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  • 1 Institute for Neural Computations, University of California San Diego, USA
  • | 2 Polish Academy of Sciences, Poland
  • | 3 Child Study Center and CASAColumbia, Yale School of Medicine, USA
  • | 4 Child Study Center and CASAColumbia, Yale School of Medicine, USA
  • | 5 Connecticut Mental Health Center, USA
Open access

Background

How best to conceptualize problematic pornography use (PPU) and intervene most effectively remain debated, with obsessive–compulsive disorder (OCD) and addiction frameworks. We investigated the efficacy of the serotonin-reuptake inhibitor paroxetine in combination with cognitive-behavioral therapy in the treatment of problematic pornography use (PPU).

Case presentation

Three heterosexual males with PPU were treated with cognitive-behavioral therapy and paroxetine. Frequency of pornography use, other sexual behaviors, and anxiety were assessed during treatment.

Discussion

Paroxetine treatment, although seemingly initially effective in reducing pornography use and anxiety, appeared related to new compulsive sexual behaviors after 3 months.

Conclusions

Paroxetine may hold promise for short-term reduction of PPU and related anxiety, but new potentially distressing sexual behaviors may emerge. The cases suggest that PPU may arise from multiple domains. We propose an explanation of the effects based on recent neuroscientific research on sexual behaviors and alcohol use.

Abstract

Background

How best to conceptualize problematic pornography use (PPU) and intervene most effectively remain debated, with obsessive–compulsive disorder (OCD) and addiction frameworks. We investigated the efficacy of the serotonin-reuptake inhibitor paroxetine in combination with cognitive-behavioral therapy in the treatment of problematic pornography use (PPU).

Case presentation

Three heterosexual males with PPU were treated with cognitive-behavioral therapy and paroxetine. Frequency of pornography use, other sexual behaviors, and anxiety were assessed during treatment.

Discussion

Paroxetine treatment, although seemingly initially effective in reducing pornography use and anxiety, appeared related to new compulsive sexual behaviors after 3 months.

Conclusions

Paroxetine may hold promise for short-term reduction of PPU and related anxiety, but new potentially distressing sexual behaviors may emerge. The cases suggest that PPU may arise from multiple domains. We propose an explanation of the effects based on recent neuroscientific research on sexual behaviors and alcohol use.

Introduction

About 70% of males aged 18–30 years use pornography weekly (Hald, 2006). While most view pornography without problems, some view compulsively and seek treatment (Gola, Lewczuk, & Skorko, 2016; Gola, Skorko, et al., 2016). How best to conceptualize problematic pornography use (PPU) and intervene most effectively remain debated, with obsessive–compulsive disorder (OCD) and addiction frameworks (Gola, 2016; Kor, Fogel, Reid, & Potenza, 2013; Kraus, Voon, & Potenza, 2016; Prause, Steele, Staley, Sabatinelli, & Hajcak, 2016). Paroxetine, due to its efficacy in OCD and anxiety disorders (Stein, Andersen, Tonnoir, & Fineberg, 2007) and negative impact on libido (Abler et al., 2011), has been used in PPU treatment. Here, we report three cases where paroxetine treatment, although seemingly initially effective, after 3 months appeared related to new compulsive sexual behaviors. We place these findings within the context of neuroscientific research on compulsive sexual behaviors and alcohol use.

Case Reports

Patients were Caucasian, heterosexual males [measured with the Polish adaptation of Kinsey’s Sexual Orientation Scale (Wierzba et al., 2015)] seeking treatment for PPU accompanied by compulsive masturbation (characteristics in Table 1). None took medication, had significant medical problems or histories of risky sexual behaviors, use of paid sexual services or affairs. All reported some risky alcohol drinking. Two had episodes of depressive disorder at ages 18 (Mr. A) and 24 (Mr. C) years, respectively. All reported preoccupations/urges, numerous failed quit attempts, and significant distress related to PPU and masturbation.

Table 1.

Characteristics of patients

PatientABC
Age243235
Relationship statusIn relationship for 3 yearsMarried for 6 yearsSingle
OccupationStudentManagerSoftware developer
Onset of pornography use (age in years)111413
Pornography use/week12 hr8 hr6.5 hr
Frequency of masturbation/week18813

Patients attended cognitive-behavioral therapy delivered by doctoral-level clinical psychologists and completed self-monitoring reports of pornography consumption (daily) and anxiety (weekly; Figure 1).

Figure 1.
Figure 1.

Top: weekly amount of pornography consumption with marked onset and end of paroxetine intake for each subject and onset of new sexual behaviors appearance. Bottom: weekly rating of anxiety level

Citation: Journal of Behavioral Addictions J Behav Addict 5, 3; 10.1556/2006.5.2016.046

All patients were asked about sexual dysfunction related to the medication and reported decreased libido and delayed ejaculation during the initial 2–4 weeks of paroxetine intake (20 mg/day). Within 10 weeks from the onset of paroxetine treatment, reported libido was close to the normal and patients A and B did not experience any difficulties in erection or ejaculation during sexual activity with their partners or during solitary sexual activity (patient C had only solitary sexual activity and also did not report experiencing any troubles). Within the 10 weeks of paroxetine intake, all patients also experienced significant decreases in self-reported anxiety [A: 45%; B: 50%; C: 49%; Mbefore = 7.03; SD = .38; Mafter = 3.66; SD = .4; t(2) = 90.7; and p < .001]. Similarly, frequency of pornography consumption decreased, albeit not to a statistically significant level [A: 80%; B: 69%; C: 52%; Mbefore = 7.57; SD = 2.46; Mafter = 2.25; SD = .28; t(2) = 3.78; and p = .078]. Interestingly, within 12–14 weeks, new sexual behaviors appeared. Patients A and C started engaging in paid sexual relations (up to three times a week), and patient B initiated an extra-marital affair (with his children’s care provider). After 13 weeks of treatment, patient C went on vacation during which he engaged in an almost 2-week-long paid sexual relationship and quit medication. Due to those new behaviors, all patients were evaluated for mania/hypomania according to the criteria presented by Basco and Rush (2005). Patients A and B were assessed for symptoms of mania for three consecutive weeks and patient C for two consecutive weeks. None of the patients met criteria for mania or hypomania. Interestingly, all of the new sexual behaviors had a dyadic characteristic and were not accompanied with rebound of pornography use and masturbation.

The appearance of new sexual behaviors was discussed with patients during the meetings. Patient C reported the use of paid sexual services as having ego-syntonic elements. In his words, a vacation with paid “girlfriend-like-experiences” was one of the best times of his life. Patient C declared that he always preferred dyadic sexual activity over solitary activity, but due to high anxiety level and difficulties in creating intimate relationships with women, he was more prone to use pornography and masturbate. Patients A and B had very strong religious-based beliefs that extra-marital sexual relationships are morally reprehensible. In the case of patient A, his first use of paid sexual services was described as having a mixture of pride and guilt. Patient A described that he always wanted to have sexual experience with prostitute but was afraid to try. He also wanted to see what it was like to have sex with another person other than his girlfriend (who was his first sexual partner). His guilt was related to feeling that he was cheating on his girlfriend in a manner not consonant with his religious beliefs. A mixture of pride regarding sexual initiation and engagement and guilt related to a mismatch of this behavior with his religious beliefs was present during his sexual encounters. Patient B also described his extra-marital affair as being characterized by feelings of both pride and guilt. As in the case of patient A, his wife had been his first and only sexual partner (with the sexual initiation age of 20 years), and the drive for the affair involved fascination and a desire “to try something new.” As patients A and B perceived the new behaviors as being contrary to their beliefs, yet nonetheless reported strong motivations to continue the behaviors, paroxetine treatment was stopped. In the following weeks, Mr. B reported ending his extra-marital relations, while Mr. A and Mr. C continued engaging in paid sexual services (about once a week). None of the patients were interested to increase the amounts of pornography use and frequency of masturbation (instead of the use of paid sexual services), as they were describing the pornography use as isolating, time consuming and humiliating. Diminished pornography consumption was sustained through the 3-month follow up for Mr. A and Mr. B (Mr. C did not follow up). Subsequently, Mr. A has reported ending his 3-year relationship with his girlfriend as he had learned that she had been cheating on him with her ex-partner.

Discussion and Conclusions

These cases highlight several important points. In the 1990s, Dr. Coleman proposed that compulsive sexual behaviors may be driven by anxiety-reduction mechanisms (Coleman, 1991). Our results are in line with Dr. Coleman’s observation that PPU may be related to anxiety as both pornography use and anxiety decreased with paroxetine treatment. Second, while paroxetine may hold promise for reducing PPU and related anxiety, new potentially distressing sexual behaviors may emerge. There are several possible explanations for these observations: (a) new sexual behaviors may be one symptom of subthreshold hypomania (Fiedorowicz et al., 2011); (b) paroxetine treatment or refraining from PPU may have compelled patients to pursue higher risk sexual behaviors; (c) patients may have experienced sexual dysfunction and may have sought more risky or arousing experiences; or, and (d) in line with recent neuroscientific findings (Gola, Miyakoshi, & Sescousse, 2015; Gola, Wordecha, et al., 2016; Victor, Sansosti, Bowman, & Hariri, 2015) and older clinical observations (Coleman, 1991, 2015), PPU may arise from multiple domains (e.g., with anxious and reward-related/impulsive components), and paroxetine treatment may target only anxiety-related aspects.

Our data do not provide convincing support for the first three possibilities. Frequently endorsed symptoms of hypomania, such as unusually high energy, decreased need for sleep, increased goal-directed activity, grandiosity, or expansive mood were not observed (Fiedorowicz et al., 2011). The new sexual behaviors had a dyadic characteristic and were not accompanied by rebound of PPU and solitary sexual activity, thus not providing strong support for the second possibility, although it cannot be completely excluded. If patients were pursuing more risky or arousing sexual behavior to overcome sexual dysfunction, we might anticipate increases in time spent viewing pornography and masturbating and new content of pornography being viewed within the first weeks of paroxetine treatment. We did not observe these patterns. Furthermore, prior to the emergence of new problematic sexual behaviors, patients were reporting the return of normal sexual functioning, suggesting that the new behaviors were not compensatory to sexual dysfunction. A possibility that fits with the data and warrants additional study relates to a theory described elsewhere (Gola et al., 2015) in response to a recent research by Nikolova et al. on risky alcohol drinking (Nikolova, Knodt, Radtke, & Hariri, 2015) and Victor et al. on risky sexual behaviors (Victor et al., 2015). Both theories propose that imbalances in ventral-striatum-related reward reactivity and amygdala-related threat reactivity may promote problematic-alcohol drinking (Nikolova et al., 2015) or sexual risk taking (Gola et al., 2015; Victor et al., 2015). Problematic behaviors may result from increased impulsivity (related to ventral-striatum-related reward reactivity) or increased anxiety (related to amygdala-related threat reactivity). Previous studies show that anxiety may be diminished with paroxetine, which has been linked to reductions in amygdala’s volume (Szeszko et al., 2004), while other medications such as naltrexone may reduce reward responsivity (e.g., craving) and impulsivity (Bostwick & Bucci, 2008; Raymond, Grant, & Coleman, 2010; Kraus, Meshberg-Cohen, Martino, Quinones, & Potenza, 2015). Therefore, we hypothesize that in PPU, both of the above-mentioned mechanisms may operate, and this possibility warrants additional investigation. Although currently speculative, we may explain the observations in this case series as follows. All three patients had an initially high level of anxiety (as presented in Figure 1) and PPU may have helped them regulate their anxiety. Paroxetine may have helped to decrease amygdala-related reactivity, resulting in decreased anxiety and subsequently decreased PPU. However, at some point, without targeting craving or reward-related processes, new compulsive sexual behaviors may have emerged in the setting of diminished anxiety. While such mechanisms appear to have support from experimental studies on sexual behaviors and problematic alcohol use (Gola et al., 2015; Nikolova et al., 2015; Victor et al., 2015), they deserve further investigation in PPU. We are aware that there exists a big leap from three cases to neuronal mechanisms; however, at the level of symptoms, the accounts of these three individuals suggest that anxiety, and reward-related processes may both warrant strong consideration in the treatment of PPU and perhaps other compulsive sexual behaviors. Therefore, future clinical trials should consider combinations of paroxetine and naltrexone with careful assessment of sexual behaviors and individual-difference measures (e.g., impulsivity and anxiety) that may relate to treatment outcome.

Authors’ contribution

MG worked with patients, collected clinical data, and performed the statistical analysis. MG and MP analyzed the findings, interpreted them, and wrote the manuscript.

Conflict of interest

The authors report no conflict of interest with respect to the content of this manuscript. Dr. M. N. Potenza has consulted for and advised Ironwood, Lundbeck, INSYS, Shire, RiverMend Health, and Opiant/Lakelight Therapeutics; has received research support from Mohegan Sun Casino, the National Center for Responsible Gaming, and Pfizer; has participated in surveys, mailings, or telephone consultations related to drug addiction, impulse-control disorders, or other health topics; has consulted for gambling and legal entities on issues related to impulse-control and addictive disorders; provides clinical care in the Connecticut Department of Mental Health and Addiction Services Problem Gambling Services Program; has performed grant reviews for the National Institutes of Health and other agencies; has edited journals or journal sections; has given academic lectures in grand rounds, CME events and other clinical or scientific venues; and has generated books or book chapters for publishers of mental health texts.

References

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    • Crossref
    • Search Google Scholar
    • Export Citation
  • Basco, M. R., & Rush, A. J. (2005). Cognitive-behavioral therapy for bipolar disorder. Retrieved from https://books.google.com/books?hl=pl&lr=&id=o2oDxFGr9C4C&oi=fnd&pg=PA1&dq=monica+ramirez+basco&ots=VElWrbGZJq&sig=yHktb8A9D72YMgLnUT8K9TB02NI

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  • Bostwick, J. M., & Bucci, J. A. (2008). Internet sex addiction treated with naltrexone. Mayo Clinic Proceedings, 83(2), 226230. doi: 10.4065/83.2.226

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Coleman, E. (1991). Compulsive sexual behavior: New concepts and treatments. Journal of Psychology & Human Sexuality, 4(2), 3752. doi: 10.1300/J056v04n02_04

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Coleman, E. (2015). Impulsive/compulsive sexual behaviour. ABC of Sexual Health. Retrieved from https://books.google.com/books?hl=pl&lr=&id=oH64CAAAQBAJ&oi=fnd&pg=PA93&dq=impulsive+compulsive+sexual+behavior&ots=3Ar-41oPQW&sig=OXe63r37ATWqqnc2vTtNEKmggHE

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  • Fiedorowicz, J. G., Endicott, J., Leon, A. C., Solomon, D. A., Keller, M. B., & Coryell, W. H. (2011). Subthreshold hypomanic symptoms in progression from unipolar major depression to bipolar disorder. American Journal of Psychiatry, 168(1), 4048. doi: 10.1176/appi.ajp.2010.10030328

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Gola, M. (2016). Decreased LPP for sexual images in problematic pornography users may be consistent with addiction models. Everything depends on the model (Commentary on Prause, Steele, Staley, Sabatinelli, & Hajcak, 2015). Biological Psychology. doi: 10.1016/j.biopsycho.2016.05.003

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Gola, M., Lewczuk, K., & Skorko, M. (2016). What matters: Quantity or quality of pornography use? Psychological and behavioral factors of seeking treatment for problematic pornography use. The Journal of Sexual Medicine, 13(5), 815824. doi: 10.1016/j.jsxm.2016.02.169

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Gola, M., Miyakoshi, M., & Sescousse, G. (2015). Sex, impulsivity and anxiety: Interplay between ventral striatum and amygdala reactivity in problematic sexual behaviors. Journal of Neuroscience, 35(46), 1522715229. doi: 10.1523/JNEUROSCI.3273-15.2015

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Gola, M., Skorko, M., Kowalewska, E., Kołodziej, A., Sikora, M., Wodyk, M., Wodyk, Z., & Dobrowolski, P. (2016). Polish adaptation of Sexual Addiction Screening Test – Revised. Polish Psychiatry, 41, 121. doi: 10.12740/PP/OnlineFirst/61414

    • Search Google Scholar
    • Export Citation
  • Gola, M., Wordecha, M., Sescousse, G., Lew-Starowicz, M., Kossowski, B., Wypych, M., Makeig, S., Potenza, M., & Marchewka, A. (2016). Can pornography be addictive? An fMRI study of men seeking treatment for problematic pornography use. bioRxiv, 057083, 125. doi: 10.1101/057083

    • Search Google Scholar
    • Export Citation
  • Hald, G. M. (2006). Gender differences in pornography consumption among young heterosexual Danish adults. Archives of Sexual Behavior, 35(5), 577585. doi: 10.1007/s10508-006-9064-0

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Kor, A., Fogel, Y., Reid, R. C., & Potenza, M. N. (2013). Should hypersexual disorder be classified as an addiction? Sexual Addiction & Compulsivity, 20(1–2), 2747. doi: 10.1080/10720162.2013.768132

    • Search Google Scholar
    • Export Citation
  • Kraus, S. W., Meshberg-Cohen, S., Martino, S., Quinones, L. J., & Potenza, M. N. (2015). Treatment of compulsive pornography use with naltrexone: A case report. The American Journal of Psychiatry, 172(12), 12601261. doi: 10.1176/appi.ajp.2015.15060843

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Kraus, S. W., Voon, V., & Potenza, M. N. (2016). Should compulsive sexual behavior be considered an addiction? Addiction. doi: 10.1111/add.13297

    • Search Google Scholar
    • Export Citation
  • Nikolova, Y. S., Knodt, A. R., Radtke, S. R., & Hariri, A. R. (2015). Divergent responses of the amygdala and ventral striatum predict stress-related problem drinking in young adults: Possible differential markers of affective and impulsive pathways of risk for alcohol use disorder. Molecular Psychiatry, 21(3), 348356. doi: 10.1038/mp.2015.85

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Prause, N., Steele, V. R., Staley, C., Sabatinelli, D., & Hajcak, G. (2016). Prause et al. (2015) the latest falsification of addiction predictions. Biological Psychology. doi: 10.1016/j.biopsycho.2016.05.007

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Raymond, N. C., Grant, J. E., & Coleman, E. (2010). Augmentation with naltrexone to treat compulsive sexual behavior: A case series. Annals of Clinical Psychiatry, 22(1), 5662.

    • Search Google Scholar
    • Export Citation
  • Stein, D. J., Andersen, E. W., Tonnoir, B., & Fineberg, N. (2007). Escitalopram in obsessive-compulsive disorder: A randomized, placebo-controlled, paroxetine-referenced, fixed-dose, 24-week study. Current Medical Research and Opinion, 23(4), 701711. doi: 10.1185/030079907X178838

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Szeszko, P. R., MacMillan, S., McMeniman, M., Lorch, E., Madden, R., Ivey, J., Banerjee, S. P., Moore, G. J., & Rosenberg, D. R. (2004). Amygdala volume reductions in pediatric patients with obsessive-compulsive disorder treated with paroxetine: Preliminary findings. Neuropsychopharmacology, 29(4), 826832. doi: 10.1038/sj.npp.1300399

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Victor, E. C., Sansosti, A. A., Bowman, H. C., & Hariri, A. R. (2015). Differential patterns of amygdala and ventral striatum activation predict gender-specific changes in sexual risk behavior. The Journal of Neuroscience, 35(23), 88968900. doi: 10.1523/JNEUROSCI.0737-15.2015

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Wierzba, M., Riegel, M., Pucz, A., Leśniewska, Z., Dragan, W. Ł, Gola, M., Jednoróg, K., & Marchewka, A. (2015). Erotic subset for the Nencki Affective Picture System (NAPS ERO): Cross-sexual comparison study. Frontiers in Psychology, 6, 113. doi: 10.3389/fpsyg.2015.01336

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Abler, B., Seeringer, A., Hartmann, A., Grön, G., Metzger, C., Walter, M., & Stingl, J. (2011). Neural correlates of antidepressant-related sexual dysfunction: A placebo-controlled fMRI study on healthy males under subchronic paroxetine and bupropion. Neuropsychopharmacology, 36(9), 18371847. doi: 10.1038/npp.2011.66

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Basco, M. R., & Rush, A. J. (2005). Cognitive-behavioral therapy for bipolar disorder. Retrieved from https://books.google.com/books?hl=pl&lr=&id=o2oDxFGr9C4C&oi=fnd&pg=PA1&dq=monica+ramirez+basco&ots=VElWrbGZJq&sig=yHktb8A9D72YMgLnUT8K9TB02NI

    • Search Google Scholar
    • Export Citation
  • Bostwick, J. M., & Bucci, J. A. (2008). Internet sex addiction treated with naltrexone. Mayo Clinic Proceedings, 83(2), 226230. doi: 10.4065/83.2.226

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Coleman, E. (1991). Compulsive sexual behavior: New concepts and treatments. Journal of Psychology & Human Sexuality, 4(2), 3752. doi: 10.1300/J056v04n02_04

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Coleman, E. (2015). Impulsive/compulsive sexual behaviour. ABC of Sexual Health. Retrieved from https://books.google.com/books?hl=pl&lr=&id=oH64CAAAQBAJ&oi=fnd&pg=PA93&dq=impulsive+compulsive+sexual+behavior&ots=3Ar-41oPQW&sig=OXe63r37ATWqqnc2vTtNEKmggHE

    • Search Google Scholar
    • Export Citation
  • Fiedorowicz, J. G., Endicott, J., Leon, A. C., Solomon, D. A., Keller, M. B., & Coryell, W. H. (2011). Subthreshold hypomanic symptoms in progression from unipolar major depression to bipolar disorder. American Journal of Psychiatry, 168(1), 4048. doi: 10.1176/appi.ajp.2010.10030328

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Gola, M. (2016). Decreased LPP for sexual images in problematic pornography users may be consistent with addiction models. Everything depends on the model (Commentary on Prause, Steele, Staley, Sabatinelli, & Hajcak, 2015). Biological Psychology. doi: 10.1016/j.biopsycho.2016.05.003

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Gola, M., Lewczuk, K., & Skorko, M. (2016). What matters: Quantity or quality of pornography use? Psychological and behavioral factors of seeking treatment for problematic pornography use. The Journal of Sexual Medicine, 13(5), 815824. doi: 10.1016/j.jsxm.2016.02.169

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Gola, M., Miyakoshi, M., & Sescousse, G. (2015). Sex, impulsivity and anxiety: Interplay between ventral striatum and amygdala reactivity in problematic sexual behaviors. Journal of Neuroscience, 35(46), 1522715229. doi: 10.1523/JNEUROSCI.3273-15.2015

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Gola, M., Skorko, M., Kowalewska, E., Kołodziej, A., Sikora, M., Wodyk, M., Wodyk, Z., & Dobrowolski, P. (2016). Polish adaptation of Sexual Addiction Screening Test – Revised. Polish Psychiatry, 41, 121. doi: 10.12740/PP/OnlineFirst/61414

    • Search Google Scholar
    • Export Citation
  • Gola, M., Wordecha, M., Sescousse, G., Lew-Starowicz, M., Kossowski, B., Wypych, M., Makeig, S., Potenza, M., & Marchewka, A. (2016). Can pornography be addictive? An fMRI study of men seeking treatment for problematic pornography use. bioRxiv, 057083, 125. doi: 10.1101/057083

    • Search Google Scholar
    • Export Citation
  • Hald, G. M. (2006). Gender differences in pornography consumption among young heterosexual Danish adults. Archives of Sexual Behavior, 35(5), 577585. doi: 10.1007/s10508-006-9064-0

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Kor, A., Fogel, Y., Reid, R. C., & Potenza, M. N. (2013). Should hypersexual disorder be classified as an addiction? Sexual Addiction & Compulsivity, 20(1–2), 2747. doi: 10.1080/10720162.2013.768132

    • Search Google Scholar
    • Export Citation
  • Kraus, S. W., Meshberg-Cohen, S., Martino, S., Quinones, L. J., & Potenza, M. N. (2015). Treatment of compulsive pornography use with naltrexone: A case report. The American Journal of Psychiatry, 172(12), 12601261. doi: 10.1176/appi.ajp.2015.15060843

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Kraus, S. W., Voon, V., & Potenza, M. N. (2016). Should compulsive sexual behavior be considered an addiction? Addiction. doi: 10.1111/add.13297

    • Search Google Scholar
    • Export Citation
  • Nikolova, Y. S., Knodt, A. R., Radtke, S. R., & Hariri, A. R. (2015). Divergent responses of the amygdala and ventral striatum predict stress-related problem drinking in young adults: Possible differential markers of affective and impulsive pathways of risk for alcohol use disorder. Molecular Psychiatry, 21(3), 348356. doi: 10.1038/mp.2015.85

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Prause, N., Steele, V. R., Staley, C., Sabatinelli, D., & Hajcak, G. (2016). Prause et al. (2015) the latest falsification of addiction predictions. Biological Psychology. doi: 10.1016/j.biopsycho.2016.05.007

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Raymond, N. C., Grant, J. E., & Coleman, E. (2010). Augmentation with naltrexone to treat compulsive sexual behavior: A case series. Annals of Clinical Psychiatry, 22(1), 5662.

    • Search Google Scholar
    • Export Citation
  • Stein, D. J., Andersen, E. W., Tonnoir, B., & Fineberg, N. (2007). Escitalopram in obsessive-compulsive disorder: A randomized, placebo-controlled, paroxetine-referenced, fixed-dose, 24-week study. Current Medical Research and Opinion, 23(4), 701711. doi: 10.1185/030079907X178838

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Szeszko, P. R., MacMillan, S., McMeniman, M., Lorch, E., Madden, R., Ivey, J., Banerjee, S. P., Moore, G. J., & Rosenberg, D. R. (2004). Amygdala volume reductions in pediatric patients with obsessive-compulsive disorder treated with paroxetine: Preliminary findings. Neuropsychopharmacology, 29(4), 826832. doi: 10.1038/sj.npp.1300399

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Victor, E. C., Sansosti, A. A., Bowman, H. C., & Hariri, A. R. (2015). Differential patterns of amygdala and ventral striatum activation predict gender-specific changes in sexual risk behavior. The Journal of Neuroscience, 35(23), 88968900. doi: 10.1523/JNEUROSCI.0737-15.2015

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Wierzba, M., Riegel, M., Pucz, A., Leśniewska, Z., Dragan, W. Ł, Gola, M., Jednoróg, K., & Marchewka, A. (2015). Erotic subset for the Nencki Affective Picture System (NAPS ERO): Cross-sexual comparison study. Frontiers in Psychology, 6, 113. doi: 10.3389/fpsyg.2015.01336

    • Crossref
    • Search Google Scholar
    • Export Citation
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Dr. Zsolt Demetrovics
Institute of Psychology, ELTE Eötvös Loránd University
Address: Izabella u. 46. H-1064 Budapest, Hungary
Phone: +36-1-461-2681
E-mail: jba@ppk.elte.hu

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WoS
Journal
Impact Factor
6,756
Rank by Psychiatry (SSCI) 12/143 (Q1)
Impact Factor Psychiatry 19/156 (Q1)
Impact Factor 6,052
without
Journal Self Cites
5 Year 8,735
Impact Factor
Journal  1,48
Citation Indicator  
Rank by Journal  Psychiatry 24/250 (Q1)
Citation Indicator   
Citable 86
Items
Total 74
Articles
Total 12
Reviews
Scimago 47
H-index
Scimago 2,265
Journal Rank
Scimago Clinical Psychology Q1
Quartile Score Psychiatry and Mental Health Q1
  Medicine (miscellaneous) Q1
Scopus 3593/367=9,8
Scite Score  
Scopus Clinical Psychology 7/283 (Q1)
Scite Score Rank Psychiatry and Mental Health 22/502 (Q1)
Scopus 2,026
SNIP  
Days from  38
submission  
to 1st decision  
Days from  37
acceptance  
to publication  
Acceptance 31%
Rate  

2019  
Total Cites
WoS
2 184
Impact Factor 5,143
Impact Factor
without
Journal Self Cites
4,346
5 Year
Impact Factor
5,758
Immediacy
Index
0,587
Citable
Items
75
Total
Articles
67
Total
Reviews
8
Cited
Half-Life
3,3
Citing
Half-Life
6,8
Eigenfactor
Score
0,00597
Article Influence
Score
1,447
% Articles
in
Citable Items
89,33
Normalized
Eigenfactor
0,7294
Average
IF
Percentile
87,923
Scimago
H-index
37
Scimago
Journal Rank
1,767
Scopus
Scite Score
2540/376=6,8
Scopus
Scite Score Rank
Cllinical Psychology 16/275 (Q1)
Medicine (miscellenous) 31/219 (Q1)
Psychiatry and Mental Health 47/506 (Q1)
Scopus
SNIP
1,441
Acceptance
Rate
32%

 

Journal of Behavioral Addictions
Publication Model Gold Open Access
Submission Fee none
Article Processing Charge 850 EUR/article
Printed Color Illustrations 40 EUR (or 10 000 HUF) + VAT / piece
Regional discounts on country of the funding agency World Bank Lower-middle-income economies: 50%
World Bank Low-income economies: 100%
Further Discounts Editorial Board / Advisory Board members: 50%
Corresponding authors, affiliated to an EISZ member institution subscribing to the journal package of Akadémiai Kiadó: 100%
Subscription Information Gold Open Access
Purchase per Title  

Journal of Behavioral Addictions
Language English
Size A4
Year of
Foundation
2011
Publication
Programme
2021 Volume 10
Volumes
per Year
1
Issues
per Year
4
Founder Eötvös Loránd Tudományegyetem
Founder's
Address
H-1053 Budapest, Hungary Egyetem tér 1-3.
Publisher Akadémiai Kiadó
Publisher's
Address
H-1117 Budapest, Hungary 1516 Budapest, PO Box 245.
Responsible
Publisher
Chief Executive Officer, Akadémiai Kiadó
ISSN 2062-5871 (Print)
ISSN 2063-5303 (Online)

Senior editors

Editor(s)-in-Chief: Zsolt DEMETROVICS

Assistant Editor(s): Csilla ÁGOSTON

Associate Editors

  • Judit BALÁZS (ELTE Eötvös Loránd University, Hungary)
  • Joel BILLIEUX (University of Lausanne, Switzerland)
  • Matthias BRAND (University of Duisburg-Essen, Germany)
  • Anneke GOUDRIAAN (University of Amsterdam, The Netherlands)
  • Daniel KING (Flinders University, Australia)
  • Ludwig KRAUS (IFT Institute for Therapy Research, Germany)
  • H. N. Alexander LOGEMANN (ELTE Eötvös Loránd University, Hungary)
  • Anikó MARÁZ (Humboldt University of Berlin, Germany)
  • Astrid MÜLLER (Hannover Medical School, Germany)
  • Marc N. POTENZA (Yale University, USA)
  • Hans-Jurgen RUMPF (University of Lübeck, Germany)
  • Attila SZABÓ (ELTE Eötvös Loránd University, Hungary)
  • Róbert URBÁN (ELTE Eötvös Loránd University, Hungary)
  • Aviv M. WEINSTEIN (Ariel University, Israel)

Editorial Board

  • Max W. ABBOTT (Auckland University of Technology, New Zealand)
  • Elias N. ABOUJAOUDE (Stanford University School of Medicine, USA)
  • Hojjat ADELI (Ohio State University, USA)
  • Alex BALDACCHINO (University of Dundee, United Kingdom)
  • Alex BLASZCZYNSKI (University of Sidney, Australia)
  • Kenneth BLUM (University of Florida, USA)
  • Henrietta BOWDEN-JONES (Imperial College, United Kingdom)
  • Beáta BÖTHE (University of Montreal, Canada)
  • Wim VAN DEN BRINK (University of Amsterdam, The Netherlands)
  • Gerhard BÜHRINGER (Technische Universität Dresden, Germany)
  • Sam-Wook CHOI (Eulji University, Republic of Korea)
  • Damiaan DENYS (University of Amsterdam, The Netherlands)
  • Jeffrey L. DEREVENSKY (McGill University, Canada)
  • Naomi FINEBERG (University of Hertfordshire, United Kingdom)
  • Marie GRALL-BRONNEC (University Hospital of Nantes, France)
  • Jon E. GRANT (University of Minnesota, USA)
  • Mark GRIFFITHS (Nottingham Trent University, United Kingdom)
  • Heather HAUSENBLAS (Jacksonville University, USA)
  • Tobias HAYER (University of Bremen, Germany)
  • Susumu HIGUCHI (National Hospital Organization Kurihama Medical and Addiction Center, Japan)
  • David HODGINS (University of Calgary, Canada)
  • Eric HOLLANDER (Albert Einstein College of Medicine, USA)
  • Jaeseung JEONG (Korea Advanced Institute of Science and Technology, Republic of Korea)
  • Yasser KHAZAAL (Geneva University Hospital, Switzerland)
  • Orsolya KIRÁLY (Eötvös Loránd University, Hungary)
  • Emmanuel KUNTSCHE (La Trobe University, Australia)
  • Hae Kook LEE (The Catholic University of Korea, Republic of Korea)
  • Michel LEJOXEUX (Paris University, France)
  • Anikó MARÁZ (Eötvös Loránd University, Hungary)
  • Giovanni MARTINOTTI (‘Gabriele d’Annunzio’ University of Chieti-Pescara, Italy)
  • Frederick GERARD MOELLER (University of Texas, USA)
  • Daniel Thor OLASON (University of Iceland, Iceland)
  • Nancy PETRY (University of Connecticut, USA)
  • Bettina PIKÓ (University of Szeged, Hungary)
  • Afarin RAHIMI-MOVAGHAR (Teheran University of Medical Sciences, Iran)
  • József RÁCZ (Hungarian Academy of Sciences, Hungary)
  • Rory C. REID (University of California Los Angeles, USA)
  • Marcantanio M. SPADA (London South Bank University, United Kingdom)
  • Daniel SPRITZER (Study Group on Technological Addictions, Brazil)
  • Dan J. STEIN (University of Cape Town, South Africa)
  • Sherry H. STEWART (Dalhousie University, Canada)
  • Attila SZABÓ (Eötvös Loránd University, Hungary)
  • Ferenc TÚRY (Semmelweis University, Hungary)
  • Alfred UHL (Austrian Federal Health Institute, Austria)
  • Johan VANDERLINDEN (University Psychiatric Center K.U.Leuven, Belgium)
  • Alexander E. VOISKOUNSKY (Moscow State University, Russia)
  • Kimberly YOUNG (Center for Internet Addiction, USA)

 

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