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.
Are sexual functioning problems associated with frequent pornography use and/or problematic pornography use? Results from a large community survey including males and females
Authors: Beáta Bőthea, István Tóth-Királyc, Mark D. Griffiths, Marc N. Potenza, Gábor Oroszh, Zsolt Demetrovics
Published: January 2021
Peer-Reviewed Journal: Addictive Behavior, 2021, 106603
Background
Although multiple studies have been conducted regarding possible positive and negative correlates of pornography use, there remain unanswered and controversial questions needing further investigation. Some popular media reports suggest that sexual wellbeing and sexual functioning problems may be becoming more prevalent among younger adults, especially among males, due to pornography use. Personal accounts, clinical presentations, and other data suggest that many young males may experience sexual functioning problems that they attribute to pornography viewing. However, empirical, scientific studies have reported inconsistent associations between pornography use and sexual functioning problems when considering different aspects of pornography use such as problematic pornography use, frequency of pornography use, or potential gender-related differences. Thus, it is important to examine whether different patterns of pornography use may relate differently to sexual functioning problems and to identify whether such problems may relate differently among males and females.
While most individuals in industrialized countries have viewed pornographic materials, a smaller number of people experience what experts call problematic pornography use (see Bőthe et al., 2018, 2020; Grubbs, Kraus, & Perry, 2019; Rissel et al., 2017; Wéry et al., 2016). In recent nationally representative studies of Australian, US, and Polish participants, 70% to 85% of participants have ever used pornography in their lifetime (Grubbs et al., 2019; Lewczuk, Glica, Nowakowska, Gola, & Grubbs, 2020; Rissel et al., 2017). Concerning gender-related differences, 84% to 85% of males and 54% to 57% of females reported lifetime pornography use. However, about 3% to 4.4% of males and 1% to 1.2% of females considered themselves addicted to pornography (Grubbs et al., 2019; Lewczuk et al., 2020; Rissel et al., 2017). Despite a link between frequency of pornography use and problematic pornography use (Tóth-Király, Potenza, Orosz, & Demetrovics, 2020; Grubbs, Perry, Wilt, & Reid, 2019), it is important to distinguish between quantity or frequency of use and the severity or problems associated with pornography use (Gola, Lewczuk, & Skorko, 2016) when examining associations with sexual functioning.
In problematic pornography use, pornography may impact people’s lives significantly and dominate their thinking, feelings, and behaviors (Wéry, Schimmenti, Karila, & Billieux, 2019). Individuals with problematic patterns use pornography to reduce or eliminate stress or negative feelings (Wéry & Billieux, 2016; Wéry et al., 2019). They may increase time spent using pornography, consume more extreme pornography and engage in pornography use despite intrapersonal and interpersonal conflicts related to their use. Although individuals with problematic pornography use may often try to control or reduce their use (Wéry et al., 2019), they may experience mental distress and/or withdrawal symptoms leading to the return of previous pornography use patterns (Grov et al., 2008).
Frequency of pornography use has been associated with problematic use patterns, although magnitudes are typically small to moderate in community samples while stronger, moderate associations have been reported in treatment-seeking and clinical samples (Bőthe, Koós, Tóth-Király, Orosz, & Demetrovics, 2019; Bőthe et al., 2018, 2020; Brand et al., 2011; Gola et al., 2016, 2017; Grubbs et al., 2015, 2019; Lewczuk, Szmyd, Skorko, & Gola, 2017; Twohig, Crosby, & Cox, 2009; Voon et al., 2014; Klucken, Wehrum-Osinsky, Schweckendiek, Kruse, & Stark, 2016). Many community-dwelling individuals may use pornography without perceiving significant adverse consequences and may control or stop use when necessary (Kor et al., 2014). Some people may experience problematic pornography use accompanied by relatively low-frequency pornography use, perhaps due to moral incongruence or other factors (Brand, Antons, Wegmann, & Potenza, 2019; Kraus & Sweeney, 2019). In summary, complex associations may exist between the frequency of pornography use and problematic patterns of pornography use, suggesting a need for more precise understandings.
Few studies have directly investigated associations between problematic pornography use and sexual functioning problems, such as delayed ejaculation, erectile dysfunction, and low sexual desire (Grubbs & Gola, 2019; Wéry & Billieux, 2016). In a recent survey-based study on males (Wéry & Billieux, 2016), problematic online sexual activities were positively and weakly related to erectile dysfunction and levels of sexual desire, and no significant associations were identified between problematic engagement in online sexual activities and orgasmic dysfunction. Cross-sectional and longitudinal data from US males indicated that problematic pornography use and erectile functioning have positive associations in cross-sectional studies, while inconclusive results were reported longitudinally (Grubbs & Gola, 2019). Existing studies are limited in that few have examined possible roles of pornography use in sexual functioning problems among females (Dwulit & Rzymski, 2019).
The aim of the present study was to examine the extent to which problematic pornography use and frequency of pornography use may relate similarly or dissimilarly to sexual functioning problems among males and females in a large non-clinical sample. Based on the extant literature, we hypothesized that sexual functioning problems would relate positively to problematic pornography use but not to the frequency of pornography use, particularly among males. Given that pornography use is often accompanied by masturbation, masturbation was considered in analyses, along with age, relationship status, and sexual orientation.
Methods
The present study aimed to examine differential correlates between quantity (frequency of pornography use) and severity (problematic pornography use) of pornography use with respect to sexual functioning problems among both males and females. This study was conducted following the Helsinki Declaration and was approved by the Institutional Ethical Review Board of the research team’s university. Data collection occurred in January 2017 on a popular Hungarian news portal via an online survey.
The study was part of a larger project. Different subsamples from this dataset were used in previously published studies. Based on prior recommendations for large-scale studies (Keith, 2015; Kline, 2015), we aimed to recruit at least 1,000 participants to ensure appropriate power. However, we did not set an upper limit for participation. Informed consent was obtained before data collection. Survey completion took approximately 30 min, and relevant data were analyzed. Individuals aged 18 years old or older were invited to participate. Before responding to pornography-related questions, participants were provided with a definition of pornography: “Pornography is defined as material (e.g., text, picture, video) that (1) creates or elicits sexual feelings or thoughts and (2) contains explicit exposure or descriptions of sexual acts involving the genitals, such as vaginal or anal intercourse, oral sex, or masturbation.” (Bőthe et al., 2018).
Multi-group structural equation modeling was conducted to investigate hypothesized associations between problematic pornography use, frequency of pornography use, and sexual functioning problems among males and females (N = 14,581 participants; females = 4,352; 29.8%; Mage = 33.6 years, SDage=11.0), controlling for age, sexual orientation, relationship status, and masturbation frequency.
This study used the Problematic Pornography Consumption Scale (PPCS; Bőthe, Tóth-Király, et al., 2018), which was developed based on a six-component addiction model (Griffiths, 2005). The scale includes six factors (salience; tolerance; mood modification, conflict, withdrawal, and relapse), each with three items concerning past-six-month use of pornography. This study also used the Sexual Function Function Scale (SFS); (Burwell, Case, Kaelin, & Avis, 2006; Sherbourne, 1992). Sexual functioning problems were assessed with four questions related to different aspects of sexual functioning: lack of interest in sexual activities, difficulty in becoming sexually aroused, difficulty in achieving orgasm, and difficulty in enjoying sex. These dimensions cover main aspects of sexual functioning problems among males and females, and the scale has been widely used (Addis et al., 2006; Broeckel, Thors, Jacobsen, Small, & Cox, 2002; Kuppermann et al., 2005; Lerman et al., 1996; Thompson et al., 2005; Zebrack, Foley, Wittmann, & Leonard, 2010).
Results
Given seemingly inconsistent results concerning associations between pornography use and sexual outcomes in past studies (Grubbs & Gola, 2019; Vaillancourt-Morel et al., 2019), the aim of the present study was to examine potentially different roles for the frequency of pornography use and problematic pornography use with respect to sexual functioning problems.
Using multi-group structural equation modeling, this study found that problematic pornography use had a significant positive association with sexual functioning problems for both men and women. This study also found that frequency of use has a weak, negative association with sexual functioning problems. This study also found that males reported using pornography significantly more frequently, and reported higher levels of problematic pornography use than females. However, females reported significantly higher levels of sexual functioning problems than males.
These findings resonate with the “high engagement versus problematic engagement” model of potentially addictive behaviors (Billieux, Flayelle, Rumpf, & Stein, 2019; Charlton & Danforth, 2007; Charlton, 2002). According to this model, some characteristics should be considered as “core” symptoms of problematic behaviors, while others represent “peripheral” symptoms that may be present in both frequent but non-problematic use and in problematic use. In other words, individuals may experience frequency pornography use but not necessarily problematic pornography use. In contrast, individuals with problematic pornography use may also report core and peripheral symptoms, including frequent use patterns (Bőthe et al., 2020). Similar observations have been reported regarding other online behaviors with respect to measures of frequency and problematic use, such as internet use (Chak & Leung, 2004), Facebook use (Koc & Gulyagci, 2013), online gaming (Király, Tóth, Urbán, Demetrovics, & Maraz, 2017; Orosz, Zsila, Vallerand, & Bőthe, 2018), and problematic television series watching (Tóth-Király, Bőthe, Tóth-Fáber, Hága, & Orosz, 2017; Tóth‐Király, Bőthe, Márki, Rigó, & Orosz, 2019).
Problematic pornography use may be associated with increased masturbation and pornography “binges” where the pornography is used multiple times or hours per day. Therefore, males who excessively view pornographic materials may be more likely to be in a refractory period when trying to engage in sexual activities with their partner, potentially leading to sexual functioning problems (Ley et al., 2014). For some, sexual intercourse with one’s partner may not be as stimulating as online pornographic material because it may not provide as much novelty as online pornography. Furthermore, clinical and case reports suggest that pornography use may alter arousal templates (Brand, Blycker, & Potenza, 2019). These potential impacts should be considered in future studies.
Stress reduction and emotion regulation are frequently reported motivations in problematic pornography use, and interventions involving training in emotion regulation (e.g., mindfulness) may be effective in reducing problematic use patterns (Bőthe, Tóth-Király, Potenza, Demetrovics, & Orosz, 2020; Levin, Lillis, & Hayes, 2012; Wéry & Billieux, 2016; Sniewski and Farvid, 2019). Individuals experiencing high levels of stress may engage in problematic pornography use, leading to sexual functioning problems, which, in turn, could result in further stress. Further studies should examine this possibility and relationships between stress, problematic pornography use and sexual functioning problems generally.
In sum, different mechanisms may underlie frequent pornography use and problematic pornography use. Such mechanisms may both directly and indirectly relate to sexual functioning problems in complex manners. When assessing relationships between pornography use and sexual functioning problems, future research should consider both frequencies of use and problematic use and other aspects of pornography and specific aspects of sexual functioning problems. Problematic pornography use appears more strongly associated with problems in sexual function in both community and clinical samples.
The full study can be accessed here.
