There still exist a debate regarding the definition and etiology of SPPA as distinct from self-perceived sex addiction. As such, the research landscape is shaped by different theoretical perspectives. Without evidence to suggest one theoretical position as superior to another, clinicians might be at risk of recommending treatment that is in line with their theoretical perspective (or personal biases) but at odds with the motivations driving an individual to engage in particular sexual behaviors. In light of these findings, the review concludes with recommendations for future research.

The concept of pornography addiction remains controversial and as such there are no diagnostic criteria. Despite this, individuals present to services with self-perceived problematic pornography use. Current treatment generally focuses on the pornography use, yet people's relationship with pornography is complex, and other factors may be relevant for therapy. Drawing on cognitive theory literature, this study explored whether thinking styles, influenced how people evaluate their pornography use. Self-reported (n = 265) "pornography addicts", "somewhat pornography addicts", and "non-addicts" were compared on their perceived effects of their pornography use, cognitive distortions, impact of religious beliefs, social desirability, and shame, within the values theory framework. Findings showed that groups differed significantly in their propensity for cognitive distortions, reported effects of their pornography use, the impact of their religious beliefs, and time spent viewing pornography. Significant differences were not found for the shame scales or social desirability. Regression analysis demonstrated that thinking styles mediated the relationship between time spent viewing pornography and the overall perceived negative impact of pornography. In light of this study's findings, thinking styles should be a focus in future research and treatment as it may help to reduce cognitive dissonance and engender agency.

AimsThe NHS Long-Term Plan includes the perinatal mental health objective: by 2023/24 ‘Maternal Mental Health Services’ will be available across the country to provide psychological therapy for those who experience mental health difficulties directly arising from birth trauma and or/perinatal loss. We achieved early implementer status via application to NHS England and, using transformation funding received, ‘Thrive’ was piloted in East Kent. A gap in service provision was identified: some existing primary care services provide intervention for this cohort, however some people remain in psychological distress but do not meet the criteria for specialist perinatal mental health secondary care services; these secondary care services are not commissioned to support those who have experienced perinatal loss. Thrive is co-delivered by a mental health trust and acute healthcare trust; NICE recommended psychological interventions are provided by Psychological Therapists, Specialist Mental Health Midwives and a Peer Support Worker. The aim of this project was to evaluate the effectiveness of the Thrive pilot in reducing PTSD symptomology whilst also collating feedback from patients, their families and healthcare staff across the maternity system, in order to adapt the service offer for full county rollout.Methods40 people who received care from Thrive from 11th January 2021 to 31st December 2021 were included in this evaluation.Data were collected retrospectively at the end of each period of care via:Clinical outcomes measures (quantitative): •PCL-5: a 20-item self-report measure assessing the 20 DSM-5 symptoms of PTSD.•CORE-34: a universal method of establishing well-being and risk.•HoNOS (Health of the Nation Outcomes Scales): a measure of the health and social functioning of people with severe mental illness.Patient Satisfaction Survey (qualitative).Results•100% of patients improved following Thrive intervention: PCL-5 (significant change = a reduction in score by 10–20 points has been met) / CORE-34 (clinically significant change =score above 10 initially and below 10 after intervention).•Clinical improvement: HoNOS = 100% of patients improved following Thrive intervention.ConclusionEvaluation has evidenced the effectiveness of Thrive in successfully treating those with PTSD symptomology arising from their maternity experience. Post-treatment measures indicate that the level of trauma symptomology and the impact of psychological distress on the functioning of patients who have received intervention from Thrive has reduced to a sub-clinical level in all cases.