Emotion regulation in compulsive sexual behavior disorder: Divergence between self-report and neural measures

Background With Compulsive Sexual Behavior Disorder (CSBD) forming a new category in the ICD-11, a discussion arose as to whether deficits in emotion regulation are part of the symptoms. Aims This study aims to further our knowledge on emotion regulation in CSBD by comparing a clinical with a control sample. Methods Questionnaires were used to measure emotion regulation strategies and deficits, as well as alexithymia. Additionally, fMRI data were acquired during an emotion regulation task using negative and neutral emotional pictures. In total, 40 heterosexual men with CSBD and 33 heterosexual men without CSBD participated in the study. Results Men with CSBD showed significantly higher difficulties in emotion regulation (i.e. less cognitive reappraisal and more expressive suppression) as well as more maladaptive and fewer adaptive emotion regulation strategies. Furthermore, men with CSBD reported greater symptoms of alexithymia. However, men with and without CSBD did not show differences in emotional valence ratings when viewing emotion-inducing images. Correspondingly, fMRI data did not reveal significant differences in neural activation patterns between the two groups during the emotion regulation task. Conclusion The results did not show differences in neural activation during the emotion regulation task between the groups. Further studies are therefore necessary to map emotion regulation deficits.