Excerpts and comments:
Almost half of this study’s 138 total subjects (porn users), average age 31.75, reported sexual dysfunction. This level of sexual dysfunction among this age group was unheard of before freely available digital porn. Is porn conditioning the sexual response of some users to porn – even when they are not addicts according to standard problematic porn use (PPU) questionnaires? Unfortunately this study didn’t settle this question.
Sixty-six participants (48%) reported sexual dysfunction with partners as per the cut-offs presented by McGahuey et al, although only 13 participants (9%) met sexual dysfunction criteria for both pornography and partnered sex….
Three variables significantly and positively predicted PPU [problematic porn use] severity: tolerance scores (medium effect size), psychological distress (small effect), and current use per week (small effect). Additionally, sexual dysfunction with pornography negatively predicted PPU severity (medium effect)….
With respect to this latter finding, the research had a weakness. The scientists didn’t ask subjects about recent partnered sex, as this research team did. Instead, they used a simple yes/no screening question about partnered sex ever. This is a weakness because many men with porn-induced dysfunctions who had partnered sex successfully at some point in their lives, don’t realize they have developed porn-induced problems – until they try again with a partner after an interval of porn reliance. That said, men who reported sexual performance issues with pornography did report greater problematic porn use severity.
On balance, this suggests that PPUs may respond increasingly robustly to pornography while sexual responsivity with partners diminishes, corroborating previous suggestions of PIED among clinical samples11 and PPU case studies. …
Tolerance scores positively predicted PPU severity, corroborating previous demonstrations of porn-related tolerance and escalation among community samples and clinical case studies, thereby aligning with substance addiction models. In addition to patterns of escalation, current pornography use also predicted PPU severity, suggesting that protracted and recent consumption are important considerations for PPU.
Virgins were excluded, perhaps veiling the extent of PIED among those surveyed:
Fifty-four participants were excluded due to a lack of experience with partnered sex. It is possible that a reliance on pornography at the expense of partnered intimacy is itself indicative of PPU, meaning that valuable cases were potentially excluded from the analysis….
A null result was also observed regarding cognitive-affective symptoms following pornography use, [but] these effects might arise as a function of quitting porn-assisted masturbation (which would be more indicative of addiction-like withdrawal)….
We also found that impulsivity and compulsivity scores did not significantly predict PPU severity….
Close to 40% of the sample met the [ADHD] cutoff despite less than 15% having previously received a formal ADHD diagnosis. This potentially indicates that PPU and ADHD symptomatology may move together, which aligns with reports throughout PPU recovery forums of concentration deficits arising in parallel with escalating use.
Finally, results debunked the persistent propaganda that religious and moral disapproval of pornography was related to self reported PPU.
Ince, C., Yücel, M., Albertella, L., & Fontenelle, L. (2020).
CNS Spectrums, 1-10. doi:10.1017/S1092852920001686
ABSTRACT
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.
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