Sexual Addiction & Compulsivity: The Journal of Treatment & Prevention
Lijun Chen, Cody Ding, Xiaoliu Jiang & Marc N. Potenza
Published online: 26 Jan 2019
https://doi.org/10.1080/10720162.2018.1547234
Abstract
Questions remain regarding how best to define problematic online sexual activities (OSAs) and about paths that may lead to problematic use of OSAs and their consequences. Although frequency and duration of use and motivational drive, as expressed through craving, to view pornography have been implicated in problematic OSAs, their inter-relationships warrant direct examination. We propose and test a model by which pornography craving may promote more frequent engagement in OSAs and more time spent engaging in OSAs, and this may lead to problematic OSAs and subsequent negative consequences like negative emotions. Data from 1070 college students suggested that 20.63% of students were at risk of problematic OSAs use, and this group had greater frequency of OSAs, more usage time, higher pornography craving and more negative academic emotions.
Our proposed path model was partially supported. Pornography craving was associated with problematic OSAs use more, so through frequency than quantity of OSAs, and OSAs were related to negative academic emotions. Future studies of problematic OSAs use should consider the complexity of relationships between craving, use of OSAs and negative health measures in college students and other groups.
RESULTS
EXCERPTS
In a sample of over 1,000 Chinese college students, we tested a model that pornography craving would operate through quantity and frequency measures of usage of OSAs to lead to problematic use of OSAs, and this then would lead to negative academic emotions. Our model was largely supported.
In the college student sample, we found that about 20% of students were in an at-risk/problematic-OSA-use group. This group, one of three identified by latent profile analysis, demonstrated higher scores on all measures of severity including problematic OSAs use, quantity and frequency of use of OSAs, pornography craving, and negative academic emotions. An intermediate- risk group, comprising 35% of the sample, showed intermediate scores on problematic OSAs relative to the at-risk/problematic and nonproblematic use groups. intermediate-risk group also demonstrated higher scores on measures of pornography craving, frequency of OSAs, and negative academic emotions, but scored comparably on OSAs usage time. These findings suggest several important results. First, there exists a sizable group of individuals (21.1%) demonstrating the greatest problematic use of OSAs, and this group exhibits greater problems across a range of sexual behaviors. Second, an even greater proportion (35%) exhibits intermediate levels of problematic use of OSAs, and this group relative to the non-problematic use group is characterized by greater pornography craving and frequency of use of OSAs, and specifically the viewing of SEM. However, the intermediate-risk group as compared to the at-risk/problematic group does not appear to differ substantially on quantity use measures and possible consequences, including with respect to negative academic emotions. These findings suggest that there may be important differences in quantity and frequency measures of pornography use, as has been suggested previously (Fernandez et al., 2017). Further study is indicated to examine the potential role for consequences related to more broad engagement in OSAs, including with respect to negative academic emotions. Further, longitudinal studies are needed to examine more precisely the stability of these groups and the extent to which specific factors may influence transitions.
The finding that 20% of college students were classified by latent profile analysis into the most severe group warrants discussion. About a decade ago, Cooper et al. reported a prevalence of 9.6% for problematic use of OSAs (Cooper, Morahan, Mathy, & Maheu, 2002), whereas Daneback et al. found a prevalence of 5.6% (Daneback, Cooper, & Mansson, 2005). More recently, a study conducted by Ross et al. reported a prevalence of problematic involvement in OSAs of 5% in women and 13% in men (Ross, Mansson, & Daneback, 2012). In these studies, the criteria and instruments varied, suggesting that the results are tentative and their comparison is difficult (Karila et al., 2014; W_ery et al., 2016). On the whole, available epidemiological studies suggest that the prevalence of problematic use of OSAs may have increased since the expansion of the Internet and with increased availability of new and free sexual websites (Wetterneck, Burgess, Short, Smith, & Cervantes, 2012).
A main aim of the present study was to investigate how pornography craving may operate through quantity/frequency measures of use of OSAs to lead to problematic use of OSAs and then to negative academic emotions. According to our a priori hypotheses, motivations to view pornography may lead individuals to use OSAs more frequently and in greater quantity (Figure 1, path B), leading to problematic use of OSAs (Figure 1, path C), and subsequently to negative academic emotions in this college sample. Our hypotheses were largely supported. Pornography craving significantly predicted statistically the problematic use of OSAs both directly and indirectly over frequency of OSAs (but not quantity of OSAs, further highlighting the importance of assessing both measures) (Fernandez et al., 2017). Further, problematic OSAs were related to negative academic emotions.
Pornography craving statistically predicted problematic use of OSAs indirectly only over frequency of use of OSAs but not quantity of use of OSAs. The frequency of OSAs in the mediation of pornography craving and problematic OSAs use is consistent with previous findings (Kraus & Rosenberg, 2014). Although data suggest that time spent using the Internet may predict problematic Internet use (Tokunaga & Rains, 2010), there are also studies suggesting that Internet usage time alone cannot stably predict Internet addiction (Carbonell et al., 2012). Problematic pornography use has been weakly related to time spent viewing Internet pornography (Bothe et al., 2017), and differences in frequency versus quantity of pornography use may be important to consider when assessing attempts to abstain from pornography use (Fernandez et al., 2017).
Problematic use of OSAs may lead to mental health concerns (Bostwick & Bucci, 2008; Cavaglion, 2008; Egan & Parmar, 2013; Gentile, Coyne, & Bricolo, 2012; Griffiths, 2011; Pyle & Bridges, 2012). In the current study, problematic use of OSAs statistically predicted college students’ negative academic emotions. Pornography may be used to induce positive affect (e.g., use for entertainment) or to alleviate negative affective states such as boredom, stress, or depression (Bridges & Morokoff, 2011), suggesting that negative mental states may precede pornography use (Kohut & Stulhofer, 2018). Over time, students may turn to watching pornography more frequently and thus may develop poor study and/or sleep habits, have difficulty concentrating, and possibly miss classes or other school activities (Ohuakanwa et al., 2012), resulting in greater academic negative emotions (boredom, helplessness, depression, or fatigue). In sum, an individual may develop a cycle of behavior in which negative emotion is experienced, Internet pornography viewing and consumption of OSAs occur, negative emotions temporarily are relieved in the shorter term, and longer-term difficulties emerge, thus reinforcing a problematic or addictive cycle (Brand et al., 2016). With each additional enactment of the cycle, diminished control, poor time management, pornography craving, and social problems may be experienced, which in turn may perpetuate a downward spiral (Cooper, Putnam, Planchon, & Boies, 1999).
The current findings have implications for clinical practice. Results indicated that higher pornography craving, greater quantity and frequency of use of OSAs, and more negative academic emotions were associated with problematic OSAs. The results resonate with those of previous studies reporting a high level of pornography craving in association with other negative health measures (Drummond, Litten, Lowman, & Hunt, 2000; Kraus & Rosenberg, 2014). The findings suggest a pathway by which craving may lead to increased use of OSAs and subsequently more problems
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