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      Inhibitory control and problematic Internet-pornography use – The important balancing role of the insula

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          Abstract

          Background and aims

          Diminished control over a specific behavior is a core characteristic in addictive behaviors such as problematic Internet-pornography (IP) use. First studies suggest that a hyperactivity of the impulsive system is one reason for impulsive behaviors in the context of problematic IP use. The tripartite-process theory of addiction explains neurocognitive mechanisms beyond common dual-process theories in addictive behaviors. However, the role of the reflective and interoceptive system is still unresolved.

          Methods

          The study comprised a stop-signal task (SST) including neutral and pornographic images during fMRI and questionnaires to investigate associations between symptoms of problematic IP use, craving, and neural activity of the impulsive, reflective, and interoceptive system. We examined 28 heterosexual males with varying symptom severity of problematic IP use.

          Results

          Data indicates that individuals with more symptoms of problematic IP use showed better performance in the SST which was linked to decreased insula and inferior frontal gyrus activity during pornographic image processing. An increase in craving was associated with lower activity of the ventral striatum during pornographic image processing. The interoceptive system showed varying effects. Increased insula activity during inhibitory control and decreased activity during pornographic image processing were associated with higher inhibitory control performance.

          Discussion and Conclusion

          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.

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          Most cited references75

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          Automated anatomical labeling of activations in SPM using a macroscopic anatomical parcellation of the MNI MRI single-subject brain.

          An anatomical parcellation of the spatially normalized single-subject high-resolution T1 volume provided by the Montreal Neurological Institute (MNI) (D. L. Collins et al., 1998, Trans. Med. Imag. 17, 463-468) was performed. The MNI single-subject main sulci were first delineated and further used as landmarks for the 3D definition of 45 anatomical volumes of interest (AVOI) in each hemisphere. This procedure was performed using a dedicated software which allowed a 3D following of the sulci course on the edited brain. Regions of interest were then drawn manually with the same software every 2 mm on the axial slices of the high-resolution MNI single subject. The 90 AVOI were reconstructed and assigned a label. Using this parcellation method, three procedures to perform the automated anatomical labeling of functional studies are proposed: (1) labeling of an extremum defined by a set of coordinates, (2) percentage of voxels belonging to each of the AVOI intersected by a sphere centered by a set of coordinates, and (3) percentage of voxels belonging to each of the AVOI intersected by an activated cluster. An interface with the Statistical Parametric Mapping package (SPM, J. Ashburner and K. J. Friston, 1999, Hum. Brain Mapp. 7, 254-266) is provided as a freeware to researchers of the neuroimaging community. We believe that this tool is an improvement for the macroscopical labeling of activated area compared to labeling assessed using the Talairach atlas brain in which deformations are well known. However, this tool does not alleviate the need for more sophisticated labeling strategies based on anatomical or cytoarchitectonic probabilistic maps.
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            Large-scale automated synthesis of human functional neuroimaging data

            The explosive growth of the human neuroimaging literature has led to major advances in understanding of human brain function, but has also made aggregation and synthesis of neuroimaging findings increasingly difficult. Here we describe and validate an automated brain mapping framework that uses text mining, meta-analysis and machine learning techniques to generate a large database of mappings between neural and cognitive states. We demonstrate the capacity of our approach to automatically conduct large-scale, high-quality neuroimaging meta-analyses, address long-standing inferential problems in the neuroimaging literature, and support accurate ‘decoding’ of broad cognitive states from brain activity in both entire studies and individual human subjects. Collectively, our results validate a powerful and generative framework for synthesizing human neuroimaging data on an unprecedented scale.
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              Integrating psychological and neurobiological considerations regarding the development and maintenance of specific Internet-use disorders: An Interaction of Person-Affect-Cognition-Execution (I-PACE) model.

              Within the last two decades, many studies have addressed the clinical phenomenon of Internet-use disorders, with a particular focus on Internet-gaming disorder. Based on previous theoretical considerations and empirical findings, we suggest an Interaction of Person-Affect-Cognition-Execution (I-PACE) model of specific Internet-use disorders. The I-PACE model is a theoretical framework for the processes underlying the development and maintenance of an addictive use of certain Internet applications or sites promoting gaming, gambling, pornography viewing, shopping, or communication. The model is composed as a process model. Specific Internet-use disorders are considered to be the consequence of interactions between predisposing factors, such as neurobiological and psychological constitutions, moderators, such as coping styles and Internet-related cognitive biases, and mediators, such as affective and cognitive responses to situational triggers in combination with reduced executive functioning. Conditioning processes may strengthen these associations within an addiction process. Although the hypotheses regarding the mechanisms underlying the development and maintenance of specific Internet-use disorders, summarized in the I-PACE model, must be further tested empirically, implications for treatment interventions are suggested.
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                Author and article information

                Journal
                2006
                Journal of Behavioral Addictions
                J Behav Addict
                Akadémiai Kiadó (Budapest )
                2062-5871
                2063-5303
                07 April 2020
                : 9
                : 1
                : 58-70
                Affiliations
                [1 ] deptGeneral Psychology: Cognition and Center for Behavioral Addiction Research (CeBAR) , univUniversity of Duisburg-Essen , Germany
                [2 ] Erwin L. Hahn Institute for Magnetic Resonance Imaging , Essen, Germany
                Author notes
                [* ]Corresponding author. General Psychology: Cognition and Center for Behavioral Addiction Research (CeBAR) , univUniversity of Duisburg-Essen , Forsthausweg 2, Duisburg, 47057, Germany. Tel.: +49 203 3792541; fax: +49 203 3791846. E-mail: matthias.brand@ 123456uni-due.de
                Author information
                https://orcid.org/0000-0002-4831-9542
                Article
                10.1556/2006.2020.00010
                a8f97bbd-1313-442d-a535-dbe1e829fe23
                © 2020 The Author(s)

                Open Access statement. This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License ( https://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted use, distribution, and reproduction in any medium for non-commercial purposes, provided the original author and source are credited, a link to the CC License is provided, and changes – if any – are indicated.

                History
                : 12 July 2019
                : 20 December 2019
                : 30 January 2020
                : 05 February 2020
                Page count
                Figures: 04, Tables: 05, Equations: 00, References: 76, Pages: 13
                Categories
                Full-Length Report

                Medicine,Psychology,Social & Behavioral Sciences,Clinical Psychology & Psychiatry
                Internet use disorder,dual process theory,cybersex addiction,compulsive sexual behavior,pornography

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