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

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          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.


          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.


          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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          Author and article information

          Journal of Behavioral Addictions
          J Behav Addict
          Akadémiai Kiadó (Budapest )
          07 April 2020
          : 1-13
          [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@
          © 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 (, 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.

          Page count
          Figures: 04, Tables: 05, Equations: 00, References: 76, Pages: 13
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