Symptoms of Problematic Pornography Use in a Sample of Treatment Considering and Treatment Non-Considering Men: A Network Approach

Abstract

Background: Pornography use may become problematic for 1 to 6% of the people and may be associated with adverse consequences leading to treatment-seeking behavior. Although the identification of the central symptoms of problematic pornography use (PPU) may inform treatment strategies, no prior study has applied the network approach to examine the symptoms of PPU. Aim:The aims of the present study were to explore the network structure of PPU symptoms, identify the topological location of pornography use frequency in this network, and examine whether the structure of this network of symptoms differs between participants who considered and those who did not consider treatment.Methods: A large-scale online sample of 4,253 men (Mage = 38.33 years, SD = 12.40) was used to explore the structure of PPU symptoms in two distinct groups: Considered treatment group (n = 509) and Not considered treatment group (n = 3,684).Outcomes: Participants completed a self-report questionnaire about their past-year pornography use frequency and PPU measured by the short version of the Problematic Pornography Consumption Scale (PPCS-6). Results:The global structure of symptoms did not differ significantly between the Considered treatment and the Not considered treatment groups. Two clusters of symptoms were identified in both groups, with the first cluster including salience, mood modification, and pornography use frequency, and the second cluster including conflict, withdrawal, relapse, and tolerance. In both groups' networks, salience, tolerance, withdrawal, and conflict appeared as central symptoms, while pornography use frequency was the most peripheral symptom. However, mood modification had a more central place in the Considered treatment group's network and a more peripheral position in the Not considered treatment group's network. NETWORK OF PROBLEMATIC PORNOGRAPHY USE 4Clinical Translation: Based on the results of the centrality analysis in the Considered treatment group, targeting salience, mood modification, and withdrawal symptoms first in the treatment may be an effective way of reducing PPU. Strengths & Limitations:The present study appears to be the first to analyze the symptoms of PPU using a network analytic approach. Self-reported measures of PPU and pornography use frequency might have introduced some biases. Conclusion:The network of PPU symptoms was similar in participants who did and those who did not consider treatment because of their pornography use, with the exception of the mood modification symptom. Targeting the central symptoms in the treatments of PPU seems to be more effective than focusing on reducing pornography use.

The negative consequences of hypersexuality: Revisiting the factor structure of the Hypersexual Behavior Consequences Scale and its correlates in a large, non-clinical sample

“…It is important to highlight that the associations between the HBCS factors and the sexuality-related questions were small, presumably given that strong sexual desire (and consequently, frequent sexual activity) may be related to the elevated levels of these sexual behaviors –and may not necessarily reflect hypersexuality ( Carvalho et al, 2015 , Štulhofer et al, 2016 , Štulhofer et al, 2016 , Werner et al, 2018 ). These results are also in line with recent findings suggesting that frequent pornography use in and of itself may not always indicate problematic pornography use ( Bőthe et al, 2020 , Bőthe et al, 2020 ).…”

Validity and reliability of the short version of the Problematic Pornography Consumption Scale (PPCS-6-A) in adolescents.

“…The BPS is a promising new scale to assess dysregulated pornography use, but its psychometric properties have not been examined as thoroughly as those of the PPCS. The PPCS demonstrated strong psychometric properties in terms of construct, convergent, divergent, and clinical validity and utility (Bőthe et al, 2017;Bőthe, Tóth-Király, et al, 2018Bőthe, Koós, et al, 2019;Bőthe, Lonza, Štulhofer, et al, 2020;Bőthe, Tóth-Király, Bella, et al, 2020;Bőthe, Tóth-Király, Demetrovics, et al, 2020;Bőthe et al, 2021;Tóth-Király et al, 2019). Moreover, gender, sexual orientation, treatment-seeking status, and culture-based measurement invariance have been established for the PPCS in previous studies (Bőthe, Tóth-Király, Demetrovics, et al, 2020;Bőthe, Tóth-Király, et al, 2018;Chen et al, 2021), while no measurement invariance has been tested for the BPS yet, and only some preliminary results are available for the PPUS (Borgogna et al, 2018(Borgogna et al, , 2019.…”

School-Based Prevention of Screen-Related Risk Behaviors during the Long-Term Distant Schooling Caused by COVID-19 Outbreak

“…There is an ongoing debate as to the potential negative effects (e.g., sexual functioning problems) of pornography use in adults [10,18]. Although current studies suggested that a problematic use of pornography (PPU) develops in "only" up to 6% of pornography users, the lower age of users has been identified as a risk factor for PPU [11,12,19,20]. Moreover, it has been shown that the use of pornography influences both sexual attitudes and practices of adolescents [13,21].…”

“…Both problematic (addiction-like) use of screens and at-risk use of screens, such as cyber-bullying and pornography use, have been reported to have negative impacts on users [9][10][11][12][13][14]. These screen related problems were present in children even before the COVID-19 pandemic [15][16][17][18][19][20].…”