Pornography Use and Loneliness: A Bidirectional Recursive Model and Pilot Investigation

Pornography Use and Associated Factors in Adolescents: A Cross-Jurisdictional Approach (Spain vs. Mexico)

Pornography use is common among adolescents. However, there has been limited in-depth examination of cross-country differences in adolescent pornography use. Therefore, the main aim of the present study was to understand cross-jurisdictional differences in problematic pornography use (PPU) in 1810 adolescents from Spain and Mexico. The relationship between sociodemographic variables, loneliness, sexual risk behaviors, and religiosity with PPU and cross-jurisdictional differences between the two Spanish-speaking populations was assessed. In the Spanish sample, pornography use was a mediator of risky sexual behaviors, with this association being greater in males, older individuals, and those with a non-heterosexual orientation. In the Mexican sample, non-use of condoms was directly statistically predicted by older age, poor familial relationships, low religiosity, and more frequent pornography use. Jurisdictional differences in relationships between variables were observed in the two samples (Spanish and Mexican). Clinical implications and potential sociocultural factors that may underlie observed differences in the two Spanish-speaking cultures are considered and warrant additional investigation.

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.

Pornography use, demographic and sexual health characteristics among university students: a gender-based comparative study of non-users, non-problematic users, and problematic users

BACKGROUND

Limited gender-based research has compared sexual health among pornography users (PUs) and non-users, including non-problematic pornography users (non-PPUs) and problematic pornography users (PPUs), particularly in non-Western cultures.

METHODS

A 2022 cross-sectional study involving 450 Iranian university students categorized participants as PUs or non-users based on 12 months of use. PUs were further classified as non-PPUs or PPUs using the 'Problematic Pornography Use Scale' cutoff point, with comparisons of demographic and sexual variables made between these groups.

RESULTS

Pornography use was reported among 39.6% of students, including 51.7% of men and 33.6% of women. In general, 9.5% of participants were PPUs, including 17.4% of men and 5.6% of women. PUs were mainly men, had fewer children, shorter marriages, lower religiosity, and lower levels of education. Compared with non-users, PUs reported earlier sexual relationships, lower satisfaction with sex frequency and communication, and greater rates of extramarital relationships, masturbation, sexual desire, and sexual distress. PPUs reported more sexual desire, pornography use, masturbation, and extramarital affairs than non-PPUs. Similar patterns in demographics, sexual history, and health were observed in pornography use across genders. The regression indicated being male (OR: 2.42, 95% CI: 1.44-4.06), having lower education (OR: 0.89, 95% CI: 0.81-0.97), fewer children (OR: 0.64, 95% CI: 0.48-0.86), higher masturbation (OR: 1.31, 95% CI: 1.14-1.49), more extramarital relationship (OR: 1.69, 95% CI: 1.07-2.67), less religiosity (OR: 0.87, 95% CI: 0.82-0.93), more sexual excitement (OR: 0.79, 95% CI:0.62-1), and more sexual distress (OR: 1.20, 95% CI: 1.02-1.32) were associated with pornography use. Two-way ANOVA found no significant effects of gender or pornography use on sexual satisfaction. Women had worse sexual function regardless of usage. Pornography users, regardless of gender, experienced higher sexual distress.

Spanish Validation of the Long and Short Versions of the Problematic Pornography Consumption Scale (PPCS and PPCS-6) in Adolescents

Although 1-14% of adolescents may experience problematic pornography use (PPU), psychometrically sound instruments for assessing PPU in Spanish-speaking adolescents are scarce. Given the advantages of the different forms of the Problematic Pornography Consumption Scale (PPCS), the aim of the present study was to assess the psychometric properties of the PPCS and PPCS-6, and to examine associations between PPU and age among boys and girls. Two school-based adolescent samples were recruited in Spain (n = 650; Mage = 16.0 [SD = 1.1]; 50% girls and 50% boys) and Mexico (n1, 160; Mage = 15.8 [SD = 1.1]; 68% girls) to assess the psychometric properties of the PPCS and PPCS-6. Confirmatory factor analysis was applied and convergent and discriminant validity with other measures related to PPU was also tested. The results provided empirical support for the six-factor structure of the PPCS and the one-factor structure of the PPCS-6. Boys with older age showed higher levels of tolerance than girls on the PPCS in both countries. Both the PPCS and the PPCS-6 may be considered valid psychometric instruments for the assessment of PPU in Spanish-speaking adolescents from Spain and Mexico.

Compulsive sexual behavior disorder in an inpatient sample with substance use disorder

Background

Several studies indicate that compulsive sexual behavior disorder (CSBD) shares core elements with substance use disorder (SUD). These findings support the assumption of common mechanisms in addiction, which may lead to a higher tendency in patients with SUD to have comorbid CSBD. Nevertheless, this relationship between CSBD and SUD is poorly understood to date.

Aim

This study aimed to compare the prevalence of CSBD and its subtype pornography use disorder (PUD) between a SUD group and a matched control group. Herein, we aimed to test whether patients with SUD are more likely to have a comorbid CSBD/PUD. We further hypothesized that a higher CSBD/PUD prevalence in patients with SUD is accompanied by more pronounced CSBD- and PUD-related personal characteristics.

Methods

We assessed CSBD, PUD, and related personal characteristics in an inpatient SUD sample (N = 92) and a healthy control sample matched by age, gender, and educational level.

Outcomes

Primary outcomes were the diagnoses of CSBD/PUD as assessed by questionnaires. CSBD/PUD-related personal characteristics were the early onset of problematic pornography consumption, relationship status as a single person, a high sexual motivation, a high level of time spent watching pornography, and a high degree of problematic pornography consumption (Problematic Pornography Consumption Scale, short version).

Results

There was no significant difference between groups regarding CSBD prevalence (SUD sample, 3.3%; control sample, 7.6%) and PUD prevalence (SUD sample, 2.2%; control sample, 6.5%). We found relationship status as a single person and the sexual motivation dimension of importance of sex to be the only CSBD-related personal characteristics that were more pronounced in the SUD sample than the matched control group.

Clinical Implications

Results indicate no higher tendency for patients with SUD to develop comorbid CSBD/PUD, yet important vulnerabilities (eg, emotional dysregulation) should be considered when treating addictive disorder to prevent possible symptom displacement.

Strengths and Limitations

A strength of the study is that we compared a sample of patients with SUD with a matched control sample and used an instrument based on ICD-11 criteria for CSBD. Possible limitations are significant differences between the groups because of the restrictions in an inpatient clinic that may have influenced responses (eg, roommates) and that the control group was not screened for SUD. Therefore, the results should be interpreted with some caution.

Conclusion

We found no evidence of an overcomorbidity of SUD and CSBD/PUD. However, a higher rate of vulnerability factors for CSBD/PUD in the SUD sample might suggest some similarities between SUD and CSBD/PUD.

Is Sex Cam Use a Substitute for "Real Sex?" Attitudes and Experiences of Consumers Using Adult Cam Platforms

Adult webcam sites with live performers who provide viewer interactive experiences are a rapidly increasing form of sexual entertainment or "sextech." The opportunity to engage with performers during synchronous contact without health risks represents a novel form of transactional sex. This study sought to understand viewer preferences in performers, and how viewers perceive webcam use is affecting their sex lives and their mood. Participants (N = 10,570) responded to a link on the adult webcam platform Chaturbate.com and completed a 93-item survey. Simple frequencies and descriptive statistics were used to characterize responses. Most viewers identified as heterosexual (75.1%) men (94.2%). Two-fifths (40.3%) had no sexual partners over the past 12 months. Exploratory factor analysis showed that respondents' preferred qualities in performers clustered around an ideal sexual partner, an emotional connection, power dynamics, and compliance with viewers' wishes. Respondents generally agreed that webcam use made them better educated about sex (66.0%) and feel better about their sex lives (54.6%), though about one-fourth reported less positive experiences. The majority (72.2%) felt watching cams was less satisfying than sex away from screen and only 19.1% defined watching cams as "real sex." Over half (64.0%) perceived their webcam use as having positive effects on their mood, while a moderate proportion perceived negative emotional consequences. Findings suggest that a majority of viewers experience their webcam activities as a means of obtaining sexual release, but that this is not considered actual sex. Future research should explore additional consequences of long-term use of transactional webcam sex.

Biopsychosocial Determinants of Problematic Pornography Use: A Systematic Review

Background

Although some studies have examined the determinants of problematic pornography use (PPU), few systematic comparisons of risk profiles have been conducted so far. Research on risk profiles can shed a bright light on our knowledge of both the early diagnosis and etiology of such highly prevalent disorders. Accordingly, the present study aimed to provide a comprehensive overview of the determinants of PPU.

Methods

Scopus, Web of Science, PubMed, and PsycINFO databases were systematically searched, and relevant English articles, including longitudinal and cross-sectional studies on risk factors published from January 2000 to February 2022 were reviewed.

Findings

The determinants of PPU extracted from the investigated studies (n=66) were summarized and clustered into biological, psychological, and social categories. The findings indicated that ventral striatum activity is a consistent biological factor which plays a key role in the development of PPU, while there were other psychological factors influencing PPU as mentioned in several studies, including craving, low self-esteem, sexual arousal, coping styles, stress, frequent pornography watching, avoidance, negative beliefs, and emotional deficiency. In addition, the social factors affecting PPU have been reported to be male gender, age, religion, moral incompatibility, and loneliness. According to these results, the identified factors could be considered in preventive treatment.

Conclusion

This systematic review provided a comprehensive overview of the biopsychosocial determinants of PPU by analyzing 66 articles mostly from Europe and North America. Most studies showed that ventral striatum activity, craving, self-esteem, stress, frequent pornography watching, gender, age, and religion are related to PPU.

Difficulties in Emotion Regulation and Problematic Pornography Use: The Mediating Role of Loneliness

Objectives

To analyze the association between difficulties in emotion regulation and problematic pornography use (PPU) and test the mediating effect of loneliness.

Methods

All 339 participants (M = 28.53 years, SD = 10.32) completed online self-report scales assessing difficulties in emotion regulation, PPU, and loneliness.

Results

Difficulties in emotion regulation are positively correlated with PPU. Loneliness partially mediates the relationship between difficulties in emotion regulation and PPU. Gender and intimate relationship status had moderating effects on the tested mediation model.

Conclusions

Greater difficulties in emotion regulation have a significant indirect effect on PPU through loneliness.

Family functioning and problematic internet pornography use among adolescents: a moderated mediation model

Background

In recent years, the issue of problematic Internet pornography use (PIPU) among adolescents has become increasingly prominent, attracting widespread attention from society. Family functioning has been recognized as a protective factor for PIPU, but the underlying mediating and moderating mechanisms remain unclear. The purpose of this study is (a) to investigate the mediating role of self-esteem in the relationship between family functioning and PIPU, and (b) to examine the moderating role of the need to belong in this mediating pathway.

Methods

A total of 771 high school students (Mage = 16.19, SD = 0.90) were surveyed using the Problematic Internet Pornography Use Scale, Family Assessment Device, Rosenberg Self-Esteem Scale, and the Need to Belong Scale.

Results

Correlation analysis showed a significant negative correlation between family functioning and PIPU (r = -0.25, p < 0.001), a significant positive correlation between self-esteem and family functioning (r = 0.38, p < 0.001), a significant negative correlation between self-esteem and PIPU (r = -0.24, p < 0.001), and a significant positive correlation between need to belong and PIPU (r = 0.16, p < 0.01). Mediation analysis showed that self-esteem partially mediated the relationship between family functioning and PIPU, with a mediation effect of -0.06. Further moderated mediation analysis showed that for adolescents with higher need to belong, the mediating effect of self-esteem was stronger.

Conclusions

For adolescents with high belonging needs who are at high risk for PIPU, good family functioning may have a protective effect by boosting self-esteem.

Associations Between Pornography Consumption Patterns, Pornography Consumption Motives, and Social Wellbeing among U.S. College Students: A Latent Profile Analysis with a Primarily Female Sample

This study identified profiles of pornography motivations and outcomes and assessed differences between profiles on three measures of social well-being: social support, fear of intimacy, and loneliness. Latent profile analysis and group comparisons were conducted using cross-sectional data from college students (N = 389). Results indicated four profiles: low motivation/average distress, porn for enjoyment, high motivation/average guilt, low motivation/high distress. Those in the high motivation/average guilt profile reported more social well-being difficulties relative to the other profiles and non-pornography consumers. Results suggest that individuals who report varying pornography use motivations and negative outcomes may report difficulties with social well-being, with implications for intimate relationships.

Pornography Use among Lebanese Adults: Association with Loneliness and Fear of Commitment

(1) Background: Sexuality is a prohibited topic about which knowledge is highly lacking among Arabs compared to Westerners, due to religious restrictions. A majority of people believes that any use of pornography is a toxic conduct that will have negative repercussions; these beliefs only shame those who engage in this behavior. Consumption of pornography can be attributed to self-reported reasons such as loneliness and fear of commitment. To date, there has been a dearth of research in Lebanon concerning pornography use. Hence, this study aims to assess the correlation between loneliness, fear of commitment, and internet pornography use among Lebanese adults. (2) Methods: This cross-sectional study conducted between October and November 2020 assessed pornography use through the Cyber-Pornography Use Inventory, Jong Gierveld Loneliness Scale, and Fear of commitment scale. It enrolled 653 adults from all Lebanese geographic areas. (3) Results: Women compared to men and Muslims compared to Christians were significantly associated with lower pornography addictive patterns scores, whereas more fear of commitment was significantly associated with higher pornography addictive patterns scores. More fear of commitment and more loneliness were significantly associated with higher having guilt regarding online porn use scores. Muslims compared to Christians had significantly lower online sexual behaviors scores. (4) Conclusions: Further research is recommended to properly assess internet pornography use and develop appropriate treatment options.

Psychometric Network Analysis of the Problematic Pornography Use Scale (PPUS) in Peruvian Adults

Objective

The aim of this research was to analyze the psychometric properties of the Problematic Pornography Use Scale (PPUS).

Methods

A sample of 704 Peruvian youth and adults aged 18 to 62 years (M = 26, SD = 6.0) was considered, of which 56% were female and 43% male. The participants were from various cities in Peru: Lima (84%), Trujillo (2.6%), Arequipa (1.8%), and Huancayo (1.6%). The validity of the theoretical structure of the PPUS was carried out by means of two techniques: Confirmatory factor analysis (CFA) and Exploratory Graphical Analysis (EGA), a new effective and efficient dimension evaluation technique, whose measure consists of verifying the fit of the dimension structure.

Results

Using the bifactor model, the hypothesis that PPUS has a unifactorial behavior was corroborated. These approximations of unidimensionality are also corroborated by the EGA method, where the centrality parameters and network loadings are found to have acceptable estimates.

Conclusion

The results demonstrate the validity of the PPUS, contrasting with the factor model and verifying the unidimensionality of the construct, which provide useful directions for future studies on the instrumentalization of problematic pornography use scale.

Understanding Serial Mediators of Problematic Pornography Use in Pakistani Men and Women

In the current digital environment, satisfying sexual needs via Internet pornography use has the potential to develop into a problem that affects one's psychological health and daily functioning. The aim of this study was to examine potential cognitive and affective factors that could help explain the maintenance and exacerbation of self-defined problematic internet pornography use.

METHODS

280 Pakistani men and women (mean age = 25.40; SD = 5.271, range 18-50) who were current pornography users were recruited through social networking sites (Facebook, Instagram, LinkedIn, WhatsApp groups) to participate in an online study about pathways to problematic pornography use (PPU). Structural equation modeling was used to estimate path analysis coefficients extending from predisposing variables (depression, anxiety, self-esteem, and loneliness) to PPU via the mediating variables of craving, dysfunctional sexual coping, and stimulus-specific inhibitory control.

RESULTS

Craving mediated the relationship between three predisposing variables (depression, anxiety, and self-esteem) and PPU, though not the fourth, namely loneliness. Indirect effects of depression, anxiety, and self-esteem were significantly linked to PPU through two serial mediation pathways: (a) craving and stimulus-specific inhibitory control, and (b) craving and dysfunctional sexual coping.

CONCLUSION

These findings demonstrate that craving, stimulus-specific inhibitory control, and dysfunctional coping serve as important mediators in maintaining and exacerbating the cycle between negative predisposing variables and PPU. These results are interpreted within the general framework of therapeutic interventions that can help develop positive coping skills in individuals seeking to alter self-perceived bothersome or unwanted habits related to pornography use.

No significant effect of frequent online sexual behaviour on Pavlovian-to-instrumental transfer (PIT): Implications for compulsive sexual behaviour disorder

Reward based learning is broadly acknowledged to underpin the development and maintenance of addictive behaviour although the mechanism in sexual compulsivity is less understood. Using a Pavlovian-to-Instrumental Transfer (PIT) task we tested whether the motivational aspect of conditioned Pavlovian conditioned stimulus invigorated instrumental responding in relation to specific compatible monetary rewards. Performance on the task was analysed between two groups of males based on Low (N = 38) and High (N = 41) self-report online sexual behaviour (OSB). Psychometric tests including sexual compulsivity scale and behavioural activation/behavioural inhibition (BIS/BAS) were also administered to determine the relationship between OSB and general reward sensitivity. We show clear evidence of acquisition in the Pavlovian and instrumental conditioning phases. Specific transfer effect was greater in the High-OSB group although the difference compared to the Low-OSB group was non-significant. OSB negatively correlated with both BIS and BAS indicative of introversion and low reward sensitivity. OSB positively correlated with sexual compulsivity although it is unclear whether individuals in the High-OSB group considered their behaviour either excessive or problematic. These findings contribute to the ongoing debate regarding the nature of problematic OSB. Fundamental differences in motivational characteristics and mechanism contributing to compulsive behaviour in relation to high-OSB might indicate incompatibility with behavioural addiction models. PIT was not enhanced in high-OSB by appetitive conditioning, although problematic OSB could stem from failure to inhibit actions. Further research should investigate whether aversive conditioning differentially affects responding in high-OSB individuals, potentially explaining perseverant behaviour despite negative consequences.

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.

Porndemic? A Longitudinal Study of Pornography Use Before and During the COVID-19 Pandemic in a Nationally Representative Sample of Americans

Of the many changes in daily life brought about by the COVID-19 pandemic, social distancing efforts and governmentally mandated lockdowns were among the most drastic. Coinciding with these changes, popular pornography websites made some previously premium content available for free, spurring dramatic increases in traffic to these websites. This increase in time spent at home and reported increases in traffic to specific pornographic websites led to some speculation that pornography use might generally increase over the course of the pandemic and that problematic use might also increase. To test these speculations and quantify the effects of the pandemic and its associated restrictions on social behaviors on pornography use, we analyzed data from a longitudinal sample of American adults. Baseline, nationally representative data were collected in August 2019 via YouGov (N = 2518). Subsequent data were collected in February 2020 (n = 1677), May 2020 (n = 1533), August 2020 (n = 1470), and October 2020 (n = 1269). Results indicated that, in May 2020, immediately following the height of the first wave of pandemic-related lockdowns, more people reported past-month pornography use than at other follow-up time points, but less did so than at baseline. Among those who reported use in May 2020, only 14% reported increases in use since the start of the pandemic, and their use returned to levels similar to all other users by August 2020. In general, pornography use trended downward over the pandemic, for both men and women. Problematic pornography use trended downward for men and remained low and unchanged in women. Collectively, these results suggest that many fears about pornography use during pandemic-related lockdowns were largely not supported by available data.

The Internet addiction test: Psychometric properties, socio-demographic risk factors and addictive co-morbidities in a large adult sample

The Internet Addiction Test (IAT) (Young, 1998) is one of the most utilized diagnostic instruments to evaluate internet addiction. Despite the wide use of IAT in research and clinical settings, there is lack of an empirical validation of this scale among a largescale adult population. The present study aimed to: (1) investigate the psychometric properties of a Hebrew version of the IAT among large-scale Israeli adult sample. (2) Assess the socio-demographic characteristics of individuals who suffer from IA. (3) Assess the co-morbidity of IA in relation to substance and behavioral addictions. A cross sectional study was conducted, by constructing a representative sample (N = 4035) of the Jewish adult (18-70 y/o, M = 40.5, SD = 14.5) population in Israel. Participants responded an online survey, that measured IAT, socio-demographic characteristics, substance and behavioral addictions. Results showed that two-factor model (Emotional and Cognitive Preoccupation with the Internet and Loss of Control and Interference with Daily Life) has good psychometric properties and fits the data well. Young age, not being married (Risk Ratio [RR] = 1.98, 95% CI [1.51-2.63]), and having a low socio-economic status (RR = 1.41, 95% CI [1.05-1.90]) were found to be associated with IA. Drug (RR = 4.50, 95% CI [2.89-7.01]) and alcohol (RR = 3.54, 95% CI [1.50-5.42]) use disorders were associated with IA. High co-morbidity between behavioral addictions and IA was also found (RR = 15.24, 95% CI [11.17-20.78]). Overall, results show that the Hebrew version of the IAT is a valid and reliable instrument, and provide a comprehensive picture of IA prevalence and profile in adult Israeli sample.

Sextech Use as a Potential Mental Health Reprieve: The Role of Anxiety, Depression, and Loneliness in Seeking Sex Online

Depression, anxiety, and loneliness have long been recognized as global mental health concerns. To temporarily relieve psychological distress, self-soothing behavior is common, including engagement in sexual behaviors that are linked to positive mental well-being. Considering the COVID-19 pandemic further exacerbated many mental health ailments alongside physical distancing regulations, we specifically examined online sexual behavior via the use of emergent digital sexual technologies, or sextech. In a 2019 study of 8004 American adults, we assessed whether people experiencing higher anxiety, depression, and/or loneliness were more likely to engage in sextech use. Furthermore, we examined whether anxiety or depression mediated the association between loneliness and sextech use, as loneliness is one contributor to anxiety and depression. People with higher anxiety and depression were more likely to engage in sextech. However, those who were more lonely were less likely to engage with sextech, suggesting the aforementioned patterns were not due to lack of social connection. Our findings suggest people with mental health struggles may be drawn to interactive, digital forms of sexual behavior as a means of alleviating symptoms through distraction or self-soothing. This insight offers an important pathway for expanding the scope of mental health interventions, particularly as technology becomes increasingly prevalent and accessible in everyday life.

Male Sexual Health and Sexual Behaviors during the First National COVID-19 Lockdown in a Western Country: A Real-Life, Web-Based Study

Restriction measures enacted during the COVID-19 pandemic had severe effects on male sexual and reproductive health. We aimed to investigate the real-life impact and perception of sexual function in 2020 in Italy, as the first Western country experiencing a national lockdown by measuring relative search volume for keywords pertaining to sexual health and behaviors provided by Google Trends and sales data for pro-erectile treatments. No significant change was observed for erectile dysfunction and premature ejaculation. Interest towards most phosphodiesterase type 5 inhibitors decreased significantly during lockdown (e.g., sildenafil, p = 0.0002; tadalafil p = 0.0016), then reverted to pre-lockdown levels (e.g., sildenafil, p < 0.0001; tadalafil p < 0.0001), mirroring a concomitant sales decrement (p = 0.0292). A subsequent recovery to previous levels at the end of the social confinement was also found (e.g., after vs. before lockdown, sildenafil, p = 0.8459; tadalafil p = 0.1166). During lockdown, interest towards pornography significantly increased during restrictions (p = 0.0053) and remained high (after vs. before lockdown, p = 0.0004), whereas interest towards paid and casual sex declined (p = 0.0015 and p = 0.049, respectively), then reverted to previous levels (after vs. before lockdown, p = 0.3969 and 0.8373, respectively). During the first Italian lockdown, we observed a transient but measurable decrease of sexual health-seeking behaviors and changes in sexual behaviors, with unknown impact for sexual medicine and public health.

Internet pornography exposures amongst young people in Malaysia: A cross-sectional study looking into the role of gender and perceived realism versus the actual sexual activities

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High prevalence of pornography exposure among participants and mostly through internet.

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Easy accessibility to free internet especially at home facilitate pornography use among young people.

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Further evidence is needed on perceived realism as a protective factor of pornography exposure.

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Male participants had earlier exposure on pornography during early adolescence.

Despite the wide accessibility to internet, pornography activities among youths are not well described in conservative countries like Malaysia. This study aimed to determine the prevalence, elicit gender differences and identify associated factors of pornographic exposure including perceived realism among college students. This cross-sectional study was conducted among students aged 18 to 25 years from seven colleges in Penang, Malaysia. A self-administered questionnaire was used to obtain data on socio-demographic characteristics, pornography exposure, pattern of use, sexual exposure and perceived realism. Among 986 participants, the prevalence of lifetime pornography exposure was 74.5%. More males (71.7%) were exposed to pornography, had started at earlier age, were frequent users and using the internet alone at home (p < 0.001). Males had higher odds of having exposure (Adjusted odds ratio, AOR = 20.44, 95% CI: 12.50 – 33.42, p < 0.001), whilst those who perceived pornography as real had lower odds of having pornographic exposure (AOR = 0.64, 95% CI: 0.43–0.94, p = 0.02). There is a high prevalence of pornography exposure among Malaysian college students, especially involving males. Easy access to pornographic materials at home facilitates this activity. Gender and perceived realism determined their pornographic exposure. Thus, parental monitoring of online access and planning structured activities to occupy free time are recommended at an early age.

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.

Measuring the Multidimensional Construct of Pornography: A Long and Short Version of the Pornography Usage Measure

With the increase in the availability and usage of pornography, the research on the effects of pornography has also increased. This research has uncovered several controversies in the field regarding how pornography usage influences attitudes, sexual behaviors, and relationships. However, many of the measures of pornography are problematic as there is often little reliability and validity information for them and it is not clear that participants in these research studies are referring to the same types of materials when they answer pornography usage questions. Consequently, many of the research findings are suspect and it is crucial to develop reliable and valid scales to measure general pornography usage. In this study, we present both a 20-item and a 7-item version of the Pornography Usage Measure (PUM) that is based on extensive previous research on what types of materials individuals consider pornographic and that indicates pornography is a multidimensional construct. We evaluated the reliability and validity of both versions by using an MTurk sample of 934 males and 705 females (N =1639 total) to conduct confirmatory factor analyses, item response analyses, and structural equation model analyses. These analyses demonstrated that there were adequate reliability and early evidence for content, construct, concurrent, and predictive validity for both versions of the PUM. This measure could improve the quality of future research on pornography by providing more consistency between different studies about what is being measured when individuals indicate their pornography usage patterns.

A cross-sectional study of psychological wellbeing of Indian adults during the Covid-19 lockdown: Different strokes for different folks

The psychological impacts of the lockdown due to the Covid-19 pandemic are widely documented. In India, a family-centric society with a high population density and extreme social stratification, the impact of the lockdown might vary across diverse social groups. However, the patterning in the psychological impact of the lockdown among LGBT adults and persons known to be at higher risk of the complications of Covid-19 (such as persons with comorbidities or a history of mental illness) is not known in the Indian context. We used mixed methods (online survey, n = 282 and in-depth interviews, n = 14) to investigate whether the psychological influence of the lockdown was different across these groups of Indian adults. We fitted linear and logistic regression models adjusted for sociodemographic covariates. Thematic analysis helped us identify emergent themes in our qualitative narratives. Anxiety was found to be higher among LGBT adults (β = 2.44, CI: 0.58, 4.31), the high-risk group (persons with comorbidities) (β = 2.20, CI:0.36, 4.05), and those with a history of depression/loneliness (β = 3.89, CI:2.34, 5.44). Persons belonging to the LGBT group reported a greater usage of pornography than the heterosexuals (β = 2.72, CI: 0.09, 5.36) during the lockdown. Qualitative findings suggested that LGBT adults likely used pornography and masturbation to cope with the lockdown, given the limited physical access to sexual partners in a society that stigmatizes homosexuality. Moreover, both qualitative and quantitative study findings suggested that greater frequency of calling family members during lockdown could strengthen social relationships and increase social empathy. The study thereby urgently calls for the attention of policymakers to take sensitive and inclusive health-related decisions for the marginalized and the vulnerable, both during and after the crisis.

[Psychopathological consequences of confinement]

The psychological effects of isolation have already been described in the literature (polar expeditions, submarines, prison). Nevertheless, the scale of confinement implemented during the COVID-19 pandemic is unprecedented. In addition to reviewing the published studies, we need to anticipate the psychological problems that could arise during or at a distance from confinement. We have gone beyond the COVID-19 literature in order to examine the implications of the known consequences of confinement, like boredom, social isolation, stress, or sleep deprivation. Anxiety, post-traumatic stress disorder, depression, suicidal or addictive behaviours, domestic violence are described effects of confinement, but the mechanisms of emergence of these disorders and their interrelationships remain to be studied. For example, what are the mechanisms of emergence of post-traumatic stress disorders in the context of confinement? We also remind the reader of points of vigilance to be kept in mind with regard to eating disorders and hallucinations. Hallucinations are curiously ignored in the literature on confinement, whereas a vast literature links social isolation and hallucinations. Due to the broad psychopathological consequences, we have to look for these various symptoms to manage them. We quickly summarize the diagnostic and therapeutic approaches already in place, such as telemedicine, which is undergoing rapid development during the COVID-19 crisis.

Are Playboy (and girl) Norms Behind the Relationship Problems Associated with Pornography Viewing in Men and Women?

Research has indicated that pornography viewing is related to romantic relationship problems. However, the correlations across past studies have been small. We tested a model in which playboy norm conformity (i.e. desires to have frequent sex with multiple partners) functions as a confound between pornography viewing constructs on three romantic relationship wellbeing indicators: Relationship satisfaction, relationship commitment, and infidelity proclivity. Results from men (n = 286) and women (n = 717) indicated that the significant inverse correlations between relationship satisfaction and relationship commitment with pornography viewing constructs becomes non-significant when playboy norm conformity is accounted. Further, the positive relationship between pornography viewing and infidelity proclivity also becomes non-significant in women (no initial connection between pornography viewing and infidelity proclivity was found in men). Though conformity to playboy norms was more strongly related to all romantic relationship wellbeing indicators across genders, pornography viewing frequency was still significantly inversely correlated with relationship satisfaction for women; though the effect size was small. Moderation analyses suggested that pornography viewing frequency was more strongly inversely correlated with relationship satisfaction for women than men. Cumulatively, our results suggest conformity to playboy norms is a significant confounding variable between pornography viewing and romantic relationship wellbeing.

High-Frequency Pornography Use May Not Always Be Problematic

BACKGROUND

Previously, variable-centered analytic approaches showed positive, weak-to-moderate associations between frequency of pornography use (FPU) and problematic pornography use (PPU). However, person-centered studies are sparse in the literature, and these could provide insight into whether there are individuals who use pornography frequently and do not experience problems or whether there are individuals with comparable high-frequency use who differ on reported experiencing of negative consequences.

AIM

The aims of the present study were (i) to identify profiles of pornography use based on FPU and PPU by applying a person-centered analytic approach and (ii) to examine whether the identified profiles could be distinguished based on theoretically relevant demographic and psychological constructs.

METHODS

Latent profile analyses were conducted on 3 nonclinical samples recruited from general websites and a pornography site (study 1: N = 14,006; study 2: N = 483; study 3: N = 672).

RESULTS

Results were consistent across all studies. 3 distinct pornography-use profiles emerged: nonproblematic low-frequency pornography use (68-73% of individuals), nonproblematic high-frequency pornography use (19-29% of individuals), and problematic high-frequency use (3-8% of individuals). Nonproblematic and problematic high-frequency-use groups showed differences in several constructs (ie, hypersexuality, depressive symptoms, boredom susceptibility, self-esteem, uncomfortable feelings regarding pornography, and basic psychological needs).

CLINICAL TRANSLATION

FPU should not be considered as a sufficient or reliable indicator of PPU because the number of people with nonproblematic high-frequency use was 3-6 times higher than that with problematic high-frequency use. These results suggest that individuals with PPU use pornography frequently; however, FPU may not always be problematic.

STRENGTHS & LIMITATIONS

Self-report cross-sectional methods have possible biases that should be considered when interpreting findings (eg, underreporting or overreporting). However, the present research included 3 studies and involved large community samples and visitors of a pornography website. The present study is the first that empirically investigated pornography-use profiles with a wide range of correlates using both severity of PPU and FPU as profile indicators on specific and general samples.

CONCLUSION

The present study is a first step in the differentiated examination of pornography-use profiles, taking into consideration both PPU and FPU, and it provides a foundation for further clinical and large-scale studies. Different psychological mechanisms may underlie the development and maintenance of FPU with or without PPU, suggesting different treatment approaches. Therefore, the present results may guide clinical work when considering reasons for seeking treatment for PPU. Bőthe B, Tóth-Király I, Potenza MN, et al. High-Frequency Pornography Use May Not Always Be Problematic. J Sex Med 2020;17:793-811.

The Use of Online Pornography as Compensation for Loneliness and Lack of Social Ties Among Israeli Adolescents

The Internet provides people with the ability to act anonymously, which may lead them to feel secure and to release them from many of their inhibitions. In many cases, this leads them to participate in cybersex activities and online pornography. This study examined the psychological factors behind young people’s sexual behavior online. Participants comprised 713 Israeli adolescents (383 boys and 330 girls) aged 14 to 18 years. Our results indicated that the impact of loneliness on online sexual activity and frequency of pornography use was dependent on participants’ attachment orientations. Engagement in online sexual activities and use of pornography were high among anxiously attached individuals regardless of the extent of their loneliness. Loneliness was found to increase the use of online sexual activities and pornography, only among secure and anxiously avoidant individuals. Online sexual activity and pornography were also found to be related to offline sexual activity. The results are described and discussed.

Association Between Specific Internet Activities and Life Satisfaction: The Mediating Effects of Loneliness and Depression

The current study examined the associations between specific Internet activities (online shopping, pornography use, social networking site use, and Internet gaming), life satisfaction, and the mediating effects of loneliness and depression for these associations. Participants were 5,215 students (2,303 male participants, Mage = 16.20 years; ranging in age from 10 to 23 years) from various school types (546 elementary school students, 1710 junior high school students, 688 senior high school students, and 2271 university students) who provided self-report data on demographic variables, online shopping, pornography use, social networking site use, loneliness, depression, and life satisfaction. The results indicated that after controlling for demographic variables (gender and age) (a) loneliness and depression had fully positive mediating effects on the association between social networking site use and life satisfaction; (b) loneliness and depression played fully negative mediating effects on life satisfaction associations with online shopping, pornography use, and Internet gaming. Therefore, loneliness and depression were the underlying mechanisms that caused life satisfaction to be affected by online shopping, pornography use, social networking site use, and Internet gaming.