Critique of “No Evidence of Emotion Dysregulation in Hypersexuals Reporting Their Emotions to a Sexual Film” (2013)

SPAN Lab porn study obscures results with study title

Results in a study by SPAN Lab entitled, “No Evidence of Emotion Dysregulation in “Hypersexuals” Reporting Their Emotions to a Sexual Film,” align with what some ex-porn users are reporting. Namely, that porn curtailed their emotional range. Or more simply, frequent porn users are more desensitized to porn than are healthy subjects who use very little porn. However, the title of SPAN Lab’s study obscures this obvious finding. (More below.)

The study

The study compared the emotional range of so-called “hypersexuals” with controls in response to viewing a 3-minute nature film and a 3-minute sex film. The lab’s working hypothesis for the study was that “hypersexuals” would report higher levels of both positive and negative emotions compared with controls. That is, after viewing the sex film, the “hypersexuals” were predicted to show high levels of positive emotions, such as sexual arousal or excitement, as well as high levels of negative emotions, such as embarrassment or anxiety. The authors call the simultaneous experience of greater positive and negative emotions in the face of a stimulus “coactivation.”
However, the researchers said:

• “This study actually found evidence for the opposite pattern: those complaining of difficulty regulating their viewing of “porn” (VSS) had less mixed emotional responses to sexual films than those who did not report problems regulating their viewing.”
• “Persons complaining of problems regulating their viewing of visual sexual stimuli exhibited less coactivation of positive and negative affect than controls.”
• “The effects actually were in the opposite of the predicted direction, not merely weaker.” (Emphasis added)

Wrong hypothesis and Poor Methodology

SPAN Lab researchers admit that there are no prior studies on which to base their hypothesis that today’s problem porn users should have experienced greater positive and negative emotional response to a sexual film.

• “Research concerning hypersexuality has not yet specified exactly when emotion dysregulation is thought to occur, and clinical publications conflict as to when emotion dysregulation is expected.”
• “There is no accepted measure of ‘level of coactivation.’”

They used a theoretical sexual-addiction model (developed prior to the Internet, and based on assumptions about addicts who act out with real people), claiming that,

•  “Many proponents of a “hypersexual disorder” suggest that affect dysregulation is a key feature of the disorder.”

There is no citation for this statement, and there’s reason to question whether classic sex-addiction concepts necessarily apply to today’s Internet porn addicts.

Isn’t it likely that SPAN Lab’s hypothesis was simply backward, and that the controls were predictably more likely to show the wider range of emotions (they in fact showed)? After all, the researchers clearly stated that an earlier study had found that it is normal to have a wide range of positive and negative emotions in response to erotic films:

• “In general, sexual stimuli tend to produce high coactivation of negative and positive feelings in response to sexual stimuli.(Peterson & Janssen, 2007).”

In other words, the controls were perfectly normal. It was the problem porn users who were out of alignment. The compulsive porn users were simply bored by the vanilla porn. They were desensitized to vanilla porn. Interestingly, numbed emotions are a common complaint of heavy Internet porn viewers—although most of them don’t realize porn muted their emotions until well after they quit using it. Here are typical comments by ex-users showing the loss of highs and lows:

First guy: “Once you quit the porn and the fapping you gotta accept the emotions you’ll feel. For me it was loneliness, sadness, neediness, etc. But these pass as you become more comfortable with yourself. The highs you feel are augmented and feel higher than before. The lows are augmented too and you nosedive further than before. Fapping to porn just kept me numb to the world but now I feel human emotions better than ever before.”

Second guy: “The thing about quitting porn, is that it cures the numbness. For me, all of the colors came back into my life. Music started sounding better, movies would make me cry (nobody make fun, or I’ll kick your butt! 😉 ); I laugh a lot more; I have way more fun in social settings, etc. I  went through a nasty period of sadness. But later, everything started falling into place, and ALL of your emotions become stronger. Don’t worry, though, as time goes by, life just keeps getting more and more awesome!”

Bottom Line: There’s a very simple explanation for compulsive porn user having less emotional response to viewing vanilla porn.  The compulsive porn users were bored. Vanilla porn no longer registered as all that interesting. They were desensitized. In fact, this is exactly what Prause reported 2 years later in a study involving many of the same subjects

Wrong theoretical basis and poor methodology

UPDATE: The subjects in this study appear to be the same subjects used in two later studies published by SPAN Lab. At the bottom of the page you can read the myriad problems outlined in these two later critiques of SPAN lab studies:

1. STUDY ONE
2. STUDY TWO

The researchers used sexual-addiction theory from decades ago, as well as the term “hypersexuals,” thereby implying that they are discovering useful information about sex addicts—without using the term. They also imply that these people, popularly regarded as “porn addicts,” don’t have the dysregulated emotions of sex addicts (and therefore perhaps are not addicts at all). Yet there are several problems with this effort:

No addiction screening
The researchers did not pre-screen the participants for Internet porn addiction, so we can’t be sure their participants are addicts. “Hypersexual” and “difficulty controlling porn use” are vague terms in comparison with an actual Internet porn addiction designation via a screening test. If the researchers are going to suggest that they’re discovering things about Internet porn addicts they need to start by screening for porn addiction.

Need homogeneous participants
The researchers need to investigate homogeneous participants, rather than a mix of men and women of various sexual orientations. A 3-minute heterosexual film might have widely different effects, depending upon participants’ sexual orientation and current porn tastes. For example, a lesbian porn addict might experience aversion when watching the heterosexual porn film, thus skewing overall results. Sorting out emotional responses in addicts is a highly nuanced endeavor.

Classic sexual addiction theory irrelevant
Today’s young Internet users often don’t fit the classic sex addiction model, which was based on childhood trauma and shame. They are perfectly at ease with porn use, which many believe is beneficial. The average age of the problem porn users in this study was only 24, making them quite likely members of Generation XXX.

Thus, it’s not clear that these participants would exhibit classic emotions such as anxiety or embarrassment (negative emotions) even if addicted. Indeed, is there any sound reason to think that young porn addicts viewing a 3-minute erotic movie in the lab, who have even been told not to masturbate, would be triggered to feel any negative emotions due to the film clip?
In any case, labeling Internet porn addicts as “hypersexuals” doesn’t render them subject to sex addicts’ (purported) emotional responses. Again, the researchers’ hypothesis is weak.

Key addiction neuroscience concepts ignored
The researchers give no indication that they understand the difference between “sensitization” and “desensitization,” or the importance of designing their research around these key neurochemical characteristics of addiction.

Porn addictions can be very specific and tied to particular fetishes. They often involve rather extreme porn because many porn addicts escalate as they need edgier material to become aroused. Visual triggers for their unique cues can cause a powerful reaction, while visual cues that don’t serve as triggers may be of milder interest. Hyper-reactivity to specific cues is known as “sensitization.”

On the other hand, “desensitization” refers to decreased responsiveness to stimuli not tied directly to an addiction. This overall numbed pleasure response has been observed in Internet addicts, food addicts and gambling addicts. It’s quite likely that the same mechanism that numbs these other behavioral addicts to normal pleasure (and satisfaction) is also narrowing porn addicts’ range of emotional responses to porn visuals.

Incidentally, changes in dopamine levels and dopamine sensitivity appear to be one factor behind the “desensitization” phenomenon. For example, consider the experience of this healthy young medical student, who voluntarily had his dopamine response blocked with a drug, and experienced profound, temporary changes:

“After 7 hours, Mr. A felt more distance between himself and his environment. Stimuli had less impact; visual and audible stimuli were less sharp. He experienced a loss of motivation and tiredness. After 18 hours, he had difficulty waking up and increasing tiredness; environmental stimuli seemed dull. He had less fluency of speech.”

The point is that it would be a rare generic 3-minute lab film that would elicit an accurate measure of positive and negative emotions for today’s Internet porn addicts. For some it would be dull (or even aversive if it doesn’t match their sexual orientation). For others it would be mildly arousing. Yet others might be highly sensitized to (aroused by) some aspect of it. However, it still might not reflect their emotional range after a full, private porn session with visuals of their own choice.

Ideally, researchers would choose a stimulus that matches each addict’s addiction—namely, each subject’s preferred genre of porn.

In any case, research that doesn’t ascertain whether it is recording addicts’ “sensitized” reactions or their numbed “desensitized” reactions can’t tell us much. Again, the general pattern for addicts is to be somewhat numb to everyday stimuli, and hyper-aroused to cues that tap into their particular addiction.

In conclusion

All of the possible confounds need to be controlled for before SPAN Lab can discover useful things about emotional dysregulation in problem porn users.

The lab may also want to choose more realistic hypotheses, and match their titles to their actual results. For example, a more accurate title for this study would have been, “Problem Porn Users Show Narrower Range Of Emotional Responses To Visual Sexual Stimuli Than Controls.”

THE PROBLEMS WITH THE SUBJECTS

It appears that the above study, Steele et al (2013), and Prause et al (2015) used many of the same subjects. The following is excerpted from a critique of Steele et al.

A major claim by Steele et al is that the lack of correlations between subjects EEG readings (P300) and certain questionnaires means porn addiction doesn’t exist. Two major reasons account for the lack of correlation:

1. The researchers chose vastly different subjects (women, men, heterosexuals, non-heterosexuals), but showed them all standard, possibly uninteresting, male+female sexual images. Put simply, the results of this study were dependent on the premise that males, females, and non-heterosexuals are no different in their response to sexual images. This is clearly not the case (below).
2. The two questionaires Steele et al. relied upon in both EEG studies to assess “porn addiction” are not validated to screen for internet porn use/addiction. In the press, Prause repeatedly pointed to the lack of correlation between EEG scores and “hypersexuality” scales, but there is no reason to expect a correlation in porn addicts.

Unacceptable Diversity Of Test Subjects: The researchers chose vastly different subjects (women, men, heterosexuals, non-heterosexuals), but 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.

This is especially critical for studies like this one, which measured arousal to sexual images, as research confirms that men and women have significantly different brain responses to sexual images or films. This flaw alone explains the lack of correlations between EEG readings and questionnaires. Previous studies confirm significant differences between males and females in response to sexual images. See, for example:

• Gender Differences in Sexual Arousal and Affective Responses to Erotica.
• Sex differences in brain activation to emotional stimuli: a meta-analysis of neuroimaging studies
• Habituation of female sexual arousal to slides and film.
• Skin sympathetic nerve activity in humans during exposure to emotionally-charged images: sex differences
• The late positive potential (LPP) in response to varying types of emotional and cigarette stimuli in smokers: a content comparison
• Sex differences in interactions between nucleus accumbens and visual cortex by explicit visual erotic stimuli: an fMRI study.
• Affective picture perception: gender differences in visual cortex?
• Sex-specific content preferences for visual sexual stimuli.
• Sex differences in patterns of genital sexual arousal: measurement artifacts or true phenomena?
• Sex differences in viewing sexual stimuli: an eye-tracking study in men and women
• Men and women differ in amygdala response to visual sexual stimuli
• Effects of gender and relationship context in audio narratives on genital and subjective sexual response in heterosexual women and men.
• Sex differences in visual attention to erotic and non-erotic stimuli
• Sex Differences in Response to Visual Sexual Stimuli: A Review
• Skin conductance responses to visual sexual stimuli.

Can we be confident that a non-heterosexual has the same enthusiasm for male-female porn as a heterosexual male? No, and his/her inclusion could distort EEG averages rendering meaningful correlations unlikely. See, for example, Neural circuits of disgust induced by sexual stimuli in homosexual and heterosexual men: an fMRI study.

Surprisingly, 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).”

In a Prause study published a few weeks before this one she said:

“Many studies using the popular International Affective Picture System (Lang, Bradley, & Cuthbert, 1999) use different stimuli for the men and women in their sample.”

Maybe Prause should read her own statements to discover the reason why her current EEG readings varied so much. Individual differences are normal, and large variations are to be expected with a sexually diverse group of subjects.

Irrelevant Questionnaires: The SCS (Sexual Compulsivity Scale) cannot assess Internet-porn addiction. It 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 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 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.“

Furthermore, the SCS includes partner-related questions that Internet-porn addicts might score quite differently compared with sex addicts, given that compulsive porn users often have a far greater appetite for cyber erotica than actual sex.

Like the SCS, the second hypersexuality questionnaire (the CBSOB) has no questions about Internet porn use. It was designed to screen for “hypersexual” subjects, and out-of-control sexual behaviors – not strictly the overuse of sexually explicit materials on the internet.

Another questionnaire the researchers administered is the PCES (Pornography Consumption Effect Scale), which has been called a “psychometric nightmare,” and there’s no reason to believe it can indicate anything about Internet porn addiction or sex addiction.

Thus, the lack of correlation between EEG readings and these questionnaires contributes no support to the study’s conclusions or the author’s claims.

No Pre-Screening: Prause’s subjects were not pre-screened. Valid addiction brain studies screen out individuals with pre-existing conditions (depression, OCD, other addictions, etc.). This is the only way responsible researchers can draw conclusions about addiction. See the Cambridge study for an example of proper screening & methodology.

Prause’s subjects were also not pre-screened for porn addiction. Standard procedure for addiction studies is to screen subjects with an addiction test in order to compare those who test positive for an addiction with those who do not. These researchers did not do this, even though an Internet porn-addiction test exists. Instead, researchers administered the Sexual Compulsivity Scale after participants were already chosen. As explained, the SCS is not valid for porn addiction or for women.

Use of Generic Porn For Diverse Subjects: Steele et al. admits that its choice of “inadequate” porn may have altered results. Even under ideal conditions, choice of test porn is tricky, as porn users (especially addicts) often escalate through a series of tastes. Many report having little sexual response to porn genres that do not match their porn-du-jour—including genres that they found quite arousing earlier in their porn-watching careers. For example, much of today’s porn is consumed via high-definition videos, and the stills used here may not elicit the same response.

Thus, the use of generic porn can affect results. If a porn enthusiast is anticipating viewing porn, reward circuit activity presumably increases. Yet if the porn turns out to be some boring heterosexual pictures that don’t match his/her current genre or stills instead of high-definition fetish videos, the user may have little or no response, or even aversion. “What was that?”

This is the equivalent of testing the cue reactivity of bunch of food addicts by serving everyone a single food: baked potatoes. If a participant doesn’t happen to like baked potatoes, she must not have a problem with eating too much, right?

A valid addiction “brain study” must: 1) have homogenous subjects and controls, 2) screen out other mental disorders and other addictions, and 3) use validated questionnaires and interviews to assure the subjects are actually porn addicts. Steele et al. did none of these, yet drew vast conclusions and published them widely.

UPDATE

Much has transpired since July, 2013. UCLA did not renew Nicole Prause’s contract (late 2014/early 2015). No longer an academic Prause has engaged in multiple documented incidents harassment and defamation as part of an ongoing “astroturf” campaign to persuade people that anyone who disagrees with her conclusions deserves to be reviled. Prause has accumulated a long history of harassing authors, researchers, therapists, reporters and others who dare to report evidence of harms from internet porn use. She appears to be quite cozy with the pornography industry, as can be seen from this image of her (far right) on the red carpet of the X-Rated Critics Organization (XRCO) awards ceremony. (According to Wikipedia 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]). It also appears that Prause may have obtained porn performers as subjects through another porn industry interest group, the Free Speech Coalition. The FSC subjects were allegedly used in her hired-gun study on the heavily tainted and very commercial “Orgasmic Meditation” scheme. Prause has also made unsupported claims about the results of her studies and her study’s methodologies. For much more documentation, see: Is Nicole Prause Influenced by the Porn Industry?