Internet Pornography Use Disorder: In Search of a Non-Pathologizing Description of an Evolving Clinical Issue

Abstract

Since the inclusion of Compulsive Sexual Behavior Disorder in the International Classification of Diseases, 11th Revision (ICD-11), there has been increased research in the area of problematic Internet Pornography (IP) use. Previous research has indicated that problematic IP users share similar experiences, neurobiological changes, and psychosocial effects to substance users. To date, there is no consensus in the research regarding diagnostic criteria, assessment tools or best practice treatment options for problematic IP use. This article builds on previous qualitative research on IP users and compares reported symptomatic behaviors with similar symptoms of substance use disorders. This may aid clinicians and services to recognize clients with problematic IP use. It also explores the case for the characterization of problematic IP Use as a distinct behavioral addiction.

Additional excerpts

The notion that pornography use is “harmless,” and that “porn addiction is not a real addiction” (Grubbs, 2021) has also permeated through the internet. The cumulative effect of this discourse could be to lull potentially problematic users into a false sense of security regarding their pornography use, and they may be encouraged to continue their behavior thinking they don’t have a problem because it is not considered a “real” addiction or mental health issue, and it is not recognized in the latest version of the DSM. The result may be that as time goes by, the problems associated with their use become more entrenched and the damage to their lives, relationships, and mental health increase exponentially

…The ele­vation of pornography in the participants’ lives over other important tasks, such as relationships, and social activities, often caused issues such as failed relationships and disconnection, loss of productivity, and impaired motivation to achieve personal goals

…Pornography users have often reported symptoms consistent with withdrawal and tolerance

…I would argue that internet pornography sits at a particular axis which involves compulsive sexual behaviors and the internet specifically, therefore it is a unique phenomenon which may benefit from its own designation and treatment.

I propose that Internet Pornography Use Disorder is an appropriate and necessary descriptive term which may be utilized with those who are unable to reduce or stop use, despite experiencing significant impairments in their social life, relationships, and mental health. [emphasis supplied]

…Viewing and treating addiction as a single disorder, with a variety of manifestations, could potentially level the playing field for all addictions and associated behaviors. Potentially, it could also reduce some of the stigma attached to some substances or behaviors such as heroin, methamphetamine or sex and internet pornography.

…Internet Pornography Use Disorder is a non-pathologizing descriptive name to describe a phenomenon of problematic pornography use, which could utilize the categories of impaired control, social impairment, risky use, and pharmacological criteria as utilized in the Diagnostic and Statistical Manual.