into Wayback Internet Archive. Nor did Giampietro’s bogus Cease and Desist letter provide evidence that I had said anything the sort. Nor did I “illegally alter the archives” of RealYBOP, and Giampietro provided zero evidence that I had (note: it is not “illegal” to insert URLs into the The Wayback Archive, even though I did not). In any case, our attorneys responded with this stern letter to Dr. Prause and her lawyer (reproduced below).
In response to RealYBOP’s Twitter rampage (in which Prause, apparently, was aided by @RonSwansonTime, who is likely a Burgess alias), NerdyKinkyCommie, and David Ley) I posted the following extensive Twitter thread exposing how “they” inserted fake YBOP URLs into the WayBack Machine archive and how I was being cyberstalked by RealYBOP, its aliases, and its allies. As you can see, none of the tweets accused anyone of “committing a felony of computer hacking”:
1/ BE AWARE- @BrainOnPorn is emailing organizations & individuals with false claims about YBOP. In the last 24 hours @BrainOnPorn has posted 30 tweets about YBOP@BrainOnPorn also appears to have created a troll account to spread lies. It was suspended: https://t.co/VhbZ3HdU9s
In the thread I explained how easy it was to insert fake URLs into the WayBack Machine Archive, and demonstrated by adding one for my own site.
5/ It's easy to insert fake URLs into The Wayback Machine. WayBack allows you to insert ANY URL as a way to save a page, even fake URLs. I just inserted this fake URL into the WayBack (eventually the URL enters the URL list): https://t.co/zDRWWbkpanpic.twitter.com/WW01FaKiLA
I also tweeted that another individual had inserted fake URLs into realyourbrainonporn.com’s Wayback Archive, thus disproving RealYBOP’s Twitter claim that it could not be done: https://web.archive.org/web/*/www.realyourbrainonporn.com/*
16/ Hilarious: An anonymous email reported that 2 fake URLs were inserted into the WayBack Machine archives of REALyourbrainonporn. Link to RealYBOP URLs: https://t.co/gGMVljnaQP The @BrainOnPorn twitter falsely stated that fake URLs could NOT be inserted. Caught in another lie: pic.twitter.com/uRj8ImkhG8
Now on to our lawyer’s 8-page response to Mr. Giampietro’s bogus August 27, 2019 cease and desist letter (PDF):
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Again, this PDF of 120 tweets contains many more examples of RealYBOP (Prause or Burgess) defaming and harassing over a 4-day period.
September, 2019: Nicole Prause gets Medium user Marny Anne suspended. Prause falsely states in defamatory tweet (along with other lies) that Marny Anne was Gary Wilson
On September 15, 2019 Prause posted the following defamatory tweet (note how she never provides evidence for any claim). Link to suspended account: https://medium.com/@marnyanne/the-experts-who-of-course-never-disagree-e6c12f0fda16
Prause’s tweet contains several instances of defamation:
2) Unlike Prause (here) and Ley (below), I have never doxxed anyone. Using the @BrainOnPorn Twitter account, Prause/Daniel Burgess posted 20 defamatory tweets in 2 days, falsely claiming that Gary Wilson “threatened families” or “posted photos of families” or “doxxed families.” In its 20 tweets, RealYBOP provided no examples of me doing so, because @BrainOnPorn is lying. Note: Burgess owns the URL of realyourbrainonporn.com and Nicole Prause filed a trademark application to obtain YOURBRAINONPORN and YOURBRAINONPORN.COM. Together they are trying to shut down YBOP.
The introduction of the above article contains a blurry picture of a single 2018 Daniel Burgess post defaming me on the YBOP Facebook page. My “first contact” with Burgess was his 5-comment defamatory tirade on the YBOP Facebook page (Feb, 2018). Before this, I had never heard of Daniel Burgess. He came after me, out of the blue, for no discernible reason.
The solitary screenshot is included to provided context. It is this excerpt that Prause/Burgess mislabel “doxxing and threatening families”:
As an example of his malice, I’ll provide Burgess’s initial comment on YBOP’s Facebook page. It includes Nicole Prause’s baseless 2015 cease and desist letter to me. (How did Burgess obtain this letter?)
According to RealYBOP’s Twitter, it’s OK for Burgess to harass and defame using multiple social media platforms. Yet, my single screenshot of Burgess defaming me on my home page means I am threatening his family and “doxing the families of all the 30 RealYBOP experts!” Welcome to the upside-down world of Prause & Burgess.
On to an example of David Ley actually doxxing a young man who criticized his agenda-driven articles. In retaliation psychologist Ley tweeted the guy’s full name, location, email and IP address:
Twitter bans Ley, yet he acts sheepish, as if he doesn’t know why:
A few years later David Ley lies about why he was really banned (always playing the victim, even when he is the perpetrator):
Notice how Ley insinuated that Mr. Eskelin had threatened him. Ley often lies about receiving threats.
In this tweet Ley commits defamation per se, falsely claiming that the folks at YBOP have sent him death threats. Ley cannot produce evidence for this supposed threat, even when challenged by several other twitter accounts:
3) Police reports? Starting in July, 2013 (a few days after I published a careful critique of Prause’s first EEG study) various usernames began posting defamatory comments wherever my name appeared. The comments were very similar in content and tone, falsely claiming that “Wilson has a police report filed on him,” “Wilson is charged with stalking a poor woman,” and “Wilson stole a woman’s pictures and placed them on a porn site”, and that “Wilson has been reported to LAPD (which agrees that he’s dangerous) and the UCLA campus police.” Very soon Prause, as herself, began to claim that a “person” had been reported to the police for physically stalking her, threatening her lab, mapping a route to her lab (whatever that means), and other vague fabrications.
By 2016, as Prause was no longer employed by UCLA or any other institution that could rein in her cyber-harassment, she finally began to identify Gary Wilson as the “person” she had reported to the LAPD and the UCLA campus police. Prause even claimed that she posted armed guards at her public talks because I had threatened to attend. (The claim that I threatened to attend is a lie and Prause has never provided documentation for this assertion.)
All these claims are untrue, and the claim that “Wilson has been spotted seen near the scientist’s home” is also fiction. I haven’t been to LA in years. It’s almost 2020, and no law enforcement agency has ever contacted me. (Any harasser can file a fake police report.)
I used to presume that Prause had, in fact, filed fraudulent, groundless reports (which were subsequently disregarded), but it turned out Prause was lying – again. In late 2017 a call to the Los Angeles Police Department and the UCLA campus police revealed no report in their systems on a “Gary Wilson,” nor any report filed by a “Nicole Prause.” I made this section to report my findings: Los Angeles Police Department and UCLA campus police confirm that Prause lied about filing police reports on Gary Wilson.
Perhaps motivated by YBOP exposing her lies, Prause brazenly filed a bizarre police report on April 25, 2018 – five years later than her claims.
After 5 years of claiming I had physically stalked her, what did Prause actually report to the LAPD? It was not a stalking report as Prause’s never stated that I was in Los Angeles, stalking her. Nor was it a cyberstalking report. The “Suspect’s Actions” section contained two incidents that were neither stalking nor a crime. A screenshot of the two alleged “crimes”:
What Prause alleges, followed by reality:
“Suspect posted victim name and pic on his website. Suspect refused to remove pictures.”
While screenshots of Prause’s defamatory tweets and her name appear on the 2 main “Prause pages,” this is not a crime. To the contrary, the pages with screenshots chronicling her ongoing harassment (1, 2, 3, 4, 5) are documenting her misdeeds: libel and cyberstalking. In reality, Prause has been breaking the law by falsely stating she has reported me to both the FBI and LADP.
The second infraction?
“Suspect traveled to Germany to victim’s conference. Suspect was not invited.”
Apart from the fact that attending a conference is not a crime, Prause is lying.
It’s true that I traveled to Germany and attended the 5th International Conference on Behavioral Addictions, which ran from April 23-25 (note that Prause filed her police report on April 25th). The untrue part is that Prause had no intentions of attending the ICBA conference in Germany. Prause has never attended or given a presentation at an ICBA conference. Prause doesn’t believe in behavioral addictions. Throughout her entire career Prause has waged a war against the concept of behavioral addiction, especially sex and porn addiction. She’s an infamous “addiction-denier.”
There is no way in hell that Prause would attend the ICBA as she would run into several members of the ICD-11 CSBD work-group and multiple other researchers who publish high-quality studies supporting the porn addiction model. In fact, several big-name researchers who have formally criticized Prause’s flawed EEG studies and were scheduled to present (i.e. Valerie Voon, Marc Potenza, Matuesz Gola, Christian Laier, Matthias Brand – who ran the conference). Put simply, Prause would have been surrounded by many of the people she deplores and attacks on social media and behind the scenes (links to these researchers’ critiques of the two Prause EEG studies: 1, 2, 3, 4, 5, 6, 7, 8). Many of these researchers are keenly aware of Prause’s ongoing unprofessional behavior and behind the scenes machinations.
Then we have the obvious: there is no way for Prause to have known in advance that I was attending the ICBA conference. As noted, Prause filed her police report on April 25th, the last day of the ICBA conference. This means that Prause was told of my attendance by another conference attendee (Prause’s former UCLA colleague/roommate also attended).
Moving on, the second part of the Prause police report is equally factually incorrect, and downright hilarious:
Even though Prause never claimed that I was seen in LA, she describes my “personal oddity” as “wearing sleeping bag” and my weapon of choice as a “long sleave (sic) sweater.” Sounds like a SNL skit. It’s hard not to imagine the police officer biting her lip, trying not to crack-up, as she jots down Prause’s drivel. In any case, I haven’t been in either Los Angeles or a sleeping bag in years.
Others – September, 2019: In response to a CNN special involving NoFap, the RealYBOP twitter (run by Prause & Burgess) defames and harasses Alex Rhodes of Nofap (over 30 tweets)
In response to a CNN program featuring NoFap and Rhodes, RealYBOP engages in targeted harassment and defamation, tweeting its lies in CNN threads and elsewhere:
Alex Rhodes did not lie. RealYBOP fails to cite an example of anyone lying. Research vs. RealYBOP propaganda? Check out the main YBOP research page, which contains links to about 1,000 studies associating porn use with myriad negative outcomes.
RealYBOP twitter continues its cyberstalking of Alex Rhodes:
On the day of Lisa Ling broadcast, RealYBOP’s cyberstalking escalates, with silly slides that have nothing to do with the program, and entering threads wherever Nofap is mentioned.
What the public may not know is that neither the ICD-11 nor the APA’s DSM-5 ever uses the word “addiction” to describe an addiction – whether it be gambling addiction, heroin addiction, cigarette addiction, or you name it. Both diagnostic manuals use the word “disorder” instead of “addiction” (i.e. “gambling disorder,” “nicotine use disorder,” and so on). Thus, “sex addiction” and “porn addiction” could never have been rejected, because they were never under formal consideration in the major diagnostic manuals. Put simply, there will never be a “porn addiction” diagnosis, just as there will never be a “meth addiction” diagnosis. Yet individuals with the signs and symptoms of consistent with either a “porn addiction” or a “methamphetamine addiction” can be diagnosed using the ICD-11’s provisions. For a complete debunking of Prause’s claims, see: Debunking “Why Are We Still So Worried About Watching Porn?,” by Marty Klein, Taylor Kohut, and Nicole Prause (2018).
RealYBOP falsely claims that porn has never caused harm to children.
Reality: This page lists 45 neuroscience-based studies (MRI, fMRI, EEG, neuropsychological, hormonal). They provide strong support for the addiction model as their findings mirror the neurological findings reported in substance addiction studies.
RealYBOP suggests that it is unliekly your kid will see porn
Continues to troll threads. Falsely claims that stats were false, but provides no example:
Trolls another person in Lisa Ling’s thread:
RealYBOP lies about the nature of its experts, claiming most are university professors: https://www.realyourbrainonporn.com/experts
Reality: Of the 19 “experts” who still allow RealYBOP to use their picture, only 6 are at universities.
In this tweet, RealYBOP seems to be encouraging other to report Alex Rhodes to the Pennsylvania Psychology board.
It wouldn’t surprise us to eventually learn that RealYBOP filed a false and malicious report on Rhodes (numerous incidents of Prause’s false and malicious reporting are on these pages – page 1, page 2).
While the WIPO decision did not go his way (these are complex matters), Wilson will continue into federal courts, if necessary.
RealYBOP re-tweeting porn star complaining about CNN program (appears to have been egged on):
Note: Prause/RealYBOP falsely claims that others (Wilson, Rhodes, etc.) are stalking her. If this were true (it’s not) why does Prause/RealYBOP continue to enter Wilson and Rhodes twitter threads – tagging both, naming both, and aggressively harassing both? The answer – Prause/RealYBOP is lying about being stalked.
The next day RealYBOP harasses Lisa Ling, lying about most everything:
Ley, Prause and RealYBOP are obsessed with opinion papers by NZ grad student Kris Taylor. Taylor, who is beyond biased – and knows nothing about neuroscience. He’s a sociologist. YBOP critiqued a 2017 article by him where he disparaged Gary Wilson and the review with US navy doctors (Taylor often resorts to simply lying in his article): Debunking Kris Taylor’s “A Few Hard Truths about Porn and Erectile Dysfunction” (2017).
This paper is a fav of Prause and Ley with Prause’s Wikipedia aliases inserting both into Wikipedia pages. Prause obsessively cites (and misrepresents) Taylor’s paper about Nofap. Reality: grad student Kris Taylor’s dissertation assessed only 15 comments from reddit/nofap, while ignoring millions of other comments. Taylor chose the 15 comments because they contained the word “masculinity”. Contrary to lies by Prause/RealYBOP, Taylor’s was not an analysis of Nofap or its users. From Taylor’s paper:
Given this approach to data collection, we wish to highlight that the data presented is not intended to be read as representative of NoFap as a whole, but to present how some users express a particular investment in masculinity and its constitution (Edley, 2001; Edley and Wetherell, 1997). That is, as opposed to an analysis in which users’ posts are understood as oblique references to masculinity (through their talk about video games, pornography, exercise and diet, etc.), our study presents the ways in which users actively constitute masculine positions. Our search term ‘masculinity’ rendered numerous pages of ‘original posts’ which pertained specifically to defining masculinity.
October, 2019: For no particular reason (on a Sunday) RealYBOP disparages NoFap. RealYBOP/Prause/Burgess are obsessed with porn recovery forums (probably because they hurt the porn industry’s bottom-line).
RealYBOP falsely calls nofap “anti-sex”. In reality, a large percentage of individuals abstaining from porn (NoFap) are doing so to regain normal sexual function.
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After 50 or so tweets about Nofap, we can officially refer to RealYBOP as Nofap/Alex Rhodes’s stalker. After its Sunday tweets, RealYBOP scoured the millions of Nofap.com comments for just the right ones to smear Nofap. RealYBOP screenshots a few random comments, tweeting 3 of them with her out-of-context take any human on the planet can comment on Nofap, including RealYBOP).
Another by RealYBOP:
Yet another
RealYBOP the cyberstalker (Note: RealYBOP has posted 150 tweets about Gary Wilson in the last 2 months). Question: Are the RealYBOP experts legally liable for its twitter hrassment?
Others – October, 2019: RealYBOP twitter (Prause & Daniel Burgess) defame Alex Rhodes & Gabe Deem, falsely claiming both tried to “take down” realyourbrainonporn.
In its twitter tirade, RealYBOP coughed up its usual lies about Alex and Gabe, while adding a new one: Gabe and Alex were involved in the legal actions by YBOP to defend its trademark. Or as RealYBOP incorrectly describes it:
“Tried to have our website taken down bc he cannot answer science”
RealYBOP is referring very specific legal actions by the owners of YBOP to defend our trademark. My attorneys filed a complaint requesting that WIPO conduct an administrative review of the apparent misuse of my trademark in the URL www.realyourbrainonporn.com.
My attorneys filed a complaint with the World Intellectual Property Organization (WIPO) as a possible route to having the trademark-infringing website www.realyourbrainonporn.com removed from the Web as swiftly and economically as possible. While the arbitrator declined to support its removal, he acknowledged that the infringing URL was indeed “confusingly similar” to my URL www.yourbrainonporn.com. He then decided that the infringing site was a “gripe” site, and as such, entitled to criticize my site.
My attorneys say it is not, in fact a “gripe site.” It does not criticze my work. In fact, it does not address the content of my site at all, and merely holds itself out as the “real” version of my site in a confusing manner. However, the arbitrator, having concluded that the infringing site was a “gripe site,” declined to examine the third element of my complaint: Prause’s abundant bad faith. He stated that the evidence my attorneys provided “could well suffice to establish bad faith,” but found no need to reach a conclusion on that element in view of his “gripe site” determination. The entire ruling is available here: https://www.wipo.int/amc/en/domains/decisions/text/2019/d2019-1544.html. This is not over.
It goes without saying that Prause’s attempt to steal my trademark, while mimicking the appearance of my website and Twitter account, reveals she is the aggressor, the obsessed harasser. She is not the victim, but the perpetrator. Prause has weaponized the WIPO decision via a press release and constantly twees a link to the WIPO page as if it exonerates her entirely.
Our legal proceedings have nothing to do with Alex Rhodes or Gabe deem. RealYBOP (Prause & Burgess) lied, defaming Rhodes and Deem. By the way, the RealYBOP tweets give the false impression that our legal actions are over. Not even close. On to RealYBOP’s defamation:
September 30, 2019 tweet about Alex Rhodes. In it RealYBOP falsely sates that NoFap tried to silence the actual science, but they lost (linking to the WIPO decision in favor of RealYBOP)
In this tweet, RealYBOP said that Gabe Deem “Tried to have our website taken down bc he cannot answer science”:
RealYBOP continues, defaming Deem, and stating that he tried to silence scientists (linking to WIPO decision).
No one is trying to silence anyone. YBOP is simply protecting its trademark. Note: The original name of their website was ScienceOfArousal.com? Why did these self-proclaimed experts change their site name to mirror our website’s name, when their first-choice URL was ScienceOfArousal.com? Proof: copy & paste this URL into your browser. It will redirect you to “realyourbrainonporn” – https://www.scienceofarousal.com . Why do they now claim that they have been censored by a request to cease their trademark infringement, when they could simply revert to their erstwhile brand name ScienceOfArousal.com and continue to operate freely and legally?
We have never attempted to censor opposing views and critiques, unlike one of the Alliance “experts,” Dr. Prause, who has repeatedly tried to remove evidence of her behavior with groundless DMCA takedown requests. We simply ask that that these vocal spokespersons hold forth from their original pulpit, the URL and brand name “Science of Arousal” (ScienceOfArousal.com). And that they relinquish the subsequent name they employed along with the corresponding trademark application (for a name that YBOP has operated under for almost 10 years). Why do they engage in these apparent attempts to suppress traffic to our website and confuse the public?
Josh Grubbs (member of RealYBOP), quote-tweets Gabe Deem, and RealYBOP is compelled to enter the thread:
RealYBOP obsessively cyberstalking young men who recovered from porn-induced ED.
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A few weeks later RealYBOP, and sidekick NerdyKinkyCommie, troll Gabe Deem (note that Gabe had blocked both, but that doesn’t stop cyberstalkers):
First, The links posted by trolls Nerdy and James F. were given to them by RealYBOP/Prause.
Second, Nerdy’s screenshot has been tweeted dozens of times by Prause & RealYBOP. It had nothing to do anything in thread, but it matters not, because RealYBOP/Prause are obsessed with MDPI (parent company of the journal Behavioral Sciences). Behavioral Sciences published Is Internet Pornography Causing Sexual Dysfunctions? A Review with Clinical Reports(Park et al., 2016). Nerdy is lying about MDPI’s rating. Here are examples of Prause (as Sciencearousal) inserting the above clerical error by the Norwegian Register, who accidentally downgraded MDPI’s rating from the normal “1” to a “0”. The downgraded rating had long been resolved on the MDPI Wikipedia page. Prause knows the zero rating was a clerical error, yet she and RealYBOP tweet that MDPI was downgraded and that MDPI is a predatory journal (both are false and both are in Sciencearousal’s/Prause Wikipedia edit).
Third, the 5-year video has nothing to do with China, or internet addiction boot camps. It was about porn.
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Blocked troll Nerdy quote-tweets Gabe (who healed porninduced ED), and RealYBOP joins with lies.
Lie #3: As for the 7 RealYBOP studies, its trying to fool the public. Four studies of the seven reported significant links between porn use and sexual problems. Data in all 4 of these studies run counter to the Allliance’s claims:
Of the Alliance’s remaining three citations, one is not peer-reviewed, while the other two were formally criticized in the peer-reviewed literature.
RealYBOP trolling again:
Reality: Gabe was accurate for a drawing. The other 2 comments are red herrings. However, RealYBOP’s comments are irrelevant. Instead, this twitter account claims represent 20 experts, yet its trolling accounts it has blocked, with inane, spurious tweets. How embarrassing. How mentally deranged.
October, 2019: In response to “The Doctors” featuring Alex Rhodes, RealYBOP twitter (Prause & Daniel Burgess) cyberstalks, defames & harasses Rhodes with numerous tweets (even asks Twitter to un-verify Nofap)
On October 30, 2019 the TV show “The Doctors” featured Alex Rhodes in a segment on porn addiction. In response, realyourbrainonporn twitter posted numerous tweets under “The Doctors” many tweets about the show. RealYBOP’s tweets involve defamation and expose RealYBOP as a cyberstalker. RealYBOP scoured the web for anything it can weponize against Alex, including random comments on Nofap (there are literally millions of comments on Nofap.com and reddit/nofap). On to RealYBOP’s obsessive cyberstalking.
Below, RealYBOP refers to specific legal actions by the owners of YBOP to defend our trademark. Our legal proceedings have nothing to do with Alex Rhodes. RealYBOP (Prause & Burgess) lied, defaming Rhodes in this tweet.
Once again, RealYBOP saying not using porn = misogyny (the porn industry isn’t misogynistic, right?). As usual RealYBOP cites Grad student Kris Taylor’s paper, lying about what its methodology and what it stated. Contrary to lies by Prause/RealYBOP, Taylor’s paper was not an analysis of Nofap or its users. Nor was it about misogyny (word is not found it paper).
Prause falsely asserts that Kris Taylor’s paper was an analysis of nofap comments. In reality Taylor’s dissertation only assessed 15 comments from reddit/nofap. “Masculinity” search criteria for the 15 cherry-picked comments. Taylor’s explicitly states the 15 comments were not representative of Nofap as a whole:
RealYBOP exposes itself as the cyberstalker, trolling millions of NoFap comments for just the right one to take out-of-context and spin
More comments taken out-of-context (out of millions of comments. For exmaple, the use of “little bitch” was a guy describing his own penis and loss of erection due to porn-induced ED. He wasn’t calling anyone a bitch.
More trolling of forums full of young men, looking for just the right out-of-context excerpt to tweet:
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Cyberstalking continues:
RealYBOP lies (while citing nothing):
There is no treament offered on Nofap.
RealYBOP is suggesting that quitting porn “makes men worse”. OK
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Creepy. RealYBOP taking screenshots of Rhodes’s youtube presentations. Also attacks Kanye West for saying he was addicted to porn:
The above excerpt is a fabricated assertion from a blog post. It cites nothing. Complete BS.
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RealYBOP asking twitter to un-verify the Nofap account.
Again, citing a blog, that cited nothing.
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First, neither the ICD-11 nor the APA’s DSM-5 ever uses the word “addiction” to describe an addiction – whether it be gambling addiction, heroin addiction, cigarette addiction, or you name it. Both diagnostic manuals use the word “disorder” instead of “addiction” (i.e. “gambling disorder,” “nicotine use disorder,” and so on). Thus, “sex addiction” and “porn addiction” could never have been rejected, because they were never under formal consideration in the major diagnostic manuals. Put simply, there will never be a “porn addiction” diagnosis, just as there will never be a “meth addiction” diagnosis. Yet individuals with the signs and symptoms of consistent with either a “porn addiction” or a “methamphetamine addiction” can be diagnosed using the ICD-11’s provisions.
Notice how RealYBOP nevers give an exmaple of “fraudulent medical information”. Never.
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Tweeting Kris Taylor’s paper and misrepresenting it:
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Tweeting the same excerpts, again (the young man is describing PIED)
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At the same time RealYBOP is tweeting on “The Doctors” threads, she tweets lies about porn recovery forums promoting ant-semitism.
Let’s be very clear: Nicole Prause and David Ley, are the ones who initiated this disgusting smear campaign years ago. Have a look at these sections of a page documenting some of the many attacks Nofap and others have been subjected to:
Like RealYBOP, Ley scours twitter for bizarre tweet he can use to disparage NoFap and Alex Rhodes:
Doesn’t Ley have anything better to do?
David Ley’s disgusting, factually innacurate interview attacking nofap becomes a pinned tweet:
This leads to RealYBOP tweeting NumbNutsNovember for the 20th time (not an exagerration):
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Retweeting hit-piece by Rolling Stone (by an author who regularly places RealYBOP members in her articles):
Check out Nofap’s threads exposing the hit-piece:
Given a platform in this article:
– PornHub vice president – xHamster vice president – A guy with a financial relationship with xHamster – A porn performer/director – Host of a podcast about porn
Asked for comment just hours before publishing without any time to respond:
We were emailed at 5:56 pm last night for comment, after working hours, to only find the article was already published at 9:02 am today before we could respond. We were eventually quoted, but just barely, as far more platform was given to porn site executives & industry insiders. https://t.co/3DbSKBXWDE
UPDATE #1: On January 24, 2020 Alex Rhodes filed his amended complaint against Nicole Prause. The new court filings contain several recent incidents of defamation (including alleged collaboration with the porn industry to defame Alex), and sworn affidavits from other Prause victims. Downloadable PDFs of the court documents filed in the amended complaint:
This is the second defamation lawsuit filed against Nicole Prause in 2019. The first was filed by Donald Hilton MD, and it contains sworn affidavits from 9 other victims of Prause.
As documented on these extensive pages – page 1, page 2 – the Rhodes and Hilton lawsuits expose just the tip of the Prause iceberg. A partial list of her victims includes researchers, medical doctors, therapists, psychologists, a former UCLA colleague, a UK charity, men in recovery, a TIME magazine editor, several professors, IITAP, SASH, Fight The New Drug, Exodus Cry, NoFap.com, RebootNation, YourBrainRebalanced, the academic journal Behavioral Sciences, its parent company MDPI, US Navy medical doctors, the head of the academic journal CUREUS, and the journal Sexual Addiction & Compulsivity. (see below for What’s going on here? )
Others – Ongoing: In response to Alex Rhodes’s defamation lawsuit Nicole Prause and alias RealYBOP twitter defame & harass Rhodes (adding to Prause’s counts of defamation).
We will no longer be silenced by those cozy with the porn industry.
Please support our founder Alexander Rhodes's federal lawsuit against the main orchestrators of this relentless campaign to smear him, our website, and 100,000s of people in recovery.https://t.co/io3eagkxLZ
In response to the lawsuit and crowdfunding Prause, RealYBOP (likely Prause), and their allies went on the offensive.
The day before NoFap put up the crowdfunding its twitter foretold of a big announcement:
Instead of just leaving us alone to focus on recovery, the porn industry and certain allies have decided to launch a campaign of defamation and smears against us and our founder. We've generally tried to ignore their attacks, but they have been escalating.
November 11, 2019: The next morning, before NoFap’s announcement, Prause began suspiciously tweeting that she had received death threats. (NOTE: Prause has never provided public evidence of verifiable threats, just as she has never provided evidence of anyone stalking her). She kept a running tab of the “death threats” throughout the first day of Alex’s crowdfunding:
While Prause is tweeting as Prause, @BrainOnPorn Twitter continued to defame and harass NoFap and Alex Rhodes:
At the same time, Prause (who is scouring the internet for material she can claim is evidence of wrongdoing) provides David Ley with a 2015 YBR podcast (featuring Alex Rhodes) to disparage:
Prause tweets about SLAPP, which refers to the legal argument she is attempting to use to dismiss the defamation lawsuits (not going to work):
Prause goes off the deep end, adding to her defamation of Rhodes and her tortious interference in NoFap’s enterpirse, by saying The FBI has asked me to make clear that the donations going to Alexander Rhode of NoFap are fraud. Law enforcement are involved.
Prause claims antisemitic death threats. Most importantly tags DonorBox, the company handling Rhodes’s fundraising. She is attempting to shut down the fundraising. This will now be a part of the lawsuit.
RealYBOP disparages Gail Dines, while posting random, out of context posts from Nofap (which contains millions of posts by people of all different mindsets) as if they are somehow representative of evidence of wrongdoing or of Alex Rhodes:
Would love to know who contacted Samantha Cole. Let’s hope that Rhodes’s lawyers are able to subpoena emails related to the VICE article. Are we looking at a 2nd, conspiracy lawsuit?
The next day 3 of the 4 porn-industry shills from the VICE hit-piece are involved in the same two tweets promoting Ley’s upcoming paid appearance on xHamster-owned Stripchat.
Nicole Prause – likely operator of @BrainOnPorn
David Ley, who is being paid by Stripchat (x-Hamster)
Vice President of Stripchat, who is paying Ley
Next, RealYBOP tweets, disparaging No-NutNovember (the real target is Nofap, even though NoFap did not create NNN).
Nothing suspicious here, folks. The official tweet:
So, the 3 people collaborating in the VICE article to defame and disparage NoFap, do the same on Twitter, to increase Stripchat’s traffic, and thus x-Hamster’s profits.
Stripchat follows up with a tweet linking to the VICE hit-piece, containing numerous lies:
Prause tweeting under the VICE hit-piece, falsely stating that she is being stalked (presumably she is alluding to Rhodes, Hilton, or Wilson). These lies are why she is being sued for defamation:
Yet another incident that will be entered into Federal court.
Prause posting under VICE article, gets into an exchange with an account calling out her lies:
She boasts Alex’s lawsuit will be dismissed. Unlikely.
RealYBOP posts in same thread falsely stating that Rhodes is a paid employee of NCOSE (yet more defamation).
In a strange turn RealYBOP is the first to discover that someone placed Alex’s lawsuit on The Daily Stormer. Many believe that Prause emails “tips” to the Daily Stormer, so she can then claim white supremacists are involved. Same events occured with Gary Wilson. Hope the defamation lawsuits subpoena relevant emails.
Above are just more examples of Prause cyberstalking Alex.
NOTE:Many of us running “anti-porn” sites receive daily threats and disparagement. Welcome to the internet. You don’t see us tweeting that they are from friends of Prause or Ley.
December 2, 2019: In several replies to a lawyer, she claims to be consulting with the FBI concerning Alex Rhodes’s fundraising. She also claims that “records” proving she has no relationship with the porn industry will be in her legal response to the Rhodes lawsuits:
Update: She lied. Her 2 motions to dismiss had nothing related to the porn industry. See this page for some actual documentation of Prause’s cozy relationship with those in the porn industry – Is Nicole Prause Influenced by the Porn Industry?
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January 23, 2020: David Ley and RealYBOP team up to defame and cyberstalk Alex Rhodes of Nofap (tweeting an untruthful article featuring Nicole Prause, who is being sued for defamation by Rhodes).
In a legally perilous move RealYBOP retweets the defamatory SCRAM article:
Two days after this tweet Alex Rhodes filed his amended complaint against Nicole Prause. In his new complaint the ScramNews article was added as a new incident of defamation:
February 8, 2020: Even though Alex Rhodes’s amended complaint against Prause also names the RealYBOP twitter account (@BrainOnPorn)as defaming him, RealYBOP continues to target Alex Rhodes and NoFap (harassers can’t help harassing):
Note on study RealYBOP cited: The program was pretty much like most guys do on nofap – logs, meditation, weekly check-ins, and trying to quit. In fact, the study is on my porn and sexual problems list as:
February 18th, 2020: Prause claims Rape threat on Nofap Forums, but cannot provide URL or screenshot. Prause never provides documentation for any of her claims (she has falsely accused Gary Wilson, Fight The New Drug, Alex Rhodes, and fictitious entities of rape threats.
Esteemed psychology professor, and real sex expert, Frederick Toates challenges Prause to cough up her evidence. She balks.
Yet another account challenges her. Nada:
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February 20, 2020: More fabricated victimhood, with zero evidence:
Actually, she is making Alex Rhodes’s case really easy. She continues to harass and defame Rhodes, and his company – NoFap.
Pathological liar RealYBOP ends her twitter tirade by defaming Gary Wilson, falsely claiming that this twitter account is actually Wilson. For example, 2 of the account’s tweets under the authors’ tweet:
3 days later RealYBOP tweets under RT’s tweet about the same article (what a cyberstalker);
RealYBOP provides no examples of “errors”. Being sued by Alex Rhodes doesn’t slow down her harassment.
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February 29, 2020: Making fun of Rhodes and Hilton:
March 5, 2020: Implying the 2 defamation lawsuits against her are moving in a favorable direction:
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March 7, 2020: Being sued, but still going after Nofap. The study she cited was NOT about NoFap. None of the participants came from NoFap. Excerpt:
The largest group of participants came from only one subreddit (“r/everymanshouldknow”), where it had been endorsed by the moderator.
She failed to excerpt the study, only mischaracterize it.
The participants were concerned with porn’s effects, yet the paper mischaracterized this as concerns with masturbation. Contrary to claims of conservatism, and religiosity being a significant factor, the demographics of their subjects tell a very different story: 70% atheists or agnostics – far higher rates than the general population. Very low rates on erectile dysfunction (3.48%), so not representative of the men quitting porn.
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March 9, 2020: Even though she is being sued by Alex Rhodes of Nofap, RealYBOP tweets a random attack on NoFap and the concept of quitting porn (called rebooting). The paper cited has nothing to with Nofap, rebooting or quitting porn (it was a questionnaire study on only Jewish Israeli adolescents – and none were attempting to quit porn).
March 9, 2020: RealYBOP goes after Nofap again, disparaging the concept of rebooting (eliminating porn use), a term coined on porn recovery forums such as Nofap.
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March 11, 2020: She finds a 3-month old thread to troll, tweeting under a link to Staci Sprout’s video supporting Nofap’s fundraising (See Staci’s write-up for documentation of Prause harassing and defaming her).
No evidence for the 30 so-called complaints. If any occure, no doubt all were well-deserved and legitimate, as are the defamation suits against her.
November, 2019: Prause enters the California “Safe At Home Program” under false pretenses, misusing it to harass her victims and critics
In the morning, before NoFap’s announcement of its crowd-fund (to pursue a defamation suit against Prause for her egregious defamation of Nofap and its founder), Prause suspiciously began tweeting that she had received death threats. (NOTE: Prause has never provided public evidence of verifiable threats, just as she has never provided evidence of anyone stalking her). In fact, throughout the first day of Alex’s crowd-funding, she kept a running tab of “death threats” supposedly sent her way. Her last tweet announces that she has entered the California Safe At Home Program:
Wilson has a documented history of stalking me. As a result, I qualified for California’s Safe at Home Program, and solicited a no-contact order against Wilson.
Prause’s “no-contact order” is pure fiction: I have never initiated contact with Prause, yet Prause has contacted me hundreds of time on social media (more below).
Our complaint to UCLA was factually accurate and justified (much more on UCLA below). Reality? UCLA did not renew Prause’s contract (late 2014, early 2015). We had simply asked that she remove defamation from her website (that posed as a UCLA website when it was not) and apologize.
Important to note that her false accusations of stalking began almost as soon as our paths crossed. In fact, she accused my wife and myself of stalking in an April, 2013 email exchange that occurred a few weeks after I published a response to David Ley’s Psychology Today blog post where Prause and he targeted my website: “Your Brain on Porn – It’s NOT Addictive.” Ley’s blog was about Nicole Prause’s unpublished, yet to be peer-reviewed EEG study (this was the first I had heard of Prause).
Prause immediately initiated her only contact with me in 2 emails and a comment under my Psychology Today response. Simultaneously, she contacted Psychology Today editors, who forwarded her second email. The following 2 emails are from the end of our brief exchange (screenshots of Prause & Wilson’s entire email exchange):
As you can see, Prause is accusing us of stalking her, although all I did was respond to two emails she sent my way. This is where Prause’s fabricated “stalking” claims began.
Question: Did I drive 800 miles to Los Angeles on the same day I published my detailed critique to hover around UCLA, or did Prause initiate a fabricated campaign of being stalked on the day after my critique? The latter. I’m really looking forward to a jury trial, testifying under oath to Prause’s litany of falsehoods. Even more, I’m looking forward to Prause being cross-examined and exposed as the serial perpetrator, not the victim.
November, 2019: Prause misuses “Safe At Home Program”: She threatens YBOP’s web-host (Linode) with a fraudulent Cease & Desist letter, falsely claiming her address is on YBOP (it wasn’t).
When her attempts failed to remove documentation of her defamation and harassment from this website, she turned to threatening YBOP’s web host Linode with a bogus cease & desist letter, penned by sex-industry lawyer Wayne Giampietro. (Prior to this dispute, Giampietro represented a party associated with Backpage – an online marketplace that was shut down for trafficking minors. Backpage.com was shuttered by the Federal government “for its willful facilitation of human trafficking and prostitution.” See this USA Today article: 93-count indictment on sex trafficking charges revealed against Backpage founders. The indictment charged Backpage owners, along with others, of conspiring to knowingly facilitate prostitution offenses through the website, and contended that the trafficked people included teenage girls.)
Wayne Giampietro’s lie-filled cease & desist letter (Prause failed to provide a screenshot or URL, because her address was not on YBOP):
Linode never informed me about Prause’s bogus C&D letter because they had no reason to act on it. Instead, the above C&D was forwarded to me from the owner of a YouTube channel whom Prause sucessfully silenced with her threats. The young man was frightened into deleting his video that contained screenshots of YBOP pages documenting her defamation/harassment. Prause falsely told him that I was violating her rights because her home address was on YBOP. She cited California’s “Safe At Home” regulations and her bogus C&D letter (above).
This screenshot from a January, 2020 Linode communication confirmed that (1) YBOP was not publishing Prause’s home address or telephone number, and (2) Prause failed to provide any actionable requests (i.e. URLs of pages allegedly containing her address):
Using “Safe At Home” to silence her critics, when no one was violating her rights under the Safe At Home Act, is misusing the Act. According to the Act, it constitutes a misdemeanor under California law.
Others – November, 2019: Prause misuses “Safe At Home Program”: She threatens YouTube channel with legal action, falsely claiming a video was defamatory & linked to her home address on YBOP (her address was never on YBOP)
Around the time the Rhodes v. Prause defamation lawsuit was filed, YouTuber Fearless Dan posted a short video discussing the Rhodes suit and Prause’s long, documented history of defamation and harassment. His video contained images of him scrolling through the first YBOP Prause page, showing the table of contents, and briefly highlighting a few sections.
I watched the video and put it up on YBOP. Fearless Dan’s video was factually accurate and defamed no one. Nevertheless, Prause reported it to YouTube and threatened Fearless Dan with legal action. Here’s what Prause emailed to YouTube:
Please see the following document supporting the defamation, harassment, and financial fraud in Mr. “Fearless Dan’s” video posted here: https://www.youtube.com/watch?v=zjeulxvGwLA
This also violates my California safe-at-home program protections. Mr. “Fearless Dan” links in the comment to a description of my physical location with images of me which he does not own.
My attorney will follow with a Cease and Desist specific to your client’s video, most likely tomorrow, if it not removed immediately.
All lies. Prause’s so-called “document supporting the defamation, harassment, and financial fraud” appears to have been her attorney Wayne Giampietro’s lie-filled cease & desist letter, which I posted in the previous section. Prause also lied when she claimed that Fearless Dan “links in the comment to a description of my physical location.” He linked to YBOP which, as documented, has never contained her home address.
Unfortunately, Fearless Dan then deleted his video, fearing that he might otherwise place his entire YouTube channel at risk. Prause thus successfully censored his right to speak the truth freely. See below.
Others – November, 2019: In response to Diana Davison’s Post Millennial expose’ Prause harasses/defames Davison, followed by a bogus Cease & Desist letter and demanding $10,000 to not file a suit
A few weeks after Rhodes v Prause was filed, accurate media coverage on serial false accuser/defamer Nicole Prause finally arrived:
Davison also produced this 6-minute YouTube video touching on Prause’s egregious behavior: “Is Porn Addictive?”
The Diana Davison YouTube video provided a link to the timeline of events chronicling Prause’s nearly 7-year campaign of harassment, defamation, threats, and false accusations called “VSS Academic War Timeline.” Prause eventually got the timeline removed(!), on what basis no one knows. Several revealing comments under the Diana Davison video expose Prause as the perpetrator, not the victim:
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As she had done with other journalists (e.g. Belinda Luscombe, Amy Fleming) Prause went on the attack, harassing, defaming and threatening Diana Davison. Prause eventually resorted to sending Davison and The Post Millennial a baseless cease & desist letter. (PDF of bogus C&D letter). We begin with Diana Davison’s original tweet linking to her article:
Is it a coincidence that the AVN email to Prause is dated November 21, the day The Post Millennial expose’ on Nicole Prause was published? This suggests that Prause emailed AVN and they immediately responded with the requested statement. It appears as if Prause and AVN have an ongoing relationship.
However, the AVN email fails to back up Prause’s claims. First, AVN’s email is only concerned with 2019, yet Don Hilton only contends that Prause stated she had attended AVN in 2015 (which Prause did tweet in 2015). Second, the AVN respnse concerns itself with only RSVP tickets, not general admission. The only thing the AVN email proves is that the AVN is at Prause’s beck and call.
Next she tweets this gem (featuring more of her private emails with porn industry insiders):
The screenshot of the XRCO Chairman’s email to Prause from the above tweet is priceless:
Bob Krotts confirms Prause had attended XRCO (contrary to Nikky’s sworn affidavit), yet he’s not sure if she’s a “part of” the porn industry or not. Prause’s tweet contains a second screenshot – of a Davison tweet:
Davison is referring to this XRCO picture of Prause sitting at a reserved table with porn-industry friends (blonde at left behind porn star Melissa Hill):
In the same thread, here she is ranting about the 2019 AVN (rather than 2015), and tweeting receipts supposedly showing she was in LA during the 2019 AVN (which is held in Las Vegas). However, no one said Prause attended the 2019 AVN award (even though Prause apparently once planned to attend AVN), and The Post Millennial article said nothing about either the AVN or the XRCO awards.
Davison responds to being blocked, then harassed by Prause:
Why does Twitter allow people who have blocked you to reply to tweets? I've got some nutter (Nicole Prause) falsely accusing me (surprise, surprise) and other people have to tell me what's going on.
The next day Prause gets her Backpage.com lawyer to send a bogus cease and desist letter to Davison and The Post Millennial. All of Prause’s alleged wrongs are fabricated nonsense – as usual.
Continues threats against Davison, The Post Millennial, and two other Twitter accounts in the Davison thread (note: Prause had already blocked Davison).
Notice how Prause’s C&D letter says RE: Your Brain On Porn. Just shows that she is probably the one writing the bogus C&D’s, not her lawyer.
Diana Davison responds to Prause’s harassment and bogus C&D letter.
That she lied about attending the XRCO event and she's threatening to sue people who say they've seen a picture of her there. Also, falsely accusing people of stalking just for doing research and defending themselves.
So I've just been threatened with a bogus lawsuit for saying things that are provably true. Interesting. For the person issuing this threat: I have an LA lawyer and you'll be hearing from him if you persist in this attempt at silencing my speech.
The problem with your question is that the person alleging defamation claims I said things I didn't. What I said is that a person was in a place where photos prove she was. She's alleging I said she was somewhere else which I have no interest in.
Weird year indeed. I did my own investigation and agree with your conclusion but disagree on some of your other statements. Disagreement isn't defamation is it? Meanwhile Prause is threatening to sue me now for stating the truth. She's the biggest nutter in No Nut November.
To clarify, when I say "stating the truth" I mean she wants to sue me for producing a picture of her at a porn award show that she claims she didn't attend.
December 19, 2019: Prause apparently scared Tiki-Toki.com into taking down Davison’s timeline of Prause’s defamation & harassment.
To be honest, I kind of feel like I should have an affidavit of being bullied in the lawsuits now. Just got a notice that Prause had my timeline documentation removed from the website that allowed me to track her nefarious activities.
March 10, 2020: Evidently Diana Davison received emails from more victims of Prause. It never ends:
At what point can Nicole Prause be declared a vexatious litigant? I'm getting messages and screenshots from numerous people of her saying she's suing them… and she doesn't. Because she knows she can't.
Hmm. Criminal harassment has to be repeated unwanted contact after being told the target is afraid of you. I'm not afraid of her. She threatens then disappears so I don't think it would meet the threshold. And she's like buckshot scattering her threats without follow up.
Davison ends with what many of us know to be true:
A fucking nutter. Obsessed with saying porn has no addictive qualities or downsides. She'll sue anyone who calls her a nutter or points out inconvenient facts that interfere with her academic neutrality.
Prause and Tom Jackson exchanged tweets back in March, and again when Diana Davison tweeted her expose’. On November 22, Prause threatens Jackson with a defamation suit, demanding a payment of $10,000:
She claims that a process server is working to locate an anonymous Twitter account. Sure, it is.
Prause enters the March, 2019 thread with additional legal threats:
Another threat under a different March tweet:
Yet another threat under a yet another March tweet:
She files a small claims court “suit” against Tom Jackson’s anonymous Twitter account in Los Angeles court.
Tom Jackson may not know that:
California small claims suits for defamation are only applicable to residents of California. If Tom lives anywhere else the suit is automatically dismissed (as long as he avoids service in CA).
Anyone can file a small claims suit, because it’s as easy as clicking a few online boxes.
No lawyers can be involved. You must represent yourself.
Suing an anonymous online account in small claims court is liking suing a ghost. Unless one is willing to spend tons of money to force Twitter to reveal an email, and the hapless victim is served in CA, it is an empty threat.
Tom Jackson deletes his Twitter account:
The members of the private Facebook group celebrate like juvenile trolls:
Too bad people don’t know their rights. The Tom Jackson small claims suit did not go forward.
She then pinned a tweet boasting about all the porn industry groups and individuals that were coming to her aid:
If any bit of evidence shows Prause’s intimate relationship with the porn industry, the above certainly does. She has big porn players at her beck and call.
Two more threats targeting Kurall_Creator (Mark Schuenemann). To threaten, she boasts about her upcoming lawsuits with Diana Davison and Tom Jackson – which never came to fruition.
More defamation and lies by Prause:
Epilogue: No “defamation” suit was filed by Prause.
Concurrently, a lawyer gives his 25-tweet opinion of the defamation suits against Prause. Even though he states up front that he’s not a fan of NoFap (one of the plaintiffs), and is a fan of porn, he eviscerates Prause for her nutty behavior and bogus legal threats:
Tweets continued:
Further tweets:
Prause claimed to have a hotline to the FBI and to being advised by the FBI on what to tell the public about the Alex Rhodes defamation suit. Probably not.
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3) December, 2019: Matthew
Background: The following tweets come from a Pascal Gobry thread featuring his extensive article: A Science-Based Case for Ending the Porn Epidemic. RealYBOP and Nicole Prause responded with 90 rambling tweets in Gobry’s thread, consisting of personal attacks, ad hominem, and false accusations (but never addressing the substance of his article).
As for her claims, none of the small claims suits went to trial. Unless she serves the party while they are in California, the suit will be dropped within a couple of months. Prause knows her small claims filings will go nowhere. Sheer intimidation. Prause has never filed an actual defamation suit against anyone in regular court. Even in the 2 defamation suits against her, she failed to counter-sue. Truth is a defense.
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4) January, 2020: TranshumanAI
Another account that also did not engage in actual defamation, yet was threatened by Prause with a suit in California small claims court. Under duress the account deleted the tweets, and changed its name:
More hyperbole and lies:
Again, this case never went to trial. Pure speech suppression and bluff. As mentioned above, California small claims suits for defamation are only applicable to residents of California. Anyone can file a small claims suit, and take a screenhot, because it’s as easy as clicking a few online boxes.
Prause threatens a defamation suit, even though the above does not rise to defamation (especially as it is true).
Under attack from Prause, Ley, and their pack of flying monkeys, the Twitter account goes private. Prause continues, claiming fake victimhood while falsely implying that she has “won” all sorts of lawsuits. In reality, the 2 defamation suits against her are the only actual lawsuits on record – and both are moving towards trial. Extensive page exposing Prause’s lies and fabrications: Nicole Prause & David Ley commit perjury in Hilton defamation lawsuit (September, 2019).
Co-harasser and defamer David Ley steps in with his usual litany of falsehoods and fake victimhood.
Others – 2019-2020: Multiple incidents – Nicole Prause and presumed aliases (@BrainOnPorn) target Don Hilton even AFTER his defamation lawsuit is filed
This section documents the attacks of Prause and her presumed aliases (@BrainOnPorn, Truth ShallSetYouFree) on Hilton after his defamation lawsuit was filed. Attorneys of individuals embroiled in defamation lawsuits usually instructed their clients to avoid discussing the case. It goes without saying that a person being sued for defamation would be wise to refrain from further defamation and targeted harassment. Nicole Prause is no ordinary defendant…or harasser. More than reckless, the following items demonstrate Prause’s malice toward Hilton.
This section documents the attacks of Prause and her presumed aliases (@BrainOnPorn, Truth ShallSetYouFree) on Hilton after his defamation lawsuit was filed. Attorneys of individuals embroiled in defamation lawsuits usually instruct their clients to avoid discussing the case. It goes without saying that a person being sued for defamation would be wise to refrain from further defamation and targeted harassment. Nicole Prause is no ordinary defendant…or harasser. More than reckless, the following items demonstrate Prause’s malice toward Hilton.
June 22, 2019: Prause’s closest ally, David Ley tweets about Hilton. Note: (1) David Ley filed a lie-filled affidavit on the behalf of Prause in this case, and (2) PornHub was the first to retweet Ley’s tweet:
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July 5, 2019: David Ley’s tweet borders on defamation itself.
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July 15, 2019:While she doesn’t mention Hilton by name, Prause has tweeted much the same about Hilton in the past:
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August 13, 2019: Prause/RealYBOP ally disparages Hilton with untrue statements:
RealYBOP likes the tweet:
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September 20, 2019: On the day of a very important hearing in her case, Prause tweets about a major issue in the suit: Kinsey collaborating with pedophiles, as is clear from Table 34 in his famous treatise Sexual Behavior in the Human Male (1948). This was a major point of discussion in the only conversation between Prause and Hilton. Prause later mischaracterizes the discussion as Hilton calling her a child molester (he never did).
While not overt, it’s still targeting Hilton.
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November 14, 2019: three tweets directly referring to Hilton and the lawsuit (tweet 1, tweet 2, tweet 3), and containing false or defamatory statements:
November 14, 2019: On the same day, Prause alias @BrainOnPorn tweets about Hilton’s appearance on a CBS show about pornography:
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November 19, 2019: RealYBOP disparages Don Hilton, MD. (He was the so-called “religious physician” in the CBS segment about porn, but he sticks to the science and never makes religiosity part of his public talks. Only his critics do.)
November 24, 2019: In response to Diana Davison exposing Prause as lying about attending porn awards, Prause tweets a Chad Sokol email mentioning Don Hilton:
The email:
Chad Sokol & my email: This brings us to reporter Chad Sokol and his biased article about a February 23, 2019 conference on the risks of porn use held at Gonzaga University. In interviewing some of the presenters (such as Don Hilton) it became apparent that Sokol had already spoken with David Ley and Nicole Prause (and Prause co-author Cameron Staley). Sokol was clearly biased, having been prepared with Prause-generated materials and talking points.
In conversations with Hilton, Sokol parroted Prause, suggesting that Hilton’s religious faith skewed his views, making him biased. If bias (not the research) was Sokol’s primary concern, Hilton wondered if Sokol might be willing to examine evidence of Prause’s and Ley’s biases.
December 16, 2019: Prause tweeted links to PDFs of defamatory documents she filed in her unsuccessful September, 2019 Motion to Dismiss in the Hilton defamation suit. She had them re-published on www.reason.com, an online magazine. At the time of her tweets, her Motion to Dismiss had already been denied, which she failed to mention. In a desperate attempt to veil her defeat, she made it her pinned tweet, and appeared to pay for fake Twitter accounts to retweet and like her tweet(!).
Prause’s tweet was once up past 100 retweets (it’s now down to 70). Almost all were fake accounts. A few screenshots supporting this assertion:
Her Motion to Dismiss was, in large part, an extensive rant defaming me, Alex Rhodes, Don Hilton, Stefanie Carnes and others. She perjured herself throughout. More importantly, her decision to publicize her court documents brings with it numerous legal implications, supplying further evidence of defaming her targets anew, including both Hilton and Alex Rhodes, and the possibility of additional lawsuits by others defamed in her now publicized/published documents.
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December 21, 2019: Prause once again tweets her defamatory, already denied, Motion to Dismiss court documents:
December 19, 2019: In an utterly shocking turn of events Prause creates and posts a YouTube video attacking Don Hilton, titles “Donald Hilton Bigotry.” It’s 5 minutes of spliced together out-of-context snippets. A good portion of the video is Hilton reading an article by someone else. Prause is attempting to make the viewers believe they are Hilton’s words, when it clearly they were not.
It was posted on the newly created YouTube channel “Truth ShallSetYouFree.” We know this is Prause’s YouTube channel because (1) it was named “RealYourBrainOnPorn” in the first few days of its existence, (2) it commented under the Rebecca Watson video outing Prause as a defamer and harasser, (3) the comment is Prause talking in the first person about the California Psychology Board complaints and the WIPO complaint (involving her). Again, she publicized her defamatory documents related to her failed Motion to Dismiss.
A screenshot of the above comment when it was named “Real YourBrainOnPorn” (before Prause changed the name of the YouTube channel to “Truth ShallSetYouFree”):
Bosmol tagged The University of Texas (where Hilton teaches), the UT Dean, the Texas Civil Rights Project, and The Daily Texan. Is this Prause once again trying to get Hilton fired from his teaching position at University of Texas? Can anyone say “undeniable malice?”
I discovered the Bosmol tweet because it was retweeted by two RealYourBrainOnPorn “experts” and close Prause allies, David Ley and Victoria Hartmann:
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The Bosmol tweet was also “liked” by Prause’s apparent Twitter alias @BrainOnPorn:
December 31, 2019: Cyberstalking Gabe Deem (who has blocked RealYBOP) on New Years Eve, RealYBOP tweets defamation and PDFs of her defamatory Motion to Dismiss documents:
December 31, 2019: RealYBOP trolls under Gary Wilson (even though I blocked her and she blocked me), tweeting about Hilton & Watts, 2011 – again, and completely out of context:
December 31, 2019: In a truly bizarre event, @BrainOnPorn Twitter (apparently managed Prause) changed its home page to superimpose Rory Reid’s unpersuasive commentary on Hilton & Watts, 2011:
Huh?
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February, 29, 2020: Prause & Luke Adams team up to disparage so-called frivolous lawsuits:
Prause is the ruling monarch of frivolous legal actions and bogus C&D letters.
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March 5, 2020: Implying the 2 defamation lawsuits against her are moving in a favorable direction:
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March 7, 2020: She threatens yet another person with a defamation suit, then falsely implies that she has “won” all sorts of lawsuits. In reality, the 2 defamation suits against her are the only actual lawsuits on record – and both are moving towards trial.
January, 2020: RealYBOP Twitter defames Dr. Tarek Pacha (who presented on PIED), falsely stating he’s not a urologist and has conflict of interests
On January 30, Gabe Deem posted the following tweet with snippets from urologist Tarek Pacha’s Porn-Induced ED presention givenat the American Urologialc Association Conference, May 6-10, 2016 (Part 1,Part 2,Part 3, Part 4)
i wake up every morning baffled this isn’t being talked about more.
Here we have a urologist, Dr. Tarek Pacha, presenting at the American Urological Association on the rise in porn-induced sexual dysfunction in young, otherwise healthy men. pic.twitter.com/lk9ymqoFgj
Right after @gabedeem tweeted Dr. Tarek Pacha’s presentation on PIED, RealYBOP twitter (thought to be run by Prause) defamed Dr. Pacha by falsely stating he is NOT a urologist and that he is somehow profiting through suggesting guys quit porn. Reality:
Pacha received only free meals and some lodging from medical companies in an amount far below the average for physicians. More to the point, medical companies would prefer Pacha refrain from telling guys that to achieve sexual health all they have to do is quit porn. Can’t sell any medical devices that way!
RealYBOP begins by posting 4 malicious and defamtory tweets:
No RealYBOP, your “critique” is defamatory, as you falsely stated that Tarek Pacha is not a urologist. You also falsely claim a conflict of interest when there was none: no medical supply company is buying Pacha lunch to encourage him to tell young men to eliminate porn to cure their ED.
RealYBOP then trolls therapist Staci Sprout with her misinformation. RealYBOP has blocked Staci Sprout (who was unaware of RealYBOP’s tweet). Important to note that Prause and RealYBOP chronically harass and defame Staci Sprout. Prause has maliciously reported Sprout to boards, defamed her, and sent her threatening letters.
Literally 5 min on Pornhub starting at most viewed videos & these faces all ended up in front of me. Millions of people are masturbating to what is depicted, if not real, child sexual abuse and Pornhub profits from it all. You think this is healthy? Think again. #PornIs#VAWGpic.twitter.com/F3DFI559KG
Please spread this message: Pornhub has no system in place to verify the ages of those in the videos or to verify their “consent”—NONE. The only thing required is an email address. There are likely thousands of trafficking victims on the site right now.#PornIs#Trafficking#Enditpic.twitter.com/x0QEXiHNYZ
As always, RealYBOP misrepresents what we say, while evading key points. The point of the Tweet is Pornhub has no age verification. Which RealYBOP confirmed and then confirmed she also found the girls most viewed video. It is completely irrelevant that other sites might have some form of ID check (which is questionable). So everything is A-ok because you can hunt around the internet trying to find these thousands of underage appearing girls and try to verify their age that way?
RealYBOP follows up with a retweet of Playboy writer, and RealYBOP expert, Justin Lehmiller’s propaganda:
Nicole Prause attempts to take down YBOP by threatening its web host with a bogus Cease & Desist letter (January, 2020)
The request has been made under the California Safe at Home Act, which prohibits you from engaging in the following:No person, business, or association shall knowingly and intentionally publicly post or publicly display on the Internet the home address, home telephone number, or image of a program participant or other individuals residing at the same home address with the intent to do either of the following:
(A) Incite a third person to cause imminent great bodily harm to the person identified in the posting or display, or to a coresident of that person, where the third person is likely to commit this harm.
(B) Threaten the person identified in the posting or display, or a coresident of that person, in a manner that places the person identified or the coresident in objectively reasonable fear for his or her personal safety.
In order to comply with the California Safe at Home Act, we ask that you remove any infringing content referencing Nicole Prause.
Please let us know how you plan to proceed.
Thanks in advance!
Kind Regards,
Trust & Safety Team
WILSON’S REPLY TO WEB HOST
Dear Linode,
This demand is nothing more or less than misuse of the Safe At Home statute to further censorship and defamation.
Nicole Prause’s home address and telephone numbers are not on www.yourbrainonporn.com. The only so-called images of Prause on my website are screenshots of her own tweets, that is, tweets posted by her. She and others have placed thousands of these, or similar, images of her across the Web. Images of Prause are found in hundreds of articles and on Prause’s twitter account and two Facebook pages: https://twitter.com/NicoleRPrause, https://www.facebook.com/nprause, https://www.facebook.com/LiberosCenter/.
In any case, the screenshots of her tweets on my website do not meet the test of the California Safe at Home Act. That is, there has been no intent to do either of the following:
(A) Incite a third person to cause imminent great bodily harm to the person identified in the posting or display, or to a coresident of that person, where the third person is likely to commit this harm.
(B) Threaten the person identified in the posting or display, or a coresident of that person, in a manner that places the person identified or the coresident in objectively reasonable fear for his or her personal safety.
Prause’s current spurious cease and desist letter addressed to Linode is but the latest event in her 7-year history of harassment and defamation of me and various others, as documented on these 2 pages:
This is the 4th time Nicole Prause or her agents have contacted Linode to attempt to have evidence of her own carefully documented harassment and defamation removed from YBOP. Below are links to the 3 previous times Prause contacted Linode with unfounded claims. As you can see, all 3 were summarily dismissed by Linode:
It’s important to let you know that Nicole Prause is currently being sued for defamation by two individuals. I have filed sworn affidavits in both lawsuits (as have many other victims of Prause). YBOP pages with the 2 lawsuits:
The images of her tweets will not be removed from my website, as they do not violate the Safe At Home statute. If Linode cannot protect my free speech rights, I will regretfully have to move my website to a different server. While I would not like to have to take this step, if you feel you must yield to Prause’s threats, I will need the information necessary to remove my content to another host.
Could you please provide any correspondence that led to your message to me?
Thank you.
Best regards,
Gary Wilson
RESPONSE FROM WEB HOST:
Hello Gary,
My apologies if the tone of our prior communication did not convey our sympathy to your position. As in the prior instances of our interactions regarding Ms. Prause, we were merely advising you of the existence of Ms. Prause’s possible claims against your website, and to confirm that you had not published Ms. Prause’s home address or telephone number.
To this end, Linode has invested considerable resources in doing our due diligence in the instant matter (as was the case with Ms. Prause’s previous issues). We take all abuse claims seriously, though as advocates of all our customers, do our best to discourage frivolous reports.
At this time, Ms. Prause has provided us with no actionable requests, so Linode will not be taking any action….
Linode is legally required to forward claims regarding content to our customers, but in doing so, we should have also advised you as to Linode’s behind the scenes efforts.
Please let us know if you have any questions.
Thank you,
Important to note that:
Linode confirmed that YBOP had not published Prause’s home address or telephone number.
Prause failed to provide any actionable requests (i.e. URL’s of pages containing her address)
As before, my web host was not fooled by Prause’s false allegations and fabricated stories of victim-hood. I doubt this will be her last attempt. No matter what she tries, the pages documenting her unethical and often illegal behaviors will remain on YBOP.
In the last few months, Prause has trumpeting to the world that she entered The Safe At Home Program. While I don’t know her circumstances, Prause implied in recent court filings (and tweets) that she entered the program under the pretense that I (Gary Wilson), Alex Rhodes (and maybe Don Hilton) are stalking her! This is a untrue, of course (Alex Rhodes and Don Hilton are suing Prause for her false accusations that they have stalked her, among other allegations). If Prause entered the Safe At Home Program under the false pretense of being stalked by any of us, she is abusing and misusing the program.
Why would Prause enter the Safe At Home Program under false pretense? To weaponize her victim-hood and to try to censor her critics.
As carefully documented on the pages chronicling her behavior (page 1, page 2), she has long falsely asserted that she is a victim of stalking and harassment. In reality, Prause is the perpetrator. For example, she has filed malicious, groundless complaints against over 20 individuals and organizations who held, or published, views on pornography counter to hers: PDF Documenting Prause’s Malicious Reporting Pattern.
Prause has been trying to censor critics with false allegations that they are somehow violating Safe At Home, which appears to disallow publishing home addresses and phone numbers. Please note: YBOP has never published Prause’s home address or phone number. Prause’s own actions demonstrate that she is, in fact, unconcerned about actual stalking. Up until a few weeks ago (months after she entered the program), Prause’s business address (rather than her surrogate Safe At Home address) was proudly displayed on her LinkedIn page. Just more of her fake victim-hood.
February, 2020: Prause tweets numerous lies: (1) that her address appears on YBOP, (2) that the CA Attorney General forced Linode to remove address from YBOP, (3) that Staci Sprout & I have been posting her home address “online”.
In response to being thwarted in her bogus C&D letter attempts, Prause went to Twitter to attempt to trump up support for her malicious de-platforming and harassment efforts (tagging Linode). She started with a series of three tweets that were nothing but lies. The first tweet falsely states that her address is on YBOP and that both the LAPD and California Attorney General were involved:
As explained above, Prause has never provided a screenshot or a URL to support this assertion. She can’t because her home address has never been on YBOP. Neither I or Linode have been contacted by the California Attorney General. Days earlier, my web host confirmed what I had told them after doing their own due diligence: Prause’s address is not on YBOP:
Important to note that:
Linode confirmed that YBOP was not publishing Prause’s home address or telephone number.
Prause failed to provide any actionable requests (i.e. URLs of pages allegedly containing her address).
In her 2nd tweet Prause flat out admits that no one, including YBOP, could have posted her home address, because all of her posted address are fake (including the address she used in her malicious US trademark application to obtain my trademarks YOURBRAINONPORN and YOURBRAINONPORN.COM). Her tweet also falsely states that I am “circulating her address from another account.” She can’t name the (imaginary) account I’m supposedly using to circulate her self-admitted fraudulent address. (Why hasn’t she provided actual evidence?)
Here’s her 3rd tweet with more lies and contradictions. Unlike tweet #2, she now says we all know her address. (How, if she has never posted it – by her own admission?)
“Brag”? “Followers to like it”? Again, why can’t she produce a screenshot of these events? Because they’re fabricated.
A few hours later, Prause claims the CA Attorney General immediately acted upon her Twitter request, forcing Linode to remove her fake address from YBOP. This never happened.
In a shocking “self-own”, she tweeted an excerpt from the current page of YBOP:
I should amend the above, as I now see that Prause’s address is still on her LinkedIn page as well as on other outlets she controls (as of 2/12/20).
Prause’s Twitter thread ends with her defaming and harassing Staci Sprout, yet again. Prause attempts to spread her smear campaign, tagging SASH and IITAP. However, the president of IITAP has filed affidavits in the defamation suits against Prause, and SASH is well aware of Prause’s malicious activity.
Becoming a public sex (addiction) educator has resulted in some major pushback…but I’m not quitting… Soon after I published my memoir and got busy promoting it, I realized I loved offering public education about sex/porn addiction and recovery.
It wasn’t long before my efforts had attracted the attention of a (once) widely quoted individual whose research is often used to “debunk” porn addiction…and her associates…at least two of whom are employed by the commercial sex industry.
Eventually, I was asked to give sworn testimony in two defamation lawsuits against her by others, which I agreed to – she is being sued for over $10 million for damages. I also supported the fund-raising efforts of one of her victims.
Now she’s filed a bogus lawsuit against me! Here is my testimony: This is a true and accurate account of the bullying, harassment, defamation and blame-shifting perpetrated by Nicole Prause to me, Staci Sprout
My name is Staci Sprout. I own two businesses, a private psychotherapy practice and Recontext Media, a publisher and platform for online education. I am writing to state that I have not defamed nor am I guilty of the wrongful allegations of libel or slander made against me by Nicole Prause. I created this statement to document her pattern of online harassment and defamation of me, starting in 2017. Her latest demand that I pay her $10,000 or she would take legal action against me felt like extortion…then she filed a small claims lawsuit in CA alleging that I am guilty of slander, libel and violating her protected victim status somehow. It is my belief that I have only sought to tell the truth about her online misconduct towards myself and colleagues I deeply respect.
In this letter I am summarizing my history of her attacks, false reports, and defamation. Far more evidence of her pattern of attacking and making false claims against not just me but many other professionals who disagree with her has also been carefully documented here, starting at least in 2013 (there is a pdf at this link that lists 20 people and organizations she has targeted – so I’m not alone). I’ve attached it at the bottom of this post.
I have never met Ms. Prause in person, nor has she been a psychotherapy client of my private practice. After enduring her online attacks and false reports against me, I eventually began to stand up for myself. I published facts online about her harassment of me, disagreed with her opinions, and made true public statements as an online educator and activist. I also stood up for colleagues she has attacked. That is not defamation. Her recent demand letter and filing a small claims suit three days later appears to be more attempts to intimidate me, this time adding financial threats. She continually uses nuisance claims and deceptive complaints in systems and organizations, forcing me to defend myself. It is exhausting.
OUR FIRST ENCOUNTER: HER ONLINE BULLYING – 2017
My first experience with Ms. Prause was when she posted a critical tweet in response to one of mine in November 2017. She used the account “Liberos@NicoleRPrause” to publicly name me and disagree with something I had posted on my public twitter account. I responded to her as a comment on her twitter post to debate the issue. Within a few exchanges it was clear to me she was not interested in genuine dialogue. In fact, I experienced her as an intellectual bully, and I responded by immediately blocking her on twitter. I have a personal policy to block people who are abusive in any way, or attempt to be. If I had known I would be facing two years of harassment after that, I would have taken a screen shot of this first exchange.
INACCURATELY ACCUSING ME OF PRACTICING WITHOUT A LICENSE – 2018
Ms. Prause also made a false accusation on my public Facebook author page in 2018, after I posted an article from World Psychiatry, saying that I was “lying to line [my] pockets” and that I “should have had a complaint filed against [me]” and stating, “…oh, you’re not licensed. Well, that makes sense.” Her comment is greyed out below because I quickly blocked her on Facebook so she could no longer harass me there. My post was not about her at all, it was an article on the Compulsive Sexual Behavior Disorder diagnosis being considered by the World Health Organization – yet she personalizes so much of what I do as an online educator.
Her statement was untrue that I was practicing without a license. In fact I am a Licensed Independent Clinical Social Worker in the state of Washington in good standing, first certified on 1/14/1997 and licensed on 7/22/2001.
Prause visits my Facebook page – greyed out because I immediately blocked her.
MS. PRAUSE FILES THREE FALSE NUISANCE COMPLAINTS AGAINST ME TO REGULATING BODIES – 2018
In the 25 years of practice since earning my Master’s Degree in Social Work, I have never had a complaint filed against me for any reason, until hers. Both of hers – after the first one was dropped without investigation, she quickly filed a second complaint, also dropped. Though I have never met Ms. Prause nor treated her for therapy, she has made three formal ethics complaints against me to my licensing or professional organizations. All three claims she reported were closed without investigation for having no merit:
1) An unfounded complaint to the WA Department of Health dated January 24, 2018, “closed without action.”
2) A second unfounded complaint to the WA Department of Health later that year, “closed without action.”
3) Another unfounded complaint to the National Association of Social Workers, where I am a member in good standing – also dropped without formal investigation.
Prause’s first bogus nuisance complaint to the WA State Department of Health, dropped without investigation.
Prause’s second bogus nuisance complaint to the WA State Department of Health, also dropped.
Yet a THIRD bogus nuisance complaint, also dropped, without investigation; this time to the National Association of Social Workers.
MS. PRAUSE IS SUED FOR DEFAMATION BY A COLLEAGUE FOR 10 MILLION DOLLARS, I CONTRIBUTE SWORN AFFIDAVIT – 2019
After being forced to address these false reports, even though they were all dropped without formal investigation, I sought support from other colleagues who had been similarly attacked by her – I know of more than a dozen, and there are far more out there I do not know. I was then asked to share my harassment experiences by a neurosurgeon colleague who had filed suit against her for defamation per se, for ten million dollars in damages. I agreed, and filed a sworn affidavit in this defamation lawsuit about my experiences up to that time.
MS. PRAUSE IS SUED A SECOND TIME FOR DEFAMATION – 2019
I have filed a second declaration for another defamation lawsuit against Ms. Prause by yet another victim of her relentless bullying. I was introduced to this young man by a mutual colleague, and felt concern for his suffering as a result of her harm to him. I offered to help him raise money for his legal campaign fundraiser, and recorded a video telling the truth about what’s been going on. To date he has received almost $100,000 in donations to support his case, for his legal fees. I suspect my activism on his behalf led to Ms. Prause escalating her targeting me to not just deceptive statements and false complaints, but now adding financial demands and legal intimidation.
MS. PRAUSE SENDS DEMAND LETTER FOR $10,000 – 2019
Ms. Prause then sent me a letter demanding that I owed her $10,000, for a list of claims that are either clearly false, or simply true things I have said. She sent a similar demand letter to a news organization that published an unflattering story about her, stating they owed her $10,000 also. Criticism based on true actions is not defamation, it is the outcome of being a public figure. She also sent a copy of this demand letter to yet another professional organization I belong to – the Society for the Advancement of Sexual Health. She also sent them a “cease and desist” letter about me (and several others), because this organization had awarded me the “Annual Media Award” last year, implying they should silence me somehow. This felt like an attempt to humiliate me in front of the entire Board of an organization I belong to. Ms. Prause’s list of allegations are either untrue or not defamation. She often conflates general statements I have made with personal attacks against her, when I did not name her at all. Where is the evidence of this list of claims?
Prause demands $10,000, page 1
Prause demands $10,000, page 2
By the way – I am not the only person she has sent a letter to demanding $10K. Another was a journalist, Diana Davison, who published an article and video about the Prause/porn controversy, and I believe there are others out there who have been silenced by her threat. The journalist’s subsequent quote about her attempts to fact-check with Prause:
Prause said many things to me but none of her “evidence” actually supported her claims. In every instance the evidence reversed who the aggressor was. She basically accuses others of the exact things she herself did. I emailed with her, on the record, for almost a week.
Yet another threatening legal letter, this time to a journalist Diana Davison, who posted it on her twitter page. Look familiar? The article was not removed, and to date no lawsuit has been filed by Prause. More empty threats.
MS. PRAUSE FILES IMPROPER SMALL CLAIMS SUIT AGAINST ME IN CALIFORNIA – 2019
Three days after emailing me her demand for $10,000, she filed a small claims suit in California, suing me for $9999. Now I am legally forced to deal with this – a small claims suit in a city I do not live in, work in, nor own property in – for her baseless claims. I believe once again she is trying to use systems with nuisance false complaints to harass others she seeks to silence.
The hearing was scheduled for 2/13/2020 – I requested it be dismissed as inappropriate. It was then postponed until 3/20/20. Prause was instructed by the court to produce documented evidence that she has served me in the state of California or the case will be dropped. She has not, it will be, and I predict she won’t even show up for the hearing. This was not about seeking justice because she is the one who has committed the violations. I believe this malicious prosecution is part of her ongoing attempts to intimidate and harass me.
HER CONTINUED DEFAMATION – NOW PERPETRATED FROM A WHOLE GROUP OF “EXPERTS” – 2019
After reading her detailed false allegations and contemplating all the attacks that have continued to me personally since 2017, I find myself feeling anxious and vigilant for the next online attack. For example, an organization where Ms. Prause serves on the “experts” panel just recently posted this defamation about me on social media – after she’d filed in small claims court against me for making false statements against her!
This statement said “my group” (what group?) recently sued them (I have not sued this organization) and lost (I have not lost a suit with any organization). This group, called “Real Your Brain on Porn,” also said I advertise myself as in recovery from bipolar disorder (I do not, and have never been given that diagnosis).
Tweet about me from organization of which Prause is a key member.
So, finally, I wrote to her directly. In order to take further legal steps I had to, though I wish to avoid all contact with her forevermore (My STOP HARASSING ME letter):
Yet even after I sent the above letter, to the P.O. box address she herself sent me via her Cease and Desist letter, she continues and even escalates her defamation per se, by tweeting on a thread where I was talking with SOMEONE ELSE about the main object of her stalking, Gary Wilson. I was explaining why Gary has meticulously documented Prause’s bad behavior on his website.
Lie. I don’t have her physical address and have never posted it anywhere. More empty legal posturing…and baseless accusations of me: defamation per se.
Hmmmm…could she be referring to me, perhaps?
In summary, dealing with all these attacks and lies has been stress-filled, time-consuming, distressing and exhausting. It has taking away my time from work, relationships, and other positive activities. I thank you for your consideration of my testimony about this situation.
Can I get back to supporting people to learn about recovery from porn/sex addiction now?
Nicole Prause’s Malicious Reporting Pattern: Nicole Prause has shown a consistent and troubling pattern of threatening, and filing groundless, malicious complaints, and publicly claiming she has filed complaints when she has not done so. Below is an incomplete list of such complaints and false claims. (Out of fear of reprisal we have omitted numerous additional individuals and organizations, and there must surely be more we don’t know about.) The baseless complaints Prause actually lodged were generally dismissed as nuisance filings. However, a few led to time-consuming investigations that were ultimately dismissed or produced little in the way of substantive results. Note: Prause regularly claims “whistleblower status” to keep her activities under the radar. So, there are likely other, non-public complaints in addition to those listed here. FOLLOW THE RABBIT TRAIL HERE
See other sections documenting Prause’s harassment and defamation of Staci Sprout:
The last tweet in the above string is a lie and constitutes defamation per se (see next section).
A few days later RealYBOP attacks and defames the author accusing him of accepting a bribe!
That’s defamation.
February, 2020: RealYBOP twitter (Prause) defames Gary Wilson, falsely claiming he created this twitter account (@RobbertSocial) to “stalk” and “threaten violence”.
RobbertSocial is apparently German. He tweets this a few days later:
February, March, 2020: Prause seeks groundless temporary restraining order (TRO) against Wilson using fabricated “evidence” and her usual lies. TRO appears to be an attempt to remove documentation of Prause’s defamation from YBOP.
She sent two spurious Cease & Desist letters to my webhost (Linode) falsely claiming that her home address was on YBOP. When her lie-filled C&Ds failed, she asked the California Attorney General to get involved. When the California AG couldn’t locate her address on YBOP, Prause resorted to badgering Wilson’s local police to take action against him (February 12, 2020). The officer determined that Prause’s assertions did not allege a crime (in any case, her home address was not on YBOP) and that this was a civil disagreement. He declined to act.
On the same day, Prause then publicly announced she was seeking a restraining order against Wilson, and did so ex parte (without having to notify Wilson):
Prause is lying about me posting her home address on YBOP or Twitter. You can always tell when Prause is lying, as she cannot provide a screenshot or link to support her claims. Prause’s earlier tweets expose her as lying. In fact, she publicly boasted that no one has ever posted her home address because she has posted only fake addresses on the internet:
In the above tweet she is lying, as I have never posted her home address and have never circulated her address (again, no link or screenshot from her).
The first judge denied the TRO, and set a hearing to determine whether a permanent restraining order should be granted on March 6, 2020.
Although Prause had promised publicly on her Twitter account that service was “coming,” Prause, in fact, did not serve me. Nevertheless, my counsel appeared as if she had, thus waiving any need for service. My counsel filed various documents (below) showing that her claims (and some of her evidence items) were false, and that I had never threatened her or placed her at risk.
To everyone’s surprise, the second judge, instead of dismissing the entire matter, continued the hearing until March 25, 2020, stating that he intends to force the parties to attend mediation before ruling.
An analysis of Prause’s Request for the restraining order revealed that she was claiming I was dangerous. She purported to “prove” this by including a photo of two young men holding guns, the shorter of whom she claimed was me. It’s absurdly obvious that he is not Gary Wilson, but rather a young man of Asian decent. Prause appears to have intended to deliberately mislead the court.
The rest of her claims were equally unfounded. She claimed that I have a second Twitter account that actively reveals her home address, and that her home address and pictures are on my website. As usual, she provided no screenshots or URL’s to support her allegations. That’s because both claims are false, although images of many of her tweets (some with her smiling face) are indeed on this website, as that is how I document her ongoing malicious activity for the benefit of members of the public who may be interested in evidence that points to her potential bias and close ties to the porn industry. Her tweets are public.
Prause’s Request for a restraining order is yet another thinly veiled attempt to have all of the incriminating evidence of her potential bias and malicious activity removed from this site. Four court filings related to Prause’s fraudulent TRO:
Respondent GARY WILSON (“Wilson” or “Respondent”) hereby submits this opposition to the Request for Civil Harassment Restraining Orders (“TRO Request”) filed by petitioner NICOLE PRAUSE (“Prause”).[1]
I. INTRODUCTION
This matter does not involve “civil harassment” in any way, shape or form. Prause resides in California and Wilson resides in Oregon. Wilson has never used violence against Prause and has never made any threats against Prause. In fact, Wilson has never met Prause or even spoken to her.
The only conduct Wilson has engaged in that relates to Prause is to exercise his constitutional right to free speech by expressing opinions on his website regarding the adverse effects of pornography that differ from Prause’s pro-pornography position, and to provide truthful testimony in support of those who are currently suing Prause for defamation. In retaliation, Prause filed this frivolous TRO Request based on allegations that are demonstrably false. The Court should deny this TRO Request in its entirety and award Wilson his attorney fees incurred in defending the Request.
II. STATEMENT OF FACTS AND PROCEDURAL HISTORY
A. Relevant Background
Wilson is a former anatomy, physiology, and pathology instructor. Wilson taught at vocational schools in California and Oregon, and also as an adjunct instructor at Southern Oregon University. Wilson was forced to retire due to a chronic recurring illness. (Declaration of Gary Wilson (“Wilson Declaration”), at ¶ 3).
Since 2010, Wilson has maintained a website entitled www.yourbrainonporn.com that presently includes over 13,000 pages of material pertaining to research on pornography’s effects on individuals as well as other related matters of public interest. The purpose of the website is to report and archive the existing research that shows the effects of pornography, chronicle recovery stories of former pornography users, and serve as a clearinghouse for related items of public interest. (Wilson Declaration, ¶ 4).
Wilson is also the author of a book entitled Your Brain on Porn: Internet Pornography and the Emerging Science of Addiction, which tracks research developments in the field. This book was published in 2014 and updated in 2017. Wilson’s book and website are reviled by proponents of the pornography industry because of the viewpoints and opinions expressed by Wilson and others, including critiques of questionable research and studies made by proponents of pornography. (Wilson Declaration, ¶¶ 5-6).
Prause is a researcher and former academic who resides in Los Angeles. Prause’s opinions often differ from Wilson’s as she is a strong proponent of pornography. There is much evidence that she is cozy with the pornography industry – public acceptance of an offer of help from the industry online, photos of her attending industry events, backing the industry’s interests consistently on social media, and attacking and defaming on social media and in false reports those who raise awareness of the potential risks of digital pornography use. (Wilson Declaration, ¶ 7).
In or around 2013, Wilson critiqued a questionable study published by Prause, which Prause and her allies assert “debunks porn addiction.” Since then, multiple other researchers have critiqued this study in the peer-reviewed literature, questioning her interpretation of its findings. Since that time, Prause’s false accusations and defamatory attacks on her critics have escalated. In recent years, she has engaged in a repeated practice of making frivolous complaints and reports to licensing boards, law enforcement and other authorities about Wilson and others who disagree with her. Prause has also falsely claimed she has filed reports when she has not done so. (Wilson Declaration, ¶ 8).
For example, Prause has repeatedly publicly claimed that she filed two FBI reports against Wilson. Wilson confirmed through a Freedom of Information Act (“FOIA”) request that the FBI had no such reports. No FBI official has ever contacted Wilson. In 2018, Prause filed a report against Wilson with the Los Angeles Police Department (which she attaches to her TRO Request). It did not allege that Wilson committed any crime. Instead, Prause seemed to object that Wilson attended a conference in Germany (which Wilson did, having registered in advance, to hear the latest research on behavioral addiction from world experts). Prause also seems to allege that Prause saw Wilson wearing a sleeping bag, armed with a long-sleeved sweater. The physical description does not match Wilson’s height, weight, age or eye-color. The police took no action and in fact never contacted Wilson. Wilson only learned of the LAPD report a year later when Prause persuaded a Wisconsin student newspaper to publish it online. (The University of Wisconsin swiftly removed it when Wilson complained.) (Wilson Declaration, ¶ 9).
Prause is currently a defendant in two defamation lawsuits entitled Donald L. Hilton, Jr. v. Nicole Prause, et al., United States District Court for the Western District of Texas San Antonio Division, Case No. 5: 19-CV-00755-OLG, and Alexander Rhodes v. Nicole Prause, et al., United States District Court for the Western District of Pennsylvania, Case No. 2:19-cv-01366. Hilton is a neurosurgeon and Rhodes runs the world’s largest online English-speaking peer-support forum for those experimenting with giving up internet porn use. Both plaintiffs are pursuing claims for defamation against Prause as a result of Prause’s false claims, including stalking, sexual harassment, antisemitism, non-existent restraining orders and groundless reports to professional boards and academic journals. While Wilson is not a party to either of the above-referenced lawsuits, Wilson signed sworn affidavits in both matters. (Wilson Declaration, affidavit in the Hilton v. Prause case attached as Exhibit “1,” affidavit in the Rhodes v. Prause, et al. case, which was recently filed on January 24, 2020, attached as Exhibit “2.”) (Wilson Declaration, ¶ 10).
On February 12, 2020, Wilson received a call from a police officer with the Ashland, Oregon police department who told Wilson Prause had spoken to him in an attempt to have the police take action against Wilson. The officer told Wilson he intended to inform Prause that he could not help her, because the matter was civil as no crimes were alleged. (Wilson Declaration, ¶ 11).
B. Prause Files Retaliatory Request For Restraining Orders Against Wilson
On or about February 13, 2020, Prause filed an ex parte Request for a Temporary Civil Harassment Restraining Orders against Wilson in this matter without notice to Wilson. The Court denied Prause’s ex parte request finding that the “allegations made in the Request do not support the issuance of a restraining order without a hearing.” The Court set the matter for hearing on March 5, 2020.
III. ARGUMENT
A. Prause’s Burden Of Proof
A petitioner in a civil harassment restraining order case must satisfy a high burden of proof in order to convince a judge to issue the order. A civil harassment restraining order will only be granted if there is “clear and convincing evidence” that harassment exists. Cal. Civ. Proc. Code §527.6(i). The party to be enjoined has certain important due process safeguards, i.e., “a full opportunity to present his or her case, with the judge required to receive relevant testimony and to find the existence of harassment by ‘clear and convincing’ proof of a ‘course of conduct’ that actually and reasonably caused substantial emotional distress, had ‘no legitimate purpose,’ and was not a ‘constitutionally protected activity.’” Adler v. Vaicius, 21 Cal.App.4th 1770, 1775 (1993).
Here, Prause cannot meet this high burden as she has absolutely no proof of any harassment by Wilson. Moreover, she is clearly seeking to stop Wilson from engaging in conduct that serves a legitimate purpose and is constitutionally protected activity.
B. There is No Basis For Any Restraining Orders Against Wilson
1. Wilson Has Not Harassed Prause
Wilson has not harassed Prause in any way and thus there is no basis for the issuance of the Restraining Order. Code of Civil Procedure section 527.6(b) defines “harassment” as “unlawful violence, a credible threat of violence, or a knowing and willful course of conduct directed at a specific person that seriously alarms, annoys, or harasses the person, and that serves no legitimate purpose and is not constitutionally protected.” To constitute harassment, the course of conduct “must be such as would cause a reasonable person to suffer substantial emotional distress, and must actively cause substantial emotional distress to the petitioner.” R.D. v. P.M., 202 Cal.App.4th 181, 188 (2011). The question is whether the evidence shows “harassment sufficient to place a reasonable person in fear of his or her own safety, or the safety of his or her immediate family.” Id. at 189.
Here, Prause fails to provide any evidence of any harassment by Wilson, much less evidence that would establish harassment as defined by the statute by clear and convincing proof. Prause’s primary allegation appears to be that Wilson posted her home address and telephone on his website. Even if this were true, it would not constitute civil harassment. In any event, it is false. Wilson does not even know Prause’s home address and telephone number, and has confirmed through his website provider that no such information is on his website. (Wilson Declaration, ¶ 4, Exh. 3). Further, Prause concedes Wilson does not know her home address and admits that for years she has posted fake addresses for her and her company which remain posted on multiple sites across the Web and appear on Google. (Wilson Declaration, ¶ 13, Exhs. 4, 5).
Prause’s TRO Request contains numerous other fabrications. Prause states there are currently protective or restraining orders in effect against Wilson relating to her. (TRO Request, ¶ 6b). This is false. No such orders exist, nor has Prause ever obtained such orders against Wilson. (Wilson Declaration, ¶ 14). Prause also claims the police had to come because of harassment by Wilson. (TRO Request, ¶ 7a (6)). This is also false. While Prause did unilaterally file a bogus police report regarding Wilson in 2018, the police took no action and did not even contact Wilson. (Wilson Declaration, ¶ 9).
Perhaps most troubling, Prause states in her TRO Request that Wilson has threatened her with a gun. (TRO Request, ¶ 7a (4)). This is another lie by Prause. Prause bases this outrageous claim on grainy copies of photographs she attaches to the TRO Request which she claims depict Wilson and his son with guns. Prause’s allegations are completely false and appear to be an effort to deliberately mislead the Court. In fact, Wilson does not appear in any photographs with a gun. Wilson does not own any guns, and has never owned a gun. (Wilson Declaration, ¶ 15). The photographs were taken years ago and depict Gary Wilson’s son Arion Sprague engaging in perfectly lawful activity. (Declaration of Arion Sprague).
In summary, the evidence clearly shows that Wilson has never met or spoken to Prause, does not live anywhere near Prause, and has not engaged in any type of civil harassment against her whatsoever. Prause’s allegations to the contrary are utterly frivolous.
2. Wilson is Engaging in Constitutionally Protected Activity Which Cannot Be Restrained
California Code of Civil Procedure section 527.6 cannot be used to prohibit constitutionally-protected speech. Smith v. Silvey, 149 Cal.App.3d 400, 406-407 (1983). Harassing speech must be “between purely private parties, about purely private parties, and on matters of purely private interest.” Brekke v. Willis, 125 Cal.App.4th 1400, 1409 (2005).
It is clear that Prause is attempting to use this TRO Request to stifle Wilson’s right to free speech. Prause’s retaliatory frivolous TRO Request is the result of the public difference of opinion online over the effects of pornography between Prause on the one hand, and Wilson and others, as well as Wilson’s efforts to defend himself and protect his rights in the face of retaliatory actions Prause has previously taken. Further, Prause is clearly using the TRO Request in an attempt to intimidate Wilson from acting as a witness in the defamation lawsuits now pending against her, and to expunge the evidence of her malicious activity (much of which is in the form of screen shots of her tweets on Wilson’s website). (Wilson Declaration, ¶ 17).
This is clearly not a dispute involving matters of purely private interests between purely private parties. Under California law, a court cannot issue a restraining order against Wilson simply for expressing his opinions and defending himself on his website.
C. Wilson Should Be Awarded His Attorney Fees
The prevailing party is entitled to an award of court costs and attorney fees, even if Plaintiff brought the action in good faith. See Cal. Civ. Proc. Code §527.6(s); seealsoKrug v. Maschmeier, 172 Cal.App.4th 796, 802-803 (2009).[2] As set forth above, Prause’s TRO Request not only has no merit, but is clearly brought in bad faith.
Accordingly, the Restraining Order should be denied and Wilson should be awarded attorney’s fees in the amount of $7850 he has incurred in defending this frivolous TRO Request.
IV. CONCLUSION
For the reasons set forth above, Wilson respectfully requests that the Court deny Prause’s Request for Restraining orders against Wilson in all respects. Wilson further requests that he be awarded his attorney fees against Prause in the amount of $7850 pursuant to California Code of Civil Procedure section 527.6(s).
[1] Prause did not serve the TRO Request on Wilson. However, Wilson learned the TRO Request had been filed and is filing this opposition to protect his rights and defend against the false allegations made by Prause.
[2] Prause improperly claims the right to recover fees for actions she allegedly took that had nothing to do with this TRO Request. Moreover, she is pro per and therefore cannot recover fees in any event. Thomas v. Quintero, Cal.App.4th 635, 651 (2005).
I am a resident of Ashland, Oregon. I make this declaration in opposition to the Request for Civil Harassment Restraining Orders (“TRO Request”) filed against me by Nicole Prause (“Prause”). I am over the age of 18 and if called upon to testify to the matters stated herein, I could and would do so competently of my own personal knowledge.
Prause’s TRO Request is completely frivolous. I have never harassed Prause or threatened her safety. In fact, I have never met Prause, never spoken to Prause, and to my knowledge, have never even been in the same city with Prause. As set forth below, my interaction with Prause has been limited to a public difference of opinion online over the effects of pornography, and my efforts to defend myself and protect my rights in the face of the retaliatory actions Prause has taken against me.
I am a former anatomy, physiology, and pathology instructor. I taught at vocational schools in CA and OR, and also as an adjunct instructor at Southern Oregon University. I was forced to retire due to a chronic recurring illness.
Since 2010, I have maintained a website entitled www.yourbrainonporn.com that presently includes over 13,000 pages of material pertaining to research on pornography’s effects on individuals as well as other related matters of public interest. The purpose of my website is to report and archive the existing research that shows the effects of pornography, chronicle recovery stories of former pornography users, and serve as a clearinghouse for related items of public interest.
I am also the author of a book entitled Your Brain on Porn: Internet Pornography and the Emerging Science of Addiction, which tracks research developments in the field. This book was published in 2014 and updated in 2017.
My book and website are reviled by proponents of the pornography industry because of the viewpoints and opinions expressed by me and others, including critiques of questionable research and studies made by proponents of pornography.
Prause is a researcher and former academic who resides in Los Angeles. Prause’s opinions often differ from mine as she is a strong proponent of pornography. There is much evidence that she is cozy with the pornography industry – public acceptance of an offer of help from the industry online, photos of her attending industry events, backing the industry’s interests consistently on social media, and attacking and defaming on social media and in false reports those who raise awareness of the potential risks of digital pornography use.
In or around 2013, I critiqued a questionable study published by Prause, which Prause and her allies assert “debunks porn addiction.” Since then, multiple other researchers have critiqued this study in the peer-reviewed literature, questioning her interpretation of its findings. Since that time, Prause’s false accusations and defamatory attacks on her critics have escalated. In recent years, she has engaged in a repeated practice of making frivolous complaints and reports to licensing boards, law enforcement and other authorities about me and others who disagree with her. Prause has also falsely claimed she has filed reports when she has not done so.
For example, Prause has repeatedly publicly claimed that she filed two FBI reports against me. I confirmed through a Freedom of Information Act (“FOIA”) request that the FBI had no such reports. No FBI official has ever contacted me. In 2018, Prause filed a report against me with the Los Angeles Police Department (which she attaches to her TRO Request). It did not allege that I committed any crime. Instead, she seemed to object that I attended a conference in Germany (which I did, having registered in advance, to hear the latest research on behavioral addiction from world experts). She also seems to allege that she saw me wearing a sleeping bag, armed with a long-sleeved sweater. The physical description does not match my height, weight, age or eye-color. The police took no action and in fact never contacted me. I only learned of the LAPD report a year later when Prause persuaded a Wisconsin student newspaper to publish it online. (The University of Wisconsin swiftly removed it when I complained.)
Prause is currently a defendant in two defamation lawsuits entitled Donald L. Hilton, Jr. v. Nicole Prause, et al., United States District Court for the Western District of Texas San Antonio Division, Case No. 5: 19-CV-00755-OLG, and Alexander Rhodes v. Nicole Prause, et al., United States District Court for the Western District of Pennsylvania, Case No. 2:19-cv-01366. Hilton is a neurosurgeon and Rhodes runs the world’s largest online English-speaking peer-support forum for those experimenting with giving up internet porn use. Both plaintiffs are pursuing claims for defamation against Prause as a result of Prause’s false claims, including stalking, sexual harassment, antisemitism, non-existent restraining orders and groundless reports to professional boards and academic journals. While I am not a party to either of the above-referenced lawsuits, I have signed sworn affidavits in both matters. A true and correct copy of my affidavit in the Hilton v. Prause case is attached hereto as Exhibit “1.” A true and correct copy of my affidavit in the Rhodes v. Prause, et al. case, which was recently filed on January 24, 2020, is attached hereto as Exhibit “2.”
On February 12, 2020, I received a call from a police officer with the Ashland, Oregon police department who told me Prause had spoken to him in an attempt to have the police take action against me. After our discussion, the officer told me he intended to inform Prause that he could not help her, because the matter was civil as no crimes were alleged. The next day, February 13, 2020, Prause filed the TRO Request against me. While Prause has never served me with the TRO Request, I learned that it had been filed. I have reviewed the TRO Request. The allegations Prause makes in support of the TRO Request are not true.
Prause claims I have posted her home address and telephone number on my website. This is not true. I have never posted Prause’s home address or phone number on my website, Twitter, or anywhere else. I do not know Prause’s home address or phone number. The company that hosts my website, Linode, has confirmed that they can find no such information on my website. A true and correct copy of Linode’s response to me dated January 31, 2020 confirming that Prause’s home address and telephone number are not on my website is attached hereto as Exhibit “3.”
Prause concedes I could not know her home address and admits that she has, for years, posted nothing but false addresses, whenever she posts her address (such as on her failed application to grab the trademarks for my well established website and its URL). A true and correct copy of Prause’s February 10, 2020 Twitter posts admitting she posts only fake addresses is attached hereto as Exhibit “4.”Fake addresses for her and for her company Liberos are still posted on multiple sites across the web and appear on Google. A true and correct copy of the results of a Google search for Prause that I performed on February 10, 2020, is attached hereto as Exhibit “5.”
Prause alleges she has other protective or restraining orders against me. This is false. No such orders exist, nor has Prause ever obtained such orders against me.
Prause attaches photographs to her Request she claims depict me and my son holding guns. This is also false. I am not depicted in the photographs that show guns. I do not own any guns, and have never owned one.
I have never used any violence against Prause or threatened to use any violence against her. I have not made any threats against Prause whatsoever nor urged anyone else to do so. I have never harassed her in any way. All of Prause’s allegations claiming that I have threatened or harassed her are completely false.
I firmly believe Prause has filed this TRO Request in an effort to stifle my right to free speech, to intimidate me from acting as a witness in the defamation lawsuits now pending against her, and to attempt to expunge the evidence of her malicious activity (much of which is in the form of screenshots of her tweets on my website). Prause has also threatened other witnesses in the defamation lawsuits with groundless, costly legal proceedings.
I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct and of my own personal knowledge. Executed this 28th day of February 2020 at Ashland, Oregon.
Others – January-March, 2020: Prause incites defamatory UK article in an effort to have Alex Rhodes’s “Donor Box” fundraising campaign removed
However, her target, news outlet SCRAM Media, removed its defamatory article, having realized its egregious error in reprinting material supplied to it by Prause.
David Ley and RealYBOP team up to spread the factually-innacurate hit-piece, with RealYBOP tagging DonorBox and its CEO (unconcerned about adding to Rhodes’s concurrent defamation suit against her):
In a legally perilous move RealYBOP retweets the defamatory SCRAM article:
Prause persuaded the outlet to print the falsehood that she had received death threats from members of the far-right after Rhodes’s crowdfunding campaign began. Hilariously, Prause began posting tweets making this phony claim 22 minutes before the campaign itself commenced. Its commencement was slightly delayed, and she impulsively jumped in based on the projected start time Rhodes had announced online.
So it was that Prause claimed the first death threats at 7:50 am, and yet another death threat a few minutes later (all before NoFap commenced its crowdfund):
Also notice that Prause never provides screenshots of her claimed death threats. (She’s a serial fabricator.)
The SCRAM article contained other blatant, defamatory misinformation supplied by Prause as well. For example, it claimed Rhodes sued her because her “research was tantamount to defamation.” That’s absurd. Rhodes sued her because of her ongoing campaign of defamation and harassment of him and NoFap. None of his claims challenge her research (although many peer-reviewed papers have implied that she misinterpreted the significance of her research, and that her findings are consistent with the presence of addiction among her subjects).
She also claimed Rhodes engaged in “misogyny” and that Rhodes’s fans have tried to hack her Facebook and email, all with no support whatsoever. The SCRAM article stated that she “believes she is being stalked and that her [home] address has been posted online.”
The later is especially difficult to take seriously, as she has publicly stated that she never posts her home address online. Prause herself has posted various fake addresses online, including an address she used for the malicious trademark application she filed in an illicit effort to grab the URL for this website! These addresses can readily be found. Save yourself a stamp, however, as any correspondence will be returned as undeliverable (as was YBOP’s attorney’s cease & desist letter for Prause’s trademark infringement).
SCRAM quotes Prause’s dismissive remarks about Rhodes’s suit, but did not ask Rhodes for his side of the story. Finally, SCRAM made the very dubious argument that because Prause claims she has no ties to the porn industry (despite images and other extensive evidence to the contrary), Rhodes’s Donor Box campaign to fund his lawsuit against Prause is fraudulent. Really?
On top of this blatant misuse of their journalistic pen, the SCRAM team deleted comments under the article when readers attempted to counter Prause’s/SCRAM’s untruthful and misleading statements with actual evidence.
So much for responsible journalism.
Shortly after the publication of the now deleted SCRAM article, and RealYBOP tweeting it, Alex Rhodes filed his amended complaint against Nicole Prause. In his new complaint the ScramNews article was added as a new incident of defamation:
March 3, 2020: Even though her RealYBOP twitter account is now named in the Rhodes’s defamation suit, she trolls “The Doctors” to tweet Scram’s defamatory hit-piece under a picture of Alex Rhodes.
Once again, revealing she is the perpetrator, not the victim.
Ongoing – The Numerous Victims of Nicole Prause’s Malicious Reporting and Malicious Use of Process.
Nicole Prause has shown a consistent and troubling pattern of (1) filing groundless, malicious complaints and lawsuits, and (2) threatening such actions, or publicly claiming that she has filed them, when she has not done so. (Three main pages documenting Prause’s behaviors: 1, 2, 3.)
Below is a partial list of such complaints and false claims. (Out of fear of reprisal we have been asked to omit additional individuals and organizations.) Also, Prause regularly claims “whistleblower status” to keep her activities under the radar. So, there are likely other, non-public complaints in addition to those listed here.
The baseless administrative complaints Prause actually lodged were generally dismissed as nuisance filings. However, a few led to time-consuming investigations that were ultimately dismissed or produced little in the way of substantive results. (see: PDF Documenting Nicole Prause’s Malicious Reporting and Malicious Use of Process).
Fight the New Drug – Reported to Utah’s Division of Child and Family Services on the theory that sharing first-hand stories of porn recovery constituted the abuse of minors. DCFS took no action.
Rory Reid PhD – Prause’s former colleague at UCLA. Appears to have been reported to UCLA (and perhaps to the California Psychology Board). Prause’s attacks on him began concurrently with UCLA’s decision not to renew her contract, bringing her academic career to an end.
Five documents currently on Prause’s AmazonAWS website urging readers to report Rory Reid to the state of California: page1, page2, page3, page4, page5.
Prause reported Rhodes to the Pennsylvania Board of Psychology for practicing psychology without a license because CNN filmed him in a group with other young men, all talking about porn’s effects. No therapy was offered or provided. (Investigation in progress). RealYBOP tweet asking followers to report Rhodes to psych Board.
Don Hilton, MD – Reported to the university where he mentors neurosurgery students, the Texas Medical Board, and academic journals with unfounded claims that he faked his credentials (No action)
Keren Landman, MD – Prause asked VICE magazine to terminate expert Dr. Landman for writing an article recommending use of condoms in porn in support of Proposition 60. Unbelievable.
(Apparently) reported Wilson to the ISSM (International Society for Sexual Medicine) for heaven knows what, which canceled his keynote address scheduled for March, 2018 in Lisbon without giving a reason. Then Prause began a social media campaign saying someone had been “removed for an actual good reason from a conference,” and claimed (again) that Gary had misrepresented his credentials (he hadn’t). Gary soon received his Oregon Psychology Board exoneration (see above), so she may also have told the ISSM earlier that he had been “reported for practicing psychology without a license” among other misleading information – in order to persuade the ISSM to cancel him.
February, 2020: When the above C&D failed, Prause called Wilson’s local Ashland Police, attempting to file a false police report, lying that her home address was on YBOP. Officer Jason St. John determined Prause’s claims did not allege a crime and that this was a civil matter.
On February 12 or thereabouts, Prause sought a temporary restraining order against Wilson, based in part on pictures of people (quite obviously not Wilson) holding guns. The judge denied the TRO, but set a hearing for a permanent restraining order on March 6, 2020. Prause did not serve Wilson, but Wilson’s counsel appeared as if she had, thus waiving service. The judge continued the matter until March 25, 2020, stating that he intends to force the parties to attend mediation before ruling.
Prause has also repeatedly, publicly urged members of the public, via social media, to report professionals and professional organizations to psychology boards, to the FTC, and to the Attorney General. Sections of Prause page with documentation:
After years of malicious administrative reporting, spurious cease & desist letters, and misuse of law enforcement personnel, Prause, in 2019, began abusing the court system (and the targets of her wrath) with malicious legal proceedings (and continued threats of legal proceedings) in order to silence anyone who calls attention to her bias or activity.
As recounted above, she filed an invalid small claims court suit against therapist Sprout, and a baseless restraining order against Wilson.
Have you heard these claims a lot recently? Or perhaps even believed they are true?
Religious populations have higher rates of porn use than their secular brethren, and lie about it.
Religious porn users are not really addicted to porn; they only believe they are addicted because they are ashamed.
Believing in porn addiction is the source of any problems, not porn use itself.
Articles about a handful of highly publicized studies on porn use and religion have spread these claims, which many people, both religious and non-religious, have mistakenly begun to accept as fact. However, several air-tight new studies (some by the very researchers whose work has been most represented in such articles) dismantle the above 3 memes.
Meme #1 arises from a few studies that found higher rates of Google searches for sexual terms in “red states” (more religious and conservative), although multiple surveys of porn users almost always find that religious individuals use less porn than secular users. Memes 2 and 3 arise from articles spinning the results of several “perceived pornography addiction” studies by Dr. Joshua Grubbs.
First study: Religious people tell the truth about their porn use
First, a backward glance. The “lying” hypothesis rested on a few studies analyzing all state-by-state frequency of Google searches for term such as “sex,” “porn,” “XXX,” and the like. These state-level studies reported that conservative or religious (“red”) states search frequently more porn-related terms. The authors of these studies suggested that their findings meant that (1) religious individuals watch more porn than the non-religious, and (2) religious porn users must therefore be lying about their porn use to researchers and in anonymous surveys.
When researchers tested the hypothesis that, “religious people are lying about their porn use,” they found no evidence supporting that assumption. In fact, their results suggested that religious people may be more honest than secular individuals about porn use. In short, the state-wide comparison approach is clearly a flawed way of researching this topic. It’s not as reliable as anonymous surveys in which each subject’s level of religiosity is identified.
From the abstract:
However, contrary to popular sentiment-and our own hypotheses-we found no evidence for and much evidence against the suggestion that religious individuals have a more pronounced social desirability bias against the reporting of pornography consumption than the irreligious. Interaction terms assessing that possibility were either nonsignificant or significant in the reverse direction.
From the conclusion:
These results do not fit the narrative that religious individuals are underreporting consumption or overstating their opposition to pornography to a degree greater than the less religious and suggest that, if anything, researchers have been underestimating religious opposition to and avoidance of consuming pornography.
Thus, rather than causing a shame-based self-labeling of normative porn use as “porn addiction,” religion appears to be protective against porn use (and thus problematic porn use).
So, what might explain increased searching for sex-related terms in “red states?” It’s highly unlikely that regular porn users enjoying an hour-long session use Google to search for the relatively innocuous terms (“XXX”, “sex”, “porn”) that the researchers investigated. They would head directly to their favorite tube sites (probably bookmarked).
On the other hand, young people who are curious about sex or porn might employ such Google search terms. Guess what? The 15 states with the highest proportion of adolescents are “red states.” For more analysis concerning religion and porn use see this article: Is Utah #1 in Porn Use?
An aside: Before leaving the topic of religiosity and porn, it’s worth noting that some researchers have been embarrassingly eager to hammer home their own biases about religious people. Take “Surfing for Sexual Sin” by MacInnis and Hodson. These researchers’ dubious conclusions that religious people watch more porn (based on comparing state-level religiosity and volume of sex-related Google search terms) were inconsistent with the overwhelming majority of research results in the field. Nevertheless, MacInnis and Hodson took matters a step farther. They shared their conclusions with religious participants and found that,
those higher (vs. lower) in religiosity or religious fundamentalism considered the findings more inconsistent with personal knowledge of religious states and individuals, considered the findings less true, and considered the authors politically motivated.
In view of the research above, the religious participants were right to rely on their personal knowledge rather than the researchers’ faulty methodology and conclusions.
Second study: “Believing yourself addicted to porn” strongly correlated with use, but not with religiosity
In the last few years Dr. Joshua Grubbs has authored a rash of studies correlating porn users’ religiosity, hours of porn use, moral disapproval, and other variables with scores on his 9-item questionnaire “The Cyber Pornography Use Inventory” (CPUI-9). In an odd decision that has lead to much confusion, Grubbs refers to a subject’s total CPUI-9 score as “perceived pornography addiction.” This gives the false impression that the instrument somehow indicates the degree to which a subject merely “perceives” he is addicted (rather than being actually addicted). But no instrument can do that, and certainly not this one.
To say it another way, the phrase “perceived pornography addiction” indicates nothing more than a number: the total score on the following 9-item pornography-use questionnaire with its three extraneous questions about guilt and shame. It doesn’t sort the wheat from the chaff in terms of perceived vs. genuine addiction.
Perceived Compulsivity Section
I believe I am addicted to Internet pornography.
I feel unable to stop my use of online pornography.
Even when I do not want to view pornography online, I feel drawn to it
Access Efforts Section
At times, I try to arrange my schedule so that I will be able to be alone in order to view pornography.
I have refused to go out with friends or attend certain social functions to have the opportunity to view pornography.
I have put off important priorities to view pornography.
Emotional Distress Section
I feel ashamed after viewing pornography online.
I feel depressed after viewing pornography online.
I feel sick after viewing pornography online.
As you can see, the CPUI-9 cannot distinguish between actual porn addiction and “belief” in porn addiction. Subjects never “labeled themselves as porn addicts” in any Grubbs study. They simply answered the 9 questions above, and earned a total score.
What correlations did the Grubbs studies actually report? Total CPUI-9 scores were related to religiosity (see next section as to why that is), but also related to “hours of porn viewed per week.” In some Grubbs studies a slightly stronger correlation occurred with religiosity, in others a stronger correlation occured with hours of porn use.
The media grabbed onto the correlation between religiosity and total CPUI-9 scores (now misleadingly labeled “perceived addiction”), and in the process journalists morphed the finding into “religious people only believe they’re addicted to porn.” The media ignored the just-as-strong correlation between CPUI-9 scores and hours of porn use, and pumped out hundreds of inaccurate articles like this blog post by David Ley: Your Belief in Porn Addiction Makes Things Worse: The label of “porn addict” causes depression but porn watching doesn’t. Here is Ley’s inaccurate description of a Joshua Grubbs study:
“If someone believed they were a sex addict, this belief predicted downstream psychological suffering, no matter how much, or how little, porn they were actually using.”
Removing Ley’s misrepresentations, the above sentence would accurately read: “Higher scores on the CPUI-9 correlated with scores on a psychological distress questionnaire (anxiety, depression, anger).” Put simply – porn addiction was associated with psychological distress (as was hours of porn use). This was a longitudinal study, and it found that this association between porn use and pyschological distress held steady for a year.
No matter how misleading, “perceived pornography addiction” appealed to the mainstream and spread across the media. Everyone assumed Grubbs had figured out a way to distinguish “addiction” and “belief in addiction.” But he hadn’t. He had just given a misleading title to his porn use inventory, the CPUI-9. Nevertheless, articles based on various CPUI-9 studies summed up these findings as:
Believing in porn addiction is the source of your problems, not porn use itself.
Religious porn users are not really addicted to porn (even if they score high on the Grubbs CPUI-9) – they just have shame.
Even practitioners were easily misled, because some clients really do believe their porn use is more destructive and pathological than their therapists think it is. These therapists assumed the Grubbs test somehow isolated these mistaken clients when it didn’t.
As the saying goes, “The only cure for bad science is more science.” Faced with thoughtful skepticism about his assumptions, and reservations about the unfounded claims that his CPUI-9 instrument could indeed distinguish “perceived pornography addiction” from genuine problematic porn use, Dr. Grubbs did the right thing as a scientist. He pre-registered a study to test his hypotheses/assumptions directly. Pre-registration is a sound scientific practice that prevents researchers from changing hypotheses after collecting data.
The results contradicted both his earlier conclusions and the meme (“porn addiction is just shame”) that the press helped to popularize.
Dr. Grubbs set out to prove that religiosity was the main predictor of “believing yourself addicted to porn.” He and his team of researchers surveyed 3 rather large, diverse samples (male, female, etc.): Who’s a Porn Addict? Examining the Roles of Pornography Use, Religiousness, and Moral Incongruence. (He posted the results online, although his team’s paper has not yet been formally published).
This time, however, he didn’t rely on his CPUI-9 instrument. (The CPUI-9 includes 3 “guilt and shame/emotional distress” questions not normally found in addiction instruments – and which skew its results, causing religious porn users to score higher and non-religious users to score lower than subjects do on standard addiction-assessment instruments.) Instead, the Grubbs team asked 2 direct yes/no questions of porn users (“I believe that I am addicted to internet pornography.” “I would call myself an internet pornography addict.”), and compared results with scores on a “moral disapproval” questionnaire.
Directly contradicting his earlier claims, Dr. Grubbs and his research team found that believing you are addicted to porn correlates most strongly withdaily hours of porn use, not with religiousness. As noted above, some of Grubbs studies also found that hours of use was a stronger predictor of “perceived addiction” than religiosity. From the new study’s abstract:
In contrast to prior literature indicating that moral incongruence and religiousness are the best predictors of perceived addiction [using the CPUI-9], results from all three samples indicated that male gender and pornography use behaviors were the most strongly associated with self-identification as a pornography addict.
Being male is also strongly predictive of self-labeling as “addicted.” Rates of male porn users who answered “yes” to one of the “addicted” questions ranged from 8-20% in the new study’s samples. These rates are consistent with other 2017 research (19% of college males addicted). Indidentally, this study on male porn users reported problematic use rates of 27.6%, and this study reported that 28% of male porn users evaluated met the threshold for problematic use.
In short, there is widespread distress among some of today’s porn users. High rates of problematic use suggest that the World Health Organization’s proposed diagnosis of “Compulsive sexual behavior disorder” (in the ICD-11 beta draft) is genuinely needed.
Based on their results, Dr. Grubbs and his co-authors advise that, “mental and sexual health professionals should take the concerns of clients identifying as pornography addicts seriously.”
A non-Grubbs study questions the CPUI-9 as instrument to assess either perceived or actual porn addiction
The researchers measured actual compulsivity by asking participants to abstain from internet porn for 14 days. (Only a handful of studies have asked participants to abstain from porn use, which is one of the most unambiguous ways to reveal its effects.)
Study participants took the CPUI-9 before and after their 14-day attempt at porn abstinence. (Note: They did not abstain from masturbation or sex, only internet porn.) The researchers’ main objective was to compare ‘before’ and ‘after’ scores of the 3 sections of the CPUI-9 to several variables.
Among other findings (discussed in depth here), the inability to control use (failed abstinence attempts) correlated with the CPUI-9’s actual addiction questions 1-6, but not with the CPUI-9’s guilt and shame (emotional distress) questions 7-9. Similarly, “moral disapproval” of pornography use was only slightly related to CPUI-9 “Perceived Compulsivity” scores. These results suggest that the CPUI-9 guilt and shame questions (7-9) shouldn’t be part of a porn addiction (or even “perceived porn addiction”) assessment because they are unrelated to frequency of porn use.
To say it differently, the most addicted subjects did not score higher on religiosity. Moreover, no matter how it is measured, actual porn addiction/compulsivity is strongly correlated with higher levels of porn use, rather than with “emotional distress” questions (guilt and shame).
In summary the three new religion and pornography studies support the following:
Religiousness does not “cause” porn addiction. Religiosity is not related to believing you are addicted to porn.
The amount of porn viewed is the strongest predictor (by far) of actual porn addiction or belief that someone is addicted to porn.
The Grubbs studies (or any study that used the CPUI-9) did not, in fact, assess”perceived porn addiction” or “belief in porn addiction” or “self-labeling as an addict,” let alone distinguish it from actual addiction.
A new study (Fernandez et al., 2017) tested and analyzed the CPUI-9, a purported “perceived pornography addiction” questionnaire developed by Joshua Grubbs, and found that it couldn’t accurately assess “actual porn addiction” or “perceived porn addiction” (Do Cyber Pornography Use Inventory-9 Scores Reflect Actual Compulsivity in Internet Pornography Use? Exploring the Role of Abstinence Effort). It also found that 1/3 of the CPUI-9 questions should be omitted to return valid results related to “moral disapproval”, “religiosity”, and “hours of porn use.” The findings raise significant doubts about conclusions drawn from any study that has employed the CPUI-9 or relied on studies that employed it. Many of the new study’s concerns and criticisms mirror those outlined in this extensive YBOP critique.
In simple terms the CPUI-9 studies and the headlines they spawned contributed to the following questionable assertions:
“Belief in porn addiction” or “perceived pornography addiction” can be distinguished from “actual pornography addiction” by the CPUI-9.
“Current levels of porn use” is the one valid proxy for actual porn addiction, not scores on porn addiction assessment questionnaires.
In some subjects “current levels of porn use” did not correlate linearly with total CPUI-9 scores. Grubbs asserts these individuals falsely “believe” they are addicted to porn.
In the CPUI-9 studies, “religiosity” correlates with Total CPUI-9 scores. Because of this Grubbs suggests that most religious porn users only believe they are addicted, and do not have an actual porn addiction.
In some of these studies both “religiosity” & “moral disapproval” correlate with Total CPUI-9 scores. Because of this Grubbs and his teams claim that religious porn users have shame-induced “belief in pornography addiction,” not actual pornography addiction.
Articles based on various CPUI-9 studies sum up these findings as:
Believing in porn addiction is the source of your problems, not porn use itself.
Religious porn users are not really addicted to porn (even if they score high on the CPUI-9) – they are simply experiencing shame & guilt surrounding their porn use.
Being labeled “porn addict” by a partner, or even by oneself, has nothing to do with the amount of porn a man views, says Joshua Grubbs, assistant professor of psychology at Bowling Green University. Instead, it has everything to do with religiosity and moral attitudes toward sex. In short, he says, “It’s shame-motivated.”
….Grubbs calls it “perceived pornography addiction.” “It functions very differently from other addictions.”
As Fernandez et al., 2017 reveals, the CPUI-9 has, in fact, failed to assess “perceived porn addiction.” And actual porn addiction functions very much like other addictions.
Bottom line:The results of Fernandez et al., 2017 place all assertions based on CPUI-9 results, and all of the resulting headlines, in serious doubt.
The problems with the “perceived pornography addiction” questionnaire (CPUI-9)
To understand the new study’s importance we need to first examine the Cyber Pornography Use Inventory (CPUI-9). Important to note:
The CPUI-9 is divided into 3 named sections with 3 questions each (take special note of the “Emotional Distress” questions).
Each question is scored using a Likert scale of 1 to 7, with 1 being “not at all,” and 7 being “extremely.”
Whenever Grubbs uses the phrase “perceived addiction” he really means nothing more than the total score on his CPUI-9 test, yet the test cannot actually distinguish “perceived” addiction from real addiction.
Perceived Compulsivity Section
I believe I am addicted to Internet pornography.
I feel unable to stop my use of online pornography.
Even when I do not want to view pornography online, I feel drawn to it
Access Efforts Section
At times, I try to arrange my schedule so that I will be able to be alone in order to view pornography.
I have refused to go out with friends or attend certain social functions to have the opportunity to view pornography.
I have put off important priorities to view pornography.
Emotional Distress Section
I feel ashamed after viewing pornography online.
I feel depressed after viewing pornography online.
I feel sick after viewing pornography online.
Examining the CPUI-9 reveals three glaring truths exposed by the authors of Fernandez et al., 2017 (and in the YBOP critique):
The CPUI-9 cannot differentiate between an actual porn addiction and a mere belief in porn addiction (“perceived addiction”).
The first two sections (questions 1-6) assess the signs and symptoms of an actual pornography addiction (not “perceived pornography addiction”).
The “Emotional Distress” questions (7-9) assess levels of shame and guilt, and are not found in any other type of addiction assessment (i.e., they don’t belong).
We will first provide a brief summary of Fernandez et al., 2017 followed by excerpts from its findings with our comments.
SECTION 2: Fernandez et al., 2017 – Design & Findings
A brief description of Fernandez et al., 2017:
This was a unique study in that it asked participants to abstain from internet porn for 14 days. (Only a handful of studies have asked participants to abstain from porn, which is one of the most unambiguous ways to reveal its effects.) Participants took the CPUI-9 before and after their 14-day attempt at porn abstinence. (Note: They did not abstain from masturbation or sex, only porn.) The researchers’ main objective was to compare ‘before’ and ‘after’ scores of the 3 sections of the CPUI-9 to the following 3 variables:
1) Actual compulsivity. The fact that the participants were attempting to quit porn allowed the researchers to measure actual compulsivity (with respect to porn use). The researchers used a formula of “failed abstinence attempts X abstinence effort” to measure actual compulsivity. This is the first study to compare actual compulsivity to subjects’ scores on a porn addiction questionnaire (the CPUI-9).
2) Frequency of Internet porn use. Subjects’ frequency of internet porn use prior to the study.
3) Moral Disapproval questionnaire. In addition to taking the CPUI-9, Fernandez’s subjects took a Moral Disapproval questionnaire, so researchers could correlate its results with CPUI-9 questions. Moral disapproval of pornography was measured by four items rated on a 7-point Likert scale from 1 (not at all) to 7 (extremely):
“Viewing pornography online troubles my conscience,”
“Viewing pornography violates my religious beliefs,”
“I believe that viewing pornography is morally wrong,” and
“I believe that viewing pornography is a sin.”
Note that 3 of the 4 “moral disapproval” questions involve religiosity.
Let’s explore what Fernandez et al., 2017 reported and what it had to say about the CPUI-9 and the conclusions put forth in studies employing the CPUI-9.
What did Fernandez et al., 2017 report?
Findings #1: Higher frequency of porn use was related to: 1) Total CPUI-9 scores, 2) “Perceived Compulsivity” questions, and 3) actual compulsivity (failed abstinence attempts X abstinence effort). However, frequency of porn use was unrelated to scores on “Emotional Distress” questions 7-9 (which assess guilt & shame).
Translation: No matter how you measure it, actual porn addiction is strongly correlated with higher levels of porn use. However, guilt & shame questions 7-9 shouldn’t be part of a porn addiction (or even “perceived porn addiction”) assessment because they are unrelated to frequency of porn use. The 3 “Emotional Distress” questions do not belong. In fact, they skew CPUI-9 results.
Take away 1:The Grubbs studies (or any study that used the CPUI-9) did not assess “perceived porn addiction” or “belief in porn addiction” or “labeling themselves as addicted.“ It’s important to keep in mind that “perceived pornography addiction” indicates nothing more than the total score on the CPUI-9. A headline such as “Believing You Have Porn Addiction Is the Cause of Your Porn Problem, Study Finds” should now be re-interpreted as “Having a Porn Addiction Is the Cause of Your Porn Problem, Study Finds.” It’s important to note that there’s no scientific precedent for a “perceived addiction” assessment test, and the CPUI-9 has not been validated as such.
Take away 2:Guilt & shame questions 7-9 have no place in a porn addiction questionnaire because they skew Total CPUI-9 scores far lower for non-religious porn users, while elevating scores for religious porn users. For example, if an atheist and devout Christian have identical scores on CPUI-9 questions 1-6, it’s almost certain that the Christian will end up with far higher CPUI-9 scores, after questions 7-9 are added – regardless of the degree of addiction in either subject.
Take away 3:Omitting guilt & shame questions 7-9 results in “hours of porn use” (not religion) being the strongest predictor of porn addiction. To say it another way, “Emotional Distress” questions correlate strongly with “religiosity” but not with “hours of porn use.” Contrary to misleading articles, the CPUI-9 studies found that higher levels of porn use correlated with so-called “perceived pornography addiction.”
Findings #2: Failed abstinence attempts correlated with the 1) Total CPUI-9 scores, and 2) “Perceived Compulsivity” questions – but not with “Emotional Distress” questions 7-9.
Translation: The inability to control use correlated with CPUI-9 actual addiction questions 1-6, but not with the guilt & shame questions 7-9.
Take away:Once again, CPUI-9 questions 1-6 assess actual porn addiction, while guilt & shame questions 7-9 do not. Inclusion of the “Emotional Distress” questions leads to far lower CPUI-9 scores for porn addicts and far higher CPUI-9 scores for religious individuals, or just about anyone who would prefer not to be using porn.
Findings #3: “Moral disapproval” of pornography use was strongly correlated with 1) Total CPUI-9 scores, and 2) “Emotional Distress” questions. However, “moral disapproval” was only slightly related to CPUI-9 “Perceived Compulsivity” scores. In other words, the most addicted subjects did not score higher on religiosity.
Translation: “Moral disapproval” of porn correlated strongly with the CPUI-9 guilt & shame questions 7-9. Most importantly, questions 7-9 are the only reason “moral disapproval” correlated with Total CPUI-9 (“perceived porn addiction”). Inclusion of the “Emotional Distress” questions is what generates the misleading claim that “belief in porn addiction” is driven by moral disapproval.
Take away 1: Omitting the guilt & shame questions (7-9) results in “moral disapproval” having nothing to do with porn addiction. The “Emotional Distress” questions assessing guilt and shame cause just about anyone who would prefer not to be using porn (especially religious individuals) to have much higher CPUI-9 scores.
Take away 2: Inclusion of guilt & shame questions 7-9 leads to artificially strong correlations between “moral disapproval” and the Total CPUI-9 (perceived addiction). The fact that religious individuals score very high on both “moral disapproval” and the “Emotional Distress” questions has led to unsupported claims that religious people are far more likely to “perceive” themselves addicted to porn (remember “perceived addiction” is shorthand for “total CPUI-9 score”). However, this is simply not true, because the “extra” points religious people earn on questions 7-9 do not measure addiction, or even “perception” of addiction. They measure nothing but emotional distress due to conflicted values.
Take away 3: Religious individuals score very high on both the “moral disapproval” questions and the “Emotional Distress” questions. CPUI-9 based studies have adopted the correlation between “moral disapproval” and the 3 “Emotional Distress” questions to create a mythology that religious individuals only believe they are addicted to porn. However, these questions assess neither porn addiction nor “belief” nor “perception” of addiction, so they are out of place in this instrument.
The discussion section of Fernandez et al., 2017 contained three main findings, three theoretical implications, and two clinical implications. They follow.
First main finding: The CPUI-9 “Perceived Compulsivity” questions assess actual compulsivity not “belief” in porn addiction
Fernandez et al., 2017 discuss how the actual compulsivity scores align with scores on the CPUI-9 “Perceived Compulsivity” questions, but not with the “Emotional Distress” questions.
We found partial support for our second hypothesis, that failed abstinence attempts would interact with abstinence effort to predict higher CPUI-9 scores, controlling for moral disapproval. However, this relationship was limited to Perceived Compulsivity scores, and not Emotional Distress scores and CPUI-9 full scale scores.Specifically, when failed abstinence attempts are high and abstinence effort is high, higher scores on the Perceived Compulsivity subscale are predicted. This finding is consistent with our proposition that it is not merely frequency of pornography use which contributes to perceptions of compulsivity, but that this would also depend on an equally important variable, abstinence effort. Previously, studies have demonstrated that frequency of pornography use accounts for some variance in the CPUI-9 (Grubbs et al., 2015a; Grubbs et al., 2015c), but frequency of pornography use alone is not sufficient to infer the presence of compulsivity (Kor et al., 2014). The present study posits that some individuals may view IP frequently, but may not be exerting substantial effort in abstaining from IP. As such, they might have never felt that their use was compulsive in any way, because there was no intention to abstain. Accordingly, the present study’s introduction of abstinence effort as a new variable is an important contribution. As predicted, when individuals tried hard to abstain from pornography (i.e., high abstinence effort) but experienced many failures (i.e., high failed abstinence attempts), this aligned with greater scores on the Perceived Compulsivity subscale.
SUMMARY: First, frequency of porn use was strongly related to the CPUI-9 “Perceived Compulsivity” questions and actual compulsivity (“failed abstinence attempts X abstinence effort”).
Second, porn users who tried really hard to stop, yet repeatedly failed, had the highest scores on the CPUI-9 “Perceived Compulsivity” questions. Put simply, CPUI-9 questions 1-3 assess actual compulsivity (cravings and inability to control use) rather than “belief in addiction.” That means they offer no support for the concept of “perceived addiction.”
Third, the “Emotional Distress” questions (assessing guilt & shame) are immaterial in assessing actual porn addiction, and only function to skew Total CPUI-9 scores higher for religious individuals and those who disapprove of porn use.
Let’s do visual stats. Here are some tips for understanding the numbers in the following tables and images: Zero means no correlation between two variables; 1.00 means a complete correlation between two variables. The bigger the number the stronger the correlation between the 2 variables. If a number has a minus sign, it means there’s a negative correlation between two things. (For example, there’s a negative correlation between exercise and heart disease. Thus, in normal language, exercise reduces the chances of heart disease. On the other hand, obesity has a positive correlation with heart disease.)
We start with the table of correlations from Fernandez et al., 2017. Number 1 is “frequency of internet porn use”, which correlates strongly the CPUI-9 “Perceived Compulsivity” questions (0.47), Abstinence Effort (0.28), and Failed Abstinence Attempts (0.47). Frequency of porn use was unrelated to “Emotional Distress” questions (0.05) and negatively correlated with “moral disapproval” (–0.14).
The results without the 3 “Emotional Distress” questions skewing the results: “Frequency of porn use” is by far the strongest predictor of actual porn addiction – not religiosity! As Fernandez et al. pointed out, the above correlations are similar for all the CPUI-9 studies conducted by Grubbs’s teams.
The core premise of the “perceived porn addiction” studies rests upon the unfounded assertion that Total CPUI-9 scores should correlate perfectly with “current hours of porn use”. The researchers presume that – if a person’s CPUI-9 scores are relatively high, yet their “hours of porn use” only moderately high – the individual falsely “believes” they are addicted to porn. A graphic representation of this assertion:
However, as Fernandez et al. and many other studies point out, current level of porn use is an unreliable measure of addiction. More importantly, the 3 “Emotional Distress” questions greatly weaken correlations between frequency of use and the Total CPUI-9 scores.
Bottom line: There is no such thing as “perceived compulsivity” or “perceived porn addiction.” If a porn user scores high on a porn addiction test, it means he is experiencing the signs and symptoms of an actual addiction. In addition, it is scientifically unsound to presume that current levels of porn consumption can be used as a proxy for actual porn addiction (as many studies have concluded).
Second main finding: Needing greater effort to abstain correlated with CPUI-9 “Perceived Compulsivity” questions
Fernandez et al., 2017 point out that needing greater effort to abstain correlated strongly with the CPUI-9 “Perceived Compulsivity” questions and frequency of porn use, but not with the “Emotional Distress” questions:
Interestingly, abstinence effort as an individual predictor also demonstrated a significant positive predictive relationship with the Perceived Compulsivity subscale (but not the Emotional Distress subscale and the CPUI-9 full scale), controlling for failed abstinence attempts and moral disapproval, although this relationship was not hypothesized a priori. We predicted in the present study that only individuals who actually experienced failed abstinence attempts might infer compulsivity from their own behavior, leading to perceptions of compulsivity. However, we found that greater abstinence effort predicted higher scores on the Perceived Compulsivity subscale, and that this relationship was seen even independent of failed abstinence attempts. This finding has the important implication that trying to abstain from pornography in and of itself is related to perceptions of compulsivity in some individuals.
SUMMARY: Similar to the first finding, higher scores on the CPUI-9 “Perceived Compulsivity” questions strongly correlated with features of actual compulsivity (needing high levels of effort to abstain from porn). Put simply, the CPUI-9 “Perceived Compulsivity” questions assess actual compulsivity. However, needing greater effort to abstain from porn had little to do with guilt, shame or remorse (“Emotional Distress” questions). Guilt & shame surrounding porn use has little to do with actual porn addiction, let alone a “belief” in porn addiction.
Bottom line: There is no such thing as “perceived compulsivity” or “perceived porn addiction.” The “Emotional Distress” questions have no place in the CPUI-9, except to skew scores higher for religious porn users and create unsupported conclusions and headlines.
Third main finding: Moral Disapproval was related to the “Emotional Distress” questions, but not to actual compulsivity or the CPUI-9 addiction questions (1-6)
Keep in mind that “moral disapproval of pornography” is the sum of 4 non-CPUI-9 questions, while the 3 CPUI-9 “Emotional Distress” questions assess guilt and shame. Fernandez et al., 2017 (and the other CPUI-9 studies) found that “moral disapproval of pornography” had little to do with actual porn addiction. The excerpt:
We found that when the CPUI-9 was taken as a whole, moral disapproval was the only significant predictor. However, when broken down, moral disapproval predicted only a specific domain of the CPUI-9, the Emotional Distress subscale (e.g., “I feel ashamed after viewing pornography online”) and had no influence on the Perceived Compulsivity subscale. This is consistent with previous research showing moral disapproval of pornography to be related only to the Emotional Distress subscale and not the Perceived Compulsivity or Access Efforts subscales (Wilt et al., 2016). This also lends support to Wilt and colleagues’ finding that moral disapproval accounts for a unique aspect of the CPUI-9, which is the emotional aspect (Emotional Distress), rather than the cognitive aspect (Perceived Compulsivity). Thus, although the Emotional Distress and Perceived Compulsivity subscales are related, our findings suggest that they need to be treated separately as they seem to be formed via different underlying psychological processes.
SUMMARY: Moral disapproval was strongly related to the 3 “Emotional Distress” questions, but only slightly related to the CPUI-9 “Perceived Compulsivity” questions. This means that “moral disapproval” is not related to porn addiction, but only to guilt & shame. Below are the correlations from the study cited in the excerpt (Wilt et al., 2016). Correlations between “moral disapproval” and the three CPUI-9 sections are highlighted:
As with the other CPUI-9 studies, believing porn is morally wrong or sinful correlated strongly with the CPUI-9 “Emotional Distress” section (#4). Yet there’s very little (or a negative) correlation between “moral disapproval” and the legitimate CPUI-9 porn addiction questions (“Access Efforts”, “Perceived Compulsivity”). Fernandez et al. says shame & guilt (questions 7-9) needs to be examined separately from actual porn addiction (questions 1-6). They do not assess addiction or “perceived” addiction.
Bottom line: The “Emotional Distress” questions have no place in the CPUI-9, except to skew scores higher for religious porn users. Researchers have exploited the natural correlation between “moral disapproval of porn” and the “Emotional Distress” questions to claim that moral objections causes the “belief in porn addiction” (Total CPUI-9 score). Since religious individuals score high on both “moral disapproval” and “Emotional Distress,” researchers incorrectly claim religion causes porn addiction, but study results supply little evidence that this is so.
Theoretical implications #1: “Perceived” pornography addiction is a myth. Moral disapproval plays no part in actual porn addiction.
Fernandez et al., 2017 found that the CPUI-9 “Perceived Compulsivity” questions assess actual compulsivity, and that moral disapproval plays no role in actual porn addiction.
Our findings have three important theoretical implications. First, the present study elucidates the previously unexplored relationship between perceived addiction to IP, as measured by the CPUI-9, and actual compulsivity. In our sample, we found that perceptions of compulsivity were indeed reflective of reality. It appears that an actual compulsive pattern (failed abstinence attempts x abstinence effort), and abstinence effort on its own, predict scores on the CPUI-9 Perceived Compulsivity subscale. We found that this relationship held even after holding moral disapproval constant. Thus, our findings suggest that regardless of whether an individual morally disapproves of pornography, the individual’s Perceived Compulsivity scores may be reflective of actual compulsivity, or the experience of difficulty in abstaining from IP. We propose that while actual compulsivity does not equate to actual addiction, compulsivity is a key component of addiction and its presence in an IP user might be an indication of actual addiction to IP. Therefore, the current study’s findings raise questions about whether research on the CPUI-9 to date can to some extent be accounted for by actual addiction, beyond mere perception of addiction.
SUMMARY: When Fernandez et al. says “perceptions of compulsivity” it means the CPUI-9 “Perceived Compulsivity” questions. Scores on “Perceived Compulsivity” aligned with actual compulsivity (failed abstinence attempts x abstinence effort). Put simply, CPUI-9 questions 1-3 assess actual compulsivity (cravings and inability to control use) rather than “belief in porn addiction.” The authors express serious reservations about using the phrase “perceived addiction” interchangeably with CPUI-9 test scores. Finally, assessing moral disapproval tells us nothing about actual porn addiction.
Note that the “Emotional Distress” questions produce the strong correlations between “moral disapproval” and Total CPUI-9 scores. Note: “Access Efforts” questions 4-6 assess core addiction behaviors (inability to control use despite severe negative consequences), yet are largely unrelated to moral disapproval and religiosity.
Bottom line: There is no such thing as “perceived porn addiction.” If a porn user scores high on a valid porn addiction test, it means he is experiencing the signs and symptoms of an actual addiction. If you believe you are addicted, you are addicted. How one feels morally about pornography has virtually nothing to do with actual pornography addiction. To be accurate, spin laden phrases such as “perceived pornography addiction” or “belief in porn addiction” should more accurately be replaced with “pornography addiction.”
Theoretical implications #2: The 3 “Emotional Distress” questions inflate Total CPUI-9 scores for religious individuals while deflating Total CPUI-9 scores for actual porn addicts.
Fernandez et al., 2017 discuss how the 3 “Emotional Distress” questions skew all results from any study that employed the CPUI-9.
Second, our findings cast doubts on the suitability of the inclusion of the Emotional Distress subscale as part of the CPUI-9. As consistently found across multiple studies (e.g., Grubbs et al., 2015a,c), our findings also showed that frequency of IP use had no relationship with Emotional Distress scores. More importantly, actual compulsivity as conceptualized in the present study (failed abstinence attempts x abstinence effort) had no relationship with Emotional Distress scores. This suggests that individuals who experience actual compulsivity in their pornography use do not necessarily experience emotional distress associated with their pornography use.
Rather, Emotional Distress scores were significantly predicted by moral disapproval, in line with previous studies which also found a substantial overlap between the two (Grubbs et al., 2015a; Wilt et al., 2016). This indicates that emotional distress as measured by the CPUI-9 is accounted for mainly by dissonance felt due to engaging in a behavior that one morally disapproves of, and is unrelated to actual compulsivity. As such, the inclusion of the Emotional Distress subscale as part of the CPUI-9 might skew results in such a way that it inflates the total perceived addiction scores of IP users who morally disapprove of pornography, and deflates the total perceived addiction scores of IP users who have high PerceivedCompulsivity scores, but low moral disapproval of pornography.
This may be because the Emotional Distress subscale was based on an original “Guilt” scale which was developed for use particularly with religious populations (Grubbs et al., 2010), and its utility with non-religious populations remains uncertain in light of subsequent findings related to this scale. “Clinically significant distress” is an important component in the diagnostic criteria proposed for Hypersexual Disorder for the DSM-5, where diagnostic criterion B states that “there is clinically significant personal distress … associated with the frequency and intensity of these sexual fantasies, urges, or behaviors” (Kafka 2010, p. 379). It is doubtful that the Emotional Distress subscale taps into this particular sort of clinically significant distress. The way the items are phrased (i.e., “I feel ashamed/depressed/sick after viewing pornography online”) suggests that distress need not be associated with the frequency and intensity of the sexual fantasies, urges, or behavior, but could be brought about merely from engaging in the behavior even in a non-compulsive way.
SUMMARY: This is the core finding: The 3 “Emotional Distress” questions have no place in the CPUI-9, or any porn addiction questionnaire. These guilt & shame questions do not assess distress surrounding addictive porn use or “perception of addiction.” These 3 questions artificially inflate Total CPUI-9 scores for religious individuals while deflating Total CPUI-9 scores for nonreligious porn addicts.
It’s important to note that assessment questionnaires for other types of addiction typically do not have questions about guilt & shame. Certainly, none make one third of their questionnaires about guilt and shame. For example, the DSM-5 criteria from Alcohol Use Disorder contain 11 questions. Yet none of the questions assess remorse or guilt after a drinking binge. Nor does the DSM-5 Gambling Addiction questionnaire contain a single question about remorse, guilt or shame.
Bottom line: Eliminate the 3 “Emotional Distress” questions and all the claims and correlations they were based upon disappear. Let’s examine how the 3 “Emotional Distress” questions skew CPUI-9 results.
Claim #1: First, it has been claimed over and over that “hours of porn use” were unrelated to “perceived porn addiction” (Total CPUI-9 scores). That’s not true as correlations taken from Grubbs’s “Transgression” study reveal:
In fact, hours of porn use is a stronger predictor of porn addiction (Total CPUI-9) than is religiosity. This alone debunks most of the headlines spawned by the the CPUI-9 “perceived addiction” studies.
While there’s still a correlation between religiosity and Total CPUI-9 scores, it’s largely produced by the 3 “Emotional Distress” questions. This data (taken from Grubbs’s “Transgression” study #2) reveals how the 3 “Emotional Distress” questions drastically lower correlations between hours of porn use and Total CPUI-9 scores:
As you can see actual porn addiction (as assessed by questions 1-6) is powerfully related to levels of porn use.
So, using Total CPUI-9 incorrectly leads to Claim #2: that being religious is strongly related to “perceived pornography addiction.” This correlation is reinterpreted as “religious people falsely believe they are addicted to porn.” Nether is true as actual porn addiction is, in fact, powerfully related to levels of porn use, and not related to religiosity. Comparing correlations between the CPUI-9 core addiction behaviors (“Access Efforts’) and Religiosity or Hours of porn use shows that religion has nothing to do with porn addiction:
The above correlation is the most important take away from this entire article: Religiosity has virtually nothing to do with actual porn addiction! Again, “Access Efforts” questions 4-6 assess core addiction behaviors (the inability to control despite severe negative consequences). In this section we provide four possible reasons why religious porn users may score higher on CPUI-9 actual addiction questions 1-6.
If religious subjects were more likely to “feel addicted” to porn, religiosity should correlate very strongly with actual porn addiction. It doesn’t. To say it another way, those subjects who are most addicted do not score higher in religiosity.
Theoretical implications #3: Actual compulsivity (failed abstinence attempts x abstinence effort) aligns with so-called “perceived compulsivity”
Fernandez et al., 2017 points out what is obvious to porn addicts: trying really hard to quit, yet continually failing, reveals the depth of your compulsion.
Third, this study introduced abstinence effort as an important variable in relation to understanding how perceptions of compulsivity might develop. It is noted that in the literature, frequency of IP use has been investigated without taking into account participants’ varying levels of abstinence effort.The present study’s findings demonstrate that abstinence effort on its own, and when interacting with failed abstinence attempts, predicts greater perceived compulsivity. We have discussed the experience of difficulty at abstaining or craving for pornography as a possible explanation of how the abstinence effort on its own may predict greater perceived compulsivity, in that the difficulty experienced may reveal to the individual that there may be compulsivity in their pornography use. However, at present, the exact mechanism by which abstinence effort relates to perceived compulsivity remains uncertain and is an avenue for further research.
SUMMARY: higher scores on the CPUI-9 “Perceived Compulsivity” were strongly related to features of actual compulsivity (needing greater effort to abstain from porn, yet being unable to do so). Put simply, so-called “perceived compulsivity” equates with actual compulsivity.
Bottom line: If you believe you are addicted to porn (because you are using it compulsively), you are addicted. All future studies should stop employing inaccurate and spin laden phrases such as “perceived pornography addiction” or “belief in porn addiction” as a proxy for CPUI-9 scores.
As an exercise in accuracy we remove the spin laden terms from a few “perceived addiction” studies, so the reader can understand the findings accurately:
“it appears that pornography users feel relationship anxiety surrounding their use only insofar as they believe themselves to have a compulsive, distressing pattern of use.”
Leonhardt et al., 2017 with accurate terminology:
Pornography addicts feel relationship anxiety surrounding their porn use.
“These findings strongly underscore the claim that perceived addiction to Internet pornography likely contributes to the experience of psychological distress for some individuals.”
Grubbs et al., 2015 with accurate terminology:
Addiction to Internet pornography is correlated with psychological distress.
Clinical implications #1:
Fernandez et al., 2017 suggests that clinicians can believe patients when they say they are addicted to pornography.
Finally, our findings provide important implications for the treatment of individuals who report being addicted to Internet pornography. There has been evidence in the literature to suggest that there have been an increasing number of individuals reporting being addicted to pornography (Cavaglion, 2008, 2009; Kalman, 2008; Mitchell, Becker-Blease, & Finkelhor, 2005; Mitchell & Wells, 2007). Clinicians working with individuals who report being addicted to pornography need to take these self-perceptions seriously, instead of being skeptical about the accuracy of these self-perceptions. Our findings suggest that if an individual perceives compulsivity in their own IP use, it is likely that these perceptions might be indeed reflective of reality.
In the same way, clinicians should realize that “perceived compulsivity” could be seen as a useful perception to have, if the perception is reflective of reality. Individuals who experience compulsivity in their IP use might benefit from gaining self-awareness that they are compulsive, and can use this insight into their own behavior to decide whether they need to take steps toward changing their behavior. Individuals who are unsure about whether their IP use is compulsive or not can subject themselves to a behavioral experiment such as the one employed in this study, with abstinence as the goal (for a 14-day period or otherwise). Such behavioral experiments might offer a useful way to ensure that perceptions are grounded in reality, through experiential learning.
SUMMARY: Since so-called “perceived compulsivity” equates with actual compulsivity in Fernandez et al., 2017, patients who claim to be addicted to porn, are in fact likely to be addicted to porn. If there is any doubt about the presence of actual addiction, clinicians should have the client try to abstain from porn for an extended period of time.
Bottom line: “Perceived addiction” doesn’t exist and its use should not be tolerated in scientific circles. Patients should be believed, regardless of the clinician’s personal bias or CPUI-9 score. Organizations such as AASECT, which has officially proclaimed that porn addiction doesn’t exist, may be causing harm to patients and the public.
Clinical implications #2:
From the Fernandez et al., 2017 discussion:
Importantly, our findings suggest that cognitive self-evaluations of compulsivity are likely to be accurate even if the individual morally disapproves of pornography. Clinicians should not be too quick to dismiss cognitive self-evaluations of individuals who morally disapprove of pornography as overly pathological interpretations due to their moralistic beliefs.
On the other hand, clinicians need to keep in mind that the emotional distress associated with pornography use experienced by clients, especially ones who morally disapprove of pornography, appears to be separate from the cognitive self-evaluation of compulsivity.Emotional distress, at least in the way it is measured by the CPUI-9, is not necessarily the result of compulsive IP use, and needs to be treated as a separate issue.
Conversely, clinicians need to also be aware that an individual could be experiencing actual compulsivity in their IP use without necessarily feeling emotions such as shame or depression associated with their IP use.
SUMMARY: First, clinicians should respect (even religious) patients’ self assessments when they feel addicted to porn in the absence of strong evidence to the contrary. Clinicians shouldn’t allow their own biases or a patient’s moral views to influence their assessments. Second, the “emotional distress” assessed by the three CPUI-9 guilt & shame questions have nothing to do with actual porn, or perceived, addiction. Clinicians are urged to avoid conflating actual or perceived porn addiction with guilt & shame – as the CPUI-9 studies have done.
Bottom line: Moral disapproval has nothing to with actual or perceived porn addiction. Claims that morality plays a role porn addiction arise from the CPUI-9’s use of inappropriate shame & guilt questions (“Emotional Distress”) to assess addiction. Clinicians harm patients by suggesting their porn-related difficulties arise from moral disapproval, shame or guilt when they in fact arise from actual compulsion.
SECTION 4: Final Thoughts
It is important to ponder how a flawed instrument like the CPUI-9 became elevated to such a position of influence in the sexology field and related articles in the mainstream. As Fernandez et al. shows, the CPUI-9 body of research is not solid science. Nor was the CPUI-9 ever validated as being able to distinguish real from “perceived” addiction. Yet the claims based on CPUI-9 findings have been enshrined as infallible, influential truths in some circles (whose preconceptions these claims appear to support).
What is really going on? As Fernandez et al. points out, the CPUI-9 appears to be aimed at producing claims about religious people – specifically, aimed at distorting “perceived addiction” results with respect to religious subjects and drawing far-reaching conclusions. Whether or not the teams employing the CPUI-9 intended this result, the “perceived addiction” claims have very effectively achieved this end, and it is not surprising that those who delight in such an outcome find the conclusions appealing and worthy of ongoing publicity.
The developer of the CPUI-9 is ex-religious, and it is not inconceivable that he has set out, consciously or unconsciously, to bring into disrepute strict religious upbringings like his own by means of his research. Some mainstream accounts, quoting him extensively, have gone even further, suggesting that his “perceived addiction” findings are evidence that any concern about porn use contributes to (or even generates) a belief in porn addiction. This unsupported assertion does a great disservice to porn users (whether religious or nonreligious) who are suffering from a wide range of severe symptoms, and trying to understand porn’s effects. Many of today’s nonreligious users have no shame whatsoever about their porn use, apart from their distress about their inability to control their porn use when they attempt to do so.
Sadly, few critics seem willing to examine the premises on which CPUI-9 study claims and mainstream interpretations are based. Instead, most psychologists and journalists take at face value assertions that scores on this highly distorted instrument are, in fact, evidence of shame-based “perceived addiction.” Yet upon even the slightest reflection, it becomes evident that no single score (and certainly not the score on a profoundly distorted questionnaire like the CPUI-9) could possibly reveal a distinction between “perceived” and actual addiction, let alone justify the far-reaching claims for which it is being cited.
All of this means that work such as Fernandez et al. is vital. Highly publicized claims like those about CPUI-9 data are unwarranted unless the validity of the instrument on which they rest is tested and results carefully evaluated for other, more plausible explanations. Thanks to Fernandez et al. it is now evident that, as a research instrument, the CPUI-9 is flawed and unreliable. As a responsible scientist and academic, its creator himself no doubt sees this.
Formal critiques (by porn researchers) of “Pornography Problems Due to Moral Incongruence: An Integrative Model with a Systematic Review and Meta-Analysis”
This page collects findings that debunk the popular sexology claim that porn use promotes egalitarian attitudes toward women (page also contains a few studies linking porn use to un-egalitarian attitudes towards males).
The Taylor Kohut study framed egalitarianism as: (1) Support for abortion, (2) Feminist identification, (3) Women holding positions of power, (4) Belief that family life suffers when the woman has a full-time job, and oddly enough (5) Holding more negative attitudes toward the traditional family. No matter what you personally believe, its easy to see that religious populations would score far lower on Taylor Kohut’s 5-part “egalitarianism” assessment.
The key: secular populations, which tend to be more liberal, have far higher rates of porn use than religious populations. By choosing these criteria and ignoring endless other variables, lead author Taylor Kohut knew he would end up with porn users scoring higher on his study’s carefully chosen selection of what constitutes “egalitarianism.” Then he chose a title that spun it all. In this 2018 presentation Gary Wilson exposes the truth behind 5 questionable and misleading studies, including both Kohut studies: Porn Research: Fact or Fiction?
Taylor Kohut has a history of publishing ‘creative’ studies designed to find little or no problems arising from the use of porn. In this 2017 study, Kohut appears to have skewed the sample to produce the results he was seeking. Whereas most studies show that a tiny minority of porn users’ female partners use porn, in this study 95% of the women used porn on their own (85% of the women had used porn since the beginning of the relationship)! Reality: Cross-sectional data from the largest US survey (General Social Survey) reported that only 2.6% of women had visited a “pornographic website” in the last month.
Kohut’s new website and his attempt at fundraising suggest that he just may have an agenda. Kohut’s bias is also revealed in a recent brief written for the Standing Committee on Health Regarding Motion M-47 (Canada). In the brief Kohut and his coauthors are guilty of cherry-picking a few outlying studies while misrepresenting the current state of the research on porn’s effects. Their distorted and laughable description of the published neurological studies on porn users leaves no doubt as to their bias. In 2019 Kohut confirmed his extreme agenda-driven bias when he joined his allies in trying to silence YourBrainOnPorn.com. Kohut and his friends at www.realyourbrainonporn.com are engaged in illegal trademark infringement and squatting.
The truth is that nearly every study assessing porn use and egalitarianism (sexual attitudes) has reported that porn use is associated with attitudes toward women that both liberals and conservatives regard as extremely problematic. (Please note that these studies all reported findings about attitude. Studies that did not report attitude correlations are not included, even if they did report a link between porn consumption and actual aggression. For those studies, see Studies linking porn use to sexual offending, sexual aggression, and sexual coercion (addresses claims about rape rates & porn.
List of relevant studies and meta-analyses (the list begins with reviews of the literature and meta-analyses):
Sexually objectifying portrayals of women are a frequent occurrence in mainstream media, raising questions about the potential impact of exposure to this content on others’ impressions of women and on women’s views of themselves. The goal of this review was to synthesize empirical investigations testing effects of media sexualization. The focus was on research published in peer-reviewed, English-language journals between 1995 and 2015. A total of 109 publications that contained 135 studies were reviewed. The findings provided consistent evidence that both laboratory exposure and regular, everyday exposure to this content are directly associated with a range of consequences, including higher levels of body dissatisfaction, greater self-objectification, greater support of sexist beliefs and of adversarial sexual beliefs, and greater tolerance of sexual violence toward women. Moreover, experimental exposure to this content leads both women and men to have a diminished view of women’s competence, morality, and humanity.
Decades of research have examined the impact of exposure to nonexplicit portrayals of sexual content in media. There is only one meta-analysis on this topic, which suggests that exposure to “sexy media” has little to no effect on sexual behavior. There are a number of limitations to the existing meta-analysis, and the purpose of this updated meta-analysis was to examine associations between exposure to sexual media and users’ attitudes and sexual behavior.
A thorough literature search was conducted to find relevant articles. Each study was coded for associations between exposure to sexual media and one of six outcomes including sexual attitudes (permissive attitudes, peer norms, and rape myths) and sexual behaviors (general sexual behavior, age of sexual initiation, and risky sexual behavior).
Overall, this meta-analysis demonstrates consistent and robust relations between media exposure and sexual attitudes and behavior spanning multiple outcome measures and multiple media. Media portray sexual behavior as highly prevalent, recreational, and relatively risk-free [3], and our analyses suggest that a viewer’s own sexual decision-making may be shaped, in part, by viewing these types of portrayals. Our findings are in direct contrast with the previous meta-analysis, which suggested that media’s impact on sexual behavior was trivial or nonexistent [4]. The previous meta-analysis used 38 effect sizes and found that “sexy” media were weakly and trivially related with sexual behavior (r = .08), whereas the current metaanalysis used more than 10 times the amount of effect sizes (n = 394) and found an effect nearly double the size (r = .14).
First, we found positive associations between exposure to sexual media and teens’ and young adults’ permissive sexual attitudes and perceptions of their peers’ sexual experiences.
Second, exposure to sexual media content was associated with greater acceptance of common rape myths.
Finally, sexual media exposure was found to predict sexual behaviors including age of sexual initiation, overall sexual experience, and risky sexual behavior. These results converged across multiple methodologies and provide support for the assertion that media contribute to the sexual experiences of young viewers.
Although the meta-analysis demonstrated significant effects of sexual media exposure on sexual attitudes and behaviors across all variables of interest, these effects were moderated by a few variables. Most notably, significant effects for all ages were apparent; however, the effect was more than twice as large for adolescents as for emerging adults, perhaps reflecting the fact that older participants likely have more comparative, real-world experience to draw on than younger participants [36, 37]. In addition, the effect was stronger for males compared with females, perhaps because sexual experimentation fits the male sexual script [18] and because male characters are punished less often than female characters for sexual initiation [38].
These findings have significant implications for adolescent and emerging adult physical and mental health. Perceiving high levels of peer sexual activity and sexual permissiveness may increase feelings of internal pressure to experiment sexually [39]. In one study, exposure to sexual media content in early adolescence was seen to advance sexual initiation by 9e17 months [40]; in turn, early experimentation may increase mental and physical health risks [37].
The effect sizes found here are similar to those of other studied areas of media psychology such as media’s impact on violence [41], prosocial behavior [42], and body image [43]. In each of these cases, although media use accounts for only a portion of the total variance in the outcomes of interest, media do play an important role. These comparisons suggest that sexual media content is a small, but consequential factor in the development of sexual attitudes and behaviors in adolescents and emerging adults.
YBOP comments: There’s some interesting background related to this paper. (See excerpt from its Conclusion below the Abstract). The Abstract states that only one other meta-analysis on this subject has been published. That other paper found that, “The impact of media on teen sexuality was minimal with effect sizes near to zero.” It was co-authored by Christopher J. Ferguson: Does Sexy Media Promote Teen Sex? A Meta-Analytic and Methodological Review (2017)
For years, Ferguson has been attacking the concept of internet addiction, while intensely campaigning to keep Internet Gaming Disorder out of the ICD-11. (He lost that one in 2018, but his campaign continues on many fronts.) In fact, Ferguson and Nicole Prause were co-authors on major paper attempting to discredit internet addictions. (Their assertions were debunked in a series of papers by experts, in this issue of Journal of Behavioral Addictions.) Here, the authors of the meta-analysis describe how Ferguson’s suspect choice of parameters produces his result.
A meta-analysis was conducted to determine whether nonexperimental studies revealed an association between men’s pornography consumption and their attitudes supporting violence against women. The meta-analysis corrected problems with a previously published meta-analysis and added more recent findings. In contrast to the earlier meta-analysis, the current results showed an overall significant positive association between pornography use and attitudes supporting violence against women in nonexperimental studies. In addition, such attitudes were found to correlate significantly higher with the use of sexually violent pornography than with the use of nonviolent pornography, although the latter relationship was also found to be significant.
The remaining studies are listed in chronological order:
Explored the consequences of continued exposure to pornography on beliefs about sexuality in general and on dispositions toward women in particular. Found that massive exposure to pornography resulted in a loss of compassion toward women as rape victims and toward women in general.
Compared to a group that had watched a control film, male subjects who were shown the violent film agreed more with items endorsing interpersonal violence against women than did the control subjects. However, contrary to predictions, there was no statistically significant difference between the two groups in their acceptance of rape myths, although there was a trend in the predicted direction.
In Studies 3 and 4, high exposure men were more likely than low exposure men to think that most men perform masculine behaviors. In Studies 5 and 6, high exposure men were also more likely lo generate sexual descriptions of women spontaneously. Finally, in Study 7, high exposure men perceived the most gender differences after viewing sexual or sexual/violent music videos; low exposure men perceived the most differences after viewing sexual or romantic ones. These studies suggest that exposure to pornography is related to broad and fundamental ways of understanding men, women, and gender relations.
Study 1 showed an inverse correlation between modern sexism and pornography use, such that participants who used pornography more frequently displayed less sexist attitudes. Study 2 found a positive correlation between pornography use and benevolent sexism, such that participants who used pornography more frequently displayed more benevolent sexism. Our studies provide insight into the largely inconclusive findings of previous research on pornography use and sexist attitudes toward women.
This cross-sectional study examined 804 adolescents, boys and girls, aged from 14 to 19 years, attending different types of high schools in the northwest of Italy. The main goals were: (i) to investigate the relationship between active and passive forms of sexual harassment and violence and the relationship between pornography (reading magazines and viewing films or videos) and unwanted sex among adolescents; (ii) to explore the differences in these relationships with respect to gender and age; and (iii) to investigate the factors (pornography, gender and age) that are most likely to promote unwanted sex. The findings showed that active and passive sexual violence and unwanted sex and pornography were correlated.
This study was done to investigate cybersex addiction, gender egalitarianism, sexual attitude and the allowance of sexual violence in adolescents, and to identify the relationships among these variables. The participants were 690 students from two middle schools and three high schools in Seoul. Cybersex addiction, gender egalitarianism, sexual attitude and the allowance of sexual violence in adolescents were different according to general characteristics. Gender egalitarianism, sexual attitude and the allowance of sexual violence in adolescents were influenced by cybersex addiction.
This study was designed to investigate whether adolescents’ exposure to a sexualized media environment is associated with stronger beliefs that women are sex objects [on-line survey of 745 Dutch adolescents aged 13 to 18]. More specifically, we studied whether the association between notions of women as sex objects and exposure to sexual content of varied explicitness (i.e., sexually non-explicit, semi-explicit, or explicit) and in different formats (i.e., visual and audio-visual) can be better described as cumulative or as hierarchical. Exposure to sexually explicit material in on-line movies was the only exposure measure significantly related to beliefs that women are sex objects in the final regression model, in which exposure to other forms of sexual content was controlled. The relationship between exposure to a sexualized media environment and notions of women as sex objects did not differ for girls and boys
This study examined the prevalence of online pornography viewing and its psychosocial correlates among a sample of young Chinese men in Hong Kong. Moreover, participants who reported to have more online pornography viewing were found to score higher on measures of premarital sexual permissiveness and proclivities toward sexual harassment.
Correlates of use and subsequent sexual attitudes and behaviors predicted by exposure to sexually explicit content in adult magazines, X-rated movies, and the Internet were examined in a prospective survey of a diverse sample of early adolescents (average age at baseline = 13.6 years; N = 967).
Longitudinal analyses showed that early exposure for males predictedless progressive gender role attitudes, more permissive sexual norms, sexual harassment perpetration, and having oral sex and sexual intercourse two years later. Early exposure for females predicted subsequently less progressive gender role attitudes, and having oral sex and sexual intercourse.
The aim of this study was to clarify causality in the previously established link between adolescents’ exposure to sexually explicit Internet material (SEIM) and notions of women as sex objects. On the basis of data from a three-wave panel survey among 962 Dutch adolescents, structural equation modeling initially showed that exposure to SEIM and notions of women as sex objects had a reciprocal direct influence on each other. The direct impact of SEIM on notions of women as sex objects did not vary by gender. However, the direct influence of notions of women as sex objects on exposure to SEIM was only significant for male adolescents. Further analyses showed that, regardless of adolescents’ gender, liking of SEIM mediated the influence of exposure to SEIM on their beliefs that women are sex objects, as well as the impact of these beliefs on exposure to SEIM.
The present study examined Japanese college students’ (N = 476) use of sexually explicit material (SEM) and associations withperceptions of women as sex objects and sexually permissive attitudes. Results indicate that Japanese college students used print media most frequently as a source for SEM followed by the Internet and the television/video/DVD. Male participants used SEM significantly more than females. In addition, sexual preoccupancy mediated the relationship between exposure to SEM and perceptions of women as sex objects, whereas exposure to SEM in mass media had a direct association with Japanese participants’ sexually permissive attitudes.
We used data from two nationally representative two-wave panel surveys among 1,445 Dutch adolescents and 833 Dutch adults, focusing on the stereotypical belief that women engage in token resistance to sex (i.e., the notion that women say “no” when they actually intend to have sex). Finally, adults, but not adolescents, were susceptible to the impact of SEIM on beliefs that women engage in token resistance to sex.
The present study surveyed 62% of the fraternity population at a Midwestern public university on their pornography viewing habits, bystander efficacy, and bystander willingness to help in potential rape situations. Results showed that men who view pornography are significantly less likely to intervene as a bystander, report an increased behavioral intent to rape, and are more likely to believe rape myths.
Using a probability-based sample of young Danish adults and a randomized experimental design, this study investigated effects of past pornography consumption, experimental exposure to nonviolent pornography, perceived realism of pornography, and personality (i.e., agreeableness) on sexist attitudes (i.e., attitudes toward women, hostile and benevolent sexism). Further, sexual arousal mediation was assessed. Results showed that, among men, an increased pastpornography consumption was significantly associated with less egalitarian attitudes toward women and more hostile sexism. Further, lower agreeableness was found to significantly predict higher sexist attitudes. Significant effects of experimental exposure to pornography were found for hostile sexism among low in agreeableness participants and for benevolent sexism among women.
This experimental study tested whether exposure to female centerfold images causes young adult males to believe more strongly in a set of beliefs clinical psychologist Gary Brooks terms “the centerfold syndrome.” The centerfold syndrome consists of five beliefs: voyeurism, sexual reductionism, masculinity validation, trophyism, and nonrelational sex. Past exposure to objectifying media was positively correlated with all five centerfold syndrome beliefs. Recent exposure to centerfolds had immediate strengthening effects on the sexual reductionism, masculinity validation, and nonrelational sex beliefs of males who view objectifying media less frequently. These effects persisted for approximately 48 hours.
Our study investigated a potential source of social influence that has often been hypothesized to reduce compassion and sympathy for women: pornography. National panel data were employed. Data were gathered in 2006, 2008, and 2010 from 190 adults ranging in age from 19 to 88 at baseline. Pornography viewing was indexed via reported consumption of pornographic movies. Attitudes toward affirmative action were indexed via opposition to hiring and promotion practices that favor women. Consistent with a social learning perspective on media effects, prior pornography viewing predicted subsequent opposition to affirmative action even after controlling for prior affirmative action attitudes and a number of other potential confounds. Gender did not moderate this association. Practically, these results suggest thatpornography may be a social influence that undermines support for affirmative action programs for women.
The purpose of this study was to examine theorized antecedents (i.e., gender role conflict and attachment styles) and consequences (i.e., poorer relationship quality and sexual satisfaction) of men’s pornography use among 373 young adult heterosexual men. Findings revealed that both frequency of pornography use and problematic pornography use were related to greater gender role conflict, more avoidant and anxious attachment styles, poorer relationship quality, and less sexual satisfaction. In addition, the findings provided support for a theorized mediated model in which gender role conflict was linked to relational outcomes both directly and indirectly via attachment styles and pornography use.
The Confluence Model of sexual aggression (Malamuth, Addison, & Koss, 2000) states that pornography use, thought to promote sexual coercion of women through presentation of submissive female imagery, works in conjunction with sexual promiscuity (SP) and hostile masculinity (HM), proposed sexual aggression risk factors, to produce anti-woman sexual aggression. An Internet based survey (N = 183 adult males) replicated results of previous Confluence Model research, such that men who were high in HM and SP were more likely to report sexual coercion when they frequently, rather than infrequently, used pornography. Exploring new ground, this study also found that HM and SP together were strong predictors of consumption of violent sexual media, in comparison to non-violent sexual media, which suggests that men at high risk of sexual aggression consume different types of sexual material than men at low risk.
The present study explored associations between pornography consumption and nonsexual gender-role attitudes in a national, two-wave panel sample of US adults. Pornography consumption interacted with age to predict gender-role attitudes. Specifically, pornography consumption at wave one predicted more gendered attitudes at wave two for older—but not for younger—adults.
The present two-wave panel survey among 1557 Dutch adolescents addressed these lacunae by studying exposure to affection-themed, dominance-themed and violence-themed SEIM. Younger adolescents were more often exposed to affection-themed SEIM, while older adolescents and adolescents with higher levels of academic achievement were more frequently exposed to dominance-themed SEIM. Hyper masculine boys and hyper feminine girls were more frequently exposed to violence-themed SEIM.
Findings highlight that many young people are exposed to porn both intentionally and unintentionally. Furthermore, they are concerned about gendered norms that reinforce men’s power and subordination over women. A link between porn exposure, young men’s sexual expectations and young women’s pressure to conform to what is being viewed, has been exposed.
We found that several motivations to view pornography were associated with suppression of willingness to intervene as a bystander, even after controlling for frequency of pornography use. This study joins others in suggesting an association between pornography use and callousness toward sexual violence.
Stereotypical sexist representations of men and women in popular culture reinforce rigid views of masculinity (e.g., males as being strong, in control, masterful, and aggressive) and femininity (e.g., women as being fragile and weak, unassertive, peaceful, irrational, and driven by emotions). The present study examined associations between the fictional series Fifty Shades-one popular culture mechanism that includes pervasive traditional gender role representations-and underlying sexist beliefs among a sample of 715 women ages 18-24 years. Analyses revealed associations between Fifty Shades readership and sexism, as measured through the Ambivalent Sexism Inventory. Namely women who reported reading Fifty Shades had higher levels of ambivalent, benevolent, and hostile sexism. Further, those who interpreted Fifty Shades as “romantic” had higher levels of ambivalent and benevolent sexism.
This study measured young women’s attitude toward the male gaze following exposure to centerfolds of varying explicitness. Explicitness was operationalized as degree of undress. Women exposed to more explicit centerfolds expressed greater acceptance of the male gaze than women exposed to less explicit centerfolds immediately after exposure and at a 48 hour follow-up. These results support the view that the more media depictions of women display women’s bodies, the stronger the message they send that women are sights to be observed by others. They also suggest that even brief exposure to explicit centerfolds can have a nontransitory effect on women’s sociosexual attitudes.
Guided by the concepts of specific and abstract sexual scripting in Wright’s sexual script acquisition, activation, application model of sexual media socialization, this study proposed that the more men are exposed to objectifying depictions, the more they will think of women as entities that exist for men’s sexual gratification (specific sexual scripting), and that this dehumanized perspective on women may then be used to inform attitudes regarding sexual violence against women (abstract sexual scripting).
Data were gathered from collegiate men sexually attracted to women (N = 187). Consistent with expectations, associations between men’s exposure to objectifying media and attitudes supportive of violence against women were mediated by their notions of women as sex objects. Specifically, frequency of exposure to men’s lifestyle magazines that objectify women, reality TV programs that objectify women, and pornography predicted more objectified cognitions about women, which, in turn, predicted stronger attitudes supportive of violence against women.
Frequent viewers of soft-core pornography, such as photographs of naked and semi-naked female models, are unlikely to think positively about women and are likely to have become desensitised to soft-core pornography common in newspapers, advertising and the media. The results indicated that people who frequently viewed soft-core pornographic images were less likely to describe these as pornographic than people who had low levels of exposure to these images. People who were desensitised to these images were more likely than others to endorse rape myths. Furthermore, people who frequently viewed these images were less likely to have positive attitudes to women.
New technology has made pornography increasingly accessible to young people, and a growing evidence base has identified a relationship between viewing pornography and violent or abusive behavior in young men. This article reports findings from a large survey of 4,564 young people aged 14 to 17 in five European countries which illuminate the relationship between regular viewing of online pornography, sexual coercion and abuse and the sending and receiving of sexual images and messages, known as “sexting.” In addition to the survey, which was completed in schools, 91 interviews were undertaken with young people who had direct experience of interpersonal violence and abuse in their own relationships.
Rates for regularly viewing online pornography were very much higher among boys and most had chosen to watch pornography. Boys’ perpetration of sexual coercion and abuse was significantly associated with regular viewing of online pornography. In addition, boys who regularly watched online pornography were significantly more likely to hold negative gender attitudes. The qualitative interviews illustrated that, although sexting is normalized and perceived positively by most young people, it has the potential to reproduce sexist features of pornography such as control and humiliation.
In this study, we conducted a survey (N = 351) of male and female adults and used structural equation modeling to analyze relationships among video game consumption, trait interpersonal aggression, ambivalent sexism, and first-order (percentage of false rape accusations) and second-order cultivation effects (RMA). We found support for the hypothesized cultivation model, indicating a relationship between video game consumption and RMA via interpersonal aggression and hostile sexism. Although these findings cannot be interpreted causally, we discuss the implications of these associations and future directions for research.
n this longitudinal study among 1,947 13–25‐year‐olds, we started to address this lacuna by examining the potential of porn literacy education at schools to attenuate the longitudinal relationship between exposure to sexually explicit Internet material (SEIM) and views of women as sex objects. A two‐way interaction effect emerged: The relationship between SEIM and sexist views became weaker, the more users had learned from porn literacy education. No gender or age differences occurred. This study thus provides some first evidence for the role of media education in reducing undesirable media effects.
Participants (N = 330) were undergraduate men at a large, Midwestern university, ranging in age from 17-54 years (M = 20.65, SD = 3.06). Participants predominantly identified as White (84.9%) and heterosexual (92.6). After providing informed consent, participants completed the study online.
Results indicated that lower age of first exposure to pornography predicted higher adherence to both the Power over Women and the Playboy masculine norms. Additionally, regardless of the nature of the men’s first exposure to pornography (i.e., intentional, accidental, or forced), participants adhered equally to the Power over Women and the Playboy masculine norm. Various explanations may exist to understand these relationships, but the results show the importance of discussing age of exposure in clinical settings with men.
Exposure to some magazines aimed at young male readers- lads’ mags-has recently been associated with behaviors and attitudes that are derogatory toward women, including sexual violence. In the present study, a group of Spanish adult men was exposed to the covers of a lads’ mag while a second group was exposed to the covers of a neutral magazine. Results showed that, compared with participants in the second group, participants who were exposed to covers of lads’ mags who also showed high rape myth acceptance and legitimized the consumption of such magazines reported higher rape proclivity in a hypothetical situation.
Women in the sex trade have experienced victim blame from first responders and victimization from buyers and traffickers. Women’s ability to exit the sex trade may be negatively affected by bias from prostitution myth adherence that has normalized sexual exploitation and violence against women. Gender, increased sexist attitudes toward women, frequency of pornography consumption, and self-control deficits significantly predicted prostitution myth adherence.
Greater dominance and avoidance of femininity ideology were predictive of men’s excessive use of pornography. Men’s restrictive emotionality and heterosexist ideologies predicted control difficulties with pornography use and using pornography to escape negative emotions. Additionally, men’s avoidance of femininity ideology predicted excessive pornography use and control difficulties.
In the current study, 82 undergraduate men were randomly assigned to one of three conditions (degrading, erotica, or control); within each condition they were randomly assigned to watch one of two approximately 10-minute clips: degrading pornography (i.e., nonviolent, debasing, dehumanizing), erotic pornography (i.e., non-degrading, nonviolent, consensual), or a news clip as a control condition.
Exposure to erotica (vs. degrading) generated less objectification of the porn actress [and] exposure to erotica (vs. control) also generated the greatest discrimination toward the fictitious woman, although the omnibus for the latter was non-significant. Exposure to degrading pornography (vs. erotica or control) generated the strongest hostile sexist beliefs and the greatest amount of objectification of the woman in the clip.
Given the link between sexual objectification experiences and negative psychological and mental health outcomes for sexual minority men, it is important to explore which men are more likely to enact sexually objectifying behavior. We examined predictors of sexual minority men’s sexual objectification of other men (e.g., engaging in body evaluations, making unwanted sexual advances), including focusing on appearance, involvement in the lesbian, gay, bisexual, transgender and queer (LGBTQ) community, pornography use, and men’s gender role conflict among 450 gay and bisexual men. Our findings revealed that importance placed on appearance, involvement in the LGBTQ community, and pornography use and less restrictive affectionate behavior between men were uniquely related to sexually objectifying other men.
Controlling for pornography viewing frequency, religious identity, and sexual orientation, structural equation modeling revealed power over women and playboy norms as associated with increased problematic pornography viewing, whereas emotional control and winning norms were negatively related to problematic pornography viewing. Of these associations, power over women norms produced consistent positive direct effects across all dimensions…
Interactions similarly evidenced positive relationships between conformity to playboy norms and problematic pornography viewing, with an exacerbation effect for those low in self-esteem. Findings suggest that men’s pornography viewing may be tied to their expressions of traditional masculinity.
Violent pornography exposure was associated with all types of TDV, though patterns differed by gender. Boys exposed to violent pornography were 2–3 times more likely to report sexual TDV perpetration and victimization and physical TDV victimization, while girls exposed to violent pornography were over 1.5 times more likely to be perpetrate threatening TDV compared to their non-exposed counterparts.
The current study addresses how sexualizing online media practices, i.e., exposure to sexually explicit internet material and receiving negative appearance feedback on social media, relate to the acceptance of sexist attitudes among adolescents. Specifically, it extends previous research on the acceptance of rape myths by exploring a construct related to these beliefs, i.e., resistance towards the metoo-movement.
The results showed that exposure to sexually explicit internet material, but not receiving negative appearance feedback on social media, was related to more resistance towards the metoo-movement and the acceptance of rape myths through notions of women as sex objects. Self-objectification did not function as a valid mediator in the examined relations. Gender and self-esteem did not moderate the proposed relations.
This paper used a classic pre-post-test design to elucidate what effects this material has on female participants (N= 242). Through the use of the Attitudes towards Women Scale and the Attitudes toward Men scale it was found that females did not experience significant attitude changes towards other females, upon exposure. However, they do show changes in their hostile male beliefs for clips depicting sexual aggression, and benevolent beliefs for clips depicting a flirtatious interaction, a romantic erotic scene, and, for a scene depicting rape. These findings are reviewed and discussed in light of the Gender-Schema Theory, Sexual Objectification Theory and Empathetic Viewer Theory.
In a correlational study, 266 participants (78.2% women; MAge = 30.79, SD = 8.89) responded to demographics, whether or not they were in a relationship, whether or not they used online pornography and how much they attributed primary and secondary emotions to their sexual partners. The results showed that people who consume pornography dehumanize their sexual partners but only when they are not in a romantic relationship. These results are relevant because dehumanization has severe consequences such as discrimination, violence, harsher punishments and prosocial behavior inhibition. Once we know when it happens, we have the chance to create strategies to neutralize it.
The Confluence Model of Sexual Aggression: An Application With Adolescent Males (2020) – Study on 10th grade boys finds that violent pornography exposure was associated with perpetrating noncontact sexual aggression in the last 6 months, along with Contact sexual aggression, Acceptance of rape myths, Engaging in more bullying, Homophobic teasing, Having more aggressive friends. Table:
One-way ANOVA results reveal that there is a statistically significant difference in attitudes toward women between respondents that had viewed pornography during the previous year and respondents that had not. Specifically, respondents that had viewed pornography during the previous year held more negative, less egalitarian attitudes toward women.
We also found that both hostile and benevolent sexism were positively related to pornography consumption and sexting behavior. Hence, boys and girls with more sexist attitudes consumed the most pornographic content and performed more sexting behaviors.
Therefore, our results show that girls who consumed more pornographic content cyberstalked their partner more. In addition, more benevolent sexist boys and girls who performed more sexting behaviors tended to cyber-monitor their partner more.
This research about objectification may be relevant:
Many individuals who cease using porn for an extended period of time report mental and cognitive benefits, such as improved concentration and focus, better grades, increased energy and motivation, social anxiety improved or gone, increased confidence, improved mood, depression reduced or gone, greater desire to be social, more intense or vibrant emotions, and increased desire to be in a loving relationship.
Relevant YBOP FAQs with hundreds of first-person accounts:
Some studies have looked at (1) porn use and mental & emotional health, and (2) porn use and cognitive functioning. Below are the two lists of these studies.
List one: Studies reporting links between porn use and poorer mental and emotional health:
Students who did not participate in either online sexual activity were more satisfied with their offline life and more connected to friends and family. Those who engaged in both online sexual activities were more dependent on the Internet and reported lower offline functioning.
Despite students’ common participation in online sexual activities (OSA) as a venue for social and sexual development, those relying on the Internet and the affiliations it provides appear at risk of decreased social integration.
Although most individuals utilize the Internet for occupational, educational, recreational, and shopping purposes, a sizable male minority exists, known as Cybersex compulsives and at-risk users, who invest an inordinate amount of their time, money, and energy in the pursuit of Cybersex experiences with negative intrapersonal ramifications in terms of depression, anxiety, and problems with felt intimacy with their real-life partners.
Using data from the Youth Internet Safety Survey, a nationally representative, cross-sectional telephone survey of 1501 children and adolescents (ages 10-17 years), characteristics associated with self-reported pornography seeking behavior, both on the Internet and using traditional methods (e.g., magazines), are identified.
Those who report intentional exposure to pornography, irrespective of source, are significantly more likely to cross-sectionally report delinquent behavior and substance use in the previous year. Further, online seekers versus offline seekers are more likely to report clinical features associated with depression and lower levels of emotional bonding with their caregiver.
Compared to non-pornographic Internet site users, infrequent pornographic Internet site users were twice as likely to have abnormal conduct problems; frequent pornographic Internet site users were significantly more likely to have abnormal conduct problems. Thus, both infrequent and frequent pornographic Internet site use are prevalent and significantly associated with social maladjustment among Greek adolescents.
The study found that adolescents with higher degrees of social interaction and bonding were not as likely to consume sexually explicit material as were their less social peers (Mesch, 2009). Additionally, Mesch found that greater quantities of pornography consumption were significantly correlated with lower degrees of social integration, specifically related to religion, school, society, and family. The study also found a statistically significant relationship between pornography consumption and aggressiveness in school….
Frequent use was also associated with many problem behaviours. High frequent viewing of pornography may be seen as a problematic behaviour that needs more attention from both parents and teachers and also to be addressed in clinical interviews.
Participants were 192 emerging-adult men ages 18–27 attending a religious university in the Western United States. While they all believed pornography to be unacceptable, those who did not use pornography (compared to those who did) reported (a) higher levels of past and recent individual religious practices, (b) past family religious practices, (c) higher levels of self-worth and identity development regarding dating and family, and (d) lower levels of depression.
After adjusting for demographics, Pornography (SEMB) users, compared to nonusers, reported greater depressive symptoms, poorer quality of life, more mental- and physical-health diminished days, and lower health status.
We found a positive relationship between subjective sexual arousal when watching Internet pornographic pictures and the self-reported problems in daily life due to the excessiveness of cybersex as measured by the IATsex. Subjective arousal ratings, the global severity of psychological symptoms, and the number of sex applications used were significant predictors of the IATsex score, while the time spent on Internet sex sites did not significantly contribute to explanation of variance in the IATsex score.
In our sample, the global symptom severity (SCL GSI), as well as interpersonal sensitivity, depression, paranoid thinking and psychoticism, were correlated particularly with the IATsex score.
The current study examined the relationship of Internet pornography viewing and experiential avoidance to a range of psychosocial problems (depression, anxiety, stress, social functioning, and problems related to viewing) through a cross-sectional online survey conducted with a non-clinical sample of 157 undergraduate college males. Results indicated that frequency of viewing was significantly related to each psychosocial variable, such that more viewing was related to greater problems.
For each of these variables, the pattern was that participants in the cybersex group and participants in the addicted/no cybersex group were more likely to experience depression, attempt suicide, or have withdrawal symptoms than participants in the non-addicted/no cybersex group. Participants in the cybersex group were more likely to report being depressed than participants in the addicted/no cybersex group.
The study sought to investigate the relationship between pornography addiction and psychosocial and academic adjustment of students in universities in Lagos State. In order to achieve this objective, five research questions were formulated and two hypotheses postulated. The subjects for the study consisted of 616 full-time third-year undergraduate students from two universities in Lagos State.
The findings show that university students in Lagos State experienced high level of pornography addiction. The results also show that university students in Lagos State experienced moderate level of psychosocial and academic adjustment. There is a significant but negative relationship between pornography addiction and psychosocial adjustment. There is a slight positive relationship between pornography addiction and academic adjustment.
In general, higher levels of positive youth development and better family functioning were related to a lower level of pornography consumption. The relative contribution of positive youth development and family factors to consumption of pornographic materials was also explored.
The present study attempted to explore the linkage between family functioning and pornography consumption. Three features of family functioning, mutuality, communication and harmony were negatively related to pornography consumption.
Compared with respondents without CSB, individuals with CSB reported more depressive and anxiety symptoms, higher levels of stress, poorer self-esteem, and higher rates of social anxiety disorder, attention-deficit/hyperactivity disorder, compulsive buying, pathological gambling, and kleptomania.
CSB is common among young adults and is associated with symptoms of anxiety, depression, and a range of psychosocial impairments.
The hours spent viewing Internet pornography use was positively correlated to participant’s narcissism level. Additionally, those who have ever used Internet pornography endorsed higher levels of all three measures of narcissism than those who have never used Internet pornography.
We found that adults who had watched an X-rated movie in the past year were more likely to be divorced, more likely to have had an extramarital affair, and less likely to report being happy with their marriage or happy overall.We also found that, for men, pornography use reduced the positive relationship between frequency of sex and happiness.
The aims of the study were to investigate predictors for frequent use of pornography and to investigate such use in relation to psychosomatic and depressive symptoms among Swedish adolescents. …..we found that being a girl, living with separated parents, attending a vocational high school program, and being a frequent user of pornography at baseline had major effects on psychosomatic symptoms at follow-up
Frequent use of pornography at baseline predicted psychosomatic symptoms at follow-up to a higher extent compared to depressive symptoms.
Thus, the purpose of this study was to examine theorized antecedents (i.e., gender role conflict and attachment styles) and consequences (i.e., poorer relationship quality and sexual satisfaction) of men’s pornography use among 373 young adult heterosexual men. Findings revealed that both frequency of pornography use and problematic pornography use were related to greater gender role conflict, more avoidant and anxious attachment styles, poorer relationship quality, and less sexual satisfaction.
Path analyses revealed that men’s frequency of pornography use was (a) positively linked to muscularity and body fat dissatisfaction indirectly through internalization of the mesomorphic ideal, (b) negatively linked to body appreciation directly and indirectly through body monitoring, (c) positively linked to negative affect indirectly through romantic attachment anxiety and avoidance, and (d) negatively linked to positive affect indirectly through relationship attachment anxiety and avoidance.
The avoidant masturbator subtype was operationalized as those cases who reported more than 1 hr (or one episode) of masturbation per day or more than 1 hr of pornography viewing per day, or more than 7 hr (or episodes) per week.
With respect to the mental health and sexological variables, the avoidant masturbator subtype [compulsive porn users] was significantly more likely to report a history of anxiety problems and of sexual functioning problems (71% vs. 31%) with delayed ejaculation being the most commonly reported sexual functioning problem.
At the outset of this study, we hypothesized that “perceived addiction” to Internet pornography would be positively associated with psychological distress. Using a large cross-sectional sample of adult web users and a large cross-sectional sample of undergraduate web users, we found consistent support for this hypothesis. Additionally, in a 1-year longitudinal analysis of undergraduate pornography users, we found links between perceived addiction and psychological distress over time. Collectively, these findings strongly underscore the claim that “perceived addiction” to Internet pornography likely contributes to the experience of psychological distress for some individuals.
Hypersexual” behavior represents a perceived inability to control one’s sexual behavior. To investigate hypersexual behavior, an international sample of 510 self-identified heterosexual, bisexual, and homosexual men and women completed an anonymous online self-report questionnaire battery. In addition to age and sex (male), hypersexual behavior was related to higher scores on measures of sexual excitation, sexual inhibition due to the threat of performance failure, trait impulsivity, and both depressed mood and anxiety.
This study investigated whether factors from three distinct psychosocial domains (i.e., psychological well-being, sexual interests/behaviors, and impulsive-psychopathic personality) predicted symptoms of compulsive use of sexually explicit Internet material among adolescent boys. Longitudinally, higher levels of depressive feelings and, again, excessive sexual interest predicted relative increases in compulsive use symptoms 6 months later.
Our data confirm previous observations that psychiatric comorbidities, especially mood, anxiety, and personality disorders, are the rule rather the exception for people with compulsive sexual behaviors. 21, 22, 23, 24 However, EM could be associated with a non-specific anxious activation.
Those who reported pornography addiction were much more likely to engage in a variety of risky antisocial behaviours, including heavy drinking, fighting, and weapon use, using illegal drugs gambling and viewing illegal images to name but a few. They also reported poorer physical and psychological health.
In this study, the frequent visitation of Internet pornography showed a high association of vulnerabilities towards mental health indicators. Lower levels of happiness and higher levels of stress, sadness, and hopelessness (possibly connected to the higher rates of suicidal ideation and suicidal attempts) seemed to be increasing factors for the frequent use of Internet pornography by adolescents.
Internet-pornography-viewing disorder (IPD) is considered one type of Internet-use disorder. For IPD’s development, it was assumed theoretically that a dysfunctional use of Internet pornography to cope with depressive mood or stress might be considered as a risk factor. Data showed that tendencies towards IPD were associated negatively with feeling generally good, awake, and calm and positively with perceived stress in daily life and using Internet pornography for excitation seeking and emotional avoidance. Moreover, tendencies towards IPD were negatively related to mood before and after Internet-pornography use.
This analysis also indicated that PSB was associated with worse quality of life, lower self-esteem, and higher rates of comorbidities across several disorders. Furthermore, the PSB group showed deficits across several neurocognitive domains, including motor inhibition, spatial working memory, and an aspect of decision making. Thus, it is possible that PSB gives rise to a host of secondary problems, ranging from alcohol dependence and depression to deteriorations in quality of life and self-esteem.
This study aimed to confirm the factorial validity of the Pornography Consumption Inventory in an online sample of men with sexual interest in animals, and to construct an association model between motivations for pornography consumption and the following psychological variables: depression, sexual impulsiveness, and strength of sexual interest in animals. Results support the 4-factor model of the Pornography Consumption Inventory. Sexual impulsiveness was positively associated with the emotional avoidance, excitement seeking, and sexual pleasure factors. Depression and sexual impulsiveness were positively correlated.
The present study tested the metacognitive model of desire thinking and craving for problematic pornography use, and expanded upon the same model to include negative affect related to desire thinking.
Visiting porn sites were associated with interest in sex, low mood, lack of concentration, and unexplained anxiety.
Pornography was significantly associated with several psychological problems in adolescents. Due to the structural immaturity of the adolescent brain and relative inexperience, they are unable to process the myriad nature of sexual content online which may lead to attention problems, anxiety, and depression.
Theoretically and empirically, we examine loneliness as it relates to pornography use in terms of pornography’s relational scripting and its addictive potential. Results from our analyses revealed significant and positive associations between pornography use and loneliness for all three models. Findings provide grounds for possible future bidirectional, recursive modeling of the relation between pornography use and loneliness.
The length of the longest streak participants performed before taking part in the survey correlates with time preferences. The second survey will answer the question if longer periods of abstinence render participants more able to delay rewards, or if more patient participants are more likely to perform longer streaks.
Longer periods of abstinence most likely cause less risk aversion (which is good). The second survey will provide the final proof.
Personality correlates with length of streaks. The second wave will reveal if abstinence influences personality or if personality can explain variation in the length of streaks.
Results of the Second Wave – Main Findings
Abstaining from pornography and masturbation increases the ability to delay rewards
Participating in a period of abstinence renders people more willing to take risks
Abstinence renders people more altruistic
Abstinence renders people more extroverted, more conscientious, and less neurotic
Gay and bisexual men (GBM) have reported viewing significantly more sexually explicit media (SEM) than heterosexual men. There is evidence that viewing greater amounts of SEM may result in more negative body attitude and negative affect. However, no studies have examined these variables within the same model.
Greater consumption of SEM was directly related to more negative body attitude and both depressive and anxious symptomology. There was also a significant indirect effect of SEM consumption on depressive and anxious symptomology through body attitude. These findings highlight the relevance of both SEM on body image and negative affect along with the role body image plays in anxiety and depression outcomes for GBM.
A sample of 2733 sexual minority males living in Australia and New Zealand completed an online survey that contained measures of pornography use, body dissatisfaction, eating disorder symptoms, thoughts about using anabolic steroids and quality of life. Almost all (98.2%) participants reported pornography use with a median use of 5.33 hours per month.
Multivariate analyses revealed that increased pornography use was associated with greater dissatisfaction with muscularity, body fat and height; greater eating disorder symptoms; more frequent thoughts about using anabolic steroids; and lower quality of life.
Objective – To investigate the current situation of pornography use among male seniors from Chongqing colleges and universities, and to analyze the correlation of pornography use with negative emotions.
In the cohort, 99.98% students had exposed to pornographic information, and 32.2% of them had a tendency to addiction.
The ratio of depression was 2.8% in the subjects who used pornography less than 1 time/week, and was 14.6% in those with a frequency of more than 3 times/week. The distribution of negative emotions in the senior students was positively correlated with pornography exposure time, frequency of use, duration and addiction.After adjustment with physical activity and sleep quality, the frequency of pornography use was still positively correlated with the scores of depression, anxiety and stress.
As expected, results indicated participants that reported higher self-esteem scores had lower odds being placed in the Complex or Auto-Erotic Porn User Classes compared with the class of Porn Abstainers. In one notable study, Nelson et al. (2010) suggested that higher levels of self-worth were related to lower pornography use patterns. The present study’s findings reinforce the negative correlation of self-esteem and pornography use. Due to the present study only offering statistical associations we cannot state cause and effect, however, our results corroborate that they are linked in some capacity.
Correlational analyses revealed significant direct relationships between internet addiction and sexual compulsivity. This suggests that the more secondary school children are addicted to internet use, the more they are predisposed to sexual compulsive behaviours
It was further revealed that a significant direct relationship between loneliness and sexual compulsivity exists. This means that the more secondary school students feel lonely or isolated, the more they are preoccupied with sexual thoughts that could predispose them to sexual compulsive behaviours.
The objective of this study is to obtain a scientific and empirical approximation to the type of consumption of the Spanish population, the time they use in such consumption, the negative impact it has on the person and how anxiety is affected when it is not possible to access to it. The study has a sample of Spanish internet users (N = 2.408). An 8-item survey was developed through an online platform that provides information and psychological counselling on the harmful consequences of pornography consumption. To reach diffusion among the Spanish population, the survey was promoted through social networks and media.
The results show that one third of the participants had suffered negative consequences in family, social, academic or work environment. In addition, 33% spent more than 5 hours connected for sexual purposes, using pornography as a reward and 24% had anxiety symptoms if they could not connect.
As hypothesized, adolescents’ exposure to online pornography was associated with depressive symptoms, and was in line with previous studies (e.g., Ma et al. 2018; Wolak et al. 2007). Adolescents, who were intentionally exposed to online pornography, reported a higher level of depressive symptom. These results are in line with past studies on the negative impact of internet usage on psychological well-being, such as depressive symptoms (Nesi and Prinstein 2015; Primack et al. 2017; Zhao et al. 2017), self-esteem (Apaolaza et al. 2013; Valkenburg et al. 2017), and loneliness (Bonetti et al. 2010; Ma 2017). Additionally, this study provides empirical support for the long-term effects of intentional exposure to online pornography on depression over time. This suggests that early intentional exposure to online pornography might lead to later depressive symptoms during adolescence…..
The negative relationship between life satisfaction and exposure to online pornography was in line with earlier studies (Peter and Valkenburg 2006; Ma et al. 2018; Wolak et al. 2007). The present study shows that adolescents who are less satisfied in their lives at Wave 2 may lead them to be exposed to both types of pornographic exposure at Wave 3.
The present study shows the concurrent and longitudinal effects of permissive sexual attitudes on both types of exposure to online pornography. As expected from previous research (Lo and Wei 2006; Brown and L’Engle 2009; Peter and Valkenburg 2006), sexually permissive adolescents reported higher levels of exposure to both types of online pornography.
Drawing on a representative survey of German internet users, we therefore analyze how women and men use SEIM to satisfy escapist needs. Lower life satisfaction, the lack of a committed relationship, and feelings of loneliness contribute to predicting the frequency of using SEIM among men. Loneliness likewise fosters the consumption of SEIM among women, yet the effect is less pronounced. For female internet users, consumption of SEIM even increases in committed relationships and rather indicates a comparably high level of life satisfaction than dissatisfaction with life circumstances. Gender hence substantially moderates the connection between need structures and the consumption of SEIM.
The above study said that higher porn use in women is related to both greater loneliness and greater life satisfaction. Very odd finding. When evaluating the research, it’s important to know that a relatively small percentage of all coupled females regularly consumes internet porn. Large, nationally representative data are scarce, but the General Social Survey reported that only 2.6% of married women had visited a “pornographic website” in the last month. The question was only asked in 2002 & 2004 (see Pornography and Marriage, 2014). The takeaway is that studies reporting positive or neutral effects on relationship satisfaction (or other variables) are deriving this correlation from the small percentage of females who are: (1) regular porn users, and, (2) in long-term relationships (perhaps 3-5% of adult females). With small samples inconsistent findings are bound to occur.
Therefore, even after controlling for a variety of demographic factors, impulsivity, pornography acceptance, and the general perception of sexual content as pornographic, the accumulated total viewing of sexual content was still significantly linked to higher levels of depressive symptoms as found in previous studies.
Results suggested that viewing sexual material that is not considered pornography was consistently associated with more depressive symptoms. In other words, when individuals tended to regularly view images of women without any clothing and did not perceive this as pornography, they were more likely to report higher depressive symptoms. Conversely, when individuals reported not viewing such images and believed such images to be pornographic, reports of depressive symptoms tended to be lower.
The analyses also revealed that the higher the prevalence of pornography use, the higher the prevalence of sexually related online activities, and the higher the loneliness and insecure attachment orientations (anxiety and/or avoidance).
Half of the patients reported that they had an idea about the female genitalia (50.7%) and they were influenced through the media (47.9%). The majority of those (71.8%) stated that they did not have normal genitalia and considered labiaplasty more than 6 months ago (88.7%). The pornography consumption rate in the last month was 19.7% and was significantly related with lower genital self-image and self-esteem.
Young people who do not have sexually explicit content on the Internet have a higher level general self-assessment than young people using this content with frequency several times a month. This translates into more confidence yourself and a better opinion about yourself and a stronger sense of your own values.
Students who do not use erotic sites, experience more social support, they feel more loved and accepted by relatives than their colleagues reaching for erotic content on the Internet. This translates into their more optimistic assessment of theirs future relationships.
Subjects who do not use erotic content have a greater sense of self-control than their peers from group three and four who use from erotic sites several times a month and more often. As a result, it translates It’s about greater control over your emotions and perseverance and discipline.
Test subjects shunned by erotica on the Internet are also characterized higher level of identity integration than other participants in the research. This is expressed by the more mature structures of the “I” and the greater internal structures a sense of continuity and cohesion.
The present study examined two partner-specific variables that were hypothesized to be linked to women’s ED symptoms: perceived male partner thinness-related pressures and pornography use.
Current and previous partner pornography use were related to higher ED symptomatology, adjusting for age and women’s reports of being bothered by this use. Partner thinness-related pressure and previous partner pornography use were associated with ED symptomatology both directly and through thin-ideal internalization, whereas current partner pornography use was directly associated with ED symptomatology.
Perceptions of male partner thinness-related pressure and pornography use constitute unique factors associated with women’s ED symptomatology that may operate indirectly by positioning women to endorse thinness as a personal standard and directly (e.g., by trying to accommodate their partner’s appearance preferences).
An increasing number of studies are concerned with various aspects of cybersex addiction, the difficulty some persons have in limiting cybersex use despite a negative impact on everyday life.
A sample of 145 subjects completed the study. Addictive cybersex use was associated with higher levels of sexual desire, depressive mood, avoidant attachment style, and male gender but not with impulsivity.
Our finding of an association between addictive cybersex use and depressive mood is congruent with other studies that showed the importance of links between addictive cybersex and diverse assessments of psychological distress and mood [22,26]. This finding is also in line with other reports of the association between excessive internet gaming [83] or internet gambling [21] and depressive mood. Such associations suggest that addictive cybersex is at least partly a coping behavior that aims to regulate negative emotions [20,35,36,84]. This finding opens the debate, as has occurred for other internet addictive-like behaviors, about an appropriate diagnostic framework [16] and adequate understanding of such an association [85].
The possible development of psychopathological distress, which could lead to a more pronounced depressive mood secondary to the negative impact of addictive cybersex (interpersonal isolation and reduction of offline sexual activities), cannot be ruled out [86], and thus, further prospective studies are warranted.
Examining sexual motivation profiles and their correlates using latent profile analysis (2019)– The write-up of this 2019 study leaves a lot to be desired. That said this figure #4 from the full paper reveals a lot: problematic porn use is strongly related to poorer scores on (1) harmonious sexual passion (HSP); (2) obsessive sexual passion (OSP); (3) sexual satisfaction (SEXSAT); (4) life satisfaction (LIFESAT). Simply put, problematic porn use was linked to far lower scores on lower sexual passion, sexual satisfaction & life satisfaction (group to the right). In comparison, the group that scored highest on all these measures had the least problematic porn use (group to left).
Given the pervasive nature of pornography, we study how viewing pornography affects unethical behavior at work. Using survey data from a sample that approximates a nationally representative sample in terms of demographics, we find a positive correlation between viewing pornography and intended unethical behavior. We then conduct an experiment to provide causal evidence.The experiment confirms the survey—consuming pornography causes individuals to be less ethical. We find that this relationship is mediated by increased moral disengagement from dehumanization of others due to viewing pornography. Combined, our results suggest that choosing to consume pornography causes individuals to behave less ethically.
Men who reported more depressive symptoms at baseline were more likely to use pornography excessively at 3 months and then to report more depressive symptoms at 6 months.
The relationship between self-perceived problematic pornography use and depressive symptoms was more straightforward in women, as depressive symptoms at baseline did not predict excessive pornography use or compulsive pornography use at 3 months. Our findings suggest temporal precedence of self-perceived problematic pornography use before increased depressive symptoms in women. In other words, women who reported depressive symptoms at baseline were not more or less likely to report self-perceived problematic pornography use at 3 months, but women who reported higher self-perceived problematic pornography use at 3 months reported more depressive symptoms at 6 months.Likewise, excessive pornography use at 3 months predicted higher depressive symptoms at 6 months for males.
Largely overlooked in the literature, this study investigated factors influencing women’s use of sexual coercion. Specifically, pornography use and personality disorder traits linked with poor impulse control, emotional regulation, and superior sense of sexual desirability were considered.
Multiple regression analyses revealed that pornography use (interest, efforts to engage with pornography, and compulsivity), narcissistic traits, and histrionic traits significantly predicted the use of nonverbal sexual arousal, emotional manipulation and deception, and exploitation of the intoxicated. Effort to engage with pornography was a significant individual predictor of nonverbal sexual arousal and emotional manipulation and deception, while histrionic traits were a significant individual predictor of exploitation of the intoxicated.
Dysfunctional coping strategies and all the personality trait variables except denial were significantly associated with CU (Cybersex Use) and FCU (frequency of CU). Specifically, self-distraction, behavioral disengagement, self-blame, neuroticism–anxiety, aggression–hostility, and sensation seeking were significantly associated with higher odds of CU and higher FCU. By contrast, sociability was associated with lower odds of CU and lower FCU.
This research was carried out to explore psychosocial and mental health issues of adults viewing pornography on the internet. In- depth interviews were conducted with twenty five university male students to explore the psychosocial issues in cases of internet pornography.
Results: After data analysis, main three categories generated on psychosocial issues associated with viewing internet pornography which were psychological issues, social issues and mental illness.
Conclusion: Findings of the study indicate that males viewing internet pornography can be affected with psychosocial and mental health issues.
Israeli adolescents (N=2112; 788 boys and 1,324 girls), age 14-18 (M = 16.52, SD = 1.63), participated in an online study. Each participant completed a randomly ordered battery of self-report questionnaires on frequency of pornography use, sexually related online activities, personality traits, narcissism, emotion regulation strategies, individualism, social intimacy and socio-demographic factors. Adolescents who consumed pornography (i.e., solo online activity) are mostly boys, introvert, neurotic, less agreeable, and with less conscientious judgement. In addition, they are more overt narcissist, use more suppression and less reappraisal to regulate emotions, are high on vertical individualism, low on social intimacy.
Significant negative correlations were reported between purpose in life and all CPUI-9 factors (compulsivity, efforts, and negative affect) as well as overall CPUI-total score.While these results were not predicted by research hypotheses, they are in line with current research. Purpose in life has been shown to be negatively related to addictions (García-Alandete et al., 2014; Glaw et al., 2017; Kleftaras & Katsogianni, 2012; Marco et al., 2015), lack of motivation, and overall life dissatisfaction (Frankl, 2006; Hart & Cary, 2014).
For our six-month longitudinal study, we recruited a sample of adults from Turkprime.com. Contrary to our hypothesis, religiosity was not related to self-perceived problematic pornography use in any of the models.
For both men and women, excessive pornography use at three months was associated with increased depression at six months. For men, depression at baseline was associated with self-perceived problematic pornography use at three months.
Hence, the goal of this study was to test a theoretical model in which self‐esteem, loneliness, and social anxiety are hypothesized to predict the type of OSAs favored and their potential addictive use. To this end, an online survey was conducted in a sample of self‐selected men who used OSAs on a regular basis (N = 209). Results showed that low self‐esteem is positively associated with loneliness and high social anxiety, which were in turn positively related to involvement in two specific OSAs: use of pornography and the search for online sexual contacts. Higher engagement in these OSA activities was related to symptoms of addictive usage.
Participants described symptoms of anxiety and depression, poor concentration, and an inability to focus on essential tasks. They also reported feelings of shame, low self-worth, and guilt. Many also reported that their use of IP led to reduced sleep and, as a consequence, low mood and feeling unmotivated or lethargic during the day. This seems to have had an adverse flow-on effect, influencing their engagement with work or study, social activities, and significant others. Many participants reported feelings of loneliness and alienation as well as self-imposed isolation.
Participants reported experiencing symptoms of both social and general anxiety, symptoms of depression, including amotivation, isolating behaviors, and low mood, which they attributed to their ongoing use of IP over time. As one participant stated, “It has caused me to be lonely, depressed, and decreased my motivation to try and do things I care about or that require some willpower. It has contributed to my social anxiety”. Another wrote that “it slowly made me depressed since the age of 17-18. I couldn’t find out what’s wrong with me the whole time. But since I quit, I more and more realized how lonely I really am and that isolating myself has had to do with it”. The following participant expressed his confusion about the relationship of IP use to his symptoms of poor mental health and his suspicion that it may have negatively influenced his perception of women.
Participants reported reduced sleep affecting their mood and ability to perform normal tasks after engaging in IP use for long hours. Many participants reported feeling lethargic and having “no energy” during normal waking hours.
The present article reports on a preliminary study exploring the relationships between Dark Triad (narcissism, Machiavellianism, psychopathy) and honesty-humility personality traits and pornography craving and deviant pornography use in a sample of 121 participants (46 men and 75 women) who completed an online survey. Narcissism and psychopathy were positively related to pornography craving and deviant pornography consumption, while honesty-humility appeared to be negatively associated with these pornography-related variables. Furthermore, the data suggested that these relationships were only present in men and not in women.
Studies have shown that viewing internet pornography is like addiction. Addictions have been implicated in the development of psychosocial issues. It is important to develop an indigenous tool for the assessment of psychosocial issues in individuals viewing internet pornography. The current study was aimed to develop a scale for the assessment of psychosocial issues associated with internet pornography in male university students.
Our study briefly concludes that pornography has negative impact on social, psychological and mental health of the individuals. Further, it would be useful in creating awareness in society related to psychosocial issues due to internet pornography that may pose a threat for the development of mental health in adults. In Pakistan, according to our knowledge, no study has been conducted on this topic so far.
To address current gaps around screening for problematic pornography use (PPU), we initially developed and tested a six-item Brief Pornography Screen (BPS) that asked about PPU in the past six months
In support of prior work, BPS scores were moderately correlated with measures of generalized feelings of distress and depression; we also found moderate correlations between BPS scores and measures of feeling addicted to pornography and prioritizing pornography viewing over other activities.
As expected, we found that after mindfulness-based relapse prevention (MBRP) participants spent significantly less time engaging in problematic pornography use and exhibited a decrease in anxiety, depression and obsessive-compulsive (OC) symptoms…. In conclusion, MBRP leads to a decrease in time spent watching porn and a decrease in emotional distress in CSBD patients.
Participants were 18-25 years old, there were six adolescents who were obtained based on the initial screening, namely self-reporting through a pornography internet addiction questionnaire… The results show that adolescents experience changes in cognition and affection for sexual stimulation caused by the internet with pornographic content. The impact of cognition is shown from their obsessive-compulsive thoughts on sexual content. They always have the desire to see those photos or video over again, which leads them to trouble sleeping due to visualizing scenes of sexual intercourse. The impact of affection can be seen from their desire to act in sexual activity, their being so passionate and pleased after seeing pornographic content, and their expectation to feel such immense affection. Furthermore, they might find difficulty in establishing interpersonal relationships with other people and tend to withdraw themselves from the social environment.
Third, for some members (n = 31), abstinence was motivated by a desire to alleviate perceived negative psychosocial consequences attributed to their pornography use. These perceived consequences included increased depression, anxiety and emotional numbness, and decreased energy, motivation, concentration, mental clarity, productivity, and ability to feel pleasure (e.g., “I know it has tremendous negative effects on my concentration, motivation, self-esteem, energy level” [050, 33 years].” Some members also perceived negative impacts of their pornography use on their social functioning. Some described a sense of decreased connection with others (e.g., “(PMO)…makes me less interested and friendly to people, more self-absorbed, gives me social anxiety and makes me just not care about anything really, other than staying home alone and jerking off to porn” [050, 33 years]), while others reported a deterioration of specific relationships with significant others and family members, especially romantic partners.
Many members reported experiencing various positive cognitive-affective and/or physical effects that they attributed to abstinence. The most common positive effects related to improvements in day-to-day functioning, including improved mood, increased energy, mental clarity, focus, confidence, motivation, and productivity (e.g., “No porn, no masturbation and I had more energy, more mental clarity, more happiness, less tiredness” [024, 21 years]). Some members perceived that abstaining from pornography resulted in feeling less emotionally numb and in an ability to feel their emotions more intensely (e.g., “I just ‘feel’ on a deeper level. with work, friends, past times, there have been waves of emotions, good & bad, but it’s a great thing” [019, 26 years]). For some, this resulted in enhanced experiences and an increased ability to feel pleasure from ordinary day-to-day experiences (e.g., “My brain can get so much more excited about little things and things that aren’t pure pleasure…like socializing or writing a paper or playing sports” [024, 21 years]). Of note, more members in the 18–29 age group reported positive affective effects during abstinence (n = 16) compared to the other two age groups, 30–39 (n = 7) and ≥ 40 (n = 2).
Additionally, 17.0, 20.4, and 13.5% of students reported severe or extremely severe levels of depression, anxiety and stress, respectively, with compulsive pornography use significantly affecting all three mental health parameters in both sexes. Exploratory Factor Analysis identified three factors suggesting emotional coping, dependence and preoccupation for the mCIUS items and three factors reflecting interoceptive, impotent, and extrinsic characteristics for the EmSS items. Regression analysis indicated that various demographics, items pertaining to reduced control and social impairment, and other variables pertaining to pornography use predicted mental health outcomes.
Conclusion: Our analyses indicate a significant relationship between mental health and pornography use, including behaviors reflecting behavioral addictions, highlighting the necessity for a better understanding and consideration of the potential contribution of internet pornography to negative mental health among university students.
List two: Studies finding links between porn use and poorer cognitive outcomes:
The first 3 studies demonstrate that either chronic porn use or exposure sexual stimuli decrease one’s ability to delay gratification.
Exposure to Sexual Stimuli Induces Greater Discounting Leading to Increased Involvement in Cyber Delinquency Among Men (2017) – In two studies exposure to visual sexual stimuli resulted in: 1) greater delayed discounting (inability to delay gratification), 2) greater inclination to engage in cyber-delinquency, 3) greater inclination to purchase counterfeit goods & hack someone’s Facebook account. Taken together this indicates that porn use increases impulsivity and may reduce certain executive functions (self-control, judgment, foreseeing consequences, impulse control). Excerpt:
These findings provide insight into a strategy for reducing men’s involvement in cyber delinquency; that is, through less exposure to sexual stimuli and promotion of delayed gratification. The current results suggest that the high availability of sexual stimuli in cyberspace may be more closely associated with men’s cyber-delinquent behavior than previously thought.
Trading Later Rewards for Current Pleasure: Pornography Consumption and Delay Discounting (2015) – The more pornography that participants consumed, the less able they were to delay gratification. This unique study also had porn users reduce porn use for 3 weeks. The study found that continued porn use was causally related to greater inability to delay gratification (note that the ability to delay gratification is a function of the prefrontal cortex). Excerpt from the first study (median subject age 20) correlated subjects’ pornography use with their scores on a delayed gratification task:
“The more pornography that participants consumed, the more they saw the future rewards as worth less than the immediate rewards, even though the future rewards were objectively worth more.”
Put simply, more porn use correlated with less ability to delay gratification for larger future rewards. In the second part of this study researchers assessed the subjects’ delayed discounting 4 weeks later and correlated with their porn use.
“These results indicate that continued exposure to the immediate gratification of pornography is related to higher delay discounting over time.”
A second study (median age 19) was performed to assess if porn use causes delayed discounting, or the inability to delay gratification. Researchers divided current porn users into two groups:
One group abstained from porn use for 3 weeks,
A second group abstained from their favorite food for 3 weeks.
All participants were told the study was about self-control, and they were randomly chosen to abstain from their assigned activity. The clever part was that the researchers had the second group of porn users abstain from eating their favorite food. This ensured that 1) all subjects engaged in a self-control task, and 2) the second group’s porn use was unaffected. At the end of the 3 weeks, participants were involved in a task to assess delay discounting. Important note: While the “porn abstinence group” viewed significantly less porn than the “favorite food abstainers,” most did not completely abstain from porn viewing. The results:
“As predicted, participants who exerted self-control over their desire to consume pornography chose a higher percentage of larger, later rewards compared to participants who exerted self-control over their food consumption but continued consuming pornography.”
The group that cut back on their porn viewing for 3 weeks displayed less delay discounting than the group that simply abstained from their favorite food. Put simply, abstaining from internet porn increases porn users’ ability to delay gratification. From the study:
Thus, building on the longitudinal findings of Study 1, we demonstrated that continued pornography consumption was causally related to a higher rate of delay discounting. Exercising self-control in the sexual domain had a stronger effect on delay discounting than exercising self-control over another rewarding physical appetite (e.g., eating one’s favorite food).
The take-aways:
It wasn’t exercising self-control that increased the ability to delay gratification. Reducing porn use was the key factor.
Internet porn is a unique stimulus.
Internet porn use, even in non-addicts, has long-term effects.
Erotica users were disproportionately male, scored higher on several psychometric measures of sexuality-related constructs, and exhibited more impulsive choice patterns on the delay discounting for money task than erotica non-users did. These findings suggest that discounting processes generalize to erotic outcomes for some individuals.
We show that exposure to sexy cues leads to more impatience in intertemporal choice between monetary rewards. Highlighting the role of a general reward circuitry, we demonstrate that individuals with a sensitive reward system are more susceptible to the effect of sex cues, that the effect generalizes to nonmonetary rewards, and that satiation attenuates the effect.
[This one also appears above in first section of this page, and is repeated here due to its “delayed discounting” finding.] How Abstinence Affects Preferences (2016)[preliminary results] – Excerpts from the article:
Results of the First Wave – Main Findings
The length of the longest streak participants performed before taking part in the survey correlates with time preferences. The second survey will answer the question if longer periods of abstinence render participants more able to delay rewards, or if more patient participants are more likely to perform longer streaks.
Longer periods of abstinence most likely cause less risk aversion (which is good). The second survey will provide the final proof.
Personality correlates with length of streaks. The second wave will reveal if abstinence influences personality or if personality can explain variation in the length of streaks.
Results of the Second Wave – Main Findings
Abstaining from pornography and masturbation increases the ability to delay rewards
Participating in a period of abstinence renders people more willing to take risks
Abstinence renders people more altruistic
Abstinence renders people more extroverted, more conscientious, and less neurotic
People should be aware that sexual arousal could reduce their attention and physiological sensitivity to monetary losses. In other words, people should pay extra attention to the losses and gains of financial decisions when they are sexually aroused.
Also, students’ cognitive abilities were positively linked to their achievement in mathematics. Finally, watching television had a negative relationship with students’ performance. Particularly, watching horror, action, or pornographic films was associated with lower test scores.
Patients seeking help for hypersexual behavior often exhibit features of impulsivity, cognitive rigidity, poor judgment, deficits in emotion regulation, and excessive preoccupation with sex. Some of these characteristics are also common among patients presenting with neurological pathology associated with executive dysfunction. These observations led to the current investigation of differences between a group of hypersexual patients (n = 87) and a non-hypersexual community sample (n = 92) of men using the Behavior Rating Inventory of Executive Function-Adult Version.
Hypersexual behavior was positively correlated with global indices of executive dysfunction and several subscales of the BRIEF-A. These findings provide preliminary evidence supporting the hypothesis that executive dysfunction may be implicated in hypersexual behavior.
Pornographic picture processing interferes with working memory performance (2013) – German scientists have discovered that Internet erotica can diminish working memory. In this porn-imagery experiment, 28 healthy individuals performed working-memory tasks using 4 different sets of pictures, one of which was pornographic. Participants also rated the pornographic pictures with respect to sexual arousal and masturbation urges prior to, and after, pornographic picture presentation. Results showed that working memory was worst during the porn viewing and that greater arousal augmented the drop. An excerpt:
Results contribute to the view that indicators of sexual arousal due to pornographic picture processing interfere with working memory performance. Findings are discussed with respect to Internet sex addiction because working memory interference by addiction-related cues is well known from substance dependencies.
Working memory is the ability to keep information in mind while using it to complete a task or deal with a challenge. It helps people hold their goals in mind, resist distractions and inhibit impulsive choices, so it’s critical to learning and planning. A consistent research finding is that addiction-related cues hinder working memory, which is a function of the prefrontal cortex.
Sexual Picture Processing Interferes with Decision-Making Under Ambiguity (2013)– Study found that viewing pornographic imagery interfered with decision making during a standardized cognitive test. This suggests porn use might affect executive functioning, which is a set of mental skills that help with meeting goals. These skills are controlled by an area of the brain called the prefrontal cortex. Excerpts:
Decision-making performance was worse when sexual pictures were associated with disadvantageous card decks compared to performance when the sexual pictures were linked to the advantageous decks. Subjective sexual arousal moderated the relationship between task condition and decision-making performance. This study emphasized that sexual arousal interfered with decision-making, which may explain why some individuals experience negative consequences in the context of cybersex use.
This study investigated whether working memory capacity (WMC) moderated the relationship between physiological arousal and sexual decision making. A total of 59 men viewed 20 consensual and 20 non-consensual images of heterosexual interaction while their physiological arousal levels were recorded using skin conductance response. Participants also completed an assessment of WMC and a date-rape analogue task for which they had to identify the point at which an average Australian male would cease all sexual advances in response to verbal and/or physical resistance from a female partner.
Participants who were more physiologically aroused by and spent more time viewing the non-consensual sexual imagery nominated significantly later stopping points on the date-rape analogue task. Consistent with our predictions, the relationship between physiological arousal and nominated stopping point was strongest for participants with lower levels of WMC. For participants with high WMC, physiological arousal was unrelated to nominated stopping point. Thus, executive functioning ability (and WMC in particular) appears to play an important role in moderating men’s decision making with regard to sexually aggressive behavior.
We investigated whether a tendency towards cybersex addiction is associated with problems in exerting cognitive control over a multitasking situation that involves pornographic pictures. We used a multitasking paradigm in which the participants had the explicit goal to work to equal amounts on neutral and pornographic material. [And] we found that participants who reported tendencies towards cybersex addiction deviated stronger from this goal.
The results of the current study point towards a role of executive control functions, i.e. functions mediated by the prefrontal cortex, for the development and maintenance of problematic cybersex use (as suggested by Brand et al., 2014). Particularly a reduced ability to monitor consumption and to switch between pornographic material and other contents in a goal adequate manner may be one mechanism in the development and maintenance of cybersex addiction
From this characterization, it is be possible to trace the problems evident in PSB and additional clinical features, such as emotional dysregulation, to particular cognitive deficits…. If the cognitive problems identified in this analysis are actually the core feature of PSB, this may have notable clinical implications.
Effects of Pornography on Senior High School Students, Ghana. (2016) – Excerpt:
The study revealed that majority of the students admitted to watching pornography before. Furthermore, it was observed that majority of them agreed that pornography affects students’ academic performance negatively…
This finding indicates better cognitive flexibility after sexual stimulation by controls compared with sexually compulsive participants. These data support the idea that sexually compulsive men do not to take advantage of the possible learning effect from experience, which could result in better behavior modification. This also could be understood as a lack of a learning effect by the sexually compulsive group when they were sexually stimulated, similar to what happens in the cycle of sexual addiction, which starts with an increasing amount of sexual cognition, followed by the activation of sexual scripts and then orgasm, very often involving exposure to risky situations.
In a sample of over 1,000 Chinese college students, we tested a model that pornography craving would operate through quantity and frequency measures of usage of OSAs to lead to problematic use of OSAs, and this then would lead to negative academic emotions. Our model was largely supported.
Results indicated that higher pornography craving, greater quantity and frequency of use of OSAs, and more negative academic emotions were associated with problematic OSAs. The results resonate with those of previous studies reporting a high level of pornography craving in association with other negative health measures.
The study was backed with four research questions sand two hypotheses, the research design adopted for the study was survey research and the population was the entire social studies students in university of Jos having the total of 244 population size and from which 180 were randomly selected as sample of the study. The study revealed that, most students who are involved in pornographic activities do not do well in academics and most times even procrastinate on their works.
We found lower RAVLT A6 score in the pornography addiction group when compared to the nonaddiction group, by 1.80 point of mean difference (13.36% of nonaddiction score). As A6 signifies recent memory capability after disruption (in B1), our results showed diminishing memory capability on pornography addiction. Working memory is known to have an important role in maintaining goal-oriented behavior [24, 25]; therefore, our findings suggested that pornography-addicted juveniles may have problem to do so.
Participants described symptoms of anxiety and depression, poor concentration, and an inability to focus on essential tasks. They also reported feelings of shame, low self-worth, and guilt. Many also reported that their use of IP led to reduced sleep and, as a consequence, low mood and feeling unmotivated or lethargic during the day. This seems to have had an adverse flow-on effect, influencing their engagement with work or study, social activities, and significant others.
Participants reported experiencing symptoms of “brain fog,” an inability to focus, and “ADHD” like symptoms. A number of participants reported a reduced ability to perform complicated tasks such as homework or work-related tasks, even when to not do so would cause significant consequences as one participant noted, “ADHD, Brain Fog, lack of concentration, stumbling about porn even when doing important work.” One participant remarked that his use of IP has affected his ability to concentrate and has “interrupted my ability to focus on lengthy tasks, including reading and writing.” A participant discussed the effects of his IP use as resulting in a “lack of motivation, clarity, and brain fog. Like I said before, dealing with drug/alcohol abuse has played a role, but I experience a hungover feeling now after watching porn”. This was echoed by the other participants, as exemplify.
To our knowledge, this was the first study to attempt at including the assessment of the impact of recently developed ADHD symptoms in addition to the ADHD diagnosis in Internet addicts. Participants with ADHD as well as those with only recently developed ADHD-like symptoms showed significantly higher lifetime and current Internet use severity compared with those who did not fulfill these conditions. Furthermore, addicted participants with recently developed ADHD symptoms (30% of the addicted group) exhibited increased lifetime Internet use severity compared with those addicted participants without ADHD symptoms.
Our results indicate that recently developed ADHD symptoms (without fulfilling the diagnostic criteria for ADHD) are associated with Internet addiction. This may lead to a first indication that the excessive Internet use has an impact on the development of cognitive deficits similar to those found in ADHD. A recent study of Nie, Zhang, Chen, and Li (2016) reported that adolescent Internet addicts with and without ADHD as well as participants with ADHD alone showed comparable deficits in inhibitory control and working memory functions.
This assumption seems to also be supported by certain studies reporting reduced gray matter density in the anterior cingulate cortex in addictive Internet users as well as in ADHD patients (Frodl & Skokauskas, 2012; Moreno-Alcazar et al., 2016; Wang et al., 2015; Yuan et al., 2011). Nevertheless, to confirm our assumptions, further studies assessing the relationship between the onset of excessive Internet use and ADHD in Internet addicts are needed. In addition, longitudinal studies should be applied to clarify causality. If our findings are confirmed by further studies, this will have clinical relevance for the diagnostic process of ADHD. It is conceivable that the clinicians would be required to carry out a detailed assessment of possible addictive Internet usage in patients with suspected ADHD.
Comments: This 2017 EEG study on porn users cited 3 Nicole Prause EEG studies. The authors believe that all 3 Prause EEG studies actually found desensitization or habituation in frequent porn users (which often occurs with addiction). This is exactly what YBOP has always claimed (explained in this critique: Critique of: Letter to the editor “Prause et al. (2015) the latest falsification of addiction predictions” 2016). Steele et al., 2013 was touted in the media by spokesperson Nicole Prause as evidence against the existence of porn/sex addiction. Contrary to claims, this study actually lends support to the existence of both porn addiction and porn use down-regulating sexual desire. How so? The study reported higher EEG readings (relative to neutral pictures) when subjects were briefly exposed to pornographic photos. Studies consistently show that an elevated P300 occurs when addicts are exposed to cues (such as images) related to their addiction. In line with the Cambridge University brain scan studies, this EEG study also reported greater cue-reactivity to porn correlating with less desire for partnered sex. To put another way – individuals with greater brain activation to porn would rather masturbate to porn than have sex with a real person. Shockingly, study spokesman Nicole Prause claimed that porn users merely had “high libido”, yet the results of the study say something quite different – as this new study points out in the excerpts. Four peer-reviewed papers expose the truth: 1, 2, 3,4. (Read an extensive critique here)
In the excerpts below these 3 citations indicate the following Nicole Prause EEG studies (#14 is Steele et al., 2013):
7 – Prause, N.; Steele, V.R.; Staley, C.; Sabatinelli, D. Late positive potential to explicit sexual images associated with the number of sexual intercourse partners. Soc. Cogn. Affect. Neurosc. 2015, 10, 93–100.
8 – Prause, N.; Steele, V.R.; Staley, C.; Sabatinelli, D.; Hajcak, G. Modulation of late positive potentials by sexual images in problem users and controls inconsistent with “porn addiction”. Biol. Psychol. 2015, 109, 192–199.
14 – Steele, V.R.; Staley, C.; Fong, T.; Prause, N. Sexual desire, not hypersexuality, is related to neurophysiological responses elicited by sexual images. Socioaffect. Neurosci. Psychol. 2013, 3, 20770
Event-related potentials (ERPs) have often been used as a physiological measure of reactions to emotional cues, e.g., [24]. Studies utilizing ERP data tend to focus on later ERP effects such as the P300 [14] and Late-Positive Potential (LPP) [7, 8] when investigating individuals who view pornography. These later aspects of the ERP waveform have been attributed to cognitive processes such as attention and working memory (P300) [25] as well as sustained processing of emotionally-relevant stimuli (LPP) [26]. Steele et al. [14] showed that the large P300 differences seen between viewing of sexually explicit images relative to neutral images was negatively related to measures of sexual desire, and had no effect on participants’ hypersexuality. The authors suggested that this negative finding was most probably due to the images shown not having any novel significance to the participant pool, as participants all reported viewing high volumes of pornographic material, consequently leading to the suppression of the P300 component. The authors went on to suggest that perhaps looking at the later occurring LPP may provide a more useful tool, as it has been shown to index motivation processes. Studies investigating the effect pornography use has on the LPP have shown the LPP amplitude to be generally smaller in participants who report having higher sexual desire and problems regulating their viewing of pornographic material [7, 8]. This result is unexpected, as numerous other addiction-related studies have shown that when presented with a cue-related emotion task, individuals who report having problems negotiating their addictions commonly exhibit larger LPP waveforms when presented images of their specific addiction-inducing substance [27]. Prause et al. [7, 8] offer suggestions as to why the use of pornography may result in smaller LPP effects by suggesting that it may be due to a habituation effect, as those participants in the study reporting overuse of pornographic material scored significantly higher in the amount of hours spent viewing pornographic material.
———–
Studies have consistently shown a physiological downregulation in processing of appetitive content due to habituation effects in individuals who frequently seek out pornographic material [3, 7, 8]. It is the authors’ contention that this effect may account for the results observed.
————
Future studies may need to utilise a more up-to-date standardised image database to account for changing cultures. Also, maybe high porn users downregulated their sexual responses during the study. This explanation was at least used by [7, 8] to describe their results which showed a weaker approach motivation indexed by smaller LPP (late positive potential) amplitude to erotic images by individuals reporting uncontrollable pornography use. LPP amplitudes have been shown to decrease upon intentional downregulation [62, 63]. Therefore, an inhibited LPP to erotic images may account for lack of significant effects found in the present study across groups for the “erotic” condition.
Comments: This EEG study on porn users cited 3 Nicole Prause EEG studies. The authors believe that all 3 Prause EEG studies actually found desensitization or habituation in frequent porn users (which often occurs with addiction). This is exactly what YBOP has always claimed (explained in this critique: Critique of: Letter to the editor “Prause et al. (2015) the latest falsification of addiction predictions” 2016). Five other peer-reviewed papers agree that Prause et al., 2015 actually found desensitization/habituation in frequent porn users: 1, 2, 3, 4. 5.
In the following excerpts these 3 citations indicate the following Nicole Prause EEG studies:
7 – Prause, N.; Steele, V.R.; Staley, C.; Sabatinelli, D. Late positive potential to explicit sexual images associated with the number of sexual intercourse partners. Soc. Cogn. Affect. Neurosc. 2015, 10, 93–100.
8 – Prause, N.; Steele, V.R.; Staley, C.; Sabatinelli, D.; Hajcak, G. Modulation of late positive potentials by sexual images in problem users and controls inconsistent with “porn addiction”. Biol. Psychol. 2015, 109, 192–199.
14 – Steele, V.R.; Staley, C.; Fong, T.; Prause, N. Sexual desire, not hypersexuality, is related to neurophysiological responses elicited by sexual images. Socioaffect. Neurosci. Psychol. 2013, 3, 20770
Event-related potentials (ERPs) have often been used as a physiological measure of reactions to emotional cues, e.g., [24]. Studies utilizing ERP data tend to focus on later ERP effects such as the P300 [14] and Late-Positive Potential (LPP) [7, 8] when investigating individuals who view pornography. These later aspects of the ERP waveform have been attributed to cognitive processes such as attention and working memory (P300) [25] as well as sustained processing of emotionally-relevant stimuli (LPP) [26]. Steele et al. [14] showed that the large P300 differences seen between viewing of sexually explicit images relative to neutral images was negatively related to measures of sexual desire, and had no effect on participants’ hypersexuality. The authors suggested that this negative finding was most probably due to the images shown not having any novel significance to the participant pool, as participants all reported viewing high volumes of pornographic material, consequently leading to the suppression of the P300 component. The authors went on to suggest that perhaps looking at the later occurring LPP may provide a more useful tool, as it has been shown to index motivation processes. Studies investigating the effect pornography use has on the LPP have shown the LPP amplitude to be generally smaller in participants who report having higher sexual desire and problems regulating their viewing of pornographic material [7, 8]. This result is unexpected, as numerous other addiction-related studies have shown that when presented with a cue-related emotion task, individuals who report having problems negotiating their addictions commonly exhibit larger LPP waveforms when presented images of their specific addiction-inducing substance [27]. Prause et al. [7, 8] offer suggestions as to why the use of pornography may result in smaller LPP effects by suggesting that it may be due to a habituation effect, as those participants in the study reporting overuse of pornographic material scored significantly higher in the amount of hours spent viewing pornographic material.
———–
Studies have consistently shown a physiological downregulation in processing of appetitive content due to habituation effects in individuals who frequently seek out pornographic material [3, 7, 8]. It is the authors’ contention that this effect may account for the results observed.
————
Future studies may need to utilise a more up-to-date standardised image database to account for changing cultures. Also, maybe high porn users downregulated their sexual responses during the study. This explanation was at least used by [7, 8] to describe their results which showed a weaker approach motivation indexed by smaller LPP (late positive potential) amplitude to erotic images by individuals reporting uncontrollable pornography use. LPP amplitudes have been shown to decrease upon intentional downregulation [62, 63]. Therefore, an inhibited LPP to erotic images may account for lack of significant effects found in the present study across groups for the “erotic” condition.
Some years ago, David Ley and study spokesperson Nicole Prause teamed up to write a Psychology Today blog post about Steele et al., 2013 called “Your Brain on Porn – It’s NOT Addictive“. The blog post appeared 5 months before Prause’s EEG study was formally published. Its oh-so-catchy title is misleading as it has nothing to do with Your Brain on Porn or the neuroscience presented there. Instead, David Ley’s March, 2013 blog post limits itself to a single flawed EEG study – Steele et al., 2013.
Contrary to claims by Ley and study author Nicole Prause, Steeleet al., 2013 reported greater cue-reactivity to porn correlating with LESS desire for sex with a partner (but not lower desire to masturbate to porn). To put it another way – individuals with more brain activation and cravings for porn would rather masturbate to porn than have sex with a real person (In this 2018 presentation Gary Wilson exposes the truth behind 5 questionable and misleading studies, including the two Nicole Prause EEG studies (Steele et al., 2013 and Prause et al., 2015): Porn Research: Fact or Fiction?)
Greater cue-reactivity to porn coupled with lower desire for sex with real partners aligns with the 2014 Cambridge University brain study on porn addicts. The actual findings of Steele et al., 2013 in no way match the concocted headlines, the Prause interviews or Ley’s blog post assertions. Eight subsequent peer-reviewed papers say that the Steele et al. findings actually lend support to the porn addiction model (as opposed to the “high sexual desire” hypothesis): Peer-reviewed critiques of Steele et al., 2013. Also see this extensive critique, which exposes unsupported claims put forth in the press and the study’s methodological flaws.
In 2015, Nicole Prause published a second EEG study (Prause et al., 2015), which found LESS neural response (with brief exposure to still images) for frequent porn users when compared to controls. This is evidence of abnormally reduced sexual desire in compulsive porn users. Put simply, chronic porn users were bored by static images of ho-hum porn (its findings parallel Kuhn & Gallinat., 2014). These findings are consistent with tolerance, a sign of addiction.
Tolerance is defined as a person’s diminished response to a drug or stimulus that is the result of repeated use. Nine peer-reviewed papers agree that this study actually found desensitization/habituation in frequent porn users (consistent with addiction): 9 peer-reviewed critiques of Prause et al., 2015. The results of Prause’s second EEG study indicate LESS sexual arousal – not higher desire. In fact, Nicole Prause stated in this Quora post she no longer ascribes to the “high libido as sex addiction” hypothesis:
“I was partial to the high sex drive explanation, but this LPP study we just published is persuading me to be more open to sexual compulsivity.”
Since Prause has flip-flopped, where is Ley’s and others continued support for the “porn/sex addiction = high libido” claim?
“On an adapted version of the Arizona Sexual Experiences Scale [43], CSB subjects compared to healthy volunteers had significantly more difficulty with sexual arousal and experienced more erectile difficulties in intimate sexual relationships but not to sexually explicit material (Table S3 in File S1).”
CSB subjects reported that as a result of excessive use of sexually explicit materials….. experienced diminished libido or erectile function specifically in physical relationships with women (although not in relationship to the sexually explicit material)…
“Hypersexuality was significantly correlated with proneness to sexual boredom andmore problems with erectile function.”
6) “Adolescents and web porn: a new era of sexuality (2015)” – This Italian study analyzed the effects of Internet porn on high school seniors, co-authored by urology professor Carlo Foresta, president of the Italian Society of Reproductive Pathophysiology. The most interesting finding is that 16% of those who consume porn more than once a week report abnormally low sexual desire compared with 0% in non-consumers (and 6% for those who consume less than once a week). From the study:
“21.9% define it as habitual, 10% report that it reduces sexual interest towards potential real-life partners, and the remaining, 9.1% report a kind of addiction. In addition, 19% of overall pornography consumers report an abnormal sexual response, while the percentage rose to 25.1% among regular consumers.”
“We assume that subjects with a high porn consumption need increasing stimulation to receive the same amount of reward. That could mean that regular consumption of pornography more or less wears out your reward system. That would fit perfectly the hypothesis that their reward systems need growing stimulation.”
“The more hours participants reported consuming pornography, the smaller the BOLD response in left putamen in response to sexual images. Moreover, we found that more hours spent watching pornography was associated with smaller gray matter volume in the striatum, more precisely in the right caudate reaching into the ventral putamen. We speculate that the brain structural volume deficit may reflect the results of tolerance after desensitization to sexual stimuli.”
In line with the Cambridge University brain scan studies, this EEG study also reported greater cue-reactivity to porn correlating with less desire for partnered sex. To put it another way – individuals with greater brain activation to porn would rather masturbate to porn than have sex with a real person. Shockingly, study spokesperson Nicole Prause claimed that porn users merely had “high libido,” yet the results of the study say the exact opposite (subjects’ desire for partnered sex was dropping in relation to their porn use).
Together these two Steele et al. findings indicate greater brain activity to cues (porn images), yet less reactivity to natural rewards (sex with a person). That”s sensitization & desensitization, which are hallmarks of an addiction. 8 peer-reviewed papers explain the truth: Peer-reviewed critiques of Steele et al., 2013. Also see this extensive YBOP critique.
In reality, the findings of Prause et al. 2015 align perfectly with Kühn & Gallinat (2014), which found that more porn use correlated with less brain activation in response to pictures of vanilla porn. Prause et al. findings also align with Banca et al. 2015 which is #13 in this list. Moreover, another EEG study found that greater porn use in women correlated with less brain activation to porn. Lower EEG readings mean that subjects are paying less attention to the pictures. Put simply, frequent porn users were desensitized to static images of vanilla porn. They were bored (habituated or desensitized). See this extensive YBOP critique. 9 peer-reviewed papers agree that this study actually found desensitization/habituation in frequent porn users (consistent with addiction): Peer-reviewed critiques of Prause et al., 2015
In couples where only one partner used pornography, we found more problems related to arousal (male) and negative (female) self-perception.
The couples who did not use pornography... may be considered more traditional in relation to the theory of sexual scripts. At the same time, they did not seem to have any dysfunctions.
“Among men who masturbated frequently, 70% used pornography at least once a week. A multivariate assessment showed that sexual boredom, frequent pornography use, and low relationship intimacy significantly increased the odds of reporting frequent masturbation among coupled men with decreased sexual desire.”
“Among men [with decreased sexual desire] who used pornography at least once a week [in 2011], 26.1% reported that they were unable to control their pornography use. In addition, 26.7% of men reported that their use of pornography negatively affected their partnered sex and 21.1% claimed to have attempted to stop using pornography.”
Mental health specialists should take in consideration the possible effects of pornography consumption on men sexual behaviors, men sexual difficulties and other attitudes related to sexuality. In the long term pornography seems to create sexual dysfunctions, especially the individual’s inability to reach an orgasm with his partner. Someone who spends most of his sexual life masturbating while watching porn engages his brain in rewiring its natural sexual sets so that it will soon need visual stimulation to achieve an orgasm.
Many different symptoms of porn consumption, such as the need to involve a partner in watching porn, the difficulty in reaching orgasm, the need for porn images in order to ejaculate turn into sexual problems. These sexual behaviors may go on for months or years and it may be mentally and bodily associated with the erectile dysfunction, although it is not an organic dysfunction. Because of this confusion, which generates embarrassment, shame and denial, lots of men refuse to encounter a specialist
Pornography offers a very simple alternative to obtain pleasure without implying other factors that were involved in human’s sexuality along the history of mankind. The brain develops an alternative path for sexuality which excludes “the other real person” from the equation. Furthermore, pornography consumption in a long term makes men more prone to difficulties in obtaining an erection in a presence of their partners.
Further, we found no associations between the CSBI Control scale and the BIS-BAS. This would indicate that lack of sexual behavior control is related to specific sexual excitation and inhibitory mechanisms and not to more general behavioral activation and inhibitory mechanisms. This would seem to support conceptualizing hypersexuality as a dysfunction of sexuality as proposed by Kafka. Further, it does not appear that hypersexuality is a manifestation of high sex drive, but that it involves high excitation and a lack of inhibitory control, at least with respect to inhibition owing to expected negative outcomes.
Emerging research supports the notion that sexual compulsivity (SC) and hypersexual disorder (HD) among gay and bisexual men (GBM) might be conceptualized as comprising three groups—Neither SC nor HD; SC only, and Both SC and HD—that capture distinct levels of severity across the SC/HD continuum.
Nearly half (48.9 %) of this highly sexually active sample was classified as Neither SC nor HD, 30 % as SC Only, and 21.1 % as Both SC and HD. While we found no significant differences between the three groups on reported number of male partners, anal sex acts, or anal sex acts
17) The effects of sexually explicit material use on romantic relationship dynamics (2016) – As with many other studies, solitary porn users report poorer relationship and sexual satisfaction. Employing the Pornography Consumption Effect Scale (PCES), the study found that higher porn use was related to poorer sexual function, more sexual problems, and a “worse sex life”. An excerpt describing the correlation between the PCES “Negative Effects” on “Sex Life” questions and frequency of porn use:
There were no significant differences for the Negative Effect Dimension PCES across the frequency of sexually explicit material use; however, there were significant differences on the Sex Life subscale where High Frequency Porn Users reported greater negative effects than Low Frequency Porn Users.
18) Male masturbation habits and sexual dysfunctions (2016) – It’s by a French psychiatrist who is the current president of the European Federation of Sexology. While the abstract shifts back and forth between Internet pornography use and masturbation, it’s clear that he’s mostly referring to porn-induced sexual dysfunctions (erectile dysfunction and anorgasmia). The paper revolves around his clinical experience with 35 men who developed erectile dysfunction and/or anorgasmia, and his therapeutic approaches to help them. The author states that most of his patients used porn, with several being addicted to porn. The abstract points to internet porn as the primary cause of the problems (keep in mind that masturbation does not cause chronic ED, and it is never given as a cause of ED). Excerpts:
Intro: Harmless and even helpful in his usual form widely practiced, masturbation in its excessive and pre-eminent form, generally associated today to pornographic addiction, is too often overlooked in the clinical assessment of sexual dysfunction it can induce.
Results: Initial results for these patients, after treatment to “unlearn” their masturbatory habits and their often associated addiction to pornography, are encouraging and promising. A reduction in symptoms was obtained in 19 patients out of 35. The dysfunctions regressed and these patients were able to enjoy satisfactory sexual activity.
Conclusion: Addictive masturbation, often accompanied by a dependency on cyber-pornography, has been seen to play a role in the etiology of certain types of erectile dysfunction or coital anejaculation. It is important to systematically identify the presence of these habits rather than conduct a diagnosis by elimination, in order to include habit-breaking deconditioning techniques in managing these dysfunctions.
“related to high levels of exposure to and experience with sexually explicit materials.“
The men experiencing erectile dysfunction had spent a considerable amount of time in bars and bathhouses where porn was “omnipresent,” and “continuously playing“. The researchers stated:
“Conversations with the subjects reinforced our idea that in some of them a high exposure to erotica seemed to have resulted in a lower responsivity to “vanilla sex” erotica and an increased need for novelty and variation, in some cases combined with a need for very specific types of stimuli in order to get aroused.”
20) Online sexual activities: An exploratory study of problematic and non-problematic usage patterns in a sample of men (2016) – This Belgian study from a leading research university found problematic Internet porn use was associated with reduced erectile function and reduced overall sexual satisfaction. Yet problematic porn users experienced greater cravings. The study appears to report escalation, as 49% of the men viewed porn that “was not previously interesting to them or that they considered disgusting.” (See studies reporting habituation/desensitization to porn and escalation of porn use) Excerpts:
“This study is the first to directly investigate the relationships between sexual dysfunctions and problematic involvement in OSAs. Results indicated that higher sexual desire, lower overall sexual satisfaction, and lower erectile function were associated with problematic OSAs (online sexual activities). These results can be linked to those of previous studies reporting a high level of arousability in association with sexual addiction symptoms (Bancroft & Vukadinovic, 2004; Laier et al., 2013; Muise et al., 2013).”
In addition, we finally have a study that asks porn users about possible escalation to new or disturbing porn genres. Guess what it found?
“Forty-nine percent mentioned at least sometimes searching for sexual content or being involved in OSAs that were not previously interesting to them or that they considered disgusting, and 61.7% reported that at least sometimes OSAs were associated with shame or guilty feelings.”
Note – This is the first study to directly investigate the relationships between sexual dysfunctions and problematic porn use. Two other studies claiming to have investigated correlations between porn use and erectile functioning cobbled together data from earlier studies in an unsuccessful attempt to debunk porn-induced ED. Both were criticized in the peer-reviewed literature: paper 1 was not an authentic study, and has been thoroughly discredited; paper 2 actually found correlations that support porn-induced ED. Moreover, paper 2 was only a “brief communication” that did not report important data.
21) Altered Appetitive Conditioning and Neural Connectivity in Subjects With Compulsive Sexual Behavior (2016)– “Compulsive Sexual Behaviors” (CSB) means the men were porn addicts, because CSB subjects averaged nearly 20 hours of porn use per week. The controls averaged 29 minutes per week. Interestingly, 3 of the 20 CSB subjects mentioned to interviewers that they suffered from “orgasmic-erection disorder,” while none of the control subjects reported sexual problems.
Young men who prefer pornography to real-world sexual encounters might find themselves caught in a trap, unable to perform sexually with other people when the opportunity presents itself, a new study reports. Porn-addicted men are more likely to suffer from erectile dysfunction and are less likely to be satisfied with sexual intercourse, according to survey findings presented Friday at the American Urological Association’s annual meeting, in Boston.
Among participants who responded to the open-ended question (n=718), problematic usage was self-identified by 88 respondents. Male participants who reported problematic usage of pornography highlighted effects in three areas: on sexual function, arousal and relationships. Responses included “I think it has been a negative influence in many ways but at the same time I can’t stop using it” (Male, Aged 18–19).
Findings suggested that latency erotic disruption by way of sexually explicit material (SEM) and/or child sexual abuse may be associated to adult online sexual behaviors.
Furthermore, results demonstrated that latency SEM exposure was a significant predictor of adult sexual dysfunctions.
We hypothesized that exposure to latency SEM exposure would predict adult use of SEM. Study findings supported our hypothesis, and demonstrated that latency SEM exposure was a statistically significant predictor of adult SEM use. This suggested that individuals who were exposed to SEM during latency, may continue this behavior into adulthood. Study findings also indicated that latency SEM exposure was a significant predictor of adult online sexual behaviors.
25) Clinical encounters with internet pornography (2008)– Comprehensive paper, with four clinical cases, written by a psychiatrist who became aware of the negative effects internet porn was having on some of his male patients. The excerpt below describes a 31 year old man who escalated into extreme porn and developed porn-induced sexual tastes and sexual problems. This is one of the first peer-reviewed papers to depict porn use leading to tolerance, escalation, and sexual dysfunctions.
A 31-year-old male in analytic psychotherapy for mixed anxiety problems reported that he was experiencing difficulty becoming sexually aroused by his current partner. After much discussion about the woman, their relationship, possible latent conflicts or repressed emotional content (without arriving at a satisfactory explanation for his complaint), he provided the detail that he was relying on a particular fantasy to become aroused. Somewhat chagrined, he described a “scene” of an orgy involving several men and women that he had found on an Internet pornography site that had caught his fancy and become one of his favorites. Over the course of several sessions, he elaborated upon his use of Internet pornography, an activity in which he had engaged sporadically since his mid-20s.
Relevant details about his use and the effects over time included clear descriptions of an increasing reliance on viewing and then recalling pornographic images in order to become sexually aroused. He also described the development of a “tolerance” to the arousing effects of any particular material after a period of time, which was followed by a search for new material with which he could achieve the prior, desired level of sexual arousal.
As we reviewed his use of pornography, it became evident that the arousal problems with his current partner coincided with use of pornography, whereas his “tolerance” to the stimulating effects of particular material occurred whether or not he was involved with a partner at the time or was simply using pornography for masturbation. His anxiety about sexual performance contributed to his reliance on viewing pornography. Unaware that the use itself had become problematic, he had interpreted his waning sexual interest in a partner to mean that she was not right for him, and had not had a relationship of greater than two months’ duration in over seven years, exchanging one partner for another just as he might change websites.
He also noted that he now could be aroused by pornographic material that he once had no interest in using. For example, he noted that five years ago he had little interest in viewing images of anal intercourse but now found such material stimulating. Similarly, material that he described as “edgier,” by which he meant “almost violent or coercive,” was something that now elicited a sexual response from him, whereas such material had been of no interest and was even off-putting. With some of these new subjects, he found himself anxious and uncomfortable even as he would become aroused.
26) Examining sexual motivation profiles and their correlates using latent profile analysis (2019) – The write-up of this 2019 study leaves a lot to be desired. That said this figure #4 from the full paper reveals a lot: problematic porn use is strongly related to poorer scores on (1) harmonious sexual passion (HSP); (2) obsessive sexual passion (OSP); (3) sexual satisfaction (SEXSAT); (4) life satisfaction (LIFESAT). Simply put, problematic porn use was linked to far lower scores on sexual passion (sexual desire), sexual satisfaction & life satisfaction (group to the right). In comparison, the group that scored highest on all these measures had the least problematic porn use (group to left).
In addition to such gender differences, our results suggest that sexual desire plays only a small role (in men), or even no role (in women) in compulsive cybersex use. Furthermore, the CMQ enhancement subscale does not seem to contribute to the CIUS score. This suggests that cybersex addiction is not driven by sex or only to a small extent in men. This finding is consistent with other studies showing that liking sexually explicit videos (Voon et al., 2014) and sexual activities (i.e., number of sexual contacts, satisfaction with sexual contacts, and use of interactive cybersex) is not associated with compulsive cybersex (Laier et al., 2014; Laier, Pekal, & Brand, 2015).
As suggested in other studies on addictive behaviors, the “liking” dimension (hedonic drive) seems to play a smaller role than the “wanting” (incentive salience) and “learning” dimensions (predictive associations and cognitions, e.g., learning about negative emotion relief when using cybersex; Berridge, Robinson, & Aldridge, 2009; Robinson & Berridge, 2008).
At first glance, the small role of sexual desire and enhancement motives in compulsive cybersex seems counterintuitive. It appears that the sexual nature of the gratification is not a major drive of the behavior. This observation could be explained by the fact that the CIUS is not a measure of sexual activity or of cybersex use, but an assessment of compulsive cybersex use.The findings are consistent with the process related to maintenance of addictive behaviors. It has been postulated that addictions are maintained by a shift from gratification (i.e., looking for direct sexual rewards) to compensation (i.e., looking for escape from negative moods; Young & Brand, 2017).
Despite the limitations mentioned, we think that this research contributes to the field of PH research and to the exploration of new perspectives on (problematic) hypersexual behavior in society. We stress that our research showed that “Withdrawal” and “Loss of pleasure”, as part of the “Negative Effects” factor, can be important indicators of PH (problematic hypersexuality). On the other hand, “Orgasm frequency”, as part of the “Sexual Desire” factor (for women) or as a covariate (for men), did not show discriminative power to distinguish PH from other conditions. These results suggest that for the experience of problems with hypersexuality, attention should focus more on “Withdrawal”, “Loss of pleasure”, and other “Negative Effects” of hypersexuality, and not so much on sexual frequency or “excessive sexual drive” [60] because it is mainly the “Negative Effects” that are associated with experiencing hypersexuality as problematic.
In short, the evidence is piling up that internet porn erodes normal sexual desire, leaving users less responsive to pleasure. They may crave porn, but that is more likely evidence of an addiction-related brain change known as “sensitization” (hyper-reactivity to addiction-related cues). Cravings certainly cannot be assumed to be evidence of greater libido.
The “perceived pornography addiction” meme continues to infect the peer-reviewed literature, this time in a new study: “Damaged Goods: Perception of Pornography Addiction as a Mediator Between Religiosity and Relationship Anxiety Surrounding Pornography Use“, 2017 (Leonhardt, et al.). The phrase “perceived pornography addiction” was promoted by Joshua Grubbs, and first used in his 2013 study. It’s abundantly clear that the present study’s support for invoking “perceived porn addiction” or “belief in porn addiction” rests upon Joshua Grubbs’s continued promotion of the concept. Leonhardt, et al. cites 3 Grubbs studies a whopping 36 times in the body of the paper.
Before we examine the Leonhardt, et al. 5-item “perceived pornography addiction” questionnaire, let’s briefly revisit the Grubbs studies. Here is an extensive critique of the claims made in the Grubbs “perceived addiction” studies and in related misleading press.)
Reality Check #1:When the Grubbs studies use the phrase “perceived pornography addiction,” it actually denotes the total score on the Grubbs “Cyber Pornography Use Inventory” (CPUI-9) – a questionnaire that cannot, and was never validated for, sorting “perceived” from actual addiction. That’s right, “perceived pornography addiction” indicates nothing more than a number: the total score on 9-item porn addiction questionnaire. This fact is lost in translation in the Grubbs studies due to the frequent repetition of the misleading descriptor “perceived addiction” instead of the accurate, spin-free label: “the Cyber Pornography Use Inventory score.”
Reality Check #2: The Grubbs CPUI-9 assesses actual porn addiction, not belief in porn addiction. It was developed using substance addiction tests. Don’t take our word for it. Here is the CPUI-9. (Each question is scored using a Likert scale of 1 to 7, with 1 being “not at all,” and 7 being “extremely.”)
Compulsivity Section
I believe I am addicted to Internet pornography.
I feel unable to stop my use of online pornography.
Even when I do not want to view pornography online, I feel drawn to it
Access Efforts Section
At times, I try to arrange my schedule so that I will be able to be alone in order to view pornography.
I have refused to go out with friends or attend certain social functions to have the opportunity to view pornography.
I have put off important priorities to view pornography.
Emotional Distress Section
I feel ashamed after viewing pornography online.
I feel depressed after viewing pornography online.
I feel sick after viewing pornography online.
Upon closer examination, questions 1-6 of the CPUI-9 assess the signs and symptoms common to all addictions, while questions 7-9 (Emotional Distress) assess guilt, shame and remorse. As a result, “actual addiction” closely aligns with questions 1-6 (Compulsivity & Access Efforts). Removing the 3 “Emotional Distress” questions (which assess shame and guilt) leads to very different results for the Grubbs studies: 1) A much weaker relationship between religiosity and actual porn addiction. 2) A much stronger relationship between “[Porn] Use In Hours” and actual porn addiction. In other words hours of porn use strongly predict porn addiction, while religiosity’s relationship to porn addiction is far weaker. If we drill down we find that religiosity has virtually no relationship to the core addiction behaviors as assessed by questions 4-6.
Put simply – actual porn addiction has very little correlation to religiosity. One may well ask if it is sound methodology to blend apples and oranges in an assessment instrument, thereby confounding correlations with addiction on the one hand and correlations with shame guilt on the other. One may also ask whether it is appropriate to then choose a descriptor (“perceived”) that implies, wrongly, that an assessment instrument can sort genuine from perceived addiction.
Reality Check #3: You can also take Joshua Grubbs’s word that the CPUI is an actual pornography addiction questionnaire. In Grubbs’s initial 2010 paper he validated the Cyber-Pornography Use Inventory (CPUI) as a questionnaire assessing actual porn addiction (see this section for more). The phrases “perceived addiction” and “perceived porn addiction” do not appear in his 2010 paper. To the contrary, Grubbs et al., 2010 clearly states in several places that the CPUI assesses genuine porn addiction:
“The CPUI design was based on the principle that addictive behavior is characterized by an inability to stop the behavior, significant negative effects as a result of the behavior, and a generalized obsession with the behavior (Delmonico & Miller, 2003)…. The CPUI does indeed show promise as an instrument assessing Internet pornography addiction.”
Reality Check #4: Later, in a 2013 study, Grubbs reduced the number of CPUI questions from 32 (or 39 or 41) to the current 9, and (astonishingly) re-labeled his actual, validated porn addiction test as a questionnaire assessing “perceived pornography addiction.” While Grubbs himself didn’t claim his test could sort perceived from actual addiction, his employment of the misleading term (“perceived addiction”) for scores on his CPUI-9 instrument have led others to assume his instrument has the magical property of being able to discriminate between “perceived” and “real” addiction. This has done enormous damage to the field of porn addiction assessment because others rely on his papers as evidence of something they do not, and cannot, deliver. No test exists that can distinguish “real” from “perceived” addiction. Merely labeling it as such cannot make it so.
Why did Joshua Grubbs re-label the CPUI a “perceived” porn addiction test?
While Grubbs himself didn’t claim his test could sort perceived from actual addiction, his employment of the misleading term (“perceived addiction”) for scores on his CPUI-9 instrument have led others to assume his instrument has the magical property of being able to discriminate between “perceived” and “real” addiction. This has done enormous damage to the field of porn addiction assessment because others rely on his papers as evidence of something they do not, and cannot, deliver. No test exists that can distinguish “real” from “perceived” addiction. Merely labeling it as such cannot make it so.
Joshua Grubbs said in an email that a reviewer of his second CPUI-9 study caused him and his co-authors of the 2013 study to alter the “porn addiction” terminology of the CPUI-9 (because the reviewer sneered at the “construct” of porn addiction). This is why Grubbs changed his description of the test to a “perceived pornography addiction” questionnaire.In essence an anonymous reviewer/editor at this single journal initiated the unsupported, misleading label of “perceived pornography addiction.” The CPUI has never been validated as an assessment test differentiating actual porn addiction from “perceived porn addiction.” Here’s Grubbs tweeting about this process, including the reviewer’s comments:
On my 1st paper on compulsive porn use: “This construct [porn addiction] is as meaningful to measure as experiences of alien abduction: it’s meaningless.”
Actually what led to my perceived addiction work, I thought about the comments as revised the focus.
Even though Grubbs used the phrase “perceived addiction” 80 times in his 2013 paper, he hinted at the true natiure of the CPUI-9 in this excerpt:
“Last, we found that the CPUI-9 was strongly positively associated with general hypersexual tendencies, as measured by the Kalichman Sexual Compulsivity Scale. This points to the high degree of interrelatedness between compulsive pornography use and hypersexuality more generally.”
Notice how the above excerpt states that the CPUI-9 assesses “compulsive pornography use.”
Reality Check #5:There is no questionnaire that assesses “perceived addiction” to anything – substance or behavior – including pornography use. This why a ‘Google Scholar’ search returns zero results for the following “perceived addictions”:
Reality Check #6:There is no set of questions that can differentiate between “belief in porn addiction” and the signs and symptoms of actual porn addiction. Like other addiction tests, the CPUI assesses behaviors and symptoms common to all addictions (and all addiction tests), such as the inability to control use, compulsion to use, cravings to use, negative psychological, social and emotional effects, and preoccupation with using. In fact, only question #1 of the CPUI-9 even hints at “perceived” addiction: I believe I am addicted to Internet pornography.
In summary, the phrase “perceived pornography addiction” means nothing more than the total score on the CPUI-9, an adaptation of a questionnaire originally validated in 2010 as an actual porn addiction test. Three years later, Grubbs was strongly “encouraged” by the publishing journal to re-label the CPUI-9 a “perceived” pornography addiction test – with no scientific basis, or formal validation whatsoever. That 2013 paper, and all subsequent Grubbs studies, replaced “total score on the CPUI-9” with the phrase “perceived pornography addiction.” If you ever see articles saying things such as:
“its your belief in porn addiction that causes psychological distress”
or a study saying that:
“subjects’ anxiety was related to their perception of porn addiction“
Know that the more accurate way to read them is as follows:
“porn addiction causes psychological distress”
“subjects’ anxiety was related to scores on a porn addiction test“
Not only did the Grubbs studies strongly, and misleadingly, imply that they assessed “the perception of porn addiction,” two other claims in the study also fall apart:
Claim #1) “Porn addiction is strongly related to religiosity.”
Not really. This section reveals that religiosity is only weakly related to actual porn addiction; while this section unravels the religiosity and porn addiction claims.
Claim #2) “Porn addiction is unrelated to hours of porn use.”
Reality Check #7: Studies recognize that amount of porn use is not linearly related to porn addiction (more below in section 5)
Where’s the evidence on which Leonhardt, et al. and the Grubbs papers are built, namely that amount of porn use is a reliable proxy for genuine addiction – with those using more being more “addicted” than those using less? Leonhardt, et al. asked about frequency, while Grubbs used hours of use, but the point is that neither test is synonymous with “degree of genuine addiction.” The fact is, established addiction assessment tools never use “amount of use” as the sole proxy for addiction.
Given that the amount of porn use is an unreliable measure of addiction, any suggestion that porn addiction is a “religious problem” based on slight discrepancies (between hours of use and scores on the 5-item test) when comparing religious and nonreligious users is thus far unsupportable, and certainly premature.
Moreover, last time I checked neither religious shame or guilt induces brain changes that mirror those found in drug addicts. Yet there are some 32 neurological studies reporting addiction-related brain changes in compulsive porn users/sex addicts. These furnish strong evidence of genuine addiction in some porn users.
Section 2: The Leonhardt, et al. 5-item questionnaire assesses only actual porn addiction
Now, back to the current BYU study: Leonhardt, Willoughby, & Young-Petersen, 2017 (Leonhardt, et al.). To assess “perceived pornography addiction” the authors adapted 5 questions taken from the 10-question “Sexual Compulsivity Scale.” The “Sexual Compulsivity Scale” was created in 1995 and designed with uncontrolled sexual relations in mind (in connection with investigating the AIDS epidemic).
By replacing “sex” or “sexual” with “pornography,” the Leonhardt, et al. authors created a questionnaire they labeled as assessing “perception of pornography addiction.” They used both that phrase and “belief in pornography addiction” throughout their study, as opposed to the more accurate “total score on our 5-item questionnaire.”
Ask yourself, do the following 5 questions measure the “belief in pornography addiction or do they assess signs, symptoms and behaviors fairly common in most addictions?
“My thoughts about pornography are causing problems in my life,”
”My desires to view pornography disrupt my daily life,”
“I sometimes fail to meet my commitments and responsibilities because of my pornography use,”
“Sometimes my desire to view pornography is so great I lose control,”
“I have to struggle to not view pornography.”
Still not sure? How about we adapt these five questions to create a substance addiction questionnaire:
“My thoughts about using alcohol are causing problems in my life,”
”My desire to use alcohol disrupts my daily life,”
“I sometimes fail to meet my commitments and responsibilities because of my alcohol use,”
“Sometimes my desire to drink alcohol is so great I lose control,”
“I have to struggle to not use alcohol.”
So, do the above 5 questions assess a “belief in alcohol addiction” or do they assess “actual alcohol addiction?” As anyone can see, these 5 questions assess actual alcohol addiction, just as they assessed actual porn addiction in Leonhardt, et al.
Yet we are told that a person’s total score for all 5 questions is synonymous with “belief in addiction” rather than addiction itself! Very misleading, and without any scientific basis, as these 5 questions were not validated as distinguishing an individual’s “belief in pornography addiction” from an actual addiction.
Note that decades of established addiction assessment tests for both chemical and behavioral addictions rely on similar questions as those above to assess actual, not “merely perceived,” addiction. For example, the Leonhardt, et al.questions assess the core addiction behaviors as outlined by the commonly used assessment tool known as the “4 Cs.” Let’s compare them. Here’s how the Leonhardt, et al questions correlate with the four Cs:
Compulsion to use (2, 3)
Inability to Control use (2, 3, 4)
Cravings to use (1, 2, 3, 4 )
Continued use despite negative consequences (2,3)
In short, Leonhardt, et al. assessed the signs, symptoms and behaviors of an actual porn addiction, not belief in addiction. There is nothing in these 5 questions that hints at “mere belief in addiction.” Not only did the Leonhardt, et al. authors improperly apply the phrase “perceived pornography addiction” throughout their paper, they took it a step further by insinuating that both the Grubbs CPUI-9 and their 5-item questionnaire can actually assess a person’s mere “belief in porn addiction.” It should be noted that Grubbs himself never used the phrase “belief in addiction.”
If these authors were correct that their 5 items assess “perceived addiction,” then no existing addiction test could ever assess true addiction. This would be groundbreaking news indeed to the thousands of addiction experts worldwide who use such tests to assess a wide range of addicts every day.
Bottom line: Every time you read an article or a study using the phase “perceived pornography addiction” or “belief in porn addiction,” just know that all such misleading terms mean only one thing: “the total score on some porn addiction test.” To reveal the true significance of the findings in such articles and studies, simply omit words such as “perceived” or “belief,” and replace them with “porn addiction.” Let’s do this with few of the over 100 instances where Leonhardt, et al. inserted either “perceived” or “belief” into their paper:
Leonhardt, et al. said:
However, it appears that pornography users feel relationship anxiety surrounding their use only insofar as they believe themselves to have a compulsive, distressing pattern of use.
Without the inaccurate terms:
Pornography users whoscore high on our 5-item porn addiction questionnaire experience relationship anxiety surrounding their compulsive porn use.
Leonhardt, et al. said:
According to these results, those who use pornography are unlikely to feel anxious in their relationships because of their use, unless they believe themselves to have a compulsive, distressing pattern of use.
Without the inaccurate terms:
According to these results those who are addicted to pornography feel anxious in their relationships.
Leonhardt, et al. said:
Considering that dating discomfort was a subsidiary construct to relationship anxiety surrounding pornography use, individuals who believe themselves to have compulsive, distressing pornography usemay be particularly reluctant to seek out dating partners.
Without the inaccurate terms:
Considering that dating discomfort was a subsidiary construct to relationship anxiety surrounding pornography use, individuals who are addicted to pornography may be particularly reluctant to seek out dating partners.
In essence the study found that porn addicts experienced anxiety surrounding their compulsive pornography use and its resulting negative consequences, such as inability control use, the disruption of their daily lives, and their inability to meet social and work commitments and responsibilities. Unsurprisingly, their porn addiction affected various aspects of romantic relationships as well.
While it is helpful for caregivers to be aware that some porn users may need to work on their self-esteem as well as any problematic porn use, it is not helpful for the public to be misled that tests can distinguish between “perceived” and actual addiction. And it is particularly unhelpful to confuse the two concepts and make unfounded claims based on such confusion.
UPDATE: On her podcast, Natasha Helfer Parker interviews Dr. Brian Willoughby about this study. In the interview Willoughby makes a startling claim that:
“We saw about 10-15% of our sample fitting into that category (actual porn addiction)…but when we looked at just the perception it was about 2-3 times larger than that number. So we saw this larger of people who self-labeling themselves as having a pornography addiction. The behavioral piece of that seemed that it didn’t line up.”
There is nothing in his study that hints at the above data. Let’s be clear: The only questions related to “perceived porn addiction” or “actual porn addiction” were the 5 questions listed above. These 5 questions cannot provide the information that Willoughby claims he possesses: the ability to distinguish who was actually addicted to porn and who only believed they were addicted to porn (but in fact were not).
These statements by Willoughby are entirely unsupported. Addiction can only be ascertained via a combination of client history taking, interviewing, and possibly assessment questionnaires (such as Cambridge University used with its subjects). No researcher is justified in simply labeling any subject as being “truly addicted” or “falsely believing they are addicted” by using a 5-item questionnaire filled out on Amazon M-turk.
Willoughby not only repeatedly uses the phrases “perceived addiction” and “internal perception of addiction”, he claims that subjects “labeled themselves as addicted”. I’ll repeat: the subject’s answered the 5-item questionnaire. The study and now Willoughby have re-labeled the total score on the 5 questions as all of the following: “perceived porn addiction”, “belief in porn addiction”, “internal perception of porn addiction”. “labeling themselves as addicted”.
Finally, both the study and Willoughby suggest that the relationship between religiosity and scores on the 5-item questionnaire must indicate that most religious porn users only experience shame and do not experience the signs and symptoms of an addiction. That’s quite a leap considering that their study did not assess shame, or any other emotion.
Section 3: Rewriting & reinterpreting the Leonhardt, et al. abstract
What would the Leonhardt, et al. abstract look like if belief and perception were eliminated? First, here’s the abstract as published:
Recent research on pornography suggests that perception of addiction predicts negative outcomes above and beyond pornography use. Research has also suggested that religious individuals are more likely to perceive themselves to be addicted to pornography, regardless of how often they are actually using pornography. Using a sample of 686 unmarried adults, this study reconciles and expands on previous research by testing perceived addiction to pornography as a mediator between religiosity and relationship anxiety surrounding pornography. Results revealed that pornography use and religiosity were weakly associated with higher relationship anxiety surrounding pornography use, whereas perception of pornography addiction was highly associated with relationship anxiety surrounding pornography use. However, when perception of pornography addiction was inserted as a mediator in a structural equation model, pornography use had a small indirect effect on relationship anxiety surrounding pornography use, and perception of pornography addiction partially mediated the association between religiosity and relationship anxiety surrounding pornography use. By understanding how pornography use, religiosity, and perceived pornography addiction connect to relationship anxiety surrounding pornography use in the early relationship formation stages, we hope to improve the chances of couples successfully addressing the subject of pornography and mitigate difficulties in romantic relationships.
Be honest, wouldn’t any reader assume from the above that the mere belief in porn addiction is the sole cause of all porn-related problems examined?
Now, here’s the Leonhardt, et al. abstract written as we think it should have based on its findings, without inaccurate phrases such as “belief in,” “perception of,” and with added context relating to the Grubbs research the Leonhardt, et al. authors relied on:
Recent research on pornography suggests that pornography addiction predicts negative outcomes above and beyond pornography use. A few studies by the Grubbs team have found that “religious porn users” score slightly higher than non-religious porn users on the “Cyber Pornography Use Inventory” (CPUI-9). This finding must be viewed in the context that all cross-sectional studies report far lower rates of porn use in religious individuals. This means that fewer religious persons regularly use porn and thus there are lower rates of “actual porn addiction” among religious populations. Several possible factors have been suggested as to why a population of religious porn users might score higher on porn addiction questionnaires than the population of secular porn users.
Using a sample of 686 unmarried adults, this study expands on previous research by testing compulsive pornography use as a mediator between religiosity and relationship anxiety surrounding pornography. Results revealed that pornography use and religiosity were weakly associated with higher relationship anxiety surrounding pornography use, whereas pornography addiction was highly associated with relationship anxiety surrounding pornography use.
However, when pornography addiction was inserted as a mediator in a structural equation model, pornography use had a small indirect effect on relationship anxiety surrounding pornography use, and pornography addiction partially mediated the association between religiosity and relationship anxiety surrounding pornography use. By understanding how pornography use, religiosity, and pornography addiction connect to relationship anxiety surrounding pornography use in the early relationship formation stages, we hope to improve the chances of couples successfully addressing the subject of pornography and mitigate difficulties in romantic relationships.
THE TAKE-AWAY: Being religious was only “weakly associated” with relationship anxiety surrounding one’s pornography use.On the other hand, pornography addiction (as assessed by the 5 questions) “was highly associated” with relationship anxiety surrounding one’s pornography use. In sum, being religious added a bit anxiety to the relationship and porn use mix – which makes sense. But it was being addicted to porn (whether religious or not) that played the major role in promoting anxiety surrounding porn use. And how did the relationship anxiety manifest in the compulsive pornography users? As study said:
“This relationship anxiety surrounding pornography use was manifest in greater reluctance seeking out dating partners and greater difficulty disclosing pornography use.”
The study’s two major revelations:
Porn addicts don’t want to talk about their porn addiction…especially on the first few dates.
Being addicted to porn has detrimental effects on your love life. Alternately, a porn addict might prefer porn to a real-life sexual partner.
Are these findings a surprise to anyone?
Section 4: Is religiosity really related to actual porn addiction?
Introduction: Anecdotal evidence from sex therapists suggests there are clients who feel addicted to porn, yet view it only occasionally. It’s possible that some of these clients are religious and experience guilt and shame surrounding their occasional porn use. Are these individuals suffering only from “perceived addiction” and not real porn addiction? Perhaps. That said, these individuals want to stop yet they continue to use porn. Whether or not these “occasional porn users” are truly addicted or just feeling guilt and shame, one thing is for sure: neither the Grubbs CPUI-9, nor the Leonhardt, et al. 5-item questionnaire can distinguish “perceived addiction” from actual addiction in these individuals or anyone else.
Religiosity does not correlate with porn use or porn addiction
Religiosity does not predict porn addiction. Quite the opposite. Religious individuals are less likely to use porn and thus less likely to become porn addicts.
Studies examining religious porn users end up with a much smaller percentage of all religious persons when compared to secular porn users (among whom porn use is fairly universal in young males). The two take-aways: 1) religiosity is protective against porn addiction; 2) the sample of religious porn users is skewed toward atypical religious people.
65% of religious young men reported viewing no pornography in the past 12 months
8.6% reported viewing two or three days per month
8.6% reported viewing daily or every other day
In contrast, cross-sectional studies of college-age men report relatively high rates of porn viewing (US – 2008: 87%, China – 2012: 86%, Netherlands – 2013 (age 16): 73%).
Leonhardt, et al. disregards all other studies ever published on rates of porn use among religious users
In an astounding move the Leonhardt, et al. authors claim that all surveys and studies on rates of porn use among religious users are flat out wrong. In other words, Leonhardt, et al. suggests that a very large and consistent percentage of religious individuals have lied about their porn use on every anonymous survey on porn-use rates ever done. In fact, Leonhardt, et al go so far as to imply that religious individuals instead use porn at higher rates than non-religious individuals! The following excerpt offers their justification for this audacious assertion:
Likely due to these conservative sexual values, and possible anxiety surrounding the use of pornography, religious individuals consistently report lower levels of pornography use than secular populations (Carroll et al., 2008; Poulsen, Busby, & Galovan, 2013; Wright, 2013). However, other studies assessing search engines (MacInnis & Hodson, 2015) and online subscriptions (Edelman, 2009) suggest that individuals from religious, conservative populations may be more likely to search out pornography than their secular counterparts. This discrepancy between self-report data and objective measures hints at the stigma against pornography use in religious cultures, as religious individuals may be more likely to conceal their pornography use due to feelings of shame surrounding such use.
So, support for this Leonhardt, et al. claim comes from 2 studies on state-wide data: 1) MacInnis & Hodson, 2015 (Google searches for certain sex-related terms), and 2) Edelman, 2009 (Subscriptions to a single paid porn site in 2007).
The often-repeated meme that Utah has the highest level of porn use arose from Benjamin Edelman’s 2009 economics paper “Red Light States: Who Buys Online Adult Entertainment?” He relied entirely on subscription data from a single top-ten provider of pay-to-view content when he ranked states on porn consumption – ignoring hundreds of other such websites. Why did he choose that one to analyze?
We do know that Edelman’s analysis was conducted circa 2007, after free, streaming “tube sites” were operational, and porn viewers were increasingly turning to them. So, Edelman’s single data point out of thousands (of free and subscription sites) cannot be presumed to be representative of all US porn users. Turns out his paper is misleading. (For more see – Is Utah #1 in Porn Use?) In fact, other studies and available data rank Utah porn use between 40th and 50th among the states. See:
MacInnis & Hodson, (2014) use Google Trends search term data as a proxy for pornography use and examine the relationship between state-level pornography use and measures of religiosity and conservatism. They find that states with more right-leaning ideological attitudes have higher rates of pornography-related Google searches.
The first problem with MacInnis & Hodson: Google Trend searches are not a proxy for pornography use. For example, self-reports suggest regular porn users visit their favorite tube sites via bookmarks or by typing the tube site’s name into the browser’s address field (while in incognito mode). Once on their favorite tube site, regular porn users often reach a new porn site via hyperlinks and ads, thus bypassing Google searches entirely.
The second weakness in MacInnis & Hodson: Google searches tells us nothing about the amount of time any particular user spends watching porn. For example, a state could have a high rate of first time porn seekers (young people, for instance) who only glance at a a few pictures, while other states could have higher rates of chronic porn users who never use Google, yet spend several hours watching porn.
A third weakness: MacInnis & Hodson failed to consider other possible reasons for higher rates of Google searches for sex and porn related words. It’s quite likely that young people searching for info about sex or sexual practices would use Google, while seasoned porn users would bypass search engines and go directly to porn sites. Moreover, surveys show that the highest rates of porn viewing occur in teen and young adult populations. As a result, we would expect states with higher populations of young people to have higher rates of Google searches for sexual content.
Check out the state by state population demographics. The 16 states with highest percentages of teen populations are considered “Red States” (more religious and politically conservative). On the other hand, all but one of the states with the lowest percentage of teens is a “Blue State” (less religious, more liberal). This one variable alone could explain the MacInnis & Hodson‘s findings.
And this is just one of many variables that must be factored in when affixing significance to correlations between state-level rankings in religiosity and a single highly questionable “proxy for porn use.” Especially when all surveys and studies report less porn use among religious populations.
The results in the first row of Table 3 show that we also find a statistically significant relationship between religiosity and conservatism in most cases when we use the Google Trends data. However, the other rows in Table 3 show that we get a much weaker statistical relationship when using any of the other three data sources. These results suggest that if MacInnis and Hodson (2014) had used any of the other three data sources, they probably would have come to a different conclusion in their paper about the strength of the relationship they were examining.
The fact that MacInnis and Hodson (2014) find a statistically significant relationship between state-level religiosity and state-level pornography use is interesting considering that past studies using individual level data find that individuals who regularly attend church are much less likely to use pornography.
Bottom line: We have Leonhardt, et al. disregarding multiple studies and cross-sectional surveys on religious individuals in favor of the conclusions of a methodologically questionable study correlating religious trends of state populations, with a very narrow representation of internet searches for sexual content. Unbelievable.
Internal inconsistency: The Leonhardt, et al. assertion is that a very large percentage of religious individuals lie about their use porn on anonymous surveys. And that they have lied in every survey ever published. If this is true, we must disregard Leonhardt, et al.’s own findings based on self-reports of religious porn users, just as Leonhardt, et al. repeatedly discounted and disregarded all other porn use surveys before theirs.
If Leonhardt, et al.’s religious subjects are consistently under-reporting their porn use (as they claim religious users have in other surveys), this means that the numerical value for “frequency of porn use” in their religious subjects needs to be adjusted upward. Raising (“correcting”) the religious group’s frequency of use brings their use into alignment with their scores on the 5-item questionnaire. Put simply, higher levels of porn use in religious subjects correlate nicely with higher scores on the porn addiction questionnaire. Or simpler yet: the amount of porn used = the levels of porn addiction – in both religious and nonreligious users. If this is so, there’s really nothing for Leonhardt, et al. to report. Null finding.
So, I ask the authors of Leonhardt, et al., which of the following 3 is accurate?
All anonymous surveys on religious subjects are to be disregarded because a very large percentage of religious individuals consistently underreport their porn use. This must include all the Grubbs studies and Leonhardt, et al. 2017
All anonymous surveys on religious subjects should be taken at face value, as all report similar findings: consistently lower rates of porn use among religious populations.
Only the survey by Leonhardt, et al. is to be trusted. All other anonymous surveys on religious subjects are to be disregarded. This is the Leonhardt, et al., authors’ current stance.
Religious porn users are likely to have higher rates of pre-existing conditions
Given that a large majority of college-age, religious men rarely views porn, the Grubbs and Leonhardt, et al. targeted samples of “religious porn users” represented a small minority of the religious population. In contrast, samples of “secular porn users” tend to represent the majority of the non-religious population.
Most young religious porn users say they would rather not watch porn (100% in this study). So why do these particular users watch? It’s extremely likely that the non-representative sample of “religious porn users” contains a far higher percentage of the slice of the entire population that struggles with the pre-existing conditions or comorbidities. These conditions are often present in addicts (i.e. OCD, depression, anxiety, social anxiety disorder, ADHD, family histories of addiction, childhood trauma or sexual abuse, other addictions, etc.).
This factor alone could explain why religious porn users, as a group, score slightly higher on the Grubbs and Leonhardt, et al. porn addiction questionnaires. This hypothesis is supported by studies on treatment seeking porn /sex addicts (whom we could expect to hail disproportionately from that same disadvantaged slice). Treatment seekers reveal no relationship between religiosity and measurements of addiction and religiosity (2016 study 1, 2016 study 2). If Leonhardt, et al.‘s conclusions were valid, we’d surely see a disproportionate number of religious porn users seeking treatment.
At high levels of porn use religious individuals return to religious practices and religion becomes more important
This 2016 study on religious porn users reported an interesting finding that alone could explain a slight correlation between actual porn addiction and religiosity. The relationship between porn use and religiosity is curvilinear. As porn use increases, religious practice and the importance of religion decrease – up to point. Yet when a religious individual begins using porn once or twice a week this pattern reverses itself: The porn user starts attending church more often and the importance of religion in his life increases. An excerpt from the study:
“However, the effect of earlier pornography use on later religious service attendance and prayer was curvilinear: Religious service attendance and prayer decline to a point and then increase at higher levels of pornography viewing.”
This graph, taken from this study, compares religious service attendance with the amount of porn used:
It seems likely that as religious individuals’ porn use grows increasingly out of control, they return to religion as a tactic to address their problematic behavior. This is no surprise, as many addiction recovery groups based on the 12-steps include a spiritual or religious component. The author of the paper suggested this as a possible explanation:
…studies of addiction suggest that those who feel helpless in their addiction often elicit supernatural help. Indeed, twelve-step programs that seek to help persons struggling with addictions ubiquitously include teachings about surrendering to a higher power, and a rising number of conservative Christian twelve-step programs make this connection even more explicit. It could very well be that persons who use pornography at the most extreme levels (i.e., use levels that might be characteristic of a compulsion or addiction) are actually pushed toward religion over time rather than pulled away from it.
This phenomenon of religious porn users returning to their faiths as addiction worsens could easily explain any correlation between actual porn addiction and religiosity.
In contrast to religious subjects, secular porn using subjects may not recognize porn’s effects because they never try to quit
Is it possible that religious porn users score higher on porn addiction questionnaires because they’ve actually tried to quit, unlike their secular brethren? In doing so they would be more likely to recognize the signs and symptoms of porn addiction as assessed by the Leonhardt, et al. 5-item questionnaire.
Based on years of monitoring porn recovery forums online, we suggest that researchers should segregate users who have experimented with quitting porn from those who haven’t, when asking them about porn’s self-perceived effects. It is generally the case that today’s porn users (both religious and nonreligious) have little understanding of internet porn’s effects on them until after they attempt to quit (and pass through any withdrawal symptoms).
In general, agnostic porn users believe porn use is harmless, so they have no motivation to quit…until they run into intolerable symptoms (perhaps, debilitating social anxiety, inability to have sex with a real partner or escalation to content they find confusing/disturbing or too risky). Prior to that turning point, if you ask them about their porn use, they will report that all is well. They naturally assume they are “casual users,” who could quit anytime, and that symptoms they have, if any, are due to something else. Shame? Nope.
In contrast, most religious porn users have been warned that porn use is risky. They are therefore more likely to have used less porn and to have experimented with giving it up, perhaps more than once. Such experiments with quitting internet porn are very enlightening, as that is when porn users (religious or not) discover:
How difficult it is to quit (if they’re addicted)
How porn use has affected them adversely, emotionally, sexually and otherwise (often because symptoms begin to recede after quitting)
[In the case of such symptoms] How withdrawal can make symptoms worse for a while, before the brain returns to balance
How bad it feels when they want to give something up and can’t (This is shame, but not necessarily “religious/sexual shame” – as researchers sometimes assume because religious users report it more often. Most all addicts unfortunately feel shame when they feel powerless to quit, whether or not they are religious.)
That they experience strong cravings to use porn. Cravings often increase in severity with a week or longer break from using porn.
Such experiences make those who have tried quitting far more wary about porn use. Since more religious users will more frequently have made such experiments, psychological instruments will show that they are more concerned about their porn use than non-religious users – even though they are likely using less porn!
In other words, shouldn’t researchers also be investigating whether secular porn users sometimes misperceive porn use as harmless, rather than assuming it’s the religious people who are misperceiving the existence of porn-related problems even though they’re using less? Addiction, after all, is not assessed based on quantity or frequency of use, but rather debilitating effects.
In any case, the failure to segregate those who have experimented with quitting from those who have not, is a huge confound in research attempting to draw conclusions about the implications of the relationship between religiosity, shame and porn use. It’s easy to misinterpret data as evidence that “religion makes people concerned about porn even if they’re using less than others, and that if they weren’t religious they wouldn’t be concerned.”
The more valid conclusion may be that those who have tried to quit, and realized the points above are more concerned, and that religion is merely the cause of their making such experiments (and otherwise largely irrelevant). It’s disheartening to see psychologists make simplistic correlations with religion/spirituality and draw “shaming” conclusions, without realizing that they are comparing “apples” with “oranges” when they compare users who have tried to quit with users who haven’t. Again, only the former tend to see the risks and harms of porn use clearly, whether or not they are religious.
This confound is too often exploited by those who want to draw attention away from the severe symptoms that non-religious users frequently experience. Agnostic users tend to have more severe symptoms by the time they do quit, simply because they tend to quit at a lower point in the downward spiral of symptoms than religious porn users do. Why aren’t researchers studying this phenomenon?
In fact, we would wager that the lion’s share of those with porn-induced sexual dysfunctions are agnostics. Why? Because the non-religious tend to be so persuaded of the harmlessness of internet porn use that they continue using it well past the warning signs, such as increasing social anxiety, escalation to extreme material, apathy, difficulty achieving an erection without porn, difficulty using condoms or climaxing with a partner, and so forth.
The fact is, even casual, or relatively infrequent, porn use can condition some users’ sexuality such that it interferes with their sexual and relationship satisfaction. Here’s one man’s account. Escalation to porn content that was once uninteresting or repelling is common in half of internet porn users. In short, as discussed above, infrequent use is no panacea. Those who do not use frequently but are anxious about their porn use may have good reason to be concerned based on their own experiments, quite apart from what they hear about porn during religious services.
Might it be better to construct research that asks porn users (both religious and otherwise) to quit porn for a time and compare their experiences with controls? See Eliminate Chronic Internet Pornography Use to Reveal Its Effects for a possible study design.
The biological reasons why intermittent porn users might score higher on porn addiction questionnaires
Very frequent internet porn use has familiar risks for many of today’s users. These include escalation to more extreme material, poorer sexual and relationship satisfaction, addiction, and/or the gradual loss of attraction to real partners (as well as anorgasmia and unreliable erections).
Less well known is the fact that intermittent use (for example, 2 hours of porn bingeing followed by a few weeks of abstinence before another porn session) poses a substantial risk of addiction. The reasons are biological, and there is an entire body of addiction research on intermittent use in animals and humans elucidating the brain events responsible.
For example, both drug and junk food studies reveal that intermittent use can lead more quickly to addiction-related brain changes (whether or not the user slips into full blown addiction). The primary change is sensitizationwhich blasts the brain’s reward center with signals that produce hard to ignore cravings. With sensitization, brain circuits involved in motivation and reward seeking become hyper-sensitive to memories or cues related to the addictive behavior. This deep pavlovian conditioning results in increased “wanting” or craving while liking or pleasure from the activity diminishes. Cues, such as turning on the computer, seeing a pop-up, or being alone, trigger intense cravings for porn. (Studies reporting sensitization or cue-reactivity in porn users: 1,2,3,4, 5,6,7,8,9,10,11,12,13,14,15, 16, 17, 18.)
Even more remarkable is that periods of abstinence (2-4 weeks) lead to neuroplastic changes that don’t occur in a user that doesn’t take such long breaks. These alterations in the brain increase cravings to use in response to triggers. Furthermore, the stress system changes such that even minor stress can cause cause cravings to use.
Intermittent consumption (especially in the form of a binge) can also produce severe withdrawal symptoms, such as lethargy, depression and cravings. In other words, when someone uses after an interim of abstinence, and binges, it can hit the user harder – perhaps because of the heightened intensity of the experience.
Based on this research, scientists have concluded that everyday consumption of say cocaine, alcohol, cigarettes, or junk food is not necessary to generate addiction-related brain changes. Intermittent bingeing can do the same thing as continuous use, and in some cases do more.
Now, let’s return to a comparison of religious and nonreligious porn users. Which group is likely to include more intermittent users? Given research showing that religious porn users prefer not to be using porn, there are probably more religious than secular users stuck in a binge-abstinence cycle. Religious users would tend to be “intermittent users.” Secular users generally report that they seldom take breaks of more than a few days – unless they become intermittent users because they are trying to quit porn use.
Another important effect of the binge-abstinence cycle is that intermittent porn users experience extended gaps (and often improvements). They can clearly see how their porn use has affected them, in contrast with frequent users. This alone might lead to higher scores on a porn addiction questionnaire. A second, more important result is that intermittent porn users will experience more frequent episodes of strong cravings. Third, when intermittent users do cave in, the science mentioned above predicts that they will often feel more out of control, and experience more of a letdown after the binge. In short, intermittent users can be quite addicted and score surprisingly high on porn addiction tests, even though they are using with less frequency than their secular brethren.
Under the circumstances, it is premature to conclude that shame accounts for the difference between religious and nonreligious users. Researchers must control for the impact of intermittent use. Said differently, if more of Leonhardt et al’s religious subjects included a higher percentage of intermittent users than their nonreligious subjects, one would expect the religious users to score higher on addiction tests despite using significantly less frequently.
Of course, the intermittent use addiction risk is not confined to religious porn users. This phenomenon shows up in animal models and secular porn users who are trying to quit but still bingeing occasionally. The point is that the phenomenon of intermittent use and porn addiction needs to be studied independently prior to drawing and publicizing assumptions about shame (or “perceived” pornography addiction) as the only possible explanation for why religious porn users report higher addiction scores in concert with less frequent use.
Summary of Religiosity and Porn Use:
Religiosity does not predict porn addiction (perceived or otherwise). A far larger percentage of secular individuals use porn.
Since a much smaller percentage of religious people use porn, religiosity is evidently protective against porn addiction.
Grubbs and Leonhardt, et al. samples taken from the minority of “religious porn users” is skewed with respect to religious users, likely resulting in a much higher percentage of the religious sample having comorbidities. As a result religious porn users have slightly higher overall scores on porn-addiction instruments and report more difficulty controlling use.
As porn use becomes frequent or compulsive, religious porn users return to their faiths. This means that those scoring highest on porn addiction tests will also score higher on religiosity.
Most religious porn users have been warned that porn use is risky. They are therefore more likely to have used less porn and to have experimented with giving it up. In doing so they are more likely to recognize the signs and symptoms of porn addiction as assessed by the Leonhardt, et al. 5-item (and similar) questionnaire(s) – regardless of amount of porn use.
Intermittent porn users can be quite addicted and score surprisingly high on porn addiction tests, even though they are using with less frequency than their secular brethren.
Section 5: Studies recognize that “levels of current porn use” is not linearly related to porn addiction
In the Grubbs studies and Leonhardt, et al. an insinuation pervades that hours of porn use is synonymous with “real porn addiction.” That is, that the extent of a “genuine porn addiction” is best indicated simply by “current hours of use” or “frequency of use,” rather than by standard porn addiction tests or by porn-induced symptoms. Addiction experts disagree.
The hole in these author’s underpinnings, which you could drive a truck through, is that research on internet porn and internet addictions (1, 2, 3, 4, 5, 6, 7, 8, 9) has reported that internet addiction sub-types do not correlate linearly with hours of use. In fact, the variable ‘hours of use’ is an unreliable measure of addiction. Established addiction assessment tools evaluate addiction using multiple other, more reliable factors (such as those listed in the first two sections of the CPUI-9 or the Leonhardt, et al. questions). The following cybersex addiction studies report little relationship between hours and indications of addiction:
“Results indicate that self-reported problems in daily life linked to online sexual activities were predicted by subjective sexual arousal ratings of the pornographic material, global severity of psychological symptoms, and the number of sex applications used when being on Internet sex sites in daily life, while the time spent on Internet sex sites (minutes per day) did not significantly contribute to explanation of variance in Internet Addiction Test sex score (IATsex). We see some parallels between cognitive and brain mechanisms potentially contributing to the maintenance of excessive cybersex and those described for individuals with substance dependence.”
“Recent findings have demonstrated an association between CyberSex Addiction (CA) severity and indicators of sexual excitability, and that coping by sexual behaviors mediated the relationship between sexual excitability and CA symptoms. Results showed strong correlations between CA symptoms and indicators of sexual arousal and sexual excitability, coping by sexual behaviors, and psychological symptoms. CyberSex Addiction was not associated with offline sexual behaviors and weekly cybersex use time.”
According to our best knowledge this study is the first direct examination of associations between the frequency of porn use and actual behavior of treatment-seeking for problematic porn use (measured as visiting the psychologist, psychiatrist or sexologist for this purpose). Our results indicate that the future studies, and treatment, in this field should focus more on impact of porn use on the life of an individual (quality) rather than its mere frequency (quantity), as the negative symptoms associated with porn use (rather than porn use frequency ) are the most significant predictor of treatment-seeking behavior.
Relation between PU and negative symptoms was significant and mediated by self-reported, subjective religiosity (weak, partial mediation) among non-treatment seekers. Among treatment-seekers religiosity is not related to negative symptoms.
Higher scores on addictive measures of internet porn use were correlated with daily or more frequent use of internet porn. However, the results indicate that there was no direct link between the amount and frequency of an individual’s pornography use and struggles with anxiety, depression, and life and relationship satisfaction. Significant correlations to high internet porn addiction scores included an early first exposure to internet porn, addiction to video games, and being male. While some positive effects of internet porn use have been documented in previous literature our results do not indicate that psychosocial functioning improves with moderate or casual use of internet porn.
This study investigated the prevalence of problematic Internet pornography viewing, how it is problematic, and the psychological processes that underlie the problem in a sample of 84 college-age males using an anonymous online survey. It was found that approximately 20%–60% of the sample who view pornography find it to be problematic depending on the domain of interest. In this study, the amount of viewing did not predict the level of problems experienced.
Imagine trying to assess the presence of addiction by simply asking, “How many hours do you currently spend eating (food addiction)?” or “How many hours do you spend gambling (gambling addition)?” or “How many hours do you spend drinking (alcoholism)?” You could get very misleading results. More important, “current porn use” questions fail to ask about key variables of porn use: age use began, years of use, whether the user escalated to novel genres of porn or developed unexpected porn fetishes, the ratio of ejaculation with porn to ejaculation without it, amount of sex with a real partner, and so forth. A combination of such questions would likely enlighten us more about who really has a problem with porn use than simply “current frequency/hours of use.”
Abstract
Damaged Goods: Perception of Pornography Addiction as a Mediator Between Religiosity and Relationship Anxiety Surrounding Pornography Use.
J Sex Res. 2017 Mar 13:1-12. doi: 10.1080/00224499.2017.1295013.
Recent research on pornography suggests that perception of addiction predicts negative outcomes above and beyond pornography use. Research has also suggested that religious individuals are more likely to perceive themselves to be addicted to pornography, regardless of how often they are actually using pornography. Using a sample of 686 unmarried adults, this study reconciles and expands on previous research by testing perceived addiction to pornography as a mediator between religiosity and relationship anxiety surrounding pornography. Results revealed that pornography use and religiosity were weakly associated with higher relationship anxiety surrounding pornography use, whereas perception of pornography addiction was highly associated with relationship anxiety surrounding pornography use. However, when perception of pornography addiction was inserted as a mediator in a structural equation model, pornography use had a small indirect effect on relationship anxiety surrounding pornography use, and perception of pornography addiction partially mediated the association between religiosity and relationship anxiety surrounding pornography use. By understanding how pornography use, religiosity, and perceived pornography addiction connect to relationship anxiety surrounding pornography use in the early relationship formation stages, we hope to improve the chances of couples successfully addressing the subject of pornography and mitigate difficulties in romantic relationships.
Compulsive porn users often describe escalation in their porn use that takes the form of greater time viewing or seeking out new genres of porn. New genres that induce shock, surprise, violation of expectations or even anxiety can function to increase sexual arousal, and in porn users whose response to stimuli is growing blunted due to overuse, this phenomenon is extremely common.
The current porn epidemic gives a graphic demonstration that sexual tastes can be acquired. Pornography, delivered by high-speed Internet connections, satisfies every one of the prerequisites for neuroplastic change…. When pornographers boast that they are pushing the envelope by introducing new, harder themes, what they don’t say is that they must, because their customers are building up a tolerance to the content.
The back pages of men’s risque magazines and Internet porn sites are filled with ads for Viagra-type drugs—medicine developed for older men with erectile problems related to aging and blocked blood vessels in the penis. Today young men who surf porn are tremendously fearful of impotence, or “erectile dysfunction” as it is euphemistically called. The misleading term implies that these men have a problem in their penises, but the problem is in their heads, in their sexual brain maps. The penis works fine when they use pornography. It rarely occurs to them that there may be a relationship between the pornography they are consuming and their impotence.
In 2012 reddit/nofap produced a member survey, which found that over 60% of its members’ sexual tastes experienced significant escalation, through multiple porn genres.
Q: Did your tastes in pornography change?
My tastes did not change significantly – 29%
My tastes became increasingly extreme or deviant and this caused me to feel shame or stress – 36%
And… my tastes became increasingly extreme or deviant and this did not cause me to feel shame or stress – 27%
And here’s the 2017 evidence from PornHub that real sex is decreasingly interesting to porn users. Porn isn’t enabling people to find their “real” tastes; it’s driving them beyond normal into extreme novelty and “unreal” genres:
It appears that the trend is moving more toward fantasy than reality. ‘Generic’ porn is being replaced with fantasy specific or scenario specific scenes. Is this as a result of boredom or curiosity? One thing is certain; the typical ‘in-out, in-out’ no longer satisfies the masses, who are clearly looking for something different” notes Dr Laurie Betito.
The only support for the meme that porn users do not escalate comes Ogas and Gaddam’s highly criticized book “A Billion Wicked Thoughts” and their claim that porn viewing tastes remain stable throughout life. Ogas & Gaddam analyzed AOL searches from 2006, over a brief 3-month period. Here’s an excerpt from an Ogi Ogas blog post on Psychology Today:
There is no evidence that viewing porn activates some kind of neural mechanism leading one down a slippery slope of seeking more and more deviant material, and plenty of evidence suggesting that adult men’s sexual interests are stable.
Porn users must be tracked over years to pick up the kinds of changing tastes men are reporting. Three months is insufficient.
Most regular porn users do not use Google to find porn. Instead, they head directly to their favorite tube site. Clicking onto a new genre (located in the sidebar) occurs while the user is masturbating.
The findings also indicated that many men viewed SEM content inconsistent with their stated sexual identity. It was not uncommon for heterosexual-identified men to report viewing SEM containing male same-sex behavior (20.7%) and for gay-identified men to report viewing heterosexual behavior in SEM (55.0%). It was also not uncommon for gay men to report that they viewed vaginal sex with (13.9%) and without a condom (22.7%) during the past 6 months.
In 2019, a Spanish study on 500 men and women (average age 21) reported that the majority had seen gay or lesbian porn, and found it arousing – even though most were straight.
In addition, see this article about a 2018 YOUPorn survey, which reported that straight men watch gay porn 23% of the time. Also note that the overwhelming majority of women (and 40% of men) report that their porn tastes have changed in the past 5 years. From the survey:
This study, taken together with others listed below, debunks the meme that today’s porn users eventually “discover their true sexuality” by surfing tube sites, and then stick to only one genre of porn for the rest of time. The evidence is mounting that streaming digital porn appears to alter sexual tastes in some users, and that this is due to the addiction-related brain change known as habituation or desensitization.
Employing various methodologies and approaches, the following diverse group of studies report habituation to “regular porn” along with escalation into more extreme and unusual genres. Several also report withdrawal symptoms in porn users.
Forty-nine percent mentioned at least sometimes searching for sexual content or being involved in OSAs that were not previously interesting to them or that they considered disgusting.
This Belgian study also found problematic Internet porn use was associated with reduced erectile function and reduced overall sexual satisfaction. Yet problematic porn users experienced greater cravings (OSA’s = online sexual activity, which was porn for 99% of subjects). Interestingly, 20.3% of participants said that one motive for their porn use was “to maintain arousal with my partner.” An excerpt:
This study is the first to directly investigate the relationships between sexual dysfunctions and problematic involvement in OSAs. Results indicated that higher sexual desire, lower overall sexual satisfaction, and lower erectile function were associated with problematic OSAs (online sexual activities). These results can be linked to those of previous studies reporting a high level of arousability in association with sexual addiction symptoms (Bancroft & Vukadinovic, 2004; Laier et al., 2013; Muise et al., 2013).
related to high levels of exposure to and experience with sexually explicit materials.
The men experiencing erectile dysfunction had spent a considerable amount of time in bars and bathhouses where porn was “omnipresent,” and “continuously playing.” The researchers stated:
Conversations with the subjects reinforced our idea that in some of them a high exposure to erotica seemed to have resulted in a lower responsivity to “vanilla sex” erotica and an increased need for novelty and variation, in some cases combined with a need for very specific types of stimuli in order to get aroused.
THIRD & FOURTH STUDIES: Both found that deviant (i.e., bestiality or minor) pornography users reported a significantly younger onset of adult pornography use. These studies link earlier onset of porn use to escalation to more extreme material.
The findings of the current study suggest Internet pornography use may follow a Guttman-like progression. In other words, individuals who consume child pornography also consume other forms of pornography, both nondeviant and deviant. For this relationship to be a Guttman-like progression, child pornography use must be more likely to occur after other forms of pornography use. The current study attempted to assess this progression by measuring if the “age of onset” for adult pornography use facilitated the transition from adult-only to deviant pornography use.
Based on the results, this progression to deviant pornography use may be affected by the individuals “age of onset” for engaging in adult pornography. As suggested by Quayle and Taylor (2003), child pornography use may be related to desensitization or appetite satiation to which offenders begin collecting more extreme and deviant pornography. The current study suggests individuals who engage in adult pornography use at a younger age may be at greater risk for engaging in other deviant forms of pornography.
Results indicated that adult + deviant pornography users scored significantly higher on openness to experience and reported a significantly younger age of onset for adult pornography use compared to adult-only pornography users.
Finally, the respondents’ self-reported age of onset for adult pornography significantly predicted adult-only vs. adult + deviant pornography use. That is to day, adult + deviant pornography users selfreported a younger age of onset for nondeviant (adult-only) pornography compared to the adult-only pornography users. Overall, these findings support the conclusion drawn by Seigfried-Spellar and Rogers (2013) that Internet pornography use may follow a Guttman-like progression in that deviant pornography use is more likely to occur after the use of nondeviant adult pornography.
FIFTH STUDY:Brain Structure and Functional Connectivity Associated With Pornography Consumption: The Brain on Porn (Kuhn & Gallinat, 2014) – This Max Planck Institute fMRI study found less grey matter in the reward system (dorsal striatum) correlating with the amount of porn consumed. It also found that more porn use correlated with less reward circuit activation while briefly viewing sexual photos. Researchers believe their findings indicated desensitization, and possibly tolerance, which is the need for greater stimulation to achieve the same level of arousal. Lead author Simone Kühn said the following about her study:
This could mean that regular consumption of pornography dulls the reward system. … We therefore assume that subjects with high pornography consumption require ever stronger stimuli to reach the same reward level …. This is consistent with the findings on the functional connectivity of the striatum to other brain areas: high pornography consumption was found to be associated with diminished communication between the reward area and the prefrontal cortex. The prefrontal cortex, together with the striatum, is involved in motivation and appears to control the reward-seeking drive.
Furthermore, in May, 2016. Kuhn & Gallinat published this review – Neurobiological Basis of Hypersexuality. In the review Kuhn & Gallinat describe their 2014 fMRI study:
In a recent study by our group, we recruited healthy male participants and associated their self-reported hours spent with pornographic material with their fMRI response to sexual pictures as well as with their brain morphology (Kuhn & Gallinat, 2014). The more hours participants reported consuming pornography, the smaller the BOLD response in left putamen in response to sexual images. Moreover, we found that more hours spent watching pornography was associated with smaller gray matter volume in the striatum, more precisely in the right caudate reaching into the ventral putamen. We speculate that the brain structural volume deficit may reflect the results of tolerance after desensitization to sexual stimuli.
Online explicit stimuli are vast and expanding, and this feature may promote escalation of use in some individuals. For instance, healthy males viewing repeatedly the same explicit film have been found to habituate to the stimulus and find the explicit stimulus as progressively less sexually arousing, less appetitive and less absorbing (Koukounas and Over, 2000). … We show experimentally what is observed clinically that Compulsive Sexual Behavior is characterized by novelty-seeking, conditioning and habituation to sexual stimuli in males.
The researchers found that sex addicts were more likely to choose the novel over the familiar choice for sexual images relative to neutral object images, whereas healthy volunteers were more likely to choose the novel choice for neutral human female images relative to neutral object images.
“We can all relate in some way to searching for novel stimuli online – it could be flitting from one news website to another, or jumping from Facebook to Amazon to YouTube and on,” explains Dr Voon. “For people who show compulsive sexual behaviour, though, this becomes a pattern of behaviour beyond their control, focused on pornographic images.”
In a second task, volunteers were shown pairs of images – an undressed woman and a neutral grey box – both of which were overlaid on different abstract patterns. They learned to associate these abstract images with the images, similar to how the dogs in Pavlov’s famous experiment learnt to associate a ringing bell with food. They were then asked to select between these abstract images and a new abstract image.
This time, the researchers showed that sex addicts where more likely to choose cues (in this case the abstract patterns) associated with sexual and monetary rewards. This supports the notion that apparently innocuous cues in an addict’s environment can ‘trigger’ them to seek out sexual images.
“Cues can be as simple as just opening up their internet browser,” explains Dr Voon. “They can trigger a chain of actions and before they know it, the addict is browsing through pornographic images. Breaking the link between these cues and the behaviour can be extremely challenging.”
The researchers carried out a further test where 20 sex addicts and 20 matched healthy volunteers underwent brain scans while being shown a series of repeated images – an undressed woman, a £1 coin or a neutral grey box.
They found that when the sex addicts viewed the same sexual image repeatedly, compared to the healthy volunteers they experienced a greater decrease of activity in the region of the brain known as the dorsal anterior cingulate cortex, known to be involved in anticipating rewards and responding to new events. This is consistent with ‘habituation’, where the addict finds the same stimulus less and less rewarding – for example, a coffee drinker may get a caffeine ‘buzz’ from their first cup, but over time the more they drink coffee, the smaller the buzz becomes.
This same habituation effect occurs in healthy males who are repeatedly shown the same porn video. But when they then view a new video, the level of interest and arousal goes back to the original level. This implies that, to prevent habituation, the sex addict would need to seek out a constant supply of new images. In other words, habituation could drive the search for novel images.
“Our findings are particularly relevant in the context of online pornography,” adds Dr Voon. “It’s not clear what triggers sex addiction in the first place and it is likely that some people are more pre-disposed to the addiction than others, but the seemingly endless supply of novel sexual images available online helps feed their addiction, making it more and more difficult to escape.” [emphasis added]
Findings suggest that the key themes are: increased levels of availability of SEM, including an escalation in extreme content (Everywhere You Look) which are seen by young men in this study as having negative effects on sexual attitudes and behaviours (That’s Not Good). Family or sex education may offer some ‘protection’ (Buffers) to the norms young people see in SEM. Data suggests confused views (Real verses Fantasy) around adolescents’ expectations of a healthy sex life (Healthy Sex Life) and appropriate beliefs and behaviours (Knowing Right from Wrong). A potential causal pathway is described and areas of intervention highlighted.
A second EEG study from Nicole Prause’s team. This study compared the 2013 subjects from Steele et al., 2013 to an actual control group (yet it suffered from the same methodological flaws named above). The results: Compared to controls “individuals experiencing problems regulating their porn viewing” had lower brain responses to one-second exposure to photos of vanilla porn. The lead author claims these results “debunk porn addiction.” What legitimate scientist would claim that their lone anomalous study has debunked a well established field of study?
In reality, the findings of Prause et al. 2015 align perfectly with Kühn & Gallinat (2014), which found that more porn use correlated with less brain activation in response to pictures of vanilla porn.Prause et al. findings also align with Banca et al. 2015. Moreover, another EEG study found that greater porn use in women correlated with less brain activation to porn. Lower EEG readings mean that subjects are paying less attention to the pictures. Put simply, frequent porn users were desensitized to static images of vanilla porn. They were bored (habituated or desensitized). See this extensive YBOP critique. Nine peer-reviewed papers agree that this study actually found desensitization/habituation in frequent porn users (consistent with addiction): Peer-reviewed critiques of Prause et al., 2015
NINTH STUDY: Unusual masturbatory practice as an etiological factor in the diagnosis and treatment of sexual dysfunction in young men (2014). One of the 4 case studies in this paper reports on a man with porn-induced sexual problems (low libido, multiple porn fetishes, anorgasmia). The sexual intervention called for a 6-week abstinence from porn and masturbation. After 8 months the man reported increased sexual desire, successful sex and orgasm, and enjoying “good sexual practices. Excerpts from the paper documenting the patient’s habituation and escalation into what he described as more extreme porn genres:
When asked about masturbatory practices, he reported that in the past he had been masturbating vigorously and rapidly while watching pornography since adolescence. The pornography originally consisted mainly of zoophilia, and bondage, domination, sadism, and masochism, but he eventually got habituated to these materials and needed more hardcore pornography scenes, including transgender sex, orgies, and violent sex. He used to buy illegal pornographic movies on violent sex acts and rape and visualized those scenes in his imagination to function sexually with women. He gradually lost his desire and his ability to fantasize and decreased his masturbation frequency.
An excerpt from the paper documents the patient’s recovery from porn-induced sexual problems and fetishes:
In conjunction with weekly sessions with a sex therapist, the patient was instructed to avoid any exposure to sexually explicit material, including videos, newspapers, books, and internet pornography. After 8 months, the patient reported experiencing successful orgasm and ejaculation. He renewed his relationship with that woman, and they gradually succeeded in enjoying good sexual practices.
TENTH STUDY: Is Internet Pornography Causing Sexual Dysfunctions? A Review with Clinical Reports (2016)– is an extensive review of the literature related to porn-induced sexual problems. Authored by US Navy doctors, the review provides the latest data revealing a tremendous rise in youthful sexual problems. It also reviews the neurological studies related to porn addiction and sexual conditioning via Internet porn. The doctors include 3 clinical reports of servicemen who developed porn-induced sexual dysfunctions. Two of the three servicemen healed their sexual dysfunctions by eliminating porn use while the third man experienced little improvement as he was unable to abstain from porn use. Two of the three servicemen reported habituation to current porn and escalation of porn use. The first servicemen describes his habituation to “soft porn” followed by escalation into more graphic and fetish porn:
A 20-year old active duty enlisted Caucasian serviceman presented with difficulties achieving orgasm during intercourse for the previous six months. It first happened while he was deployed overseas. He was masturbating for about an hour without an orgasm, and his penis went flaccid. His difficulties maintaining erection and achieving orgasm continued throughout his deployment. Since his return, he had not been able to ejaculate during intercourse with his fiancée. He could achieve an erection but could not orgasm, and after 10–15 min he would lose his erection, which was not the case prior to his having ED issues.
Patient endorsed masturbating frequently for “years”, and once or twice almost daily for the past couple of years. He endorsed viewing Internet pornography for stimulation. Since he gained access to high-speed Internet, he relied solely on Internet pornography. Initially, “soft porn”, where the content does not necessarily involve actual intercourse, “did the trick”. However, gradually he needed more graphic or fetish material to orgasm. He reported opening multiple videos simultaneously and watching the most stimulating parts. [emphasis added]
The second serviceman describes increased porn use and escalation into more graphic porn. Soon thereafter sex with his wife “not as stimulating as before”:
A 40-year old African American enlisted serviceman with 17 years of continuous active duty presented with difficulty achieving erections for the previous three months. He reported that when he attempted to have sexual intercourse with his wife, he had difficulty achieving an erection and difficulty maintaining it long enough to orgasm. Ever since their youngest child left for college, six months earlier, he had found himself masturbating more often due to increased privacy.
He formerly masturbated every other week on average, but that increased to two to three times per week. He had always used Internet pornography, but the more often he used it, the longer it took to orgasm with his usual material. This led to him using more graphic material. Soon thereafter, sex with his wife was “not as stimulating” as before and at times he found his wife “not as attractive”. He denied ever having these issues earlier in the seven years of their marriage. He was having marital issues because his wife suspected he was having an affair, which he adamantly denied. [emphasis added]
ELEVENTH STUDY: Shifting Preferences In Pornography Consumption (1986)– Six weeks of exposure to nonviolent pornography resulted in subjects having little interest in vanilla porn, electing to almost exclusively watch “uncommon pornography” (bondage, sadomasochism, bestiality). An excerpt:
Male and female students and nonstudents were exposed to one hour of common, nonviolent pornography or to sexually and aggressively innocuous materials in each of six consecutive weeks. Two weeks after this treatment, they were provided with an opportunity to watch videotapes in a private situation. G-rated, R-rated, and X-rated programs were available. Subjects with considerable prior exposure to common, nonviolent pornography showed little interest in common, nonviolent pornography, electing to watch uncommon pornography (bondage, sadomasochism, bestiality) instead. Male nonstudents with prior exposure to common, nonviolent pornography consumed uncommon pornography almost exclusively. Male students exhibited the same pattern, although somewhat less extreme. This consumption preference was also in evidence in females, but was far less pronounced, especially among female students. [emphasis added]
Age of first exposure to IP was found to be significantly correlated with frequent and addictive IP use (see Table 2). Participants who were exposed to IP at an earlier age were more likely to use IP more frequently, have longer IP sessions, and more likely to score higher on Adapted DSM-5 Internet Pornography Addiction Criteria and CPUI-COMP measures. Finally, total IP exposure was found to be significantly correlated with higher frequency of IP use. Participants who had longer total exposure to IP were also more likely to have more IP sessions per month.
Among frequent users, the most common type of pornography consumed was hard core pornography (71%) followed by lesbian pornography (64%), while soft core pornography was the most commonly selected genre for average (73%) and infrequent users (36%). There was also a difference between the groups in the proportion who watched hard core pornography (71%, 48%, 10%) and violent pornography (14%, 9%, 0%).
The authors suggest that frequent porn may ultimately lead to a preference for hard-core or violent pornography:
It is also noteworthy that a statistically significant relationship was found between fantasizing about pornography several times a week and watching hard core pornography. Since verbal and physical sexual aggression is so commonplace in pornography, what most adolescents considered hard core pornography could likely be defined as violent pornography. If this is the case, and in light of the suggested cyclical nature of sexual preoccupancy in Peter and Valkenburg,it may be that rather than ‘purging’ individuals of their fantasies and inclinations of sexual aggression, watching hard core pornography perpetuates them, thereby increasing the likelihood of manifested sexual aggression.
FOURTEENTH STUDY: The Development of the Problematic Pornography Consumption Scale (PPCS) (2017) – This paper developed and tested a problematic porn use questionnaire that was modeled after substance addiction questionnaires. Unlike previous porn addiction tests, this 18-item questionnaire assessed tolerance and withdrawal with the following 6 questions:
———-
Each question was scored from one to seven on a likert scale: 1- Never, 2- Rarely, 3- Occasionally, 4- Sometimes, 5- Often, 6- Very Often, 7- All the Time. The graph below grouped porn users into 3 categories based on their total scores: “Nonprobelmatic,” “Low risk,” and “At risk.” The yellow line indicates no problems, which means that the “Low risk” and “At risk” porn users reported both tolerance and withdrawal. Put simply, this study actually asked about escalation (tolerance) and withdrawal – and both are reported by some porn users. End of debate.
Anna Ševčíková1, Lukas Blinka1 and Veronika Soukalová1
1Masaryk University, Brno, Czech Republic
Background and aims:
There is an ongoing debate whether excessive sexual behaviour should be understood as a form of behavioural addiction (Karila, Wéry, Weistein et al., 2014). The present qualitative study aimed at analysing the extent to which out-of-control use of the internet for sexual purposes (OUISP) may be framed by the concept of behavioural addiction among those individuals who were in treatment due to their OUISP.
Methods:
We conducted in-depth interviews with 21 participants aged 22–54 years (Mage = 34.24 years). Using a thematic analysis, the clinical symptoms of OUISP were analysed with the criteria of behavioural addiction, with the special focus on tolerance and withdrawal symptoms (Griffiths, 2001).
Results:
The dominant problematic behaviour was out-of-control online pornography use (OOPU). Building up tolerance to OOPU manifested itself as an increasing amount of time spent on pornographic websites as well as searching for new and more sexually explicit stimuli within the non-deviant spectrum. Withdrawal symptoms manifested themselves on a psychosomatic level and took the form of searching for alternative sexual objects. Fifteen participants fulfilled all of the addiction criteria.
Conclusions:
The study indicates a usefulness for the behavioural addiction framework
Clinical experience and now research evidence are accumulating to suggest that the Internet is not simply drawing attention to those with existing paedophilic interests, but is contributing to the crystallisation of those interests in people with no explicit prior sexual interest in children.
STUDY SEVENTEEN:How difficult is it to treat delayed ejaculation within a short-term psychosexual model? A case study comparison (2017) – A report on two “composite cases” illustrating the causes and treatments for delayed ejaculation (anorgasmia). “Patient B” represented several young men treated by the therapist. Interestingly, the paper states that Patient B’s “porn use had escalated into harder material”, “as is often the case”. The paper says that porn-related delayed ejaculation is not uncommon, and on the rise. The author calls for more research on porn’s effects of sexual functioning. Patient B’s delayed ejaculation was healed after 10 weeks of no porn. Excerpts related to escalation:
The cases are composite cases taken from my work within the National Health Service in Croydon University Hospital, London. With the latter case (PatientB), it is important to note that the presentation reflects a number of young males who have been referred by their GPs with a similar diagnosis. Patient B is a 19-year-old who presented because he was unable to ejaculate via penetration. When he was 13, he was regularly accessing pornography sites either on his own through internet searches or via links that his friends sent him. He began masturbating every night while searching his phone for image…If he did not masturbate he was unable to sleep. The pornography he was using had escalated, as is often the case (see Hudson-Allez, 2010), into harder material (nothing illegal)…
Patient B was exposed to sexual imagery via pornography from the age of 12 and the pornography he was using had escalated to bondage and dominance by the age of 15.
We agreed that he would no longer use pornography to masturbate. This meant leaving his phone in a different room at night. We agreed that he would masturbate in a different way….The article calls for research into pornography usage and its effect on masturbation and genital desensitisation.
Interestingly, the high porn use group rated the erotic images as more unpleasant than the medium use group. The authors suggest this may be due to the relatively “soft-core” nature of the “erotic” images contained in the IAPS database not providing the level of stimulation that they may usually seek out, as it has been shown by Harper and Hodgins [58] that with frequent viewing of pornographic material, many individuals often escalate into viewing more intense material to maintain the same level of physiological arousal. The “pleasant” emotion category saw valence ratings by all three groups to be relatively similar with the high use group rating the images as slightly more unpleasant on average than the other groups.
This may again be due to the “pleasant” images presented not being stimulating enough for the individuals in the high use group.Studies have consistently shown a physiological downregulation in processing of appetitive content due to habituation effects in individuals who frequently seek out pornographic material [3,7,8]. It is the authors’ contention that this effect may account for the results observed.
4.3. Startle Reflex Modulation (SRM)
The relative higher amplitude startle effect seen in the low and medium porn use groups may be explained by those in the group intentionally avoiding the use of pornography, as they may find it to be relatively more unpleasant. Alternatively, the results obtained also may be due to a habituation effect, whereby individuals in these groups do watch more pornography than they explicitly stated—possibly due to reasons of embarrassment among others, as habituation effects have been shown to increase startle eye blink responses [41,42].
STUDY NINETEEN: Exploring the Relationship between Sexual Compulsivity and Attentional Bias to Sex-Related Words in a Cohort of Sexually Active Individuals (2017)– This study replicates the findings of this 2014 Cambridge University study that compared the attentional bias of porn addicts to healthy controls. Here’s what’s new: The study correlated the “years of sexual activity” with 1) the sex addiction scores and also 2) the results of the attentional bias task. Among those scoring high on sexual addiction, fewer years of sexual experience were related to greater attentional bias. So higher sexual compulsivity scores + fewer years of sexual experience = greater signs of addiction (greater attentional bias, or interference). But attentional bias declines sharply in the compulsive users, and disappears at the highest number of years of sexual experience.
The authors concluded that this result could indicate that more years of “compulsive sexual activity” lead to greater habituation or a general numbing of the pleasure response (desensitization). An excerpt from the conclusion section:
“One possible explanation for these results is that as a sexually compulsive individual engages in more compulsive behaviour, an associated arousal template develops [36–38] and that over time, more extreme behaviour is required for the same level of arousal to be realised. It is further argued that as an individual engages in more compulsive behaviour, neuropathways become desensitized to more ‘normalised’ sexual stimuli or images and individuals turn to more ‘extreme’ stimuli to realise the arousal desired. This is in accordance with work showing that ‘healthy’ males become habituated to explicit stimuli over time and that this habituation is characterised by decreased arousal and appetitive responses [39].
This suggests that more compulsive, sexually active participants have become ‘numb’ or more indifferent to the ‘normalised’ sex-related words used in the present study and as such display decreased attentional bias, while those with increased compulsivity and less experience still showed interference because the stimuli reflect more sensitised cognition.”
Some respondents described a rapid progression of a previously existing compulsive sexual behavior problem, whereas others had no history of sexual addiction but became rapidly involved in an escalating pattern of compulsive cybersex use after they discovered Internet sex. Adverse consequences included depression and other emotional problems, social isolation, worsening of their sexual relationship with spouse or partner, harm done to their marriage or primary relationship, exposure of children to online pornography or masturbation, career loss or decreased job performance, other financial consequences, and in some cases, legal consequences.
One of the examples:
A 30-year-old man with a previous history of “porn, masturbation, and frequent sexual thoughts,” wrote about his cybersex experience: In the last couple of years, the more porn I’ve viewed, the less sensitive I am to certain porn that I used to find offensive. Now I get turned on by some of it (anal sex, women peeing, etc.) The sheer quantity of porn on the Net has done this. It’s so easy to click on certain things out of curiosity in the privacy of your home, and the more you see them, the less sensitized you are. I used to only be into softcore porn showing the beauty of the female form. Now I’m into explicit hardcore.
No matter, this study debunks the claim that porn users like only a narrow range of genres. While it doesn’t directly ask about escalation over time, the study found that subjects they categorized as “non-mainstream” porn viewers like many different types of porn . A few relevant excerpts:
The findings suggest that in classified non-mainstream Sexually Explicit Media [porn] groups, patterns of sexual arousal might be less fixated and category specific than previously assumed.
Particularly for heterosexual men and non-heterosexual women, who were characterized by substantial levels of sexual arousal to non-mainstream SEM themes, the findings suggest that patterns of sexual arousal induced by SEM in non-laboratory settings might be more versatile, less fixed, and less category specific than previously assumed. This supports a more generalized SEM arousability and indicates that non-mainstream SEM group participants also are aroused by more mainstream (“vanilla”) themes.
The study is saying that so-called “non-mainstream porn viewers” are aroused by all sorts of porn, whether it’s so-called “mainstream” (Bukkake, Orgy, Fist-fucking) or so-called “non-mainstream” (Sadomasochism, Latex). This finding debunks the often repeated meme that frequent porn users stick to one type of porn. (An example of the unfounded claim about “fixed” tastes is Ogas and Gaddam’s highly criticized book A Billion Wicked Thoughts.)
Most previous studies have relied on small clinical samples. The present study presents a new method for assessing sex addiction—the Bergen–Yale Sex Addiction Scale (BYSAS)—based on established addiction components (i.e., salience/craving, mood modification, tolerance, withdrawal, conflict/problems, and relapse/loss of control).
The authors expand on the six established addiction components assessed, including tolerance and withdrawal.
The BYSAS was developed utilizing the six addiction criteria emphasized by Brown (1993), Griffiths (2005), and American Psychiatric Association (2013) encompassing salience, mood modification, tolerance, withdrawal symptoms, conflicts and relapse/loss of control…. In relation to sex addiction, these symptoms would be: salience/craving—over-preoccupation with sex or wanting sex, mood modification—excessive sex causing changes in mood, tolerance—increasing amounts of sex over time, withdrawal—unpleasant emotional/physical symptoms when not having sex, conflict—inter-/intrapersonal problems as a direct result of excessive sex, relapse—returning to previous patterns after periods with abstinence/control, and problems—impaired health and well-being arising from addictive sexual behavior.
The most prevalent “sex addiction” components seen in the subjects were salience/craving and tolerance, but the other components, including withdrawal, also showed up to a lesser degree:
Salience/craving and tolerance were more frequently endorsed in the higher rating category than other items, and these items had the highest factor loadings. This seems reasonable as these reflect less severe symptoms (e.g., question about depression: people score higher on feeling depressed, then they plan committing suicide). This may also reflect a distinction between engagement and addiction (often seen in the game addiction field)—where items tapping information about salience, craving, tolerance, and mood modification are argued to reflect engagement, whereas items tapping withdrawal, relapse and conflict more measure addiction. Another explanation could be that salience, craving, and tolerance may be more relevant and prominent in behavioral addictions than withdrawal and relapse.
This study, along with the 2017 study that developed and validated the “Problematic Pornography Consumption Scale,” refutes the often-repeated claim that porn and sex addicts do not experience either tolerance or withdrawal symptoms.
It is well known that adolescents use the Internet for sexual purposes, for example viewing sexually explicit materials, a practice which increases with age. Prior research has suggested a link between cognitive and behavioral effects on the one hand and viewing sexually explicit materials on the Internet on the other. The present study aimed to explore exposure to sexually explicit materials on the Internet and a possible desensitizing effect on the perception of online sexual content over time. The study design was longitudinal; data were collected in 3 waves at 6 months intervals starting in 2012. The sample included 1134 respondents (girls, 58.8%; mean age, 13.84 ± 1.94 years) from 55 schools. A multivariate growth model was used for analyzing data.
The results showed that the respondents changed their perception of sexually explicit material on the Internet over time depending on age, frequency of exposure and whether exposure was intentional. They became desensitized in terms of being less bothered by the sexual content. The results may indicate a normalization of sexually explicit material on the Internet during adolescence.
All patients suffered from recurrent sexual fantasies/behaviors and admitted that their sexual behavior resulted in the mishandling of important life duties. All patients noticed a gradual progression of the problem and admitted using sexual behaviors (mostly pornography viewing accompanied by masturbation) to cope with stressful life events. Each of the patients reported multiple attempts to limit or terminate CSB. Usually, effects were poor and temporary, but some reported longer periods of sexual abstinence (several months up to 1 year) followed by relapses.
Similarly, tolerance can also develop to pornography. After prolonged consumption of pornography, excitatory responses to pornography diminish; the repulsion evoked by common pornography fades and may be lost with prolonged consumption (Zillman, 1989). Thus, what initially led to an excitatory response does not necessarily lead to the same level of enjoyment of the frequently consumed material. There-fore, what aroused an individual initially may not arouse them in the later stages of their addiction. Because they do not achieve satisfaction or have the repulsion they once did, individuals addicted to pornography generally seek increasingly novel forms of pornography to achieve the same excitatory result.
For example, pornography addiction may begin with non-pornographic but provocative images and can then progress to more sexually explicit mages. As arousal diminishes with each use, an addicted individual may move on to more graphic forms of sexual images and erotica. As arousal again diminishes, the pattern continues to incorporate increasingly graphic, titillating, and detailed depictions of sexual activity through the various forms of media. Zillman (1989) states that prolonged pornography use can foster a preference for pornography featuring less common forms of sexuality (e.g., violence), and may alter perceptions of sexuality. Although this pattern typifies what one would expect to see with pornography addiction, not all pornography users experience this cascade into an addiction.
Withdrawal symptoms from pornography use may include depression, irritability, anxiety, obsessive thoughts, and an intense longing for pornography. Due to these often intense withdrawal symptoms, cessation from this reinforcement can be extremely difficult for both the individual and the couple’s relationship.
STUDY TWENTY SIX: Consequences of Pornography Use (2017) – This study asked if internet users experienced anxiety when they couldn’t access porn on the internet (a withdrawal symptom): 24% experienced anxiety. One third of the participants had suffered negative consequences related to their porn use. Excerpts:
The objective of this study is to obtain a scientific and empirical approximation to the type of consumption of the Spanish population, the time they use in such consumption, the negative impact it has on the person and how anxiety is affected when it is not possible to access to it. The study has a sample of Spanish internet users (N = 2.408). An 8-item survey was developed through an online platform that provides information and psychological counselling on the harmful consequences of pornography consumption. To reach diffusion among the Spanish population, the survey was promoted through social networks and media.
The results show that one third of the participants had suffered negative consequences in family, social, academic or work environment. In addition, 33% spent more than 5 hours connected for sexual purposes, using pornography as a reward and 24% had anxiety symptoms if they could not connect.
Progression from legal material. For nine participants, their CP offending appeared to be the result of prolonged exposure and potential desensitisation to legal pornography. Some participants provided fairly detailed responses of their journey:
“The gradual escalation from normal adult material to more extreme material (dehumanising) after first accessing the internet, that I used it to cope with emotional and stressful situations. Followed by viewing younger and younger woman, girls and preteen, i.e. child modeling [sic] and cartoons showing extreme adult and other abusive subject matter. (Case 5164)”
Again, some of the responses clearly linked back to a developing sexual interest in children, based on increasing exposure to the material…. Overall, this theme shared some similarities with the previous theme in that CP, used as a source of sexual satisfaction, acts as a potential stress reliever. However, for offenders belonging to this thematic group, CP had been approached via progression through other forms of pornography, which may still be used.
STUDY TWENTY EIGHT: Effect of Pornography Exposure on Junior High School Teenagers of Pontianak in 2008 (2009)– Malaysian porn use study on junior high students. Unique in that this is the only study to report escalation into more extreme material, desensitization (tolerance), and porn addiction in a teen population. (It’s the only study to ask teens these questions.) Excerpts:
A total of 83.3% of junior high school adolescents in Pontianak City have exposed to pornography, and from being exposed as many as 79.5% experience the effects of exposure to pornography. Teenagers who experience the effects of exposure to pornography as much as 19.8% were in the addiction stage, [among the addicted] adolescents 69.2% is at the escalation stage, [among those who escalated] 61.1% is at the desensitization stage, and [among those who reported desensitization] 31.8% was at the stage of act out.
Pornography can affect teens to do shape behavior, consciously or unconsciously, has changing perceptions and even the behavior of adolescent life daily especially in terms of sexuality The results of this study show that as many as 52 (19.78%) of junior high school students in Pontianak City has experienced the effects of exposure to pornography is on stage addiction.
The next change in attitude or behavior is escalation. The results showed 36 people (69.2%) of 52 adolescents who are addicted to the stage escalation / increased needs. After all this time consume pornography, adolescents who are hooked will experienced an increase in the need for sex material which is heavier, more explicit, more sensational and more distorted than previously consumed. This increase in demand is not in terms of quantity but especially the quality of which is increasingly explicit, then it is will be more satisfied. If before he had enough satisfied watching the image of a woman naked, then want to see a movie that contains a sex scene.
Once saturated, he wants to see that sex scene different ones that are sometimes more wild and distorted than which he had seen. Also in accordance with the results study Zillman & Bryant (1982, in Thornburgh & Herbert, 2002) which states that when someone is exposed to repeated pornography, they are will show a tendency to have distorted perceptions of sexuality also occur increased need for more pornographic types hard and distorted.
The next stage of desensitization has been experienced by 22 people (61.11%) teenagers from 36 people who experiencing stage escalation. At this stage, sex material which was taboo, immoral and degrading/humiliating human dignity, gradually considered to be something that is considered normal which means the longer it becomes insensitive again.
The results of this study further found from 22 people in the desensitization stage exist as many as 7 people (31.8%) are in actout stage. At this stage there is a tendency to engage in sexual behavior such as pornography he has been watching for real life
STUDY TWENTY NINE: Clinical encounters with internet pornography (2008)– Comprehensive paper, with four clinical cases, written by a psychiatrist who became aware of the negative effects internet porn was having on some of his male patients. The excerpt below describes a 31 year old man who escalated into extreme porn and developed porn-induced sexual tastes and sexual problems. This is one of the first peer-reviewed papers to depict porn use leading to tolerance, escalation, and sexual dysfunctions.
A 31-year-old male in analytic psychotherapy for mixed anxiety problems reported that he was experiencing difficulty becoming sexually aroused by his current partner. After much discussion about the woman, their relationship, possible latent conflicts or repressed emotional content (without arriving at a satisfactory explanation for his complaint), he provided the detail that he was relying on a particular fantasy to become aroused. Somewhat chagrined, he described a “scene” of an orgy involving several men and women that he had found on an Internet pornography site that had caught his fancy and become one of his favorites. Over the course of several sessions, he elaborated upon his use of Internet pornography, an activity in which he had engaged sporadically since his mid-20s.
Relevant details about his use and the effects over time included clear descriptions of an increasing reliance on viewing and then recalling pornographic images in order to become sexually aroused. He also described the development of a “tolerance” to the arousing effects of any particular material after a period of time, which was followed by a search for new material with which he could achieve the prior, desired level of sexual arousal.
As we reviewed his use of pornography, it became evident that the arousal problems with his current partner coincided with use of pornography, whereas his “tolerance” to the stimulating effects of particular material occurred whether or not he was involved with a partner at the time or was simply using pornography for masturbation. His anxiety about sexual performance contributed to his reliance on viewing pornography. Unaware that the use itself had become problematic, he had interpreted his waning sexual interest in a partner to mean that she was not right for him, and had not had a relationship of greater than two months’ duration in over seven years, exchanging one partner for another just as he might change websites.
He also noted that he now could be aroused by pornographic material that he once had no interest in using. For example, he noted that five years ago he had little interest in viewing images of anal intercourse but now found such material stimulating. Similarly, material that he described as “edgier,” by which he meant “almost violent or coercive,” was something that now elicited a sexual response from him, whereas such material had been of no interest and was even off-putting. With some of these new subjects, he found himself anxious and uncomfortable even as he would become aroused.
In addition, participants talked about the ever increasing levels of extremity within SEM content online. SEM could therefore be seen as an influential force in the moulding of more extreme sexual preferences.
“due to the ever increasing availability of porn, the videos are becoming more and more adventurous and shocking in order to keep up with the demand for it to still be deemed exciting”. – Jay
“It has probably made me case hardened. It takes a lot to shock me now, Because of the amount I have seen it doesn’t affect me as much as it used to” – Tom
To test the spectrum hypothesis and to have comparable symptoms for each technology-mediated behavior, the first and the last author linked each scale item with the following “classical” addiction symptoms: continued use, mood modification, loss of control, preoccupation, withdrawal, and consequences technology-mediated addictive behaviors were investigated using symptoms derived from the Diagnostic and Statistical Manual of Mental Disorders (5th ed.) and the component model of addiction: Internet, smartphone, gaming, and cybersex.
Between-conditions edges often connected the same symptoms through Internet addiction symptoms. For example, Internet addiction withdrawal symptoms were connected with withdrawal symptoms of all other conditions (gaming addiction, smartphone addiction, and cybersex addiction) and adverse consequences of Internet addiction were also connected with adverse consequences of all other conditions.
STUDY THIRTY TWO: Sexual Interests of Child Sexual Exploitation Material (CSEM) Consumers: Four Patterns of Severity Over Time (2018) – Study analyzed the evolution over time of the activity of consumers of child porn, using data extracted from the hard drives of 40 convicted individuals. Found that the most prevalent pattern was a drop in age of the person depicted and a rise in the extremeness of the sexual acts. The researchers discuss habituation and escalation, as well as the literature demonstrating that porn collectors have escalated to more extreme sexual interests than contact offenders. Excerpts:
37.5% of the collections exhibited increased severity in terms of both age and COPINE [extremeness] score: The children depicted became younger, and the acts became more extreme.
… [A second pattern was] exemplified by … an increase in the COPINE [extremeness] score and in the age of the subjects…. This pattern was present in [an additional] 20%.
… It should be noted that all the child pornography collections included mainstream pornography content.
… A second explanation that is also related to the sexual interest explanation is that collectors become habituated to low-severity pornography, which is congruent with the patterns 1, 2, and 3 of the current study. It has been suggested that habituation to pornographic content leads to boredom, which in turn impels the pornography consumer to seek out new content that is more severe…. Thus, to maintain their degree of sexual arousal, child-pornography collectors may be driven to explore other age categories and sexual acts.
…During masturbatory activities, CSEM collectors have the possibility of exploring a wider range of sexual interests than offline sexual offenders, who are limited by the availability of victims. Consequently, they may become motivated to search for new illegal content to nourish their sexual fantasies. This explanation is in agreement with Babchishin et al.’s (2015) meta-analysis, which reveals that online offenders have more deviant sexual interests than offline offenders.
Scores on pornography consumption were introduced as covariate in the analysis pertaining the automatic attention task because the task may have been influenced by the habituation to sexually explicit stimuli.
Findings revealed that sexually explicit pictures yielded more automatic attention capture. However, this effect was superseded by pornography consumption, which likely reflects a habituation mechanism
These findings align with the Sexual Content Induced Delay, an effect that has been consistently reported in literature and shows that individuals present delayed responses when exposed to sexual stimuli—therefore signaling an attentional bias toward sexual stimuli—as compared with other types of stimuli. However, the introduction of pornography consumption as covariate reduced the impact of the sexually explicit pictures (to the level of nonstatistical significance), thus revealing a habituation mechanism in automatic attention to erotic stimuli.
STUDY THIRTY FOUR: Pornography Induced Erectile Dysfunction Among Young Men (2019) – Study on men with porn-induced erectile dysfunction (PIED) reveals tolerance (declining arousal) and escalation (needing more extreme material to be aroused) in all the subjects. From the abstract:
This paper explores the phenomenon of pornography induced erectile dysfunction (PIED), meaning sexual potency problems in men due to Internet pornography consumption. Empirical data from men who suffer from this condition have been collected…. they report that an early introduction to pornography (usually during adolescence) is followed by daily consumption until a point is reached where extreme content (involving, for example, elements of violence) is needed to maintain arousal.A critical stage is reached when sexual arousal is exclusively associated with extreme and fast-paced pornography, rendering physical intercourse bland and uninteresting. This results in an inability to maintain an erection with a real-life partner, at which point the men embark on a “re-boot” process, giving up pornography. This has helped some of the men to regain their ability to achieve and sustain an erection.
Introduction to the results section:
Having processed the data, I have noticed certain patterns and recurring themes, following a chronological narrative in all of the interviews. These are: Introduction. One is first introduced to pornography, usually before puberty. Building a habit. One begins to consume pornography regularly. Escalation. One turns to more “extreme” forms of pornography, content-wise, in order to achieve the same effects previously achieved through less “extreme” forms of pornography.Realization. One notices sexual potency problems believed to be caused by pornography use. “Re-boot” process. One tries to regulate pornography use or eliminate it completely in order to regain one’s sexual potency. The data from the interviews are presented based on the above outline.
STUDY THIRTY FIVE (not peer-reviewed): xHamster Report on Digital Sexuality, Part 1: Bisexuality (2019) – A surprising study by porn-tube site Xhamster suggests that heavy porn use can lead to some users believing they may be bisexual. While this finding is politically incorrect, YBOP has documented many instances of chronic porn users who believed themselves to be bisexual, yet no longer believed this after extended periods away from porn. These pages contain many examples of eliminating porn leading a reversal of sexual tastes:
Does watching too much porn make you gay? No, but it might make you bi.
Earlier this month, xHamster launched an ambitious internal study — the xHamster Report on Digital Sexuality — compiling data on our porn users age, gender, sexuality, relationship status, political views, viewing habits and more, to try to understand just who watches what and why. Over 11,000 users completed this survey.
While we’re just beginning to process the data, one number jumped out at us immediately. Over 22.3% of all US-based xHamster visitors consider themselves bisexual. Only 67% consider themselves to be entirely “straight.”
At first, we thought there was something wrong with the numbers, or the study design. But as we dug deeper, we saw a consistency with their answers — from relationship status, to what porn they viewed, to where they lived — that supported the numbers…….
So we wondered, is there something about watching porn that opens up users to the idea of a more fluid sexuality. The answer is … it may.
We compared responses from users who watch porn once a week, with users who report watching it several times a day. Porn fans who watched multiple times a day were more than twice as likely to identify as bisexual as porn fans who watched only once a week (27% vs 13%).
As you can see, there’s a direct correlation between the amount of time a person spends watching porn, and whether or not they identified as bisexual. (It doesn’t seem to have an affect on gay identity — that stays in a pretty narrow range.)
We also wondered if there was some way that women porn fans — 38% of whom in our study identified as bisexual — might be somehow skewing the data. So we repeated the calculations with just men. The results were even more dramatic.
Just 10.8% of men who watched porn once a week identified as bisexual, but 27.2% of men who watch porn multiple times a day identify as bisexual. (After all, if you’re looking at naked men all day — even if there’s a woman in the picture — maybe it opens you up to a broader ideas about human sexuality.)
Now, we should stress that correlation is not causation. Bisexual and gay people both report greater frequency of viewing of porn, and a lower stigma associated with watching it. (Both groups are also less likely to be married, and thus might have greater freedom to watch. But again — we didn’t see any significant correlation between frequency of viewing, and gay identification.)……
The purpose of this study was to characterize and predict sex offenders’ pornography consumption at the time of the index offense. Participants were 146 male sex offenders incarcerated in a Portuguese prison establishment. A semi-structured interview and the Wilson Sex Fantasy Questionnaire were administered.
Thus, for those individuals, pornography had a conditioning effect, making them want to try out those behaviors. This is of importance, since 45% used pornography that featured forced sex and 10% that included children at least once at the time of the index offense. It appears that for some individuals with specific characteristics using pornography may help disinhibit their sexual desires. It was not the subject of this investigation to assess what those characteristics were, but past research has delved on this matter (e.g. Seto et al., 2001)….
Contrariwise, while some studies point to the “catharsis” role of pornography as a means of relief (Carter et al., 1987; D’Amato, 2006), that does not appear to be equal for all individuals, since for some it was not enough and made them try to reproduce the visualized contents. This is of specific importance for clinicians when tailoring treatment strategies for sex offenders of child pornography, for instance, as the motivation for using pornography needs to be fully assessed beforehand. A better understanding of the dynamics surrounding pornography consumption prior to an individual’s perpetration of sexual offenses is of utmost importance, due to its relationship with sexual aggression (Wright et al., 2016) and violent recidivism (Kingston et al., 2008)….
The authors studied the effect of repeated exposure to pornographic material on young men. The 23 experimental subjects spent 90 minutes a day for three weeks viewing pornographic films and reading pornographic materials. Before-and-after measurements on these subjects and a control group of nine men included penile circumference changes and acid phosphatase activity in response to pornographic films. The data support the hypothesis that repeated exposure to pornography results in decreased interest in it and responsiveness to it. A variety of psychological tests and scales discerned no lasting effects on the subjects’ feelings or behavior other than feeling bored by pornography, both immediately following the study and eight weeks later.
The way we access pornography has certainly changed over time, as has the depth and breadth of pornographic content. Yet, despite decades of research on the effects of pornography, far less is known about specific genres, consumption patterns, and the characteristics of those consuming varying types of content. Utilizing Google search trends and image searches, this research explores the interest and relationships at the macro level within the niche of youth-oriented pornography. Results indicate that interest varies based on gender, age, geographic origin, and income.
Excerpt:
As our current research here can only speak to the trends illuminated from our analysis, future studies must be conducted in order to ascertain information regarding actual attitudes and behaviors associated with consuming youth-oriented pornography. Overall, the results indicate all three hypotheses were supported. We found that there has been a significant increase in the rate of interest within teenage pornography, amateur pornography, and Hentai inspired pornography, which is unsurprising given the popularity of the niches among and widespread availability content via pornographic hubs (Ogas and Gaddam 2011).
Clearly the interest in youth-oriented pornography has increased over the past decade, and that increase appears to coincide with what Gill (2008, 2012) and others argue is the continued ‘‘sexualization of culture’’. Only the search interest in Lolita pornography has decreased, most likely a result of the antiquated terminology and decrease in popularity, as more specific queries have arisen. Moreover, the evidence supports our hypothesis that those seeking out these subgenres within the niche of teenage pornography are a heterogeneous population rather than a homogenous group. Not only does the interest in types of youth-oriented pornography vary, but so too do the characteristics of the consumers seeking out the varying niches examined here.
A further interesting result is that the effect size for post-hoc tests duration in minutes per session, when comparing unregulated [problematic] users with recreational–frequent users, was higher [in problematic users] in comparison to the frequency per week. This might indicate that individuals with unregulated IP [internet porn] use especially have difficulties to stop watching IP during a session or need longer time to achieve the desired reward, which might be comparable with a form of tolerance in substance use disorders.
The most common self-perceived adverse effects of pornography use included: the need for longer stimulation (12.0%) and more sexual stimuli (17.6%) to reach orgasm, and a decrease in sexual satisfaction (24.5%)…
The present study also suggests that earlier exposure may be associated with potential desensitization to sexual stimuli as indicated by a need for longer stimulation and more sexual stimuli required to reach orgasm when consuming explicit material, and overall decrease in sexual satisfaction…..
Various changes of pattern of pornography use occurring in the course of the exposure period were reported: switching to a novel genre of explicit material (46.0%), use of materials that do not match sexual orientation (60.9%) and need to use more extreme (violent) material (32.0%). The latter was more frequently reported by females considering themselves as curious compared tothose regarding themselves as uninquisitive
the present study found that a need to use more extreme pornography material was more frequently reported by males describing themselves as aggressive.
Additional signs of tolerance/escalation: needing multiple tabs open and using porn outside of home:
The majority of students admitted to use of private mode (76.5%, n = 3256) and multiple windows (51.5%, n = 2190) when browsing online pornography. Use of porn outside residence was declared by 33.0% (n = 1404).
Earlier age of first use related to greater problems and addiction (this indirectly indicates tolerance-habituation-escalation):
Age of first exposure to explicit material was associated with increased likelihood of negative effects of pornography in young adults—the highest odds were found for females and males exposed at 12 years or below. Although a cross-sectional study does not allow an assessment of causation, this finding may indeed indicate that childhood association with pornographic content may have long-term outcomes….
Addiction rates were relatively high, even though it was “self-perceived”:
Daily use and self-perceived addiction was reported by 10.7% and 15.5%, respectively.
The study reported withdrawal symptoms, even in non-addicts (a definitive sign of addiction-related brain changes):
Among those surveyed who declared themselves to be current pornography consumers (n = 4260), 51.0% admitted to making at least one attempt to give up using it with no dif ference in the frequency of these attempts between males and females. 72.2% of those attempting to quit pornography use indicated the experience of at least one associated e ffect, and the most frequently observed included erotic dreams (53.5%), irritability (26.4%), attention disturbance (26.0%), and sense of loneliness (22.2%) (Table 2).
Many of the participants believed that porn is a public health issue:
In the present study, the surveyed students often indicated that pornography exposure may have an adverse outcome on social relationships, mental health, sexual performance, and may affect psychosocial development in childhood and adolescence. Despite this, the majority of them did not support any need for restrictions to pornography access….
Debunking the claim that pre-existing conditions are the real issue, not porn use, the study found that personality traits were not related to outcomes:
With some exceptions, none of personality traits, which were self-reported in this study, differentiated the studied parameters of pornography. These findings support the notion that access and exposure to pornography are presently issues too broad to specify any particular psychosocial characteristics of its users. However, an interesting observation was made regarding consumers who reported a need to view increasingly extreme pornographic content. As shown, frequent use of explicit material may potentially be associated with desensitization leading to a need to view more extreme content to reach similar sexual arousal.
In line with our hypothesis, problematic online pornography use was associated with the amount of time spent viewing online pornography. The greater the overall online pornography use, the higher the s-IATsex score. Of note, the correlation explains only 18% of the common variance, leaving a large percentage of the variance unexplained. As a result, the total time spent viewing online pornography (hours per week) cannot be equated to problematic online pornography use, as has been done in some previous studies. Nonetheless, our data show that overall, the amount of time spent viewing online pornography is a significant predictor of problematic online pornography use.
We also identified a greater variance in pornography categories as a good predictor of problematic online pornography use—that is, the more diverse material a participant watched, the higher her s-IATsex score. This demonstrates that women with problematic online pornography use seek more diverse material, which could be an indicator for habituation effects. Habituation in turn could lead to tolerance building, leading consumers to explore new material to elicit the same neuronal response to pornography as when they initially started watching.
Our findings add to the growing body of literature suggesting that problematic online pornography use might constitute a clinically relevant phenomenon. Although in 2013 the editors of the revised Diagnostic and Statistical Manual, Fifth Edition declined to add “hypersexual disorder” as a diagnosis, more recent research has led to the likely inclusion of the diagnosis “compulsive sexual behavior disorder” in the upcoming revision of the International Classification of Diseases and Related Health Problems.
An excerpt from the case reporting withdrawal symptoms:
Perry (22, P_akeh_a):
Perry felt he had no control over his pornography use and that viewing pornography was the only way he could manage and regulate emotions, specifically anger. He reported outbursts at friends and family if he abstained from pornography for too long, which he described as a period of roughly 1 or 2 weeks.
Excerpts from the 3 cases reporting escalation or habituation:
Preston (34, M_aori)
Preston self-identified with SPPPU because he was concerned with the amount of time he spent watching and ruminating on pornography. To him, pornography had escalated beyond a passionate hobby and reached a level where pornography was the center of his life. He reported watching pornography for multiple hours a day, creating and implementing specific viewing rituals for his viewing sessions (e.g., setting up his room, lighting, and chair in a specific and orderly way before viewing, clearing his browser history after viewing, and cleaning up after his viewing in a similar way), and investing significant amounts of time in maintaining his online persona in a prominent online pornography community on PornHub, the world’s largest Internet pornography website…
Patrick (40, P_akeh_a)
Patrick volunteered for the present research because he was concerned with the duration of his pornography viewing sessions, as well as the context in which he viewed. And Patrick regularly watched pornography for several hours at a time while leaving his toddler son unattended in the living room to play and/or watch television…
Peter (29, P_akeh_a)
Peter was concerned with the type of pornographic content he was consuming. He was attracted to pornography made to resemble acts of rape. The more real and realistically depicted the scene, the more stimulation he reported experiencing when viewing it. Peter felt his specific tastes in pornography were a violation of the moral and ethical standards he held for himself…
STUDY FORTY THREE: Hidden in Shame: Heterosexual Men’s Experiences of Self-Perceived Problematic Pornography Use (2019) – Study involving interviews of 15 male porn users. Several of the men reported porn addiction, escalation of use, habituation, poorer sexual satisfaction and porn-induced sexual problems. Excerpts relevant to escalation of use and habituation, and porn use altering sexual tastes.
The participants talked about how pornography influenced the various aspects of their sexuality and sexual experiences. Michael discussed how pornography had influenced his sexual behaviors, specifically about the acts he would attempt to recreate with women that he had watched in pornography. He openly discussed the sexual acts he regularly engaged in, and questioned how natural these acts were:
Michael: I sometimes cum on a girl’s face, which serves no biological purpose, but I got it from porn. Why not the elbow? Why not the knee? There’s a level of disrespect to it. Even though the girl consents, it’s still disrespectful. (23, Middle-Eastern, Student)
The data provided by the participants seem to align with literature, with pornography impacting sexual expectations, sexual preferences, and sexual objectification of women….After years of watching pornography, some of the men began to get uninterested in everyday sex because it did not measure up to the expectations set by pornography:
Frank: I feel like real sex isn’t as good because the expectations are too high. The stuff I would expect her to do in bed. Porn is an unrealistic portrayal of a regular sex life. When I got used to unrealistic images, you expect your real sex life to match the intensity and pleasure of porn. But that doesn’t happen, and when it doesn’t happen, I get a little disappointed. (27, Asian, Student)
George: I think the expectations I have about how whizz, bang, wonderful things should be during sex are not the same in real life [. . .] And it’s harder for me when what I get used is something that’s not real, and staged. Porn sets up unrealistic expectations for sex. (51, Pa¯keha¯, Mentor)
Frank and George highlight an aspect of pornography that is referred to as “Pornotopia,” a fantasy world where an endless supply of “lusty, gorgeous, and always orgasmic women” are readily available for male viewing (Salmon, 2012). For these men, pornography created a sexual fantasy world that could not be met in “reality.”…. When these expectations were not met, some of the men were disappointed and became less sexually aroused:
Albert: Because I’ve seen so many images and videos of women I find attractive, I find it difficult to be with women that do not match the quality of the women I watch in videos or see in images. My partners do not match up to the behaviors that I watch in the videos [. . .] When you watch porn very often, I’ve noticed that women are always dressed very sexy, in sexy high heels and lingerie, and when I do not get that in bed I get less aroused. (37, Pa¯keha¯, Student)
Participants also discussed how their sexual preferences evolved as a result of their pornography use. This could involve an “escalation” in pornographic preferences:
David: At first it was one person getting progressively naked, then it progressed to couples having sex, and from quite early on, I started narrowing down to heterosexual anal sex. This all happened within a couple years of starting my porn viewing [. . .] From there, my viewing got more and more extreme. I found that the more believable expressions were those of pain and discomfort, and the videos I viewed started to get more and more violent. Such as, videos that are made to look like rape. What I was going for was the homemade stuff, amateur style. It looked believable, like a rape was actually happening. (29, Pa¯keha¯, Professional)
Literature has suggested that compulsive and/or problematic pornography users often experience a phenomenon where their pornography use escalates and takes the form of greater time spent viewing or seeking out new genres that induce shock, surprise, or even violation of expectations (Wéry & Billieux, 2016). Consistent with literature, David attributed his niche pornographic preferences to pornography. Indeed, the escalation from nudity to realistic looking rape was the primary reason David perceived his use to be problematic. Like David, Daniel also noticed that what he found sexually arousing had evolved after years of watching pornography. Daniel discussed his extensive exposure to pornographic scenes, specifically of penises penetrating vaginas, and subsequently becoming sexually stimulated by the sight of a penis:
Daniel: When you watch enough porn, you begin getting aroused by the sights of penises as well, since they’re on the screen so much. Then a penis becomes a conditioned and automatic source of stimulation and arousal. For me it’s fascinating just how localized my attraction is to the penis, and nothing else of a man. So like I said, I derive nothing from men, other than the penis. If you copy and paste it onto a woman, then that’s excellent. (27, Pasifika, Student)
Over time, as their pornographic preferences evolved, both men sought to explore their preferences in real life. David reenacted some of his pornographic preferences with his partner, specifically anal sex. David reported feeling very relieved when his partner was accepting of sexual desires, which is certainly not always the case in such instances. However, David did not disclose his preference for rape pornography with his partner. Daniel, like David, also reenacted his pornographic preferences and experimented by engaging in sexual acts with a transgender woman. According to literature pertaining to pornographic content and real-life sexual experiences, however, the cases of both David and Daniel do not necessarily represent the norm. Although there is a link between less conventional practices, a significant proportion of individuals have no interest in reenacting the pornography acts— especially the unconventional acts—they enjoy viewing (Martyniuk, Okolski, & Dekker, 2019).
Lastly, men reported the impacts pornography had had on their sexual function, something that has only recently been examined within the literature. For example, Park and colleagues (2016) found that Internet pornography viewing might be associated with erectile dysfunction, decreased sexual satisfaction, and diminished sexual libido. Participants in our study reported similar sexual dysfunctions, which they attributed to pornography use.
STUDY FORTY FOUR:Signs and symptoms of cybersex addiction in older adults (2019)– In Spanish, except for the abstract. Average age was 65. Contains surprising findings that thoroughly support the addiction model, including 24% reported symptoms of withdrawal when unable to access porn (anxiety, irritability, depression, etc.). From the abstract:
Thus, the aim of this work was double: 1) to analyze the prevalence of older adults at risk of developing or showing a pathological profile of cybersex use and 2) to develop a profile of signs and symptoms that characterize it in this population. 538 participants (77% men) over 60 years of age (M = 65.3) completed a series of online sexual behavior scales. 73.2% said they used the Internet with sexual aim. Among them, 80.4% did it recreationally whereas a 20% showed a risk consumption. Among the main symptoms, the most prevalent were the perception of interference (50% of participants), spending >5 hours a week on the Internet for sexual purposes (50%), recognize that they may be doing it excessively (51%) or presence of symptoms of withdrawal (anxiety, irritability, depression, etc.) (24%). This work highlights the relevance of visualizing online risky sexual activity in a silent group and usually outside any intervention for the promotion of online sexual health.
STUDY FORTY FIVE:Effect of pornography on married couples (2019) – A rare Egyptian study. While the study reports porn use increasing parameters of arousal, the long-term effects don’t match porn’s short-term effects. The conclusion:
Conclusion: Pornography has a negative effect on marital relation.
Excerpts related to tolerance or escalation:
The study shows that watching pornography has a statistically positive correlation with years of marriage. This was in agreement with Goldberg et al.[14] who stated that pornography is highly addictive. This was also in agreement with Doidge [15] who said that the body develops tolerance to dopamine released while watching pornography by time.
There is a highly negative correlation between satisfaction of sexual life and watching pornography as 68.5% of positive watchers are not satisfied with their sexual life. This was in agreement with Bergner and Bridges [17] who found that there is a decrease in sexual desire and satisfaction with pornography users.
In the current study although pornography increases desire and frequency of intercourse, it does not help the user to reach orgasm. This was in agreement with Zillman [24] who found that habitual use of pornography leads to greater tolerance of sexually explicit materials, thus requiring more novel and bizarre materials to achieve the same level of arousal and interest, which was also in agreement with Henderson [25], who found that materials which was used to produce arousal and stimulation no longer does so and therefore more materials and longer viewing time and more degrading materials are sought to achieve the same degree of stimulation and satisfaction.
27 of 33 interviewees mentioned withdrawal symptoms.
15 of 33 interviewees mentioned escalation to more extreme content.
Graph of interviewees ratings the six dimensions of the porn questionnaire that assessed tolerance and withdrawal (The PPCS):
The most accurate of the 3 questionnaire was the “PPCS” which is modeled after substance addiction questionnaires. Unlike the other 2 questionnaires, and previous porn addiction tests, the PPCS assesses tolerance & withdrawal. An excerpt describing importance of assessing tolerance and withdrawal:
The more robust psychometric properties and higher recognition accuracy of the PPCS may be attributable to the fact that it has been developed in accordance with Griffiths’s six-component structural theory of addiction (i.e., in contrast to the PPUS and s-IAT-sex). The PPCS has a very strong theoretical framework, and it assesses more components of addiction [11]. In particular, tolerance and withdrawal are the important dimensions of problematic IPU that are not assessed by the PPUS and s-IAT-sex;
The interviewees see withdrawal as a common and important feature of problematic porn use:
It also can be inferred from Figure 1 that both volunteers and therapists emphasized the centrality of conflict, relapse and withdrawal in IPU (basing the frequency of mentions); at the same time, they weighted the mood modification, relapse and withdrawal as more important features in the problematic use (basing the important rating).
STUDY FORTY SEVEN:Attenuation of Deviant Sexual Fantasy across the Lifespan in U.S. Adult Males (2020)– Study reported that the 18–30 year-old group reported the highest mean of deviant sexual fantasy followed by those 31–50, then those 51–76 years of age. Put simply, the age group with the highest rates of porn use (and who grew up using tube sites) report the highest rates of sexual deviant fantasies (rape, fetishism, sex with children). Excerpt from the discussion section suggests that porn use may be the reason:
Additionally, a possible explanation for why those under 30 years of age endorsed more deviant sexual fantasies than those over the age of 30 could be due to increased pornography consumption among younger men. Researchers found that pornography consumption has increased since the 1970s, rising from 45% to 61%, with change over time being the smallest for older age groups for which pornography consumption decreases (Price, Patterson, Regnerus, & Walley, 2016). Additionally, in a study of pornography consumption among 4339 Swedish young adults, less than one third of participants reported viewing deviant sexual pornography of violence, animals and children (Svedin, Åkerman, & Priebe, 2011).
Although pornography exposure and usage were not assessed in the current study, those under 30 years in our sample could be viewing more pornography, as well as more deviant forms of pornography, than those over the age of 51 years as pornography usage in young adulthood has become more socially accepted (Carroll et al., 2008).
STUDY FORTY EIGHT: Motivational pathways underlying the onset and maintenance of viewing child pornography on the Internet (2020) – New study reports large % of child porn (CP) users have no sexual interest in children. It was only after years of viewing adult porn, resulting in habituation to new genre after new genre, that porn users eventually sought even more extreme material, genres, eventually escalating into CP. Researchers point to the nature of internet porn (endless novelty via tube sites) as playing a substantial role in conditioning sexual arousal to the most extreme content, such as CP. Relevant excerpts:
The nature of the internet promotes non-pedophiles to eventually escalate:
Here we discuss men’s self-identified subjective motivations for the onset and maintenance of viewing CP on the Internet. We focus specifically on Internet-based sexual stimuli due to previous assertions that the Internet itself may introduce unique factors contributing to this behavior (Quayle, Vaughan, & Taylor, 2006).
Escalation as a pathway to CP use:
Several participants reported being sexually interested in pornography that they described as ‘taboo’ or ‘extreme’, meaning it fell outside the range of what they considered traditional sexual activities or behaviors. For example, Mike reported searching for “anything unusual really, as long as it wasn’t … regular looking things.” Participants often started by viewing Internet pornography on the lower end of the taboo spectrum (e.g., spanking, transvestism), and described a gradual progression to viewing more extreme sexual stimuli in response to what appeared to be habituation to these sexual activities or themes.
As shown in Figure 1, the drive to discover increasingly taboo pornography ultimately facilitated the use of CP for some participants, following their habituation to a myriad of pornographic themes, including illicit but non-pedophilic behaviors (e.g., incest, bestiality). As Jamie described, “I’d look at BDSM things, and then get to more really sadistic things and other taboos, and then eventually just kind of feel like, ‘well, again, fuck it. I’ll take the plunge’”. The fact that CP is illegal actually increased some participants’ arousal, such as Ben who explained, “I felt like what I was doing was illegal, and it gave me a tremendous rush”, and Travis, who noted, “Sometimes it felt good to do something you’re not supposed to be doing.”
Hyperfocused sexual arousal
Once in this state of hyperfocused sexual arousal, participants found it easier to justify viewing increasingly taboo and eventually illegal pornography. This finding is supported by previous research suggesting that ‘visceral’ states of arousal allow people to ignore factors that would otherwise prevent specific sexual behaviors (Loewenstein, 1996). …. Once participants were no longer in this state of hyperfocused sexual arousal, they reported that the CP they had been viewing became unappealing and aversive, a phenomenon that has also been reported by Quayle and Taylor (2002).
Seeking novelty
Participants explained that as their exposure to Internet pornography intensified, they found themselves increasingly uninterested in the genres of (legal) pornography that they had traditionally preferred. Consequently, participants began to desire and seek out sexual stimuli involving new sexual themes and activities. The Internet appeared to contribute to participants’ sense of boredom and desire for novel sexual stimuli, as the vastness of the Internet suggested the existence of an endless amount of pornography, any or all of which could be more exciting or arousing than what they were currently viewing. In describing this process, John explained:
It started just with normal adult men with women kind of thing, and it’s a bit dull, so then maybe you watch some lesbian stuff for a while, and it gets a bit dull, and then you start exploring.
Desensitization (habituation) leading to escalation:
In their attempts to find novel and sexually exciting stimuli, participants began exploring categories of pornography involving a broader range of sexual behaviors, partners, roles, and dynamics than they would previously have considered viewing. This may reflect a slight broadening of the moral or legal boundaries that a person (consciously or unconsciously) sets for themselves regarding the types of pornography they consider ‘acceptable’. As Mike explained, “You just keep crossing boundaries and crossing boundaries – [you tell yourself] ‘you’ll never do that’, but then you do it.”
The progression that Mike and other participants described suggests the possibility of a habituation effect, as many participants reported that eventually they required increasingly taboo or extreme pornography in order to achieve the same degree of arousal. As Justin explained, “I found myself kind of slipping downhill where it just, it needed to be a bigger thrill to have any sort of an impact on you.” Many participants in our study reported viewing a myriad of different types of pornography prior to seeking out CP, which is similar to previous research indicating that people with CP offenses may begin by using legal pornography and gradually progress to viewing illegal materials, possibly resulting from extensive exposure and boredom (Ray et al., 2014).
Habituation leads to CP:
As shown in Figure 1, participants often cycled between seeking novelty and habituation multiple times before they began actively seeking CP. After discovering a new and highly arousing genre of pornography, participants would spend many hours searching, viewing, and collecting stimuli of this nature, essentially ‘binge’ watching these materials.Participants explained that due to this extensive exposure, they reached a point when this genre of pornography no longer provided a strong degree of sexual arousal, causing them to resume the search for novel sexual stimuli:
I think at first, I got bored. Like, I would find a theme that I was interested in … and very easily I would get sort of, I don’t know, I’d use up the theme – I’m not interested, I’ve seen so much – and then I’d move onto more. (Jamie)
I started looking at pictures of younger [adult] women when I was first looking at pornography on the Internet, and then I just kept getting into looking at younger and younger girls, and eventually children. (Ben)
The habituation effect is well-established in other areas of psychology and has previously been discussed in relation to viewing pornography. Elliott and Beech describe this process as, “… a reduction in arousal levels to the same stimuli over repeated exposures – where, in viewing sexual images, offenders are likely to seek out novel, more extreme images over time to feed their arousal levels,” Elliott and Beech, (2009, p. 187).
As with other genres of pornography, extensive exposure to CP eventually caused most participants to describe habituating to these materials, including participants who reported a sexual interest in children (just as participants interested in adults habituated to genres of adult pornography). This often led participants to seek out CP involving younger victims and/or more graphic sexual depictions in an attempt to evoke the same degree of arousal originally experienced in response to viewing these materials. As Justin explained, “You try to look for something that will give you some spark, or some feeling, and initially, it didn’t. As you get younger and younger, it did.”
Some participants reported reaching a point where they began seeking CP involving children who would previously have been too young for them to find arousing. Travis commented, “Over time, the models did get younger … before, I would not even consider anything under 16.” It is particularly interesting that, unlike other types of pornography, participants reported continuing to view CP even after their arousal to these materials had diminished. This raises questions regarding the personal and situational factors involved in maintaining this behavior.
Sexual conditioning:
Several participants who reported no known pre-existing sexual interest in children prior to viewing CP believed that repeated exposure to these materials essentially ‘conditioned’ them to develop a sexual interest in children.
Since nearly all participants reported no desire to engage in contact sexual offenses, it is possible that this process conditioned participants to develop an interest in CP, rather than in children themselves (and by extension child sexual abuse). Participants provided varying descriptions of how they perceived this conditioning process:
It’s kind of like … when you have your first sip of gin, or whatever. You think, ‘this is horrible’, but you keep going and eventually you start to like gin. (John).
The circuits in my brain that were related to sexual arousal, the circuits that were firing when I was looking at pictures of children … years of doing that probably caused things in my brain to change. (Ben)
As their interest in CP increased, participants who had previously viewed both adult and child pornography reported finding it increasingly difficult to become aroused to sexual stimuli involving adults.
At face value, this conditioning process may seem contradictory to the experience of habituation described earlier. However, it is important to understand that for people without a sexual interest in children, the conditioning process seemed to occur between the onset of viewing CP and participants’ eventual habituation to these materials.
Their compulsion to us looks like addiction is several ways:
Perhaps one of the most interesting findings relates to participants’ described inability to ‘progress’ from CP following their habitation and diminished response to these materials. The perceived inability to desist from this behavior led some participants to regard their use of CP as a ‘compulsion’ or ‘addiction’. As Travis described:
I don’t know if there’s such a thing as an addiction…where you do something you don’t want to do, but I always found myself compulsively checking over and over again these sites … I’d be up late at night doing this, because I’d have to go back and check.
It should be noted, however, that none of the participants described true obsessive–compulsive behaviors or reported any symptoms of withdrawal upon discontinuing their use of CP, suggesting that this behavior is not an addiction in the traditional use of the term….
The search for novelty, due to habituation, was more arousing than viewing CP.
One manifestation of this ‘compulsion’ is reflected by our finding that nearly all participants, regardless of their original motivation for viewing CP, reported that the act of searching the Internet for new sexual stimuli eventually superseded the enjoyment of actually viewing these materials. Following from our proposed behavioral facilitation process, we suggest the possibility that participants began to prefer the search for CP over the act of viewing it because by the time participants reached the stage of actively seeking CP – arguably the most taboo type of pornography – they had progressed through (and habituated to) numerous genres of pornography and could no longer conceive of any sexual themes or activities that would be sufficiently taboo or extreme to evoke the intense sexual response they desired.
Consequently, we suggest that the excitement and anticipation associated with potentially discovering novel and highly arousing pornography becomes more intense than the feelings experienced in response to viewing these materials. This, in turn, is expected to fuel participants’ desire to continue seeking CP (even past the point of habituation), and an inability to find strongly arousing pornography may underlie participants’ perceived compulsion to engage in this behavior. As Dave described:
I had to flip, like from one [image/video] to another, because once I started watching one, I’d get bored and I’d have to go to another one. And that’s how it was. And it took over my life.
Our current study should be seen as a first approach inspiring future investigations regarding the associations between psychological and neural mechanisms of craving, problematic IP use, motivation to change behavior, and inhibitory control.
Consistent with previous studies (e.g., Antons & Brand, 2018; Brand, Snagowski, Laier, & Maderwald, 2016; Gola et al., 2017; Laier et al., 2013), we found a high correlation between subjective craving and symptom severity of problematic IP use in both conditions. However, the increase in craving as measure for cue-reactivity was not associated with symptom severity of problematic IP use, this may relate to tolerance (cf. Wéry & Billieux, 2017) given that the pornographic images used in this study were not individualized in terms of subjective preferences. Therefore, the standardized pornographic material used may not be strong enough for inducing cue-reactivity in individuals with high symptom severity associated with low effects on the impulsive, reflective, and interoceptive systems as well as inhibitory control ability.
Effects of tolerance and motivational aspects may explain the better inhibitory control performance in individuals with higher symptom severity which was associated with differential activity of the interoceptive and reflective system. Diminished control over IP use presumably results from the interaction between the impulsive, reflective, and interoceptive systems.
Taken together, the insula as the key structure representing the interoceptive system plays a pivotal role in inhibitory control when pornographic images are present. Data suggest that individuals with higher symptom severity of problematic IP use performed better in the task due to decreased insula activity during image processing and increased activity during inhibitory control processing.
This pattern of activity might be based on effects of tolerance, that is, less hyperactivity of the impulsive system causes less controlling resources of the interoceptive and reflective system. Hence, a shift from impulsive to compulsive behaviors as a consequence of developing problematic IP use or a motivational (avoidance-related) aspect might be relevant, so that all resources were focused on the task and away from pornographic images. The study contributes to a better understanding of diminished control over IP use which is presumably not only a result of an imbalance between dual systems but of the interaction between impulsive, reflective, and interoceptive systems.
A few excerpts related to escalation and habituation:
The participants reported experiencing symptoms of feeling “addicted” to IP. The language of dependency, i.e., “cravings,” being “sucked in,” and “habit,” was used often. Participants also reported symptoms and experiences consistent with addictive disorders such as; an inability to reduce use of IP, increased use of IP over time or needing to use more extreme forms of IP to get the same effect, use of IP as a way to manage discomfort or gain a sense of satisfaction or “high,” and continuing to use IP despite negative consequences and life outcomes. The following sub-themes illustrate these phenomena.
Escalation was often described as either spending more time on IP or finding it necessary to view more extreme content in order to experience the same “high” over time, as this participant disclosed, “At first, I watched relatively soft porn, and as years passed by, I moved towards more brutal and degrading kinds of porn.”
This escalation to more extreme, novel, and often violent content also contributed to participants’ feelings of shame associated with their IP use
Escalation was often described as either spending more time on IP or finding it necessary to view more extreme content in order to experience the same “high” over time
Escalation of porn use was also linked to erectile dysfunction in some of the participants, as they found that after a time, no amount or genre of porn was able to cause them to have an erection, as described in the next subtheme.
Symptoms such as erectile dysfunction- conceptualized as an inability to gain an erection without porn or with a real-life partner- were often described: “I couldn’t get an erection with women I found attractive. And even when I did, it didn’t last long at all.” These symptoms were often lamented by the participants, with one participant declaring, “It has kept me from having sex! Lots of times! Because I can’t stay erect. Enough said.”
Participants reported spending more extended amounts of time viewing IP and consequently neglecting other areas in life, reducing time spent pursuing relationships with others, personal development goals, career goals, or other activities, “Mainly, it takes time away from me,” said one participant. “Watching porn takes away study time, work time, time with friends, rest time, etc.” Another participant noted that the time taken up by viewing IP had a negative effect on his productivity; “Then there is the sheer amount of time I have spent viewing internet porn rather than doing something constructive.” The impact of lost time is hard to quantify, as this participant stated, “I lost count of the times when I was watching porn and was supposed to be doing something else which was really important.
These extracts offer a significant challenge to the idea that pornography’s impact upon others might be over-rated, as the following extracts suggest that there are those for whom the effects of pornography have been self-ascribed:
I am currently very confused as to where I sit with my pornography use. Up until about six months ago, I would not have thought about the negative effects of its use. I believe it was one of the contributing factors that led me to break up with my girlfriend of four years, I saw a psychologist for pornography addiction in aid of trying to keep our relationship together but this did not seem to help…. [Survey response 194, Q2].
Media has influenced me a bit on this and I do sometimes feel like I consume too much porn. I also feel like it desensitises me to my real life sexual experiences. My real life sexual experiences are always better when I’ve had a break from porn. I also worry the type of porn I watch influences my desire to have vanilla sex. [Survey response 186, Q2].
For example, the following interview with a man who wondered whether he was ‘addicted’ to pornography, as a result of spending too much time viewing it, indicates an explicit rejection of the idea that pornography addiction is a problem of escalating content – for himself at least:
C: Well, you know, I don’t think that there’s anything unusual about my scenario in that I think I can relate to all people my age and those guys I grew up with is you go from looking at soft focus nudie pictures –
Interviewer: Yeah like Penthouse and –
C: Yeah, well even less than that and then it just goes up and up. You go from Playboy to Penthouse to uurgh I dunno, and then it’s turned into vids umm, and it’s getting stronger and stronger.
Interviewer: Mmm but there’s a point that you stop though isn’t there? Because –
C: Aww, well that was my choice umm, because I just thought ‘urgh that’s enough for me
Interviewer: And – is there a concern that other people won’t be able to make that –
C: I – well I think the fact that there’s so much bondage and abuse type of stuff on these sites – says there’s a market. I don’t – I assume that those people started off like me just looking at nudie pictures of girls and went from there.
Interviewer: Yeah, and then at some point you ended up –
C: Into real real hardcore.
Here C’s ‘choice’ to halt the progression from stronger and stronger content is contrasted with those who might have started by viewing the same pornography that he had, but had ended up in the ‘real hardcore’. Such concerns were explicitly made clear in relation to both how the internet has changed pornography’s content, and how young people’s experiences might contrast with that of the speaker….
Here, E describes his early experiences with pornography through the familiar index of pornography sources (i.e. a friend’s father), suggesting that this early exposure made things ‘a lot easier’ as he grew older. However, at a later stage in the interview, E also suggests that such early exposure to pornography can actually be detrimental to ‘other’ young people:
Interviewer: Or like what about violence or like –
E: Yeah, well, it’s the same thing. Like you know that violence is wrong as a child when you see – you know, ‘Don’t hit Ji – Johnny ‘cause he didn’t give you the donut’, you know, you know it’s wrong. So, it’s like that kind of behaviour is – you should be but the hard part of course is um the youth, before they get a cognitive brain before they’re 23, 24, um struggle often to make the distinction between um acceptable behaviour and non-acceptable behaviour and consequences to their behaviour. So, they might think that it’s okay for three guys to take some girl and bang her in the back of the car because that’s what they’ve seen on video you know, like on the internet, and they might think that but they haven’t really grasped the concept of what it actually means for what they’ve done to that girl and so on and so forth.
Interviewer: So in your experience though when you were like 13 you said you’d seen like multiple partners, let’s say. So – but were you ever like tempted to, you know, as you said, like, you know, get some friends together and –
E: Oh, and go after a – no.
Interviewer: Or, I mean, like in terms of the influence of what you’d seen in – in the pornography?
E: No. I just thought that, well, that’d be pretty cool you know. [Laughs]
Interviewer: Yeah. But you weren’t gonna be like, oh, you know, ‘Come on guys’ –
E: Yeah. No.
Interviewer: No. [Laughs]
E: No, and I – I think that – and it – I – it’s – it’s like I said before, I mean, I think that people um – people’s behaviour, it comes down to um their intelligence, you know, and how they’ve been treated. If you have the wro – wrong kind of upbringing then you might do exactly that, you might, ‘Come on dudes, let’s get this chick’, you know. You know, blah blah blah ‘cause you can’t relate to anything other than the – the – that little split second of time, you know. And some people never grow out of it.
Thus, again, the problem of pornography is both the changes to the medium over time and the (in)ability of young people to make sense of this new medium. In the first instance, E suggests that pornography in magazine form was helpful to his sexual development, before then suggesting that exposure to similar pornography – specifically group sex scenes – could lead young men to ‘take some girl and bang her in the back of the car’.
To shed light on men who sexually offend online, this chapter synthesizes the research on this subgroup of sexual offenders against children, with a focus on typologies, assessment, treatment issues, and prevention strategies for online offenders. It reviews the typologies proposed for three large groups of offenders against children—consumers of child sexual exploitation material (CSEM), sexual solicitors of children, and contact sexual offenders—recognizing that while typologies provide a helpful summary of research findings, individual offenders may display features of more than one offender type or may change from one set of motives and behaviors to another. For some men, use of legal pornography precedes use of CSEM. However, for various reasons, surfing legal pornography websites sometime leads to consumption of CSEM. The majority of intervention programs for online sexual offenders represent adaptations of existing programs for contact offenders, with adjustment of the overall intensity of the treatment and some specific components.
STUDY FIFTY FOUR: Male psychogenic sexual dysfunction: the role of masturbation (2003) – Relatively old study on men with so-called ‘psychogenic’ sexual problems (ED, DE, inability to be aroused by real partners). While the data is even older than 2003, interviews revealed tolerance and escalation related to “erotica” use:
Participants themselves had begun to question whether there may be a link between masturbation and the difficulties they were experiencing. Jim wonders whether reliance on masturbation and erotica during the 2 year period of celibacy preceding the onset of his problem has contributed to its cause:
J: . . . that two year period I was masturbating while I wasn’t in a regular relationship, umm and perhaps there were more images on television, so it wasn’t you had to buy a magazine – or – its just more available.
Additional excerpts:
Although inspiration could develop from their own experience, most participants used visual or literary erotica to enhance their fantasies and increase arousal. Jim, who is ‘not good at mental visualizations’, explains how his arousal is enhanced by erotica during masturbation:
J: I mean quite often there are times when I’m stimulating myself there’s some sort of aid; watching a TV programme, reading a magazine, something like that.
B: Sometimes the excitement of being with other people is enough, but as the years go by you need a book, or you see a film, or you have one of those dirty magazines, so you close your eyes and you fantasize about these things.
More excerpts:
The effectiveness of erotic stimuli in creating sexual arousal has been noted by Gillan (1977). The use of erotica by these participants was restricted to masturbation in the main. Jim is aware of a heightened level of arousal during masturbation as compared to sex with his partner.
During sex with his partner, Jim fails to achieve levels of erotic arousal sufficient to trigger orgasm, during masturbation the use of erotica significantly increases levels of erotic arousal and orgasm is achieved. Fantasy and erotica increased erotic arousal and were used freely during masturbation but its use was restricted during sex with a partner.
Paper continues:
Many participants ‘could not imagine’ masturbating without the use of fantasy or erotica, and many recognized the need progressively to extend fantasies (Slosarz, 1992) in an attempt to maintain levels of arousal and prevent ‘boredom’. Jack describes how he has become desensitized to his own fantasies:
J: Latterly in the last five, ten years, I, I, I’d be hard pushed to get stimulated enough by any fantasy that I might create myself.
Based on erotica, Jack’s fantasies have become highly stylised; scenarios involving women with a specific ‘body type’ in particular forms of stimulation. The reality of Jack’s situation and partners is very different, and fails to match his ideal created on the basis of porno perception (Slosarz, 1992); the real partner may not be erotically arousing enough.
Paul compares the progressive extension of his fantasies to his need for progressively ‘stronger’ erotica to produce the same response:
P: You get bored, it’s like those blue movies; you’ve got to get stronger and stronger stuff all the time, to cheer yourself up.
By changing the content, Paul’s fantasies retain their erotic impact; despite masturbating several times a day, he explains:
P: You can’t keep doing the same thing, you get bored with one scenario and so you’ve got to (change) – which I was always good at ’cause . . . I always lived in a land of dreams.
From the summary sections of the paper:
This critical analysis of participants’ experiences during both masturbation and partner sex has demonstrated the presence of a dysfunctional sexual response during sex with a partner, and a functional sexual response during masturbation. Two interrelated theories emerged and are summarized here… During partner sex, dysfunctional participants focus on non-relevant cognitions; cognitive interference distracts from the ability to focus on erotic cues. Sensate awareness is impaired and the sexual response cycle is interrupted resulting in sexual dysfunction.
In the absence of functional partner sex, these participants have become masturbation dependant. Sexual response has become conditional; learning theory does not postulate specific conditions, it merely identifies conditions of acquisition of the behaviour. This study has highlighted frequency and technique of masturbation, and the ability to focus on task relevant cognitions (supported by the use of fantasy and erotica during masturbation), as such conditional factors.
This study has highlighted the relevance of detailed questioning in two main areas; behaviour and cognitions. Firstly details of the specific nature of masturbatory frequency, technique and accompanying erotica and fantasy provided an understanding of how the individual’s sexual response has become conditional on a narrow set of stimuli; such conditioning appears to exacerbate difficulties during sex with a partner. It is acknowledged that as part of their formulation, practitioners routinely ask whether an individual masturbates: this study suggests that also asking precisely how the individual’s idiosyncratic masturbatory style has developed provides relevant information.
A large-scale online sample of 4,253 men ( Mage = 38.33 years, SD = 12.40) was used to explore the structure of PPU symptoms in 2 distinct groups: considered treatment group ( n = 509) and not-considered treatment group (n = 3,684).
The global structure of symptoms did not differ significantly between the considered treatment and the not-considered treatment groups. 2 clusters of symptoms were identified in both groups, with the first cluster including salience, mood modification, and pornography use frequency and the second cluster including conflict, withdrawal, relapse, and tolerance. In the networks of both groups, salience, tolerance, withdrawal, and conflict appeared as central symptoms, whereas pornography use frequency was the most peripheral symptom. However, mood modification had a more central place in the considered treatment group’s network and a more peripheral position in the not-considered treatment group’s network.
In the three samples’ networks, withdrawal was the most central node, while tolerance was also a central node in the subclinical individuals’ network. In support of these estimates, withdrawal was characterized by high predictability in all networks (Chinese community men:76.8%, Chinese subclinical men: 68.8%, and Hungarian community men: 64.2%).
Centrality estimates indicated that the subclinical sample’s core symptoms were withdrawal and tolerance, but only the withdrawal domain was a central node in both community samples.
Consistent with previous studies (Gola & Potenza, 2016; Young et al., 2000), worse mental health scores and more compulsive sexual behaviors correlated with higher PPCS scores. These results suggest it may be advisable to consider craving, mental health factors, and compulsive use in screening and diagnosing PPU (Brand, Rumpf et al., 2020).
Additionally, centrality estimates in the six factors of the PPCS-18 displayed withdrawal as the most crucial factor in all three samples. According to the strength, closeness, and betweenness centrality results among subclinical participants, tolerance also contributed importantly, being second only to withdrawal. These findings suggest that withdrawal and tolerance are particularly important in subclinical individuals. Tolerance and withdrawal are considered as physiological criteria relating to addictions (Himmelsbach, 1941). Concepts like tolerance and withdrawal should constitute a crucial part of future research in PPU (de Alarcón et al., 2019; Fernandez & Griffiths, 2019). Griffiths (2005) postulated that tolerance and withdrawal symptoms should be present for any behavior to be considered addictive. Our analyses support the notion that withdrawal and tolerance domains are important clinically for PPU. Consistent with Reid’s view (Reid, 2016), evidence of tolerance and withdrawal in patients with compulsive sexual behaviors may be an important consideration in characterizing dysfunctional sexual behaviors as addictive.
The main objective of this study was to analyse the evolution of the child-pornography collections of individuals convicted of child-pornography offences. In light of the results, we propose four explanations of the nature of, and variations in, child-pornography collections.
…The most prevalent pattern was a progressive decrease in the age of the person depicted and a progressive increase in the severity of the sexual acts. …
The first explanation is that child-pornography collections are an indicator of the sexual interests of the collector (Seto, 2013). This explanation implies that the collector would focus on content that is sexually arousing for him….
A second explanation that is also related to the sexual interest explanation is that collectors become habituated to low-severity pornography, which is congruent with the patterns 1, 2, and 3 of the current study. It has been suggested that habituation to pornographic content leads to boredom, which in turn impels the pornography consumer to seek out new content that is more severe (Reifler et al., 1971; Roy, 2004; Seto, 2013; Taylor & Quayle, 2003). According to Laws and Marshall (1990),
a previously conditioned sexual fantasy (conditional stimulus, CS1) plus masturbatory stimulation (unconditioned stimulus, UCS) can produce high sexual arousal plus orgasm. Minor variations of the original fantasy (CS2) successively substitute for the original one (perhaps to avoid boredom) and paired with masturbation, can elicit the same response. (p. 212)
Thus, to maintain their degree of sexual arousal, child-pornography collectors may be driven to explore other age categories and sexual acts. This discovery process presumably takes the form of trial and error in which they establish how congruent the new content is with their evolving sexual interests.
Despite the limitations mentioned, we think that this research contributes to the field of PH research and to the exploration of new perspectives on (problematic) hypersexual behavior in society. We stress that our research showed that “Withdrawal” and “Loss of pleasure”, as part of the “Negative Effects” factor, can be important indicators of PH (problematic hypersexuality). On the other hand, “Orgasm frequency”, as part of the “Sexual Desire” factor (for women) or as a covariate (for men), did not show discriminative power to distinguish PH from other conditions. These results suggest that for the experience of problems with hypersexuality, attention should focus more on “Withdrawal”, “Loss of pleasure”, and other “Negative Effects” of hypersexuality, and not so much on sexual frequency or “excessive sexual drive” [60] because it is mainly the “Negative Effects” that are associated with experiencing hypersexuality as problematic.
Following the substance addiction framework, it has been postulated that extensive pornography use may lead to tolerance.33,34,39 In line with the models of addictive sexual behavior, tolerance can manifest in 1 of 2 ways: (i) higher frequency or time devoted to pornography use, in an attempt to achieve the same level of arousal, (ii) seeking and consuming more stimulating pornographic material, as one becomes desensitized and searches for more arousing stimuli.33,34,40 While the first manifestation of tolerance is tightly related to duration and frequency of use, the second is not. It is better operationalized by the variability of consumed pornographic content, especially when this variability pertains to consumption of violent, paraphilic or even lawfully prohibited types of pornographic content (eg, pornographic scenes including minors). However, despite the mentioned theoretical claims, in relation to problematic pornography use and/or compulsive sexual behavior, the characteristics and variability in the content of consumed pornography have rarely been studied.
Discussion
Broadly, our results indicate the importance of prolonged engagement in pornography viewing and variability in consumed pornographic content for treatment seeking, as well as the severity of problematic sexual behavior symptoms. This importance is not captured in the amount of time devoted to pornography use, suggesting that the mentioned indicators contribute to explaining problematic pornography use–related symptoms and treatment seeking…
…Variability of pornographic content consumed (operationalized in the present study as consumption of pornography scenes counter to one’s sexual orientation – scenes containing homosexual sex, containing violence, group sex scenes, scenes of sex with minors) significantly predicted the decision to seek treatment and the severity of symptoms among the study participants.
One possible explanation for this result is that said variability is simply a function of time devoted to pornography use – people who devote more time to this activity can consume a higher number of pornographic content genres, types, or categories. Our results rule out this explanation and show that the relationship between variability of consumed pornographic content and dependent variables is significant even when time devoted to pornography use is controlled. Moreover, a bivariate correlation between variability of consumed explicit content and time devoted to this consumption in the whole sample was surprisingly weak. This further supports the distinctiveness of these 2 indicators and the need to study them both to obtain a better picture of pornography use habits.
Although the described result by itself does not directly imply increased tolerance or desensitization, as the propensity to consume pornographic material with specific characteristics may reflect a more basic, initial preference, it does seem to be at least potentially consistent with addictive models of problematic pornography use.33,34 Future research should investigate the trajectories of pornography use depending on the characteristics of explicit content and verify if the preference for certain types of pornographic content is acquired as a result of being exposed to explicit content throughout the lifetime or is better explained by initial preferences. This issue seems to be both clinically important and scientifically interesting and should attract more research attention.
One primary self-perceived problem related to pornography use concerns addiction-related symptomatology. These symptoms generally include impaired control, preoccupation, craving, use as a dysfunctional coping mechanism, withdrawal, tolerance, distress about use, functional impairment, and continued use despite negative consequences (e.g., Bőthe et al., 2018; Kor et al., 2014).
Withdrawal:
Abstaining from pornography was perceived to be difficult largely due to the interaction of situational and environmental factors, and the manifestation of addiction-like phenomena (i.e., withdrawal-like symptoms, craving, and loss of control/relapse) during abstinence (Brand et al., 2019; Fernandez et al., 2020).
Some members reported that they experienced heightened negative affect during abstinence. Some interpreted these negative affective states during abstinence as being part of withdrawal. Negative affective or physical states that were interpreted as being (possible) “withdrawal symptoms” included depression, mood swings, anxiety, “brain fog,” fatigue, headache, insomnia, restlessness, loneliness, frustration, irritability, stress, and decreased motivation. Other members did not automatically attribute negative affect to withdrawal but accounted for other possible causes for the negative feelings, such as negative life events (e.g., “I find myself getting agitated very easily these past three days and I don’t know if it’s work frustration or withdrawal” [046, 30s]). Some members speculated that because they had previously been using pornography to numb negative emotional states, these emotions were being felt more strongly during abstinence (e.g., “Part of me wonders if these emotions are so strong because of the reboot” [032, 28 years]). Notably, those in the 18–29 years age range were more likely to report negative affect during abstinence compared to the other two age groups, and those 40 years and above were less likely to report “withdrawal-like” symptoms during abstinence compared to the other two age groups. Regardless of the source of these negative emotions (i.e., withdrawal, negative life events, or heightened preexisting emotional states), it appeared to be very challenging for members to cope with negative affect during abstinence without resorting to pornography to self-medicate these negative feelings.
Tolerance/Habituation:
Three main consequences attributed to excessive pornography use were cited by members as motivations for initiating abstinence. First, for many members (n = 73), abstinence was motivated by a desire to overcome a perceived addictive pattern of pornography use (e.g., “I’m 43 now and I’m addicted to porn. I think the moment to escape from this horrible addiction has arrived” [098, 43 years]). Accounts of addiction were characterized by the experience of compulsivity and loss of control (e.g., “I’m trying to stop but it is so hard I feel that there is something pushing me to porn” [005, 18 years]), desensitization and tolerance to the effects of pornography over time (e.g., “I don’t really feel anything anymore when watching porn. It is sad that even porn has become so unexciting and unstimulating” [045, 34 years]), and distressing feelings of frustration and disempowerment (“I hate that I don’t have the strength to JUST STOP…I hate that I have been powerless against porn and I want to regain and assert my power” [087, 42 years].
It is interesting to note that paradoxically, close to one-third of members reported that instead of experiencing increased sexual desire, they experienced diminished sexual desire during abstinence, which they called the “flatline.” The “flatline” is a term that members used to describe a significant decrease or loss of libido during abstinence (although some appeared to have a broader definition for this to also include accompanying low mood and a sense of disengagement in general: (e.g., “I feel like I’m probably in a flatline right now as the desire to engage in any sort of sexual activity is almost nonexistent” [056, 30s]).
Lists of related studies:
Porn/sex addiction? This page lists over 50 neuroscience-based studies (MRI, fMRI, EEG, neuropsychological, hormonal). All provide strong support for the addiction model as their findings mirror the neurological findings reported in substance addiction studies.
UPDATE 2017: A new study (Fernandez et al., 2017) tested and analyzed the CPUI-9, a purported “perceived pornography addiction” questionnaire developed by Joshua Grubbs, and found that it couldn’t accurately assess “actual porn addiction” or “perceived porn addiction” (Do Cyber Pornography Use Inventory-9 Scores Reflect Actual Compulsivity in Internet Pornography Use? Exploring the Role of Abstinence Effort). It also found that 1/3 of the CPUI-9 questions should be omitted to return valid results related to “moral disapproval”, “religiosity”, and “hours of porn use.” The findings raise significant doubts about conclusions drawn from any study that has employed the CPUI-9 or relied on studies that employed it. Many of the new study’s concerns and criticisms mirror those outlined in the following critique.
UPDATE 2019: Finally, Grubbs didn’t rely on his CPUI-9 instrument. The CPUI-9 includes 3 “guilt and shame/emotional distress” questions not normally found in addiction instruments – and which skew its results, causing religious porn users to score higher and non-religious users to score lower than subjects do on standard addiction-assessment instruments. Instead, Grubbs’s new study asked 2 direct yes/no questions of porn users (“I believe that I am addicted to internet pornography.” “I would call myself an internet pornography addict.”). Directly contradicting his earlier claims, Dr. Grubbs and his research team found that believing you are addicted to porn correlates most strongly with daily hours of porn use, not with religiousness.
UPDATE 2020: Unbiased researcher Mateuz Gola teamed up with Grubbs. Instead of using Grubbs’s terribly skewed CPUI-9, the study used a single question: “I believe I am addicted to Internet pornography“. This resulted in little or no correlation between religiousness and believe oneself addicted to porn. See: Evaluating Pornography Problems Due to Moral Incongruence Model (2019).
UPDATES: Formal critiques (by porn researchers) of “Pornography Problems Due to Moral Incongruence: An Integrative Model with a Systematic Review and Meta-Analysis”
Watching Porn Is OK. Believing In Porn Addiction Is Not
Perceived Addiction To Porn Is More Harmful Than Porn Use Itself
Believing You Have Porn Addiction Is the Cause of Your Porn Problem, Study Finds
Here we revisit Joshua Grubbs’s work as he continues to publish “perceived porn addiction” papers. In this 2015 press release Grubbs suggests that pornography use itself doesn’t cause any problems:
“It doesn’t seem to be the pornography itself that is causing folks problems, it’s how they feel about it,”
“Perceived addiction involves a negative interpretation of your own behavior, thinking about yourself, like, ‘I have no power over this’ or ‘I’m an addict, and I can’t control this.’
Being labeled “porn addict” by a partner, or even by oneself, has nothing to do with the amount of porn a man views, says Joshua Grubbs, assistant professor of psychology at Bowling Green University. Instead, it has everything to do with religiosity and moral attitudes toward sex. In short, he says, “It’s shame-motivated.”…
….Grubbs calls it “perceived pornography addiction.” “It functions very differently from other addictions.”
If Josuha Grubbs was accurately quoted, the above claims border on propaganda, as we will show that:
Grubbs’s questionnaire assesses only actual porn addiction, not “perceived porn addiction.” That porn addiction doesn’t “function differently from other addictions,” and that Grubbs has not shown that it does. In fact, Grubbs based his questionnaire on (standard) drug addiction questionnaires.
Contrary to his statement above, the amount of porn used is strongly related to scores on Grubbs’s porn addiction questionnaire (CPUI). In fact, Grubbs’s studies reveal that porn addiction (CPUI sections 2 & 3) is far more related to the amount of porn viewed than it is to religiosity.
Moreover, “hours of use” are not a reliable measure of (proxy for) addiction. Previous studies have established that “hours of porn viewed” aren’t linearly correlated with porn addiction scores or symptoms. Many additional variables of use also contribute to the development of a porn addiction.
Beyond these evident challenges to Grubbs’s “porn addiction is only religious shame” claim, his model crumbles when we consider that:
Religious shame doesn’t induce brain changes that mirror those found in drug addicts. Yet there are some 39 neurological studies reporting addiction-related brain changes in compulsive porn users/sex addicts.
This means Grubbs’s sample of religious porn users is inevitably skewed (see below). It also means that “religiosity” does not predict porn addiction.
Many atheists and agnostics develop porn addiction. Two 2016 studies on men who had used porn in the last the last 6 months, or in the last 3 months, reported extraordinarily high rates of compulsive porn use (28% for both studies).
“Perceived addiction” obviously couldn’t induce chronic erectile dysfunction, low libido and anorgasmia in healthy young men. Yet numerous studies link porn use to sexual dysfunctions and lower sexual satisfaction, and ED rates have inexplicably skyrocketed by 1000% in men under 40 since “tube” porn arrived in porn users’ lives.
In the following sections we will address Grubbs’s major claims, look deeper into his data and methodology, and suggest alternative explanations for his claim that religiosity is related to porn addiction. But first let’s start with the 3 pillars upon which Grubbs builds his assorted papers.
For Grubbs’s claims to be valid ALL of these 3 must be true and supported by actual research:
1) The Grubbs Cyber Pornography Use Inventory (CPUI) must assess “perceived porn addiction” rather than actual porn addiction.
It does not. The CPUI assesses actual porn addiction, as Grubbs himself stated in his original 2010 paper validating the CPUI (more below). In fact, the CPUI was only validated as an actual porn addiction test, and never as a “perceived addiction” test. With no supporting scientific justification, in 2013, Grubbs unaccountably re-labeled his porn addiction test a “perceived porn addiction” test.
Note: In Grubbs’s studies he uses the phrase “perceived addiction” or “perceived porn addiction” to denote the total score on his CPUI test (an actual porn addiction test). This is lost in translation due to the frequent repetition of “perceived addiction,” instead of the accurate, spin-free label: “the Cyber Pornography Use Inventory score.”
2) Grubbs must have found little to no correlation between hours of use and CPUI scores (porn addiction).
No again. For example, Grubbs et al. 2015 reveals a strong correlation between hours of use and CPUI scores. From p. 6 of the study:
“Additionally, average daily pornography use in hours was significantly and positively associated with depression, anxiety, and anger, as well as with perceived addiction [total CPUI score].“
Grubbs’s second 2015 study reported a stronger correlation between CPUI scores and “hours of porn use” than it did between CPUI scores and religiosity.
How could Grubbs claim in Psychology Today that porn addiction “has nothing to do with the amount of porn a man views,” when his studies reveal that quantity of use was “significantly and positively” correlated with CPUI scores?
3) Other studies must have reported that the amount porn used is linearly correlated with symptoms of porn addiction or scores on porn addiction tests.
They did not. Other research teams have found that the variable “hours of use” is not linearly correlated with cybersex addiction (or video-gaming addiction). That is, addiction is more reliably predicted by other variables than “hours of use” anyway, so the materiality of Grubbs’s claims is questionable even if his methodology were sound and his claims were accurate. (Not the case.) “Hours of use” is not a reliable proxy for “porn addiction,” so neither correlations with it nor lack of correlations with it can have the vast significance Grubbs presumes.
Most of the Grubbs-generated headlines and claims depend upon all 3 of the above points being true. They are not. We now examine these 3 pillars and the details surrounding Grubbs’s studies and claims.
SECTION 1: The Myth of “Perceived” Porn Addiction:
The Cyber Pornography Use Inventory (CPUI): It’s an actual addiction test.
Important to note:
Whenever Grubbs uses the phrase “perceived addiction” he really means the total score on his CPUI.
The CPUI is divided into 3 sections, which becomes very important later on as we examine how scores on each section correlate with other variables such as “hours of use” and “religiosity.”
Each question is scored using a Likert scale of 1 to 7, with 1 being “not at all,” and 7 being “extremely.”
COMPULSIVITY:
1. I believe I am addicted to Internet pornography.
2. I feel unable to stop my use of online pornography.
3. Even when I do not want to view pornography online, I feel drawn to it
ACCESS EFFORTS:
4. At times, I try to arrange my schedule so that I will be able to be alone in order to view pornography.
5. I have refused to go out with friends or attend certain social functions to have the opportunity to view pornography.
6. I have put off important priorities to view pornography.
EMOTIONAL DISTRESS:
7. I feel ashamed after viewing pornography online.
8. I feel depressed after viewing pornography online.
9. I feel sick after viewing pornography online.
In reality, Grubbs’s Cyber Pornography Use Inventory (CPUI) questionnaire is very similar to many other drug and behavioral addiction questionnaires. Like other addiction tests, the CPUI assesses behaviors and symptoms common to all addictions, such as: the inability to control use; compulsion to use, cravings to use, negative psychological, social and emotional effects; and preoccupation with using. In fact, only 1 of the 9 CPUI questions above even hints at “perceived addiction.”
Yet we are told that a person’s total score for all 9 questions is synonymous with “perceived addiction” rather than addiction itself. Very misleading, very clever, and without any scientific basis. Agnotology fodder, anyone? (Agnotology is the study of culturally induced ignorance or doubt, particularly the publication of inaccurate or misleading scientific data designed to confuse the public about the state of research in a particular field. Big Tobacco is credited with inventing the field of agnotology.)
Note that decades of established addiction assessment tests for both chemical and behavioral addictions rely on similar questions as the CPUI to assess actual, not merely perceived, addiction. CPUI questions 1-6 assess core addiction behaviors as outlined by the 4 Cs, while questions 7-9 evaluate negative emotional states after using porn. Let’s compare the CPUI to a commonly used addiction assessment tool known as the “4 Cs.” The CPUI questions that correlate with the four Cs are noted as well.
Compulsion to use (2, 3)
Inability to Control use (2, 3, maybe 4-6)
Cravings to use (3 especially, but 1-6 could be interpreted as cravings)
Continued use despite negative consequences (4-6, perhaps 7-9)
Addiction experts rely on assessment tools like the 4Cs as indicating addiction because neuroscientists have correlated the symptoms those questions with underlying addiction-related brain changes in decades of basic-research studies. See the public policy statement of the American Society of Addiction Medicine. In short, the Grubb’s CPUI is an actual porn addiction test; it was never validated for “perceived addiction.”
The initial 2010 Grubbs study said the CPUI assessed actual porn addiction
In Grubbs’s initial 2010 paper he validated the Cyber-Pornography Use Inventory (CPUI) as a questionnaire assessing actual porn addiction. The phrases “perceived addiction” and “perceived porn addiction” do not appear in his 2010 paper. To the contrary, Grubbs et al., 2010 clearly states in several places that the CPUI assesses genuine porn addiction:
The previously described models proposed for understanding behavioral addictions were the primary theoretical assumptions used to derive the instrument for this study, the Cyber-Pornography Use Inventory (CPUI), patterned after the Internet Sex Screening Test developed by Delmonico (Delmonico & Griffin, 2008). The CPUI design was based on the principle that addictive behavior is characterized by an inability to stop the behavior, significant negative effects as a result of the behavior, and a generalized obsession with the behavior (Delmonico & Miller, 2003).
The CPUI does indeed show promise as an instrument assessing Internet pornography addiction. Whereas previous instruments, such as the ISST, had assessed only broad-spectrum online sexual addiction, this scale did demonstrate promise in specifically assessing Internet pornography addiction. Furthermore, the items on the previously explained Addictive Patterns scale seem to find some level of theoretical support and potential construct validity when compared with the diagnostic criteria for both Substance Dependence and Pathological Gambling, an ICD.
Finally, five of the items on the Addictive Patterns scale from the original Compulsivity scale seem to directly tap into the individual’s perceived or actual inability to stop the behavior in which they are engaging. Inability to stop a problematic behavior under any circumstances is not only an important diagnostic criterion for both SD and PG, but it can also can be thought of as one of the core elements of both addiction, as manifested in SD, and ICDs (Dixon et al., 2007; Potenza, 2006). It seems that it is this inability that creates the disorder.
In a 2013 study Grubbs reduced the number of CPUI questions from 32 (or 39 or 41) to the current 9, and re-labeled his actual, validated porn addiction test as a “perceived porn addiction” test (here’s a 41-question version of the CPUI). He did so without any explanation or justification and proceeded to use the phrase “perceived addiction” 80 times in his 2013 paper. That said, Grubbs hinted at the true nature of the CPUI-9 in this excerpt from the 2013 paper:
“Last, we found that the CPUI-9 was strongly positively associated with general hypersexual tendencies, as measured by the Kalichman Sexual Compulsivity Scale. This points to the high degree of interrelatedness between compulsive pornography use and hypersexuality more generally.”
Let’s be very clear – the CPUI was never validated as an assessment test differentiating actual porn addiction from “perceived porn addiction.” This means the public is relying only on Grubbs’s word that his revised test can differentiate between “perceived porn addiction” and the “actual porn addiction” the CPUI was originally validated to assess. How scientific is it to re-label a validated test as something altogether different without validating the radically altered use of the test?
Why did Joshua Grubbs re-label the CPUI a “perceived” porn addiction test?
While Grubbs himself didn’t claim his test could sort perceived from actual addiction, his employment of the misleading term (“perceived addiction”) for scores on his CPUI-9 instrument have led others to assume his instrument has the magical property of being able to discriminate between “perceived” and “real” addiction. This has done enormous damage to the field of porn addiction assessment because others rely on his papers as evidence of something they do not, and cannot, deliver. No test exists that can distinguish “real” from “perceived” addiction. Merely labeling it as such cannot make it so.
How did this happen? It’s not unusual for academic journal editors and reviewers to require substantial revisions before they accept a paper for publication. Joshua Grubbs said in an email that a reviewer of his second CPUI-9 study caused him and his co-authors of the 2013 study to alter the “porn addiction” terminology of the CPUI-9 (because the reviewer sneered at the “construct” of porn addiction). This is why Grubbs changed his description of the test to a “perceived pornography addiction” questionnaire.In essence an anonymous reviewer/editor at this single journal initiated the unsupported, misleading label of “perceived pornography addiction.” The CPUI has never been validated as an assessment test differentiating actual porn addiction from “perceived porn addiction.” Here’s Grubbs tweeting about this process, including the reviewer’s comments:
On my 1st paper on compulsive porn use: “This construct [porn addiction] is as meaningful to measure as experiences of alien abduction: it’s meaningless.”
Actually what led to my perceived addiction work, I thought about the comments as revised the focus.
There’s no historical precedent for a “perceived addiction” assessment test
The two studies Grubbs consistently cites (1, 2) to imply that his concept of “perceived addiction” is established/legitimate were done on smokers, and neither supports the concept of “perceived addiction” as Grubbs uses it. First, neither study suggests, as Grubbs does with porn, that actual cigarette addiction doesn’t exist. Nor did either of those studies claim to have developed a questionnaire that could distinguish or isolate “perceived addiction” from actual addiction. Both studies focused instead on assessing how future success in quitting smoking related to earlier self-reports of addiction.
There is no questionnaire for “perceived addiction” to anything – substance or behavior – including pornography use (regardless of Grubbs’s claims). There’s a good reason ‘Google Scholar’ returns zero results for the following “perceived addictions”:
Other researchers predictably use the CPUI as an actual porn addiction test
Reality check: other researchers describe the CPUI as an actual porn addiction assessment questionnaire (as that’s what it was validated as), and use it as such in their published studies:
The last study above used a longer version of the Grubbs CPUI and an Internet pornography addiction questionnaire derived from the DSM-5 Internet video-gaming addiction criteria. The graphs below show the same subjects‘ scores on the two different porn addiction questionnaires:
——
No surprise: very similar results and distribution for the Grubbs CPUI and the researchers’ DSM-5-based porn addiction questionnaire. If the CPUI could differentiate “perceived addiction” from “actual addiction” the graphs and distributions would be sharply dissimilar. They are not.
Suggestion: whenever you read a Grubbs paper or a Grubbs sound-bite in the media, eliminate the word “perceived” and see how differently it reads – and how it aligns with other research on porn addiction. For example, two sentences from the introduction of a Grubbs’s paper with the word “perceived” deleted:
Addiction to Internet pornography is associated with lower levels of well-being. Recent research has found porn addiction to be related to anxiety, depression, and stress (Grubbs, Stauner, Exline, Pargament, & Lindberg, 2015; Grubbs, Volk et al., 2015).
Eliminate the unsupported claim that the CPUI assesses “perceived porn addiction” and we have completely different study results and no misleading headlines. Again, such actual findings of porn addiction being associated with anxiety, depression and stress align with decades of “actual,” not “perceived,” addiction research. Inability to control use is distressing.
SECTION 2: Claimed Correlations? “Hours of use” and “Religiosity”
Contrary to Grubbs’s claim the amount of porn viewed is significantly related to porn addiction scores (CPUI)
While we will see that “hours of use” is never used as the sole proxy for addiction, media sound-bites claim that Grubbs found no relationship between “hours of porn use” and scores on the porn addiction test (CPUI). This is not the case. Let’s start with Grubb’s 2013 study that decreed (by fiat) the CPUI-9 a “perceived porn addiction” test:
“Scores on the total CPUI-9, the compulsivity subscale, and the access efforts subscale were all associated with increased use of online pornography, indicating that perceived addiction [total CPUI score] is related to greater frequency of use.”
Remember “perceived addiction” is shorthand for the total CPUI score. As described earlier, this 2015 Grubbs study reported a pretty strong correlation between hours of use and CPUI scores. From p. 6 of the study:
“Additionally, average daily pornography use in hours was significantly and positively associated with depression, anxiety, and anger, as well as with perceived addiction [total CPUI score].”
In other words, contrary to the headlines and Grubbs’s claims in the press, subjects’ total CPUI-9 scores were significantly associated with hours of porn use. But how does “average daily pornography use in hours” compare with religiosity? Which is more correlated with the CPUI- total score?
We will use data from a 2015 Grubbs paper (“Transgression as Addiction: Religiosity and Moral Disapproval as Predictors of Perceived Addiction to Pornography“), as it contains 3 separate studies and its provocative title suggests that religiosity causes porn addiction. Table 2 below contains data from 2 separate studies. These data reveal correlations between a few variables (hours of porn use; religiosity) and CPUI scores (entire CPUI-9 and broken down into the 3 CPUI subsections).
Tips for understanding the numbers in the table: zero means no correlation between two variables; 1.00 means a complete correlation between two variables. The bigger the number the stronger the correlation between the 2 variables. If a number has a minus sign, it means there’s a negative correlation between two things. (For example, there’s a negative correlation between exercise and heart disease. Thus, in normal language, exercise reduces the chances of heart disease. On the other hand, obesity has a positive correlation with heart disease.)
Highlighted below are the correlations between total CPUI-9 scores (#1) and “Use In Hours” (#5) and the “Religiosity Index“ (#6) for two of Grubbs’s studies:
The correlations between total CPUI scores and religiosity:
Study 1: 0.25
Study 2: 0.35
Average: 0.30
The correlations between total CPUI scores and “hours of porn use”:
Study 1: 0.30
Study 2: 0.32
Average 0.31
Shockingly, CPUI-9 scores have a slightly stronger relationship to “hours of porn use” than to religiosity! Put simply “hours of porn use” predicts porn addiction better than does religiosity. Yet the study’s abstract assures us that religiosity is “robustly related to perceived addiction” (CPUI scores). If this is the case, then “hours of porn use” are evidently also “robustly related” to scores on the CPUI. It’s curious how religiosity’s relationship to porn addiction is emphasized, while hours of use is overlooked or hidden by doublespeak.
There’s no other way to say this – Grubbs’s data flat out contradict his claims in the media and in his studies’ abstracts. To refresh your memory, Grubbs’s claims in this Psychology Today feature article:
Being labeled “porn addict” by a partner, or even by oneself, has nothing to do with the amount of porn a man views, says Joshua Grubbs, assistant professor of psychology at Bowling Green University. Instead, it has everything to do with religiosity…
In reality, the opposite is true: porn addiction is more related to hours of use than to religiosity. The next section will reveal that actual “porn addiction,” as measured by CPUI questions 1-6, is far more related to “hours of porn use” than it is to religiosity.
Grubbs’s studies reveal that actual porn addiction is far more related to “hours of porn use” than to religiosity
Grubbs found that porn addiction (CPUI-9 total score) is more strongly correlated with “current hours of porn use” than to religiosity. But you may be thinking, “Grubbs was right about one claim: porn addiction (CPUI scores) is related to religiosity.” Not really. In the next section we will see why this claim is not what it seems.
Sticking with Grubbs’s numbers for now, there is a relationship between actual porn addiction and religiosity. However, it’s far weaker than indicated in the previous section. Just as important, the correlation between actual porn addiction and “hours of porn use” is far stronger than indicated in the previous section.
On closer examination, questions 1-6 of the CPUI-9 assess the signs and symptoms common to all addictions, while questions 7-9 (Emotional Distress) assess guilt, shame and remorse. As a result, “actual addiction” closely aligns with questions 1-6 (Compulsivity & Access Efforts).
Compulsivity:
I believe I am addicted to Internet pornography.
I feel unable to stop my use of online pornography.
Even when I do not want to view pornography online, I feel drawn to it
Access Efforts:
At times, I try to arrange my schedule so that I will be able to be alone in order to view pornography.
I have refused to go out with friends or attend certain social functions to have the opportunity to view pornography.
I have put off important priorities to view pornography.
Emotional Distress:
I feel ashamed after viewing pornography online.
I feel depressed after viewing pornography online.
I feel sick after viewing pornography online.
First, let’s examine the correlations between each of the 3 CPUI subsections and Religiosity. In the following table the three CPUI subsections are numbered 2, 3 and 4, and the Religiosity Index is number 6.
The correlation between Religiosity and Perceived Compulsivity (questions 1-3)
Study 1: 0.25
Study 2: 0.14
Average: 0.195
The correlation between Religiosity and Access Efforts (questions 4-6)
Study 1: 0.03
Study 2: 0.11
Average: 0.07
The correlation between Religiosity and Emotional Distress (questions 7-9)
Study 1: 0.32
Study 2: 0.45
Average: 0.385
The key finding is that religiosity is strongly related (.39) to only the Emotional Distress section of the CPUI-9: questions 7-9, which asks porn users how they feel after viewing porn (ashamed, depressed, or sick). Religion is far less related to the two sub-sections (questions 1-6) that most accurately assess actual porn addiction: Compulsivity (.195) and Access Efforts (.07). Simplified: the shame and guilt questions (7-9) powerfully skew the total CPUI scores upward for religious individuals. Take away the 3 shame questions and the correlation between religiosity and the CPUI drops to a mere 0.13.
Examining the actual-addiction CPUI questions, it’s evident that the 3 “Access Efforts” questions 4-6 assess principal addiction criteria for any addiction: “The inability to stop despite severe negative consequences.” Compulsive use is a hallmark of addiction.
In contrast, question #1 in the Compulsivity section relies on subjective interpretation (“Do I feel addicted?”).
Now, back to those Access Efforts questions 4-6, which assess specific behaviors, not beliefs or feelings. The key takeaway: there’s an extremely weak correlation between Religiosity and the 3 Access Efforts questions (only 0.07). In summary, religiosity has very little relationship with actual porn addiction. (In fact, there’s good reason to suggest there is virtually no relationship as we will see in the next section.)
Next, let’s examine the correlations between each of the 3 CPUI subsections and “Hours of Porn Use.” In the following table the three CPUI subsections are numbered 2, 3 and 4, and “[Porn] Use In Hours” is number 5.
The correlation between “[Porn] Use In Hours” and Perceived Compulsivity (questions 1-3)
Study 1: 0.25
Study 2: 0.32
Average: 0.29
The correlation between “[Porn] Use In Hours” and Access Efforts (questions 4-6)
Study 1: 0.39
Study 2: 0.49
Average: 0.44
The correlation between “[Porn] Use In Hours” and Emotional Distress (questions 7-9)
Study 1: 0.17
Study 2: 0.04
Average: 0.10
This is the exact opposite of what we saw with religiosity. “[Porn] Use In Hours” correlates very strongly with the CPUI questions (1-6), which, again, most accurately assess actual porn addiction (0.365). More importantly, “[Porn] Use In Hours” correlate even more strongly with the CPUI’s core addiction questions 4-6 (0.44).This means that actual porn addiction (as assessed by behaviors) is robustly related to how much porn a person views.
On the other hand, “[Porn] Use In Hours” is weakly related (0.10) to the “Emotional Distress” questions (7-9). These 3 questions ask porn users how they feel after viewing porn (ashamed, depressed, or sick). In summary, actual porn addiction (1-6) is strongly related to the amount of porn viewed, yet shame and guilt (7-9) are not. To put this another way, porn addiction has a whole lot to do with how much porn is viewed, and very little to do with shame (religious or otherwise).
Summary of Grubbs’s actual findings
Total CPUI-9 scores were better correlated with “[Porn] Use In Hours” than with religiosity. This finding directly contradicts claims in the media by Joshua Grubbs.
Removing the 3 “Emotional Distress” questions leads to an even stronger relationship between “[Porn] Use In Hours” and actual porn addiction as assessed by questions 1-6.
Removing the 3 “Emotional Distress” questions (which assess shame and guilt) leads to a much weaker relationship between religiosity and actual porn addiction as assessed by questions 1-6.
A very strong relationship exists between “hours of porn use” and the core addiction behaviors as assessed by the “Access Efforts” questions 4-6. Put simply: porn addiction is very strongly related to amount of porn viewed.
The relationship between “religiosity” and the core addiction behaviors (Access Efforts questions 4-6) is virtually non-existent (0.07). Put simply: addiction-related behaviors, rather than religiosity, predict porn addiction. Religiosity has next to nothing to do with porn addiction.
Here’s what a more accurate conclusion in Grubbs’s study might have looked like:
Actual porn addiction is robustly related to hours of porn use and very weakly related to religiosity. Hours of porn use is a far better predictor of actual porn addiction than is religiosity. Why religiosity has any relationship to porn addiction is unknown. It could be the result of a skewed sample. When compared to non-religious individuals, a far lower percentage of religious individuals regularly view pornography. Perhaps this skewed sample of “religious porn users” contains a far higher percentage of individuals with pre-existing conditions (OCD, ADHD, depression, bipolar disorder, etc.) or familial/genetic influences commonly associated with addiction.
Finally, a recent study (by a non-Grubbs team) examined the relationships between pornography use and sexual satisfaction/functioning employing the CPUI-9. The study found that the amount of porn used was robustly related to questions 1-6 (0.50), yet not at all related to questions 7-9 (0.03). This means that the amount of porn used is a very strong factor in the development of a porn addiction. On the other hand, shame and guilt were not associated with porn use, and had nothing to do with porn addiction.
Studies recognize that amount of porn use is not linearly related to porn addiction
As explained above, the amount of porn used is far more related to actual porn addiction than is religiosity. That said, we need to address Grubbs’s insinuation that hours of porn use is synonymous with “real porn addiction.” That is, that the extent of a “genuine porn addiction” is best indicated simply by “current hours of internet porn viewing,” rather than by standard porn addiction tests or by porn-induced symptoms.
The hole in these author’s underpinnings, which you could drive a truck through, is that research on internet porn and internet addictions (1, 2, 3, 4, 5, 6, 7, 8, 9) has reported that internet addiction sub-types do not correlate linearly with hours of use. In fact, the variable ‘hours of use’ is an unreliable measure of addiction. Established addiction assessment tools evaluate addiction using multiple other, more reliable factors (such as those listed in the first two sections of the CPUI). The following cybersex addiction studies, which Grubbs omitted, report little relationship between hours and indications of addiction:
“Results indicate that self-reported problems in daily life linked to online sexual activities were predicted by subjective sexual arousal ratings of the pornographic material, global severity of psychological symptoms, and the number of sex applications used when being on Internet sex sites in daily life, while the time spent on Internet sex sites (minutes per day) did not significantly contribute to explanation of variance in Internet Addiction Test sex score (IATsex). We see some parallels between cognitive and brain mechanisms potentially contributing to the maintenance of excessive cybersex and those described for individuals with substance dependence.”
“Recent findings have demonstrated an association between CyberSex Addiction (CA) severity and indicators of sexual excitability, and that coping by sexual behaviors mediated the relationship between sexual excitability and CA symptoms. Results showed strong correlations between CA symptoms and indicators of sexual arousal and sexual excitability, coping by sexual behaviors, and psychological symptoms. CyberSex Addiction was not associated with offline sexual behaviors and weekly cybersex use time.”
According to our best knowledge this study is the first direct examination of associations between the frequency of porn use and actual behavior of treatment-seeking for problematic porn use (measured as visiting the psychologist, psychiatrist or sexologist for this purpose). Our results indicate that the future studies, and treatment, in this field should focus more on impact of porn use on the life of an individual (quality) rather than its mere frequency (quantity), as the negative symptoms associated with porn use (rather than porn use frequency ) are the most significant predictor of treatment-seeking behavior.
Relation between PU and negative symptoms was significant and mediated by self-reported, subjective religiosity (weak, partial mediation) among non-treatment seekers. Among treatment-seekers religiosity is not related to negative symptoms.
Higher scores on addictive measures of internet porn use were correlated with daily or more frequent use of internet porn. However, the results indicate that there was no direct link between the amount and frequency of an individual’s pornography use and struggles with anxiety, depression, and life and relationship satisfaction. Significant correlations to high internet porn addiction scores included an early first exposure to internet porn, addiction to video games, and being male. While some positive effects of internet porn use have been documented in previous literature our results do not indicate that psychosocial functioning improves with moderate or casual use of internet porn.
This study investigated the prevalence of problematic Internet pornography viewing, how it is problematic, and the psychological processes that underlie the problem in a sample of 84 college-age males using an anonymous online survey. It was found that approximately 20%–60% of the sample who view pornography find it to be problematic depending on the domain of interest. In this study, the amount of viewing did not predict the level of problems experienced.
Thus, from the outset this study and its assertions collapse because its conclusions rest upon equating current hours of use with the level of addiction/problems/distress reported by subjects as a valid measure of addiction.
Why don’t addiction specialists rely solely on hours of use?
Imagine trying to assess the presence of addiction by simply asking, “How many hours do you currently spend eating (food addiction)?” or “How many hours do you spend gambling (gambling addition)?” or “How many hours do you spend drinking (alcoholism)?” To demonstrate how problematic “hours of use” would be as an indicator of addiction, consider alcohol as an example:
A 45-year old Italian man has a tradition of drinking 2 glasses of wine every night with dinner. His meal is with his extended family and it takes 3 hours to complete (lots of yakking). So he drinks for 3 hours a night, 21 hour per week.
A 25 year-old factory worker only drinks on the weekends, but binge drinks both Friday and Saturday night to the point of passing out or getting sick. He regrets his actions and wants to stop, but can’t, drives drunk, gets in fights, is sexually aggressive, etc. He then spends all of Sunday recovering, and feels like crap until Wednesday. However, he spent only 8 hours a week drinking.
Which drinker has a problem? How helpful is applying “hours of use” to gambling addiction? Take these two gamblers;
A retired elementary school teacher who lives in Las Vegas. She and three of her friends regularly spend weekday afternoons on the strip playing nickel slot machines and video-poker at various non-smoking casinos. Afterwards they usually eat dinner at the CircusCircus $9.99 buffet. Total losses could be as high as $5.00, but they often break even. Total time per week – 25 hours.
A 43-year old electrician with 3 teenage kids, who is now living alone in a seedy motel. Betting on the ponies has led to divorce, lost jobs, bankruptcy, inability to pay child support, and the loss of visitation rights. While he only visits the track 3 times a week, about 2 hours each time, his compulsive gambling ruined his life. He can’t stop and is contemplating suicide. Total time gambling per week – 6 hours.
But, you wonder, surely the amount of drug used must equate to the level of addiction? Not necessarily. For example, millions of Americans with chronic pain are users of prescription opioids (Vicodin, Oxycontin) on a regular basis. Their brains and tissues have become physically dependent on them, and immediate cessation of use could cause severe withdrawals symptoms. However, very few chronic pain patients are addicted. Addiction involves multiple well-indentified brain changes that lead to the signs and symptoms experts recognize as addiction. (If the distinction is unclear, I recommend this simple explanation by NIDA.) The vast majority of chronic pain patients would happily throw away their narcotics in exchange for a life free of debilitating pain. This is quite different from true opioid addicts who often risk everything to continue their addiction.
Neither “current hours of use” nor “the amount used” alone can inform us as to who is addicted and who is not. There’s a reason why “continued use despite severe negative consequences” helps experts define addiction, and “current hours of use” does not. Remember, the 3 “Access Efforts” CPUI questions assessed “the inability to stop despite severe negative consequences.” In Grubbs’s data, these questions were the strongest predictors of actual porn addiction.
Bottom line: Grubbs’s claims depend upon “current hours of use” being the sole valid criterion for true addiction. They are not. Even if hours of use were a proxy for addiction, Grubbs’s full studies reveal that “current hours of porn use” is strongly related to total CPUI-9 scores (i.e., “perceived” addiction). More importantly, “hours of porn use” is far more related to actual porn addiction (CPUI questions 1-6) than it is to religiosity. So Grubbs’s conclusions are both untrue and not based on existing addiction science.
“Current hours of porn use” omits many variables
A secondary methodological problem is that Grubbs assessed porn use by asking subjects about their “current hours of porn use.” That question is troublingly vague. Over what period? One subject may be thinking “How much did I use yesterday?” another “over the last week?” or “on average since I decided to quit viewing because of unwanted effects?” The result is data that are not comparable and cannot be analyzed for the purpose of drawing reliable conclusions, let alone the vast, unsupported conclusions Grubbs draws.
More important, the “current porn use” question, on which the study’s conclusions rest, fails to ask about key variables of porn use: age use began, years of use, whether the user escalated to novel genres of porn or developed unexpected porn fetishes, the ratio of ejaculation with porn to ejaculation without it, amount of sex with a real partner, and so forth. Those questions would likely enlighten us more about who really has a problem with porn use than simply “current hours of use.”
SECTION 3: Is Religiosity Related to Actual Porn Addiction?
Introduction: Anecdotal evidence from sex therapists suggests there are clients who feel addicted to porn, yet view it only occasionally. It’s possible that some of these clients are religious and experience guilt and shame surrounding their occasional porn use. Are these individuals suffering only from “perceived addiction” and not real porn addiction? Perhaps. That said, these individuals want to stop yet they continue to use porn. Whether or not these “occasional porn users” are truly addicted or just feeling guilt and shame, one thing is for sure: the Grubbs CPUI cannot distinguish “perceived addiction” from actual addiction in these individuals or anyone else.
One third of CPUI questions assess remorse and shame, resulting in higher scores for religious individuals
Because the last 3 of the 9 CPUI questions assess guilt, shame and remorse, religious porn users’ CPUI scores tend to be skewed upward. For example, if an atheist and devout Christian have identical scores on CPUI questions 1-6, it’s almost certain that the Christian will end up with far higher CPUI-9 scores, after questions 7-9 are added.
I feel ashamed after viewing pornography online.
I feel depressed after viewing pornography online.
I feel sick after viewing pornography online.
Grubbs’s actual findings are that religious pornusers may feel more guilt about porn use (questions 7-9), but they are not any more addicted (questions 4-6).
In the end, all we can take from Grubbs’s studies is that some religious porn users experience regret and shame. No surprise there. Since a much lower percentage of religious individuals use porn, Grubb’s findings tell us nothing about religious people as a whole. The key point:Grubbs is using a skewed sample of religious subjects – the porn using minority – to claim that porn addiction is related to religiosity.
It’s important to note that assessment questionnaires for other types of addiction rarely have questions about guilt and shame. Certainly, none make one third of their questionnaires about guilt and shame. For example, the DSM-5 criteria from Alcohol Use Disorder contain 11 questions. Yet none of the questions assess remorse or guilt after a drinking binge. Nor does the DSM-5 Gambling Addiction questionnaire contain a single question about remorse, guilt or shame. Rather, both of these DSM-5 addiction questionnaires emphasize dysfunctional behaviors, similar to questions 4-6 of the CPUI-9:
At times, I try to arrange my schedule so that I will be able to be alone in order to view pornography.
I have refused to go out with friends or attend certain social functions to have the opportunity to view pornography.
I have put off important priorities to view pornography.
Remember, CPUI questions 4-6 are far more related to current “Hours of Porn Use” than any other factor (0.44). Meaning that “hours of use” is by far the strongest predictor of actual porn addiction in Grubbs’s data. On the other hand, questions 4-6 bore very little relation to “religiosity” (0.07). Meaning that religiosity is not really related to porn addiction. The very small relation between religiosity and actual porn addiction are likely better explained by Grubb’s s skewed sample and other factors discussed below.
Religiosity does NOT predict porn addiction. Not even a wee bit.
In Section 2 we pointed out that “hours of porn use” was more related to total CPUI-9 scores than was religiosity. Or as a researcher might say: “hours of porn use” predicted porn addiction slightly better than did religiosity. We also pointed out that the correlation between actual porn addiction (CPUI questions 4-6) and Religiosity averaged 0.07, while the correlation actual porn addiction (CPUI questions 4-6) and “hours of porn use” was 0.44. To put it another way: “hours of porn use” predicted porn addiction 600+% more strongly than did religiosity.
That said, Grubbs still reports a weak positive relationship between religiosity and core addiction questions 4-6 (0.07). So is Grubbs is right, that religiosity predicts porn addiction? No, religiosity does not predict porn addiction. Quite the opposite. Religious individuals are far less likely to use porn and thus less likely to become porn addicts.
Grubbs’s sample of religious porn users is therefore skewed to the small percentage of religious men using porn. Put simply, religiosity is protective against porn addiction.
65% of religious young men reported viewing no pornography in the past 12 months
8.6% reported viewing two or three days per month
8.6% reported viewing daily or every other day
In contrast, cross-sectional studies of college-age men report relatively high rates of porn viewing (US – 2008: 87%, China – 2012: 86%, Netherlands – 2013 (age 16) – 73%). In short, given that a large majority of college-age, religious men rarely views porn, Grubbs’s targeted sample of “religious porn users” is quite skewed, while his sample of “secular porn users” is fairly representative.
Now we turn to a few reasons why religious porn users might score higher on porn addiction questionnaires.
#1) Religious porn users are likely to have higher rates of pre-existing conditions
Given that a large majority of college-age, religious men rarely views porn, the Grubbs and Leonhardt, et al. targeted samples of “religious porn users” represented a small minority of the religious population. In contrast, samples of “secular porn users” tend to represent the majority of the non-religious population.
Most young religious porn users say they would rather not watch porn (100% in this study). So why do these particular users watch? It’s extremely likely that the non-representative sample of “religious porn users” contains a far higher percentage of the slice of the entire population that struggles with the pre-existing conditions or comorbidities. These conditions are often present in addicts (i.e. OCD, depression, anxiety, social anxiety disorder, ADHD, family histories of addiction, childhood trauma or sexual abuse, other addictions, etc.).
This factor alone could explain why religious porn users, as a group, score slightly higher on the Grubbs porn addiction questionnaire. This hypothesis is supported by studies on treatment seeking porn /sex addicts (whom we could expect to hail disproportionately from that same disadvantaged slice). Treatment seekers reveal no relationship between religiosity and measurements of addiction and religiosity (2016 study 1, 2016 study 2). If Grubbs’s conclusions were valid, we’d surely see a disproportionate number of religious porn users seeking treatment. This hypothesis is supported by studies on treatment seeking porn /sex addicts which reveal no relationship between religiosity and measurements of addiction and religiosity (2016 study 1, 2016 study 2).
#2) At high levels of porn use religious individuals return to religious practices and religion becomes more important
This 2016 study on religious porn users reported an odd finding that by itself could explain Grubbs’s slight correlation between actual porn addiction and religiosity. The relationship between porn use and religiosity is curvilinear. As porn use increases, religious practice and the importance of religion decrease – up to point. Yet when a religious individual begins using porn once or twice a week this pattern reverses itself: The porn user starts attending church more often and the importance of religion in his life increases. An excerpt from the study:
“However, the effect of earlier pornography use on later religious service attendance and prayer was curvilinear: Religious service attendance and prayer decline to a point and then increase at higher levels of pornography viewing.”
This graph, taken from this study, compares religious service attendance with the amount of porn used:
It seems likely that as religious individuals’ porn use grows increasingly out of control, they return to religion as a means to address their problematic behavior. This is no surprise, as many addiction recovery groups based on the 12-steps include a spiritual or religious component. The author of the paper suggested this as a possible explanation:
…studies of addiction suggest that those who feel helpless in their addiction often elicit supernatural help. Indeed, twelve-step programs that seek to help persons struggling with addictions ubiquitously include teachings about surrendering to a higher power, and a rising number of conservative Christian twelve-step programs make this connection even more explicit. It could very well be that persons who use pornography at the most extreme levels (i.e., use levels that might be characteristic of a compulsion or addiction) are actually pushed toward religion over time rather than pulled away from it.
This phenomenon of religious porn users returning to their faiths as addiction worsens could easily explain the slight correlation between actual porn addiction and religiosity.
#3) In contrast to religious subjects, secular porn using subjects may not recognize porn’s effects because they never try to quit
Is it possible that religious porn users score higher on porn addiction questionnaires because they’ve actually tried to quit, unlike their secular brethren? In doing so they would be more likely to recognize the signs and symptoms of porn addiction as assessed by the Leonhardt, et al. 5-item questionnaire.
Based on years of monitoring porn recovery forums online, we suggest that researchers should segregate users who have experimented with quitting porn from those who haven’t, when asking them about porn’s self-perceived effects. It is generally the case that today’s porn users (both religious and nonreligious) have little understanding of internet porn’s effects on them until after they attempt to quit (and pass through any withdrawal symptoms).
In general, agnostic porn users believe porn use is harmless, so they have no motivation to quit…until they run into intolerable symptoms (perhaps, debilitating social anxiety, inability to have sex with a real partner or escalation to content they find confusing/disturbing or too risky). Prior to that turning point, if you ask them about their porn use, they will report that all is well. They naturally assume they are “casual users,” who could quit anytime, and that symptoms they have, if any, are due to something else. Shame? Nope.
In contrast, most religious porn users have been warned that porn use is risky. They are therefore more likely to have used less porn and to have experimented with giving it up, perhaps more than once. Such experiments with quitting internet porn are very enlightening, as that is when porn users (religious or not) discover:
How difficult it is to quit (if they’re addicted)
How porn use has affected them adversely, emotionally, sexually and otherwise (often because symptoms begin to recede after quitting)
[In the case of such symptoms] How withdrawal can make symptoms worse for a while, before the brain returns to balance
How bad it feels when they want to give something up and can’t (This is shame, but not necessarily “religious/sexual shame” – as researchers sometimes assume because religious users report it more often. Most all addicts unfortunately feel shame when they feel powerless to quit, whether or not they are religious.)
That they experience strong cravings to use porn. Cravings often increase in severity with a week or longer break from using porn.
Such experiences make those who have tried quitting far more wary about porn use. Since more religious users will more frequently have made such experiments, psychological instruments will show that they are more concerned about their porn use than non-religious users – even though they are likely using less porn!
In other words, shouldn’t researchers also be investigating whether secular porn users sometimes misperceive porn use as harmless, rather than assuming it’s the religious people who are misperceiving the existence of porn-related problems even though they’re using less? Addiction, after all, is not assessed based on quantity or frequency of use, but rather debilitating effects.
In any case, the failure to segregate those who have experimented with quitting from those who have not, is a huge confound in research attempting to draw conclusions about the implications of the relationship between religiosity, shame and porn use. It’s easy to misinterpret data as evidence that “religion makes people concerned about porn even if they’re using less than others, and that if they weren’t religious they wouldn’t be concerned.”
The more valid conclusion may be that those who have tried to quit, and realized the points above are more concerned, and that religion is merely the cause of their making such experiments (and otherwise largely irrelevant). It’s disheartening to see psychologists make simplistic correlations with religion/spirituality and draw “shaming” conclusions, without realizing that they are comparing “apples” with “oranges” when they compare users who have tried to quit with users who haven’t. Again, only the former tend to see the risks and harms of porn use clearly, whether or not they are religious.
This confound is too often exploited by those who want to draw attention away from the severe symptoms that non-religious users frequently experience. Agnostic users tend to have more severe symptoms by the time they do quit, simply because they tend to quit at a lower point in the downward spiral of symptoms than religious porn users do. Why aren’t researchers studying this phenomenon?
In fact, we would wager that the lion’s share of those with porn-induced sexual dysfunctions are agnostics. Why? Because the non-religious tend to be so persuaded of the harmlessness of internet porn use that they continue using it well past the warning signs, such as increasing social anxiety, escalation to extreme material, apathy, difficulty achieving an erection without porn, difficulty using condoms or climaxing with a partner, and so forth.
The fact is, even casual, or relatively infrequent, porn use can condition some users’ sexuality such that it interferes with their sexual and relationship satisfaction. Here’s one man’s account. Escalation to porn content that was once uninteresting or repelling is common in half of internet porn users. In short, as discussed above, infrequent use is no panacea. Those who do not use frequently but are anxious about their porn use may have good reason to be concerned based on their own experiments, quite apart from what they hear about porn during religious services.
Might it be better to construct research that asks porn users (both religious and otherwise) to quit porn for a time and compare their experiences with controls? See Eliminate Chronic Internet Pornography Use to Reveal Its Effects for a possible study design.
#4) The biological reasons why intermittent porn users might score higher on porn addiction questionnaires
Very frequent internet porn use has familiar risks for many of today’s users. These include escalation to more extreme material, poorer sexual and relationship satisfaction, addiction, and/or the gradual loss of attraction to real partners (as well as anorgasmia and unreliable erections).
Less well known is the fact that intermittent use (for example, 2 hours of porn bingeing followed by a few weeks of abstinence before another porn session) poses a substantial risk of addiction. The reasons are biological, and there is an entire body of addiction research on intermittent use in animals and humans elucidating the brain events responsible.
For example, both drug and junk food studies reveal that intermittent use can lead more quickly to addiction-related brain changes (whether or not the user slips into full blown addiction). The primary change is sensitizationwhich blasts the brain’s reward center with signals that produce hard to ignore cravings. With sensitization, brain circuits involved in motivation and reward seeking become hyper-sensitive to memories or cues related to the addictive behavior. This deep pavlovian conditioning results in increased “wanting” or craving while liking or pleasure from the activity diminishes. Cues, such as turning on the computer, seeing a pop-up, or being alone, trigger intense cravings for porn. (Studies reporting sensitization or cue-reactivity in porn users: 1,2,3,4, 5,6,7,8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20.)
Even more remarkable is that periods of abstinence (2-4 weeks) lead to neuroplastic changes that don’t occur in a user that doesn’t take such long breaks. These alterations in the brain increase cravings to use in response to triggers. Furthermore, the stress system changes such that even minor stress can cause cravings to use.
Intermittent consumption (especially in the form of a binge) can also produce severe withdrawal symptoms, such as lethargy, depression and cravings. In other words, when someone uses after an interim of abstinence, and binges, it can hit the user harder – perhaps because of the heightened intensity of the experience.
Based on this research, scientists have concluded that everyday consumption of say cocaine, alcohol, cigarettes, or junk food is not necessary to generate addiction-related brain changes. Intermittent bingeing can do the same thing as continuous use, and in some cases do more.
Now, let’s return to a comparison of religious and nonreligious porn users. Which group is likely to include more intermittent users? Given research showing that religious porn users prefer not to be using porn, there are probably more religious than secular users stuck in a binge-abstinence cycle. Religious users would tend to be “intermittent users.” Secular users generally report that they seldom take breaks of more than a few days – unless they become intermittent users because they are trying to quit porn use.
Another important effect of the binge-abstinence cycle is that intermittent porn users experience extended gaps (and often improvements). They can clearly see how their porn use has affected them, in contrast with frequent users. This alone might lead to higher scores on a porn addiction questionnaire. A second, more important result is that intermittent porn users will experience more frequent episodes of strong cravings. Third, when intermittent users do cave in, the science mentioned above predicts that they will often feel more out of control, and experience more of a letdown after the binge. In short, intermittent users can be quite addicted and score surprisingly high on porn addiction tests, even though they are using with less frequency than their secular brethren.
Under the circumstances, it is premature to conclude that shame accounts for the difference between religious and nonreligious users. Researchers must control for the impact of intermittent use. Said differently, if more of Leonhardt et al’s religious subjects included a higher percentage of intermittent users than their nonreligious subjects, one would expect the religious users to score higher on addiction tests despite using significantly less frequently.
Of course, the intermittent use addiction risk is not confined to religious porn users. This phenomenon shows up in animal models and secular porn users who are trying to quit but still bingeing occasionally. The point is that the phenomenon of intermittent use and porn addiction needs to be studied independently prior to drawing and publicizing assumptions about shame (or “perceived” pornography addiction) as the only possible explanation for why religious porn users report higher addiction scores in concert with less frequent use.
Summary of Religiosity and Porn Use:
Religiosity does not predict porn addiction (perceived or otherwise). A far larger percentage of secular individuals use porn.
Since a much smaller percentage of religious people use porn, religiosity is evidently protective against porn addiction.
Grubbs and Leonhardt, et al. samples taken from the minority of “religious porn users” is skewed with respect to religious users, likely resulting in a much higher percentage of the religious sample having comorbidities. As a result religious porn users have slightly higher overall scores on porn-addiction instruments and report more difficulty controlling use.
As porn use becomes frequent or compulsive, religious porn users return to their faiths. This means that those scoring highest on porn addiction tests will also score higher on religiosity.
Most religious porn users have been warned that porn use is risky. They are therefore more likely to have used less porn and to have experimented with giving it up. In doing so they are more likely to recognize the signs and symptoms of porn addiction as assessed by the Grubss CPUI-9 of the Leonhardt, et al. 5-item questionnaire – regardless of amount of porn use.
Intermittent porn users can be quite addicted and score surprisingly high on porn addiction tests, even though they are using with less frequency than their secular brethren.
SECTION 4: Grubbs Distorts the Current State of Addiction Research
The validity of internet pornography addiction is addressed in at least three of Joshua Grubbs’s studies (Grubbs et al., 2015; Bradley et al., 2016; Grubbs et al., 2016.) All three papers casually toss aside decades of neuropsychological and other addiction research (and related assessment tools) to attempt to persuade readers that the scientific literature shows that internet porn addiction doesn’t exist (thus supporting the Grubbs claim that all evidence of porn addiction must be “perceived,” not real).
The studies Grubbs cited to dismiss porn addiction
In their opening paragraphs, Grubbs’s three studies mentioned in the previous paragraph demonstrate their profound bias by basing their claim about the nonexistence of internet porn addiction on the papers of two self-proclaimed “internet porn addiction debunkers”: David Ley, author of The Myth of Sex Addiction, and former UCLA researcher Nicole Prause, whose work has been formally criticized in the medical literature for weak methodology and unsupported conclusions. The three papers Grubbs believes debunk porn addiction:
Sexual Desire, Not Hypersexuality, is Related to Neurophysiological Responses Elicited by Sexual Images (2013),Vaughn R. Steele, Cameron Staley, Timothy Fong, Nicole Prause
Viewing Sexual Stimuli Associated with Greater Sexual Responsiveness, Not Erectile Dysfunction (2015), Nicole Prause & Jim Pfaus
Paper #1 (Ley et al., 2013) is a one-sided propaganda piece by Ley, Prause and their colleague Peter Finn, which claimed to be a review of the porn addiction model. It was not. First, Ley et al. omitted all published studies showing ill effects from porn use on the grounds that they are “merely” correlational. You read that right. Secondly, it cherry-picked random, misleading lines from within studies, failing to report the researchers’ actual opposing conclusions. Third, Ley et al. cited numerous studies that were entirely irrelevant to the claims made. We realize these are very strong assertions, yet they are fully supported and documented in this line-by-line critique. It should be noted that Ley et al. editor, Charles Moser, has long been a vocal critic of porn and sex addiction. Also know that Current Sexual Health Reports has a short and rocky history. It started publishing in 2004, and then went on hiatus in 2008, only to be resurrected in 2014, just in time to feature Ley et al.
Paper #2 (Steele et al., 2013) was an EEG study touted in the media as evidence against the existence of porn addiction. Not so. This SPAN Lab study actually lends support to the existence of both porn addiction and porn use down-regulating sexual desire. How so? The study reported higher EEG readings (P300) when subjects were briefly exposed to pornographic photos. Studies show that an elevated P300 occurs when addicts are exposed to cues (such as images) related to their addiction. However, due to methodological flaws the findings are uninterpretable: 1) subjects were heterogeneous (males, females, non-heterosexuals); 2) subjects were not screened for mental disorders or addictions; 3) study had no control group for comparison; 4) questionnaires were not validated for porn addiction. In line with the Cambridge University brain scan studies, this EEG study also reported greater cue-reactivity to porn correlating with less desire for partnered sex. Put another way, individuals with more brain activation and cravings for porn preferred to masturbate to porn than have sex with a real person. Study spokesperson Nicole Prause claimed that these porn users merely had high libido, yet the results of the study say the exact opposite (their desire for partnered sex was dropping in relation to their porn use). As neither result matched the concocted headlines, Grubbs perpetuated flawed conclusions of the original authors (the “debunkers of porn addiction”). Six peer-reviewed papers have formally analyzed Steele et al., 2013 concluding that its findings are consistent with the porn addiction model it claims to debunk: 1, 2, 3, 4, 5, 6. Also see this extensive critique.
Paper #3 (Prause & Pfaus 2015) was presented by Grubbs as evidence for the positive effects of porn:
…some studies even suggest potentially positive outcomes associated with pornography use (Prause & Pfaus, 2015).
Prause and Pfaus wasn’t a real study and it did not find “positive outcomes” related to porn use. None of the data from the Prause & Pfaus (2015) paper matched the four earlier studies on which it was based. The discrepancies were not small and have not been explained. A comment by researcher Richard A. Isenberg MD, published in Sexual Medicine Open Access, points out several (but not all) of the discrepancies, errors, and unsupported claims. The solitary positive outcome Prause & Pfaus claimed was a slightly higher “subjective arousal rating” after viewing porn in subjects who watched more porn at home. Several problems with this claim:
The more science-based way to interpret this arousal difference is that the men who used more porn experienced greater cravings to use porn. Interestingly, they had less desire for sex with a partner and more desire to masturbate than those who logged fewer hours watching porn.
Prause & Pfaus could not have accurately assessed the subjects’ arousal because:
the underlying 4 studies used different types of porn. Two studies used a 3-minute film, one study used a 20-second film, and one study used still images.
the underlying 4 studies employed different number scales. One used a 0 to 7 scale, one used a 1 to 7 scale, and one study did not report sexual arousal ratings.
Richard A. Isenberg MD asked Prause & Pfaus to explain how they could claim this result in the absence of supporting data. Neither author has been able to provide a comprehensible answer.
What the Grubbs studies omitted
With respect to Grubbs’s bias, it is even more telling that the 3 studies named above omit every neurological and neuropsychological study that found evidence in support of the porn addiction model (over 40 collected here). In addition, Grubbs omitted 17 recent reviews of literature & commentaries of literature on porn and sex addiction (in the same list). Many of these studies and reviews are by some the top neuroscientists at Yale University, Cambridge University, University of Duisburg-Essen, and the Max Planck Institute. (Some of these were not yet published when Grubbs’s studies went to press, but many were, and were simply ignored.)
Contrast those eminent researchers with Ley and Prause. Ley has no background in neuroscience and had published nothing until Ley et al., 2014. Prause hasn’t been associated with any university since December, 2014, and her claims surrounding her 2 EEG studies have been repeatedly discredited in the peer-reviewed literature (2015 study: 1, 2, 3, 4, 5, 6, 7.; 2013 study: 1, 2, 3, 4, 5, 6.)
“has everything to do with religiosity and moral attitudes toward sex. In short, he says, “It’s shame-motivated.”…
If “porn addiction is simply shame” how does Grubbs explain away the growing number of neurological studies that have found brain changes in problematic porn users that align with substance addiction? How could shame cause the same brain changes that occur with drug addiction? How could evidence of shame disprove the presence of addiction in brains showing evidence of addiction? It can’t.
We cannot tell you how many times the following “letter to editor” to a Salt Lake newspaper has been cited as “proof” porn use causes no problems and porn addiction doesn’t exist: Op-ed: Anti-porn school program misrepresents science. It’s often posted on social media (Quora, Twitter, Facebook) as evidence that YBOP, Fight the New Drug or others have misrepresented the current state of the research or have misquoted studies. On the surface it appears legitimate as 7 PhD buddies of author Nicole Prause signed off on it.
However, upon closer examination we find that:.
It provides no examples of misrepresentation by “Fight The New Drug”, or anyone else.
None of the claims are supported by citations.
The 8 neuroscientists cited zero neuroscience-based studies.
Most had collaborated with the lead author of the Op-Ed (Prause) or her colleague (Pfaus).
This 600-word Op-Ed is chock full of unsupported assertions meant to fool the lay public. It fails to support a single assertion as it cites only 4 papers – none of which have anything to do with porn addiction, porn’s effects on relationships, or porn-induced sexual problems. Experts in this field debunked its assertions and empty rhetoric in a relatively short response below. Unlike the “neuroscientists of the Op-Ed,” we cited several hundred studies and multiple reviews of the literature, including many of the following:
52 neuroscience-based studies (MRI, fMRI, EEG, neuropsychological, hormonal) providing strong support for the addiction model.
Op-ed: Who exactly is misrepresenting the science on pornography?
8 neuroscientists fail to cite a single neuroscience study to support their claims
By Clay Olsen, Gail Dines, Mary Anne Layden, Gary Wilson, Jill Manning, Donald Hilton and John Foubert
Charges of misrepresenting science are serious. We write in response to a recent op-ed’s critique of Fight the New Drug’s scientific claims. Rather than mere “activists” as the op-ed authors labeled us, we represent some 130 years of combined professional experience researching or assisting those impacted by pornography.
While the authors of the earlier op-ed acknowledge “some cause for concern” regarding pornography consumption, nearly half their commentary highlights the “positive effects of sex film use,” while minimizing any serious harm. It is this kind of “balanced view,” they argue, FTND has failed to acknowledge in their work in schools.
Citing only one study, their expansive list of purported benefits from pornography range from “enhancing sex,” to greater “happiness and joy” and improved “comfort with one’s own appearance.” On the basis of a single citation we are asked to believe the production of pornography promotes “higher self-esteem” for performers while its consumption “reduc[es] violence and sexual assaults”—this, without mention of either six studies confirming mental and physical health problems of female performers or a full 50 peer-reviewed studiesdirectly linking porn use to sexual violence.
The authors assert that a more accurate scientific analysis confirms only a “tiny percentage of those who viewed sex films” as having any negative effects—quoting “less than 2 percent of men, less than 0.05 percent of women.” They do so without citation, and without mentioning either the 2016 US study in which 28% of porn users scored at (or above) the cutoff for possible hypersexual disorder, or the 2016 Belgian study in which 28% of porn users self-assessed their porn consumption as problematic (alarmingly high rates, given that users of potentially addictive stimuli are typically among the last to recognize they have problems). Despite this, the authors of the op-ed go on to contend that pornography does “not have even primarily negative effects” and instead “mostly positive effects.”
Passed over are 75 peer-reviewed studies—a preponderance of the evidence to date—linking pornography use to lower relationship or sexual satisfaction (yes, most examined positive effects too). Also disregarded are 30 studies linking porn consumption to sexual problems and lower arousal, 55 studies documenting pornography escalation or habituation and a full 20 scientific reviews that establish serious risks with pornography use.
Such research, these authors argue, ought to be dismissed in a more “balanced” assessment. By contrast, those who disagree with their rosy analysis have, in their words, simply “disregarded the scientific method” or failed to conduct sufficiently “rigorous” studies.
How eight neuroscientists could overlook these studies is difficult to understand, especially when over sixty neuroscientists have concluded their own brain data supports pornography’s addictive potential. Indeed, the single team interpreting their data from the brains of porn users otherwise is the one led by the lead author of the op-ed. When ten outside reviews published re-analyses of these data, they concluded the team was overlooking evidence of the very habituation and desensitization characterizing all addictive patterns. Contrary to claims of the lead author that her team’s anomalous study had singlehandedly “debunked porn addiction,” the evidence in that study just doesn’t stand up.
Despite this, these authors argue that the real public harm comes not from pornography use, but from insisting publicly that it can be harmful! To share a message about pornography’s potential harms with youth, they insist, is the true danger—imploring school authorities to ensure youth hear a “balanced” view that also acknowledges pornography’s “positive” effects.
Given how sharply out of line the authors’ proposals are with the preponderance of evidence consistently documenting an array of potential harms associated with pornography consumption, we are compelled to ask: Who are the activists here? And, whose interest would be served by passing along these authors’ conclusions to our children?
In light of the documented social, emotional, cognitive, sexual and developmental impacts on youth, we propose it is time to develop a robust, evidenced-based public health approach to educating and protecting youth from pornography’s harm. Our children deserve at least that much.
[For responses to the many additional claims made in this op-ed, see below]
Clay Olsen is CEO and co-founder of Fight the New Drug, and the founder, lead developer and artistic director of Fortify, an educational support community for those facing compulsive pornography issues.
Gail Dines, Ph.D. is a professor of sociology and women’s studies at Wheelock College in Boston, and founding president of Culture Reframed, a public health organization building resilience and resistance in youth to the porn culture.
Mary Anne Layden, Ph D, is the Director of Sexual Trauma and Psychopathology Program and Center for Cognitive Therapy in the Department of Psychiatry at the University of Pennsylvania
Gary Wilson is the creator of YourBrainOnPorn.com and the author of “Your Brain on Porn: Internet Pornography and the Emerging Science of Addiction.”
Jill Manning, Ph.D. is a licensed marital and family therapist, researcher and author based in Colorado. She currently serves on the board of directors for Enough is Enough, a non-profit organization dedicated to making the Internet safer for children and families.
Donald Hilton, MD, is an adjunct associate professor of neurosurgery at the University of Texas Health Science Center at San Antonio and a fellow of the American Association of Neurological Surgeons.
John D. Foubert, Ph.D., is an Endowed Professor of College Student Development at Oklahoma State University and is the author of the new book, How Pornography Harms: What Teens, Young Adults, Parents and Pastors Need to Know.
Addendum: Seven more points of response:
1. Philosophy of science. After contending that FTND is “systematically misrepresenting science” and “disregard[ing] the scientific method” the authors spend a long paragraph walking through principles they claim have been violated, namely:
“The scientific method requires forming a falsifiable hypothesis, then creating experiments to disprove this hypothesis. Only if data consistently fail to disprove the hypothesis can one conclude that the hypothesis is supported, not proven.”
Got it! And right on. We’re following you so far…
They continue, “The FTND letter suggests that (a) there has been rigorous testing seeking to disprove the hypothesis that pornography is addictive or harmful”
Yep. There has!
“(b) this testing has consistently failed to disprove this hypothesis”
Yep. It has!
“and (c) no contradictory evidence has been found.”
Not a whole lot. Nope!
It’s baffling why eight neuroscientists would overlook the direction this preponderance of evidence is pointing.
2. Study representativeness. The Op-Ed authors say, “Sex film users were not sampled in any representative way, and the studies ended up with biased samples reporting distress regarding their sex film use.”
In fact, our list of over 75 studies correlating porn use with sexual or relationship satisfaction has the only studies that sampled this satisfaction issue in a representative way: both cross-sectional and longitudinal.
3. Addiction language and distress. The authors say, “the conceptualization of behavior as ‘addictive’ has documented significant psychological harm.”
Yet the study they reference did not assess the psychological harm done to people who felt their behavior was addictive. Their link goes to a study that found that scores on a porn addiction test related to psychological distress. Simply put, higher levels of porn addiction correlated with higher levels of distress, which is to be expected in problematic users. For a full critique of this study click here.
4. Addiction language and sexual dysfunction. The authors say, “the conceptualization of behavior as ‘addictive’…has caused boys to think they have erectile dysfunction when they do not.”
False again. The link goes to a paper with 4 complex case studies of young men who had erectile dysfunction (not “believed” they had ED as the authors claim). There is no mention of porn use or porn addiction in that paper.
5. Pornography and women’s rights. They say, “Sex-film viewing also has been associated with more egalitarian attitudes….”
The study referenced by the authors framed ‘egalitarianism’ as support for: Feminist identification, Women holding positions of power, Women working outside home, and Abortion. Secular populations tend to be more liberal, and have significantly higher rates of porn use than religious populations. This reality produces a stronger correlation between porn use and (what this study defines as) “egalitarianism.” in reality, there are over 40 studies linking porn use to “un-egalitarian attitudes” toward women.
6. Pornography and higher education/religiosity. The authors say, “Sex-film viewing also has been associated with…higher education, more prayer and religiosity at high use, and are commonly used in sex therapy.”
The link the authors supply addresses only the “egalitarianism” correlation reported by a single study – not the authors’ other claims. Moreover, many studies report opposing results, including studies linking porn to sexist attitudes, objectification and less egalitarianism: 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13.
7. Diagnostic Manuals. With respect to the ICD (International Classification of Diseases and Related Health Problems), which the authors mentioned, the important point is that the upcoming ICD-11 proposes a diagnosis for “Compulsive Sexual Behavior Disorder,” the acknowledged “narrower term” for which is “sex addiction.”
Clearly, the international medical field is moving in the direction of the preponderance of the neuroscience and other evidence. Doubt about the validity of pornography addiction as a risk for some users is rapidly fading despite efforts like the current one to kick dust in the eyes of the public. Incidentally, the World Health Organization’s ICD “outranks” the foot-dragging Diagnostic and Statistical Manual (DSM) as a diagnostic guide. The the ICD is the most widely used classification of mental disorders worldwide, and its diagnostic codes are mandated for use in the US and elsewhere by international treaty as opposed to DSM-5 diagnoses, which enjoy no such mandate. Finally, the assertion that our initial reply referred to descriptive codes in the current diagnostic manuals rather than standalone diagnoses is incorrect, as made clear by DSM veteran psychiatrist Richard Krueger, MD.
A number of articles and interviews have attempted to pushback at the TIME article (“Porn and the Threat to Virility”) and the Utah resolution declaring internet porn a public health problem. What might be a few “dead giveaways” that such an article is nothing more than a propaganda piece?
Psychologists David Ley and/or Nicole Prause are cited as “the experts,” while actual top addiction neuroscientists, who have published highly respected studies on porn users (Voon, Kraus, Potenza, Brand, Laier, Hajela, Kuhn, Gallinat, Klucken, Seok, Sohn, Gola, Banca, etc.), are omitted. Neither Ley nor Prause are affiliated with any university, yet some journalists, perhaps influenced by Prause’s potent media services, mysteriously prefer both over the top neuroscientists at Yale University, Cambridge University, University of Duisburg-Essen, and the Max Planck Institute. Go figure.
The articles omit the many studies on adolescents, which report that porn use is related to such factors as poorer academics, more sexist attitudes, more aggression, poorer health, poorer relationships, lower life satisfaction, viewing people as objects, increased sexual risk taking, less condom use, greater sexual violence, unexplained anxiety, greater sexual coercion, less sexual satisfaction, lower libido, greater permissive attitudes, and a whole lot more.
Prause’s 2015 EEG study (claiming to debunk porn addiction) actually supports the existence of porn addiction because her team found desensitization in the heavy porn users.
Compared to controls, more frequent porn users had lower brain activation to one-second exposure to photos of vanilla porn. The lead author, Nicole Prause claims these results debunk porn addiction. However, these findings align perfectly with Kühn & Gallinat (2014), which found that more porn use correlated with lower brain activation in response to pictures of vanilla porn (and less gray matter in the dorsal striatum). In other words, the frequent porn users were desensitized to still images and needed greater stimulation than occasional porn users. Seven peer-reviewed papers agree with the PSC analysis, namely that what Prause actually found is consistent with the effects of addiction in her study’s subjects:
Author of the second critique, neuroscientist Mateusz Gola, summed up it up nicely:
“Unfortunately the bold title of Prause et al. (2015) article has already had an impact on mass media, thus popularizing a scientifically unjustified conclusion.”
What legitimate researcher would ever claim to have debunked an entire field of research and to refute all previous studies with a single EEG study? (Close ties to the industry in question might cloud a researcher’s perceptions). Not only was the title scientifically unjustified, Nicole Prause claimed her study contained 122 subjects (N). In reality, the study had only 55 subjects who were “experiencing problems regulating their viewing of sexual images”. The subjects were recruited from Pocatello Idaho, which is over 50% Mormon. The other 67 participants were controls.
In a second dubious claim, Prause et al., 2015 stated in both the abstract and in the body of the study:
“These are the first functional physiological data of persons reporting VSS regulation problems”.
In a third claim Nicole Prause has consistently asserted that Prause et al., 2015 is the largest neuroscience study published on porn addiction. Two problems with this claim:
It’s not a study on porn addiction if it has no porn addicts. This study, and 2 earlier Prause studies (Prause et al., 2013 & Steele et al., 2013) did not assess whether any of the subjects were porn addicts or not. Prause admitted in a an interview that many of the subjects had little difficulty controlling use. All of the subjects would have to have been confirmed porn addicts to permit a legitimate comparison with a group of non-porn addicts. Three of the five peer-reviewed critiques point out this fatal flaw.
HPA axis dysregulation in men with hypersexual disorder (2015) is the largest neuroscience based study to date on “hypersexuals” (67 subjects). The study assessed the brain’s response to stress by assessing a hormone release by the brain (ACTH), and a hormone controlled by the brain (cortisol). While this study was a published a few months after Prause et al., 2015, Nicole Prause continues to claim her EEG study as the largest.
You Can’t “Debunk Porn Addiction” If Your Subjects Are Not Porn Addicts
The 3 Prause Studies (Prause et al., 2013, Prause et al., 2015, Steele et al., 2013.) all involved the same subjects. Here’s what we know about the “porn addicted users” in Prause’s 3 studies (the “Prause Studies”): They were not necessarily addicts, as they were never assessed for porn addiction. Thus, they can’t legitimately be used to “falsify” anything to do with the addiction model. As a group they were desensitized or habituated to vanilla porn, which is consistent with predictions of the addiction model. Here’s what each study actually reported about the “porn addicted” subjects:
Prause et al., 2013: “Porn addicted users” reported more boredom and distraction while viewing vanilla porn.
Steele et al., 2013: Individuals with greater cue-reactivity to porn had less desire for sex with a partner, but not less desire to masturbate.
Prause et al., 2015: “Porn addicted users” had less brain activation to static images of vanilla porn. Lower EEG readings mean that the “porn addicted” subjects were paying less attention to the pictures.
A clear pattern emerges from the three studies: The “porn addicted users” were desensitized or habituated to vanilla porn, and those with greater cue-reactivity to porn preferred to masturbate to porn than have sex with a real person. Put simply they were desensitized (a common indication of addiction) and preferred artificial stimuli to a very powerful natural reward (partnered sex). There is no way to interpret these results as falsifying porn addiction.
Make no mistake, neither Steele et al., 2013 nor Prause et al., 2015 described these 55 subjects as porn addicts or compulsive porn users. The subjects only admitted to feeling “distressed” by their porn use. Confirming the mixed nature of her subjects, Prause admitted in 2013 interview that some of the 55 subjects experienced only minor problems (which means they were not porn addicts):
“This study only included people who reported problems, ranging from relatively minor to overwhelming problems, controlling their viewing of visual sexual stimuli.”
In summary, the 3 Prause Studies did not assess whether the subjects were porn addicts or not. The authors admitted that many of the subjects had little difficulty controlling use. All of the subjects would have to have been confirmed porn addicts to permit a legitimate comparison with a group of non-porn addicts.
In 2013 Prause Said That Less Brain Activation Would Indicate Habituation or Addiction
You read that correctly. Prause’s 2015 claim of “debunking porn addiction” represents a flip-flop from her 2013 study’s claim of “debunking porn addiction.”
In her 2013 EEG study and related blog post, Prause admits that reduced brain activation would indicate habituation or addiction, but claimed her subjects didn’t show reduced activation. This claim, however, was groundless as explained here. She had no control group, so she could not compare “porn addicts'” EEG readings to “non-addicts'” readings. As a result, her 2013 study told us nothing about the EEG readings for either healthy individuals or “hypersexuals.”
Finally, in 2015 she added control subjects and published a second study. Sure enough, her “porn addicted” subjects displayed reduced brain activation in comparison to controls – just as would be expected in porn users suffering from habituation or addiction. Undaunted by findings that undermined her 2013 conclusion, she boldly, and without any basis in science, claimed that her corrected findings – which were consistent with the presence of addiction – “dismantled porn addiction.” And this is the talking point these propaganda pieces latch onto, with no support other than Prause’s unfounded claims.
Let’s back up and look more closely at Prause’s views from her 2013 study (Steele et al.):
“Therefore, individuals with high sexual desire could exhibit large P300 amplitude difference between sexual stimuli and neutral stimuli due to salience and emotional content of the stimuli. Alternatively, little or no P300 amplitude difference could be measured due to habituation to VSS.“
In 2013, Prause said that porn addicts, when compared to controls, could either exhibit:
higher EEG readings due to cue-reactivity to images, or
lower EEG readings due to habituation to porn (VSS).
Five months before her 2013 EEG study was published, Prause and David Ley teamed up to write this Psychology Today blog post about her upcoming 2013 study (and its unsupported claims). In it they admit that “diminished electrical response” would indicate habituation or desensitization:
“But, when EEG’s were administered to these individuals, as they viewed erotic stimuli, results were surprising, and not at all consistent with sex addiction theory. If viewing pornography actually was habituating (or desensitizing), like drugs are, then viewing pornography would have a diminished electrical response in the brain. In fact, in these results, there was no such response. Instead, the participants’ overall demonstrated increased electrical brain responses to the erotic imagery they were shown, just like the brains of “normal people”…
So, we have 2013 Prause saying “diminished electrical response” would indicate habituation or desensitization. Later, however, in 2015, when Prause added controls for comparison and found evidence of desensitization (common in addicts), she tells us “diminished electrical response” debunks porn addiction. Huh?
In the intervening two years it took Prause to compare her same tired subject data with an actual control group, she executed a complete flip-flop. In 2015, she claimed the evidence of desensitization that she found when she added the control group isn’t evidence of addiction (which she claimed in 2013 it would have been). Instead, evidence of desensitization now (magically) “disproves addiction” (even though it aligns with addiction perfectly). This is inconsistent and unscientific, and suggests that regardless of opposing findings, she will always claim to have “disproven addiction.”
What About Brain Studies That Falsify Porn Addiction?
There are none (really). This page lists all the studies assessing the brain structure and functioning of internet porn users. To date, every study offers support for the porn addiction model (including Prause’s two studies just discussed). However, whenever an article claiming to debunk porn addiction cites a study, I expect you will find one of her two EEG studies, or an irresponsible “review” by Prause, Ley and Finn. Here they are for easy reference:
Kinsey Institute grad Nicole Prause is the lead author on studies 1 and 2, and is the second author on paper #3. We already saw above that study #2 (Prause et al., 2015) lends support to the porn addiction model. But how does Prause’s 2013 EEG study (Steele et al., 2013), touted in the media as evidence against the existence of porn addiction, actually support the porn addiction model?
This study’s only significant finding was that individuals with greater cue-reactivity to porn had less desire for sex with a partner (but not lower desire to masturbate to porn). Put another way, individuals with more brain activation and cravings for porn would rather masturbate to porn than have sex with a real person. This is typical of addicts, not healthy subjects.
Study spokesman Nicole Prause claimed that frequent porn users merely had high libido, yet the results of the study say something quite different. As Valerie Voon (and 10 other neuroscientists) explained, Prause’s 2013 findings of greater cue-reactivity to porn coupled with lower desire for sex with real partners aligned with their 2014 brain scan study on porn addicts. Put simply, the actual findings of the 2013 EEG study in no way match the unsupported “debunking” headlines. Seven peer-reviewed papers expose the truth about this earlier study by Prause’s team: 1, 2, 3,4, 5, 6,7.
As a side note, this same 2013 study reported higher EEG readings (P300) when subjects were exposed to porn photos. Studies consistently show that an elevated P300 occurs when addicts are exposed to cues (such as images) related to their addiction. This finding supports the porn addiction model, as the above peer-reviewed papers explained and psychology professor emeritus John A. Johnson pointed out in a comment under a 2013 Psychology Today Prause interview:
“My mind still boggles at the Prause claim that her subjects’ brains did not respond to sexual images like drug addicts’ brains respond to their drug, given that she reports higher P300 readings for the sexual images. Just like addicts who show P300 spikes when presented with their drug of choice. How could she draw a conclusion that is the opposite of the actual results?“
Mustanski asks, “What was the purpose of the study?” And Prause replies, “Our study tested whether people who report such problems [problems with regulating their viewing of online erotica] look like other addicts from their brain responses to sexual images.”
But the study did not compare brain recordings from persons having problems regulating their viewing of online erotica to brain recordings from drug addicts and brain recordings from a non-addict control group, which would have been the obvious way to see if brain responses from the troubled group look more like the brain responses of addicts or non-addicts…..
Aside from the many unsupported claims in the press, it’s disturbing that Prause’s 2013 EGG study passed peer-review, as it suffered from serious methodological flaws:
The third paper listed above is not a study at all. Instead, it poses as an impartial “review of the literature” on porn addiction and porn’s effects. Nothing could be farther from the truth. The lead author, David Ley, is the author of The Myth of Sex Addiction and Nicole Prause is its second author. Ley & Prause not only teamed up to write paper #3, they also teamed up to write a Psychology Today blog post about paper #1. The blog post appeared 5 months before Prause’s paper was formally published (so no one could refute it). You may have seen Ley’s blog post with the oh-so-catchy title: “Your Brain on Porn – It’s NOT Addictive”. Ley zealously denies both sex and porn addiction. He has written 20 or so blog posts attacking porn-recovery forums, and dismissing porn addiction and porn-induced ED. He is not an addiction scientist, but rather a clinical psychologist, and like Prause is not associated with any university or research institute. Read more about Ley & Prause and their collaborations here.
The following is a very long analysis of paper #3, which goes line-by-line, showing all the shenanigans Ley & Prause incorporated in their “review”: The Emperor Has No Clothes: A Fractured Fairytale Posing As A Review. It completely dismantles the so-called review, and documents dozens of misrepresentations of the research they cited. The most shocking aspect of the Ley review is that it omitted ALL the many studies that reported negative effects related to porn use or found porn addiction!
Yes, you read that right. While purporting to write an “objective” review, Ley & Prause justified omitting hundreds of studies on the grounds that these were correlational studies. Guess what? Virtually all studies on porn are correlational, even those they cited, or misused. There are, and pretty much will be, only correlational studies, because researchers have no way to prove causation by comparing users with “porn virgins” or by keeping subjects off of porn for extended periods in order compare effects. (Thousands of guys are quitting porn voluntarily on various forums, however, and their results suggest that removing internet porn is the key variable in their symptoms and recoveries.)
Inherent Bias?
It’s unprecedented for a legitimate researcher to claim that their lone anomalous study has debunked a hypothesis supported by multiple neurological studies and decades of relevant research. Moreover, what legitimate researcher would be constantly tweeting that has debunked porn addiction? What legitimate researcher would personally attack young men who run porn-recovery forums? What’s going on here? By her own admission, rejects the concept of porn addiction. For example, a quote from this recent Martin Daubney article about sex/porn addictions:
Dr Nicole Prause, principal investigator at the Sexual Psychophysiology and Affective Neuroscience (Span) Laboratory in Los Angeles, calls herself a “professional debunker” of sex addiction.
In addition, Nicole Prause’s former Twitter slogan suggests she may lack the impartiality required for scientific research:
“Studying why people choose to engage in sexual behaviors without invoking addiction nonsense”
Updates on Nicole Prause’s twitter slogan:
UCLA did not renew Prause’s contract. She hasn’t been affiliated with any university since early 2015.
While many articles continue to describe Prause as a UCLA researcher, she hasn’t been employed by any university since the beginning of 2015. Finally, it’s important to know that the enterprising Prause offered (for a fee) her “expert” testimony against sex addiction and porn addiction. It seems as though Prause is attempting to sell her services to profit from the unsupportable anti-porn addiction conclusions of her two EEG studies (1, 2), even though 9 peer-reviewed analyses say both studies support the addiction model.
Interestingly, David Ley also profits from denying sex and porn addiction. At the end of this Psychology Today blog post Ley states:
“Disclosure: David Ley has provided testimony in legal cases involving claims of sex addiction.“
Ley also makes money selling two books which deny sex and porn addiction (“The Myth of Sex Addiction“, 2012 and “Ethical Porn for Dicks“, 2016). Pornhub is one of the four Amazon.com endorsements listed for Ley’s 2016 book.
The following articles cite numerous studies, furnish illustrative examples, and elaborate logical arguments to dismantle many common anti-porn addiction propaganda talking points:
This section collects studies about which many experts have reservations – Questionable & Misleading Studies. In some, the methodology raises concerns. In others, the conclusions appear inadequately supported. In others, the title or terminology used is misleading given the actual study results. Some grossly misrepresent the actual findings.
All the Neuroscience Supports the Porn Addiction Model
Listed below are all the studies assessing the brain structure and functioning of Internet porn users (even the one claiming to have debunked porn addiction). To date every study offers support for the porn addiction model. The results of these 40 studies (and upcoming studies) are consistent with 260+ Internet addiction brain studies, many of which also include internet porn use. All support the premise that internet porn use can cause addiction-related brain changes, as do recent neuroscience-based reviews of the literature:
Neurobiology of Compulsive Sexual Behavior: Emerging Science (2016) Excerpt: “Given some similarities between CSB and drug addictions, interventions effective for addictions may hold promise for CSB, thus providing insight into future research directions to investigate this possibility directly.”
Should Compulsive Sexual Behavior be Considered an Addiction? (2016) Excerpt: “Overlapping features exist between CSB and substance use disorders. Common neurotransmitter systems may contribute to CSB and substance use disorders, and recent neuroimaging studies highlight similarities relating to craving and attentional biases. Similar pharmacological and psychotherapeutic treatments may be applicable to CSB and substance addictions”
Neurobiological Basis of Hypersexuality (2016). Excerpt: “Taken together, the evidence seems to imply that alterations in the frontal lobe, amygdala, hippocampus, hypothalamus, septum, and brain regions that process reward play a prominent role in the emergence of hypersexuality. Genetic studies and neuropharmacological treatment approaches point at an involvement of the dopaminergic system.“
Cybersex Addiction (2015) Excerpts: In recent articles, cybersex addiction is considered a specific type of Internet addiction. Some current studies investigated parallels between cybersex addiction and other behavioral addictions, such as Internet Gaming Disorder. Cue-reactivity and craving are considered to play a major role in cybersex addiction. Neuroimaging studies support the assumption of meaningful commonalities between cybersex addiction and other behavioral addictions as well as substance dependency.
Searching for clarity in muddy water: future considerations for classifying compulsive sexual behavior as an addiction (2016) – Excerpts: We recently considered evidence for classifying compulsive sexual behavior (CSB) as a non-substance (behavioral) addiction. Our review found that CSB shared clinical, neurobiological and phenomenological parallels with substance-use disorders. Although the American Psychiatric Association rejected hypersexual disorder from DSM-5, a diagnosis of CSB (excessive sex drive) can be made using ICD-10. CSB is also being considered by ICD-11.
Is Internet Pornography Causing Sexual Dysfunctions? A Review with Clinical Reports (2016) – An extensive review of the literature related to porn-induced sexual problems. Involving US Navy doctors, the review provides the latest data revealing a tremendous rise in youthful sexual problems. It also reviews the neurological studies related to porn addiction and sexual conditioning via Internet porn. The doctors provide 3 clinical reports of men who developed porn-induced sexual dysfunctions.
Sexual Addiction chapter from Neurobiology of Addictions, Oxford Press (2016) – Excerpt: We review the neurobiological basis for addiction, including natural or process addiction, and then discuss how this relates to our current understanding of sexuality as a natural reward that can become functionally “unmanageable” in an individual’s life.
Neuroscientific Approaches to Online Pornography Addiction (2017) – Excerpt: In the last two decades, several studies with neuroscientific approaches, especially functional magnetic resonance imaging (fMRI), were conducted to explore the neural correlates of watching pornography under experimental conditions and the neural correlates of excessive pornography use. Given previous results, excessive pornography consumption can be connected to already known neurobiological mechanisms underlying the development of substance-related addictions.
Is excessive sexual behaviour an addictive disorder? (Potenza et al., 2017) – Excerpts: Compulsive sexual behaviour disorder seems to fit well with non-substance addictive disorders proposed for ICD-11, consistent with the narrower term of sex addiction currently proposed for compulsive sexual behaviour disorder on the ICD-11 draft website. We believe that classification of compulsive sexual behaviour disorder as an addictive disorder is consistent with recent data and might benefit clinicians, researchers, and individuals suffering from and personally affected by this disorder.
Compulsive Sexual Behavior in Humans and Preclinical Models (2018) – Excerpts: Compulsive sexual behavior (CSB) is widely regarded as a “behavioral addiction,” and is a major threat to quality of life and both physical and mental health. In conclusion, this review summarized the behavioral and neuroimaging studies on human CSB and comorbidity with other disorders, including substance abuse. Together, these studies indicate that CSB is associated with functional alterations in dorsal anterior cingulate and prefrontal cortex, amygdala, striatum, and thalamus, in addition to decreased connectivity between amygdala and prefrontal cortex.
Sexual Dysfunctions in the Internet Era (2018) – Excerpt: Among behavioral addictions, problematic Internet use and online pornography consumption are often cited as possible risk factors for sexual dysfunction, often with no definite boundary between the two phenomena. Online users are attracted to Internet pornography because of its anonymity, affordability, and accessibility, and in many cases its usage could lead users through a cybersex addiction: in these cases, users are more likely to forget the “evolutionary” role of sex, finding more excitement in self-selected sexually explicit material than in intercourse.
Neurocognitive mechanisms in compulsive sexual behavior disorder (2018) – Excerpt: To date, most neuroimaging research on compulsive sexual behavior has provided evidence of overlapping mechanisms underlying compulsive sexual behavior and non-sexual addictions. Compulsive sexual behavior is associated with altered functioning in brain regions and networks implicated in sensitization, habituation, impulse dyscontrol, and reward processing in patterns like substance, gambling, and gaming addictions. Key brain regions linked to CSB features include the frontal and temporal cortices, amygdala, and striatum, including the nucleus accumbens.
A Current Understanding of the Behavioral Neuroscience of Compulsive Sexual Behavior Disorder and Problematic Pornography Use – Excerpt: Recent neurobiological studies have revealed that compulsive sexual behaviors are associated with altered processing of sexual material and differences in brain structure and function. Although few neurobiological studies of CSBD have been conducted to date, existing data suggest neurobiological abnormalities share communalities with other additions such as substance use and gambling disorders. Thus, existing data suggest that its classification may be better suited as a behavioral addiction rather than an impulse-control disorder.
Ventral Striatal Reactivity in Compulsive Sexual Behaviors (2018) – Excerpt: Among currently available studies, we were able to find nine publications (Table 1) which utilized functional magnetic resonance imaging. Only four of these (36–39) directly investigated processing of erotic cues and/or rewards and reported findings related to ventral striatum activations. Three studies indicate increased ventral striatal reactivity for erotic stimuli (36–39) or cues predicting such stimuli (36–39). These findings are consistent with Incentive Salience Theory (IST) (28), one of the most prominent frameworks describing brain functioning in addiction.
Online Porn Addiction: What We Know and What We Don’t—A Systematic Review (2019) – Excerpt: As far as we know, a number of recent studies support this entity as an addiction with important clinical manifestations such as sexual dysfunction and psychosexual dissatisfaction. Most of the existing work is based off on similar research done on substance addicts, based on the hypothesis of online pornography as a ‘supranormal stimulus’ akin to an actual substance that, through continued consumption, can spark an addictive disorder.
Brain Structure and Functional Connectivity Associated With Pornography Consumption: The Brain on Porn (2014) – This Max Planck Institute fMRI study found less gray matter in the reward system (dorsal striatum) correlating with the amount of porn consumed. It also found that more porn use correlated with less reward circuit activation while briefly viewing sexual photos. Researchers believed their findings indicated desensitization, and possibly tolerance, which is the need for greater stimulation to achieve the same high. The study also reported that more porn viewing was linked to poorer connections between the reward circuit and prefrontal cortex – a common addiction-related brain change.
Enhanced Attentional Bias towards Sexually Explicit Cues in Individuals with and without Compulsive Sexual Behaviours (2014) – The second Cambridge University study. An excerpt: “Our findings of enhanced attentional bias… suggest possible overlaps with enhanced attentional bias observed in studies of drug cues in disorders of addictions. These findings converge with recent findings of neural reactivity to sexually explicit cues in [porn addicts] in a network similar to that implicated in drug-cue-reactivity studies and provide support for incentive motivation theories of addiction underlying the aberrant response to sexual cues in [porn addicts].“
Novelty, Conditioning and Attentional Bias to Sexual Rewards (2015) – Compared to controls porn addicts preferred sexual novelty and conditioned cues associated porn. However, the brains of porn addicts habituated faster to sexual images. Since novelty preference wasn’t pre-existing, porn addiction drives novelty-seeking in an attempt to overcome habituation and desensitization.
Neural Substrates of Sexual Desire in Individuals with Problematic Hypersexual Behavior (2015) – This Korean fMRI study replicates other brain studies on porn users. Like the Cambridge University studies it found cue-induced brain activation patterns in sex addicts which mirrored the patterns of drug addicts. In line with several German studies it found alterations in the prefrontal cortex which match the changes observed in drug addicts.
Sexual Desire, not Hypersexuality, is Related to Neurophysiological Responses Elicited by Sexual Images (2013)– This EEG study was touted in the media as evidence against the existence of porn/sex addiction. Not so. This SPAN Lab study, like #7 below, actually lends support to the existence of both porn addiction and porn use downregulating sexual desire. How so? The study reported higher EEG readings (P300) when subjects were briefly exposed to pornographic photos. Studies consistently show that an elevated P300 occurs when addicts are exposed to cues (such as images) related to their addiction. However, due to methodological flaws the findings are uninterpretable: 1) subjects were heterogeneous (males, females, non-heterosexuals); 2) subjects were not screened for mental disorders or addictions; 3) the study had no control group for comparison; 4) the questionnaires were not validated for porn addiction. In line with the Cambridge University brain scan studies, this EEG study also reported greater cue-reactivity to porn correlating with less desire for partnered sex. To put another way – individuals with greater brain activation to porn would rather masturbate to porn than have sex with a real person. Shockingly, study spokesman Nicole Prause claimed that porn users merely had “high libido”, yet the results of the study say something quite different. Four peer-reviewed papers expose the truth: 1, 2, 3,4, 5.Read an extensive critique here.
Modulation of Late Positive Potentials by Sexual Images in Problem Users and Controls Inconsistent with “Porn Addiction” (2015) – Another SPAN Lab EEG study comparing the 2013 subjects from the above study to an actual control group. The results: compared to controls porn addicts had less response to photos of vanilla porn. Ignoring all the other studies on this page, lead author Nicole Prause, boldly claims that her results “debunked porn addiction”. What legitimate scientist would claim that their lone anomalous study has debunked an entire field of study? In reality, the findings of Prause et al. 2015 align perfectly with Kühn & Gallinat (2014), which found that more porn use correlated with less brain activation in response to pictures of vanilla porn. Prause’s findings also align with Banca et al. 2015 which is #4 in this list. Moreover, another EEG study found that greater porn use in women correlated with less brain activation to porn. Lower EEG readings mean that subjects are paying less attention to the pictures. Put simply, frequent porn users were desensitized to static images of vanilla porn. They were bored. Read an extensive critique here. Six peer-reviewed papers agree with this critique of the study – 1, 2, 3,4,5, 6.
HPA axis dysregulation in men with hypersexual disorder (2015) – A study with 67 male sex addicts and 39 age-matched controls. The Hypothalamus-Pituitary-Adrenal (HPA) axis is the central player in our stress response. Addictions alter the brain’s stress circuits leading to a dysfunctional HPAaxis. This study on sex addicts (hypersexuals) found altered stress responses that mirror drug addiction.
The Role of Neuroinflammation in the Pathophysiology of Hypersexual Disorder (2016) – This study reported higher levels of circulating Tumor Necrosis Factor (TNF) in sex addicts when compared to healthy controls. Elevated levels of TNF (a marker of inflammation) have also been found in substance abusers and drug addicted animals (alcohol, heroin, meth). There were strong correlations between TNF levels and rating scales measuring hypersexuality.
Compulsive sexual behavior: Prefrontal and limbic volume and interactions (2016) – Compared to healthy controls CSB subjects (porn addicts) had increased left amygdala volume and reduced functional connectivity between the amygdala and dorsolateral prefrontal cortex DLPFC. Reduced functional connectivity between the amygdala and the prefrontal cortex aligns with substance addictions. It is thought that poorer connectivity diminishes the prefrontal cortex’s control over a user’s impulse to engage in the addictive behavior. This study suggests that drug toxicity may lead to less gray matter and thus reduced amygdala volume in drug addicts. The amygdala is consistently active during porn viewing, especially during initial exposure to a sexual cue. Perhaps the constant sexual novelty and searching and seeking leads to a unique effect on the amygdala in compulsive porn users. Alternatively, years of porn addiction and severe negative consequences is very stressful – and chronic social stress is related to increased amygdala volume. Study #8 above found that “sex addicts” have a overactive stress system. Could the chronic stress related to porn/sex addiction, along with factors that make sex unique, lead to greater amygdala volume?
Altered Appetitive Conditioning and Neural Connectivity in Subjects With Compulsive Sexual Behavior (2016)– A German fMRI study replicating two major findings from Voon et al., 2014 and Kuhn & Gallinat 2014. Compared to controls compulsive porn users had 1) greater conditioned cue-induced activity in the amygdala, while having 2) decreased coupling between the ventral striatum and the prefrontal cortex. Number 1 indicates sensitization, while number 2 indicates hypofronatlity. In addition, 3 of the 20 compulsive porn users suffered from “orgasmic-erection disorder”.
Compulsivity across the pathological misuse of drug and non-drug rewards (2016)– A Cambridge University study comparing aspects of compulsivity in alcoholics, binge-eaters, video game addicts and porn addicts (CSB). Excerpts: CSB subjects were faster to learning from rewards in the acquisition phase compared to healthy volunteers and were more likely to perseverate or stay after either a loss or a win in the Reward condition. These findings converge with our previous findings of enhanced preference for stimuli conditioned to either sexual or monetary outcomes, overall suggesting enhanced sensitivity to rewards (Banca et al., 2016).
Can pornography be addictive? An fMRI study of men seeking treatment for problematic pornography use (2017)– Excerpts: Men with and without problematic porn sue (PPU) differed in brain reactions to cues predicting erotic pictures, but not in reactions to erotic pictures themselves, consistent with the incentive salience theory of addictions. This brain activation was accompanied by increased behavioral motivation to view erotic images (higher ‘wanting’). Ventral striatal reactivity for cues predicting erotic pictures was significantly related to the severity of PPU, amount of pornography use per week and number of weekly masturbations. Our findings suggest that like in substance-use and gambling disorders the neural and behavioral mechanisms linked to anticipatory processing of cues relate importantly to clinically relevant features of PPU. These findings suggest that PPU may represent a behavioral addiction and that interventions helpful in targeting behavioral and substance addictions warrant consideration for adaptation and use in helping men with PPU.
Conscious and Non-Conscious Measures of Emotion: Do They Vary with Frequency of Pornography Use? (2017)– Study assessed porn user’s responses (EEG readings & Startle Response) to various emotion-inducing images – including erotica. The study found several neurological differences between low frequency porn users and high frequency porn users. An excerpt: Findings suggest that increased pornography use appears to have an influence on the brain’s non-conscious responses to emotion-inducing stimuli which was not shown by explicit self-report.
Pornography Addiction Detection based on Neurophysiological Computational Approach (2018) – Excerpt: In this paper, a method of using brain signal from frontal area captured using EEG is proposed to detect whether the participant may have porn addiction or otherwise. Experimental results show that the addicted participants had low alpha waves activity in the frontal brain region compared to non-addicted participants. The theta band also show there is disparity between addicted and non-addicted. However, the distinction is not as obvious as alpha band.
The above studies are all the “brain studies” published (or in the press) on internet porn users.
Together these brain studies found:
The 3 major addiction-related brain changes: sensitization, desensitization, and hypofrontality.
More porn use correlated with less grey matter in the reward circuit (dorsal striatum).
More porn use correlated with less reward circuit activation when viewing sexual images.
More porn use correlated with disrupted neural connections between the reward circuit and prefrontal cortex.
Addicts had greater prefrontal activity to sexual cues, but less brain activity to normal stimuli (matches drug addiction).
Porn addicts have greater preference for sexual novelty yet their brains habituated faster to sexual images. Not pre-existing.
60% of compulsive porn addicted subjects in one study experienced ED or low libido with partners, but not with porn: all stated that internet porn use caused their ED/low libido.
Greater wanting & craving for porn, but not greater liking. This aligns with the accepted model of addiction – incentive sensitization.
The younger the porn users the greater the cue-induced reactivity in the reward center.
Higher EEG (P300) readings when porn users were exposed to porn cues (which occurs in other addictions).
Less desire for sex with a person correlating with greater cue-reactivity to porn images.
More porn use related with lower LPP amplitude when viewing sexual photos: indicates habituation or desensitization.
Dysfunctional HPA axis which reflects altered brain stress circuits (and greater amygdala volume, which is associated with chronic social stress).
Epigenetic changes on genes central to the human stress response and closely associated with addiction.
Higher levels of Tumor Necrosis Factor (TNF) – which also occurs in drug abuse and addiction.
A deficit in temporal cortex gray matter; poorer connectivity between temporal corporate and several other regions
Neuro-Psychological Studies on Porn Users (with excerpts):
Self-reported differences on measures of executive function and hypersexual behavior in a patient and community sample of men (2010)– Patients seeking help for hypersexual behavior often exhibit features of impulsivity, cognitive rigidity, poor judgment, deficits in emotion regulation, and excessive preoccupation with sex. Some of these characteristics are also common among patients presenting with neurological pathology associated with executive dysfunction. These observations led to the current investigation of differences between a group of hypersexual patients (n = 87) and a non-hypersexual community sample (n = 92) of men using the Behavior Rating Inventory of Executive Function-Adult Version Hypersexual behavior was positively correlated with global indices of executive dysfunction and several subscales of the BRIEF-A. These findings provide preliminary evidence supporting the hypothesis that executive dysfunction may be implicated in hypersexual behavior.
Watching Pornographic Pictures on the Internet: Role of Sexual Arousal Ratings and Psychological-Psychiatric Symptoms for Using Internet Sex Sites Excessively (2011)– Results indicate that self-reported problems in daily life linked to online sexual activities were predicted by subjective sexual arousal ratings of the pornographic material, global severity of psychological symptoms, and the number of sex applications used when being on Internet sex sites in daily life, while the time spent on Internet sex sites (minutes per day) did not significantly contribute to explanation of variance in IATsex score. We see some parallels between cognitive and brain mechanisms potentially contributing to the maintenance of excessive cybersex and those described for individuals with substance dependence
Pornographic picture processing interferes with working memory performance (2013) – Some individuals report problems during and after Internet sex engagement, such as missing sleep and forgetting appointments, which are associated with negative life consequences. One mechanism potentially leading to these kinds of problems is that sexual arousal during Internet sex might interfere with working memory (WM) capacity, resulting in a neglect of relevant environmental information and therefore disadvantageous decision making. Results revealed worse WM performance in the pornographic picture condition of the 4-back task compared with the three remaining picture conditions. Findings are discussed with respect to Internet addiction because WM interference by addiction-related cues is well known from substance dependencies.
Sexual Picture Processing Interferes with Decision-Making Under Ambiguity (2013) – Decision-making performance was worse when sexual pictures were associated with disadvantageous card decks compared to performance when the sexual pictures were linked to the advantageous decks. Subjective sexual arousal moderated the relationship between task condition and decision-making performance. This study emphasized that sexual arousal interfered with decision-making, which may explain why some individuals experience negative consequences in the context of cybersex use.
Cybersex addiction: Experienced sexual arousal when watching pornography and not real-life sexual contacts makes the difference (2013) – The results show that indicators of sexual arousal and craving to Internet pornographic cues predicted tendencies towards cybersex addiction in the first study. Moreover, it was shown that problematic cybersex users report greater sexual arousal and craving reactions resulting from pornographic cue presentation. In both studies, the number and the quality with real-life sexual contacts were not associated to cybersex addiction. The results support the gratification hypothesis, which assumes reinforcement, learning mechanisms, and craving to be relevant processes in the development and maintenance of cybersex addiction. Poor or unsatisfying sexual real life contacts cannot sufficiently explain cybersex addiction.
Cybersex addiction in heterosexual female users of internet pornography can be explained by gratification hypothesis (2014)– Results indicated that Internet porn users rated pornographic pictures as more arousing and reported greater craving due to pornographic picture presentation compared with non-users. Moreover, craving, sexual arousal rating of pictures, sensitivity to sexual excitation, problematic sexual behavior, and severity of psychological symptoms predicted tendencies toward cybersex addiction in porn users. Being in a relationship, number of sexual contacts, satisfaction with sexual contacts, and use of interactive cybersex were not associated with cybersex addiction.
Prefrontal control and internet addiction: a theoretical model and review of neuropsychological and neuroimaging findings (2015) – Consistent with this, results from functional neuroimaging and other neuropsychological studies demonstrate that cue-reactivity, craving, and decision making are important concepts for understanding Internet addiction. The findings on reductions in executive control are consistent with other behavioral addictions, such as pathological gambling. They also emphasize the classification of the phenomenon as an addiction, because there are also several similarities with findings in substance dependency. Moreover, the results of the current study are comparable to findings from substance dependency research and emphasize analogies between cybersex addiction and substance dependencies or other behavioral addictions.
Implicit associations in cybersex addiction: Adaption of an Implicit Association Test with pornographic pictures. (2015)– Recent studies show similarities between cybersex addiction and substance dependencies and argue to classify cybersex addiction as a behavioral addiction. In substance dependency, implicit associations are known to play a crucial role. Results show positive relationships between implicit associations of pornographic pictures with positive emotions and tendencies towards cybersex addiction, problematic sexual behavior, sensitivity towards sexual excitation as well as subjective craving.
Symptoms of cybersex addiction can be linked to both approaching and avoiding pornographic stimuli: results from an analog sample of regular cybersex users (2015)– Results showed that individuals with tendencies toward cybersex addiction tended to either approach or avoid pornographic stimuli. Additionally, moderated regression analyses revealed that individuals with high sexual excitation and problematic sexual behavior who showed high approach/avoidance tendencies, reported higher symptoms of cybersex addiction. Analogous to substance dependencies, results suggest that both approach and avoidance tendencies might play a role in cybersex addiction.
Getting stuck with pornography? Overuse or neglect of cybersex cues in a multitasking situation is related to symptoms of cybersex addiction (2015) – Individuals with tendencies towards cybersex addiction seem to have either an inclination to avoid or to approach the pornographic material, as discussed in motivational models of addiction. The results of the current study point towards a role of executive control functions, i.e. functions mediated by the prefrontal cortex, for the development and maintenance of problematic cybersex use (as suggested by Brand et al., 2014). Particularly a reduced ability to monitor consumption and to switch between pornographic material and other contents in a goal adequate manner may be one mechanism in the development and maintenance of cybersex addiction.
Trading Later Rewards for Current Pleasure: Pornography Consumption and Delay Discounting (2015) –Study 1: Participants completed a pornography use questionnaire and a delay discounting task at Time 1 and then again four weeks later. Participants reporting higher initial pornography use demonstrated a higher delay discounting rate at Time 2, controlling for initial delay discounting. Study 2: Participants who abstained from pornography use demonstrated lower delay discounting than participants who abstained from their favorite food. The finding suggests that Internet pornography is a sexual reward that contributes to delay discounting differently than other natural rewards. It is therefore important to treat pornography as a unique stimulus in reward, impulsivity, and addiction studies and to apply this accordingly in individual as well as relational treatment.
Sexual Excitability and Dysfunctional Coping Determine Cybersex Addiction in Homosexual Males (2015) – Recent findings have demonstrated an association between CyberSex Addiction (CA) severity and indicators of sexual excitability, and that coping by sexual behaviors mediated the relationship between sexual excitability and CA symptoms. The aim of this study was to test this mediation in a sample of homosexual males. Questionnaires assessed symptoms of CA, sensitivity to sexual excitation, pornography use motivation, problematic sexual behavior, psychological symptoms, and sexual behaviors in real life and online. Moreover, participants viewed pornographic videos and indicated their sexual arousal before and after the video presentation. Results showed strong correlations between CA symptoms and indicators of sexual arousal and sexual excitability, coping by sexual behaviors, and psychological symptoms. CA was not associated with offline sexual behaviors and weekly cybersex use time. Coping by sexual behaviors partially mediated the relationship between sexual excitability and CA. The results are comparable with those reported for heterosexual males and females in previous studies and are discussed against the background of theoretical assumptions of CA, which highlight the role of positive and negative reinforcement due to cybersex use.
Subjective Craving for Pornography and Associative Learning Predict Tendencies Towards Cybersex Addiction in a Sample of Regular Cybersex Users (2016) – There is no consensus regarding the diagnostic criteria of cybersex addiction. Some approaches postulate similarities to substance dependencies, for which associative learning is a crucial mechanism. In this study, 86 heterosexual males completed a Standard Pavlovian to Instrumental Transfer Task modified with pornographic pictures to investigate associative learning in cybersex addiction. Additionally, subjective craving due to watching pornographic pictures and tendencies towards cybersex addiction were assessed. Results showed an effect of subjective craving on tendencies towards cybersex addiction, moderated by associative learning. Overall, these findings point towards a crucial role of associative learning for the development of cybersex addiction, while providing further empirical evidence for similarities between substance dependencies and cybersex addiction
Exploring the Relationship between Sexual Compulsivity and Attentional Bias to Sex-Related Words in a Cohort of Sexually Active Individuals (2016)– This study replicates the findings of this 2014 Cambridge University study that compared the attentional bias of porn addicts to healthy controls. The new study differs: rather than comparing porn addicts to controls, the new study correlated scores on a sex addiction questionnaire to the results of a task assessing attentional bias (explanation of attentional bias). The study described two key results: 1) Higher sexual compulsivity scores correlated with greater interference (increased distraction) during the attentional bias task. This aligns with substance abuse studies. 2) Among those scoring high on sexual addiction, fewer years of sexual experience were related to greater attentional bias. The authors concluded that this result could indicate that more years of “compulsive sexual activity” lead to greater habituation or a general numbing of the pleasure response (desensitization). An excerpt from the conclusion section: “One possible explanation for these results is that as a sexually compulsive individual engages in more compulsive behaviour, an associated arousal template develops and that over time, more extreme behaviour is required for the same level of arousal to be realised. It is further argued that as an individual engages in more compulsive behaviour, neuropathways become desensitized to more ‘normalised’ sexual stimuli or images and individuals turn to more ‘extreme’ stimuli to realise the arousal desired.”
Mood changes after watching pornography on the Internet are linked to symptoms of Internet-pornography-viewing disorder (2016) – Excerpts: The main results of the study are that tendencies towards Internet Pornography Disorder (IPD) were associated negatively with feeling generally good, awake, and calm as well as positively with perceived stress in daily life and the motivation to use Internet pornography in terms of excitation seeking and emotional avoidance. Furthermore, tendencies towards IPD were negatively related to mood before and after watching Internet pornography as well as an actual increase of good and calm mood. The relationship between tendencies towards IPD and excitement seeking due to Internet-pornography use was moderated by the evaluation of the experienced orgasm’s satisfaction. Generally, the results of the study are in line with the hypothesis that IPD is linked to the motivation to find sexual gratification and to avoid or to cope with aversive emotions as well as with the assumption that mood changes following pornography consumption are linked to IPD (Cooper et al., 1999 and Laier and Brand, 2014).
Executive Functioning of Sexually Compulsive and Non-Sexually Compulsive Men Before and After Watching an Erotic Video (2017) – Exposure to porn affected executive functioning in men with “compulsive sexual behaviors”, but not healthy controls. Poorer executive functioning when exposed to addiction-related cues is a hallmark of substance disorders (indicating both altered prefrontal circuits and sensitization). Excerpts: This finding indicates better cognitive flexibility after sexual stimulation by controls compared with sexually compulsive participants. These data support the idea that sexually compulsive men do not to take advantage of the possible learning effect from experience, which could result in better behavior modification. This also could be understood as a lack of a learning effect by the sexually compulsive group when they were sexually stimulated, similar to what happens in the cycle of sexual addiction, which starts with an increasing amount of sexual cognition, followed by the activation of sexual scripts and then orgasm, very often involving exposure to risky situations.
Exposure to Sexual Stimuli Induces Greater Discounting Leading to Increased Involvement in Cyber Delinquency Among Men (2017) – In two studies exposure to visual sexual stimuli resulted in: 1) greater delayed discounting (inability to delay gratification), 2) greater inclination to engage in cyber-deliquency, 3) greater inclination to purchase counterfeit goods & hack someone’s Facebook account. Taken together this indicates that porn use increases impulsivity and may reduce certain executive functions (self-control, judgment, foreseeing consequences, impulse control). Excerpt: These findings provide insight into a strategy for reducing men’s involvement in cyber delinquency; that is, through less exposure to sexual stimuli and promotion of delayed gratification. The current results suggest that the high availability of sexual stimuli in cyberspace may be more closely associated with men’s cyber-delinquent behavior than previously thought.
Predictors for (Problematic) Use of Internet Sexually Explicit Material: Role of Trait Sexual Motivation and Implicit Approach Tendencies Towards Sexually Explicit Material (2017)– Excerpts: The present study investigated whether trait sexual motivation and implicit approach tendencies towards sexual material are predictors of problematic SEM use and of the daily time spent watching SEM. In a behavioral experiment, we used the Approach-Avoidance Task (AAT) for measuring implicit approach tendencies towards sexual material. A positive correlation between implicit approach tendency towards SEM and the daily time spent on watching SEM might be explained by attentional effects: A high implicit approach tendency can be interpreted as an attentional bias towards SEM. A subject with this attentional bias might be more attracted to sexual cues on the Internet resulting in higher amounts of time spent on SEM sites.
Tendencies toward Internet-pornography-use disorder: Differences in men and women regarding attentional biases to pornographic stimuli (2018) – [greater cue reactivity/sensitization, enhanced cravings]. Excerpts Several authors consider Internet-pornography-use disorder (IPD) as addictive disorder. One of the mechanisms that has been intensively studied in substance- and non-substance-use disorders is an enhanced attentional bias toward addiction-related cues. Attentional biases are described as cognitive processes of individual’s perception affected by the addiction-related cues caused by the conditioned incentive salience of the cue itself. It is assumed in the I-PACE model that in individuals prone to develop IPD symptoms implicit cognitions as well as cue-reactivity and craving arise and increase within the addiction process. To investigate the role of attentional biases in the development of IPD, we investigated a sample of 174 male and female participants. Attentional bias was measured with the Visual Probe Task, in which participants had to react on arrows appearing after pornographic or neutral pictures. In addition, participants had to indicate their sexual arousal induced by pornographic pictures. Furthermore, tendencies toward IPD were measured using the short-Internetsex Addiction Test. The results of this study showed a relationship between attentional bias and symptom severity of IPD partially mediated by indicators for cue-reactivity and craving. While men and women generally differ in reaction times due to pornographic pictures, a moderated regression analysis revealed that attentional biases occur independently of sex in the context of IPD symptoms. The results support theoretical assumptions of the I-PACE model regarding the incentive salience of addiction-related cues and are consistent with studies addressing cue-reactivity and craving in substance-use disorders.
Introduction: In various comments, articles and tweets, Nicole Prause has claimed that not only did Prause et al., 2015 falsify “a core tenet of the addiction model, the cue reactivity biomarker,” but that “a series of behavioral studies replicated by independent laboratories [falsify] other predictions of the addiction model.” Prause cites the Letter to the Editor (critiqued here) as her supporting evidence. Put simply, Prause has gathered all her debunking eggs into one basket – the single paragraph excerpted below. This response serves as a debunking of the debunker (Nicole Prause) and all her favorite “eggs.”
In response to neuroscientist Matuesz Gola’s critical analysis of their 2015 EEG study (Prause et al., 2015), Prause et al. wrote their own letter to the editor, entitled, “Prause et al. (2015) the latest falsification of addiction predictions,” which we will refer to as the “Reply to Gola.” (Interestingly, the editor’s original “accepted manuscript” of the Reply to Gola listed only Nicole Prause as the author, so it’s unclear if her co-authors participated in crafting the Reply to Gola, or whether it was a solo effort by Prause.)
Certainly, most of the Reply to Gola is devoted to defending Prause’s interpretations. Back in 2015 Prause made over-the-top claims that her team’s anomalous study had singlehandedly “debunked porn addiction.” What legitimate researcher would ever claim to have “debunked” an entire field of research and to have “falsified” all previous studies with a single EEG study?
Now, in 2016, the Reply to Gola’s closing paragraph puts forward an equally unwarranted assertion that a handful of papers, spearheaded by Prause’s single EEG study, falsify “multiple predictions of the addiction model.”
In Section #1 below we debunk the falsification claim by revealing what the papers cited in the Reply to Gola actually found (and did not find), as well as bringing to light the many relevant studies omitted. In Section #2 below, we examine other unsupported claims and inaccuracies in the Reply to Gola. Before we begin, here are links to the pertinent items:
SECTION ONE: Debunking the Prause et al. Claimed Falsification of The Addiction Model
This is the closing paragraph where Prause et al. summarizes the evidence purporting to falsify the porn addiction model:
“In closing, we highlight the Popperian falsification of multiple predictions of the addiction model using multiple methods. Most addiction models require that addicted individuals exhibit less control over their urge to use (or engage in the behavior); those reporting more problems with viewing sexual images actually have better control over their sexual response (replicated by Moholy, Prause, Proudfit, Rahman, & Fong, 2015; first study by Winters, Christoff, & Gorzalka, 2009). Addiction models typically predict negative consequences. Although erectile dysfunction is the most commonly suggested negative consequence of porn use, erectile problems actually are not elevated by viewing more sex films (Landripet & Štulhofer, 2015; Prause & Pfaus, 2015; Sutton, Stratton, Pytyck, Kolla, & Cantor, 2015). Addiction models often propose that the substance use or behavior is used to ameliorate or escape negative affect. Those reporting problems with sex films actually reported less negative affect at baseline/pre-viewing than controls (Prause, Staley, & Fong, 2013). Meanwhile, two more compelling models have received more support since the publication of Prause et al. (2015). These include a high sex drive model (Walton, Lykins, & Bhullar, 2016) supporting the original high-drive hypothesis (Steele, Prause, Staley, & Fong, 2013). Parsons et al. (2015) have suggested that high sex drive may represent a subset of those reporting problems. Also, distress related to viewing sex films has been shown to be most strongly related to conservative values and religious history (Grubbs et al., 2014). This supports a social shame model of problem sex film viewing behaviors. The discussion should move from testing the addiction model of sex film viewing, which has had multiple predictions falsified by independent laboratory replications, to identifying a better fitting model of those behaviors.”
Before we address each of the above assertions, it’s important to reveal what Prause et al. chose to omit from the so-called “falsification”:
Studies on actual porn addicts. You read that right. Of all the studies cited, only one contained a group of porn addicts, and 71% of those subjects reported severe negative effects. Bottom line: You cannot falsify “porn addiction” if the studies you cite don’t investigate porn addicts.
All the neurological studies published on porn users and sex addicts – because all support the addiction model. This page lists 41 neuroscience-based studies (MRI, fMRI, EEG, Neurospych, Hormonal) providing strong support for the addiction model.
All the peer-reviewed reviews of the literature – because all support the porn addiction model. Here are 20 literature reviews & commentaries by some of the top neuroscientists in the world, supporting the porn addiction model.
Over 30 studies reporting findings consistent with escalation of porn use (tolerance), habituation to porn, and even withdrawal symptoms.
All the many studies on adolescents, which report porn use is related to poorer academics, more sexist attitudes, more aggression, poorer health, poorer relationships, lower life satisfaction, viewing people as objects, increased sexual risk taking, less condom use, greater sexual violence, greater sexual coercion, less sexual satisfaction, lower libido, greater permissive attitudes, and a whole lot more. (In short, ED is not the “most commonly suggested negative consequence of porn use” as claimed in the Reply to Gola below.)
In the Reply to Gola, Prause et al. attempt to falsify each of the following Claims (“predictions”) relating to the addiction model. The relevant excerpts and supporting studies from the Reply to Gola are given in full, followed by comments.
Update 2: In this 2018 presentation Gary Wilson exposes the truth behind 5 questionable and misleading studies, including this study (Steele et al., 2013): Porn Research: Fact or Fiction?
Claim 1: The inability to control use despite negative consequences.
PRAUSE: “Most addiction models require that addicted individuals exhibit less control over their urge to use (or engage in the behavior); those reporting more problems with viewing sexual images actually have better control over their sexual response (replicated by Moholy, Prause, Proudfit, Rahman, & Fong, 2015; first study by Winters, Christoff, & Gorzalka, 2009)”
The 2 studies cited falsified nothing as they did not assess if subjects had trouble controlling their porn use. Most importantly, neither study started by assessing who was or wasn’t a “porn addict.” How can you debunk the porn addiction model if you don’t begin by assessing subjects with clear evidence of (what addiction experts define as) addiction? Let’s briefly examine what the 2 studies actually assessed and reported, and why they falsify nothing:
The purpose of this study was to see if men could dampen their self-reported sexual arousal while watching sex films. The important findings: the men best at suppressing sexual arousal were also best at making themselves laugh. The men least successful at suppressing sexual arousal were generally hornier than the rest. These findings have nothing to do with actual porn addicts’ “inability to control use despite severe negative consequences.”
This online anonymous survey did not assess who was and who wasn’t a “porn addict,” because the assessment tool was the “Sexual Compulsivity Scale” (SCS). The SCS isn’t a valid assessment test for Internet-porn addiction or for women, so the study’s findings do not apply to internet porn addicts. The SCS was created in 1995 and designed with uncontrolled sexual relations in mind (in connection with investigating the AIDS epidemic). The SCS says:
“The scale has been shown to predict rates of sexual behaviors, numbers of sexual partners, practice of a variety of sexual behaviors, and histories of sexually transmitted diseases.”
This study, like the above study, did not assess which participants were or were not “porn addicts.” This study relied upon the CBSOB, which has zero questions about Internet porn use. It only asks about “sexual activities,” or if subjects are worried about their activities (e.g., “I am worried I am pregnant,” “I gave someone HIV,” “I experienced financial problems”). Thus any correlations between scores on the CBSOB and ability to regulate arousal are not relevant to many internet porn addicts, who do not engage in partnered sex.
Like the Winters study above, this study reported that hornier participants had a harder time down-regulating their sexual arousal while watching porn. Prause et al. are right: this study replicated Winters, et al., 2009: hornier people have higher sexual desire. (Duh)
This study has the same fatal flaw seen in other Prause-team studies: The researchers chose vastly different subjects (women, men, heterosexuals, non-heterosexuals), but showed them all standard, possibly uninteresting, male+female porn. Put simply, the results of this study were dependent on the premise that males, females, and non-heterosexuals do not differ in their response to a set of sexual images. This is clearly not the case.
Even though neither study identified which participants were porn addicts, the Reply to Gola seems to claim that actual “porn addicts” should be the least able to control their sexual arousal while viewing porn. Yet why would the Reply to Gola’s authors think porn addicts should have “higher arousal’ when Prause et al., 2015 reported that “porn addicts” had less brain activation to vanilla porn that did controls? (Incidentally, another EEG study also found that greater porn use in women correlated with less brain activation to porn.) The findings of Prause et al. 2015 align with Kühn & Gallinat (2014), which found that more porn use correlated with less brain activation in response to pictures of vanilla porn.
Prause et al. 2015’s EEG findings also align with Banca et al. 2015, which found faster habituation to sexual images in porn addicts. Lower EEG readings mean that subjects are paying less attention to the pictures. The more frequent porn users were probably bored by vanilla porn shown in the lab. Moholy & Prause’s compulsive porn users did not “have better control over their sexual response.” Instead, they had become habituated or desensitized to static images of vanilla porn.
It is not uncommon for frequent porn users to develop tolerance, which is the need for greater stimulation in order to achieve the same level of arousal. A similar phenomenon occurs in substance abusers who require bigger “hits” to achieve the same high. With porn users, greater stimulation is often achieved by escalating to new or extreme genres of porn.
New genres that induce shock, surprise, violation of expectations or even anxiety can function to increase sexual arousal, which often flags in those who overuse internet porn. A recent study found that such escalation is very common in today’s internet porn users. 49% of the men surveyed had viewed porn that “was not previously interesting to them or that they considered disgusting.” In sum, multiple studies have reported habituation or escalation in frequent porn users – an effect entirely consistent with the addiction model.
Key point: This entire claim in the Reply to Gola rests upon the unsupported prediction that “porn addicts” should experience greater sexual arousal to static images of vanilla porn, and thus less ability to control their arousal. Yet the prediction that compulsive porn users or addicts experience greater arousal to vanilla porn and greater sexual desire have repeatedly been falsified by several lines of research:
27 studies link porn use to lower sexual arousal or sexual dysfunctions with sex partners.
25 studies falsify the claim that sex and porn addicts “have high sexual desire” (more below).
The two studies cited have nothing to do with porn addicts’ inability to control use despite negative consequences.
The two studies cited did not identify who was or wasn’t a porn addict, so can tell us nothing about “porn addiction.”
Those subjects who scored higher on the sex addiction questionnaire (not porn addiction) did not “control their arousal better” while viewing vanilla porn. They were very likely bored by the vanilla porn (i.e., desensitized, which is an addiction-related brain change).
Claim 2: Addicts use the substance or behavior to escape negative emotions
PRAUSE: “Addiction models often propose that the substance use or behavior is used to ameliorate or escape negative affect. Those reporting problems with sex films actually reported less negative affect at baseline/pre-viewing than controls (Prause, Staley, & Fong, 2013).”
While addicts often do use to escape negative affect (emotions), once again the Reply to Gola cites as support a study that has nothing to do with falsifying the above addiction prediction. Prause, Staley & Fong 2013 did not examine this phenomenon at all. Here’s what it actually reported:
“Unexpectedly, the VSS-P group exhibited significantly less coactivation of positive and negative affect to the sexual film than VSS-C.”
Translation: the so-called “porn addicts” (VSS-P group) had less emotional reaction to porn than did the control group (VSS-C). Put simply, “porn addicts” experienced less emotional response to both sexual and neutral films. Key point: Prause’s 2013 study used the same subjects as Prause et al., 2015, which is the very same 2015 EEG study that found less brain activation to static images of vanilla porn.
There’s a very simple explanation for the “more frequent porn users” having less emotional response to viewing vanilla porn. Vanilla porn no longer registered as all that interesting. The same goes “more frequent porn users” reactions to the neutral films – they were desensitized. Prause, Staley, & Fong, 2013 (also called Prause et al., 2013) has been thoroughly critiqued here.
A few patterns emerge in the Reply to Gola’s claims of falsification:
The studies cited have nothing to do with the falsification of the porn addiction model.
Here’s what we know about the “porn addicted users” in Prause’s 3 studies (the “Prause Studies“): They were not necessarily addicts, as they were never assessed for porn addiction. Thus, they can’t legitimately be used to “falsify” anything to do with the addiction model. As a group they were desensitized or habituated to vanilla porn, which is consistent with predictions of the addiction model. Here’s what each study actually reported about the “porn addicted” subjects:
Prause et al., 2013: “Porn addicted users” reported more boredom and distraction while viewing vanilla porn.
Steele et al., 2013: Individuals with greater cue-reactivity to porn had less desire for sex with a partner, but not less desire to masturbate.
Prause et al., 2015: “Porn addicted users” had less brain activation to static images of vanilla porn. Lower EEG readings mean that the “porn addicted” subjects were paying less attention to the pictures.
A clear pattern emerges from the three studies: The “porn addicted users” were desensitized or habituated to vanilla porn, and those with greater cue-reactivity to porn preferred to masturbate to porn than have sex with a real person. Put simply they were desensitized (a common indication of addiction) and preferred artificial stimuli to a very powerful natural reward (partnered sex). There is no way to interpret these results as falsifying porn addiction.
You cannot falsify the porn addiction model if your “porn addicts” are not really porn addicts.
A major flaw in the Prause Studies is that no one knows which, if any, of Prause’s subjects were actually porn addicts. This is why there are often quotation marks around “porn addicts” in our descriptions of these 3 studies. The subjects were recruited from Pocatello, Idaho via online advertisements requesting people who were “experiencing problems regulating their viewing of sexual images.” Pocatello, Idaho is over 50% Mormon, so many of the subjects may feel that any amount of porn use is a serious problem.
In a 2013 interview Nicole Prause admits that a number of her subjects experienced only minor problems (which means they were not porn addicts):
“This study only included people who reported problems, ranging from relatively minor to overwhelming problems, controlling their viewing of visual sexual stimuli.”
Again, the questionnaire employed in the 3 studies to assess “porn addiction” (Sexual Compulsivity Scale) was not validated as a screening instrument for porn addiction. It was created in 1995 and designed with uncontrolled sexual relations (with partners) in mind, in connection with investigating the AIDS epidemic. The SCS says:
“The scale has been should [shown?] to predict rates of sexual behaviors, numbers of sexual partners, practice of a variety of sexual behaviors, and histories of sexually transmitted diseases.”
Moreover, the Prause Studies administered the questionnaire to the female subjects. Yet the SCS’s developer warns that this tool won’t show psychopathology in women,
“Associations between sexual compulsivity scores and other markers of psychopathology showed different patterns for men and women; sexual compulsivity was associated with indexes of psychopathology in men but not in women.”
Besides not establishing which of the subjects were porn addicted, the Prause Studies did not screen subjects for mental disorders, compulsive behaviors, or other addictions. This is critically important for any “brain study” on addiction, lest confounds render results meaningless. Another fatal flaw is that the Prause study subjects were not heterogeneous. They were men and women, including 7 non-heterosexuals, but were all shown standard, possibly uninteresting, male+female porn. This alone discounts any findings. Why? Study after study confirms that men and women have significantly different brain responses to sexual images or films. This is why serious addiction researchers match subjects carefully.
In summary,
The study cited in the Reply to Gola (Prause et al., 2013) has nothing to do with assessing a porn addicts’ motivations for using porn. It certainly does not assess the extent to which porn addicts use porn to escape negative feelings.
The Prause Studies did not assess whether the subjects were porn addicts or not. The authors admitted that many of the subjects had little difficulty controlling use. All of the subjects would have to have been confirmed porn addicts to permit a legitimate comparison with a group of non-porn addicts.
All valid brain studies must have homogeneous subjects for accurate comparisons. Since the Prause Studies did not, the results are unreliable, and cannot be used to falsify anything.
Claim: Porn addicts simply have a “high sex drive”
PRAUSE: Meanwhile, two more compelling models have received more support since the publication of Prause et al. (2015). These include a high sex drive model (Walton, Lykins, & Bhullar, 2016) supporting the original high-drive hypothesis (Steele, Prause, Staley, & Fong, 2013). Parsons et al. (2015) have suggested that high sex drive may represent a subset of those reporting problems.
The claim that porn and sex addicts simply have “high sexual desire,” has been falsified by 24 recent studies. In fact, Nicole Prause stated in this Quora post that she no longer believes that “sex addicts” have high libidos:
“I was partial to the high sex drive explanation, but this LPP study we just published is persuading me to be more open to sexual compulsivity.”
No matter what any study has reported it’s important to address the spurious claim that “high sexual desire” is mutually exclusive with porn addiction. Its irrationality becomes clear if one considers hypotheticals based on other addictions. (For more, see this critique of Steele, Prause, Staley, & Fong, 2013 High desire’, or ‘merely’ an addiction? A response to Steele et al., 2013). For example, does such logic mean that being morbidly obese, unable to control eating, and being extremely unhappy about it, is simply a “high desire for food?”
Extrapolating further, one must conclude that alcoholics simply have a high desire for alcohol, right? The fact is that all addicts have “high desire” for their addictive substances and activities (called “sensitization“), even when their enjoyment of such activities declines due to other addiction-related brain changes (desensitization). However, it doesn’t annul their addiction (which remains a pathology).
Most addiction experts consider “continued use despite negative consequences” to be the prime marker of addiction. After all, someone could have porn-induced erectile dysfunction and be unable to venture beyond his computer in his mother’s basement due to porn’s effects on his motivation and social skills. Yet, according to these researchers, as long as he indicates “high sexual desire,” he has no addiction. This paradigm ignores everything known about addiction, including symptoms and behaviors shared by all addicts, such as severe negative repercussions, inability to control use, cravings, etc.
Let’s look more closely at the 3 studies cited in support of the above “high desire” claim:
1. Steele, Prause, Staley, & Fong, 2013(Sexual desire, not hypersexuality, is related to neurophysiological responses elicited by sexual images):
We discussed this study above (Steele et al., 2013). In 2013 spokesperson Nicole Prause made two unsupported public claims about Steele et al., 2013:
Claim #1) The study reported higher EEG readings when subjects were briefly exposed to pornographic photos. Studies consistently show that an elevated P300 occurs when addicts are exposed to cues (such as images) related to their addiction. This finding supports the porn addiction model, as 7 peer-reviewed papers analyzing Steele et al. explained (1, 2, 3,4, 5, 6, 7.) and psychology professor emeritus John A. Johnson pointed out in a comment under a 2013 Psychology Today Prause interview:
“My mind still boggles at the Prause claim that her subjects’ brains did not respond to sexual images like drug addicts’ brains respond to their drug, given that she reports higher P300 readings for the sexual images. Just like addicts who show P300 spikes when presented with their drug of choice. How could she draw a conclusion that is the opposite of the actual results?”
Mustanski asks, “What was the purpose of the study?” And Prause replies, “Our study tested whether people who report such problems [problems with regulating their viewing of online erotica] look like other addicts from their brain responses to sexual images.”
But the study did not compare brain recordings from persons having problems regulating their viewing of online erotica to brain recordings from drug addicts and brain recordings from a non-addict control group, which would have been the obvious way to see if brain responses from the troubled group look more like the brain responses of addicts or non-addicts…..
Claim #2) Study spokesperson Nicole Prause claimed that porn users merely had “high sexual desire,” yet the study reported greater cue-reactivity to porn correlating with less desire for partnered sex. To put another way, individuals with greater brain activation to porn would rather masturbate to porn than have sex with a real person. That’s not “high sexual desire.” An excerpt from a critique of Steele et al. taken from this 2015 review of the literature:
Moreover, the conclusion listed in the abstract, “Implications for understanding hypersexuality as high desire, rather than disordered, are discussed” [303] (p. 1) seems out of place considering the study’s finding that P300 amplitude was negatively correlated with desire for sex with a partner. As explained in Hilton (2014), this finding “directly contradicts the interpretation of P300 as high desire” [307]. The Hilton analysis further suggests that the absence of a control group and the inability of EEG technology to discriminate between “high sexual desire” and “sexual compulsion” render the Steele et al. findings uninterpretable [307].
Bottom line: The findings of Steele et al., 2013 actually falsify the assertions made in the Reply to Gola.
2. Parsons et al., 2015(Hypersexual, Sexually Compulsive, or Just Highly Sexually Active? Investigating Three Distinct Groups of Gay and Bisexual Men and Their Profiles of HIV-Related Sexual Risk):
Like nearly every study cited in the Reply to Gola, this study failed to assess which subjects were, in fact, porn addicted. It employed two questionnaires that asked only about sexual behaviors: the “Sexual Compulsivity Scale” (discussed above), and the “Hypersexual Disorder Screening Inventory.” Neither questionnaire contained a single item about internet porn use, so this study can tell us nothing about internet porn addiction.
While Parsons et al., 2015 only concerns itself with sexual behaviors in gay and bisexual men, its findings actually falsify the claim that “sex addiction is merely high sexual desire.” If high sexual desire and sex addiction were the same, there would only be one group of individuals per population. Instead, this study reported several distinct sub-groups, yet all groups reported similar rates of sexual activity.
Emerging research supports the notion that sexual compulsivity (SC) and hypersexual disorder (HD) among gay and bisexual men (GBM) might be conceptualized as comprising three groups—Neither sexually compulsive nor hypersexual; Sexually compulsive only, and Both sexually compulsive and hypersexual—that capture distinct levels of severity across the SC/HD continuum. Nearly half (48.9 %) of this highly sexually active sample was classified as Neither SC nor HD, 30 % as SC Only, and 21.1 % as Both SC and HD. While we found no significant differences between the three groups on reported number of male partners, anal sex acts….
Simplified: High sexual desire, as measured by sexual activity, tells us very little about whether a person is a sex addict or not. The key finding here is that sex addiction is not the same as “high sexual desire.”
Why this “letter to the editor” is cited remains a mystery. It’s not a peer-reviewed study and it has nothing to do with porn use, porn addiction, or hypersexuality. Are the authors of the Reply to Gola padding their citation count with irrelevant papers?
In summary:
The three studies cited did not assess whether any subject was porn addicted or not. As a result, they can tell us little about the claim that porn addicts simply have high sexual desire.
Steele, Prause, Staley, & Fong, 2013 reported that greater cue-reactivity to porn was related to less desire for sex with a partner. This falsifies the claim that porn addicts have high sexual desire.
Parsons et al., 2015 reported that sexual activity was unrelated to measures of hypersexuality. This falsifies the claim that “sex addicts” simply have high sexual desire.
Walton, Lykins, & Bhullar, 2016 is a letter to the editor that has nothing to do with the subject at hand.
Claim: Erectile dysfunction is the most commonly suggested negative consequence of porn use.
PRAUSE: Addiction models typically predict negative consequences. Although erectile dysfunction is the most commonly suggested negative consequence of porn use, erectile problems actually are not elevated by viewing more sex films (Landripet & Štulhofer, 2015; Prause & Pfaus, 2015; Sutton, Stratton, Pytyck, Kolla, & Cantor, 2015).
The claim that “erectile dysfunction is the most common negative consequence of porn use” is without support. It’s a straw man argument as:
No peer-reviewed paper has ever claimed that erectile dysfunction is the #1 consequence of porn use.
The #1 consequence of porn use has never been described in a peer-reviewed paper (and probably never will be).
This claim limits itself to the consequences of porn use, which is not the same as the consequences of porn addiction.
How could erectile dysfunction be the #1 negative consequence of porn use when the female half of the population is omitted? If any sexual problem were the number one consequence of porn use it would have to be low libido or anorgasmia, so as to include females.
In any case, only one of the three studies cited actually identified which subjects, if any, were porn addicted: Sutton, Stratton, Pytyck, Kolla, & Cantor, 2015. Indeed, this is the only study cited in the entire Reply to Gola that identifies any study participants as porn addicts. The two other studies cited here (Landripet & Štulhofer, 2015; Prause & Pfaus, 2015) tell us nothing about the relationship between porn addiction and erectile dysfunction because neither assessed whether any subject was porn addicted or not. Sound familiar?
So, let’s first examine the only relevant study cited in the Reply to Gola.
It’s a study on men (average age 41.5) seeking treatment for hypersexuality disorders, such as paraphilias and chronic masturbation or adultery. 27 were classified as “avoidant masturbators,” meaning they masturbated (typically with porn use) one or more hours per day or more than 7 hours per week. 71% of the compulsive porn users reported sexual functioning problems, with 33% reporting delayed ejaculation (often a precursor to porn-induced ED).
What sexual dysfunction do 38% of the remaining men have? The study doesn’t say, and the authors have ignored repeated requests for details. Two primary choices for male sexual dysfunction in this age group are ED and low libido. The men were not asked about their erectile functioning without porn. Often men have no idea that they have porn-induced ED if they aren’t having partnered sex and all their climaxes entail masturbation to porn. This means sexual problems might have been higher than 71% in the porn addicts. Why the Reply to Gola cited this study as evidence that “negative consequences” are not associated with porn addiction remains a mystery.
Sutton et al., 2015 has been replicated by the only other study to directly investigate the relationships between sexual dysfunctions and problematic internet porn use. A 2016 Belgian study from a leading research university found problematic internet porn use was associated with reduced erectile function and reduced overall sexual satisfaction. Yet problematic porn users experienced greater cravings. The study also appears to report escalation, as 49% of the men viewed porn that “was not previously interesting to them or that they considered disgusting.”
In fact, 27 studies have replicated this link between porn use/porn addiction and sexual dysfunctions or decreased sexual arousal. The first 3 studies in that list demonstrate causation as participants eliminated porn use and healed chronic sexual dysfunctions. In addition, over 30 studies correlate porn use with lower sexual and relationship satisfaction. Sounds like “negative consequences of porn use” to me.
While “debunking” porn-induced sexual dysfunctions has no bearing on the existence of “porn addiction,” we turn next to examining the first two studies cited above for the claim there’s little relationship between erectile dysfunction and current levels of porn use.
First, it’s important to know that studies assessing young male sexuality since 2010 report historic levels of sexual dysfunctions, and startling rates of a new scourge: low libido. All are documented in this 2016 peer-reviewed paper.
Prause & Pfaus 2015 (Viewing Sexual Stimuli Associated with Greater Sexual Responsiveness, Not Erectile Dysfunction):
Since this cobbled together paper did not identify any subjects as porn addicted, its findings cannot support the claim that the porn addiction model has been falsified. Prause & Pfaus 2015 wasn’t a study at all. Instead, Prause claimed to have gathered data from four of her earlier studies, none of which addressed erectile dysfunction. Additional problem: None of the data of the Prause & Pfaus (2015) paper match the data in the four earlier studies. The discrepancies are not small and have not been explained.
Many journalists’ articles about this study claimed that porn use led to better erections, yet that’s not what the paper found. In recorded interviews, both Nicole Prause and Jim Pfaus falsely claimed that they had measured erections in the lab, and that the men who used porn had better erections. In the Jim Pfaus TV interview Pfaus states:
“We looked at the correlation of their ability to get an erection in the lab.”
“We found a liner correlation with the amount of porn they viewed at home, and the latencies which for example they get an erection is faster.”
In this radio interview Nicole Prause claimed that erections were measured in the lab. The exact quote from the show:
“The more people watch erotica at home they have stronger erectile responses in the lab, not reduced.”
Yet this paper did not assess erection quality in the lab or “speed of erections.” The paper only claimed to have asked guys to rate their “arousal” after briefly viewing porn (and it’s not clear from the underlying papers that even that actually happened in the case of all subjects). In any case, an excerpt from the paper itself admitted that:
“No physiological genital response data were included to support men’s self-reported experience.”
In a second unsupported claim, lead author Nicole Prause tweeted several times about the study, letting the world know that 280 subjects were involved, and that they had “no problems at home.” However, the four underlying studies contained only 234 male subjects, so “280” is way off.
A third unsupported claim: Dr. Isenberg wondered how it could be possible for Prause & Pfaus 2015 to have compared different subjects’ arousal levels when three different types of sexual stimuli were used in the 4 underlying studies. Two studies used a 3-minute film, one study used a 20-second film, and one study used still images. It’s well established that films are far more arousing than photos, so no legitimate research team would group these subjects together to make claims about their responses. What’s shocking is that in their paper Prause & Pfaus unaccountably claim that all 4 studies used sexual films:
“The VSS presented in the studies were all films.”
This statement is false, as clearly revealed in Prause’s own underlying studies.
A fourth unsupported claim: Dr. Isenberg also asked how Prause & Pfaus 2015 compared different subjects’ arousal levels when only 1 of the 4 underlying studies used a 1 to 9 scale. One used a 0 to 7 scale, one used a 1 to 7 scale, and one study did not report sexual arousal ratings. Once again Prause & Pfaus inexplicably claim that:
“Men were asked to indicate their level of “sexual arousal” ranging from 1 “not at all” to 9 “extremely.”
This too is false as the underlying papers show. In summary, all the Prause-generated headlines about porn improving erections or arousal, or anything else, are unwarranted. Prause & Pfaus 2015 also claimed they found no relationship between erectile functioning scores and the amount of porn viewed in the last month. As Dr. Isenberg pointed out:
“Even more disturbing is the total omission of statistical findings for the erectile function outcome measure. No statistical results whatsoever are provided. Instead the authors ask the reader to simply believe their unsubstantiated statement that there was no association between hours of pornography viewed and erectile function. Given the authors’ conflicting assertion that erectile function with a partner may actually be improved by viewing pornography the absence of statistical analysis is most egregious.”
In the Prause & Pfaus response to the Dr. Isenberg critique, they once again failed to provide any data to support their “unsubstantiated statement.” As this analysis documents, the Prause & Pfaus response not only evades Dr. Isenberg’s legitimate concerns, it contains several new misrepresentations and several transparently false statements. Finally, a review of the literature by seven US Navy doctors commented on Prause & Pfaus 2015:
“Our review also included two 2015 papers claiming that Internet pornography use is unrelated to rising sexual difficulties in young men. However, such claims appear to be premature on closer examination of these papers and related formal criticism. The first paper contains useful insights about the potential role of sexual conditioning in youthful ED [50]. However, this publication has come under criticism for various discrepancies, omissions and methodological flaws. For example, it provides no statistical results for the erectile function outcome measure in relation to Internet pornography use. Further, as a research physician pointed out in a formal critique of the paper, the papers’ authors, “have not provided the reader with sufficient information about the population studied or the statistical analyses to justify their conclusion” [51]. Additionally, the researchers investigated only hours of Internet pornography use in the last month. Yet studies on Internet pornography addiction have found that the variable of hours of Internet pornography use alone is widely unrelated to “problems in daily life”, scores on the SAST-R (Sexual Addiction Screening Test), and scores on the IATsex (an instrument that assesses addiction to online sexual activity) [52, 53, 54, 55, 56]. A better predictor is subjective sexual arousal ratings while watching Internet pornography (cue reactivity), an established correlate of addictive behavior in all addictions [52, 53, 54]. There is also increasing evidence that the amount of time spent on Internet video-gaming does not predict addictive behavior. “Addiction can only be assessed properly if motives, consequences and contextual characteristics of the behavior are also part of the assessment” [57]. Three other research teams, using various criteria for “hypersexuality” (other than hours of use), have strongly correlated it with sexual difficulties [15, 30, 31]. Taken together, this research suggests that rather than simply “hours of use”, multiple variables are highly relevant in assessment of pornography addiction/hypersexuality, and likely also highly relevant in assessing pornography-related sexual dysfunctions.”
The US Navy paper highlighted the weakness in correlating only “current hours of use” to predict porn-induced sexual dysfunctions. The amount of porn currently viewed is just one of many variables involved in the development of porn-induced ED. These may include:
Ratio of masturbation to porn versus masturbation without porn
Ratio of sexual activity with a person versus masturbation to porn
Gaps in partnered sex (where one relies only on porn)
Virgin or not
Total hours of use
Years of use
Age started using porn
Escalation to new genres
Development of porn-induced fetishes (from escalating to new genres of porn)
Level of novelty per session (i.e. compilation videos, multiple tabs)
Addiction-related brain changes or not
Presence of hypersexuality/porn addiction
The better way to research this phenomenon, is to remove the variable of internet porn use and observe the outcome, which was done in the Navy paper and in two other studies. Such research reveals causation instead of fuzzy correlations open to varying interpretation. My site has documented a few thousand men who removed porn and recovered from chronic sexual dysfunctions.
Landripet & Štulhofer 2015 (Is Pornography Use Associated with Sexual Difficulties and Dysfunctions among Younger Heterosexual Men?A Brief Communication):
As with Prause & Pfaus, 2015, this “Brief Communication” failed to identify any subjects as porn addicted. With no porn addicts to assess it cannot falsify the “negative consequences” of porn addiction. The Reply to Gola claimed that Landripet & Štulhofer, 2015 found no relationships between porn use and sexual problems. This is not true, as documented in both this YBOP critique and the US Navy review of the literature:
A second paper reported little correlation between frequency of Internet pornography use in the last year and ED rates in sexually active men from Norway, Portugal and Croatia [6]. These authors, unlike those of the previous paper, acknowledge the high prevalence of ED in men 40 and under, and indeed found ED and low sexual desire rates as high as 31% and 37%, respectively. In contrast, pre-streaming Internet pornography research done in 2004 by one of the paper’s authors reported ED rates of only 5.8% in men 35–39 [58]. Yet, based on a statistical comparison, the authors conclude that Internet pornography use does not seem to be a significant risk factor for youthful ED. That seems overly definitive, given that the Portuguese men they surveyed reported the lowest rates of sexual dysfunction compared with Norwegians and Croatians, and only 40% of Portuguese reported using Internet pornography “from several times a week to daily”, as compared with the Norwegians, 57%, and Croatians, 59%. This paper has been formally criticized for failing to employ comprehensive models able to encompass both direct and indirect relationships between variables known or hypothesized to be at work [59]. Incidentally, in a related paper on problematic low sexual desire involving many of the same survey participants from Portugal, Croatia and Norway, the men were asked which of numerous factors they believed contributed to their problematic lack of sexual interest. Among other factors, approximately 11%–22% chose “I use too much pornography” and 16%–26% chose “I masturbate too often” [60].
As the Navy doctors described, this paper found a pretty important correlation: Only 40% of the Portuguese men used porn “frequently,” while the 60% of the Norwegians used porn “frequently.” The Portuguese men had far less sexual dysfunction than the Norwegians. With respect to the Croats, Landripet & Štulhofer, 2015 acknowledge a statistically significant association between more frequent porn use and ED, but claim the effect size was small. However, this claim may be misleading according to an MD who is a skilled statistician and has authored many studies:
Analyzed a different way (Chi Squared), … moderate use (vs. infrequent use) increased the odds (the likelihood) of having ED by about 50% in this Croatian population. That sounds meaningful to me, although it is curious that the finding was only identified among Croats.
In addition, Landripet & Stulhofer 2015 omitted two significant correlations, which one of the authors presented to a European conference. He reported a significant correlation between erectile dysfunction and “preference for certain pornographic genres”:
“Reporting a preference for specific pornographic genres were significantly associated with erectile (but not ejaculatory or desire-related) male sexual dysfunction.”
It’s telling that Landripet & Stulhofer chose to omit this significant correlation between erectile dysfunction and preferences for specific genres of porn from their paper. It’s quite common for porn users to escalate into genres that do not match their original sexual tastes, and to experience ED when these conditioned porn preferences do not match real sexual encounters. As we and the US Navy pointed out above, it’s very important to assess the multiple variables associated with porn use – not just hours in the last month, or frequency in the last year.
The second significant finding omitted by Landripet & Stulhofer 2015 involved female participants:
“Increased pornography use was slightly but significantly associated with decreased interest for partnered sex and more prevalent sexual dysfunction among women.”
A significant correlation between greater porn use and decreased libido and more sexual dysfunction seems pretty important. Why didn’t Landripet & Stulhofer 2015 report that they found significant correlations between porn use and sexual dysfunction in women, as well as a few in men? And why hasn’t this finding been reported in any of Stulhofer’s many studies arising from these same data sets? His teams seem very quick to publish data they claim debunks porn-induced ED, yet very slow to inform women about the negative sexual ramifications of porn use.
Finally, Danish porn researcher Gert Martin Hald’s formal critical comments echoed the need to assess more variables (mediators, moderators) than just frequency per week in the last 12 months:
The study does not address possible moderators or mediators of the relationships studied nor is it able to determine causality. Increasingly, in research on pornography, attention is given to factors that may influence the magnitude or direction of the relationships studied (i.e., moderators) as well as the pathways through which such influence may come about (i.e., mediators). Future studies on pornography consumption and sexual difficulties may also benefit from an inclusion of such focuses.
Bottom line: All complex medical conditions involve multiple factors, which must be teased apart. In any case, Landripet & Stulhofer’s statement that, “Pornography does not seem to be a significant risk factor for younger men’s desire, erectile, or orgasmic difficulties” goes too far, since it ignores all the other possible variables related to porn use that might be causing sexual performance problems in users – including escalation to specific genres, which they found, but omitted in the “Brief Communication.”
Claim: Religious porn users have slightly more distress about their porn use than atheists.
PRAUSE: Also, distress related to viewing sex films has been shown to be most strongly related to conservative values and religious history (Grubbs et al., 2014). This supports a social shame model of problem sex film viewing behaviors.
Here the Reply to Gola’s attempt to debunk porn addiction drifts even farther from the target. What are we to make of a seemingly obvious finding that deeply religious individuals experience a bit more distress about their porn use than do atheists? How does this finding falsify the porn addiction model? It doesn’t. Moreover, the study cited did not concern itself with “distress related to sex film viewing.”
That said, several lay articles about the Joshua Grubbs studies (“perceived addiction studies”) have tried to paint a very misleading picture of what his perceived addiction studies actually reported and what these findings mean. In response to these spurious articles, YBOP published this extensive critique of the claims made in the perceived addiction studies and in the related misleading articles.
Grubbs et al., 2014 (Transgression as Addiction: Religiosity and Moral Disapproval as Predictors of Perceived Addiction to Pornography):
The reality of this study:
This study failed to identify who was and was not a porn addict, so it’s not relevant to assessing the porn addiction model.
Contrary to the Reply to Gola’s assertion above, this study was not concerned with “distress related to sex film viewing.” The word “distress” is not in the study’s abstract.
Contrary to the Reply to Gola and the Grubbs et al., 2014 conclusion, the strongest predictor of porn addiction was actually hours of porn use, not religiosity! See this extensive section with the study’s tables, the correlations, and what the study actually found.
When we break down the Grubbs’s porn addiction questionnaire (CPUI-9), the relationship between “religiosity” and the core addiction behaviors (Access Efforts questions 4-6) is virtually non-existent. Put simply: religiosity has next to nothing to do with actual porn addiction.
On the other hand, a very strong relationship exists between “hours of porn use” and the core addiction behaviors as assessed by the “Access Efforts” questions 4-6. Put simply: Porn addiction is very strongly related to amount of porn viewed.
The Reply to Gola, bloggers like David Ley, and even Grubbs himself, seem to be endeavoring to construct a meme that religious shame is the “real” cause of porn addiction. Yet it’s simply not true that the “perceived addiction” studies are evidence of this trendy talking point. Again, this extensive analysis debunks the “porn addiction is only religious shame” claim. The meme crumbles when we consider that:
Religious shame doesn’t induce brain changes that mirror those found in drug addicts. In contrast, there are now 41 neurological studies reporting addiction-related brain changes in compulsive porn users/sex addicts.
This means Grubbs’s sample of “religious porn users” is relatively tiny and inevitably skewed towards individuals with pre-existing conditions or underlying issues.
It also means that “religiosity” does not predict porn addiction. Instead, religiosity apparently protects one from developing a porn addiction.
Many atheists and agnostics develop porn addiction. Two 2016 studies on men who had used porn in the last the last 6 months, or in the last 3 months, reported extraordinarily high rates of compulsive porn use (28% for both studies).
Being religious doesn’t induce chronic erectile dysfunction, low libido and anorgasmia in healthy young men. Yet numerous studies link porn use to sexual dysfunctions and lower sexual satisfaction, and ED rates have inexplicably skyrocketed by 1000% in men under 40 since “tube” porn captured porn viewers’ attention beginning at the end of 2006.
Research shows that as the severity of their porn addiction increases, religious individuals often return to religious practices, attend church more often, and become more devout as a way of coping/seeking recovery (think 12 Steps). This alone could account for any relationship between porn addiction and religiosity.
In summary:
Both the Reply to Gola assertion and the single study cited have nothing to with the porn addiction model.
The 2014 Grubbs “perceived addiction” study actually found porn addiction was more strongly correlated with the amount of porn viewed than with religiosity.
There’s no evidence that religious “shame” induces addiction-related brain changes, and yet these changes have repeatedly been found in problematic porn users’ brains.
There’s much evidence that religiosity actually protects individuals from porn use and thus porn addiction.
Grubbs’s sample of “religious porn users” is not cross-sectional, and therefore inevitably skewed towards higher rates of genetic predispositions or underlying issues.
Two recent studies reported no relationship between porn addiction and religiosity in men seeking treatment.
Update: two new studies drive a stake through the heart of the meme that “religiosity causes porn addiction”:
In this section we examine a few of the unsupported assertions and false statements put forth in the Reply to Gola. While it’s tempting to challenge the Reply to Gola line by line, its major weakness is that its arguments are specious. They fail to address the content of the YBOP critique or the 8 peer-reviewed analyses of Prause et al. 2015 (including Matuesz Gola’s):: 1, 2, 3,4,5, 6, 7, 8. All 8 expert analyses agree that Prause et al., 2015 actually found desensitization or habituation, which is consistent with the addiction model.
The following assertions of the Reply to Gola relate to Mateusz Gola’s concerns about the Prause et al., 2015 methodological flaws. Several major flaws in this and the other Prause Studies leave any study results and associated claims in serious doubt:
Subjects were not screened for porn addiction (potential subjects only answered a single question).
Questionnaires used did not ask about porn use and were not valid for assessing “porn addiction.”
Subjects were heterogeneous (males, females, non-heterosexuals).
Subjects were not screened for confounding psychiatric conditions, drug use, psychotropic medications, drug addictions, behavioral addictions, or compulsive disorders (any single one of which is exclusionary).
Reply To Claim: Prause et al., 2015 employed “proper” methodology in recruiting and identifying which subjects were porn addicts and Voon et al., 2014 did not.
Nothing could be further from the truth, as the Prause et al. methodology failed on every level, while Voon et al. employed meticulous methodology in the recruitment, screening and assessment of its “porn addicted” subjects (Compulsive Sexual Behaviors subjects).
A little background. Prause compared the average EEG readings of 55 “porn addicts” to the average EEG readings of 67 “non-addicts.” Yet the validity of Prause et al., 2015 would be entirely dependent on comparing the brain activation patterns of a group of porn addicts to a group of non-addicts. For Prause’s claims of falsification and the resulting dubious headlines to be legitimate, all of Prause’s 55 subjects would have to have been actual porn addicts. Not some, not most, but every single subject (as Voon’s were). All signs point to a good number of the 55 Prause subjects being non-addicts. An excerpt from Steele et al., 2013 describes the entire selection process and exclusion criteria employed in the 3 Prause Studies (Prause et al., 2013, Steele et al., 2013, Prause et al., 2015):
“Initial plans called for patients in treatment for sexual addiction to be recruited, but the local Institutional Review Board prohibited this recruitment on the grounds that exposing such volunteers to VSS could potentiate a relapse. Instead, participants were recruited from the Pocatello, Idaho community by online advertisements requesting people who were experiencing problems regulating their viewing of sexual images.”
That’s it. The only criterion for inclusion was answering yes to a single question: “Are you experiencing problems regulating your viewing of sexual images.” The first noticeable error involves the screening question used, which asks only about viewing sexual images, and not about viewing internet porn, especially streaming videos (which appear to be the form of porn causing the most severe symptoms).
A much bigger flaw is that the Prause Studies did not screen potential subjects by using a sex or porn addiction questionnaire (as Voon et al. did). Nor were potential subjects asked whether porn use had negatively affected their lives, whether they considered themselves addicted to porn, or whether they experienced addiction-like symptoms (as Voon et al. did).
Make no mistake, neither Steele et al., 2013 nor Prause et al., 2015 described these 55 subjects as porn addicts or compulsive porn users. The subjects only admitted to feeling “distressed” by their porn use. Confirming the mixed nature of her subjects, Prause admitted in 2013 interview that some of the 55 subjects experienced only minor problems (which means they were not porn addicts):
“This study only included people who reported problems, ranging from relatively minor to overwhelming problems, controlling their viewing of visual sexual stimuli.”
Compounding the failure to screen subjects for actual porn addiction, the 3 Prause Studies chose to ignore standard exclusion criteria normally employed in addiction studies to prevent confounds. The Prause Studies did not:
Screen subjects for psychiatric conditions (an automatic exclusion)
Screen subjects for other addictions (an automatic exclusion)
Ask subjects if they were using psychotropic medications (often exclusionary)
Screen subjects for those currently using drugs (automatic exclusion)
Voon et al., 2014 did all the above and much more to ensure they were investigating only homogeneous, porn addicted subjects. Yet Prause et al., 2015 admitted they employed no criteria for excluding subjects:
“As hypersexuality is not a codified diagnosis and we were expressly prohibited from recruiting patients, no thresholds could be used to empirically identify problem users”
It appears that in Prause’s view simply answering the single-question ad met the exclusion criteria for the Prause Studies. This brings us to Matuesz Gola’s concern about Prause’s subjects not being porn addicts, as they only viewed an average of 3.8 hours of porn per week, while Voon’s subjects viewed 13.2 hours per week:
Mateusz Gola: “It is worthy to notice that in Prause et al. (2015) problematic users consume pornography in average for 3.8 h/week it is almost the same as non-problematic pornography users in Kühn and Gallinat (2014) who consume in average 4.09 h/week. In Voon et al. (2014) non-problematic users reported 1.75 h/week and problematic 13.21 h/week (SD = 9.85) – data presented by Voon during American Psychological Science conference in May 2015.”
The hours of porn use per week for each study:
Voon et al: 13.2 hours (all were porn addicts)
Kuhn & Gallinat: 4.1 hours (none were porn addicts)
Prause et al: 3.8 hours (no one knows)
Gola also pondered how Prause’s 55 subjects could possibly be porn addicts (for purpose of “falsifying porn addiction”) when they watched less porn than the Kühn & Gallinat, 2014 non-addicts. How in the world can all of the Prause subjects be “porn addicts” when none of the Kühn & Gallinat subjects are porn addicts? However they are labeled, subjects have to be comparable across studies before you can claim to have “falsified” competing research. This is elementary science procedure.
So, how did Prause & company address the many gaping holes in their subjects’ recruitment and assessment process? By attacking the meticulous methodology of Voon et al., 2014! First, the description of recruitment process, assessment criteria for porn addiction, and exclusion criteria excerpted from Voon et al., 2014 (also see Schmidt et al., 2016 & Banca et al., 2016):
“CSB subjects were recruited via internet-based advertisements and from referrals from therapists. Age-matched male HV were recruited from community-based advertisements in the East Anglia area. All CSB subjects were interviewed by a psychiatrist to confirm they fulfilled diagnostic criteria for CSB (met proposed diagnostic criteria for both hypersexual disorder [Kafka, 2010; Reid et al., 2012] and sexual addiction [Carnes et al., 2007]), focusing on compulsive use of online sexually explicit material. This was assessed using a modified version of the Arizona Sexual Experiences Scale (ASES) [Mcgahuey et al., 2011], in which questions were answered on a scale of 1–8, with higher scores representing greater subjective impairment. Given the nature of the cues, all CSB subjects and HV were male and heterosexual. All HV were age-matched (±5 years of age) with CSB subjects. Subjects were also screened for compatibility with the MRI environment as we have done previously [Banca et al., 2016; Mechelmans et al., 2014; Voon et al., 2014]. Exclusionary criteria included being under 18 years of age, having a history of SUD, being a current regular user of illicit substances (including cannabis), and having a serious psychiatric disorder, including current moderate-severe major depression or obsessive-compulsive disorder, or history of bipolar disorder or schizophrenia (screened using the Mini International Neuropsychiatric Inventory) [Sheehan et al., 1998]. Other compulsive or behavioral addictions were also exclusions. Subjects were assessed by a psychiatrist regarding problematic use of online gaming or social media, pathological gambling or compulsive shopping, childhood or adult attention deficit hyperactivity disorder, and binge-eating disorder diagnosis. Subjects completed the UPPS-P Impulsive Behavior Scale [Whiteside and Lynam, 2001] to assess impulsivity, and the Beck Depression Inventory [Beck et al., 1961] to assess depression. Two of 23 CSB subjects were taking antidepressants or had comorbid generalized anxiety disorder and social phobia (N = 2) or social phobia (N = 1) or a childhood history of ADHD (N = 1). Written informed consent was obtained, and the study was approved by the University of Cambridge Research Ethics Committee. Subjects were paid for their participation.”
“Nineteen heterosexual men with CSB (age 25.61 (SD 4.77) years) and 19 age-matched (age 23.17 (SD 5.38) years) heterosexual male healthy volunteers without CSB were studied (Table S2 in File S1). An additional 25 similarly aged (25.33 (SD 5.94) years) male heterosexual healthy volunteers rated the videos. CSB subjects reported that as a result of excessive use of sexually explicit materials, they had lost jobs due to use at work (N = 2), damaged intimate relationships or negatively influenced other social activities (N = 16), experienced diminished libido or erectile function specifically in physical relationships with women (although not in relationship to the sexually explicit material) (N = 11), used escorts excessively (N = 3), experienced suicidal ideation (N = 2) and using large amounts of money (N = 3; from £7000 to £15000). Ten subjects either had or were in counselling for their behaviours. All subjects reported masturbation along with the viewing of online sexually explicit material. Subjects also reported use of escort services (N = 4) and cybersex (N = 5). On an adapted version of the Arizona Sexual Experiences Scale [43], CSB subjects compared to healthy volunteers had significantly more difficulty with sexual arousal and experienced more erectile difficulties in intimate sexual relationships but not to sexually explicit material (Table S3 in File S1).”
The Reply to Gola excerpt attacking Voon et al., 2014:
“Gola notes that hours of film consumption appeared lower in our participants than in two other studies of problem erotica use. We pointed this out in our paper (paragraph beginning “The problem group reported significantly more…”). Gola argues that our sample of problem users reported fewer hours of sex film viewing than the problem sample from Voon et al. (2014). However, Voon et al. specifically recruited for participants high in sexual shame, including advertisements on shame-based websites about sex-film use, “treatment-seeking” men despite “porn” use not being recognized by the DSM-5, and with funding by a television show framed as the “harms” of “porn”. Those who adopt addiction labels have been shown to have a history of socially conservative values and high religiosity (Grubbs, Exline, Pargament, Hook, & Carlisle, 2014). It is more likely that the Voon et al. (2014) sample is characterized by high sexual shame in online communities that encourage reporting of high use. Also, “porn” use was assessed during a structured interview, not a standardized questionnaire. Thus, the psychometrics and implicit biases inherent in a structured interview are unknown. This makes it difficult to compare sex film use measures between studies. Our strategy for identifying groups is consistent with widely-cited work demonstrating the importance of distress criterion in sexual difficulties (Bancroft, Loftus, & Long, 2003).”
This is nothing more than a web of easily debunked false statements and unwarranted claims calculated to divert the reader’s attention away from Prause’s deficient screening process. We start with:
Reply to Gola: However, Voon et al. specifically recruited for participants high in sexual shame, including advertisements on shame-based websites about sex-film use, “treatment-seeking” men despite “porn” use not being recognized by the DSM-5, and with funding by a television show framed as the “harms” of “porn.”
First, the Reply to Gola supplies no evidence to support the claim that participants experienced “high sexual shame” or were recruited from so-called “shame based websites.” This is nothing more than baseless propaganda. On the other hand, the Prause Studies recruited subjects from Pocatello, Idaho which is over 50% Mormon. It’s very likely that Prause’s religious subjects experienced shame or guilt in relationship to their porn use, in contrast to Voon’s subjects recruited publicly in the UK.
Second, many of Voon’s participants were seeking treatment for porn addiction and referred by therapists. What better way is there to ensure porn-addicted subjects? It’s very odd that the Reply to Gola would spin this as a negative (rather than an unarguable strength), when the Prause Studies wanted to use only “treatment seeking” sex addicts, but were prohibited by the university review board. Taken from the first Prause EEG study:
Steele et al., 2013: “Initial plans called for patients in treatment for sexual addiction to be recruited, but the local Institutional Review Board prohibited this recruitment on the grounds that exposing such volunteers to VSS could potentiate a relapse.”
Third, the Reply to Gola stoops to an outright lie by claiming that Voon et al. 2014 was funded by a “television show.” As clearly stated in Voon et al., 2014, the study was funded by “Wellcome Trust“:
Voon et al., 2014: “Funding: Funding provided by Wellcome Trust Intermediate Fellowship grant (093705/Z/10/Z). Dr. Potenza was supported in part by grants P20 DA027844 and R01 DA018647 from the National Institutes of Health; the Connecticut State Department of Mental Health and Addiction Services; the Connecticut Mental Health Center; and a Center of Excellence in Gambling Research Award from the National Center for Responsible Gaming. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.”
This is followed by more false and misleading statements. For example, the Reply to Gola throws in another untruth about the Voon et al. recruitment/assessment methodology:
Reply to Gola: Also, “porn” use was assessed during a structured interview, not a standardized questionnaire.
False. In screening potential subjects Voon et al., 2014 used four standardized questionnaires and employed an extensive psychiatric interview. The following is a shortened description of the screening process taken from Banca et al., 2016 (CSB is Compulsive Sexual Behaviors):
Voon et al., 2014: CSB subjects were screened using the internet sex screening test (ISST; Delmonico and Miller, 2003) and an exhaustive experimenter-designed questionnaire which included items pertaining to age of onset, frequency, duration, attempts to control use, abstinence, patterns of use, treatment and negative consequences. CSB participants were interviewed by a psychiatrist to confirm they fulfilled two sets of diagnostic criteria for CSB (proposed diagnostic criteria for Hypersexual Disorder; criteria for sexual addiction; Carnes et al., 2001; Kafka, 2010; Reid et al., 2012), focusing on compulsive use of online sexually explicit material. These criteria emphasize failure to cut down or control sexual behaviors, including consumption of pornography, despite social, financial, psychological and academic or vocational problems. Detailed description of CSB symptoms are described in Voon et al. (2014).
It’s shocking that the Reply to Gola would dare to compare the virtually nonexistent screening procedure used in the Prause Studies (subjects answered a single-question advertisement) with the exhaustive, expert screening procedures used for Voon et al., 2014:
Extensive investigator-designed questionnaire on details including age of onset, frequency, duration, attempts to control use, abstinence, patterns of use, treatment and negative consequences.
Incidentally, this process was merely the screening to confirm the existence of porn addiction; Voon et al. didn’t stop there. More questionnaires and interviews excluded those with psychiatric conditions, drug or behavioral addictions, OCD or compulsive disorders, and current or past substance abusers. The researchers in the Prause Studies did none of this.
Finally, the Reply to Gola regurgitates the unsupported claim that porn addiction is nothing more than religious shame,
Reply to Gola: “Those who adopt addiction labels have been shown to have a history of socially conservative values and high religiosity (Grubbs, Exline, Pargament, Hook, & Carlisle, 2014).”
The claimed correlation between porn addiction and religiosity was addressed above and thoroughly debunked in this extensive analysis of the Joshua Grubbs material.
Reply to Gola evades serious flaw in Prause et al., 2015: Unacceptable diversity of subjects
Critiques of Nicole Prause’s controversial EEG studies (Steele et al., 2013, Prause et al., 2015) have raised grave concerns about the diverse nature of the “distressed” porn using subjects. The EEG studies included males and females, heterosexuals and non-heterosexuals, yet the researchers showed them all standard, possibly uninteresting, male+female porn. This matters, because it violates standard procedure for addiction studies, in which researchers select homogeneous subjects in terms of age, gender, orientation, even similar IQ’s (plus a homogeneous control group) in order to avoid distortions caused by such differences.
In other words, the results of the 2 EEG studies were dependent on the premise that males, females, and non-heterosexuals are no different in their brain responses to sexual images. Yet study after study confirms that males and female have significantly different brain responses to sexual images or films. Gola knew this and mentioned this fatal flaw in a note:
Mateusz Gola: “It is worthy to notice that the authors present results for male and female participants together, while recent studies shows that sexual images ratings of arousal and valence differs dramatically between genders (see: Wierzba et al., 2015).”
In an evasive maneuver, the Reply to Gola ignores this elephant in the room: Male and female brains respond quite differently to sexual imagery. Instead, the Reply to Gola informs us that both men and women become aroused by sexual imagery, and other irrelevant fun facts:
“Gola claims that data for men and women should not be presented together, because they do not respond to the same sexual stimuli. Actually, men and women’s preferences for sexual stimuli overlap heavily (Janssen, Carpenter, & Graham, 2003). As we described, the images were pretested to equate subjective sexual arousal in both men and women. “Sexual” images from the International Affective Picture System were supplemented, because they are processed as romantic rather than sexual by both men and women (Spiering, Everaerd, & Laan, 2004). More importantly, research has shown that differences in sexual arousal ratings attributed to gender are better understood as attributable to sexual drive (Wehrum et al., 2013). Since sexual desire was a predictor in the study, it was not appropriate to segment the sexual arousal reports by the known confound: gender.”
The above response has nothing to do with Mateusz Gola’s criticism: When viewing the exact same porn male and female brains exhibit very different brain wave (EEG) and blood flow (fMRI) patterns. For example, this EEG study found that women had far higher EEG readings than men when viewing the same sexual pictures. You can’t average together male and female EEG readings, as the Prause Studies did, and end up with anything meaningful. Nor can you compare the brain responses of a mixed group to the brain responses of another mixed group, as the Prause Studies did.
There’s a reason why none of the published neurological studies on porn users (except for Prause’s) mixed males and females. Every single neurological study involved subjects who were all the same sex and same sexual orientation. Indeed, Prause herself stated in an earlier study (2012) that individuals vary tremendously in their response to sexual images:
“Film stimuli are vulnerable to individual differences in attention to different components of the stimuli (Rupp & Wallen, 2007), preference for specific content (Janssen, Goodrich, Petrocelli, & Bancroft, 2009) or clinical histories making portions of the stimuli aversive (Wouda et al., 1998).”
“Still, individuals will vary tremendously in the visual cues that signal sexual arousal to them (Graham, Sanders, Milhausen, & McBride, 2004).”
“Many studies using the popular International Affective Picture System (Lang, Bradley, & Cuthbert, 1999) use different stimuli for the men and women in their sample.”
Large variations are to be expected with a sexually diverse group of subjects (males, females, non-heterosexuals), rendering comparisons and conclusions of the type made in the Prause Studies unreliable.
A collection of studies confirming that male and female brains respond very differently to the same sexual imagery:
In summary, the Prause Studies suffered from serious methodological flaws that call into question the studies’ results and the authors’ claims about “falsifying” the porn addiction model:
Update: In this 2018 presentation Gary Wilson exposes the truth behind 5 questionable and misleading studies, including this study (Kohut et al., 2017): Porn Research: Fact or Fiction?
1) It does not contain a representative sample. Whereas most studies show that a tiny minority of females in long-term relationships use porn, in this study 95% of the women used porn on their own. And 83% of the women had used porn since the beginning of the relationship (in some cases for years). Those rates are higher than in college-aged men! In other words, the researchers appear to have skewed their sample to produce the results they were seeking.
The reality? Cross-sectional data from the largest nationally representative US survey (General Social Survey) reported that only 2.6% of married women had visited a “pornographic website” in the last month. Data from 2000, 2002, 2004 (for more see Pornography and Marriage, 2014). While these rates may seem low, keep in mind that (1) its only married women, (2) represents all age groups, (3) its “once a month or more”: most studies ask “ever visited” or “ visited in the last year”.
2) The study used “open ended” questions where the subject could ramble on and on about porn. Then the researchers read the ramblings and decided, after the fact, what answers were “important,” and how to present (spin?) them in their paper. In other words, the study did not correlate porn use with any variable assessing sexual or relationship satisfaction. Then the researchers had the gall to suggest that all the other studies on porn and relationships, which employed more established, scientific methodology and straightforward questions about porn’s effects were flawed. Is this really science? The lead author’s website and his attempt at fundraising raise a few questions.
In reality, almost 60 studies have linked porn use to poorer sexual and relationship satisfaction (In the list of studies 1 & 2 are meta-analyses, study #3 had porn users attempt to quit using porn for 3 weeks, and studies 4 through 8 are longitudinal). While a few studies have correlated greater porn use in females to slightly greater sexual satisfaction, the vast majority of studies have not (see this list: Porn studies involving female subjects: Negative effects on arousal, sexual satisfaction, and relationships). As far as we know all studies involving males have reported porn use linked to poorer sexual or relationship satisfaction.
A bit more about this study. There were 430 participants who provided a total of 3963 responses to 42 open-ended questions about the effects of pornography use on their couple relationship. The researchers identified 66 “themes,” with each theme represented by between 621 and 5 individual responses. Despite these fatal flaws and despite the negative effects reported by some of their sample, the researchers claimed porn’s impact was overwhelmingly positive.
A few excerpts from the study showing that some couples reported significant negative effects from porn use:
Porn Replaces Partner: 90 Responses involved the perception that pornography was replacing or was in competition with partnered sex. Some responses provided a rationale by mentioning that pornography is easier, more interesting, more arousing, more desirable, or more gratifying than sex with a partner. Alternatively, some porn users pointed out their partners’ may feel like they are in competition with pornography
Decreased Arousal Response: 71 Responses discussed how pornography use is desensitizing, decreases the ability to achieve or maintain sexual arousal, or to achieve orgasm. Note as above, it can was sometimes difficult to differentiate true arousal responses from sexual interest responses so there is overlap with Decreases Interest in Sex
Sexual Desensitization (subtheme): 17 of 71 Responses that specifically described desensitization as the effect of pornography use. Often the context is vague, making it difficult to infer much meaning from surrounding context. In other places it is explicitly connected to impaired sexual arousal
Addiction: 60 Responses revolved around too much use,‘‘reliance’’ or dependence on pornography, pornography using being obsessive, or becoming a sex addict. The reliance and dependence terminology suggests theoretical connections with decreased sexual interest and arousal as well as desensitization, though this terminology was used infrequently in discussions of addiction in this sample
Loss of Intimacy or Love: 42 Responses concerned a loss of intimacy or love. There was some diversity in this category of responses. Some indicated that pornography makes sex more recreational and less about love or closeness, while others said that their partner does not like their porn use, which creates a distance in the relationship. A couple of comments suggest that distancing is a function of the discrepancy between desired pornography-inspired behavior and actual sexual behavior with a partner. Finally, at least one participants suggested that porn use contributes to a fear of intimacy
Mistrust: 29 Responses discussed how pornography use contributes to mistrust or damaged trust
Reinforces Stereotypes About Sex and Gender: 28 Responses were concerned pornography’s perpetuation of sexism, contribution to male domination or degradation of women, or reinforcement of sexual objectification
Damaged Relationship: 28 Responses described how pornography use damages or puts strain on relationships, marriages and sex life. There was some discussion of how people want less sex from a partner because the partner uses pornography
Relationship Dissolution: 23 Responses involved how pornography use contributes or may contribute to relationship dissolutions. The reasons that were offered for this consequence were diverse: porn contributes to infidelity or is perceived as possible infidelity, porn use negatively impacts sexual behavior, or porn use leads to a loss of interest in having sexual relations with the current partner
Less Enjoyment of Real Sex: 17 Responses suggested that pornography makes real sex more boring, more routine, less exiting, or less enjoyable. A minority of responses described a loss of intimacy, or loving component of having sex together
Less Satisfied with Partner: 17 Responses indicated that pornography use lowers interest in, or satisfaction with, or desire for, or attraction to a sexual partner. Partners feel like they are in competition with porn or porn stars
The current study adopted a participant-informed, “bottom-up,” qualitative approach to identifying perceived effects of pornography on the couple relationship. A large sample (N = 430) of men and women in heterosexual relationships in which pornography was used by at least one partner was recruited through online (e.g., Facebook, Twitter, etc.) and offline (e.g., newspapers, radio, etc.) sources. Participants responded to open-ended questions regarding perceived consequences of pornography use for each couple member and for their relationship in the context of an online survey. In the current sample of respondents, “no negative effects” was the most commonly reported impact of pornography use. Among remaining responses, positive perceived effects of pornography use on couple members and their relationship (e.g., improved sexual communication, more sexual experimentation, enhanced sexual comfort) were reported frequently; negative perceived effects of pornography (e.g., unrealistic expectations, decreased sexual interest in partner, increased insecurity) were also reported, albeit with considerably less frequency. The results of this work suggest new research directions that require more systematic attention.
KEYWORDS: Pornography; Relationship quality; Relationship satisfaction; Relationships; Sexual satisfaction; Sexually explicit material
A 2013 EEG study by Steele et al. reported higher P300 amplitude to sexual images, relative to neutral pictures, in individuals complaining of problems regulating their Internet pornography use [48]. Substance abusers also exhibit greater P300 amplitude when exposed to visual cues associated with their addiction [148]. In addition, Steele et al. reported a negative correlation between P300 amplitude and desire for sex with a partner [48]. Greater cue reactivity to Internet pornography paired with less sexual desire for partnered sex, as reported by Steele et al., aligns with the Voon et al. finding of “diminished libido or erectile function specifically in physical relationships with women” in compulsive Internet pornography users [31]. Supporting these findings, two studies assessing sexual desire and erectile function in “hypersexuals” and compulsive Internet pornography users reported associations between measures of hypersexuality, and reduced desire for partnered sex and sexual difficulties [15,30]. Additionally, the 2016 survey of 434 men who viewed Internet pornography at least once in the last three months reported that problematic use was associated with higher levels of arousabilty, yet lower sexual satisfaction and poorer erectile function [44]. These results should be viewed in light of the multiple neuropsychology studies that have found that sexual arousal to Internet pornography cues and cravings to view pornography were related to symptom severity of cybersex addiction and self-reported problems in daily life due to excessive Internet pornography use [52,53,54,113,115,149,150]. Taken together, multiple and varied studies on Internet pornography users align with the incentive-salience theory of addiction, in which changes in the attraction value of an incentive correspond with changes in activation of regions of the brain implicated in the sensitization process [31,106]. To sum up, in alignment with our hypothesis, various studies report that greater reactivity toward pornographic cues, cravings to view, and compulsive pornography use are associated with sexual difficulties and diminished sexual desire for partners.
A 2015 EEG study by Prause et al. compared frequent viewers of Internet pornography (mean 3.8 h/week) who were distressed about their viewing to controls (mean 0.6 h/week) as they viewed sexual images (1.0 s exposure) [130]. In a finding that parallels Kühn and Gallinat, frequent Internet pornography viewers exhibited less neural activation (LPP) to sexual images than controls [130]. The results of both studies suggest that frequent viewers of Internet pornography require greater visual stimulation to evoke brain responses when compared with healthy controls or moderate Internet pornography users [167,168]. In addition, Kühn and Gallinat reported that higher Internet pornography use correlated with lower functional connectivity between the striatum and the prefrontal cortex. Dysfunction in this circuitry has been related to inappropriate behavioral choices regardless of potential negative outcome [169]. In line with Kühn and Gallinat, neuropsychological studies report that subjects with higher tendency towards cybersex addiction have reduced executive control function when confronted with pornographic material [53,114].
1Swartz Center for Computational Neuroscience, Institute for Neural Computations, University of California San Diego, San Diego, USA; Institute of Psychology, Polish Academy of Science, Warsaw, Poland. Electronic address: [email protected].
Internet technology provides affordable and anonymous access to a wide range of pornography content (Cooper, 1998). Avail-able data show that 67.6% of male and 18.3% of female Danish young adults (18–30 years old) use pornography on the regular weekly basis (Hald, 2006). Among USA college students 93.2% of boys and 62.1% of girls were watching online pornography before age of 18 (Sabina, Wolak, & Finkelhor, 2008). For the majority of users, pornography viewing plays a role in entertainment, excitement, and inspiration (Rothman, Kaczmarsky, Burke, Jansen, & Baughman, 2014) (Häggström-Nordin, Tydén, Hanson,& Larsson, 2009), but for some, frequent pornography consumption is a source of suffering (about 8% out of users according to Cooper et al., 1999) and becomes a reason for seeking treatment (Delmonico and Carnes, 1999; Kraus, Potenza, Martino, & Grant,2015; Gola, Lewczuk, & Skorko, 2016; Gola and Potenza, 2016). Due to its widespread popularity and conflicting clinical observations, pornography consumption is an important social issue, garnering much attention in the media, (e.g., high-profile movies: “Shame” by McQueen and “Don Jon” by Gordon-Levitt) and from politicians(e.g., UK prime minister David Cameron’s 2013 speech on pornography use by kids), as well as neuroscience research (Steele, Staley, Fong, & Prause, 2013; Kühn and Gallinat, 2014; Voon et al., 2014). One of the most frequently asked questions is: whether pornography consumption can be addicting?
The finding of Prause, Steele, Staley, Sabatinelli, & Hajcak, (2015) published in the June issue of Biological Psychology delivers interesting data on this topic. The researchers showed that men and women reporting problematic pornography viewing (N = 55),1 exhibited lower late positive potential (LPP – an event related potential in EEG signaling associated with significance and subjective silence of the stimuli) to sexual images as compared with non-sexual images, when compared with the responses of controls. They also show that problematic pornography users with higher sexual desire have smaller LPP differences for sexual and non-sexual images. The authors concluded that: “This pattern of results appears inconsistent with some predictions made by addiction models” (p. 196) and announced this conclusion in the article’s title: “Modulation of late positive potentials by sexual images in problem users and controls inconsistent with “porn addiction””.
Unfortunately, in their article, Prause et al. (2015) did not explicitly define which model of addiction they were testing. Presented results when considered in relation to the most established models either do not provide clear verification of the hypothesis that problematic pornography use is an addiction (like in case of Incentive Salience Theory; Robinson and Berridge, 1993; Robinson, Fischer, Ahuja, Lesser, & Maniates, 2015) or support this hypothesis (like in case of Reward Deficiency Syndrome; Blum et al., 1996; 1996; Blum, Badgaiyan, & Gold, 2015). Below I explain it in details.
Correspondence address: Swartz Center for Computational Neuroscience, Institute for Neural Computations, University of California San Diego, 9500 Gilman Drive, San Diego, CA 92093-0559, USA. E-mail address: [email protected]
1 It is worthy to notice that the authors present results for male and female participants together, while recent studies shows that sexual images ratings of arousal and valence differs dramatically between genders (see: Wierzba et al., 2015)
2 This guess is supported by fact that references used in Prause et al. (2015) also refer to IST (i.e. Wölfling et al., 2011
Why theoretical framework and clear hypothesis matter
Based on the multiple uses of the term “cue-reactivity” by the authors we may guess that the authors have in mind Incentive Salience Theory (IST) proposed by Robinson and Berridge (Berridge, 2012; Robinson et al., 2015).2 This theoretical frame-work distinguishes two basic components of motivated behavior − “wanting” and “liking”. The latter is directly linked to the experienced value of the reward, while the former is related to the expected value of the reward, typically measured in relation to a predictive cue. In terms of Pavlovian learning, reward is an unconditioned stimulus (UCS) and cues associated with this reward through learning are conditioned stimuli (CS). Learned CSs acquire incentive salience and evoke “wanting”, reflected in motivated behavior (Mahler and Berridge, 2009; Robinson & Berridge, 2013). Thus they acquire similar properties as the reward itself. For example domesticated quail willingly copulate with a terrycloth object (CS) previously paired with the opportunity to copulate with a female quail (UCS), even if a real female is available (Cetinkaya and Domjan, 2006)
According to IST, addiction is characterized by increased “wanting” (elevated cue-related reactivity; i.e. higher LPP) and decreased “liking” (diminished reward-related reactivity; i.e. lower LPP). In order to interpret data within the IST framework researchers must clearly disentangle cue-related “wanting” and reward-related “liking.” Experimental paradigms testing both processes introduce separate cues and rewards (i.e. Flagel et al., 2011; Sescousse, Barbalat, Domenech, & Dreher, 2013; Gola, Miyakoshi, & Sescousse, 2015). Prause et al. (2015) instead use a much simpler experimental paradigm, wherein subjects passively view different pictures with sexual and non-sexual content. In such simple experimental design the crucial question from the IST perspective is: Do the sexual images play the role of cues (CS) or rewards (UCS)? And therefore: does the measured LPP reflect “wanting” or “liking”?
The authors assume that sexual images are cues, and there-fore interpret decreased LPP as a measure of diminished “wanting.”Diminished “wanting” with respect to cues would indeed be inconsistent with the IST addiction model. But many studies show that sexual pictures are not mere cues. They are rewarding in them-selves (Oei, Rombouts, Soeter, van Gerven, & Both, 2012; Stoléru,Fonteille, Cornélis, Joyal, & Moulier, 2012; reviewed in: Sescousse, Caldú, Segura, & Dreher, 2013; Stoléru et al., 2012). Viewing sexual images evokes ventral striatum (reward system) activity (Arnowet al., 2002; Demos, Heatherton, & Kelley, 2012; Sabatinelli, Bradley,Lang, Costa, & Versace, 2007; Stark et al., 2005; Wehrum-Osinskyet al., 2014), dopamine release (Meston and McCall, 2005) and both self-reported and objectively measured sexual arousal (review: Chivers, Seto, Lalumière, Laan, & Grimbos, 2010).
The rewarding properties of sexual images may be innate due to the fact that sex (like food) is a primary reward. But even if some-one rejects such innate rewarding nature, rewarding properties of erotic stimuli may be acquired due to Pavlovian learning. Under natural conditions, visual erotic stimuli (such as a naked spouse or pornographic video) may be a cue (CS) for sexual activity leading to the climax experience (UCS) as a result of either dyadic sex or solitary masturbation accompanying pornography consumption. Furthermore in the case of frequent pornography consumption, visual sexual stimuli (CS) are strongly associated with orgasm (UCS)and may acquire properties of reward (UCS; Mahler and Berridge, 2009; Robinson & Berridge, 2013) and then lead to approach (i.e.seeking pornography) and consummatory behaviors (i.e., hours of viewing before reaching climax).
Regardless of innate or learned reward value, studies show that sexual images are motivating in themselves, even without the possibility of climax. Thus they have intrinsic hedonic value for humans (Prévost, Pessiglione, Météreau, Cléry-Melin, & Dreher,2010) as well as rhesus macaques (Deaner, Khera, & Platt, 2005). Their rewarding value may even be amplified in an experimental setting, where a climax experience (natural UCS) is unavailable, as in the Prause et al.’s (2015) study (“participants in this study were instructed not to masturbate during the task”, p. 197). According to Berridge, task context influences reward prediction (Berridge,2012). Thus, as no other pleasure than sexual images was available here, the viewing of pictures was the ultimate reward (rather than simply a cue).
Decreased LPP for sexual rewards in problematic pornography users is consistent with addiction models
Taking all of the above into account we may assume that sexual images in the Prause et al. (2015) study, instead of being cues, might have played the role of rewards. If so, according to the IST framework, lower LPP for sexual vs. non-sexual pictures in problematic pornography users and subjects with high sexual desire indeed reflects diminished “liking”. Such a result is in line with the addiction model proposed by Berridge and Robinson (Berridge, 2012; Robinson et al., 2015). However, to fully verify an addiction hypothesis within IST framework, more advanced experimental studies, disentangling cue and reward are required. A good example of a well designed experimental paradigm was used in studies on gamblers by Sescousse, Redouté, & Dreher (2010). It employed monetary and sexual cues (symbolic stimuli) and clear rewards(monetary wins or sexual pictures). Due to lack of well defined cues and rewards in Prause et al. (2015) study, role of sexual pictures remains unclear and therefore obtained LPP effects are ambiguous within IST framework. For sure conclusion presented in the study’s title “Modulation of late positive potentials by sexual images in problem users and controls inconsistent with “porn addiction” is ungrounded with respect to IST
If we take another popular addiction model – Reward Deficency Syndrome (RDS; Blum et al., 1996, 2015) the data obtained by the authors actually speaks in favor of addiction hypothesis. RDS frame-work assumes that genetic predisposition to lower dopaminergic response for rewarding stimuli (expressed in diminished BOLD and electrophysiological reactivity) is related to sensation-seeking, impulsivity and higher risk of addiction. The authors’ findings of lower LPPs in problematic pornography users is entirely consistent with the RDS addiction model. If Prause et al. (2015) were testing some other model, less well known than IST or RDS, it would be highly desirable to present it briefly in their work.
Final remarks
The study by Prause et al. (2015) delivers interesting data on problematic pornography consumption.3 Yet, due to the lack of clear hypothesis statement which addiction model is tested and ambiguous experimental paradigm (hard to define role of erotic pictures), it is not possible to say if the presented results are against, or in favor of, a hypothesis about “pornography addiction.” More advanced studies with well defined hypotheses are called for. Unfortunately the bold title of Prause et al. (2015) article has already had an impact on mass media,4 thus popularizing scientifically unjustified conclusion. Due to the social and political importance of the topic of the effects of pornography consumption, researchers should draw future conclusions with greater caution.
3 It is worthy to notice that in Prause et al. (2015) problematic users consume pornography in average for 3.8 h/week (SD = 1.3) it is almost the same as non-problematic pornography users in Kühn and Gallinat (2014) who consume in average 4.09 h/week (SD = 3.9). In Voon et al. (2014) problematic users reported 1.75 h/week (SD = 3.36) and problematic 13.21 h/week (SD = 9.85) – data presented by Voon during American Psychological Science conference in May 2015.
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UPDATE 2: Landripet & Stulhofer’s paper omitted two significant correlations they presented to a European conference:
Reporting a preference for specific pornographic genres were significantly associated with erectile (but not ejaculatory or desire-related) male sexual dysfunction.
Increased pornography use was slightly but significantly associated with decreased interest for partnered sex and more prevalent sexual dysfunction among women.
UPDATE 4: (August, 2016): Peer-reviewed paper by US Navy doctors – Is Internet Pornography Causing Sexual Dysfunctions? A Review with Clinical Reports (2016)– It’s an extensive review of the literature on porn-induced sexual problems. The review provides the latest data revealing a tremendous rise in youthful sexual problems. The paper also examines the neurological studies related to porn addiction and sexual conditioning. The doctors provide 3 clinical reports of men who developed porn-induced sexual dysfunctions.
THE ARTICLE
Study on young men: ED rates of 31%; low libido 37%, but, hey, it can’t be porn
The conclusion of this brief paper on young men in Portugal, Croatia and Norway stated that:
Pornography does not seem to be a significant risk factor for younger men’s desire, erectile, or orgasmic difficulties.
Let’s’ examine a few major problems with this overly confident conclusion.
PROBLEM 1: Study reports incredibly high rates of ED & low sexual desire
This simple cross-sectional study comparing a pair of existing databases found rates of ED as high as 31% and rates of ‘low sexual desire’ as high as 37% in men 18-40. Yet the title and abstract mention neither of these findings. Instead, the authors reassure us that “It’s not the porn”, even though the study acknowledges an ED epidemic in young men:
“Several large-scale epidemiological studies recently pointed to a high prevalence of erectile dysfunction (ED) among younger men.”
What were the ED rates in young men in the new study, which is based on a 2011 questionnaire and another from 2014?
“In Study 1, 14.2–28.3% of participants reported ED” (2011)
“In Study 2, 30.8% of men were classified as having ED” (2014)
Note the continued rise in ED rates even between the 2011 survey and the 2014 survey. Back in 2004, Stulhofer’s research showed that ED rates in men 35-39 were only 5.8%!
This study found the same extraordinarily high rates of unexplained ED in young men found in several other studies. What were ED rates before the Internet? Kinsey (1948) reported less than 3% rate of ED for men under 40, and less than 1% for men 19 and under. The only cross-sectional study of ED rates in American men reported a 5% rate of ED in men ages 18-59. This was based on data from 1992, and one third of the men were over40. Similarly, a 2002 meta-analysis by Dutch researchers reported that of 6 studies analyzed, 5 found ED rates for men under 40 were approximately 2%. The other one reported rates of 9%.
Also note that in the first survey, “low sexual desire” rates were an alarming 16.3% to 37.4%. How can almost 40% of young men have low libido? Such high rates were unheard of only a few short years ago. For example, in 2004, Italian urologist Carlo Foresta found low-sexual-desire rates of only 1.7% in teens. However, rates had jumped 600% to 10.3% by 2012.
Bottom line: ED rates for men under 40 have increased at least 600% in the last 20 years, and the study’s authors assert that porn is not the cause. What other variable has changed radically in the last 15-20 years?
PROBLEM 2: The only variable assessed was frequency of use in the last 12 months
The authors only assess one variable related to porn use across all subjects: self-reported frequency of use (not hours of use) over the last 12 months. There are several problems with this limited measure:
Frequency of use may have no relationship to hours per week, let alone various other, more relevant, variables of use
It tells us nothing about porn use prior to the last 12 months
It tells us nothing about total porn use over a lifetime
The authors conclude that in their cross-sectional study, using the questions they used, there is little evidence that frequency of porn determines which young men develop sexual dysfunctions. This result is not altogether surprising. In fact, one of the most common questions posed on recovery forums is, “Why did I develop PIED when my friends watch as much (or more) porn than I do?”
Instead of frequency of use, a combination of variables appear to be involved in porn-induced ED. These include:
Total hours of use
Years of use
Age started consistent porn use
Escalation to new genres
Development of porn-induced fetishes (from escalating to new genres of porn)
Ratio of masturbation to porn versus masturbation without porn
Ratio of sexual activity with a person versus masturbation to porn
Gaps in partnered sex (where one relies only on porn)
Virgin or not
Addiction-related brain changes or not
Presence of porn addiction/hypersexuality
Genetics
What other aspects of internet porn use might better explain porn-related sexual dysfunctions? German researchers found that intensity of arousal and number of applications opened were associated with porn-related problems, while time spent watching was not.
Results indicate that self-reported problems in daily life linked to online sexual activities were predicted by subjective sexual arousal ratings of the pornographic material, global severity of psychological symptoms, and the number of sex applications used when being on Internet sex sites in daily life, while the time spent on Internet sex sites (minutes per day) did not significantly contribute to explanation of variance in IATsex score. Personality facets were not significantly correlated with the IATsex score. [emphasis added]
To reiterate, the Germans found that time spent watching porn was not a factor in either porn addiction or the negative consequences of using. Instead it was the number of applications (genres), and one’s response to porn use, that made the difference. That is, a need for novelty and more stimulation. Similarly, hours of use by internet videogamers also do not predict problems. Rather, motives and obsessive passion for gaming are predictive.
In short, criteria for diagnosing problems with internet use need to be broader than hours/frequency of use. This casts doubt of the usefulness and conclusions of the “Brief Communication” under discussion here. Danish porn researcher Gert Martin Hald’s editorial comments echoed the need to assess more variables (mediators, moderators) than just frequency per week in the last 12 months:
Third, the study does not address possible moderators or mediators of the relationships studied nor is it able to determine causality. Increasingly, in research on pornography, attention is given to factors that may influence the magnitude or direction of the relationships studied (i.e., moderators) as well as the pathways through which such influence may come about (i.e., mediators). Future studies on pornography consumption and sexual difficulties may also benefit from an inclusion of such focuses.
Bottom line: All complex medical conditions involve multiple factors which must be teased apart. In any case, the authors’ statement that, “Pornography does not seem to be a significant risk factor for younger men’s desire, erectile, or orgasmic difficulties“ is unsupported, since it ignores all the other possible variables related to porn use that might be causing sexual performance problems in users. Before confidently claiming that we have nothing to worry about from internet porn, one still needs to explain away the very recent, astonishing rise in youthful ED and low sexual desire.
PROBLEM 3: Study excluded virgins and men who hadn’t had intercourse in the last 12 months
The two populations most likely to report porn-induced ED, virgins and men not having sex, were excluded from the survey. It’s not unusual for men with PIED to say they have remained virgins because they cannot achieve strong enough erections to penetrate. Many sexually experienced men say they no longer attempt sex due to PIED.
In other words, this survey wouldn’t pick up new ED in guys who had sex almost a year ago. It also wouldn’t pick up sexual dysfunctions in those who haven’t had sex in the last year, or who have exclusively been using internet porn to climax, or those who are virgins because they can’t get it up without porn. And were these men to be included (and asked if they can masturbate without internet porn), it may well be that a correlation between frequency of porn use and ED/low sexual desire would have appeared.
PROBLEM 4: The study actually found a few correlations between ED and porn use
The abstract doesn’t mention a pretty important correlation: Only 40% of the Portuguese men used porn “frequently”, while the 60% of the Norwegians used porn “frequently”. The Portuguese men had far less sexual dysfunction than the Norwegians.
Elsewhere, the authors acknowledge a statistically significant association between more frequent porn use and ED, but claim the effect size was small. However, this claim may be misleading according to an MD who is a skilled statistician and has authored many studies:
Analyzed a different way (Chi Squared), … moderate use (vs. infrequent use) increased the odds (the likelihood) of having ED by about 50% in this Croatian population. That sounds meaningful to me, although it is curious that the finding was only identified among Croats.
The authors blow this finding off and ignore it in reaching their conclusions, but in Gert Martin Hald’s formal comments about the study he says:
However, in pornography research, the interpretation of “size” may depend as much on the nature of the outcome studied as the magnitude of the relationship found. Accordingly, if the outcome is to be considered “sufficiently adverse” (e.g., sexual aggressive behaviors), even small effect sizes may carry considerable social and practical significance [2].
Landripet and Stulhofer omitted two correlations which they presented to a European conference:
However, increased pornography use was slightly but significantly associated with decreased interest for partnered sex and more prevalent sexual dysfunction among women.
Reporting a preference for specific pornographic genres were significantly associated with erectile, but not ejaculatory or desire-related male sexual dysfunction.
It’s quite telling that Landripet & Stulhofer chose to omit a very significant correlation between erectile dysfunction and preferences for specific genres of porn from their paper. It’s quite common for porn users to escalate into genres that do not match their original sexual tastes, and to experience ED when these conditioned porn preferences do not match real sexual encounters. As pointed out below, it’s very important to assess the multiple variables associated with porn use – not just hours in the last month, or frequency in the last years.
PROBLEM 5: Claiming a 1000% increase in youthful ED can be explained by other factors.
So how do the authors explain the current ED epidemic in men under 40? They suggest the epidemic must arise from he same old factors that existed before the internet.
“Epidemiological studies suggest that unhealthy lifestyles, substance abuse, stress, depression, intimacy deficit, and misinformation about sexuality are more likely factors behind male sexual dysfunctions than pornography use.”
The authors are simply quoting earlier studies that suggest smoking, lack of exercise, and drug use may be factors, because those are the historical factors, but this conclusion is difficult to swallow.
“Prevalence of ED in 1,947 men was 35.0% (73.7% mild, 26.3% moderate/complete)…. Also, no association was found between ED and smoking, alcoholism, obesity, sedentary life, diabetes, hypertension, cardiovascular disease, hyperlipidemia, depression or anxiety.”
But what about the claim that “misinformation about sexuality” and “intimacy deficits” are now playing a major role in ED? Simply pulled out of the air, an exercise in creative writing.
And why have the authors ignored the research showing evidence of a link porn use and sexual dysfunction? Cambridge University, for example, reported that 60% of their porn-addicted subjects had problems with erections and desire with real partners, but not with porn. In this 2014 case study a man with low libido and anorgasmia healed his both sexual dysfunctions by eliminating porn for 8 months.
We are back to asking “What one major variable influencing sexuality has changed since 1992?” Let me guess: internet porn.
Still other sexologists doggedly parrot the outdated assumption that all youthful ED with partners is solely “performance anxiety.” Yet if a young man cannot masturbate without porn in private – but can perform just fine masturbating privately with internet porn, isn’t it a bit premature to conclude his issue is “anxiety about performance?” Is he “anxious when performing” with his own hand?
Compulsive sexual behaviour disorder seems to fit well with non-substance addictive disorders proposed for ICD-11, consistent with the narrower term of sex addiction currently proposed for compulsive sexual behaviour disorder on the ICD-11 draft website. We believe that classification of compulsive sexual behaviour disorder as an addictive disorder is consistent with recent data and might benefit clinicians, researchers, and individuals suffering from and personally affected by this disorder.
And I will be quite happy to see your ‘bullet in the barrel’ critique be thrown out the window.
\
In apparent retaliation for Wilson’s February Twitter comments Betzler & Stroozas created a section about Wilson, which featured a baseless April 25, 2018 (i.e., a year earlier) Los Angeles police report filed, and supplied to The Racquet, by 
Clerk endorsed – Please confirm & check for sleepers. The behavioral evidence (fixation on 
Confirmed to each other and 
Unrelated to NeuroSex:
We will start with Prause’s consistent claims to the media that no studies have been published that support either porn addiction or porn-induced sexual problems. Prause said this in the Congressional Quarterly Researcher (2016, October 21):
With respect to Grubbs’s bias, it is even more telling that the 3 studies named above omit every neurological and neuropsychological study that found evidence in support of the porn addiction model (over 40 
A few comments on Ley’s lies and spin.
Behavioral Sciences is PubMed indexed, unlike the journals that have accepted Ley’s 2 opinion pieces (e.g. Porn Studies Journal, Current Sexual Health Reports).
Typical Ley. Among the eight authors were seven physicians with the following expertise: two urologists, a neuroscientist, and two psychiatrists, and a general medical physician.” One author, Dr. Klam, is Director of Mental Health at the Naval Medical Center – San Diego. As for the ophthalmologist, Dr. Doan is both an MD and a PhD (Neuroscience – Johns Hopkins), is the former of Head of “Addictions and Resilience Research” in the Department of Mental Health at the Naval Medical Center. In addition to the papers on internet pornography, Doan has authored multiple papers on behavioral addiction/pathologies relating to technologies, (he published peer-reviewed studies before he evengraduating from high school).
Ley thinks it was egregious for the doctors to suggest giving up the sex toy and porn (even though the sailor was severely distress about his toy/porn induced sexual problems). An excerpt from the case-report exposing Ley’s advice as malpractice:
More evidence that Ley should handing out sexual advice.
A comment by a Prause alias (she dares not comment as herself as she is involved in 2 lawsuits as of August, 2016):
An idiotic comment as Park et al., 2016 was not a study, but a review. As exposed on the current page, Prause is lying about ethics problems and the case reports. But what do you expect from MDPI’s cyberstalker?
Another comment by a Prause alias:
As above, Park was a review, so it did not present experimental data. However, it contained massive data throughout and 200 references.
——————
January, 2017 (and earlier): Prause employs multiple sock puppets (including “NotGaryWilson“) to edit Wikipedia pages
The use of multiple user accounts to edit Wikipedia pages violates Wikipedia rules and is referred to as “sock puppetry” (or simply “socking”). We have already revealed one of Prause’s sock puppets, who edited the Belinda Luscombe Wikipedia page that day after TIME published Luscombe’s cover story, “Porn and the Threat to Virility,” which Prause disapproved of. It’s clear from the comments, content, and usernames that Nicole Prause has created several more accounts to edit Wikipedia articles, such as “pornography addiction,” “sex addiction” and “effects of pornography.”
First, here’s a list of edits done by a Prause sock puppet identified only by an IP address (75.82.147.215). Note the comment associated with this one particular edit:
Naming “Gary Wilson” is a dead give-away that the above user account is Nicole Prause. Reality Check: Gary Wilson makes no money related to this endeavor, and he did not add the DeltaFosB section to the “Pornography Addiction” Wiki page. As time passed, Prause fell back into her usual pattern of creating usernames with 3-4 capitalized words. For example:
While the above edits suggest that all are Prause as they consistently attack IITAP, Carnes, the addiction model, and falsely claim there’s no science supporting either porn or sex addiction. If there was any doubt, two of them once again comment about Gary Wilson and DeltaFosB. First, a telling “PatriotsAllTheWay” comment:
A few comments: 1) All of Gary Wilson’s profits from the sales of his book go to charity, and his website is otherwise entirely non-commercial; 2) Contrary to Prause’s claim, DeltaFosB is present in humans and all neuroscientists studying its mechanisms agree that DeltaFosb is involved with multiple physiological functions, including sensitization to sexual activity and addiction.
A Wikipedia “user-page” is automatically created for every username that edits a Wikipedia article. “NotGaryWilson” is the only Prause sock puppet to have made a comment on its user page. Here’s what “NotGaryWilson” wrote about the “Sex Addiction” article:
As with the “Pornography Addiction” Wikipedia page, Gary Wilson in fact added none of the DeltaFosB material to the “Sexual Addiction” Wikipedia page. As stated, Wilson is paid by no one, and makes no money on this endeavor. Finally, only non-academics David Ley and Nicole Prause ever assert that DeltaFosB is not involved with initiating addiction-related brain changes. (Prause is particularly obsessed discrediting with DeltaFosB.) Contrary to their unsupported rantings, DeltaFosB’s role in addiction and sensitization is well established in both animal and human studies (see list 1 and list 2 for DeltaFosB studies). A veteran Wikipedia editor responds to the above comments by “NotGaryWilson”:
And,
Don’t hold your breath for broad (legitimate) support for unsupported claims about Wilson or DeltaFosB. Sometimes Prause uses an IP address as a username. This Wikipedia user only edited “Sex Addiction” blabbering on about “FosB” and CSATs & IITAP – two of Prause’s favorite targets:
It appears that Nicole Prause employed two additional usernames to edit the Fight The New Drug Wikipedia page (FTND is one of Prause’s favorites targets):
What makes us suspect that both usernames are Nicole Prause? Not only did both usernames edit only the FTND Wikipedia page, both created the section featuring Prause’s often-tweeted op-ed that appeared in the Salt Lake City Tribune. Prause wrote the critique of Fight the New Drug’s previous op-ed, then persuaded 7 of her PhD buddies to sign off on it. Prause’s op-ed cited only a few irrelevant citations, while offering no neuroscience-based studies. It also made several false statements about the content and references in the earlier FTND op-ed. Several experts responded with this dismantling of the Prause op-ed: Op-ed: Who exactly is misrepresenting the science on pornography? (2016).
In late November, 2017 Prause once again asked the ICD-11 to delete the proposed diagnosis of “Compulsive sexual behavior disorder” (sex addiction, porn addiction). Her entire argument on the ICD rested upon a press release by 3 non-profit kink organizations (Center for Positive Sexuality, National Coalition for Sexual Freedom, and The Alternative Sexualities Health Research Alliance), and AASECT’s 2016 proclamation. (In addition, she falsely claimed that ATSA supported her views.) YBOP wrote an article dismantling the “group position” paper opposing porn and sex addiction (November, 2017). A few days later Prause used two new usernames to edit the Sex Addiction Wikipedia page adding content that mirrors her ICD-11 request to abolish “Compulsive Sexual Behavior Disorder”:
In a rare turn of events, the Nicole Prause Wikipedia page was created by a Wikipedia employee. Whatever this employee’s motivation, there is little doubt that two primary usernames editing thsi page are Prause herself:
As pointed out above, Prause’s usernames often conatin 2-3 capitalized words. The last user name – OMer1970 – likely stands for “Orgasmic Meditation”, as this user’s edits are about Prause’s study on the effects of “Orgasmic Mediation”(commonly called “OM”). Prause is receiving a whole lot of money to study “the benefits” of OM, which involves a man straddling a woman and stroking clitoris. A 3-day workshop OM workshop costs $3,999.00 per person (if paid in full). It also appears that Prause may have obtained porn performers as subjects through another porn industry interest group, the Free Speech Coalition. The FSC-obtained subjects were allegedly used in her hired-gun study on the heavily tainted and very commercial “Orgasmic Meditation” scheme (which is now being investigated by the FBI).
Others – April, 2017: Prause insults Professor Gail Dines, PhD, perhaps for joining the Op-ed: Who exactly is misrepresenting the science on pornography? (plus updates)
Prause, who has not been affiliated with any academic institution since early 2015, attacks Professor Dines in a Tweet:
This public insult was part of a thread where Prause scathingly assailed a university student in Sweden for endeavoring to study abuse of porn performers (later deleted by Prause).
Another tweet calling both Gail Dines and Fight The New Drug (FTND) liars and “anti-LGBT” and “anti-woman”:
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The @BrainOnPorn twitter is believed to be Prause. who uses it to disparage the same people Prause does, while promoting the porn industry’s agenda. Here, RealYBOP trolls an account that quotes Gail Dines (April 22, 2019).