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Thomas H, Binnie J. The paradox of pornography - sexuality and problematic pornography use. Cult Health Sex 2024; 26:433-448. [PMID: 37212017 DOI: 10.1080/13691058.2023.2213750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 05/10/2023] [Indexed: 05/23/2023]
Abstract
The experiences of sexual minority men who report self-perceived problematic pornography use is under theorised and not well understood despite controversial and conflicting research into the phenomena in heterosexual male populations. This study aimed to widen the conversation to consider the experience of sexuality in relation to self-perceived problematic pornography use, rather than contribute to literature that debates the definition and aetiology of problematic pornography use. Semi-structured online qualitative interviews were conducted with three sexual minority men who self-reported problematic pornography use. Interpretive phenomenological analysis was used to develop themes. Five themes pertinent to understanding the participants' experiences with problematic pornography use were developed: problematised sexuality, pornography as liberator, pornography as corrupter, reform, and relapse and restore. The themes highlight three men's relationship with their sexuality as a feature of their self-perceived problematic pornography use. The research suggests that idiographic experiences of self-perceived problematic pornography use are influenced and maintained by an incongruent and conflicting relationship between an individual's own experiences of sexuality and self-perceptions of pornography use. Limitations and future research recommendations are discussed.
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Affiliation(s)
- Howard Thomas
- Division of Psychology, School of Applied Sciences, London South Bank University, London, UK
| | - James Binnie
- Division of Psychology, School of Applied Sciences, London South Bank University, London, UK
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Borgogna NC, Johnson DAL, Shegedin M, Brasil KM. Taking Another Look at the Pornography Problems Due to Moral Incongruence Model: Does Gender Play a Role? Arch Sex Behav 2024; 53:703-714. [PMID: 38015310 DOI: 10.1007/s10508-023-02743-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 10/03/2023] [Accepted: 10/31/2023] [Indexed: 11/29/2023]
Abstract
The pornography problems due to moral incongruence (PPMI) model is a premier framework for understanding problematic pornography use (PPU). However, past studies have generally examined men or entered gender as a covariate in primary analyses. Such approaches mask between-gender differences. Additionally, dysregulation constructs are also thought to be relevant to PPU, yet it is unclear the degree to which they incrementally predict PPU beyond moral incongruence constructs in non-pathological populations. We addressed these gaps by gathering a large sample of college students (n = 295 men, n = 838 women). Analyses with pornography users (n = 251 men, n = 407 women) were consistent with the PPMI model, adjusted for pornography use frequency. Findings did not change when dysregulation constructs of impulsivity and emotional resilience were added to the model. No paths significantly differed between genders. Altogether, among college student pornography users, religiosity was strongly positively correlated with moral disapproval (β = .65 men, β = .62 women), moral disapproval was moderately positively correlated with PPU (β = .41 men, β = .29 women), religiosity was initially moderately positively correlated with PPU (r = .21 men, r = .22 women), but became non-significant in the full model (β = - .21 men, β = - .04 women), and indirect effects of religiosity to PPU through moral disapproval were significant (indirect β = .27 men, β = .18 women). None of the dysregulation constructs significantly predicted PPU. The full model accounted for 23-22% of the PPU variance in men and women, respectively. Implications, future directions, and limitations are discussed.
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Affiliation(s)
- Nicholas C Borgogna
- Department of Psychological Sciences, Texas Tech University, Box 42051, Lubbock, TX, 79409, USA.
| | - David A L Johnson
- Department of Psychological Sciences, Texas Tech University, Box 42051, Lubbock, TX, 79409, USA
| | - Michelle Shegedin
- Department of Psychological Sciences, Texas Tech University, Box 42051, Lubbock, TX, 79409, USA
| | - Kyle M Brasil
- Deparmtent of Psychology, University of South Alabama, Mobile, AL, USA
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Villena-Moya A, Granero R, Chiclana-Actis C, Potenza MN, Blycker GR, Demetrovics Z, Bőthe B, Steward T, Fernández-Aranda F, Jiménez-Murcia S, Mestre-Bach G. Spanish Validation of the Long and Short Versions of the Problematic Pornography Consumption Scale (PPCS and PPCS-6) in Adolescents. Arch Sex Behav 2024; 53:673-687. [PMID: 37845419 DOI: 10.1007/s10508-023-02700-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/23/2022] [Revised: 06/26/2023] [Accepted: 09/06/2023] [Indexed: 10/18/2023]
Abstract
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.
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Affiliation(s)
- Alejandro Villena-Moya
- Centro de Investigación, Transferencia e Innovación, Universidad Internacional de la Rioja, La Rioja, 26006, Spain
- Unidad de Sexología Clínica y Salud Sexual de la Consulta Dr. Carlos Chiclana, Madrid, Spain
| | - Roser Granero
- Ciber Fisiopatología Obesidad y Nutrición, Instituto de Salud Carlos III, Barcelona, Spain
- Departament de Psicobiologia i Metodologia de les Ciències de la Salut, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Carlos Chiclana-Actis
- Centro de Investigación, Transferencia e Innovación, Universidad Internacional de la Rioja, La Rioja, 26006, Spain
- Unidad de Sexología Clínica y Salud Sexual de la Consulta Dr. Carlos Chiclana, Madrid, Spain
| | - Marc N Potenza
- Department of Psychiatry and Child Study Center, Yale University School of Medicine, New Haven, CT, USA
- Connecticut Mental Health Center, New Haven, CT, USA
- Connecticut Council on Problem Gambling, Wethersfield, CT, USA
- Department of Neuroscience, Yale University, New Haven, CT, USA
| | - Gretchen R Blycker
- College of Nursing, University of Rhode Island, Kingston, RI, USA
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Zsolt Demetrovics
- Centre of Excellence in Responsible Gaming, University of Gibraltar, Gibraltar, Gibraltar
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
| | - Beáta Bőthe
- Département de Psychologie, Université de Montréal, Montréal, QC, Canada
- Département de Psychologie, Université du Québec á Trois-Rivières, Trois-Rivières, QC, Canada
| | - Trevor Steward
- Melbourne School of Psychological Sciences, University of Melbourne, Parkville, VIC, Australia
| | - Fernando Fernández-Aranda
- Ciber Fisiopatología Obesidad y Nutrición, Instituto de Salud Carlos III, Barcelona, Spain
- Department of Clinical Psychology, Bellvitge University Hospital-IDIBELL, Barcelona, Spain
- Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | - Susana Jiménez-Murcia
- Ciber Fisiopatología Obesidad y Nutrición, Instituto de Salud Carlos III, Barcelona, Spain
- Department of Clinical Psychology, Bellvitge University Hospital-IDIBELL, Barcelona, Spain
- Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | - Gemma Mestre-Bach
- Centro de Investigación, Transferencia e Innovación, Universidad Internacional de la Rioja, La Rioja, 26006, Spain.
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Roza TH, Noronha LT, Shintani AO, Massuda R, Lobato MIR, Kessler FHP, Passos IC. Treatment Approaches for Problematic Pornography Use: A Systematic Review. Arch Sex Behav 2024; 53:645-672. [PMID: 37880509 DOI: 10.1007/s10508-023-02699-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 05/30/2023] [Accepted: 09/06/2023] [Indexed: 10/27/2023]
Abstract
Problematic pornography use (PPU) is an emerging condition associated with several negative psychological and sexual outcomes. This study aimed to systematically review treatment approaches for PPU. Potentially eligible studies were searched for in PubMed/MEDLINE, Embase, PsycINFO, and Web of Science up to April 1, 2023. The quality of the evidence was assessed with the use of the Joanna Briggs Institute's checklists, the Cochrane risk-of-bias tools, and the GRADE approach. A total of 8936 references were retrieved, and 28 studies were included in the systematic review (n = 500 participants). Included studies were case reports (k = 16), case series (k = 1), quasi-experimental investigations (k = 7), and randomized clinical trials (k = 4). The majority of included studies presented overall low quality and significant risk of bias, with all interventions receiving a low or very low rating according to the GRADE approach. Most studies investigated psychological interventions, with the predominance of second and third wave cognitive behavioral therapy interventions. Pharmacological treatments included opioid antagonists (naltrexone in most cases) and antidepressants, while one study investigated a protocol that included rTMS. Several investigations described the combination of psychological and pharmacological approaches. Most studies did not report on side effects, with online and self-help interventions presenting significant issues in terms of treatment adherence. Even though there are promising options that may have efficacy for the treatment of patients with PPU, the literature in the topic still presents significant limitations that compromise the reaching of more definitive conclusions.
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Affiliation(s)
- Thiago Henrique Roza
- Department of Psychiatry, Universidade Federal do Paraná, Rua Padre Camargo, 280, Curitiba, PR, CEP: 80060-240, Brazil.
- Laboratory of Molecular Psychiatry, Centro de Pesquisa Experimental and Centro de Pesquisa Clínica, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil.
- Graduate Program in Psychiatry and Behavioral Sciences, Department of Psychiatry, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil.
| | - Lucas Tavares Noronha
- Laboratory of Molecular Psychiatry, Centro de Pesquisa Experimental and Centro de Pesquisa Clínica, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil
| | - Augusto Ossamu Shintani
- Laboratory of Molecular Psychiatry, Centro de Pesquisa Experimental and Centro de Pesquisa Clínica, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil
- Graduate Program in Psychiatry and Behavioral Sciences, Department of Psychiatry, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Raffael Massuda
- Department of Psychiatry, Universidade Federal do Paraná, Rua Padre Camargo, 280, Curitiba, PR, CEP: 80060-240, Brazil
| | - Maria Inês Rodrigues Lobato
- Graduate Program in Psychiatry and Behavioral Sciences, Department of Psychiatry, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Felix Henrique Paim Kessler
- Graduate Program in Psychiatry and Behavioral Sciences, Department of Psychiatry, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Ives Cavalcante Passos
- Laboratory of Molecular Psychiatry, Centro de Pesquisa Experimental and Centro de Pesquisa Clínica, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil
- Graduate Program in Psychiatry and Behavioral Sciences, Department of Psychiatry, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
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Pistre N, Schreck B, Grall-Bronnec M, Fatseas M. Should problematic sexual behavior be viewed under the scope of addiction? A systematic review based on DSM-5 substance use disorder criteria. Addict Behav Rep 2023; 18:100510. [PMID: 37519859 PMCID: PMC10374865 DOI: 10.1016/j.abrep.2023.100510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 06/19/2023] [Accepted: 07/15/2023] [Indexed: 08/01/2023] Open
Abstract
Despite similarities between compulsive sexual disorder and substance use disorder, the issue whether problematic sexual behavior should be viewed within an addiction framework continues to be a subject of debate with no consensus regarding its conceptualization and diagnosis criteria. Examining the presence of addiction criteria among clinical and no clinical samples in the existing literature could permit to ascertain clinical validity of sex addiction diagnosis and support its overlapping feature with other addictive disorders. The aim of this systematic review was to examine this issue by assessing DSM-5 criteria of substance use disorder among individuals engaged in problematic sexual activity. Methods: Using PRISMA criteria, three databases were comprehensively searched up to April 2022, in order to identify all candidate studies based on broad key words. Resulting studies were then selected if they examined problematic sexual behavior within the framework of DSM-5 addiction criteria. Results: Twenty articles matched the selection criteria and were included in this review. DSM-5 criteria of addictive disorders were found to be highly prevalent among problematic sex users, particularly craving, loss of control over sex use, and negative consequences related to sexual behavior. Exposition to sexual cues was also shown to trigger craving, with an association to problematic use and symptom severity. Conclusions: More studies should been done to assess homogeneously according to the DSM-5 criteria the addiction-like features of problematic sexual behaviors in clinical and no-clinical populations. Furthermore, this work argues for the need of further research to examine the extent to which anti-craving interventions could be effective in improving clinical outcomes.
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Affiliation(s)
- Natasha Pistre
- Department of Addictology, CHU Bordeaux, F-33000 Bordeaux, France
| | - Benoît Schreck
- Nantes Université, CHU Nantes, UIC Psychiatrie et Santé Mentale, F-44000 Nantes, France
- Nantes Université, Univ Tours, CHU Nantes, INSERM, MethodS in Patient-Centered Outcomes and HEalth ResEarch, SPHERE, F-44000 Nantes, France
| | - Marie Grall-Bronnec
- Nantes Université, CHU Nantes, UIC Psychiatrie et Santé Mentale, F-44000 Nantes, France
- Nantes Université, Univ Tours, CHU Nantes, INSERM, MethodS in Patient-Centered Outcomes and HEalth ResEarch, SPHERE, F-44000 Nantes, France
| | - Melina Fatseas
- Department of Addictology, CHU Bordeaux, F-33000 Bordeaux, France
- Department of Addictology, CH Charles Perrens, F-33000 Bordeaux, France
- Univ. Bordeaux, CNRS, INCIA, UMR 5287, F-33000 Bordeaux, France
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Seyedzadeh Dalooyi SI, Aghamohammadian Sharbaaf H, Abdekhodaei MS, Ghanaei Chamanabad A. Biopsychosocial Determinants of Problematic Pornography Use: A Systematic Review. Addict Health 2023; 15:202-218. [PMID: 38026725 PMCID: PMC10658102 DOI: 10.34172/ahj.2023.1395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Accepted: 10/08/2022] [Indexed: 12/01/2023]
Abstract
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.
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Affiliation(s)
| | | | - Mohammad Saeed Abdekhodaei
- Department of Psychology, Faculty of Educational Sciences and Psychology, Ferdowsi University of Mashhad, Mashhad, Iran
| | - Ali Ghanaei Chamanabad
- Department of Psychology, Faculty of Educational Sciences and Psychology, Ferdowsi University of Mashhad, Mashhad, Iran
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Gewirtz-Meydan A, Godbout N. Between pleasure, guilt, and dissociation: How trauma unfolds in the sexuality of childhood sexual abuse survivors. Child Abuse Negl 2023; 141:106195. [PMID: 37116448 DOI: 10.1016/j.chiabu.2023.106195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 03/02/2023] [Accepted: 04/07/2023] [Indexed: 06/05/2023]
Abstract
BACKGROUND Childhood sexual abuse (CSA) is a significant risk factor for sexual difficulties in adulthood. OBJECTIVE In the current study we aimed to expand the understanding of the association between CSA and sexual difficulties by examining the moderating role of traumatic sexuality in the association between CSA and sexual difficulties among a sample of CSA survivors. PARTICIPANTS AND SETTING The hypothesized moderation model was examined among a sample of 393 CSA survivors. METHODS Significant interactions were probed using simple slopes tests using the interactions R package. RESULTS The results indicated main effects of traumatic sexuality on survivors' sexual difficulties: Greater severity of dissociation during sex was linked with greater sexual dysfunction and higher compulsive sexual behavior disorder (CSBD), and greater intrusiveness during sex and pleasing the other during sex were linked with higher CSBD. Experiencing higher sex-related guilt and/or shame and hypervigilance with regard to sex were associated with greater sexual dysfunction. As for the moderations, intrusiveness during sex and pleasing the other during sex moderated the association between CSA and sexual dysfunction. Intrusiveness during sex and sex-related guilt and/or shame moderated the association between CSA and CSBD. Intrusiveness during sex, pleasing the other during sex, and/or hypervigilance with regard to sex moderated the association between CSA and problematic pornography use. CONCLUSION This study points to the potential contribution of traumatic sexuality symptoms to sexual difficulties among survivors of CSA and lends support to the idea of offering trauma-focused therapy when treating the sexual difficulties of CSA survivors.
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Affiliation(s)
- Ateret Gewirtz-Meydan
- School of Social Work, Faculty of Social Welfare & Health Sciences, University of Haifa, Israel. agewirtz-@univ.haifa.ac.il
| | - Natacha Godbout
- Sexology department, Université du Québec à Montréal (UQAM), Canada.
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Gewirtz-Meydan A, Spivak-Lavi Z. The association between problematic pornography use and eating disorder symptoms among heterosexual and sexual minority men. Body Image 2023; 45:284-295. [PMID: 37011472 DOI: 10.1016/j.bodyim.2023.03.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 03/10/2023] [Accepted: 03/14/2023] [Indexed: 04/05/2023]
Abstract
In this study, we investigated the link between problematic pornography use and eating disorder symptoms in men, with body comparison and body image as mediators, and perceived realism and anxiety and depression as moderators. We also analyzed the model for both heterosexual and sexual minority men to detect any differences. The current study included 705 Israeli men, 479 of whom identified as heterosexual and 226 as sexual minority. The majority of the sample (90.6%) identified as Jewish with a mean age of 32.5. Results showed that problematic pornography use was linked to more upward body comparison, which in turn was related to negative body image, and ultimately, increased severity of eating disorder symptoms. Anxiety and depression moderated the association between male body image and eating disorder symptoms. However, perceived realism did not moderate the link between problematic pornography use and upward body comparison. Whereas there were significant differences in the mean rank values between heterosexual and sexual minority men in all measures, the processes linking these measures were virtually the same. To reduce the risk of developing or worsening eating disorder symptoms, clinicians working with male clients should assess for problematic pornography use and body image concerns during therapy.
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Affiliation(s)
- Ateret Gewirtz-Meydan
- School of Social Work, Faculty of Social Welfare and Health Sciences University of Haifa, Israel. agewirtz-@univ.haifa.ac.il
| | - Zohar Spivak-Lavi
- Faculty of Social Work, Max Stern Yezreel Valley College, Emek Yezreel, Israel.
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Lewczuk K, Wizła M, Gola M. The Relation of Sexual Attitudes to Hypersexuality and Problematic Pornography Use. Arch Sex Behav 2023; 52:411-430. [PMID: 35896936 PMCID: PMC9328619 DOI: 10.1007/s10508-022-02358-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/04/2021] [Revised: 05/24/2022] [Accepted: 05/26/2022] [Indexed: 05/02/2023]
Abstract
Previous studies have shown that specific attitudes related to moral convictions can have an important role in the development and maintenance of problematic sexual behavior symptoms. However, although other types of attitudes, like sexual attitudes, are potentially highly relevant, they have not yet been studied in this role. We investigated how four dimensions of sexual attitudes: Permissiveness, Birth Control, Communion and Instrumentality, contribute to problematic pornography use (PPU) and hypersexual disorder (HD) symptoms, controlling for religiosity, sex, age and relationship status. The study was administered through an online questionnaire and based on a representative sample of n = 1036 (Mage = 43.28, SD = 14.21; 50.3% women) Polish adult citizens. When adjusting for other variables, higher sexual Permissiveness positively predicted HD and PPU among both men (HD: β = .26, p < .001; PPU: β = .22, p < .001) and women (HD: β = .44, p < .001; PPU: β = .26; p < .001). Sexual Instrumentality positively, although weakly, contributed to HD severity among men (β = .11, p < .05). Attitudes reflecting higher support for responsible sexuality (Birth Control subscale) negatively and weakly predicted HD among women (β = - .11, p < .05). Permissiveness was also the only sexual attitude dimension that consistently predicted a higher frequency of sexual activity among men and women. Based on the cutoff criteria proposed by the authors of the used screening instruments (≥ 53 points for the Hypersexual Behavior Inventory and ≥ 4 points for the Brief Pornography Screen), the prevalence of being at risk for HD was 10.0% (men: 11.4%, women: 8.7%) and for PPU was 17.8% (men: 26.8%, women: 9.1%). Our results point to a significant contribution of sexual attitudes to problematic sexual behavior symptoms, which was not encapsulated by the previously studied influence of religious beliefs, although most of the obtained relationships were relatively weak. Particularly, a consistent link between permissive attitudes and both HD and PPU among men and women may indicate that permissive attitudes can potentially contribute to the development and maintenance of problematic sexual behavior. The prevalence of being at risk for PPU (and to some degree HD) in the current representative sample was high. Such results raise questions about the appropriateness of the proposed cutoff criteria and the risk of overpathologizing normative sexual activity, if the cutoff thresholds are not tailored adequately. The results have implications for the assessment, diagnosis and theory of problematic sexual behavior.
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Affiliation(s)
- Karol Lewczuk
- Institute of Psychology, Cardinal Stefan Wyszynski University, Wóycickiego 1/3, 01-938, Warsaw, Poland.
| | - Magdalena Wizła
- Institute of Psychology, Cardinal Stefan Wyszynski University, Wóycickiego 1/3, 01-938, Warsaw, Poland
| | - Mateusz Gola
- Swartz Center for Computational Neuroscience, Institute for Neural Computations, University of California, San Diego, CA, USA
- Institute of Psychology, Polish Academy of Sciences, Warsaw, Poland
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Jepsen D, Brzank PJ. Hypersexual behaviour among young adults in Germany: characteristics and personality correlates. BMC Psychiatry 2022; 22:804. [PMID: 36536318 DOI: 10.1186/s12888-022-04370-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 11/04/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Hypersexual behaviour (HB) is characterized by recurring unsuccessful efforts to control intense, repetitive sexual impulses that result in sexual activities and manifest in the behaviour of the concerning individual over an extended period. This study aims to describe the characterization of HB among the target group, identify personality correlates, and associations between HB and a lack of sexual education and reflection during school time. METHODS A cross-sectional design was used to survey the participants (age 18-27; n = 609) online who were recruited via a web forum for addiction selfcare, a website for casual sex dating, Facebook and the mail distribution of the University of Applied Science Nordhausen (Germany). Standardised questionnaires were used to measure the key variables in the study. The sexual behaviour (masturbation, pornography consumption, promiscuity), several personality tendencies, and retrospective information about sexual education of the participants during school time were investigated. Correlation and binomial logistic regression were used to analyse the data with HB as the outcome variable. RESULTS 10.5% (n = 64) of the participants were identified as hypersexual. The assignment to male sex, a problematic pornography consumption, and impulsive tendencies were determined as predictors of HB. Strong correlates were identified between HB and promiscuity, and impairments in important areas of life. Weak to moderate correlates comprise between HB and all investigated personality traits, and several aspects of sexual risk behaviour. No association was found between HB and a lacking sexual education during school time. The descriptive analysis revealed further sexual problems within the sample (e.g. feelings of shame and guilt, sexual risk behaviour, sexual dysfunction). CONCLUSION Young adults should get more attention as a vulnerable group for the development of hypersexuality in sexual education, prevention and therapy. Regarding to its treatment, HB therefore should be considered together with its associations with sociodemographic information, personality traits, and psychosocial factors.
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Wizła M, Glica A, Gola M, Lewczuk K. The relation of perceived social support to compulsive sexual behavior. J Psychiatr Res 2022; 156:141-150. [PMID: 36252343 DOI: 10.1016/j.jpsychires.2022.10.021] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 09/27/2022] [Accepted: 10/05/2022] [Indexed: 01/20/2023]
Abstract
We conducted two studies to investigate the links between perceived social support, problematic pornography use (PPU) and compulsive sexual behavior disorder (CSBD). In Study 1 (n=807, convenience sample recruited via social media) we collected preliminary data and in Study 2 (n=1526) we checked whether the results replicate in a sample representative of the Polish adult population. In both studies participants completed the Brief Pornography Screen, Compulsive Sexual Behavior Disorder Scale and Multidimensional Scale of Perceived Social Support. In Study 1 and 2, general social support was a weak protective factor against CSBD (β = -0.15 and β = -0.10) and PPU (β = -0.12 and β = -0.09 respectively, all p values ≤ .001) adjusting for gender, age, sexual orientation and relationship status. The results for three domains of social support (from friends, significant other and family), however, largely differed between the two studies. In Study 1, perceived friends' support weakly protected against PPU and CSBD symptoms. In Study 2 higher support from friends weakly predicted lower CSBD symptoms among men; and stronger family support predicted lower PPU. Support from a significant other was weakly related to lower CSBD for women in Study 1. The conducted studies provided evidence that perceived social support is a protective factor against problematic sexual behavior; however, its predictive power is limited and further studies are needed to assess the importance of various domains of social support in the development of CSBD and PPU symptoms.
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Affiliation(s)
- Magdalena Wizła
- Institute of Psychology, Cardinal Stefan Wyszynski University, Warsaw, Poland.
| | - Agnieszka Glica
- Institute of Psychology, Cardinal Stefan Wyszynski University, Warsaw, Poland; Laboratory of Language Neurobiology, Nencki Institute of Experimental Biology, Polish Academy of Sciences, Warsaw, Poland.
| | - Mateusz Gola
- Swartz Center for Computational Neuroscience, Institute for Neural Computations, University of California, San Diego, United States; Institute of Psychology, Polish Academy of Sciences, Warsaw, Poland.
| | - Karol Lewczuk
- Institute of Psychology, Cardinal Stefan Wyszynski University, Warsaw, Poland.
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Wizła M, Kraus SW, Lewczuk K. Perspective: Can psychedelic-assisted therapy be a promising aid in compulsive sexual behavior disorder treatment? Compr Psychiatry 2022; 115:152303. [PMID: 35334305 DOI: 10.1016/j.comppsych.2022.152303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 11/24/2021] [Accepted: 03/01/2022] [Indexed: 11/03/2022] Open
Abstract
Recently, there has been an increase in studies yielding evidence for psychedelics' anxiolytic and anti-depressive qualities. Preliminary evidence for treatment in substance addiction is also available. In our manuscript, we present a perspective on the possible effectiveness and mechanisms of action of psychedelics' introduction in the treatment of Compulsive Sexual Behavior Disorder (CSBD) and other p roblematic sexual behaviors, which are considered representative of the so-called "behavioral addiction" category. Evidence for the efficacy of Mindfulness Based Interventions in CSBD treatment is promising. Psychedelics- and mindfulness-induced states share common characteristics on both a subjective and objective level. One of the proposed mechanisms regards reduction of experiential avoidance through the promotion of exposure and acceptance. On the neurophysiological level, a shift from higher- to lower-level association regions and an impact on 5- HT2A receptors is observed. Elaborated mechanisms explain the possible enhancement of therapeutic processes by psychedelics. Psychedelics' relative safety and low addictive potential support their introduction into traditional forms of therapy for CSBD and other out of control behaviors.
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Affiliation(s)
- Magdalena Wizła
- Institute of Psychology, Cardinal Stefan Wyszynski University, Warsaw, Poland.
| | - Shane W Kraus
- Department of Psychology, University of Nevada, Las Vegas, NV, USA.
| | - Karol Lewczuk
- Institute of Psychology, Cardinal Stefan Wyszynski University, Warsaw, Poland.
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Okabe Y, Ito D. Psychometric Properties of the Problematic Pornography Use Scale in a Japanese Sample. Arch Sex Behav 2022; 51:1221-1235. [PMID: 34853978 DOI: 10.1007/s10508-021-02141-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/05/2020] [Revised: 05/10/2021] [Accepted: 08/27/2021] [Indexed: 06/13/2023]
Abstract
Problematic pornography use (PPU) is the inability to control the use of pornography and is considered a form of compulsive sexual behavior. It can have a negative effect on one's life and is an important clinical and social issue. In Japan, there is no assessment tool to measure PPU and very little research has been done. The Problematic Pornography Use Scale is one of the scales assessing the severity of PPU. This study validated a Japanese version of the Problematic Pornography Use Scale (PPUS-J) and examined its psychometric properties in a sample of 1011 individuals through an online survey (502 men, 509 women; Mage = 35.9 years, SD = 13.75). The results of the confirmatory factor analysis indicated that the four factors in the original scale were consistent with the factors in the PPUS-J, and strict invariance could be assumed for male and female participants. With regard to reliability, internal consistency indices were appropriate both at the overall and subscale levels for male and female participants. The PPUS-J showed good convergent and divergent validity due to the relationship between the subscales and other measures such as the Sexual Compulsivity Scale. These results demonstrate the validity of the PPUS-J for assessing problematic pornography use in a Japanese sample. Given the paucity of studies conducted in non-Western cultures and on women, this study will be useful in advancing research on PPU across different cultures. Future studies should examine test-retest reliability of the PPUS-J and its use with clinical groups.
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Affiliation(s)
- Yushun Okabe
- Graduate School of Education, Hyogo University of Teacher Education, 942-1 Shimokume Kato-city, Hyogo, 673-1494, Japan.
| | - Daisuke Ito
- Department Clinical Psychology, Graduate School of Education, Hyogo University of Teacher Education, 1-5-7 Higashikawasaki-cho, Kobe, Hyogo, Japan
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Bőthe B, Vaillancourt-Morel MP, Dion J, Paquette MM, Massé-Pfister M, Tóth-Király I, Bergeron S. A Longitudinal Study of Adolescents' Pornography Use Frequency, Motivations, and Problematic Use Before and During the COVID-19 Pandemic. Arch Sex Behav 2022; 51:139-156. [PMID: 35059944 PMCID: PMC8773393 DOI: 10.1007/s10508-021-02282-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 12/04/2021] [Accepted: 12/22/2021] [Indexed: 05/10/2023]
Abstract
Since the beginning of the COVID-19 pandemic, an increase in pornography use has been reported based on cross-sectional findings, raising concerns about associated adverse outcomes, such as problematic pornography use (PPU). The aims of the present study were to document potential changes in adolescents' pornography use frequency, motivations, and PPU before and during the COVID-19 pandemic. As part of an ongoing study on adolescents' sexual health, we used a large sample (NTime 1 = 1771; 47.6% girls, Mage = 15.42 years, SD = 0.59) to examine changes from baseline (before the COVID-19 pandemic) to one year later (during the COVID-19 pandemic) in adolescents' self-reported pornography use frequency, motivations, and PPU, using latent change models and examining potential gender differences. No significant changes were observed in adolescents' pornography use frequency and pornography use motivations, and no gender differences were present in these trends. Although statistically significant, slight decrease was observed in boys' PPU levels, and a statistically significant, slight increase was observed in girls' PPU levels, these changes were very small, providing no practical or clinical relevance. In sum, despite previous propositions, concerns, and cross-sectional findings, longitudinal results suggest that adolescents' pornography use characteristics were rather stable between November 2019 and June 2021, and the COVID-19 pandemic and related lockdowns might not have led to general increases in adolescents' pornography use as it was expected.
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Affiliation(s)
- Beáta Bőthe
- Department of Psychology, Université de Montréal, C.P. 6128, Succursale Centre-Ville, Montréal, QC, H3C 3J7, Canada.
| | | | - Jacinthe Dion
- Intersectoral Center for Sustainable Health, Université du Québec à Chicoutimi, Chicoutimi, QC, Canada
| | - Marie-Michèle Paquette
- Department of Psychology, Université de Montréal, C.P. 6128, Succursale Centre-Ville, Montréal, QC, H3C 3J7, Canada
| | - Maude Massé-Pfister
- Department of Psychology, Université de Montréal, C.P. 6128, Succursale Centre-Ville, Montréal, QC, H3C 3J7, Canada
| | - István Tóth-Király
- Substantive-Methodological Synergy Research Laboratory, Department of Psychology, Concordia University, Montreal, QC, Canada
| | - Sophie Bergeron
- Department of Psychology, Université de Montréal, C.P. 6128, Succursale Centre-Ville, Montréal, QC, H3C 3J7, Canada
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Grubbs JB, Perry SL, Grant Weinandy JT, Kraus SW. Porndemic? A Longitudinal Study of Pornography Use Before and During the COVID-19 Pandemic in a Nationally Representative Sample of Americans. Arch Sex Behav 2022; 51:123-137. [PMID: 34282505 PMCID: PMC8288831 DOI: 10.1007/s10508-021-02077-7] [Citation(s) in RCA: 35] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 06/01/2021] [Accepted: 06/09/2021] [Indexed: 05/19/2023]
Abstract
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.
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Affiliation(s)
- Joshua B Grubbs
- Department of Psychology, Bowling Green State University, 400 E. Merry Street, Bowling Green, OH, 43403, USA.
| | - Samuel L Perry
- Department of Sociology, University of Oklahoma, Norman, USA
| | - Jennifer T Grant Weinandy
- Department of Psychology, Bowling Green State University, 400 E. Merry Street, Bowling Green, OH, 43403, USA
| | - Shane W Kraus
- Department of Psychology, University of Nevada, Las Vegas, Las Vegas, USA
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Abstract
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.
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Affiliation(s)
- Mary Sharpe
- The Reward Foundation, The Melting Pot, 15 Calton Road, Edinburgh, EH8 8DL UK.,Lucy Cavendish College, University of Cambridge, Cambridge, CB3 0BU UK
| | - Darryl Mead
- The Reward Foundation, The Melting Pot, 15 Calton Road, Edinburgh, EH8 8DL UK
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Chasioti D, Binnie J. Exploring the Etiological Pathways of Problematic Pornography Use in NoFap/PornFree Rebooting Communities: A Critical Narrative Analysis of Internet Forum Data. Arch Sex Behav 2021; 50:2227-2243. [PMID: 34143364 PMCID: PMC8275519 DOI: 10.1007/s10508-021-01930-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/09/2020] [Revised: 01/07/2021] [Accepted: 01/20/2021] [Indexed: 06/12/2023]
Abstract
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.
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Affiliation(s)
- Dimitra Chasioti
- Division of Psychology, School of Applied Sciences, London South Bank University, 103 Borough Road, London, SE1 0AA, UK
| | - James Binnie
- Division of Psychology, School of Applied Sciences, London South Bank University, 103 Borough Road, London, SE1 0AA, UK.
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Bőthe B, Tóth-Király I, Griffiths MD, Potenza MN, Orosz G, Demetrovics Z. Are sexual functioning problems associated with frequent pornography use and/or problematic pornography use? Results from a large community survey including males and females. Addict Behav 2021; 112:106603. [PMID: 32810799 DOI: 10.1016/j.addbeh.2020.106603] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 07/05/2020] [Accepted: 08/05/2020] [Indexed: 02/07/2023]
Abstract
There is much debate regarding whether pornography use has positive or negative associations with sexuality-related measures such as sexual functioning problems. The present study aimed to examine differential correlates between quantity (frequency of pornography use-FPU) and severity (problematic pornography use-PPU) of pornography use with respect to sexual functioning problems among both males and females. Multi-group structural equation modeling was conducted to investigate hypothesized associations between PPU, FPU, and sexual functioning problems among males and females (N = 14,581 participants; females = 4,352; 29.8%; Mage=33.6 years, SDage=11.0), controlling for age, sexual orientation, relationship status, and masturbation frequency. The hypothesized model had excellent fit to the data (CFI = 0.962, TLI = 0.961, RMSEA = 0.057 [95% CI = 0.056-0.057]). Similar associations were identified in both genders, with all pathways being statistically significant (p < .001). PPU had positive, moderate associations (βmales=0.37, βfemales=0.38), while FPU had negative, weak associations with sexual functioning problems (βmales=-0.17, βfemales=-0.17). Although FPU and PPU had a positive, moderate association, they should be assessed and discussed separately when examining potential associations with sexuality-related outcomes. Given that PPU was positively and moderately and FPU negatively and weakly associated with problems in sexual functioning, it is important to consider both PPU and FPU in relation to sexual functioning problems.
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Chen L, Luo X, Bőthe B, Jiang X, Demetrovics Z, Potenza MN. Properties of the Problematic Pornography Consumption Scale (PPCS-18) in community and subclinical samples in China and Hungary. Addict Behav 2021; 112:106591. [PMID: 32768797 DOI: 10.1016/j.addbeh.2020.106591] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 07/23/2020] [Accepted: 07/28/2020] [Indexed: 11/21/2022]
Abstract
Several scales assessing problematic pornography use (PPU) are available. However, in most previous studies, primarily nonclinical and Western samples were used to validate these scales. Thus, further research is needed to validate scales to assess problematic pornography use across diverse samples, including subclinical populations. The aim of the present study was to examine and compare the psychometric properties of the PPCS-18 in Hungarian and Chinese community samples and in subclinical men. A sample of Chinese community men (N1 = 695), a sample of subclinical men who were screened for PPU using the Brief Pornography Screen (N2 = 4651), and a sample of Hungarian community men (N3 = 9395) were recruited to investigate the reliability and validity of the PPCS-18. Item-total score correlation, confirmatory factor analyses, reliability, and measurement invariance tests showed that the PPCS-18 yielded strong psychometric properties among Hungarian and Chinese community men and indicated potential utility in the subclinical men. The network analytic approach also corroborates that the six factors of the PPCS-18 can reflect the characteristic of the participants from different cultural contexts, and participants from community and subclinical populations. In sum, the PPCS-18 demonstrated high generalizability across cultures and community and subclinical men.
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Niazof D, Weizman A, Weinstein A. The contribution of ADHD and attachment difficulties to online pornography use among students. Compr Psychiatry 2019; 93:56-60. [PMID: 31349137 DOI: 10.1016/j.comppsych.2019.07.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Revised: 07/07/2019] [Accepted: 07/07/2019] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND There is a high rate of ADHD among individuals with compulsive sexual behavior disorder (CSBD). There is also evidence for an association between compulsive sexual behavior disorder, sensation seeking and attachment difficulties. Problematic pornography use may be considered as a subtype of CSBD hence it merits investigation. The aim of the current study was to investigate the relationships between ADHD, attachment style, sensation seeking and problematic use of pornography online in the general population. METHODS The sample was comprised of 85 participants [38 men (44.7%) and 47 women (55.3%)] with mean age 25. 66 (SD = 4.63) and 26.42 (SD = 6.94) years, respectively. There were 30 participants (35%) with ADHD and 55 participants (65%) without ADHD. They were recruited on-line via social network sites. They filled in a demographic questionnaire, Zukerman's Sensation Seeking Scale, Experience in Close Relationship (ECR) questionnaire that assessed anxious and avoidant attachment and the Cyber Pornography Use Inventory (CPUI). RESULTS Individuals with self-reported ADHD had higher scores of avoidant attachment on the ECR and CPUI compared with individuals without ADHD. Multivariate linear regression analysis has indicated that male gender, ADHD and anxious attachment on the ECR contributed significantly to the variance of cyber pornography use, and explained 34% of the variance. CONCLUSIONS The results indicate that males with ADHD and anxious attachment show an extensive use of pornography online. Males with ADHD who have difficulties in close relationship may use online pornography excessively that in turn may exacerbate their difficulty in forming secure attachment at adult life, a finding that has major clinical implications.
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Brand M, Wegmann E, Stark R, Müller A, Wölfling K, Robbins TW, Potenza MN. The Interaction of Person-Affect-Cognition-Execution (I-PACE) model for addictive behaviors: Update, generalization to addictive behaviors beyond internet-use disorders, and specification of the process character of addictive behaviors. Neurosci Biobehav Rev 2019; 104:1-10. [PMID: 31247240 DOI: 10.1016/j.neubiorev.2019.06.032] [Citation(s) in RCA: 584] [Impact Index Per Article: 116.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Revised: 06/17/2019] [Accepted: 06/23/2019] [Indexed: 12/24/2022]
Abstract
We propose an updated version of the Interaction of Person-Affect-Cognition-Execution (I-PACE) model, which we argue to be valid for several types of addictive behaviors, such as gambling, gaming, buying-shopping, and compulsive sexual behavior disorders. Based on recent empirical findings and theoretical considerations, we argue that addictive behaviors develop as a consequence of the interactions between predisposing variables, affective and cognitive responses to specific stimuli, and executive functions, such as inhibitory control and decision-making. In the process of addictive behaviors, the associations between cue-reactivity/craving and diminished inhibitory control contribute to the development of habitual behaviors. An imbalance between structures of fronto-striatal circuits, particularly between ventral striatum, amygdala, and dorsolateral prefrontal areas, may be particularly relevant to early stages and the dorsal striatum to later stages of addictive processes. The I-PACE model may provide a theoretical foundation for future studies on addictive behaviors and clinical practice. Future studies should investigate common and unique mechanisms involved in addictive, obsessive-compulsive-related, impulse-control, and substance-use disorders.
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Affiliation(s)
- Matthias Brand
- General Psychology: Cognition and Center for Behavioral Addiction Research (CeBAR), University of Duisburg-Essen, Germany; Erwin L. Hahn Institute for Magnetic Resonance Imaging, Essen, Germany.
| | - Elisa Wegmann
- General Psychology: Cognition and Center for Behavioral Addiction Research (CeBAR), University of Duisburg-Essen, Germany
| | - Rudolf Stark
- Department of Psychotherapy and Systems Neuroscience, Justus-Liebig-University of Giessen, Germany; Bender Institute of Neuroimaging, Justus-Liebig-University of Giessen, Germany
| | - Astrid Müller
- Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, Hannover, Germany
| | - Klaus Wölfling
- Outpatient Clinic for Behavioral Addiction, Department of Psychosomatic Medicine and Psychotherapy, University Medical Center, Johannes Gutenberg University Mainz, Germany
| | - Trevor W Robbins
- Department of Psychology, Behavioural and Clinical Neuroscience Institute, University of Cambridge, UK
| | - Marc N Potenza
- Departments of Psychiatry, Neuroscience and Child Study, Yale University School of Medicine, New Haven, USA; Connecticut Council on Problem Gambling, Wethersfield, USA; Connecticut Mental Health Center, New Haven, USA
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Sniewski L, Farvid P, Carter P. The assessment and treatment of adult heterosexual men with self-perceived problematic pornography use: A review. Addict Behav 2018; 77:217-224. [PMID: 29069616 DOI: 10.1016/j.addbeh.2017.10.010] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2017] [Revised: 08/17/2017] [Accepted: 10/11/2017] [Indexed: 01/27/2023]
Abstract
Self-Perceived Problematic Porn Use (SPPPU) refers to an individual who self-identifies as addicted to porn because they feel they are unable to regulate their porn consumption, and that use interferes with everyday life. Although porn addiction has not been formally classified as its own distinct behavioral addiction, therapists and clinicians are advised to educate themselves on the current state of literature pertaining to pornography consumption given the widespread availability and consumption of sexually explicit material online. This review article begins with a general overview of pornography and porn use so that therapists and researchers can discern between non-intrusive and problematic pornography consumption patterns within their practice and understand the common characteristics of those that most commonly present with SPPPU. Thereafter, an overview and examination of therapeutic interventions for SPPPU will be identified and analysed. Finally, the review concludes with recommendations for therapists, clinicians, and future research.
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