Rudolf Stark

Background: The manner of breathing affects the autonomic nervous system (ANS) and corresponding processes in the body. Most studies focus on techniques prolonging breathing. Nevertheless, there are also techniques aimed at accelerating or changing other aspects of the breath. The variety of concepts suggests that different breathing techniques could have different effects on the ANS. This study intended to investigate differential effects of four yogic breathing techniques on heart-rate variability: (1) Ujjayi—relaxation through slowing down the breath; (2) Paced Breathing—enhancement of concentration by following a precise protocol of slowdown breathing; (3) Kapalabhati—raising wakefulness by mild hyperventilation; and (4) Alternate Nostril Breathing—balancing the autonomic nervous system by alternating breath between the nostrils. We hypothesized that there would be (1) differences in the impact on baseline measures after the training weeks, (2) differences between baseline and practice, (3) higher impact with longer performance of the breathing technique, and (4) differences between techniques. Methods: This study was conducted with 36 participants who learned each technique in group sessions and practiced them daily for two weeks of an eight-week program. After practicing each technique, participants performed the breathing technique while HRV, breathing frequency and other psychological variables were recorded; rMSSD was calculated for to interpret the HRV. Results: We found significant differences between calming and accelerating breathing techniques on HRV and breathing frequency, and different effects of the four breathing techniques compared to their baseline and over practice time. Conclusions: Because breathing is such an easily accessible tool for regulation, it seems important to see which breathing technique helps people regulate quickly and effectively in everyday life.

Background and aims: Problematic usage of the internet (PUI) refers to maladaptive patterns of specific online activities such as gaming, social networking, online shopping, or pornography use. Building on theoretical frameworks such as the I-PACE model and the incentive-sensitization theory, the present multicenter study ( N = 1,015) examined automatic approach and avoidance tendencies toward internet-related cues. Methods: Using an explicit Approach-Avoidance Task (AAT), reaction times to addiction-related and neutral stimuli were assessed and related to symptom severity, cue reactivity, and outcome expectancies. Results: Across all user groups (non-problematic, risky, pathological), participants displayed relative approach tendencies toward internet-related stimuli, with pathological users showing the strongest differentiation between addiction-related and neutral cues. Associations between approach tendencies and both cue reactivity and gratification were best described as linear, with higher cue reactivity and greater experienced gratification being associated with stronger approach tendencies. For symptom severity, curve estimation analyses provided evidence for significant, albeit weak, quadratic associations, suggesting that at high symptom severity approach as well as avoidance tendencies may occur. Discussion and Conclusions: Overall, these findings indicate that approach tendencies toward internet-related cues increase gradually with reward experiences and cue-reactivity, while at higher levels of symptom severity approach or avoidance responses may be observed suggesting that motivational responses remain heterogeneous. From a clinical perspective, approach–avoidance tendencies may serve as behavioral markers relevant to the development and maintenance of PUI and may help inform individualized prevention and intervention strategies targeting cognitive-motivational processes underlying problematic internet use.

Background and aims: The nature and classification of dysregulated sexual behaviors remain widely debated. Compulsive Sexual Behavior Disorder (CSBD) and Problematic Pornography Use (PPU) are the two most commonly studied constructs in this area, each carrying significant implications for mental health, interpersonal functioning, and broader well-being. Although scientific output on these topics has expanded rapidly in the past decade, recent reviews have tended to focus on specific subthemes, single constructs, or narrow disciplinary perspectives. Accordingly, this review provides an updated and interdisciplinary overview of empirical and theoretical knowledge. Methods: In this narrative review, we summarize current knowledge regarding CSBD and PPU, with contributions from diverse experts across multiple disciplines (e.g., psychology, psychiatry, sexology, addiction science, neuroscience). We provide research and clinical perspectives to ensure a comprehensive and balanced discussion. Results: We extensively summarize eleven key areas, namely historical context, conceptualization and symptomatology, assessment and measurement, epidemiology, co-occurring disorders, etiology, potential negative consequences, intervention, treatment, and policy considerations. Additionally, we consider underrepresented populations and contexts, including adolescents, LGBTQ+ (i.e., lesbian, gay, bisexual, trans, queer, and other diverse identities) individuals, women, and cultural factors. The review concludes with a critical discussion of prevailing controversies, methodological challenges, and key directions for future research. Discussion and Conclusions: By providing a comprehensive and integrative overview, this work aims to advance scientific discourse, promote interdisciplinary collaborations, inform clinical practice, and support public health initiatives in the field of CSBD and PPU.

Background and aims: Steroid hormones, such as testosterone and cortisol, may play a role in addictive behaviors, such as problematic pornography use (PPU). According to the dual-hormone hypothesis, their effects are probably interactive and may influence specific behavioral tendencies, like risk taking and impulsivity, which may, in turn, contribute to PPU. To examine these relationships, the present research utilizes endocrine hair analyses, providing a robust index of long-term hormone secretion. Methods: The sample ( N = 252) was part of a multi-center study (FOR2974), including male participants who consume pornography at least occasionally. Testosterone and cortisol concentrations were determined from a proximal 3 cm hair sample via Liquid Chromatography-Tandem Mass Spectrometry. Additionally, decision-making paradigms (i.e., Delay-Discounting Task, Game of Dice Task) and questionnaires assessing impulsivity and symptoms of PPU were used. Results: Testosterone was positively related to PPU, but showed no significant associations with impulsivity and risk taking in a moderated mediation model. Furthermore, cortisol and testosterone interacted with a significant positive effect of testosterone on PPU severity for participants with low cortisol levels, and a non-significant effect in case of high cortisol levels. Discussion and conclusion: This study delivers novel evidence for an association between basal testosterone and cortisol levels in PPU for males. However, the assumed association between hormonal levels, risk taking and impulsivity could not be supported.

Background and Aims: Most men consume pornography, with a small but significant percentage losing control over their use. Since ICD-11, problematic pornography use can be diagnosed as “compulsive sexual behavior disorder.” Debate persists on whether problematic pornography use is an impulse-control disorder or a behavioral addiction. Mechanisms of learning and memory play a central role in addictive disorders but are presumably less relevant for impulse control disorders. Methods: One hundred thirty-nine heterosexual male users of pornography and gaming participated in our study which was part of a multi-center research project on internet use disorders in Germany. We focus on a subsample of fifty-eight non-problematic ( n = 35) and problematic pornography users ( n = 23, labeled pathological). FMRI data were collected during appetitive conditioning, extinction and recall. Pornographic, game, and money images served as unconditioned stimuli, geometric shapes as conditioned stimuli (CS). Results: During appetitive conditioning pathological pornography users showed a generally stronger response in ventral striatum to all CSs, whereas altered activations in extinction and recall were specific to the porn-associated CS. Greater activations in the dorsal anterior cingulate cortex during extinction and in the medial orbitofrontal cortex during recall suggest persistence of appetitive memory for pornography in pathological users, supported by valence ratings and skin conductance responses (SCR). Sensitization to the monetary cue also emerged in SCR. Discussion and Conclusions: Based on these new neurobiological findings, which are consistent with current addiction theories about stimulus-specific altered reward sensitivity and appetitive memory, we argue that problematic pornography use should be considered a behavioral addiction.

Emotion regulation (ER) is a relevant transdiagnostic mechanism for mental health, involving cognitive, behavioral, and physiological processes. Children of parents with a mental illness (COPMI) are at increased risk for ER difficulties, yet the integration of state and trait ER assessments remains underexplored. This study employs a multimodal approach to assess ER in COPMI compared to children of parents without a mental illness (COPWMI). We examined trait ER via self-report in 195 children (96 COPMI/99 COPWMI) aged 4 – 16, cognitive state ER using an emotional Go/Nogo task in 243 children (96 COPMI/147 COPWMI) aged 7 – 16, and physiological state ER through heart rate and electrodermal activity responses during an emotional video task in 124 children (49 COPMI/75 COPWMI) aged 7 – 16. No significant group differences emerged in cognitive or physiological measures of state ER. Emotional stimuli affected physiological responses across all participants, but COPMI did not show heightened reactivity or diminished affective inhibitory control compared to COPWMI. Furthermore, trait ER did not significantly predict state ER responses across groups. These findings challenge the assumption of broad ER impairments in COPMI and highlight the importance of considering situational and environmental factors when assessing ER. The absence of universal state ER deficits suggests that some COPMI may compensate for potential vulnerabilities.

Purpose of Review: This preregistered systematic review examines the role of the striatum in sexual cue processing, with a focus on its involvement in problematic pornography use (PPU) and associations with psycho-behavioral markers of pornography use. Distinctions are made between cue processing in ventral and dorsal striatal subregions as well as between proximal and distal cue types. Recent Findings: Both ventral and dorsal striatal regions are involved in processing proximal and distal sexual cues in clinical and non-clinical populations. Some studies find higher ventral and dorsal striatal activity in participants with PPU compared to non-problematic users when processing proximal and distal sexual cues, whereas other studies report no striatal activity differences. Moreover, altered cue-induced corticostriatal connectivity has been observed in PPU groups. Striatal reactivity and connectivity are further associated with motivational salience, subjective valence of cues and pornography viewing behavior. Summary: Striatal dysregulation may contribute to mechanisms fostering PPU, but the evidence is still limited. The involvement of striatal subregions in specific processes underlying PPU development should be examined in future research.