Why it's important to recognize compulsive sexual behavior disorder | Casper Schmidt | TEDxAarhus

Summary

This transcript discusses Compulsive Sexual Behavior Disorder (cSPD), a condition recently recognized by the World Health Organization. Through an example of escalating inappropriate behavior, the speaker highlights how addiction to pornography can negatively impact lives. The disorder is linked to changes in brain structures like the amygdala and prefrontal cortex, reducing self-control and increasing sensitivity to sexual stimuli. The inclusion of cSPD in diagnostic manuals offers hope for better treatment and less stigmatization, paralleling progress made in other addictive disorders like gambling addiction.

Takeaways

• 🚫 Compulsive sexual behavior disorder (CSBD) is a condition where individuals cannot control their sexual urges, leading to personal, social, and occupational dysfunction.
• 🆕 CSBD was officially recognized as a disease by the World Health Organization in 2018, after research showed brain changes associated with the disorder.
• 📈 The accessibility of pornography has significantly increased with the internet, making it a major contributor to the development of CSBD.
• 🌐 Denmark's statistics show that pornographic websites are among the most visited, highlighting the global scale of pornography consumption.
• 🚨 A significant percentage of the population, particularly men, may watch more pornography than they intend to, indicating a potential for addiction.
• 🧠 Neuroscientific studies have found that individuals with CSBD have an enlarged amygdala and reduced connections to the prefrontal cortex, affecting their ability to control sexual behaviors.
• 🔄 There is a parallel between CSBD and other addictions like gambling disorder, suggesting a shared neurobiological basis for addiction.
• ✅ The formal recognition of CSBD as a diagnosable condition will lead to better treatment options and reduced stigma for those affected.
• 🌟 The inclusion of CSBD in diagnostic manuals will help raise awareness among healthcare professionals and improve the chances of successful treatment.
• 🤝 The collaboration between research and clinical practice is crucial for understanding and treating CSBD, with the ultimate goal of improving the lives of those suffering from the disorder.

Q & A

What is Compulsive Sexual Behavior Disorder (CSBD)?

Compulsive Sexual Behavior Disorder (CSBD) is a condition where an individual cannot stop engaging in sexual behaviors, often involving pornography, which leads to personal, social, and occupational dysfunctioning to the extent that it becomes difficult to lead a normal life.

When was CSBD officially recognized as a disorder by the World Health Organization?

CSBD was officially recognized as a disorder by the World Health Organization in 2018, when it was included in their list of diseases.

What is the significance of CSBD being included in the World Health Organization's list of diseases?

The inclusion of CSBD in the WHO's list of diseases signifies that it is now formally recognized as a diagnosable condition. This can lead to better treatment options, reduced stigmatization, and increased awareness among medical professionals.

What role does the amygdala play in individuals with CSBD?

In individuals with CSBD, the amygdala, a region of the brain involved in emotional processing and emotional salience, is often enlarged. This enlargement, along with reduced connections to the prefrontal cortex, may contribute to a shift towards more instinctive behavior and less control over sexual actions.

How does the prefrontal cortex's involvement affect individuals with CSBD?

The prefrontal cortex, often referred to as the 'boss of the brain,' is responsible for exerting conscious control over actions and behavior. In CSBD, the connections between the amygdala and the prefrontal cortex are reduced, which may result in less control over compulsive sexual behaviors.

What is the prevalence of CSBD in the adult population according to the script?

It is estimated that 3 to 6 percent of the adult population in the West suffers from CSBD.

How has the accessibility of pornography changed over the past two decades as mentioned in the script?

Twenty years ago, accessing pornography required physical effort such as visiting a store to rent a video or buy a magazine. In contrast, by 2009, two of the top ten most visited websites in Denmark were pornographic, indicating a significant increase in easy and immediate online access to such material.

What is the reported percentage of children under 12 who regularly watch pornography according to a British survey mentioned in the script?

According to a British survey mentioned in the script, 12% of children below the age of 12 regularly watch pornography.

What does the script suggest about the overlap between CSBD and other addictive disorders?

The script suggests that there is an overlap between CSBD and other addictive disorders such as gambling disorder, where individuals with these conditions are hypersensitive to their respective rewards, be it sexual or monetary.

How has the recognition of gambling disorder as an official diagnosis impacted treatment outcomes, according to the script?

Since gambling disorder was included in diagnostic manuals, 85% of gamblers in Denmark are reportedly in remission one year after treatment, indicating that formal recognition can significantly improve treatment success rates.

What is the importance of individual reports of suffering in advancing research and treatment for CSBD?

Individual reports of suffering are crucial as they bring attention to the phenomenon, prompting clinicians and scientists to initiate research, which in turn can lead to better understanding, diagnosis, and treatment of CSBD.

Outlines

00:00

🤔 The Impact of Pornography Addiction on Behavior

The paragraph introduces a real-life story of a man in Cambridge, referred to as 'M', who suffered from Compulsive Sexual Behavior Disorder (cSPD). It highlights an extreme example where the addiction to pornography leads to inappropriate social behavior, such as propositioning a woman and then a man, despite personal boundaries. M’s story emphasizes the significance of pornography addiction as recognized by the World Health Organization (WHO), with cSPD being included in their list of diseases in 2018. The paragraph underscores the disorder's severity, linking it to social, occupational, and personal dysfunction.

05:01

🧠 Neuroscience Behind cSPD: Enlarged Amygdala & Reduced Control

This section explains the neurological findings related to cSPD, focusing on brain regions like the amygdala and prefrontal cortex. The amygdala, involved in emotional processing, was found to be enlarged in individuals with cSPD, while connections to the prefrontal cortex, which governs self-control, were reduced. This suggests that people with cSPD are more driven by instinctive behaviors and have less control over their actions. The paragraph also draws parallels between cSPD and gambling disorder, emphasizing hypersensitivity to sexual and monetary rewards in both conditions. It highlights the overlap between different behavioral addictions.

Keywords

💡Compulsive Sexual Behavior Disorder (CSBD)

Compulsive Sexual Behavior Disorder, or CSBD, is a condition where an individual experiences an uncontrollable urge to engage in sexual behaviors, often involving pornography. Defined by the World Health Organization, it is characterized by personal, social, and occupational dysfunction. In the script, CSBD is the central theme, with the speaker discussing its diagnosis, impact on individuals, and the brain changes associated with it.

💡Pornography

Pornography refers to the portrayal of sexual subject matter for the purpose of sexual arousal. The script discusses how easy access to pornography has increased significantly, leading to potential addiction and CSBD. It is used as an example of a stimulus that can trigger compulsive sexual behaviors.

💡Amygdala

The amygdala is an almond-shaped structure in the brain involved in emotional processing and salience. In the context of the video, the speaker mentions that individuals with CSBD have an enlarged amygdala, which may contribute to their hypersensitivity to sexual rewards.

💡Prefrontal Cortex

The prefrontal cortex is the anterior part of the frontal lobes in the brain, responsible for executive functions such as decision-making and self-control. The script explains that in CSBD, the connection between the amygdala and the prefrontal cortex is reduced, leading to less control over compulsive sexual behaviors.

💡Neuroscience

Neuroscience is the scientific study of the nervous system and brain functions. The speaker, a neuroscientist, uses neuroscience to investigate the brain changes associated with CSBD, such as the enlargement of the amygdala and its reduced connection with the prefrontal cortex.

💡MRI Scanner

An MRI (Magnetic Resonance Imaging) scanner is a medical imaging technique used to visualize detailed internal structures of the body. In the script, it is mentioned as a tool used by neuroscientists to study the brain's anatomy and function in individuals with CSBD.

💡Diagnosis

A diagnosis is the identification of the nature of an illness or condition through assessment and analysis. The script discusses the importance of CSBD being recognized as a diagnosable disorder by the World Health Organization, which facilitates better treatment and reduces stigma.

💡Stigmatization

Stigmatization refers to the process of labeling and discrediting individuals based on their perceived differences. The script touches on how the inclusion of CSBD in diagnostic manuals can lead to less stigmatization and more understanding of the condition.

💡Treatment

Treatment in the context of the script refers to the therapeutic interventions for individuals suffering from CSBD. The speaker highlights the importance of proper diagnosis for accessing effective treatment and mentions how the recognition of CSBD as a disorder can improve treatment outcomes.

💡Gambling Disorder

Gambling Disorder is a condition where an individual has an uncontrollable urge to gamble, leading to significant harm or distress. The script uses gambling disorder as a comparative example to illustrate how the inclusion of a disorder in diagnostic manuals can improve treatment success rates and reduce stigma.

💡Sexual Rewards

Sexual rewards refer to the pleasurable responses associated with sexual stimuli or behaviors. The script mentions that individuals with CSBD are hypersensitive to sexual rewards, which may contribute to their compulsive sexual behaviors, similar to how individuals with gambling disorder are hypersensitive to monetary rewards.

Highlights

Compulsive sexual behavior disorder (cSPD) was officially recognized as a diagnosis by the World Health Organization in 2018.

Before 2018, people like 'M', who suffered from compulsive sexual behavior, would not have been diagnosed with cSPD.

cSPD affects 3-6% of the adult population in the West, highlighting its prevalence and the potential number of affected individuals.

Pornography addiction and compulsive sexual behavior can lead to significant personal, social, and occupational dysfunction, impacting normal life.

Studies show that the amygdala, which processes emotions, is enlarged in individuals with cSPD, while connections to the prefrontal cortex are reduced.

The prefrontal cortex, responsible for conscious control over behavior, is less engaged in those with cSPD, leading to more instinctive actions.

Compulsive sexual behavior is often hypersensitive to sexual rewards, similarly to how gambling addiction is hypersensitive to monetary rewards.

cSPD becoming an official diagnosis allows general practitioners to diagnose and treat the condition, reducing stigma and improving access to treatment.

Comparisons to gambling addiction show that 85% of individuals with gambling addiction remain in remission one year after treatment, offering hope for cSPD sufferers.

Advances in brain imaging have enabled neuroscientists to study the brain changes associated with cSPD, providing new insights into the condition.

In 2009, Denmark’s 10th and 13th most visited websites were pornographic, indicating the global demand for pornography.

A recent survey in Denmark found that almost one in five men and one in twenty women watch more pornography than they would like.

The inclusion of cSPD in diagnostic manuals helps channel funding and resources into research and treatment efforts.

The story of 'M' illustrates how individual reports of compulsive sexual behavior have helped inform scientific research and improve treatments.

The recognition of cSPD offers the possibility for sufferers to receive better help and for scientists to further research the disorder's underlying brain mechanisms.

Transcripts

you know that woman sitting next to you

in the bar has a boyfriend you know

because he just left for the bathroom

and still the minute he leaves you

approached her and asked if she wants to

come home with you for a night of fun

she refuses you insist then the

boyfriend comes back slaps you a couple

of times until you back off after a

while

you catch sight of a good-looking guy

sitting in the corner of the bar even

though you're not bisexual you go over

to him and offer him a drink and the

same suggestion now this is quite an

extreme example of what can actually

happen when the addiction to pornography

spins out of control but I heard this

specific story from a guy in Cambridge

we can call em who suffered from

compulsive sexual behavior disorder

before 2018 em would have never been

diagnosed with this as it was only last

year that addiction involving

pornography was put on the World Health

Organization's lists of diseases coined

as compulsive sexual behavior disorder

or cSPD

two years before that I published one of

the first narrow scientific studies on

the brain changes associated with cSPD

which helped pave the way towards its

inclusion and acceptance as a diagnosis

by the World Health Organization so what

is cSPD compulsive this means something

that you cannot stop doing and I know

that none of you check your phones every

five minutes for no reasonable intention

to see if you've had any new

notifications but if you did that would

in some mild sense be compulsive sexual

behavior this means that the

compulsivity centers on sexual behavior

and

in most cases pornography and disorder

this implies both personal social and

occupational dysfunctioning for the

individual to an extent where it becomes

very difficult to lead a normal life

basically it ruins people's lives that's

why it's called compulsive sexual

behavior disorder and not compulsive

sexual behavior inconvenience and this

is the exact behavioral pattern that we

see an M twenty years ago if you wanted

to get access to pornographic material

you had to physically go into a store

and rent a video or buy a magazine 20

years later in 2009 T Denmark's 10th and

13th most visited websites are both

pornographic now think about that just

for one second that's including Google

YouTube Facebook Amazon etc and

according to such a statistic

pornography is one of the most

sought-after digital services in Denmark

and abroad as well according to a brand

new Danish survey between 15 and 89

year-olds almost one out of five men and

one twentieth of every woman actually

watch more pornography than they want to

and a British survey has demonstrated

that 12% of children below 12 years old

regularly watch pornography this is

quite frightening statistics and the

adult population it is estimated in the

West that 3 to 6 percent suffer from

cSPD so that means arguably that out of

the 500 people here today you guys in

the front row watch way too much porn

and I'm sorry to call you out like this

but actually you guys in the front row

are addicted to pornography ok anyway

that is if we follow statistics but

quite a lot of people are able to watch

pornography without necessarily become

an addicted

so where does this go wrong for some

people and why do they lose control I'm

a neuroscientist

and basically what that means is that I

stick people inside MRI scanners and see

what happens inside their brains and we

did this with people suffering from cSPD

and what we found was that as a function

here of a region in the brain called the

amygdala was actually enlarged and the

amygdala is a tiny structure that sits

almost at the very center of the brain

and which is very much too involved with

emotional processing and emotional

salience in the brain and not only was

the amygdala enlarged the connections it

had with the prefrontal cortex were

reduced now the prefrontal cortex can be

said to be the boss of the brain this is

where we as humans consciously exert

control over our actions and behavior so

what this means is that when you have

cSPD your brain is actually geared

towards more instinctive behavior and so

what's taking less control over that

behavior and this actually corresponds

very well with what many cSPD subjects

report also cSPD has been associated

with hypersensitivity to sexual rewards

just like this is shown in gambling

disorder that they are hyper sensitive

towards monetary rewards

so there's actually overlap across these

disorders as well so why is it a good

thing that this has become a diagnosis

well the inclusion of cSPD into the

diagnostic manuals means that now

general practitioners throughout the

world will be able to diagnose this

which can lead to better treatment and

better and less stigmatization as of now

people who suffer from cSPD

cannot really receive the same

generalized help on par with other

addictive disorders such as gambling or

alcohol use disorder and that's the

simple answer to this to give you guys a

bit more of a nuanced impression of what

this political decision means we can

draw an example from gambling as an

addictive disorder

since the yes where gambling has been

included into the diagnostic manuals 85%

of gamblers are still in remission

one year after treatment here in Denmark

that's quite remarkable in this sense

it's a genuinely good thing for these

individuals that cSPD has become a

diagnosis as these money as money are

prioritized to these research areas so

actually there may be hope for you guys

in the front row but aside from all

these political classifications in the

scientific conceptualizations that may

seem a bit fancy what it really boils

down to it's the people suffering from

their addictions based on the reports of

M people and without those reports

clinicians and neuroscientists alike

wouldn't really know that that this

phenomenon existed in the first place

but we do thanks to the systematized and

multiple reports of others like him and

the reason that M came into treatment in

the first place came down to the fact

that he himself sought treatment and

when clinicians and scientists begin to

hear about this and talk about this

research can be initiated to examine its

scientific processes behind such

phenomena or behaviors and from that

research better treatment efforts can be

applied to those suffering in this sense

it really is the people's suffering that

should inform the research in order to

create value for these very people a

century ago and may have been considered

a freak by society and perhaps even

admitted to the psychiatric hospital by

a medical professional

today M receives the best help he can

possibly get at this moment in time

through the combined efforts of the

research conducted within this area and

the International classifications based

on that research help is on the way

now therapists and clinicians around the

world will be better able

assess diagnose and treat compulsive

sexual behavior disorder thanks for your

attention

[Music]