Deficits in loss-related feedback processing and risky decision-making among heterosexual males at risk for problematic pornography use

Background and aims: Problematic pornography use (PPU) has been associated with impaired risk-based decision-making, possibly stemming from disrupted feedback processing. However, the underlying cognitive and neural mechanisms remain unclear. This study examined behavioral risk-taking and feedback-related electrophysiological responses in individuals at risk for PPU. Methods: Thirty-five male university students at risk for PPU (M = 20.51, SD = 0.89) and thirty-four matched controls (M = 20.79, SD = 1.70) completed the Balloon Analogue Risk Task (BART) while EEG data were recorded. Self-report questionnaires assessing impulsivity traits were also administered. Results: At the behavioral level, individuals in the PPU risk group exhibited significantly more balloon explosions and lower total earnings than controls, while no group difference was found in the adjusted number of pumps. At the neural level, there were no group differences in the feedback-related negativity (FRN), suggesting intact early evaluation of feedback valence. However, the PPU risk group exhibited significantly reduced P300 amplitudes in response to negative (loss) feedback, suggesting impaired attentional allocation and feedback integration, which may reflect a diminished capacity to adapt behavior based on aversive outcomes. Furthermore, individuals at risk for PPU reported elevated levels of impulsivity, particularly in emotion-driven components such as positive and negative urgency. Conclusion: This neurocognitive profile may contribute to the persistence of maladaptive behaviors despite adverse consequences and highlights potential intervention targets to improve feedback sensitivity and self-regulation in individuals with PPU.