Problematic pornography use across countries, genders, and sexual orientations: Insights from the International Sex Survey and comparison of different assessment tools

Bőthe, Beáta, Nagy, Léna, Koós, Mónika, Demetrovics, Zsolt, Potenza, Marc N., International Sex Survey Consortium, , and Kraus, Shane W. (2024) Problematic pornography use across countries, genders, and sexual orientations: Insights from the International Sex Survey and comparison of different assessment tools. Addiction, 119 (5). pp. 928-950.

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Background and aims: Problematic pornography use (PPU) is a common manifestation of the newly introduced Compulsive Sexual Behavior Disorder diagnosis in the 11th edition of the International Statistical Classification of Diseases and Related Health Problems. Although cultural, gender- and sexual orientation-related differences in sexual behaviors are well documented, there is a relative absence of data on PPU outside Western countries and among women as well as gender- and sexually-diverse individuals. We addressed these gaps by (a) validating the long and short versions of the Problematic Pornography Consumption Scale (PPCS and PPCS-6, respectively) and the Brief Pornography Screen (BPS) and (b) measuring PPU risk across diverse populations.

Methods: Using data from the pre-registered International Sex Survey [n = 82 243; mean age (Mage) = 32.4 years, standard deviation = 12.5], a study across 42 countries from five continents, we evaluated the psychometric properties (i.e. factor structure, measurement invariance, and reliability) of the PPCS, PPCS-6, and BPS and examined their associations with relevant correlates (e.g. treatment-seeking). We also compared PPU risk among diverse groups (e.g. three genders).

Results: The PPCS, PPCS-6, and BPS demonstrated excellent psychometric properties [for example, comparative fit index = 0.985, Tucker–Lewis Index = 0.981, root mean square error of approximation = 0.060 (90% confidence interval = 0.059–0.060)] in the confirmatory factor analysis, with all PPCS’ inter-factor correlations positive and strong (rs = 0.72–0.96). A total of 3.2% of participants were at risk of experiencing PPU (PPU+) based on the PPCS, with significant country- and gender-based differences (e.g. men reported the highest levels of PPU). No sexual orientation-based differences were observed. Only 4–10% of individuals in the PPU+ group had ever sought treatment for PPU, while an additional 21–37% wanted to, but did not do so for specific reasons (e.g. unaffordability).

Conclusions: This study validated three measures to assess the severity of problematic pornography use across languages, countries, genders, and sexual orientations in 26 languages: the Problematic Pornography Consumption Scale (PPCS, and PPCS-6, respectively), and the Brief Pornography Screen (BPS). The problematic pornography use risk is estimated to be 3.2–16.6% of the population of 42 countries, and varies among different groups (e.g. genders) and based on the measure used.

Item ID: 82594
Item Type: Article (Research - C1)
ISSN: 1360-0443
Keywords: Addictive behavior, compulsive behavior, compulsive sexual behavior, impulsive behavior, International Sex Survey (ISS), problematic pornography use
Copyright Information: © 2024 The Authors. Addiction published by John Wiley & Sons Ltd on behalf of Society for the Study of Addiction. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.
Additional Information:

Daniel J. Miller is part of the International Sex Survey Consortium group. All collaborators are listed at the end of the article.

Date Deposited: 07 May 2024 03:18
FoR Codes: 52 PSYCHOLOGY > 5203 Clinical and health psychology > 520302 Clinical psychology @ 50%
42 HEALTH SCIENCES > 4202 Epidemiology > 420201 Behavioural epidemiology @ 50%
SEO Codes: 28 EXPANDING KNOWLEDGE > 2801 Expanding knowledge > 280121 Expanding knowledge in psychology @ 34%
20 HEALTH > 2004 Public health (excl. specific population health) > 200401 Behaviour and health @ 33%
20 HEALTH > 2004 Public health (excl. specific population health) > 200409 Mental health @ 33%
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