Alterations in oxytocin and vasopressin in men with problematic pornography use: The role of empathy

Ariel Kor, Amir Djalovski, Marc N. Potenza, Orna Zagoory-Sharon, Ruth Feldman

Research output: Contribution to journalArticlepeer-review

2 Scopus citations


Background: Addictive behaviors share clinical, genetic, neurobiological and phenomenological parallels with substance addictions. Despite the prevalence of compulsive sexual behaviors, particularly problematic pornography use (PPU), how neuroendocrine systems relate to PPU is not well understood. Preclinical studies demonstrate alterations in oxytocin and arginine vasopressin (AVP) function in animal models of addiction, but no human study has tested their involvement in PPU. Method: Participants included 122 males; 69 reported PPU, and 53 were demographically-matched participants without PPU. Plasma oxytocin and AVP levels and oxytocin-to-AVP balance were measured at baseline. Salivary oxytocin was assessed at baseline and in response to four videos depicting neutral/positive social encounters. Participants reported on empathy and psychiatric symptoms. Results: Baseline plasma AVP levels were elevated in men with PPU, and the ratio of oxytocin-to-vasopressin suggested AVP dominance. Men with PPU reacted with greater oxytocin increases to presentation of neutral/positive social stimuli. Decreased empathic tendencies were found in men with PPU, and this reduced empathy mediated links between oxytocin and pornography-related hypersexuality. Structural equation modeling revealed three independent paths to pornography-related hypersexuality; two direct paths via increased AVP and higher psychiatric symptoms and one indirect path from oxytocin to pornography-related hypersexuality mediated by diminished empathy. Conclusions: Findings are among the first to implicate neuropeptides sustaining mammalian attachment in the pathophysiology of pornography-related hypersexuality and describe a neurobiological mechanism by which oxytocin-AVP systems and psychiatric symptomatology may operate to reduce empathy and lead to pornography-related hypersexuality.

Original languageEnglish
Pages (from-to)116-127
Number of pages12
JournalJournal of Behavioral Addictions
Issue number1
StatePublished - 31 Mar 2022
Externally publishedYes

Bibliographical note

Funding Information:
Funding sources: Supported by the Simms/Mann Foundation Chair to Ruth Feldman.

Publisher Copyright:
© 2021 The Author(s).


  • addictive behaviors
  • arginine vasopressin
  • compulsive sexual behaviors
  • empathy
  • oxytocin
  • pornography


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