Difficulties in sexual functioning and compulsive pornography use. What is the cause and what is the effect? (2020)

LINK to full dissertation: Difficulties in sexual functioning and compulsive pornography use. What is the cause and what is the effect?

I conducted my analyses based on a created initial pool of statements corresponding to six dimensions:

1.) sexual obsessions and a sense of control over one’s sexual life

2.) sexual functioning in the partner relationship

3.) satisfaction with the partner relationship

4.) frequency and patterns of pornography use

5.) sexual functioning during autoerotic practices

6.) sexual dysfunctions

Due to the large number of data obtained in this study, I will limit myself to a most relevant result. The survey involved 193 PPU who declared their willingness to reduce or stop watching pornography. All of the PPUs experienced a subjective sense of loss of control over their own sexual behavior, 36.8% of them received help for difficulties in sexual functioning, and half (50.3%) declared avoiding engaging in a sexual relationship due to perceived problems. I compared the sexual functioning of PPU subjects to a control group of 112 pornography users who did not experience a subjective sense of loss of control over their sexual behavior.

Sexual obsessions and a sense of control over one’s sexual life

• The most common problematic sexual behaviors among PPU were excessive pornography use, compulsive masturbation, and obsessive fantasizing about sex.
• Loss of control is not always limited to one aspect – more than a third of PPUs experienced loss of control over three sexual behaviors.
• PPU (compared to controls) obtained higher scores on questionnaires measuring CSBD (HBI, SAST-R, BPS).

Sexual functioning in the partner relationship

• PPU reported lower satisfaction with their first sexual contacts with a partner compared to the control group.
• Among PPU, masturbation proved to be the dominant sexual activity, while in control men, vaginal intercourse dominated, followed by masturbation.
• The average number of sexual intercourses undertaken by participants in the month before the study was significantly lower in PPU than in the control group.
• There was no difference between the groups in terms of relationship/marital status, so this difference in forms of sexual activity is not because there are more singles among the PPU than among the controls. It can be assumed that the first experience of partnered sex is less pleasant in the PPU group and may, as a result, project a less frequent attempt at subsequent sexual contact. Failure can push men toward pornography and masturbation, which in combination provide a quick way to relieve tension (sexual and non-sexual). On the other hand, problematic pornography consumption preceding sexual initiation can result in the sexual act itself not being stimulating enough to achieve comparable pleasure as during masturbation with pornographic materials.
• In PPU, the decrease in perceived sexual pleasure since the onset of pornography consumption was significantly greater than in male controls.

Satisfaction with the partner relationship

• Among all participants in a relationship at the time of the survey, men in the PPU group were less satisfied with the sexual sphere of their relationship and rated their partner’s perceived satisfaction with sex together lower.
• In the context of satisfaction with the sexual relationship, it also seems interesting that in 17.9% of men in the PPU group, sexual intercourse increases pornography consumption and masturbation, while in the control group the percentage was 4.3%. In the case of PPU, sexual activity with a partner may either not be fulfilling enough, submitting them to continue seeking sexual satisfaction in pornography, or sex may act as a strategy to regulate emotions or stress, and in the case of high severity of these factors at any given time, partner intercourse alone is not sufficient, and pornography is an easily accessible form of continuing coping strategy.
• 75% of PPU and 42.6% of men in the control group happen to watch material they would not want to show to their partner.
• 8% of PPUs and 51.1% of control subjects happened to use pornography with their partner(s).

Frequency and patterns of pornography use

• Nearly half of the PPU reported reaching for pornographic material four times a week or more often (compared to 26.6% of control subjects).
• In the week prior to completing the survey, PPUs spent twice as much time on pornography (on the Internet, TV or newspapers) as men in the control group (267.85 vs. 139.65 minutes per week), and they were almost twice as likely to consume pornographic material per week over the past month.
• The average duration of a single porn session in the PPU group was 54.51 minutes, and 36.31 minutes in the control group. This result is interesting because, according to PornHub.com’s compilation of data summarizing pornography viewing in 2019, the average duration of a single session in Poland was 10 minutes 3 seconds.
• The participants’ perceived change in the frequency of pornography use over the years and escalation to increasingly extreme material was evident in all subjects, but to a greater extent in PPU. The perceived progression in PPU was confirmed while analyzing the history of pornography use over a lifetime. It turned out that the point at which the frequency of pornography consumption began to differentiate between groups was at age 15. During this period of life, PPUs began to reach for pornographic materials with increasing frequency, while in men in the control group the frequency of undertaken consumption remained relatively stable.
• Experiencing unpleasant pornography withdrawal symptoms occurred to a greater extent in the PPU than in the control group. Most of the symptoms experienced were consistent with the results of the analysis of self-reports conducted as part of Study 2 (TESTIMONIES). Consistent with the similarities picked up, problematic pornography users experienced an increase in anxiety when taking a break from pornography consumption, increased anxiety, decreased mood and decreased libido. In addition, nearly half of the PPUs experienced a strong desire to watch pornography, which can eventually lead to relapse in people who try to quit pornography.

Sexual functioning during autoerotic practices

• Autoerotic practices were undertaken more frequently in the PPU group. This applied to both the week before the survey, the last month, and the maximum number of masturbations per day.
• Autoerotic behaviors engaged in while watching pornography were related to the perceived pleasure of masturbating at pornographic materials.
• PPUs, more often than control subjects, had a strong compulsion/desire to masturbate, and its severity was greater in PPUs both without and while viewing pornography.

Sexual dysfunctions

I used some of the aspects of pornography use identified in Study 2 and 3 to initially create three subscales. Each of them, after evaluation, has satisfactory psychometric properties.

1. Problematic Pornography Use

The subscale consists of 10 test items describing situations related to pornography consumption over the past month, to which the participant refers on a 6-point scale (0 – not at all, 1 – not at all, 2 – rarely, 3 – occasionally, 4 – often, 5 – always). The range of scores possible on this subscale is from 0 to 50, and the higher the score on the scale, the greater the likelihood of a loss of control over pornography consumption.

2. Erectile Dysfunction

The subscale consists of 9 test items writing situations related to possible difficulties in obtaining and/or maintaining an erection, some of which are related to pornography consumption. As with the PPU subscale, the participant is asked to respond to each statement on a 6-point scale taking into account the last month. The range of possible scores on the subscale is from 0 to 45, with a high score indicating a significant deterioration in sexual performance following problematic pornography use.

3. Orgasmic Dysfunction

The subscale consists of 7 statements describing situations in which problems with experiencing orgasm may (or may not) arise. Some items describe situations related to pornography consumption. With the last month in mind, the participant responds to each statement on a 6-point scale (also used in the Problematic subscale of the Pornography Use and Erectile Dysfunction), able to score from 0 to 35. The higher the score, the greater the severity of orgasmic problems.

• In the PPU group, the Problematic Pornography Use subscale positively correlates with questions on the frequency of pornography consumption, including: frequency of pornography use in the last year, amount of time spent using pornography in the last week, average duration of a single pornography session in the last month, frequency of pornography viewing during the period of highest symptom severity, average duration of a single session during the period of highest symptom severity, maximum number of hours spent watching pornography per day, sense of change in frequency of pornography use over the years, and amount of time spent per week consuming pornography. In the control group, the above correlations were lower and did not include all the questions listed above.
• In both study groups, scores on the Problematic Pornography Use subscale correlated positively with psychometric instruments measuring the severity of compulsive sexual behavior, i.e., HBI, SAST-R, BPS.
• Moreover, in the PPU, scores on the Problematic Pornography Use subscale were positively related to the “Replacement Arousal” subscale (Sexual Arousability Questionnaire), as well as the total score on a questionnaire measuring 12 dimensions of sexual functioning (Multidimensional Sexuality Questionnaire) and its three subscales, i.e., Sexual Preoccupation, Anxiety about Sex, Sexual Depression.
• The single correlations noted for the Erectile Dysfunction subscale and the Orgasmic Dysfunction subscale are weak enough not to provide a basis for inference.
• The PPU group scored significantly higher than the control group on each newly developed subscale, but the difference for the Orgasmic Disorders subscale was not significant.