The Internet’s impact on sexuality: A critical review of 15years of research

The standardization of a new Explicit Pornographic Picture Set (EPPS)

Pictures with affective content have been extensively used in scientific studies of emotion and sexuality. However, only a few standardized picture sets have been developed that offer explicit images, with most lacking pornographic pictures depicting diverse sexual practices. This study aimed to fill this gap through developing a standardized affective set of diverse pornographic pictures (masturbation, oral sex, vaginal sex, anal sex, group sex, paraphilia) of same-sex and opposite-sex content, offering dimensional affective ratings of valence, arousal, and dominance, as well as co-elicited discrete emotions (disgust, moral and ethical acceptance). In total, 192 pornographic pictures acquired from online pornography platforms and 24 control IAPS images have been rated by 319 participants (Mage = 22.66, SDage = 4.66) with self-reported same- and opposite-sex sexual attraction. Stimuli were representative of the entire affective space, including positively and negatively perceived pictures. Participants showed differential affective perception of pornographic pictures according to gender and sexual attraction. Differences in affective ratings related to participants' gender and sexual attraction, as well as stimuli content (depicted sexual practices and sexes). From the stimuli set, researchers can select explicit pornographic pictures based on the obtained affective ratings and technical parameters (i.e., pixel size, luminosity, color space, contrast, chromatic complexity, spatial frequency, entropy). The stimuli set may be considered a valid tool of diverse explicit pornographic pictures covering the affective space, in particular, for women and men with same- and opposite-sex sexual attraction. This new explicit pornographic picture set (EPPS) is available to the scientific community for non-commercial use.

The risks and benefits of technologised sexual practice scale: a quantitative measure of technology facilitated sex and intimacy

BACKGROUND

Technologies such as the Internet, smartphones, and sex toys have demonstrated the capacity to facilitate and enhance sexual and intimate practice by offering new ways to meet sexual partners, maintain and establish intimate connections, and providing access to sexual education and exposure to new ways of engaging in sex. They have also afforded novel risks to safety, privacy, and sexual autonomy. Understanding how people perceive and experience both the risks and benefits of using technology to facilitate sex and intimacy is important to understanding contemporary sexual practice, health, and pleasure. However, research in this space is currently hampered by a lack of quantitative measures to accurately and holistically assess both the risks and benefits in the context of technologised sexual practices.

METHODS

To facilitate a nuanced quantitative exploration of these concepts, we present the psychometric properties of the newly developed Risks and Benefits of Technologised Sexual Practice Scale .

RESULTS

Using an exploratory (Study 1, n =445) and confirmatory factor analysis (Study 2, n =500), this paper presents evidence for a 6-factor scale (Benefits (3): 'sexual gratification', 'connection', and 'access to information and culture'; Risks (3): 'concerns', 'worries', and 'knowledge of rights and ownership').

CONCLUSION

This scale may be used to contribute to research areas including sexual health, sexual behaviour, sexual education, online connection, online safety, and digital literacy with the aim to contribute to a sex- and technology-positive framework for understanding sexual health and pleasure.

Crimes without a body: reflections on a case series of online crimes

There is a large volume of online crimes. The aim of this work is to reflect on virtual crimes that are apparently different but actually have commonalities. In these cases, the corporeal sphere that mediates interpersonal relationships is absent, and perceptions of the real world and emotional regulation may be altered, which poses the risk of destructive behaviours. From this standpoint, self/hetero-directed aggression is the result of a certain type of transition from the real to the virtual world, where the body either is not involved at all or is experienced in an aberrant manner. In this study, we present three cases that clearly illustrate this concept.

Digital sexual identities: Between empowerment and disempowerment

In the digital age, people increasingly explore and express their sexual identities online. The management and development of digital sexual identities can provide opportunities of empowerment on the individual, interpersonal, and societal level. At the same time, social media users are confronted with risks of sexual disempowerment in terms of identity de-validation, social exclusion, discrimination or even criminalization. The review article summarizes the current state of research on six selected sexual identities: (1) heterosexual, (2) LGBTIQ+, (3) asexual, (4) kink and fetish, (5) polyamory, and (6) sex worker identities in digital contexts. Covering a variety of social media platforms and cultural backgrounds, the review demonstrates that digital sexual identities are best understood as multifaceted socio-technical phenomena with ambivalent outcomes.

Adolescent Dilemmas About Viewing Pornography and Their Efforts to Resolve Them

Concerns have been raised about how viewing Sexually Explicit Internet Material (SEIM) shapes adolescents’ understanding of sexual relationships and has potentially negative impacts. However, research frequently takes a narrow view of adolescent SEIM use and excludes their understandings. The present study explored how 13 participants, aged 14 to 15 years, made sense of their experiences with SEIM. In-depth individual interviews were conducted, and five dominant dilemmas faced by participants were abstracted using interpretive analysis. We discuss how these dilemmas were negotiated by adolescents using various strategies. The analysis provides new understandings on how adolescents interpret their SEIM experiences and highlight the limitations of understanding SEIM use solely through risk models. On a practical level, these findings can inform youth, parents and caregivers, and professionals as to how they might understand and help young people navigate the complex area of SEIM.

Gender Differences in Sending Nude Pictures and Videos Across Multiple Relationship Contexts in the Adult Norwegian Population

This article aims to determine the prevalence of sending nude pictures/videos in the Norwegian population and investigates gender differences regarding consensual, unsolicited, and coerced experiences. Data were obtained from a probability-based web survey of 2181 men and 1967 women between 18 and 89 years old. The majority of participants expressed relatively accepting attitudes toward sending nude pictures/videos, and men expressed more positive attitudes than women. Twenty-nine percent of participants reported having lifetime experience with sending nude pictures/videos, and sending nude pictures/videos was more common in younger individuals than older individuals. More women than men claimed that they sent their most recent nude picture to a committed partner, and twice as many men than women had sent a nude picture to a stranger or a person they only had contact with on the Internet. In addition, more than twice as many women than men reported consensual sending nude pictures/videos, and more men than women sent unsolicited pictures/videos. Consensual sending nude pictures/videos was characterized by the presence of men and women within committed relationships. In Norway, sending nude pictures/videos seems to be a way of being sexual in the context of committed relationships.

Findings From a Community Survey of Individuals Who Engage in Pup Play

This study presents findings from a community survey on pup play. Pup play is a kink activity and a form of role play that is growing in popularity internationally, and gaining increasing attention in sexology, yet prior research on pup play has almost entirely employed qualitative methods and primarily involved gay and bisexual men. Using survey data of 733 pup play participants primarily from the US, but also internationally, this study reports on the demographics of participants, how they engage in pup play, its social and sexual elements, and how it relates to social identity and mental health. Unique pup names and identifying with breeds of dogs were used to foster a sense of individuality within pup play, while the majority of participants owned and wore gear when engaging in pup play. We also found significant associations between being younger and identifying as a pup. Most participants reported that pup play improved their mental health. Binary logistic regression analyses indicated that having a mental health diagnosis was associated with identifying with a more social style of pup play and self-reporting the mental health benefits of pup play. We find that the conceptualization of pup play in the existing literature to be accurate to this international sample and highlight areas where further research is needed, alongside limitations of the study.

Treatments and interventions for compulsive sexual behavior disorder with a focus on problematic pornography use: A preregistered systematic review

Background and aims

Compulsive sexual behavior disorder (CSBD) which includes problematic pornography use (PPU) is a clinically relevant syndrome that has been included in the ICD-11 as impulse control disorder. The number of studies on treatments in CSBD and PPU increased in the last years. The current preregistered systematic review aimed for identifying treatment studies on CSBD and PPU as well as treatment effects on symptom severity and behavior enactment.

Methods

The study was preregistered at Prospero International Prospective Register of Systematic Reviews (CRD42021252329). The literature search done in February 2022 at PubMed, Scopus, Web of Science, and PsycInfo, included original research published in peer-reviewed journals between 2000 to end 2021. The risk of bias was assessed with the CONSORT criteria. A quantitative synthesis based on effect sizes was done.

Results

Overall 24 studies were identified. Four of these studies were randomized controlled trials. Treatment approaches included settings with cognitive behavior therapy components, psychotherapy methods, and psychopharmacological therapy. Receiving treatment seems to improve symptoms of CSBD and PPU. Especially, evidence for the efficacy of cognitive behavior therapy is present.

Discussion and conclusions

There is first evidence for the effectiveness of treatment approaches such as cognitive behavior therapy. However, strong conclusions on the specificity of treatments should be drawn with caution. More rigorous and systematic methodological approaches are needed for future studies. Results may be informative for future research and the development of specific treatment programs for CSBD and PPU.

The Great Porn Experiment V2.0: Sexual Arousal Reduces the Salience of Familiar Women When Heterosexual Men Judge Their Attractiveness

Pornography has become widely accessible in recent years due to its integration with the Internet, generating social scientific and moralistic debate on potential "media effects," given correlations between consumption and various sexual traits and behaviors. One popular public debate (Wilson, 2012) claimed that exposure to Internet pornography has addictive qualities that could impact men's sexual relationships, underpinned by the "Coolidge effect," where males are sexually motivated by the presence of novel mates. As claims about Internet and sexual addictions are scientifically controversial, we provide a direct experimental test of his proposal. Adapting a paradigm used to examine "Coolidge-like" effects in men, we examined the extent to which exposure to images of pornographic actresses altered men's attractiveness ratings of (1) familiar faces/bodies on second viewing and (2) familiar versus novel women's faces/bodies. Independent of slideshow content (pornographic versus clothed versions of same actress), heterosexual men were less attracted to familiar bodies, and homosexual men were less attracted to familiar women (faces and bodies), suggesting that mere visual exposure to attractive women moderated men's preferences. However, consistent with one of our preregistered predictions, heterosexual but not homosexual men's preferences for familiar versus novel women were moderated by slideshow content such that familiar women were less salient on the attractiveness dimension compared to novel women when sexual arousal was greater (pornographic versus clothed slideshows). In sum, our findings demonstrate that visual exposure/sexual arousal moderates attractiveness perceptions, albeit that much greater nuance is required considering earlier claims.

Prevalence of Sexting among Greek University Students: A Matter of Relationships?

The study examines sexting among 3,171 Greek university students in the context of different relationship types (i.e. romantic partners, friends, strangers). Participants completed an anonymous online survey, assessing sexting during the last year along with demographic and relationship status information. Sexting was a common practice among participants, with the use of mobile phones and the Messenger application to exchange sexts. Sexting was more common among males and non-heterosexuals. Participants aged 25 and above were more likely to exchange sexts with strangers than those aged between 18 and 24. Romantic partners reported exchanging sexts more often than strangers. Hierarchical regression analyses indicated that non-heterosexual males in a long-distance romantic relationship were more likely to participate in sexting, and that non-heterosexual older males who have been single for the last year were more likely to exchange sexual or provocative messages with strangers. Findings are discussed in terms of their implications.

Dating in Motion: Online Dating Through the Lives of Different Generations of Men Who Have Sex with Men

From the early years of the internet, its key importance was recognized as a site for sexual minorities to explore and express their identity and sexuality. Gay men were quick to connect online, first in chat rooms and subsequently on an ever-expanding array of sites and apps, culminating in geolocation apps such as Grindr. Although a lot of research has investigated the uses of these services, the focus is mostly on younger users, disregarding the experiences of older people. Moreover, the life stage of users is not sufficiently addressed, nor are their evolving uses throughout the life course. The current paper aims to contribute to this knowledge by reporting on a study involving four generations of Belgian men who have sex with men (MSM), combining insights gained in an exploratory survey (N = 684) with in-depth interviews (N = 80). The results show how men from different generations got access to dating sites and apps at different times in their lives, in a shifting balance with offline dating practices. Moreover, at the time of the research, participants were in different stages of their lives, which led to a variety of online dating practices. The end picture is one of dating "in motion", both shifting between generations and changing with the life course of individuals. This paper contributes to the literature on MSM online dating by adding a non-Anglophone perspective, studying a broad age range including older users, disclosing clear intergenerational differences, and transcending a static view of online dating among a single age cohort.

Psychometric Properties of the Problematic Pornography Use Scale in a Japanese Sample

Problematic pornography use (PPU) is the inability to control the use of pornography and is considered a form of compulsive sexual behavior. It can have a negative effect on one's life and is an important clinical and social issue. In Japan, there is no assessment tool to measure PPU and very little research has been done. The Problematic Pornography Use Scale is one of the scales assessing the severity of PPU. This study validated a Japanese version of the Problematic Pornography Use Scale (PPUS-J) and examined its psychometric properties in a sample of 1011 individuals through an online survey (502 men, 509 women; M_age = 35.9 years, SD = 13.75). The results of the confirmatory factor analysis indicated that the four factors in the original scale were consistent with the factors in the PPUS-J, and strict invariance could be assumed for male and female participants. With regard to reliability, internal consistency indices were appropriate both at the overall and subscale levels for male and female participants. The PPUS-J showed good convergent and divergent validity due to the relationship between the subscales and other measures such as the Sexual Compulsivity Scale. These results demonstrate the validity of the PPUS-J for assessing problematic pornography use in a Japanese sample. Given the paucity of studies conducted in non-Western cultures and on women, this study will be useful in advancing research on PPU across different cultures. Future studies should examine test-retest reliability of the PPUS-J and its use with clinical groups.

Sexual Interaction in Digital Contexts and Its Implications for Sexual Health: A Conceptual Analysis

Based on its prevalence, there is an urgent need to better understand the mechanisms, opportunities and risks of sexual interaction in digital contexts (SIDC) that are related with sexual arousal. While there is a growing body of literature on SIDC, there is also a lack of conceptual clarity and classification. Therefore, based on a conceptual analysis, we propose to distinguish between sexual interaction (1) through, (2) via, and (3) with digital technologies. (1) Sexual interactions through digital technologies are face-to-face sexual interactions that (a) have been started digitally (e.g., people initiating face-to-face sexual encounters through adult dating apps) or (b) are accompanied by digital technology (e.g., couples augmenting their face-to-face sexual encounters through filming themselves during the act and publishing the amateur pornography online). (2) Sexual interactions via digital technology are technology-mediated interpersonal sexual interactions (e.g., via text chat: cybersex; via smartphone: sexting; via webcam: webcam sex/camming). (3) Sexual interactions with digital technology occur when the technology itself has the role of an interaction partner (e.g., sexual interaction with a sex robot or with a media persona in pornography). The three types of SIDC and their respective subtypes are explained and backed up with empirical studies that are grouped according to two major mediators: consent and commerce. Regarding the causes and consequences of the three types of SIDC we suggest a classification that entails biological, psychological, social, economic, and technological factors. Regarding implications of SIDC we suggest to focus on both opportunities and risks for sexual health. The proposed conceptual framework of SIDC is meant to inform future research.

Sex on the Screen: A Content Analysis of Free Internet Pornography Depicting Mixed-Sex Threesomes from 2012-2020

Viewing online pornography is common among US adults, with mixed-sex threesome (MST) videos being one of the top 10 most popular categories of pornography for both men and women. The current content analysis applied sexual script theory to understand the themes present in these mixed-sex threesome videos. Independent coders viewed a total of 50 videos (25 MMF and 25 FFM) at each timepoint (2012, 2015, 2020) and coded for different sexual behaviors and themes in each video. By examining both same-sex (female–female, male–male) and other-sex (female–male) behaviors, as well as themes of aggression and sexual initiation in different videos and across three timepoints, it was determined that other-sex behaviors are more common in MST videos than same-sex behaviors. Same-sex behaviors between two female actors were more common than same-sex behaviors between two male actors. Aggression was a common theme in videos, with male actors being more aggressive on average than female actors. Most of these trends did not change across 8 years, suggesting that the impacts of traditional sexual scripts are pervasive in pornography, even in current online content. Important implications for both researchers and clinical professionals are discussed.

Electrophysiological evidence of enhanced early attentional bias toward sexual images in individuals with tendencies toward cybersex addiction

BACKGROUND AND AIMS

Attentional bias is a key factor in addictive behavior maintenance. However, whether attentional bias has a similar effect on cybersex addiction is unclear. We investigated differences in the attentional processing of sexually explicit images between individuals with high tendencies toward cybersex addiction (TCA) versus low tendencies using behavioral and electrophysiological indices.

METHODS

Twenty-eight individuals with high TCA and 29 with low TCA performed an addiction Stroop task comprising sexual and neutral images in colored frames. Participants were asked to respond to the frame color and not the image contents, and behavioral and event-related potentials were recorded.

RESULTS

Behaviorally, an addiction Stroop interference effect was found in the high TCA group, as shown by the longer reaction times to judge the frame colors of sexual images. Electrophysiologically, a P200 (150-220 ms) enhancement was present in response to sexual images compared with neutral ones, which was absent in the low TCA group. The event-related potential correlates with the addiction Stroop interference effect, indicating that the attentional bias underlying the addiction Stroop interference operates at an automatic level. A general, sexually related bias was found in the late positive potential (300-700 ms) amplitude, although between-group differences were insignificant.

DISCUSSION AND CONCLUSIONS

These findings indicate that sexual stimuli grab the attentional resources of individuals with high TCA at early automatic stages of attentional processing. Increased cue reactivity to sexual stimuli may contribute to pornographic consumption and play a crucial role in sustaining problematic excessive use of online pornography.

Pornography Addiction: An Exploration of the Association Between Use, Perceived Addiction, Erectile Dysfunction, Premature (Early) Ejaculation, and Sexual Satisfaction in Males Aged 18-44 Years

INTRODUCTION

The way men consume pornography changed over the last decade, with increased numbers of men presenting with self-perceived Internet pornography (IP) addiction and related sexual dysfunction. A lack of consensus and formal recognition in the DSM-5 lead to a variety of definitions of IP addiction. Currently, the majority of evidence linking IP addiction and sexual dysfunction was derived from consumers, case studies, and qualitative research. Where empirical measures were used, researchers found mixed outcomes in sexual response. Inconclusive data appeared to relate to the conflation of IP use and self-perceived IP addiction, and normal variations in sexual response with clinical diagnosis of sexual dysfunction. Thus, further empirical clarification is required to assess the impact of both IP use and self-perceived IP addiction, on men's sexual function.

AIMS

This study has 3 aims: First, to assess if there is an association between IP use alone and erectile dysfunction (ED), premature (early) ejaculation (EE) and sexual satisfaction (SS); Second, to assess whether there is an association between self-perceived IP addiction and ED, EE and SS. Third, to assess whether IP use or self-perceived IP addiction uniquely predicts ED, EE, SS in men.

METHOD

Correlation and regression analysis was conducted on a cross-sectional sample of 942 heterosexual men aged 18-44 years who participated in an online survey sourced from Reddit IP subgroups.

MAIN OUTCOME MEASURES

Cyber-Pornography Use Inventory; International Index Erectile Dysfunction; The Checklist for Early Ejaculation Symptoms; New Sexual Satisfaction Scale; Depression Anxiety Stress Scale-21.

RESULTS

There was no evidence for an association between IP use with ED, EE, or SS. However, there were small to moderate positive correlations between self-perceived IP addiction and ED, EE and sexual dissatisfaction. Further, self-perceived IP addiction uniquely predicted increased ED, EE and individual sexual dissatisfaction. Contrary to expectations, self-perceived IP addiction did not predict sexual dissatisfaction with one's sexual partner.

CONCLUSION

These results suggest that IP use alone does not predict sexual dysfunction. Rather, self-perception of increased IP addiction was related to negative sexual outcomes. Thus, we concluded that subjective interpretation of ones IP use was a contributor to IP related sexual problems in our sample of males who share IP on social media sites. We recommend that clinicians consider self-perceived IP addiction as a possible contributing factor to sexual dysfunction. Whelan G, Brown J. Pornography Addiction: An Exploration of the Association Between Perceived Addiction, Erectile Dysfunction, Premature (Early) Ejaculation, and Sexual Satisfaction in Males Aged 18-44 Years. J Sex Med 2021;18:1582-1591.

Adolescents who solely engage in online sexual experiences are at higher risk for compulsive sexual behavior

In addition to its expression offline, sexual behavior is frequently expressed online. Some adolescents solely engage in online sexual activities, whereas others in offline and online activities, or have no sexual experience at all. In the current research, we examined whether those who solely engage in online sexual activities are at greater risk for compulsive sexual behavior. In Study 1 (n = 164), we examined differences in compulsive sexual behavior (CSB) and risky sexual action tendencies between study groups. In Study 2 (n = 713), we statistically replicated the classification into different sexual behaviors and examined differences between the clusters in CSB, social tendencies and socio-demographic measures. Results indicated that adolescents who only engaged in online sexual activities had significantly higher percentage of clinical CSB, were less likely boys and more likely to be religious. There were not more prone to risky sexual behavior, however. The current research expands the knowledge about offline or online sexually related activities among adolescence.

Adolescent Sexting: The Role of Body Shame, Social Physique Anxiety, and Social Networking Site Addiction

The aim of this study was to analyze the relationship between body shame and participation in sexting among adolescents by examining the mediational roles of social physique anxiety and misuse of social networking sites (SNSs). Four hundred thirty-nine adolescents completed self-report measures for assessing their levels of body shame, social physique anxiety, SNS addiction symptoms, and sexting participation. Female adolescents reported higher scores in body shame, social physique anxiety, and SNS addiction symptoms, whereas male adolescents reported higher participation in sexting behaviors. In addition, gender did not moderate the relationship between body shame and higher sexting behaviors. Finally, the results showed an indirect (but not a direct) association between body shame and sexting behaviors through social physique anxiety and SNS addiction symptoms. These findings provide empirical evidence for the development of sexting prevention programs that are focused on body acceptance with the aim of reducing body shame, social physique anxiety, and SNS addiction.

Pornography Use and Perceived Gender Norms Among Young Adolescents in Urban Poor Environments: A Cross-site Study

PURPOSE

The purpose of the study is to assess the prevalence of pornography use and its association with a range of perceived gender norms among adolescents aged 10-14 years across five urban poor settings globally.

METHODS

The study includes 9,250 adolescents aged 10-14 years from Belgium, China, the Democratic Republic of the Congo, Ecuador, and Indonesia, as part of the Global Early Adolescent Study. We examined the percentage of pornography use by sex and site and conducted multivariate logistic regressions to examine the relation between gender norm perceptions and pornography use, adjusting for individual, family, peer, and media exposures.

RESULTS

Ever-use of pornography ranged from 14.5% in Ecuador to 33.0% in Belgium and was more common among boys than girls. Overall, boys who perceived greater permissiveness about romantic relations, adolescents who engaged in such relations, and adolescents who assumed that their friends were sexually active had greater pornography exposure. Pornography use did not systematically correlate with unequal gender norms. Such correlations only exist among boys in two Asian sites, where a supportive school environment, more caregiver awareness, and/or neighborhood cohesion were related to less pornography use.

CONCLUSIONS

Pornography use is a gendered experience that begins in early adolescence. Although factors of pornography use vary across the social context, the exposure to pornography has become a normative part of adolescent sexuality development. Young people, especially those from where sexuality remains taboo, need the ability to critically process information and avoid potential risks associated with pornographic gendered and sexual stereotypes, calling for comprehensive sexuality education programs to help them build the knowledge and confidence they need.

Cognitive processes related to problematic pornography use (PPU): A systematic review of experimental studies

INTRODUCTION

Some people experience symptoms and negative outcomes derived from their persistent, excessive, and problematic engagement in pornography viewing (i.e., Problematic Pornography Use, PPU). Recent theoretical models have turned to different cognitive processes (e.g., inhibitory control, decision making, attentional bias, etc.) to explain the development and maintenance of PPU, but empirical evidence derived from experimental studies is still limited. In this context, the present systematic review aimed to review and compile the evidence around cognitive processes related to PPU.

METHODS

A systematic review was performed in accordance with PRISMA guidelines to compile evidence regarding cognitive processes related to PPU. We retained and analyzed 21 experimental studies addressing this topic.

RESULTS

Studies were focused on four cognitive processes: attentional bias, inhibitory control, working memory, and decision making. In brief, PPU is related to (a) attentional biases toward sexual stimuli, (b) deficient inhibitory control (in particular, to problems with motor response inhibition and to shift attention away from irrelevant stimuli), (c) worse performance in tasks assessing working memory, and (d) decision making impairments (in particular, to preferences for short-term small gains rather than long-term large gains, more impulsive choice patterns than non-erotica users, approach tendencies toward sexual stimuli, and inaccuracies when judging the probability and magnitude of potential outcomes under ambiguity).

CONCLUSION

This systematic review offers a comprehensive overview of the current state of knowledge regarding the cognitive features related to PPU, and points out new areas that warrants further research.

Pornography Use, Two Forms of Dehumanization, and Sexual Aggression: Attitudes vs. Behaviors

Sexual objectification is a common pornographic theme. Research shows that sexual objectification leads to the expression of aggressive attitudes and behaviors toward women. Based on a survey study of 320 male participants, this study re-conceptualizes sexual objectification in terms of two forms of dehumanization. Evidence suggests men's pornography use is positively associated with both forms, but mechanistic dehumanization of women is more associated with aggressive attitudes while animalistic dehumanization is more associated with aggressive behaviors. Findings indicate how objectifying pornography use may relate to aggressive attitudes and behaviors and inform the future education campaigns and interventions to reduce sexual aggression.

Young Adults' Qualitative Self-Reports of Their Outcomes of Online Sexual Activities

Online sexual activities (OSA) refer to Internet-based activities, behaviours, and materials that are sexual in nature. Many young adults engage in OSA, but report doing so infrequently. Most OSA outcome research has focused on negative effects of only some types of OSA (e.g., viewing pornography online). The goal of this study was to enhance knowledge on the range of OSA outcomes by qualitatively exploring young adults' self-reported negative and positive outcomes from OSA experiences generally. University/College students from Canada (n = 246), Germany (n = 411), Sweden (n = 299), and the USA (n = 123) completed an online survey that included open-ended questions about "one of the most positive/negative effects that engaging in online sexual activities has had on your life". More participants provided positive outcome responses than negative outcome responses. Qualitative analysis of the responses suggested a wide range of positive and negative outcome content that fit into seven bi-polar, higher-order themes: No Outcomes, Relationship Outcomes, Sexual Experience, Emotional Outcomes, Knowledge, Personal Outcomes, and Security. We found no variations in themes or their respective codes across the four countries. The findings suggests that researchers, educators, health care and psychology providers need to include multiple dimensions of positive and negative, personal and interpersonal, sexual and non-sexual OSA outcomes in their work.

Sex Education in the Spotlight: What Is Working? Systematic Review

Adolescence, a period of physical, social, cognitive and emotional development, represents a target population for sexual health promotion and education when it comes to achieving the 2030 Agenda goals for sustainable and equitable societies. The aim of this study is to provide an overview of what is known about the dissemination and effectiveness of sex education programs and thereby to inform better public policy making in this area. Methodology: We carried out a systematic review based on international scientific literature, in which only peer-reviewed papers were included. To identify reviews, we carried out an electronic search of the Cochrane Database Reviews, ERIC, Web of Science, PubMed, Medline, Scopus and PsycINFO. This paper provides a narrative review of reviews of the literature from 2015 to 2020. Results: 20 reviews met the inclusion criteria (10 in school settings, 9 using digital platforms and 1 blended learning program): they focused mainly on reducing risk behaviors (e.g., VIH/STIs and unwanted pregnancies), whilst obviating themes such as desire and pleasure, which were not included in outcome evaluations. The reviews with the lowest risk of bias are those carried out in school settings and are the ones that most question the effectiveness of sex education programs. Whilst the reviews of digital platforms and blended learning show greater effectiveness in terms of promoting sexual and reproductive health in adolescents (ASRH), they nevertheless also include greater risks of bias. Conclusion: A more rigorous assessment of the effectiveness of sexual education programs is necessary, especially regarding the opportunities offered by new technologies, which may lead to more cost-effective interventions than with in-person programs. Moreover, blended learning programs offer a promising way forward, as they combine the best of face-to-face and digital interventions, and may provide an excellent tool in the new context of the COVID-19 pandemic.

Women in Relationships and Their Pornography Use: A Systematic Review and Thematic Synthesis

A systematic review and thematic synthesis were conducted on the motivations, purposes, and influence of pornography use among women who are in committed relationships. Pornography use was identified as having both positive and negative outcomes for women's sexual and relationship lives. Women watched pornography for diverse reasons: to feel sexually empowered, to enhance sexual arousal, and for masturbation purposes. Shared use of pornography with partners provided variety in sexual activities, could aid communication about sexual issues and helped improve intimacy. Pornography use can help some women feel sexually empowered, relaxed and better able to enjoy their sexual lives.

Posts, Likes, Shares, and DMs: A Qualitative Exploration of How Social Media Is Related to Sexual Agency in Young People

It is well documented that social interactions have a crucial impact on all aspects of personal development for adolescents, however few studies have documented how social interactions affect a young person's sense of sexual agency. The aim of the current qualitative study was to examine young people's perceptions of their own sexual agency in relation to their social media attitudes and behaviors. Participants (n = 31) were recruited from a nonprofit organization and asked to complete a one-hour in-depth interview and a demographic survey. Using an inductive method, involving constant comparison, we identified four overarching themes: (a) Participants utilize different social media platforms for distinct purposes and are cognizant of each audience; (b) Based on past experiences, participants have negotiated and created their own rules of engagement for online behavior; (c) Participants have different expectations about how others should act online versus how they act in relation to flirty or sexual messages; (d) Participants were concerned about the authenticity of online identities and are aware of vulnerability in online interactions. Our results highlight the need for sexual health researchers to observe social network etiquette closely through the lens of autonomy and agency.

Compulsive Internet Pornography Use and Mental Health: A Cross-Sectional Study in a Sample of University Students in the United States

Background

The sustained rise in negative mental health reports among university students is a source of continued global concern, and investigation continues into potential contributors to this rise. This includes the increased prevalence of risky sexual behaviors. Related is the increased prevalence of pornography use. Our study sought to explore the potential relationship between compulsive use of pornography and mental health in university students.

Methods

Our sample consisted of university students (N = 1031; 34% male, 66% female) from Franciscan University of Steubenville, Steubenville, Ohio. An anonymous survey was sent to all students at the university over the age of 18. The survey was comprised of the following: (1) demographic questions, (2) questions on pornography use and perception, (3) a modified version of the Compulsive Internet Use Scale (mCIUS) assessing various factors associated with compulsive internet pornography use, (4) questions assessing emotional and sexual states relative to pornography use (EmSS), and (5) the 21-question version of the Depression, Anxiety and Stress Scale (DASS-21).

Results

Our results indicate that 56.6% of those surveyed reported lifetime pornography use, with a significantly higher proportion of males than females reporting such use. The majority of students reported accessing pornography through internet-related technologies. Additionally, 17.0, 20.4, and 13.5% of students reported severe or extremely severe levels of depression, anxiety and stress, respectively, with compulsive pornography use significantly affecting all three mental health parameters in both sexes. Exploratory Factor Analysis identified three factors suggesting emotional coping, dependence and preoccupation for the mCIUS items and three factors reflecting interoceptive, impotent, and extrinsic characteristics for the EmSS items. Regression analysis indicated that various demographics, items pertaining to reduced control and social impairment, and other variables pertaining to pornography use predicted mental health outcomes. Faith, morals and personal motivation were the primary variables reported to help reduce pornography use.

Conclusion

Our analyses indicate a significant relationship between mental health and pornography use, including behaviors reflecting behavioral addictions, highlighting the necessity for a better understanding and consideration of the potential contribution of internet pornography to negative mental health among university students.

Experiences with Diverse Sex Toys Among German Heterosexual Adults: Findings From a National Online Survey

Studies from English-speaking countries show that sex toy use is common in various populations and often associated with sexual well-being. Empirical data on sex toy use and perceived effects in other countries is still missing. Based on the Positive Sexuality framework and the Positive Technology framework, this study documented the prevalence of sex toy use in solo and partnered sex among heterosexual-identified women and men in Germany, as well as perceived positive and/or negative effects of sex toy use on sexual well-being. A survey was conducted with a national online sample of 1,723 heterosexual-identified adults in Germany (M_age = 42.71, SD = 13.25, 49% women, 51% men). The majority (52%) reported sex toy use in partnered sex, and 45% reported sex toy use in solo sex. Stronger positive than negative perceived effects of sex toy use were reported by women and men alike. Findings indicate that professionals in sexual health/sexuality education should consider sex toy use as a common and beneficial sexual behavior. Future studies could explore specific effects of sex toy use and their predictors in more detail.

The Neurosciences of Health Communication: An fNIRS Analysis of Prefrontal Cortex and Porn Consumption in Young Women for the Development of Prevention Health Programs

This work explores the use of fNIRS neuroimaging technique using young female college students with different levels of consumption of pornography, and the activation of the prefrontal cortex (cue reactivity) when viewing a pornographic clip (cue exposure) versus a control clip. The results indicate that the viewing of the pornographic clip (vs. control clip) causes an activation of Brodmann's area 45 of the right hemisphere (BA 45, pars triangularis) (p < 0.01). An effect also appears between the level of self-reported consumption and the activation of right BA 45: the higher the level of self-reported consumption, the greater the activation (p < 0.01). On the other hand, those participants who have never consumed pornographic material do not show activity of the right BA 45 compared to the control clip (p < 0.01) indicating a qualitative difference between non-consumers and consumers. These results are consistent with other research made in the field of addictions. It is hypothesized that the mirror neuron system may be involved, through the mechanism of empathy, which could provoke vicarious eroticism. Finally, we suggest the applications that these results may have for primary and secondary prevention programs in the field of problematic consumption of pornography.

Meeting Sexual Partners Online and Associations With Sexual Risk Behaviors in the Swedish Population

BACKGROUND

Online arenas may facilitate sexual encounters. However, to what extent finding sexual partners online is associated with sexual risk behavior and sexual health outcomes is still not fully explored.

METHODS

A stratified randomized population based study on sexual and reproductive health and rights of 50,000 Swedes was conducted in 2017. The final sample consisted of 14,537 women and men aged 16-84 years. We identified sexual health factors associated with finding sexual partners online and estimated prevalences thereof.

RESULTS

Having used the internet to meet sexual partners was reported by 11% (95% confidence interval: 10.1-12.3) of men and 7% (95% confidence interval: 6.0-7.4) of women and was most common among men aged 30-44 years (13.7%). After adjustment, those reporting a non-heterosexual identity were most likely to meet sexual partners online. Meeting sexual partners online was also associated with reporting several sexual risk behaviors: condomless sex with temporary partner during the past 12 months, adjusted odds ratio (AOR): 5.1 (3.8-6.8) for women and AOR: 6.0 (4.5-7.9) for men, and having had a test for sexually transmitted infections (STIs) generated a 4-fold AOR for both sexes, STI diagnosis showed a 2-fold AOR, ever having paid or given other compensation for sex AOR: 4.8 (2.7-8.8) for women and AOR: 4.2 (2.9-6.1) for men as well as ever having received money or other compensation for sex AOR: 4.0 (1.3-11.9) for women and AOR: 6.0 (2.4-15.1) for men.

CLINICAL TRANSLATION

Meeting sexual partners online was associated with sexual risk behaviors, which is of importance in tailoring sexual health interventions and STI/HIV-control activities.

STRENGTHS AND LIMITATIONS

Few studies of online sexual behaviors are based on population-based surveys of the general population with results stratified by sexual identity. However, the use of lifetime prevalence of ever having used the internet, smartphone, or app to meet sexual partners has limitations.

CONCLUSION

Meeting sexual partners online was associated with sexual risk behaviors in a randomized sample of the Swedish population, which is of importance to tailoring sexual health interventions. Deogan C, Jacobsson E, Mannheimer L, et al. Meeting Sexual Partners Online and Associations With Sexual Risk Behaviors in the Swedish Population. J Sex Med 2020;17:2141-2147.

Design, Use, and Effects of Sex Dolls and Sex Robots: Scoping Review

BACKGROUND

Although sex toys representing human body parts are widely accepted and normalized, human-like full-body sex dolls and sex robots have elicited highly controversial debates.

OBJECTIVE

This systematic scoping review of the academic literature on sex dolls and sex robots, the first of its kind, aimed to examine the extent and type of existing academic knowledge and to identify research gaps against this backdrop.

METHODS

A comprehensive multidisciplinary, multidatabase search strategy was used. All steps of literature search and selection, data charting, and synthesis followed the leading methodological guideline, the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) checklist. A total of 29 (17 peer reviewed) and 98 publications (32 peer reviewed) for sex dolls and sex robots, respectively, from 1993 to 2019 were included.

RESULTS

According to the topics and methodologies, the sex doll and sex robot publications were divided into 5 and 6 groups, respectively. The majority of publications were theoretical papers. Thus far, no observational or experimental research exists that uses actual sex dolls or sex robots as stimulus material.

CONCLUSIONS

There is a need to improve the theoretical elaboration and the scope and depth of empirical research examining the sexual uses of human-like full-body material artifacts, particularly concerning not only risks but also opportunities for sexual and social well-being.

Aligning the "Manifesto for a European Research Network into Problematic Usage of the Internet" with the Diverse Needs of the Professional and Consumer Communities Affected by Problematic Usage of Pornography

The Manifesto for a European research network into Problematic Usage of the Internet was published in May 2018. It was written from the perspective of the COST Action Network, a programme of the European Cooperation in Science and Technology CA16207 and is expected to have significant influence on research funding priorities over the next decade. The Manifesto identified nine key research priorities to advance understanding in the field. Our analysis shows that while at the most general level it identified problematic usage of pornography (PUP) as a key research priority, it then barely mentioned it again within the body of the report. This paper uses the Manifesto's framework to suggest research areas into the problematic usage of pornography which are of particular relevance to clinicians and other professionals working in the field who want to develop approaches to assist individuals and target groups affected by PUP. It also looks at potential research opportunities inspired by the lived-experience of users withdrawing from PUP. A large number of opportunities are identified for new work on PUP across all nine key research areas of the Manifesto.

Hooking-Up, Religiosity, and Sexting Among College Students

The purpose of this study was to evaluate the mediation effect of sexting, and taking sexually suggestive photos on religiosity and hooking-up with three separate sexual outcomes. A web-based survey examined the relationship between religiosity and the three hooking-up outcomes among students reporting sexting or taking a sexually suggestive photo in the last 30 days (n = 231). Sexting, as well as taking sexually suggestive photos mediated the relationship between religiosity and hooking-up among females. Sexting may be initiated by females as a way to engage in a nonphysical sexual interaction, which ultimately predisposes them to a physical sexual outcome.

Behind Closed Doors: Individual and Joint Pornography Use Among Romantic Couples

Most previous research on the associations between pornography use and relational well-being has utilized individual data sets that have limited scholars' ability to truly understand the dyadic nature of pornography use within romantic couples. Using a dyadic data set of 240 committed heterosexual couples from the United States, we explored actor and partner associations between pornography use, sexual dynamics, and relational well-being. We also explored how couple pornography use and partner knowledge of pornography use were associated with well-being. Results suggested that female pornography use was associated with higher female sexual desire but no other dependent variables. Male pornography use was associated with a wide array of negative well-being indicators, including less male and female relationship satisfaction, lower female sexual desire, and lower male positive communication. Couple pornography use was associated with higher reported sexual satisfaction for both partners but no other well-being indicators. Partner knowledge of use had little direct association with well-being, but some evidence suggested that unknown individual use may be associated with less sexual satisfaction but more relationship satisfaction. Results suggest that different configurations of use among heterosexual couples are associated with varying relational well-being indicators.

AS, Thakur PC, N. S, Sahu M, John N, Tapatrikar A, Biswas A, Vishwakarma A, R. A, Singh P, Murthy KD. Pathways to Cybersex: Case-Report-Based Exploration

The internet has become the preferred platform for use of webcam. The interactive online aspect of webcamming allows participants to have stimulating enjoyable experience for each act. There has been an increasing trend in users seeking help from the service for healthy use of technology (SHUT) specialty clinic for the management of pornography use. Clinical interviews were used to elicit details about their concern. The cases demonstrated the role of online behaviors especially cybersex in managing stress, free time, loneliness, boredom, as well as the need for novelty. It implies the need for screening the pathways to cybersex as well as to evolve intervention to manage these pathways in an Indian context.

Contribution of sexual desire and motives to the compulsive use of cybersex

BACKGROUND AND AIMS

Cybersex is increasingly associated with concerns about compulsive use. The aim of this study was to assess the roles of motives and sexual desire in the compulsive use of cybersex.

METHODS

The sample consisted of 306 cybersex users (150 men and 156 women). The participants were assessed using the Compulsive Internet Use Scale (CIUS) adapted for cybersex, the Cybersex Motives Questionnaire (enhancement, coping, and social motives), and the Sexual Desire Inventory-2 (dyadic and solitary sexual desire).

RESULTS

For both genders, coping motive was associated with CIUS score. For women, an additional association with social motives was found whereas an association with sexual desire was found for men.

CONCLUSION

The study showed gender differences in the contributors to sex-related CIUS scores.

The Sentiment Analysis of Tweets as a New Tool to Measure Public Perception of Male Erectile and Ejaculatory Dysfunctions

INTRODUCTION

Twitter is a social network based on "tweets," short messages of up to 280 characters. Social media has been investigated in health care research to ascertain positive or negative feelings associated with several conditions but never in sexual medicine.

AIM

To assess perceptions related to erectile dysfunction (ED) and premature ejaculation (PE) among Twitter users.

METHODS

Data collection was performed on a daily basis between May 24-October 9, 2018 (138 days) via an automated script. Data collection was then performed after data cleaning. The statistical software R and the rtweet packages were used in both phases.

RESULTS

We collected 11,000 unique tweets for PE and 30,546 unique tweets for ED. After data cleaning, we analyzed 7,020 tweets on PE and 22,648 tweets on ED by analyzing the most recurring words and the clusters describing word associations. The most popular words for ED were "Treatment," "Health," and "Viagra," whereas "Sex," "Sexual," and "Cure" were the top 3 for PE. Word clusters suggest the presence of some recurring themes, such as medical terms being grouped together. Additionally, tweets reflect the general feelings triggered by specific events, such as pieces of news pertaining to sexual dysfunctions.

CLINICAL IMPLICATIONS

Tweets on sexual dysfunctions are posted every day, with more tweets on ED than on PE. Treatment is among the chief topics discussed for both conditions, although health concerns differ between PE and DE tweets.

STRENGTH AND LIMITATIONS

This is the first analysis conducted on Tweets in the field of andrology and sexual medicine. A significant number of tweets were collected and analyzed. However, quantitative assessment of the sentiment was not feasible.

CONCLUSION

Sexual dysfunctions are openly discussed on social media, and Twitter analysis could help understand the needs and interests of the general population on these themes. Sansone A, Cignarelli A, Ciocca G, et al. The Sentiment Analysis of Tweets as a New Tool to Measure Public Perception of Male Erectile and Ejaculatory Dysfunctions. Sex Med 2019;7:464-471.

Portuguese Version of the Cyber Pornography Use Inventory-9: Psychometric Properties and Gender Invariance

We aimed to analyze the factor structure and the psychometric properties of the Portuguese version of the Cyber Pornography Use Inventory-9 (CPUI-9) and to verify the invariance between men and women. A total sample of 257 university students (153 women and 104 men) participated through a web survey. The results of confirmatory factor analysis showed that the three-factor structure of the original version of the CPUI-9 has a good model fit and good convergent and discriminant validities. The findings of the multigroup confirmatory factor analysis demonstrated non-invariance on factor structure across both genders, suggesting that the CPUI-9 should be applied with caution to men and women.

Not all Online Sexual Activities Are the Same

Young people's use and participation in online sexual activities (OSA) has increased in the past two decades and has changed their behavior in the area of sexuality. The existing literature has some important limitations, concerning the assessment of the construct and its orientation toward problematic use, while ignoring its healthy use or social participation and its relationship with well-being. The main objective of this study was to analyze the relationships between the three types of OSA (compulsive, isolated, and social) proposed by Delmonico and Miller, as well as offline sexual behavior, and psychosexual well-being. It was also necessary to evaluate the factor structure of the Internet Sexual Screening Test (ISST). Participants were 1,147 university students of both sexes, aged between 18 and 26 years, who completed a battery of online questionnaires. The main finding of the study is that, when controlling for other online sexual behavior, different types of OSA evaluated relate differently to offline sexual behavior and to psychosexual well-being, and that most young people made healthy use and participation of OSA. It also presents a new structure of the ISST. The discussion emphasizes the need to recognize the positive consequences of OSA to implement programs for the promotion of sexual health.