An Examination of the Influence of Prefrontal Cortical Brain Stimulation on Sexual Decision Making

Abstract Objective: The goal of this study was to clarify the contribution of prefrontal cortex activity to men’s appraisals, affect states, and decision making in the context of hypothetical heterosexual dating scenarios lacking clear consent. Methods: Transcranial direct stimulation (tDCS) was applied to the prefrontal cortex to examine whether it would modify and reduce the likelihood of hypothetical dating violence. Participants (n = 102) responded to first-person vignettes wherein a woman responded either ambiguously or with a refusal to their sexual advance. While responding to the vignettes, participants received sham or active tDCS to modulate prefrontal cortex-mediated responding. Results: Neuromodulation interacted with the communication response type of the woman in the vignette (e.g. ambiguous vs. refusal responses) to influence participants’ reports of negative affect (F = 9.57, P = 0.002, Cohen’s f2 = 0.02) and their sexual decision making (F = 5.06, P = 0.025, Cohen’s f2 = 0.003). For example, participants that received a refusal from a woman while receiving tDCS were more likely to report greater negative affect and a reduced likelihood of sexual behavior as compared with vignettes including an ambiguous response. Conclusions: These findings highlight the complex interplay of situational context on affect and social behavior while providing initial support for the utility of brain stimulation techniques in developing a mechanistic, neurocognitive understanding of the prefrontal cortex’s role in men's sexual decision making in dating scenarios.