Journal corrects, but will not retract, controversial paper on internet porn

Gary Wilson

Dismissing concerns of the Committee on Publication Ethics and extensive allegations of misconduct, a journal has corrected, but is refusing to retract, a 2016 paper linking online pornography to sexual dysfunction in men.
The article, “Is internet pornography causing sexual dysfunctions? A review with clinical reports,” appeared last year in Behavioral Sciences, which is published by MDPI.
After publication, critics asked COPE to look at the paper, and in particular whether the authors had obtained adequate informed consent for two patients described in the work. COPE, which has no enforcement authority, said in an email to the publisher that it would have recommended retraction of the article.


But the criticisms didn’t stop there. We learned about the controversy about the article from Nicole Prause, a neuroscientist who frequently butts heads with anti-porn campaigners, including Wilson. Prause has produced a 77-item list of alleged misconduct or otherwise sketchy scientific practice. Prause included us on a group email that started out strange and got progressively stranger.
Among the the claims is that one of the authors, Gary Wilson, failed to adequately disclose his work with The Reward Foundation, a UK group whose mission is to

highlight the benefits of quitting porn based on the latest research and self reports of those who have.

Prause claims that Wilson, an “anti-porn blogger” whose TED Talk on the topic has garnered nearly 10 million views, lodged a complaint against her with the California Board of Psychology — “which I have successfully refuted at great expense.”
The corresponding author, Andrew Doan, is an ophthalmologist at the Naval Medical Center in San Diego who runs an anti-porn ministry — a fact not disclosed in the article. His only scholarly work in the field, however, appears to be this 2015 article in the Yale Journal of Biological Medicine and service as an academic editor for an 2015 paper in Behavioral Sciences.
The journal has now corrected the article to reflect Wilson’s undisclosed conflict of interest, but the notice does not mention Doan’s affiliation with Real Battle Ministries:

The conflict of interest section of the published paper [1] has been updated as follows:
“Gary Wilson is the author of Your Brain on Porn: Internet Pornography and the Emerging Science of Addiction. He holds an unremunerated, honorary position at The Reward Foundation, the Registered Scottish Charity to which his book proceeds are donated. The authors declare no other conflicts of interest. Opinions and points of view expressed are those of the authors’ and do not necessarily reflect the official position or policies of the U.S. NAVY or the Department of Defense.”
In addition, the academic editor’s name has been removed from the manuscript.

That editor, Scott Lane, told us that his involvement with the paper:

was one of the most bizarre and atypical experiences I have encountered in my academic career. However, other work I have completed for the journal has not been met with these kind of complications or misunderstandings.

Lane, who is on the editorial board of the journal, said

I wish to make clear that I was not in involved in the final decision regarding correction/retraction/authorship. I only agreed, after reading the second draft of paper (primarily for formatting and article type, not content) that the authors had revised the paper in accord with my original suggestion, which was to focus the manuscript as a case report series rather than a review paper.

Doan told us:

At the time of the submission of the paper in 2015, I was an unpaid volunteer with Real Battle Ministries, a US 501(c)(3) non-profit, which I founded. Real Battle is mainly self-funded by my wife and I. I spoke at schools and community organizations about video game addiction and healthy habits with technology (http://realbattle.org/about/). Because I did not speak at Real Battle events about erectile dysfunction associated with internet pornography and about porn in general (which is a topic not appropriate for general audiences) at the time the paper was submitted for publication, I felt that the topic of the paper on internet pornography and my affiliation with Real Battle Ministries was not a potential conflict of interest. I’ve asked the Editors at Behavioral Sciences, and they agree with me.

Bucking COPE
The nut of COPE’s issue with the article centers on claims by critics of the work that the authors lacked appropriate patient consent from two men who allegedly experienced sexual dysfunction linked to their viewing of online porn. Although the publisher disputes this assertion, in an email to the publisher, a COPE representative expressed concern that the men’s identity was not adequately protected, and that:

Should this case have been raised at one of the COPE Forums, we feel that the recommendation would have been to consider the retraction of the article on the basis of the consent requirements not following expectations of research and publication ethics.

With regard to the COPE comments, Shu-Ku Lin, president of MDPI, told us:

We take COPE’s advise very seriously, of course. I can only tell you that we have done thorough investigation about the editorial procedure and we did not find enough reason to retract.

Lin has now stopped responding to our queries, but he continued to carry on a debate with Prause and others by email — a dispute that got weirder and weirder by turns. In one message, he equated publishing with prostitution to make a point, that, well, we’re not sure we understand:

Everyone needs respect. A publisher provides publishing service. A prostitute provides sexual service legally in some states I suppose. If a guy blame the provider that you are ugly, you are not attractive, you are dirty, you are predatory (only want to collect money from man!), you provided terrible service to other man, I guess the guy might be in trouble and the service provider will refuse to give any service to the guy. This means we can refuse publishing service to your team if you do not stop attacking people. It is a wise decision of the authors to publish with MDPI. You scornfully claim it is a bad idea to publish with us but the paper has been downloaded about 13000 times already and cited many times (see the statistics at the lower part of http://www.mdpi.com/2076-328X/6/3/17), while your guys would prefer to criticized fully and expressed fully your scientific idea only on the social media. The argument is already done. Both sides got large audience. Time to stop and made peace.

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14 thoughts on “Journal corrects, but will not retract, controversial paper on internet porn”

  1. “in accord with my original suggestion, which was to focus the manuscript as a case report series rather than a review paper.”

    This paper presents such a limited set of case reports (2???), they might as well have not included them. It’s mostly just a review with lots of miscellaneous citations

  2. “[…] the paper has been downloaded about 13000 times already […]”.

    Sorry, but this argument is weak: any paper including the words “Pornography” and “Sexual” in the title will obviously attract at least 100 times more potential readers than a paper about, say, “the transference of Madame de La Fayette to the characters of her psychological novel La Princesse de Clèves”. 13,000 views is quite low, indeed.

    Off-topic (not limited to MDPI). I do not really trust the metrics released by publishers about articles impact. Maybe 90% of the hits result from the google-robots crawling the web…

  3. I was unaware that Lead author Doan is an ophthalmologist, and am confused as to whereby he could claim credentials to be lead author publishing case studies on treatment of erectile dysfunction and pornography? Granted, you do use your eyes to look at naked pictures, but beyond that, it sounds grossly unethical for an eye doctor to treat sexual issues.

  4. The facts surrounding the publication of this paper can be found here: “Prause’s efforts to have Behavioral Sciences review paper (Park et al., 2016) retracted.” https://www.yourbrainonporn.com/prause%E2%80%99s-efforts-have-behavioral-sciences-review-paper-retracted. Please note that Dr. Prause’s subterfuge in connection with this paper began before the paper was submitted to “Behavioral Sciences.” She reviewed different versions of it at both journals where it was submitted (the “Yale Journal of Biology & Medicine” in 2015; “Behavioral Sciences” in 2016). Incidentally, both journals ultimately accepted the paper, although the first one didn’t publish it due to a looming print deadline for a special issue.

    It is my understanding (as I have been asked to testify) that the California investigation of Dr. Prause is in full swing, and has not been resolved – let alone resolved in Dr. Prause’s favor.

    It is misleading to imply that COPE was ignored or dismissed, as this is not the case. As is well known, as long as researchers comply with their institution’s IRB consent rules (which was the case here), COPE should have had no problem.

    However, it is true that at one point in Dr. Prause’s lengthy COPE campaign, COPE finally wrote MDPI with a hypothetical question about retraction based on the assumption that no patients had supplied written consents for the case studies. It’s very important to note that the Naval Medical Center San Diego’s IRB policy does not consider case reports of less than four patients in a single article to be human subject research and does not require the patients to consent to inclusion in an article. Although the researchers were not required to obtain consent, for two cases, verbal and written consents were obtained. In the third case where anonymity was unlikely to be compromised, no written consent was obtained.

    In response to COPE’s retraction inquiry, both MDPI and the US Navy thoroughly re-investigated the consents obtained by the doctors who co-authored the paper, as well as the above Navy policy around obtaining consents. Again, even though consents were superfluous for this paper under Navy rules, written consents had been obtained for the two extensive case studies, and the third case study involved so little identifying information that a written consent was deemed unnecessary. Thus, the consent situation did not rise to grounds for retraction, and MDPI declined to retract the paper.

    This was explained to COPE, without further objection from COPE. Yet Dr. Prause, continues to claim falsely that this issue was unresolved and that the patients were not “consented” and retraction is appropriate.

    Dr. Prause’s 77 concerns weren’t 77. A third of them didn’t relate at all to the “Behavioral Sciences” paper she was asked to review! They only made sense if they were read in light of the earlier version of the paper, which she had reviewed when it was submitted to the “Yale Journal of Biology & Medicine.” Such cut-and-paste sloppiness is quite unprofessional, and would justify throwing out the review entirely. (There’s much more to the YJBM story and the mysterious activity of a certain “Janey Wilson” here: https://www.yourbrainonporn.com/prause%E2%80%99s-efforts-have-behavioral-sciences-review-paper-retracted#yale.)

    Nevertheless, despite two additional favorable reviews, “Behavioral Sciences” duly rejected the paper, allowing the authors the option of rewriting it. In the process, all of the remaining concerns were thoroughly addressed and reviewed by the journal. We carefully combed through each comment looking for any useful insights, and wrote a comprehensive response to all comments for “Behavioral Sciences” and its editors.

    Almost all of the remaining 50 critical comments were either scientifically inaccurate, groundless, or were simply false statements. Some were repetitive. Several complained about the presence of quotations from the 3 patients, even though the paper was submitted as “a review with clinical reports.” A few made claims about some of the sources we cited, but the claims were not supported by the papers themselves. More than 10 comments insisted that the doctors were not competent to examine their patients for the case studies(!).

    In short, while reviewers’ comments always improve any paper to some degree, there really wasn’t the need to “fix” much of the paper itself in light of Dr. Prause’s comments. What we did do was strengthen the paper itself with 50 more citations, lest other readers make any of the same errors. The paper was then reviewed favorably twice more.

    If the paper is so flawed, why not ask Dr. Prause why she refused to write a formal criticism of it for the journal when invited (repeatedly) to do so? That’s how scholarly science advances, isn’t it? That way, the authors could have responded formally, rather than being pilloried without benefit of a fair, public exchange. Further, any of Dr. Prause’s own potential conflicts of interest would have had to be disclosed.

    Readers may not realize that this paper had eight authors and three case studies. As it is, your piece misleadingly reads as if Wilson and Doan were the only authors. Among the eight authors were seven physicians with the following expertise: two urologists, a neuroscientist, and two psychiatrists, and a general medical physician.” One author, Dr. Klam, is Director of Mental Health at the Naval Medical Center – San Diego.

    Doan, who is both an MD and a PhD (Neuroscience – Johns Hopkins), is the former of Head of “Addictions and Resilience Research” in the Department of Mental Health at the Naval Medical Center. (He has since been transferred and promoted, and has different responsibilities.) In addition to the papers you mentioned on internet pornography, Doan has authored multiple papers on behavioral addiction/pathologies relating to technologies (in some cases with a co-author of the paper you have written about here). In short, he is a qualified senior author. Those other papers can be found here: https://www.ncbi.nlm.nih.gov/pubmed/?term=doan+klam

    To clarify David Ley’s confusion, Dr. Doan was the corresponding author, while Dr. Park was the first author and Flight Surgeon who first saw the patients described in clinical cases 1 & 2. In the paper, it clearly states what the authors contributed: “Brian Y. Park and Warren P. Klam collected patient case data; all authors contributed to writing the paper.”

    What’s not clear in this article is that my (Wilson’s) affiliation with The Reward Foundation was disclosed from the start (see the original PubMed version, published in August, 2016 – https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5039517/). The correction was published for my protection, in an attempt to stop Dr. Prause from continuing to claim that I was being paid by The Reward Foundation as a lobbyist, or just being “paid off.” (She has publicly advanced several baseless theories about my imagined corruption.) In the journal’s correction, only the title of my book (“Your Brain On Porn: Internet Pornography and the Emerging Science of Addiction”) and a clear indication of my unremunerated role at The Reward Foundation were added. Again, this was to prevent further assertions of any possible financial conflict of interest. Corrected version: http://www.mdpi.com/2076-328X/8/6/55/htm

    In emails to MDPI & COPE and on social media Dr. Prause has multiple times claimed that I received 9,000+ pounds from The Reward Foundation. She also posted this falsehood on the ICD-11 comment board, and apparently endeavored to publish it on Wikipedia multiple times. The evidence is clear that I was not the recipient (evidence in this section: https://www.yourbrainonporn.com/nicole-prauses-pdf-her-span-lab-website#mdpi2).

    In emails to MDPI & COPE and on social media Dr. Prause falsely claimed that I have misrepresented my credentials. This falsehood is addressed in this section: https://www.yourbrainonporn.com/nicole-prauses-pdf-her-span-lab-website#cred

    Scott Lane’s comments are especially puzzling. Your first quotation from him sounds like he might well be referring to being confronted by an irate Dr. Prause (as being atypical) rather than the review process itself having been out of order.

    In any case, all of us share Lane’s feelings that the history of this paper is a “most bizarre and atypical experience.” No one has ever seen anything like Dr. Prause’s campaign against this paper for the last 3 years at two different journals, employing subterfuge, social media, the press, lying, dismissal of evidence, malicious reporting to various agencies (including reporting each of the physicians on the paper to regulatory boards), unsubstantiated public claims that she filed police, FBI and FTC reports and obtained “no contact” orders, Wikipedia campaigns, name-calling – in short every tactic except actual scholarly discourse.

    Again, if Dr. Prause had a problem with the paper’s substance, she should have replied formally when the journal invited her to do so, and allowed the authors a fair “hearing” in a scholarly forum instead of carrying her campaign to the press and social media. For further documentation of this campaign (among others), see this page: https://www.yourbrainonporn.com/nicole-prauses-pdf-her-span-lab-website

  5. I was unaware that Lead author Doan is an ophthalmologist…but beyond that, it sounds grossly unethical for an eye doctor to treat sexual issues.

    As an aside, Doan is the “senior” author (the last name on the list) and the “corresponding” author (the point of contact for the manuscript pre- and post-publication) not the “lead” author.

    In any case, neither the lead nor the senior author of a paper is necessarily involved in treatment. Two of the middle authors list affiliations with NMCSD’s Department of Urology; two others with NMCSD’s Department of Mental Health. Presumably at least two of them were involved in the patients’ treatment.

    While I agree that it would be both bizarre and grossly unethical (except under truly remarkable circumstances) for an opthalmologist to treat sexual issues, I see no reason to suspect that occurred here.

    COPE’s concerns about a failure to properly secure informed consent, however, is an ethical lapse that all of the paper’s authors – and the publisher – share responsibility for.

  6. COPE say that they have been working on the issues raised by this paper for over a year and are still investigating the matter. I believe OASPA is also aware of the issues.

    I wonder if Gary Wilson can confirm that the site he references a number of times in his comment is managed and written by him? If so, why is he repeatedly referred to in the third person on the site?

    I am puzzled as to how until the recent correction Scott Lane was listed as the academic editor and yet he says he was not aware that that was his role.

    Should we be concerned when a paper has been published without an academic editor? Who made the final decision on publication and whether all the changes asked for were made, and in a sufficient manner? Both reviewers appear to have had some reservations about aspects of the paper. Did they both agree to the final version of the paper?

    Should we be concerned that the owner and founder of a scholarly publisher is sending out what some might feel to be unprofessional emails (some of which I have been copied into)? Should not publishers always be professional and completely neutral?

  7. To Richard Poynder:

    Yes, of course it is Dr. Scott Lane who decided to accept the final version for publication.

    Yes, I stay neutral and I never stop inviting the other side to write comments for consideration and publication in our journal.

  8. Shu-Kun Lin

    Thank you for responding, although I am not sure you really address the questions I asked.

    As it is, we are left wondering why Scott Lane asked for his name to be removed as academic editor if, as you seem to be saying, final acceptance was his decision. I am told he made the request because he had not been made aware that the paper was his responsibility, which must leave us wondering about the processes that operate at the journal.

    I also understand that when Scott Lane requested his name be removed an editorial board member was asked to check both the reviews and the process — presumably, therefore, taking on the job of academic editor. One might, therefore, feel that — if only for purposes of tranparency — that person should be named.

    As to the tone of the emails you have been sending out (one example of which is given in the RW post): since you do not address that point I can only assume you feel it to be an acceptable tone for publishers to adopt when engaging with the research community. Personally, I do not.

    Richard Poynder

    1. Thank you for your great concern. It is just fine to satisfy Dr. Scott Lane’s request and have his name removed. I agree with you that the tone of the emails I sent out can be fine tuned but I was writing to sexuality researchers in a hurry to make peace, continue to persuade them to submit a critique and I took example of service for Dr. Nicole Prause and her colleagues to understand extremely easily. I would not tell which service is more humble. I hope I understand your question correctly.

  9. It seems the only person who was to review the reviews, Lane, clearly stated he did not do so. Indeed, he did not know it was expected of him, because he was unaware he was servicing as editor. Thus, it seems this paper was not subject to peer-review, in addition to not behaving ethically with patients. It is unclear why the publisher defends the indefensible.

    1. Exactly. This paper should have been retracted. Period. It does not in any way pass the tests of academic review. It drives me crazy when a bunch of nonsense is presented, then revealed as nonsense, and finally an author ( or authors) step forward with the “we invite debate” garbage that has the undertone of “we started a conversation leading to ‘AWARENESS’ “. Ugh. The point is that if one has an OPINION on a subject, write an editorial…or blog! However, there is an epidemic of OPINIONS with names falsely being added to give credibility to the paper as a scientific study with hypotheses proven. This appears to be done with specific intent. The “Gee whiz, we will take a name off…” reply is insufficient. Bad work done by all who still remain connected to it.

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