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

Problematic pornography use and novel patterns of escalating use: A cross-sectional network analysis with two independent samples

Modern internet pornography allows users to harness sexual novelty in numerous ways, which can be used to overcome desensitisation through increasing volume of use (quantitative tolerance), progressing to more stimulating genres (qualitative escalation), skipping between stimuli (tab-jumping), delaying orgasm ('edging'), and engaging in pornographic binges. However, existing research has not yet evaluated how these potentially reciprocal consumption patterns relate to problematic pornography use (PPU). To this end, we recruited two independent samples of male pornography users (N1 = 1,356, Mage = 36.86, SD = 11.26; N2 = 944, Mage = 38.69, SD = 12.26) and examined the relationships between these behavioural dimensions and self-reported difficulties in controlling one's pornography use. Data were analysed through the network analysis approach (using Gaussian graphical models). As hypothesised, i) quantitative tolerance was centrally placed within the overall network, and ii) acted as a statistical bridge node between other patterns of pornography use (e.g., pornographic binges), and all measured facets of PPU. Our results are consistent with other emerging literature suggesting that tolerance, pornographic binges, tab-jumping, and edging behaviours as relevant features ofPPU, and that upscaling overall usage may connect broader patterns of use with problematic engagement. Clinical and theoretical implications, as well as future research directions, are discussed.

Clarifying and extending our understanding of problematic pornography use through descriptions of the lived experience

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.

Impact of COVID-19 on adolescent sexual life and attitudes: have we considered all the possible secondary effects of the pandemic?

A significant increase in pornography use has been reported in the adolescent population worldwide over the past few years, with intensification of the phenomenon during the COVID-19 pandemic. The aim of the present review is to provide data on the frequency of pornography consumption among adolescents during the pandemic and raise awareness about its potential impact on personal beliefs and sexual attitudes in the long term. A comprehensive literature review was performed in two scientific databases using the crossmatch of the terms "pornography", "adolescents" and "COVID-19". A significant increase in pornography consumption in adolescents was documented during the COVID-19 pandemic as a result of social detachment. Fulfilment of sexual desires in the context of social distancing, alleviation of COVID-19-related boredom and psychological strain, and coping with negative emotions are some of the reported reasons for increased pornography use during the pandemic. However, concerns have been raised in the literature regarding potentially negative effects of excessive pornography use from an early age, including the development of pornography addiction, sexual dissatisfaction and aggressive sexual attitudes reinforced by gender preoccupations and sexual inequality beliefs.

CONCLUSION

The extent to which increased pornography consumption from an early age during the COVID-19 pandemic may have affected adolescents' mental well-being, personality construction and sexual behaviour is yet to be seen. Vigilance from the society as a whole is required so that potential negative adverse effects of adolescent pornography use and potential social implications are recognized early and managed. Further research is needed so that the full impact of the COVID-19-related pornography use in the adolescent population is revealed.

WHAT IS KNOWN

•A significant increase in pornography consumption has been documented in the adolescent population worldwide over the past decades due to its quick, affordable and easy access from electronic devices and the possibility of anonymous and private participation. •During the COVID-19 pandemic, this phenomenon was intensified as a coping mechanism to social isolation and increased psychosocial strain.

WHAT IS NEW

•Concerns have been raised regarding the risk of pornography addiction in adolescents during the COVID-19 pandemic, making the post-pandemic adaptation challenging. •Awareness is raised in parents, health care providers and policy makers about the potential negative impacts of pornography consumption from an early, vulnerable age, such as sexual dissatisfaction and development of aggressive sexual attitudes and sex inequality beliefs.

What the grey literature can contribute to addictive behaviour disorder classification •

This commentary examines the proposal made by Brand et al. (2022) regarding a framework outlining relevant criteria for considering possible behavioural addictions within the current World Health Organisation's International Classification of Diseases (ICD-11) category of 'other specified disorders due to addictive behaviours'. We agree with the framework as it highlights the clinical perspective requiring agreed-upon classifications and criteria to produce effective diagnostic procedures and efficacious treatments. Additionally, we propose to add the need of recognising potential addictive behaviour through the inclusion of a fourth meta-level criterion: 'grey literature evidence'. Utilising non-academic evidence can provide validity in the social context where the behaviour takes place, and it can support authorities in taking action to prevent and treat the resultant behavioural problems. The inclusion of the proposed fourth criterion will aid comprehensibility of the current proposal and provide clarity, as indicated in the present commentary, which includes the fourth criterion analysis for problematic pornography use, shopping/buying and social networking site use.

Problematic Pornography Use: Legal and Health Policy Considerations

Purpose of Review

Reports of sexual violence, especially towards women and children, are rapidly increasing. At the same time, rates of problematic pornography use (PPU) are accelerating across the world too. The purpose of this review is to consider the recent research on PPU and its contribution to sexual violence. The article offers guidance to governments on possible health policy interventions and legal actions to prevent the development of PPU and to reduce the incidence of sexual violence in society.

Recent Findings

Working from the consumer’s point of view, we identify PPU and ask how much pornography is needed to cause PPU. We examine how PPU drives sexual offending in children, adolescents and adults. The impact of PPU on some consumers’ behaviour suggests significant links to domestic violence. Sexual strangulation is highlighted as an example. Artificial intelligence algorithms play a key role in the pornography industry and appear to be driving escalation to more violent material, inducing high levels of sexual dysfunction in consumers and creating appetites for viewing child sexual abuse material (CSAM).

Summary

Easy access to internet pornography has led to an increase in PPU and sexual violence. Diagnoses and treatments for PPU are examined, as are legal transgressions of a civil and criminal nature arising from PPU. Legal remedies and government policy implications are discussed from the point of view of the precautionary principle. Strategies covered include age verification for pornography, public health campaigns and embedded health and legal warnings for users at the start of pornography sessions along with lessons for pupils about pornography’s impact on the brain.

Emerging Health and Education Issues Related to Internet Technologies and Addictive Problems

This timely editorial paper outlines some of the main emerging research on technological topics on health and education approaches to Internet use-related problems before and during the beginning of coronavirus disease 2019 (COVID-19). Background: The aim is to provide a brief overview to facilitate a rapid comprehensive and practical approach to these new trends to promote research, interventions, education, and prevention. Methods: The rapid review includes an analysis of both health and education technologies studies on Internet use-related addiction problems included in the Special Issue “Internet and Smartphone Use-Related Addiction Health Problems: Treatment, Education and Research” to extract recent findings and a few reflections about the development of the field before and during the first wave of the COVID-19. Results: Main findings highlighted studies which tended to be empirical, with a relational type associating specific addictive problems with individual and a few contextual factors in adult populations. Psychometric studies about scales are prevalent, but predictive and mixed methods ones are starting to emerge, together with reviews about conceptualisation, measure, treatment, and prevention. Conclusions: From the arrival of Internet, our societies have converged in a global culture which has impacted health and educational domains. Internet use-related addiction problems have globally emerged and common knowledge, advances, and strategies exist to overcome challenges which are starting to be tested, and prevention interest has arisen in a pandemic situation with global health problems holistically tackled.