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Exploring the Clinical Profile of Problematic Pornography Use

Exploring the clinical profile of problematic pornography useFull Article Title: Exploring the Clinical Profile of Problematic Pornography Use

Open Access: No


Background: Although problematic pornography use (PPU) will soon be diagnosable through the International Classification for Diseases, 11th revision, its clinical profile remains contentious. The current study assessed whether PPU may be characterized by various symptoms sometimes observed among online recovery forums that currently lack empirical assessment, such as heightened cognitive-affective issues following pornography use and sexual dysfunction with partners as a result of escalating use.

Method:Cross-sectional surveys were completed by male PPUs (N = 138, mean age = 31.75 years, standard deviation = 10.72) recruited via online recovery communities and Amazon Mechanical Turk. Multiple regression analysis was performed using the Problematic Pornography Use Scale as the dependent variable and variables of interest (Arizona Sexual Experiences Scales modified for partnered sex and pornography use, Brunel Mood Scale, Social Interaction Anxiety Scale, and the Tolerance subscale from the Problematic Pornography Consumption Scale) and potential confounders (eg, comorbid psychopathology) as independent variables.

Results: Current levels of pornography use, indicators of tolerance and escalation, greater sexual functioning with pornography, and psychological distress were uniquely associated with PPU severity, while cognitive-affective issues after pornography use, impulsivity and compulsivity were not. Although sexual dysfunction did not predict PPU severity, nearly half the sample indicated sexual dysfunction with intimate partners.

Conclusions: The present findings suggest that PPU may be characterized by tolerance and escalation (as per substance addiction models), greater sexual responsivity toward pornography, and psychological distress. Meanwhile, the high rate of partnered sexual dysfunction observed suggests that PPU might be somewhat separable from other forms of compulsive sexual behavior.



Pornography consumption can lead to what the International Classification for Diseases (ICD-11) calls “compulsive sexual behavior disorder.” It is sometimes informally called problematic pornography use (PPU). In this study, men with PPU reported sexual dysfunction with their partners but not while watching pornography. They also exhibited indications of “tolerance and escalation” — over time, for example, they consumed more pornography and more “intense” genres — “which are well known markers of addiction.” These men also displayed greater psychological distress. “On balance, our findings support the conceptualization of PPU as a behavioral addiction.”



Ince, C., Yücel, M., Albertella, L., & Fontenelle, L. (2020). Exploring the clinical profile of problematic pornography use. CNS Spectrums, 1-10. doi:10.1017/S1092852920001686


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