Decades of studies from respected academic institutions, have demonstrated significant impacts of porn consumption for individuals, relationships, and society. "What’s the Research" aims to shed light on the expanding field of academic resources that showcase porn’s harms in a variety of ways. Below are selected excerpts from published studies on this issue.
The full study can be accessed here.
The contribution of ADHD and attachment difficulties to online pornography use among students
Authors: Daniel Niazof, Abraham Weizman, Aviv Weinstein
Published: August 2019
Peer-Reviewed Journal: Comprehensive Psychiatry, 2019, pages 56-60
Background
According to the ICD-11, compulsive sexual behavior disorder is characterized by a persistent pattern of failure to control intense, repetitive sexual impulses resulting in repetitive sexual behavior. Accordingly, the symptoms of this disorder include repetitive sexual activities that induce significant mental distress and eventually harm an individual’s physical and mental health despite an unsuccessful effort to reduce that repetitive sexual impulses and behaviors. Compulsive sexual behavior disorder is a pathological behavior that has compulsive, cognitive, and emotional consequences. Compulsive sexual behavior is harmful to the individual and it influences interactions with friends and family members, as well as overall life satisfaction.
A previous study has investigated the effects of attachment styles on sexual compulsivity among men and women (Weinstein et al., 2015). In particular, this study measured “avoidant attachment,” which involves the avoidance of intimacy, and “anxious attachment” that is related to fears of abandonment and separation anxiety. There are 4 combinations of attachment style: (1) secure attachment is indicated by low avoidance measures and low anxiety measures, (2) avoidant attachment which is indicated by low anxiety measures with high avoidance measures, (3) anxious attachment which is indicated by low avoidance measures with high anxious measures, and (4) avoidant-anxious attachment which is indicated by high anxiety and high avoidance measures. This study found a positive correlation between anxious and avoidant attachment and sexual compulsivity in all participants. The results provide preliminary evidence for an association between difficulties in attachment and sexual compulsivity in both men and women.
There is also evidence that the link between attachment difficulties and compulsive pornography use may be exacerbated in individuals dealing with sensation-seeking tendencies and ADHD symptoms. Regarding pornography use, sensation seeking is arguably the most prevalently examined impulsivity-related characteristic studied to date. Sensation seeking has been found to be positively related to the frequency of pornography consumption (see Bőthe et al., 2019, for review). For men, sensation seeking has also been found to be positively related to online pornography use (Paul, 2009). The evidence so far suggests that individuals with higher levels of sensation-seeking may spend more time using online pornography and may develop problematic online pornography use.
Previous evidence also points to a high rate of ADHD in men with hypersexual disorder. Kafka and Prentky (1998) found that among men with hypersexual disorder about 17% were diagnosed with ADHD and the following study by Kafka and Hennen’s (2002) has found a rate of 18.7% in those with ADHD in their sample.
In view of the current evidence for an association between compulsive sexual behavior and anxious and avoidance attachment, this study investigated the online use of pornography among a group of subjects, with or without ADHD, who were recruited on social networks online. In the current study, based on previous research, we hypothesized that men with attachment problems together with an ADHD diagnosis and high sensation seeking would show increased problematic pornography use online.
Methods
The aim of the current study was to investigate the relationships between attachment style, style, sensation seeking, ADHD, and problematic use of pornography online in the general population. The sample was comprised of 85 participants (38 men and 47 women) with mean age 25.6 and 26.4 years, respectively. There were 30 participants (35%) with ADHD and 55 participants (65%) without ADHD.
The questionnaires were publicized online in social networks on the Internet. Participants answered questionnaires and sent them to the investigators using email. Participants were informed that the study investigates sex addiction and that the questionnaires will remain anonymous for research purposes. ADHD diagnosis was reported by the participants and it was not verified by medical records. Participants filled in a demographic questionnaire, Zukerman’s Sensation Seeking Scale, Experience in Close Relationship (ECR) questionnaire that assessed anxious and avoidant attachment, and the Cyber Pornography Use Inventory (CPUI).
Results
This study showed that individuals who experience anxious attachment use online pornography at higher levels than those with secure attachment styles, thus confirming that anxiety is often associated with excessive use of pornography. Furthermore, participants with ADHD scored higher on measures of avoidant attachment and problematic pornography use than participants without ADHD. The findings imply that when individuals have high levels of compulsive sexual behaviors or problematic pornography use, disrupted attachment and ADHD should be assessed as potential contributing disorders.
A further implication of the link between compulsive sexual behaviors with insecure attachment and ADHD is that these types of personal struggles may be associated with ambivalence in the motivation to make changes. Reid (2007) has shown that individuals with anxiety were more likely to be in the contemplation stage than subjects presenting with alternative diagnoses, indicating ambivalence about treatment. In their view, many of the associated characteristics of poor attachment and ADHD, such as increased peer rejection, problems in romantic relationships and employment difficulties, may make them vulnerable to compulsive sexual behaviors as a way of ‘escaping’ or ‘avoiding’ emotional discomfort.
There are other explanations why individuals with disrupted attachment and ADHD engage with online pornography. It is plausible that this is due to possible mechanisms common to both, such as impulsivity. Another possibility is that using pornography online may be a means of dealing with the burden of daily life. Brand and colleagues (2011) found that self-reported problems in daily life are linked to online sexual activities.
The higher levels of avoidant attachment in the participants with ADHD observed in this study are supported by previous evidence for an association of ADHD with attachment difficulties (Clarke, 2006). This evidence is compatible with attachment theory that postulates that difficulties in forming a secure attachment with others are associated with problems in intimacy (Bowlby, 1988). According to Freeburg and VanWinkle (2011) real persons cannot live up to the idealistic imaginings in virtual reality that a sexually compulsive person is seeking. The sexually compulsive persons yearn for close attachments, but their expectant models prevent any form of sustained intimacy. Individuals with compulsive sexual behavior compensate for their inability to form close attachments by fantasizing about unattainable and unrealistic surrogates (Leedes, 2001).
Accordingly, individuals with anxious insecure attachment tend to be more vulnerable and seek sex as a source for comfort without a need for emotional intimacy. It is plausible that sexual activity without commitment may also ease fears of separation and abandonment and therefore are favorable to the anxious types. The clinical evidence shows that those with avoidant attachment also seek sexual relationships without emotional commitment. This interpretation is highly compatible with the established data on high rates of anxiety disorders (over 33%) as comorbid conditions of ADHD.
In sum, this study found several key things. First, participants with anxious attachment showed extensive use of pornography online. Second, there is a high rate of ADHD among individuals with compulsive sexual behavior. From these two patterns, it is clear that attachment difficulties and sensation-seeking are associated with compulsive sexual behavior. Inversely, this study also found that participants with ADHD who use online pornography excessively may have difficulty in forming a secure attachment.
Thus, individuals with ADHD who have difficulties in a close relationship may use online pornography excessively that in turn may exacerbate their difficulty in forming secure attachment, a finding that has major clinical implications. Individuals with problematic pornography use should also be screened for disrupted attachment and ADHD in the diagnostic process.
The full study can be accessed here.
