RP4: Cue reactivity in gaming disorder and pornography-use disorder: Behavioral and neural correlates and effects of acute stress

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Cue reactivity and craving are core concepts in research on substance use disorders and addictive behaviors. Deficits in executive functions and decision making have also been considered as playing an important role in addictive behaviors. The association between acute stress and addictive behaviors may be moderated by executive functions. Gaming disorder has been included in the ICD-11 as a disorder due to addictive behaviors. Pornography use disorder may be considered as a subcomponent of compulsive sexual behavior disorder, which has been included in the ICD-11. Many authors, however, rather see parallels between the specific problems in controlling the use of pornography and addictive behaviors, suggesting that pornography use disorder may be considered as subtype of Internet use disorders, comparable to gaming disorder. Neuroimaging studies on cue reactivity and craving in gaming disorder and pornography use disorder have shown activities in the ventral striatum and further structures involved in fronto-striatal loops. To date, there are no studies which systematically examined neural and behavioral correlates of cue reactivity and craving in gaming disorder compared to pornography use disorder. It is important to address this contrast given that pornography-related stimuli may be considered as natural rewards, compared to gaming-related stimuli, which may be considered as secondary reinforcers. This project aims at investigating 1) behavioral and neural correlates of cue reactivity and craving in gaming disorder compared to pornography use disorder, 2) the effects of acute stress on cue reactivity and craving, and 3) interactions between cue reactivity and craving, acute stress, and measures of executive functions and inhibitory control. The project will include five groups (each with 52 male participants): individuals with 1) gaming disorder, 2) risky use of games, 3) pornography use disorder, 4) risky use of pornography, and 5) control participants, who use both games and pornography non-problematically. The study will consist of three parts. At t1, the intensive diagnostics will be conducted including the experimental and neuropsychological tasks of the core battery. In the second part of t1, participants will be randomly assigned to either the stress condition of the Trier Social Stress Test or the control group and will perform a cue reactivity paradigm and a decision-making task with addiction-related pictures. At t2, the fMRI experiment (with 34 participants of each group) with a modified cue reactivity paradigm will be conducted. RP4 is strongly linked to RP2, RP3, and RP6, which will also investigate facets of cue reactivity. Moreover, there are links between RP4 and RP7, which will address inhibitory control and executive functions, and RP4 and RP5, which will examine effects of stress on cue reactivity.