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Ince C, Fontenelle LF, Carter A, Albertella L, Tiego J, Chamberlain SR, Rotaru K. Clarifying and extending our understanding of problematic pornography use through descriptions of the lived experience. Sci Rep 2023; 13:18193. [PMID: 37875697 PMCID: PMC10598215 DOI: 10.1038/s41598-023-45459-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 10/19/2023] [Indexed: 10/26/2023] Open
Abstract
Problematic pornography use (PPU) is a complex and growing area of research. However, knowledge of the PPU lived experience is limited. To address this gap, we conducted an online qualitative study with 67 individuals who self-identified as having problematic pornography use (76% male; Mage = 24.70 years, SD = 8.54). Results indicated several dimensions that have not been fully explored in the literature. These included various mental and physical complaints following periods of heavy pornography use, sexual functioning deficits with real partners, and a subjectively altered state of sexual arousal while using pornography. Moreover, we expanded on current knowledge regarding the inner conflict associated with PPU and clarified the ways that users can progress to increasingly intensified patterns of pornography use, such as tolerance/escalation and pornographic binges. Our study highlights the complex and nuanced nature of PPU and provides suggestions for future research and clinical practice.
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Affiliation(s)
- Campbell Ince
- School of Psychological Sciences, Monash University, 770 Blackburn Rd, Clayton, VIC, 3168, Australia.
- Turner Institute for Brain and Mental Health, Monash University, Clayton, Australia.
| | - Leonardo F Fontenelle
- Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
- D'Or Institute for Research and Education (IDOR), São Paulo, Brazil
| | - Adrian Carter
- School of Psychological Sciences, Monash University, 770 Blackburn Rd, Clayton, VIC, 3168, Australia
- Turner Institute for Brain and Mental Health, Monash University, Clayton, Australia
| | - Lucy Albertella
- School of Psychological Sciences, Monash University, 770 Blackburn Rd, Clayton, VIC, 3168, Australia
- Turner Institute for Brain and Mental Health, Monash University, Clayton, Australia
| | - Jeggan Tiego
- School of Psychological Sciences, Monash University, 770 Blackburn Rd, Clayton, VIC, 3168, Australia
- Turner Institute for Brain and Mental Health, Monash University, Clayton, Australia
- Monash Biomedical Imaging, Monash University, Clayton, Australia
| | - Samuel R Chamberlain
- Department of Psychiatry, Faculty of Medicine, University of Southampton, Southampton, UK
- Southern Health NHS Foundation Trust, Southampton, UK
| | - Kristian Rotaru
- School of Psychological Sciences, Monash University, 770 Blackburn Rd, Clayton, VIC, 3168, Australia
- Turner Institute for Brain and Mental Health, Monash University, Clayton, Australia
- Monash Business School, Monash University, Clayton, Australia
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Abstract
The aim of this study was to investigate the association between masturbation frequency and sexual dysfunction among men and women, focusing on individuals with and without regular sexual partners, and to determine whether sexual compatibility (e.g., similar sexual desire levels and a match between desired behaviors and behaviors one’s partner is willing to engage in) in the relationship affects masturbation frequency. Here, 12,271 Finnish men and women completed an online survey about masturbation frequency, sexual function, and sexual compatibility with their partner for those who were in a relationship. The results indicated that masturbation frequency was positively associated with overall sexual function for women. This was moderated by relationship status, meaning that more frequent masturbation was associated with better orgasmic function and sexual satisfaction in single women, whereas the opposite was true for women who were in a relationship. For men, more frequent masturbation was associated with better erectile function for single men, and better ejaculatory latency but worse orgasmic function, intercourse satisfaction, and more symptoms of delayed ejaculation for men who were in a relationship. Lower sexual compatibility and sexual dysfunctions in the partner were associated with more frequent masturbation in both sexes. The associations between masturbation frequency and sexual function vary for single and partnered individuals, and are, for the latter group, further affected by sexual compatibility.
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Fernandez DP, Kuss DJ, Griffiths MD. The Pornography "Rebooting" Experience: A Qualitative Analysis of Abstinence Journals on an Online Pornography Abstinence Forum. ARCHIVES OF SEXUAL BEHAVIOR 2021; 50:711-728. [PMID: 33403533 PMCID: PMC7889567 DOI: 10.1007/s10508-020-01858-w] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 09/09/2020] [Accepted: 10/03/2020] [Indexed: 05/06/2023]
Abstract
A growing number of individuals using online forums are attempting to abstain from pornography (colloquially termed "rebooting") due to self-perceived pornography-related problems. The present qualitative study explored phenomenological experiences of abstinence among members of an online "rebooting" forum. A total of 104 abstinence journals by male forum members were systematically analyzed using thematic analysis. A total of four themes (with a total of nine subthemes) emerged from the data: (1) abstinence is the solution to pornography-related problems, (2) sometimes abstinence seems impossible, (3) abstinence is achievable with the right resources, and (4) abstinence is rewarding if persisted with. Members' primary reasons for initiating "rebooting" involved desiring to overcome a perceived addiction to pornography and/or alleviate perceived negative consequences attributed to pornography use, especially sexual difficulties. Successfully achieving and maintaining abstinence was typically experienced to be very challenging due to habitual behavior patterns and/or cravings triggered by a multiplicity of cues for pornography use, but a combination of internal (e.g., cognitive-behavioral strategies) and external (e.g., social support) resources made abstinence attainable for many members. A range of benefits attributed to abstinence by members suggest that abstaining from pornography could potentially be a beneficial intervention for problematic pornography use, although future prospective studies are needed to rule out possible third variable explanations for these perceived effects and to rigorously evaluate abstinence as an intervention. The present findings shed light on what the "rebooting" experience is like from members' own perspectives and provide insights into abstinence as an approach for addressing problematic pornography use.
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Affiliation(s)
- David P Fernandez
- Psychology Department, Nottingham Trent University, 50 Shakespeare Street, Nottingham, NG1 4FQ, UK.
| | - Daria J Kuss
- Psychology Department, Nottingham Trent University, 50 Shakespeare Street, Nottingham, NG1 4FQ, UK
| | - Mark D Griffiths
- Psychology Department, Nottingham Trent University, 50 Shakespeare Street, Nottingham, NG1 4FQ, UK
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Ince C, Yücel M, Albertella L, Fontenelle LF. Exploring the clinical profile of problematic pornography use. CNS Spectr 2020; 26:1-10. [PMID: 32690117 DOI: 10.1017/s1092852920001686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Although problematic pornography use (PPU) will soon be diagnosable through the International Classification for Diseases, 11th revision, its clinical profile remains contentious. The current study assessed whether PPU may be characterized by various symptoms sometimes observed among online recovery forums that currently lack empirical assessment, such as heightened cognitive-affective issues following pornography use and sexual dysfunction with partners as a result of escalating use. METHOD Cross-sectional surveys were completed by male PPUs (N = 138, mean age = 31.75 years, standard deviation = 10.72) recruited via online recovery communities and Amazon Mechanical Turk. Multiple regression analysis was performed using the Problematic Pornography Use Scale as the dependent variable and variables of interest (Arizona Sexual Experiences Scales modified for partnered sex and pornography use, Brunel Mood Scale, Social Interaction Anxiety Scale, and the Tolerance subscale from the Problematic Pornography Consumption Scale) and potential confounders (eg, comorbid psychopathology) as independent variables. RESULTS Current levels of pornography use, indicators of tolerance and escalation, greater sexual functioning with pornography, and psychological distress were uniquely associated with PPU severity, while cognitive-affective issues after pornography use, impulsivity and compulsivity were not. Although sexual dysfunction did not predict PPU severity, nearly half the sample indicated sexual dysfunction with intimate partners. CONCLUSIONS The present findings suggest that PPU may be characterized by tolerance and escalation (as per substance addiction models), greater sexual responsivity toward pornography, and psychological distress. Meanwhile, the high rate of partnered sexual dysfunction observed suggests that PPU might be somewhat separable from other forms of compulsive sexual behavior.
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Affiliation(s)
- Campbell Ince
- Turner Institute for Brain and Mental Health, Monash University, Melbourne, Australia
| | - Murat Yücel
- Turner Institute for Brain and Mental Health, Monash University, Melbourne, Australia
| | - Lucy Albertella
- Turner Institute for Brain and Mental Health, Monash University, Melbourne, Australia
| | - Leonardo F Fontenelle
- Turner Institute for Brain and Mental Health, Monash University, Melbourne, Australia
- D'Or Institute for Research and Education (IDOR), Rio de Janeiro, Brazil
- Obsessive, Compulsive and Anxiety Spectrum Research Program, Institute of Psychiatry of the Federal University of Rio de Janeiro (IPUB/UFRJ), Rio de Janeiro, Brazil
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Fernandez DP, Griffiths MD. Psychometric Instruments for Problematic Pornography Use: A Systematic Review. Eval Health Prof 2019; 44:111-141. [PMID: 31284745 DOI: 10.1177/0163278719861688] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Despite a lack of consensus in the field about how best to conceptualize problematic pornography use, psychometric instruments have nonetheless been developed to assess the construct. The present systematic review aimed to (i) identify psychometric tools that have been developed to assess problematic pornography use; (ii) summarize key characteristics, psychometric properties, and strengths and limitations of instruments for problematic pornography use; (iii) compare the instruments' theoretical conceptualizations of problematic pornography use; and (iv) evaluate each instrument on their ability to assess various core components of addiction. In this article, 22 instruments assessing problematic pornography use were reviewed. Results indicated that while the instruments had different conceptualizations of problematic pornography use, addiction still emerged as the most common theoretical framework used by the instruments. Five of the most commonly assessed addiction components across the different instruments were (1) impaired control, (2) salience, (3) mood modification, (4) interpersonal conflict, and (5) general life conflict. Contextual factors that may potentially affect the assessment of problematic pornography use and recommendations for researchers and clinicians are discussed.
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Affiliation(s)
- David P Fernandez
- Psychology Department, 6122Nottingham Trent University, Nottingham, United Kingdom
| | - Mark D Griffiths
- International Gaming Research Unit, Psychology Department, 6122Nottingham Trent University, Nottingham, United Kingdom
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Thérapie d’acceptation et d’engagement (ACT) et addiction sexuelle. Encephale 2018; 44:387-391. [DOI: 10.1016/j.encep.2017.06.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2017] [Revised: 05/30/2017] [Accepted: 06/01/2017] [Indexed: 11/23/2022]
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Petri-Kelvasa M, Schulte-Herbrüggen O. Disinhibited Exposing Behavior, Hypersexuality, and Erectile Dysfunction as a Consequence of Posttraumatic Stress in a 42-Year-Old Male Patient. ARCHIVES OF SEXUAL BEHAVIOR 2017; 46:2197-2205. [PMID: 28484862 DOI: 10.1007/s10508-017-0985-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/13/2015] [Revised: 03/25/2017] [Accepted: 03/26/2017] [Indexed: 06/07/2023]
Abstract
Research into sexual dysfunction and its explanations within a cognitive behavioral framework in patients with posttraumatic stress is sparse. In this report, we present the case of a 42-year-old male with severe posttraumatic stress symptoms who displayed apparent exhibitionistic behavior, hypersexual behavior in the form of excessive masturbation, and erectile dysfunction. Differential diagnostics showed that the presented exhibitionistic behavior could be more accurately classified as non-paraphilic disinhibited exposing behavior. Functional behavioral analysis of his sexual behavior suggested that disinhibited exposing and hypersexual behavior served as dysfunctional coping strategies for trauma-associated negative emotions. Erectile dysfunction seemed to be the result of trauma-associated hyperarousal and excessive masturbation. Within the context of operant learning processes, we propose that his sexual behaviors became highly automated and were used as the main strategies to regulate trauma-associated negative emotions. Implications for the diagnoses and suggestions for the conceptualization and incorporation into a cognitive behavioral therapy treatment of posttraumatic stress disorder are made.
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Affiliation(s)
- Mirja Petri-Kelvasa
- Department of Psychiatry and Psychotherapy, Charité-University Medicine, Charité Campus Mitte, Große Hamburger Straße 5-11, 10115, Berlin, Germany.
| | - Olaf Schulte-Herbrüggen
- Department of Psychiatry and Psychotherapy, Charité-University Medicine, Charité Campus Mitte, Große Hamburger Straße 5-11, 10115, Berlin, Germany
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Fernandez DP, Tee EYJ, Fernandez EF. Do Cyber Pornography Use Inventory-9 Scores Reflect Actual Compulsivity in Internet Pornography Use? Exploring the Role of Abstinence Effort. ACTA ACUST UNITED AC 2017. [DOI: 10.1080/10720162.2017.1344166] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Blair L. How difficult is it to treat delayed ejaculation within a short-term psychosexual model? A case study comparison. SEXUAL AND RELATIONSHIP THERAPY 2017. [DOI: 10.1080/14681994.2017.1365121] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Linsey Blair
- The Heath Clinic, Croydon University Hospital & Tavistock Relationships, London, UK
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