Should compulsive sexual behavior be considered an addiction?

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Valerie Voon

Valerie Voon is a neuropsychiatrist and neuroscientist at the University of Cambridge.  The Voon research group focuses on mechanisms underlying impulsivity and compulsivity with specific application to addictions.  She obtained her medical degree and psychiatry residency training from the University of British Columbia and University of Toronto in Canada.  She completed a movement disorders research fellowship at the National Institutes of Neurological Disorders and Stroke and concurrently a PhD in neuroscience from the University College London and recently completed a Wellcome Trust Intermediate Fellowship at the University of Cambridge.  Her PhD focused on the dopamine-agonist related impulse control disorders (e.g. pathological gambling, binge eating, compulsive sexual behaviours and shopping).  She has published over 120 manuscripts and book chapters including in high impact journals.  She is a Fellow of the American Neuropsychiatric Association and chairs their Committee for Research and is on the Board of Directors for the British Neuropsychiatric Association.



Compulsive sexual behaviours are excessive uncontrollable sexual behaviours associated with significant negative consequences.  How we conceptualize these behaviours - as excessive appetites or hobbies, impulse control, obsessive compulsive spectrum or non-drug process or behavioural addictions - remains to be established. 

This talk focuses on emerging neurobiological studies of compulsive sexual behaviours.  I will discuss preclinical evidence for neuroadaptation and amphetamine cross-sensitization in rodent models of repeated sexual behavior.  I then present evidence from multimodal imaging and cognitive studies focusing on the compulsive use of online pornography supporting incentive motivation addiction theories.  We show greater brain volumes involved in assigning of incentive salience and a decrease in prefrontal-limbic functional connectivity at rest. Converging studies from several labs demonstrate greater anticipatory and approach behaviours towards sexual cues engaging similar brain regions observed to drug cues in addictions. These findings dovetail with observations of enhanced conditioning towards sexual images.  The role of novelty and its relationship with tolerance is discussed in the context of the internet and unlimited access to novel online sexual material.  Together these emerging findings provide preliminary evidence to support incentive motivation addiction models.  

The studies were funded by a Wellcome Trust Intermediate Fellowship for Dr Voon.


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