Pornography Addiction in Adults: A Systematic Review of Definitions and Reported Impact

"There is No One Way to Be Transgender and to Live Sex": Transgender and Non-Binary Individuals' Experiences with Pornography

Transgender or non-binary (TGNB) people are often present as protagonists of pornographic material. This study is the first to consider TGNB people as critical consumers of sexually explicit material. The sample included 212 self-identified TGNB individuals: 47.2% trans man/transmasculine, 15.6% trans woman/transfeminine and 37.3% non-binary. The online questionnaire consisted of a sociodemographic data collection, multiple-choice questions about preferences and habits concerning pornography, and open-ended questions about the sensations experienced when watching pornography, opinions on the representation of TGNB people in pornography, and their experience in watching pornographic videos with cisgender or TGNB protagonists. The answers were analyzed using the qualitative method of thematic analysis. We identified four themes that appeared across the responses: 1) heteronormativity and cisnormativity in pornography: the need for deconstructing the current cis-het-patriarchial normative and binary system, which dominates pornography except for the ethical porn industry, 2) cisgender pornography compared to TGNB pornography, 3) pleasurable sensations (e.g., identification and empowerment) associated with TGNB pornography, and 4) negative sensations (e.g., objectification and dysphoria) associated with TGNB pornography. Results are discussed in light of the objectification framework and the minority stress model.

Women's Pornography Use Patterns and Sexuality Education in U.S. Public Schools

This study investigated the relationship between sexuality education in U.S. public schools and women's pornography use. Utilizing quantitative methods, we examined a sample of women attending U.S. public schools who reported regular pornography use. Results revealed that, regardless of the type of sexuality education received, women exhibited similar rates of pornography use, with 60% reporting its use. A substantial portion (69%) of the women began using pornography during childhood or adolescence. Women who received abstinence only sexuality education reported higher frequencies of pornography use compared to their comprehensive sexuality education counterparts. About 79% of women using pornography perceived it as a source of sexuality learning, especially regarding sexual pleasure. However, they expressed reluctance in using pornography for sexual education and did not consider it a preferred method for learning about sexuality. The findings suggest the need for comprehensive sexuality education that addresses essential topics, such as sexual pleasure and sexual script development, to cater to women's diverse learning needs, ideally taught by parents or primary caregivers, but may be necessary for public education in the absence of parental instruction. Policymakers and educators should bridge these gaps to develop more effective sexuality education curricula. This study contributes valuable insights, highlighting the importance of an inclusive approach to sexuality education in U.S. public schools. Future research should explore the implications of different sexuality education approaches on women's sexual development and well-being, emphasizing comprehensive education to foster healthy sexual behaviors among women.

Pornography Use and Mental Health Problems in the Chinese Population: Examining the Pornography Problems Due to Moral Incongruence Model

Pornography has become increasingly prevalent worldwide with the development of the Internet, and considerable research on the effects of pornography use has emerged. Based on existing research and the Pornography Problems Due to Moral Incongruence (PPMI) model, we examined problematic pornography use (PPU) as a mediator and moral disapproval of pornography use as a moderator in the links between pornography use frequency and mental health problems in a Chinese sample (N = 833). Our results support the completely mediated effect of PPU (ab = 0.16) and the moderated effect of moral disapproval of pornography use on the association between pornography use frequency and PPU. Pornography use frequency was strongly associated with PPU when participants experienced high moral incongruence (MI), and the indirect effect of PPU was weaker (ab = 0.13) at the lower level of moderator (-1 SD), and stronger (ab = 0.23) at the higher level of moderator (+1 SD). However, the direct effect of MI on mental health problems was not supported. This study advances our understanding of the internal mechanism between pornography use and mental health and extends the PPMI model to the Chinese cultural context (characterized as low religiosity and sexually conservative). The findings confirm the cross-cultural consistency of the PPMI model in China and highlight another important source of MI besides religiosity: cultural characteristics.

Labels Are For Soup Cans: How Self-Labeling as "Addicted" to Pornography Is Associated with Negative Outcomes

Pornography viewers often report being addicted to pornography even if their behavior does not indicate such addiction. In this study with 1099 participants (52% male), we explored how the specific belief in being addicted to pornography could predict both individual and relational outcomes beyond actual pornography use and reported compulsive pornography use (i.e., considering one's use to be out of control). Using a structural equation model, our results showed that higher agreement with the pornography addiction label, without accounting for compulsivity, was associated with higher depression, suicide ideation, communication discomfort about pornography, and higher odds of having a relationship end solely because of pornography. After accounting for compulsivity, higher agreement with the pornography addiction label was only associated with higher communication discomfort about pornography and higher odds of having a relationship end solely because of pornography. This study highlights that identifying as addicted to pornography may include a stigma that is particularly detrimental to relationship outcomes.

Problematic Pornography Use, Mental Health, and Suicidality among Young Adults

The relationship between suicidality and problematic pornography use (PPU) is not clear, and the limited research data that exists show contradictory results. The present study aims to explore the associations between these two variables in a sample of young adults, taking into account gender differences and the role of loneliness, emotional states, and well-being. A total of 332 national and international students (60% female) at an Italian University with a mean age of 23 years (SD = 2.84) completed an anonymous online survey during the period from March 2023 to May 2023. The results show that PPU was associated with higher levels of anxiety, depression, stress, loneliness, and suicide ideation, as well as lower life satisfaction. Gender comparison analysis revealed significantly higher scores for PPU and loneliness among men, while women scored higher in stress, anxiety, and life satisfaction. Significant correlations between PPU and suicidal ideation and having a suicide plan were established for female participants despite their lower scores in PPU. Multiple regression analysis revealed that PPU and its interaction with gender were both significant predictors of suicidal ideation. Future attention should be paid to how young women may be influenced by exposure to sexually explicit materials, while always considering the role of loneliness.

Understanding the Co-occurrence of Gambling Disorder and Problematic Pornography Use: Exploring Sociodemographic and Clinical Factors

The co-occurrence between gambling disorder (GD) and problematic pornography use (PPU) has not yet been explored. Therefore, the present study compared (a) sociodemographic variables, (b) GD-related factors, (c) substance use, (d) psychopathology, (e) personality features, (f) impulsivity, and (g) emotion regulation between individuals with GD (GD group) and those with co-occurring GD and PPU (GD+PPU group). The sample consisted of 359 treatment-seeking individuals with GD: n = 332 individuals had GD only (GD group) and n = 37 individuals had GD and co-occurring PPU (GD+PPU group). GD severity, impulsivity, psychopathology, personality, emotion regulation, and other sociodemographic and clinical variables were assessed. No between-group differences in sociodemographic measures were observed. The GD+PPU group demonstrated greater GD severity and a higher likelihood of substance use compared to those without PPU. Furthermore, the presence of PPU was associated with worse psychopathology, higher impulsivity (except for lack of premeditation and positive urgency), more difficulties in emotion regulation (except for non-acceptance of emotions and limited access to emotions), and a personality profile characterized by lower levels of self-directedness and cooperativeness. The co-occurrence of GD and PPU seems associated with a more dysfunctional clinical profile.

Validation of the ACSID-11 for consistent screening of specific Internet-use disorders based on ICD-11 criteria for gaming disorder: A multitrait-multimethod approach

INTRODUCTION

With the inclusion of gaming disorder in the ICD-11, diagnostic criteria were introduced for this relatively new disorder. These criteria may be applied to other potential specific Internet-use disorders. The 11-item Assessment of Criteria for Specific Internet-use Disorders (ACSID-11) was developed for consistent screening of gaming disorder, online buying-shopping disorder, online pornography-use disorder, social networks-use disorder, and online gambling disorder. This study tested the construct validity of the ACSID-11, including convergent and divergent measures.

METHODS

The ACSID-11 measures five behavioral addictions with the same set of items by following the principles of the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST). The ACSID-11 was administered to a convenience sample of active Internet users (N = 1597) together with validated and established measures of each specific Internet-use disorder along with screeners for mental health. Included are the Ten-Item Internet Gaming Disorder Test (IGDT-10), the Bergen Shopping Addiction Scale (BSAS), the Problematic Pornography Consumption Scale (PPCS), the Bergen Social Media Addiction Scale (BSMAS) and the Berlin Inventory of Gambling behavior - Screening (BIG-S). The ACSID-11 was compared convergently and divergently through a multitrait-multimethod approach along with contingency tables with the other Internet-use disorder screeners.

RESULTS

The multitrait-multimethod results shows that each behavior assessed with the ACSID-11 has moderate to strong correlations (r's from 0.462 to 0.609) with the scores of the corresponding established measures and, furthermore, positive correlations (r's from 0.122 to 0.434) with measures of psychological distress and further shows that the ACSID-11 can be used for a comprehensive assessment of different behaviors. The contingency tables reveal large divergences between the ACSID-11 and other screening instruments concerning the classification of problematic specific Internet use based on the given cut-off values.

CONCLUSION

The current work provides additional validation for the ACSID-11. Accordingly, this tool can be considered as reliable and valid for the simultaneous assessment of different Internet-use disorders: gaming disorder, online buying-shopping disorder, online pornography use disorder, social networks use disorder, and online gambling disorder. With a subsequent clinical validation of the scale and the proposed cut-off score, the ACSID-11 will be a thoroughly validated useful screening tool for clinical practice.

Relationship Between Atypical Sexual Fantasies, Behavior, and Pornography Consumption

Paraphilia is a condition in which the sexual excitement relies on fantasizing and/or participating in unusual sexual behaviors although the line between "normal" and "abnormal" has been disputed. The project aimed to explore which sexual fantasies and behaviors are common and uncommon in the general population. Furthermore, the relationship between sexual fantasies, sexual behaviors, and problematic pornography consumption was examined. Finally, the impact of gender was assessed. Analyses were conducted on a sample of 139 participants. Correlations were found between fantasies, behaviors, and problematic pornography consumption. Furthermore, gender differences were found for both sexual fantasies and problematic pornography consumption. Finally, multiple regression revealed that age, gender [Men], fantasies, and behaviors were significant predictor of problematic pornography consumption. Those findings are in-line with previous studies which highlighted that the threshold to consider a sexual practice as being abnormal needs to be reconsidered on the basis of self-reported fantasies and behaviors in the general population.

Comparing the Effectiveness of Cognitive Rehabilitation and Binaural Beats on Craving and Comorbidities of Sexual Hyperactivity: A Pilot, Exploratory Quasi-Experimental Study

Sexual hyperactivity, often linked with substantial psychological and social disturbances, remains under-researched, particularly in contexts like Iran where cultural and social norms may influence the reporting and treatment of such conditions. This study explores the therapeutic potential of cognitive rehabilitation (CR) and binaural beats (BB) in addressing this issue. The primary objective was to compare the effectiveness of CR and BB in reducing symptoms of sexual hyperactivity and associated comorbid conditions, with a focus on fluctuations in sexual desire and overall mental health. Utilizing a quasi-experimental design, the study involved pretest, posttest, and follow-up assessments to evaluate the interventions' impacts. Recruitment through social media yielded 45 participants from a larger pool, who were then assigned to either the CR group, the BB group, or a control group. The CR and BB interventions were administered over a period of 10 sessions, each lasting 20 min, 3 times a week. Significant improvements were observed in both intervention groups compared to the control group. The CR group showed a marked reduction in Sexual Addiction Screening Test (SAST) scores from an initial average of 24.87 to 6.80 at follow-up, indicating a reduction in symptoms of sexual hyperactivity. The BB group also showed improvement, with SAST scores decreasing from 19.93 to 9.57. In terms of mental health comorbidities, the Depression, Anxiety, and Stress Scale (DASS-21) scores decreased notably in the CR group from a baseline of 8.53 to 3.07 post-intervention, and in the BB group from 10.33 to 5.80. Both interventions showed similar effectiveness in reducing anxiety and stress, with no statistically significant differences between the groups for most of the outcomes studied, affirming their potential for clinical application.

Examination of Gender Differences in Depression, Relationship Satisfaction, and Problematic Pornography Use Among Romanian Gay Men and Lesbian Women

This study investigates factors influencing the psychological well-being of gay and lesbian individuals in Romania. Participants (N = 172) included 61.6% gay and 38.4% lesbians, currently in relationships, aged between 18 and 62 years (M = 28.28; SD = 9.53). Surveys assessed relationship satisfaction, depression, and problematic pornography use. Significant associations were found among these variables, with gender differences observed. We tested a regression model for problematic pornography use, where depression provided additional explanatory power to the initial model. Age, gender, and depression accounted for 18% of the variance in problematic pornography use. The theoretical and practical implications are discussed.

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.

Moderating Role of Sexual Attitudes in the Association between Online Sexual Activity and Problematic Pornography Use: Evidence from the Chinese Community and Help-Seeking Men

Objectives

This study aimed to investigate the moderating role of sexual attitudes in the association between online sexual activity (OSA) and problematic pornography use (PPU) in the Chinese context. Specifically, we examined whether incongruence stemming from attitudes (i.e., disapproval of nonmarital and casual sex but engaging in OSA) amplifies the perception of PPU.

Methods

We recruited two samples of Chinese men, one from the community (N1 = 525) and the other comprising help-seeking individuals (N2 = 578).

Results

Sexual attitudes moderate the relationship between OSA and PPU in both samples, with the predictive influence of OSA on PPU weakening among individuals with a relatively permissive attitude (scored one SD above the mean of sexual attitudes), and strengthened among individuals with a relatively conservative attitude (scored one SD below the mean of sexual attitudes).

Conclusions

In the conservative sexual cultural context of China, a relatively conservative sexual attitude might strengthen the association between OSA and PPU.

Understanding Perceived Problematic Pornography Use with the Differential Susceptibility to Media Effects Model

Problematic pornography use and its adverse consequences are prevalent, but little is known about its psychosocial contributors. Drawing on the Differential Susceptibility to Media Effects Model (DSMM), this study explores whether and how perceived problematic Internet pornography use is associated with psychological factors from three domains: social (i.e., family adaptability), dispositional (i.e., self-acceptance), and development factors (i.e., impulse control difficulties). Analysis of an anonymous survey of 1,483 Chinese emerging adults showed that family adaptability and self-acceptance were negatively correlated with perceived problematic pornography use, whereas impulse control difficulties were positively correlated with perceived problematic pornography use. Self-acceptance mediated the association between family adaptability and perceived problematic pornography use. Impulse control difficulties moderated such mediation effect, in which the protective effect of family adaptability on self-acceptance and that of self-acceptance on perceived problematic pornography use were attenuated by impulse control difficulties. These findings advance understanding of the complex underlying psychosocial mechanisms of perceived problematic pornography use by providing evidence to the applicability of DSMM on such problematic use and clarifying the direct, indirect, and/or moderating role(s) of family adaptability, self-acceptance, and impulse control difficulties in those mechanisms. They also provide insights for targeted approaches in future intervention programs among emerging adults.

A new variation of modern prejudice: young Korean men's anti-feminism and male-victim ideology

In South Korea, anti-feminism is now rapidly spreading online among young men, who have started to identify themselves as a social minority or "victims" of female power. Despite its ramifications, theoretically, anti-feminism is indistinct from the racism and sexism of White men that emerged more than half a century ago. In view of this, it shares the same root as typical modern racism or sexism, although it appears to be a novel phenomenon. Such a hypothesis was buttressed by quantifying the attitudes of anti-feminists toward various outgroups based on the transference of prejudice theory. Moreover, the subtle sexist undertones hidden in their arguments have been discussed using various psychological theories and empirical data/statistics. Additionally, various potential factors that may shape or accelerate their attitudes or behaviors have been discussed on the basis of the threat-defense theory. Through comprehensive literature review based on this theory, this study proposes the features related to Korean anti-feminism, encompassing behavioral/situational (overindulging violent or degrading Internet contents, verbal aggression), relational/epistemic (ostracism, attachment insecurity, pseudo-rationalism), and group-level (provocative interactions, polarization) attributes, some of which may also influence groups other than young men and ingrain or exacerbate the extreme ideologies of other groups, including young women. Scrutinizing Korean online anti-feminism and male-victim ideology may improve our understanding of the psychological origins of various social extremities or radical ideologies beyond cultural barriers.

Sexual development in ADHD and internet pornography consumption

Development of sexual identity during adolescence is a major process of transition in individual life which in cases of ADHD specifically interacts with other ontogenetic, pathological and psychosocial conditions. According to recent findings growing consumption of internet pornography mainly in male ADHD population is closely related to compulsive sexual behavior and hypersexuality. Recent findings also indicate that consumption of internet pornography in ADHD individuals and other sexual activities may serve as a mood-altering "self-medication" which may help to cope with stressful events and decrease depression and anxiety. Taken together recent findings indicate that internet pornography consumption mainly in ADHD individuals is closely related to stressful experiences, anxiety, depression and identity problems in partnerships which significantly increase their vulnerability to the so-called "problematic pornography use" and other forms of addictive sexual behavior. From this developmental perspective "problematic pornography use" in ADHD individuals represents significant epidemiological problem which requires further research mainly with focus on clinical diagnostics and treatment.

Pornography Consumption and Cognitive-Affective Distress

ABSTRACT

According to recent studies, the growing consumption of Internet pornography mainly in male population becomes an increasing problem, which is closely linked to compulsive sexual behavior. Some findings also suggest that Internet pornography consumption might represent a defense mechanism against excessive stress, which enables to cope with stressful events, helps in mood regulation, and decreases depression and anxiety. Users of online pornography involved in these activities also reported that their self-exposition to pornographic material may create guilty feelings and internal conflict in themselves with respect to their own "involuntary" sexual behavior, which suggest that psychosocial stress and possibly traumatic experiences may play a significant role in Internet pornography addiction. Taken together, these findings show that stressful experiences, anxiety, and depression are strongly related to pornography consumption. In addition, conflicting emotional experiences as well as identity problems significantly increase vulnerability to addictive sexual behavior and pornography consumption.

Profiles of Pornography Use Based on Addictive Mechanisms and Psychopathological Features

Studies using person-centered approaches to further explore the profiles of pornography users throw their psychiatric features are lacking. This study was designed to examine the different profiles of pornography users based on the addictive dimensions of Problematic Pornography Use (PPU) and to characterize these profiles according to psychopathological variables such as depression, anxiety, attention deficit hyperactivity disorder (ADHD) and obsessive-compulsive disorder (OCD). A sample of 1001 French adults participated to a survey containing scales related to psychopathological variables, cybersexual addiction and PPU. PPU was assessed with the French Version of Problematic Pornography Consumption Scale (Fr-PPCS-18). An Agglomerative Hierarchical Classification was performed on the basis of FR-PPCS-18. A student's t-test was used to observe PPU and psychopathological differences between profiles. Findings revealed three profiles of users: non-problematic users (66.5%), at-risk users (29.9%), and problematic users (3.6%). There were significant differences between the three profiles concerning levels of global PPU, PPU mechanisms, cybersexual addiction symptoms, ADHD symptomatology and depressive symptomatology. Results confirmed the existence of different levels of severity of pornography use corresponding to three different profiles. Also, findings revealed the influence of ADHD symptoms, obsessive-compulsive symptoms and depressive symptoms on PPU.

The Development and Validation of the Pornography Use in Romantic Relationships Scale

Recent reviews of the pornography literature have called for the development of valid and reliable measures that assess multiple facets of pornography use. Moreover, despite pornography use having important implications for romantic relationships, there are currently no self-report assessments of pornography use specifically within the context of romantic relationships. To address these limitations, the current paper reports on two studies regarding the development and psychometric evaluation of a 38-item multidimensional measure of pornography use within the context of romantic relationships: the Pornography Use in Romantic Relationships Scale (PURRS). Study 1 (n = 739) reports on an Exploratory and Confirmatory Factor Analytic approach to determine the factor structure of the PURRS. Study 2 (n = 765) reports on the cross-validation of the factor structure of the PURRS, before assessing the criterion validity of the measure. The PURRS exhibited good internal consistency, construct validity, and criterion validity. The findings suggest that the PURRS is best modeled by 13 first-order factors, though a higher-order factor structure comprising four broad factors may also be used. The PURRS significantly extends on past assessments of pornography use, and in particular, advances the assessment and study of pornography use within the context of romantic relationships.

"It was in Control of Me": Notions of Addiction and Online Child Sexual Exploitation Material Offending

This paper focuses on notions of "addiction" among users of online child sexual exploitation material (CSEM) through a comparative analysis of two qualitative studies. The first is a 17-month anthropological ethnography (participant observation, interviews, and focus groups) in UK group programs for CSEM users, and the second is based on interviews with individuals in sexual offense treatment units of a US prison. We thematically analyze the narratives of 103 CSEM users at different timepoints and settings from pre-trial to incarceration. Those citing "addiction" focused on three areas. First was pornography progression. Second were perceived indicators of "addiction" and alignment/analogy to other addictions, including ideas about losing control; ignoring detrimental consequences and continuing; physiological signs similar to withdrawal; likening to substances; and progression from "softer" to "harder" material. Third, less common was rejecting the "addiction" label, citing choice and responsibility. We situate these results within debates and literature regarding pornography and Internet "addiction"; implications of the label; societal conceptions of sexual offending; harms of CSEM; and treatment/prevention considerations. Lastly, highlighting the merit of interdisciplinary comparative qualitative analysis, we demonstrate similarities in narratives despite differences in location, timeframe, setting, conviction status, intervention programming, and research methods.

Development of an Instrument to Assess Expectations for the Use of Online Gaming, Social Networking Sites, and Online Pornography: the Marburg Internet Use Expectations (MINUS-X) Questionnaire

User’s expectations contribute to the maintenance of problematic use of online gaming (OG), social networking (SN), and online pornography (OP). Since an instrument to assess use expectations across applications is lacking, this study aimed at developing and testing such a questionnaire. It consists of a general module (GM), which includes expectations relevant to all three applications, and three application-specific modules. A pilot and a validation study were conducted with 2880 German adults. We conducted item analyses, exploratory factor analyses (EFA), exploratory structural equation modelling, and correlation analyses. The EFA revealed six factors for the GM and two factors for each specific module. The GM demonstrated measurement invariance between applications. The instrument showed excellent psychometric properties, indicating its suitability for assessing expectations concerning the use of OG, SN, and OG reliably and validly. It could be helpful for treating patients with problematic use of the applications and investigating the role of the relevant expectations.

Males' Lived Experience with Self-Perceived Pornography Addiction: A Qualitative Study of Problematic Porn Use

The positive impact of pornography use has been demonstrated; however, most research points towards problematic, compulsive, or excessive engagement with pornography and associated adverse effects on well-being. However, results remain inconclusive and qualitative research capturing perspectives of affected people is scarce. This phenomenological study aimed to explore the perspective and lived experience of males with a self-reported addiction to pornography. Semi-structured in-depth interviews with 13 males aged between 21 and 66 years from Australia and the USA were conducted. A thematic analysis of the transcripts was undertaken, resulting in the identification of four themes. The interviews explored the participants' reasoning for determining themselves as porn addicts, investigated patterns of use, examined the perceived multifaceted impacts of pornography use, illustrated applied individual strategies to overcome the addiction, and proposed interventions helping to inform future recommendations. Experiences and perceptions of pornography addiction were consistently depicted as problematic and harmful. Most participants described an inability to stop their consumption despite experiencing adverse effects. Commonly reported was a gradual increase in the use of and consumption of new or more shocking content. Consumption of content was outlined as an escape or coping mechanism for negative emotions or boredom. Participants reported a variety of applied strategies to manage their addiction and suggested recommendations. Investigation into strategies for the identification of problematic pornography use, its conceptualization, associated health outcomes, and effective preventative and interventional strategies are required to provide academic consistency, support those negatively affected by pornography, and achieve increased public awareness of the issue.

Expert Stakeholders' Perspectives on How Cisgender Heterosexual Boys and Young Men Navigate Sex and Intimacy in Australia: A Case for "Heterosexual Intimacies" in Policy and Practice

INTRODUCTION

Cisgender heterosexual boys and young men in Australia may experience or perpetuate a range of harms in their romantic and sexual encounters with women due to expectations that they adhere to problematic ideals and norms concerning masculinity and heterosexuality. This paper explores expert stakeholders' perceptions on these key issues, and their broader implications for policy and practice.

METHODS

Using inductive thematic analysis techniques, this paper draws on semi-structured interviews from 23 expert stakeholders working across sectors of gendered violence prevention, sexual health, relationships and sexuality education, sport, and emotional and physical wellbeing.

RESULTS

Findings note several key concerns, including (1) hesitation and lack of adequate information regarding relationships with women; (2) the potential negative influence of pornography; (3) the lack of opportunities to be engaged in sexual health promotion initiatives; and (4) limited opportunities to have meaningful conversations about dating, sex, and intimacy.

CONCLUSIONS

Expert stakeholders note several important gaps in policy and practice that need to be addressed to better support cisgender heterosexual boys and young men, and to confront gendered violence and sexual violence.

SOCIAL AND POLICY IMPLICATIONS

Understanding these gaps is vital for policymakers, content and program creators, and service providers working with cisgender heterosexual boys and men. We advocate for thinking about a strategy that is centred around "heterosexual intimacies", in which addressing boys and young men's sexual health and wellbeing is brought together with gendered violence prevention and sexual violence prevention initiatives.

Desire thinking and craving as predictors of problematic Internet pornography use in women and men

INTRODUCTION

According to the recent adaptation of the I-PACE model, desire thinking and craving might be closely related to problematic Internet pornography use. The overall aim of the present study was to investigate the role of two components of desire thinking (imaginal prefiguration and verbal perseveration) and craving in problematic Internet pornography use. Furthermore, we examined gender differences in the underlying mechanism linking desire thinking to problematic Internet pornography use.

METHOD

A total of 414 Italian adults (mean age = 27.55 years, SD = 6.13; age range = 18-58; 53.6 % men) participated in this study. Participants completed an online survey to assess problematic Internet pornography use, pornography craving, desire thinking and problematic Internet use. Path analyses and a multi-group approach were used to test the relationships among variables and to explore gender differences.

RESULTS

Imaginal prefiguration was associated to pornography craving which, in turn, was associated to verbal perseveration as proximal antecedent of problematic Internet pornography use, above and beyond the effect of age, relationship status, and problematic Internet use. Two paths significantly differed between men and women: the path between verbal perseveration and problematic Internet pornography, which for women was weaker and did not reach significance; and the path between problematic Internet use and problematic Internet pornography use that was not significant for women.

CONCLUSIONS

In line with the I-PACE model, the present study provided support for the potential role of desire thinking in problematic Internet pornography use as a specific Internet-use disorder and expanded the literature in the field by testing unexplored gender differences. Preventive and clinical implications are discussed.

Aggravation of Obsessive-Compulsive Disorder Due to Excessive Porn Consumption: A Case Report

The past few decades have seen a significant rise in pornography consumption. This has brought into existence a new behavioral addiction, addiction to internet pornography, which impacts the psycho-somatic health of the individuals and people around them. The accessibility, affordability, and anonymity of online pornography have fed the growing popularity of online pornography. The International Classification of Diseases (ICD-11) has included pornography in Compulsive Sexual Behavior Disorder with it being categorized as an impulse control disorder and not necessarily an addictive disorder. However, the recently published Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR) does not recognize a diagnosis of sexual addiction/compulsion (including internet pornography). Psychiatry remains an ever-evolving branch, and as the understanding evolves, the schools of thought change as well. The constantly evolving literature on behavioral addictions has helped the understanding that any source capable of stimulating the reward circuitry in an individual can become addictive. The stigma associated with behavioral addictions, particularly pornographic addiction, as well as a lack of awareness, contribute to under-reporting, making the reported cases just the tip of the iceberg. Addictions have been associated with various complications and other psychiatric phenomena. We describe a case of a 28-year-old male with mild features of obsessive-compulsive disorder (OCD) that took major shape with the advent of pornographic addiction. The patient was a known case of exam anxiety, panic attacks, auditory hallucinations, and mild obsessive and compulsive symptoms. However, with the death of his girlfriend's father, a breakup with his girlfriend, and coronavirus disease 2019 (COVID-19), he indulged in porn consumption which soon shifted to religious pornographic content leading to guilt with a fair insight. This later culminated in the aggravation of his OCD with repetitive cleaning activities. The patient was started on pharmacological and behavioral therapy and has responded well in follow-ups. In light of the special presentation of this case, we strongly recommend better reporting of such complications aiding in broadening the understanding of the spectrum of possible psychiatric impacts of pornographic consumption.

Assessment of Criteria for Specific Internet-use Disorders (ACSID-11): Introduction of a new screening instrument capturing ICD-11 criteria for gaming disorder and other potential Internet-use disorders

Background and aims

With the inclusion of gaming disorder in the ICD-11, diagnostic criteria were introduced for this relatively new disorder. These criteria may also be applied to other potential specific Internet-use disorders, which may be classified in ICD-11 as other disorders due to addictive behaviors, such as online buying-shopping disorder, online pornography-use disorder, social-networks-use disorder, and online gambling disorder. Due to the heterogeneity in existing instruments, we aimed to develop a consistent and economic measure of major types of (potential) specific Internet-use disorders based on ICD-11 criteria for gaming disorder.

Methods

The new 11-item Assessment of Criteria for Specific Internet-use Disorders (ACSID-11) measures five behavioral addictions with the same set of items by following the principles of WHO's ASSIST. The ACSID-11 was administered to active Internet users (N = 985) together with an adaptation of the Ten-Item Internet Gaming Disorder Test (IGDT-10) and screeners for mental health. We used Confirmatory Factor Analyses to analyze the factor structure of ACSID-11.

Results

The assumed four-factorial structure was confirmed and was superior to the unidimensional solution. This applied to gaming disorder and to the other specific Internet-use disorders. ACSID-11 scores correlated with IGDT-10 as well as with the measures of psychological distress.

Discussion and Conclusions

The ACSID-11 seems to be suitable for the consistent assessment of (potential) specific Internet-use disorders based on ICD-11 diagnostic criteria for gaming disorder. The ACSID-11 may be a useful and economic instrument for studying various behavioral addictions with the same items and improving comparability.

Predictors of Pornography Use: Difficulties in Emotion Regulation and Loneliness

BACKGROUND

Pleasure-seeking reasons are the main drivers of pornography use (PU), but the regulation of unpleasant states, namely distraction from or suppression of negative emotions and stress relief, are other potential predictors of this behavior.

AIM

Our main objective is to develop an explanatory model of problematic PU, assessing difficulties in emotion regulation, loneliness, perceived stress, as well as age and gender as predictors.

METHODS

A cross-sectional study was conducted that included a total of 340 participants (M = 28.50 years, SD = 10.32). Self-report inventories were administered that measured problematic PU (PPCS), difficulties in emotion regulation (DERS-SF), loneliness (UCLALS-3), and perceived stress (PSS-10).

RESULTS

The findings were indicative of recreational PU, with only a small number of participants (4.6%) reporting a possible problematic PU. There were statistically significant gender differences (F(1,337) = 33.306, P ≤ .001), namely that men were more likely to report problematic PU (M = 36.03, SD = 21.30) than women (M = 25.32, SD = 9.24). Problematic PU was significantly and positively correlated either with difficulties in emotion regulation, loneliness, perceived stress and age. Stepwise multiple linear regression analysis showed that difficulties in emotion regulation (β = 0.259, P ≤ .001), loneliness (β = 0.209, P = .001), and gender (β = -0.377, P ≤ .001) define the best subset of predictors of problematic PU. Age and perceived stress were not selected as predictors in this subset.

CLINICAL TRANSLATION

The promotion of better emotion regulation abilities and strategies for adaptive coping with loneliness must be taken into consideration, namely in cases of problematic PU or compulsive sexual behavior disorder.

STRENGTHS & LIMITATIONS

Being a cross-sectional study with a convenience sample and the fact that these variables explain only a part of the explained variance of the problematic PU are the main limitations. Despite the limitations, the principal contribution of this study is the understanding that gender, difficulties in emotion regulation, and loneliness remain as main predictors of problematic PU, even when combined in the explanatory model.

CONCLUSION

The current study provides a better understanding of the predictors of problematic PU related with the reduction or avoidance of unpleasant states. Emotion regulation, loneliness, and perceived stress, studied simultaneously, provide a better understanding of the complex relationships between these factors and problematic PU. Difficulties in emotion regulation and loneliness are predictors of higher problematic PU, as well as the expected gender effect. Cardoso J, Ramos C, Brito J, et al. Predictors of Pornography Use: Difficulties in Emotion Regulation and Loneliness. J Sex Med 2022;19:620-628.

"Pornography Addiction": Elements for Discussion of a Case Report

Can Internet pornography use (IPU) lead to addiction? "Pornography addiction" is a highly controversial concept within the scientific community. In the absence of consensus, international classifications do not consider that the concept meets the criteria to be recognized as a distinct diagnostic entity. However, the term "pornography addiction" has now become common parlance and is therefore present in the discourse of patients seeking therapy to address what they perceive as problematic pornography consumption. Drawing on a brief case vignette, presenting the case of a man who views himself as a pornography addict, we offer a critical review of this concept. Different diagnostic hypotheses will be considered. Beyond the diagnostic process, we consider the issue of "perceived addiction" and its relationship with "moral incongruence." From a psychotherapeutic view, we suggest that patients who self-identify as "porn addicts" must be supported using a more comprehensive approach that goes beyond their symptomatic behavior or the manner in which they present or perceive themselves. The proposed therapy did not seek or require an end to the behavior. The therapy approach focused on exploring the patient's history in an attempt to understand the construction of his sexuality and morality. In the case analyzed, focusing on the source of moral incongruence led to the disappearance of IPU and all associated suffering.

Sexual Shame as a Unique Distress Outcome of Morally Incongruent Pornography Use: Modifications and Methodological Considerations

Researchers focused on the model of pornography problems due to moral incongruence (PPMI) have suggested that perceptions of addiction, stemming from a misalignment between one's moral values and online sexual behavior, may lead to heightened sexual shame. Even so, it has been suggested that the associations found in previous models of PPMI may have been inflated by the inclusion of the emotional distress subscale in the widely used Cyber Pornography Use Inventory (CPUI-9), leading many to use the abridged 4-item version (i.e., the CPUI-4), which excludes emotional distress. Prior models assessing sexual shame have yet to fully address this potential methodological limitation. Considering advances in the conceptualization of PPMI and recommendations concerning best practices, a sample of participants (N = 296) that reported using pornography in the last six months was utilized to compare findings from two moderated mediation models. The first model assessed the differential strength of effects when the subscales of the CPUI-9 were assessed as separate mediators of the associations between moral incongruence and sexual shame, while the second model examined whether such associations persisted when using the recommended CPUI-4. Model results provide further justification for previous findings, indicating that associations between constructs were not the sole result of emotional distress, which supports the utility of the CPUI-4 in models that include sexual shame. Findings provide added support for sexual shame as a unique outcome among those who, due to moral incongruence, perceive that they are addicted to Internet pornography.

Self-Perceived Problematic Use of Online Pornography Is Linked to Clinically Relevant Levels of Psychological Distress and Psychopathological Symptoms

Online pornography is a widespread Internet application. As with other Internet applications, in some cases its use can become problematic. First indications point to a link between problematic use of online pornography and psychological distress and general functional impairment. However, to date, there are no standardized criteria for assessing problematic use of online pornography. In this study, we used the Online Pornography Disorder Questionnaire (OPDQ)-an instrument which adapted the official criteria for Internet Gaming Disorder to online pornography-to measure problematic use and investigated to what extent consumers with a self-perceived problematic use of online pornography differed from casual users with regard to their psychological distress. An online sample of German adult visitors to a popular casual dating site completed the OPDQ, the Brief Symptom Inventory (BSI), and provided information on their online pornography use (n = 1539; 72.6% male; 31.43 ± 11.96 years). T-scores for the BSI were calculated and independent t-tests were conducted to compare casual users with consumers with a self-perceived problematic use of online pornography. Of the users, 5.9% fulfilled the criteria for problematic use. This group consumed online pornography for longer amounts of time and showed higher levels of psychological distress (Hedges' g from 0.75 to 1.21). The T-scores of users with self-perceived problematic online pornography use reached clinically relevant levels on all subscales. Overall, the results of the study indicate that self-perceived problematic use of online pornography seems to be linked to severe psychological distress that may warrant clinical attention.

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.

The Impact of Negative Mood on Event-Related Potentials When Viewing Pornographic Pictures

Background: Negative affective states may increase the risk for problematic pornography use. Underlying neurophysiological mechanisms are, however, not completely understood. Previous research suggests that the participants' emotional state may affect neural processing of sexual stimuli. The aim of this study was to investigate neural correlates of negative affect-induced alterations in sexual cue reactivity in healthy men. The moderating effects of habitual porn consumption, trait sexual motivation, and symptoms of cybersex addiction were also considered. Method: Sixty-four healthy men engaged in a sexual cue reactivity task (passive viewing of explicit sexual pictures and neutral pictures depicting scenes of social interaction) during negative (n = 32) vs. neutral affect (n = 32), induced via tailored feedback on a performance task. Self-reported sexual arousal and event-related brain potentials indicated cue reactivity and motivated attention. Symptoms of cybersex addiction and trait sexual motivation were assessed with the help of the short Internet Addiction Test, adapted to online sexual activities, and the Trait Sexual Motivation Questionnaire. Results: Negative feedback increased negative affect after the performance task. While sexual pictures compared to neutral pictures elicited significantly larger P300 and late positive potential (LPP) amplitudes, there was no general effect of negative feedback on sexual stimuli-related P300 and LPP amplitudes. In the negative feedback group, men with higher solitary sexual motivation levels showed higher P300/LPP difference amplitudes for sexual stimuli compared to men with lower levels of solitary sexual motivation. The opposite effect was found in the group with neutral feedback. There was no link to other aspects of trait sexual motivation and symptoms of cybersex addiction. Conclusions: Results suggest that higher levels of solitary sexual motivation may enhance motivated attention toward sexual stimuli among men receiving negative performance feedback. Other characteristics of sexual behaviors and traits provided no exploratory value. Future studies extending onto men suffering from compulsive sexual behavior disorder will have to closer look at the neurophysiological bases of why and when some men develop an addictive pornography consumption.

Exploring the Etiological Pathways of Problematic Pornography Use in NoFap/PornFree Rebooting Communities: A Critical Narrative Analysis of Internet Forum Data

Problematic pornography use (PPU) has been extensively studied in terms of its negative implications for various life domains. The empirical literature reveals measured outcomes of interpersonal and intrapersonal dysfunction in participants' everyday living, supporting its classification as a disorder. The increasing number of complaints around PPU opens the door to the creation of online self-help rebooting communities. This qualitative study aimed to provide a better understanding of this behavior by investigating potential etiological pathways contributing to the onset of PPU, as they were expressed by members of the online NoFap/PornFree self-help communities with self-perceived PPU. The critical narrative analysis reveals a complex web of mutually informing causal connections. The dialectical relationship between situational resources, material conditions, and an embodied spectator gives rise to an online persona with motivations of self-exploration, experimentation, and socializing. A sense of vulnerability rendered the use of pornography as a means of escape and validation. Furthermore, commitment to abstinence, framed by the notions of recovery and relapse, was found to be a major factor for maintaining distress. The study highlighted the need for a thorough understanding of the etiological pathways of PPU for a more effective and targeted intervention. Moving beyond biomedical conceptualizations suggests an intervention whereby PPU is placed in a context of a crisis of meaning.

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.

Mindfulness in Treatment Approaches for Addiction — Underlying Mechanisms and Future Directions

Purpose of Review

While the treatment of addictive disorders proves to be challenging, new treatment approaches that evolved around the concepts of mindfulness and acceptance have been utilized and investigated in recent years. Our goal is to summarize the efficacy and possible underlying mechanisms of mindfulness-based interventions (MBI) in addictive disorders.

Recent Findings

Various meta-analyses have suggested that MBIs show clinical efficacy in the treatment of addictive disorders. Considering the factors that impact addictive disorders, MBIs have been indicated to augment responsiveness to natural rewards in contrast to addiction-related cues as well as to increase top-down cognitive control, decrease subjective and physiological stress perception, and enhance positive affect.

Summary

In summary, MBIs hold promise in treating addictive disorders while larger randomized controlled trials with longitudinal study designs are needed to confirm their utility. Newest clinical endeavors strive to enhance the clinical utility of MBIs by augmentation or personalization.

Clinical use and implications of sexual devices and sexually explicit media

Given that sexual pleasure is a core component of sexual health, devices that are designed to enhance and diversify sexual pleasure are particularly useful in clinical practice. Despite their growing popularity and widespread use in various biopsychosocial circumstances, many taboos still seem to exist, as indicated by the paucity of scientific literature on the prevalence, application and effectiveness of sexual devices for therapeutic use. However, sex toys and sexual devices are commonly used and have a variety of indications to expand individual and partnered sexuality and to treat sexual difficulties. Different devices are associated with specific advantages and potential risks, opportunities, barriers and ethical challenges when used in a clinical context. Increased knowledge about the aim and functional possibilities of sexual devices might help health-care professionals overcome potential embarrassment, preconceptions and other barriers, learn which patients might benefit from which products, consider their use in treatment programmes, educate about correct use and safety issues, and facilitate open communication about sexual pleasure with their patients.

Child pornography possession/receipt offenders: developing a forensic profile

Child pornography possession/receipt offenders are a controversial offender group due to mixed and occasionally divergent evidence about their risk profile, offending history and psychopathology. Using a population of male offenders who ever perpetrated a sexual offense from a federal jurisdiction in the central United States, the current study developed an exploratory post hoc empirical profile of these offenders. The profile has some success in the validation component of our study and showed significant associations with self-reported sexual abuse of child victims ages 3-12 years, but non-significant associations to adolescent and adult victims. It significantly linked to the conceptually expected victim group and the significant statistical effect withstood controls for generally robust indicators of antisocial conduct including antisocial personality disorder, arrest onset, total adverse childhood experiences, age and race. We view the findings as exploratory and encourage additional empirical study of this important offender group.

Markers of Prenatal Androgen Exposure Correlate With Online Sexual Compulsivity and Erectile Function in Young Men

Pornography addiction and sexual dysfunction are increasingly prevalent in young men. Previous studies suggest that prenatal androgen exposure plays a role in addiction and sexual functionality. Here, we tested whether lower second-to-fourth finger length ratio (2D:4D) and later age at spermarche, both putative indicators of higher androgen levels in utero, correlate with online sexual compulsivity (OSC scale of ISST), erectile function (IIEF-5), and ejaculatory control (PEPA) in 4,370 young men (age IQR: 25-26 years) of the Cohort Study on Substance Use Risk Factors. Statistical analyses revealed that lower 2D:4D correlated with higher scores on the OSC scale. Moreover, higher age at spermarche correlated with higher OSC scores and decreased erectile function. Interestingly, OSC severity, but not the frequency of pornography use, correlated negatively with erectile function and ejaculatory control. This is the first study to associate two independent proxies of prenatal testosterone level with OSC. These findings provide novel insight into intrauterine predisposition of sexual behavior and related sexual function in adulthood.

The woman and the penile prosthetic implant. Primary or secondary role? Personal experiences on 355 implanted patients

In a group of 355 pts  submitted to Penile Prosthesis Implant (PPI) we recorded data on their relationships with the woman (wife, partner, girlfriend, lover); the aspects of their sexual life; if they were married, divorced or widowed; if they had a lover; if they frequented brothels; if they were satisfied of their actual couple's life; after operation we recorded data concerning if they had some difficulties utilizing the PPI and their level of satisfaction. After operation most pts (93%) confirmed their satisfaction. Relational aspects:  Unmarried pts: 6 pts (21-30 years old) who weren't able to penetrate their girlfriends managed to have regular sex with PPI and could marry. 42/46 unmarried pts after PPI decided to marry.  In the group of married pts 3 pts weren't able to penetrate  their wives; after PPI  they  managed to have regular intercourses and pregnancies. 15 widowers and 23 divorced  pts decided to have a PPI for possible sexual encounters or stable relationships. 96/271 (28,2%) married pts declared a stable extramarital relation that could represent the main reason for having a PPI.  The results of PPI are commonly accepted. Until now PPI may re-establish  penile rigidity and maintenance. In our opinion the simple act of penetrate and ejaculate in vagina, without considering the importance of personal, relational, emotional factors  often well linked to the specific woman, cannot be considered the ideal target of PPI.

Theoretical Antecedents of Male Adolescents' Problematic Pornography Use: A Longitudinal Assessment

Although considerable research has examined the antecedents of adolescents' pornography use (PU), little data exist on the underlying mechanisms of problematic pornography use (PPU) in adolescence. To bridge this gap, the current longitudinal study examined the long-term associations between adolescent boys' PU frequency, PPU, and theory-based predictors of PPU. Testing three conceptual models (the moral incongruence, out of control, and mood management models), we examined the relative contributions of impulsivity, depression/anxiety symptoms, and religiosity to PPU, controlling for PU over time. The analysis was conducted using a panel sample of 337 Croatian men (M_age = 15.9 years, SD = 0.52). Latent growth curve modeling showed that baseline levels of, and subsequent growth in PU predicted later higher levels of PPU, irrespective of participants' religiosity, negative emotions, and impulsivity. Baseline higher levels of negative emotions and impulsivity predicted higher levels of PPU three years later, even after controlling for the growth in PU over time. Religiosity moderated the association between changes in PU and PPU. Growth in PU resulted in higher PPU among more religious adolescents, compared to their less religious peers. This study's findings support all three conceptual models explaining PPU in adults and may guide clinical work with adolescents seeking help for PPU.

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.

Decision-Making in Gambling Disorder, Problematic Pornography Use, and Binge-Eating Disorder: Similarities and Differences

Purpose of Review

The present review attempts to provide a comprehensive and critical overview of the neurocognitive mechanisms of gambling disorder (GD), problematic pornography use (PPU) and binge-eating disorder (BED), focusing specifically on decision-making processes.

Recent findings

GD, PPU and BED have been associated with decision-making impairments both under risk and ambiguity. Features such as intelligence, emotions, social variables, cognitive distortions, comorbidities, or arousal may condition decision-making processes in these individuals.

Summary

Impairments in decision-making seem to be a shared transdiagnostic feature of these disorders We also hypothesized the EG relative to the NEG group would demonstrate weaker relationships between problem-gambling severity and health/functioning measures (e.g., substance use) and gambling behaviors (e.g., more time spent gambling) given that EG would account for some of the variance in the relationships between ARPG and these measures. However, there is varying support for the degree to which different features may affect decision-making. Therefore, the study of decision-making processes can provide crucial evidence for understanding addictions and other disorders with addiction-like symptomatology.

Cybersex addiction in a gay man: a case report

BACKGROUND

Cybersex addiction is a sexual addiction characterized by virtual Internet sexual activity that causes serious negative consequences to one's physical, mental, social, and/or financial well-being. Previous studies have mostly addressed cybersex addiction in heterosexual males.

PURPOSE

To describe a case report of a 26-year-old gay man suffering from a cybersex addiction.

METHODS

We use Griffiths' model of the common components of addictions.

RESULTS

We reveal this case report of cybersex addiction possesses all of six components universal for addictions.

CONCLUSIONS

In light of the increasing prevalence of various behavioral addictions (especially, Internet addictions), clinical psychiatrists should be aware of the cybersex addiction phenomenon.

COVID-19 Lockdown Restrictions and Online Media Consumption in Germany

The lockdown restrictions due to the COVID-19 pandemic have led to increased stress levels and feelings of anxiety in the general population. Problematic usage of certain online applications is one frequent way to compensate for negative feelings and stress. The current study investigated changes of online media consumption during the lockdown in Germany. Gender and age specific differences in specific online activities were assessed. n = 3245 subjects participated in an online survey conducted between the 8th April and the 11th May 2020. Participants' age ranged between 18 and >55 years. A considerably high percentage (71.4%) of participants reported increased online media consumption during the lockdown. Male participants were more likely to increase their consumption of gaming and erotic platforms, while female participants reported a higher increase in the engagement in social networks, information research, and video streaming than males. The findings revealed an increased usage of all online applications during the lockdown. For the clarification whether the increase might present a risk for elevated Internet-use disorders or can be regarded as a functional and time-limited phenomenon, further studies, assessing changes in these online activities after the end of the pandemic, are needed.

Associations between pornography exposure, body image and sexual body image: A systematic review

There is evidence for associations between pornography exposure and sexual behaviors of adults and adolescents. Here, we review associations between pornography exposure and body image/sexual body image. Using a systematic search, we found 26 studies meeting inclusion criteria. Compelling evidence shows that frequency of pornography exposure is associated with negatively perceived body image and sexual body image; both heterosexual men and women appear to be affected. Due to scarcity of studies in adolescents and non-heterosexual samples, findings cannot be generalized to adolescents or individuals who identify as sexual minorities. Implications and future directions are discussed.