Highlights
• PPU had positive, moderate links to sexual function problems in males and females.
• FPU had negative, weak links to sexual function problems in males and females.
• FPU and PPU should be discussed separately concerning its links to sexual outcomes.
Abstract: There is much debate regarding whether pornography use has positive or negative associations with sexuality-related measures such as sexual functioning problems. The present study aimed to examine differential correlates between quantity (frequency of pornography use–FPU) and severity (problematic pornography use–PPU) of pornography use with respect to sexual functioning problems among both males and females. Multi-group structural equation modeling was conducted to investigate hypothesized associations between PPU, FPU, 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. The hypothesized model had excellent fit to the data (CFI = 0.962, TLI = 0.961, RMSEA = 0.057 [95% CI = 0.056-0.057]). Similar associations were identified in both genders, with all pathways being statistically significant (p < .001). PPU had positive, moderate associations (βmales=0.37, βfemales=0.38), while FPU had negative, weak associations with sexual functioning problems (βmales=-0.17, βfemales=-0.17). Although FPU and PPU had a positive, moderate association, they should be assessed and discussed separately when examining potential associations with sexuality-related outcomes. Given that PPU was positively and moderately and FPU negatively and weakly associated with problems in sexual functioning, it is important to consider both PPU and FPU in relation to sexual functioning problems.
Keywords: Pornography use frequencyProblematic pornography useSexual dysfunctionSexual functioning problemsSexual problems
4. Discussion
Given seemingly inconsistent results concerning associations between pornography use and sexual outcomes (Grubbs and Gola, 2019, Vaillancourt-Morel et al., 2019), the aim of the present study was to examine potentially different roles for FPU and PPU with respect to relationships with sexual functioning problems among males and females. FPU had a weak, negative association with sexual functioning problems, and PPU had a moderate, positive association with sexual functioning problems. Although most studies of PPU have investigated males (Bőthe et al., 2020, Dwulit and Rzymski, 2019, Gola et al., 2016, Kraus and Rosenberg, 2014, Kraus et al., 2017)—especially when associations between PPU and sexual functioning problems have been examined (Grubbs and Gola, 2019, Landripet and Štulhofer, 2015, Prause and Pfaus, 2015, Wéry and Billieux, 2016)—the present results suggest that similar associations may be identified among females concerning associations between PPU, FPU, and sexual functioning problems. Implications are discussed below.
4.1. Differences between the quantity and severity of pornography use
Similarities and differences between FPU and PPU is an understudied field within behavioral addictions and problematic sexual behaviors (Gola et al., 2016, Grubbs et al., 2018, Grubbs et al., 2018). The results of the present study corroborate recent findings (Bőthe et al., 2020, Gola et al., 2016, Grubbs et al., 2018, Grubbs et al., 2018) suggesting that FPU and PPU are distinct yet related patterns of pornography consumption. In the present largescale cross-sectional study, although FPU and PPU were positively and moderately related, their associations with sexual functioning problems were in opposite directions. Therefore, the results suggest that FPU and PPU represent related yet distinct aspects of pornography use not only in the case of treatment-seeking populations (Gola et al., 2016) but also in community samples, particularly as they relate to sexual functioning problems.
These findings resonate with the “high engagement versus problematic engagement” model of potentially addictive behaviors (Billieux et al., 2019, Charlton and 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, such as FPU (Billieux et al., 2019, Bőthe et al., 2020, Charlton and Danforth, 2007, Charlton, 2002). In other words, individuals may experience FPU but not necessarily PPU. In contrast, individuals with PPU may also report core and peripheral symptoms (including FPU) (Bőthe et al., 2020). As found here and elsewhere (Billieux et al., 2019, Charlton and Danforth, 2007, Charlton, 2002), when only FPU was present (i.e., a peripheral symptom), no major adverse consequences may be observed. However, when PPU is present (i.e., both core and peripheral symptoms), it is more likely that adverse and harmful consequences will be observed. Similar observations have been reported regarding other online behaviors with respect to measures of quantity/frequency and problematic use, such as internet use (Chak & Leung, 2004), Facebook use (Koc & Gulyagci, 2013), online gaming (Király et al., 2017, Orosz et al., 2018), and problematic television series watching (Tóth-Király et al., 2017, Tóth‐Király et al., 2019).
Taking findings together, while quantities of the aforementioned activities were often unrelated to maladaptive states and conditions, problematic engagement in these online behaviors has been related to maladaptive or harmful measures. Therefore, thorough examinations are needed when effects of potentially problematic online behaviors are investigated, taking into consideration not only the quantity of behaviors but also quality levels of engagement.
4.2. Differentiated roles for quantity and severity of pornography use in sexual functioning problems among males and females
While FPU had a weak, negative association with sexual functioning problems, PPU had a positive and moderate association, suggesting that FPU may be associated with fewer sexual functioning problems in some cases (Landripet & Štulhofer, 2015). Nevertheless, males reported using pornography significantly more frequently, and reported higher levels of PPU, compared to females. However, females reported significantly higher levels of sexual functioning problems than males.
Differentiated relationships with FPU and PPU may relate to several underlying biopsychosocial factors. Speculatively, FPU may stem from stronger sexual desire and relate to lower levels of sexual functioning problems, perhaps due to variety in pornographic material that could lead to easier and quicker responses to different offline sexual stimuli (Prause & Pfaus, 2015). FPU may facilitate sexual thoughts, which, in turn, may lead to quicker sexual responses in and thus not lead to sexual functioning problems assessed here (Watson & Smith, 2012). Another possible explanation concerning the negative association between FPU and sexual functioning problems could reflect familiarity generated from viewing pornographic materials (Griffiths, 2000, Kohut et al., 2017, Watson and Smith, 2012), whereby individuals with FPU may feel more sexual comfort when engaging in offline sexual activities because given pornography-related familiarity with sexual activities (Kohut et al., 2017). Based on qualitative analysis of males and females, the most frequently reported effect of pornography use was “no negative impacts”, followed by using pornography as an information source, for sexual experimentation, and for sexual comfort. Thus, higher levels of sexual comfort and self-acceptance, and lower levels of anxiety, shame, and guilt concerning sexual behaviors may be related to FPU. Increased arousal and orgasm response, interest in sex, and more acceptance towards different sexual activities and more sexual experimentation were also reported as positive effects of pornography use (Kohut et al., 2017). Alternate explanations include that individuals with poor sexual functioning may be less likely to engage in FPU, individuals may not be fully aware of pornography-use-related sexual problems and some sexual problems may not have been captured by the assessment instrument. Nevertheless, FPU explained only a very small amount of the variance related to sexual functioning problems in the present study, indicating that other factors are likely to play a more important role in the development and maintenance of sexual functioning (McCabe et al., 2016).
PPU may be associated with increased masturbation and pornography “binges” (i.e., using pornography multiple times or hours per day), based on results from a ten-week long diary study with treatment-seeking males (Wordecha et al., 2018). 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 (e.g., 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. Additional possible explanations exist. For example, among men seeking treatment for compulsive sexual behaviors, severity of PPU was associated positively with sexual anxiety and negatively with sexual satisfaction (Kowalewska, Kraus, Lew-Starowicz, Gustavsson, & Gola, 2019); as these factors may impact sexual dysfunction, further study is warranted.
As males and females with compulsive-pornography-use profiles (likely PPU) reported lower levels of sexual functioning problems than individuals with a highly distressed non-compulsive profile (Vaillancourt-Morel et al., 2017), stress may impact sexual functioning problems (McCabe et al., 2016). Stress reduction and emotion regulation are frequently reported motivations in PPU, and interventions involving training in emotion regulation (e.g., mindfulness) may be effective in reducing PPU (Bőthe et al., 2020, Levin et al., 2012, Wéry and Billieux, 2016, Sniewski and Farvid, 2019). Individuals experiencing high levels of stress may engage in PPU, leading to sexual functioning problems, which, in turn, could result in further stress. Further studies should examine this possibility and relationships between stress, PPU and sexual functioning problems generally.
In sum, different mechanisms may underlie FPU and PPU. 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 FPU and PPU and other aspects of pornography and specific aspects of sexual functioning problems.
4.3. Limitations and future studies
Study findings should be considered alongside limitations. Self-report methods have biases (e.g., underreporting and overreporting). Causality cannot be inferred from cross-sectional studies. The internal consistency of the SFS was less than optimal (perhaps related to diversity of the 4 domains assessed), and this may have affected findings, as could have the limited number of domains and lack of specificity. For example, context specificity is not detailed in the SFS (e.g., partnered versus solitary sexual activities), and individuals with hypersexuality have reported sexual functioning problems during partnered sex but not during pornography use (Voon et al., 2014).
Moral incongruence and religiosity were not assessed, which may limit generalizability. Moral incongruence and religiosity may relate to PPU (Grubbs and Perry, 2019, Grubbs et al., 2019, Grubbs et al., 2020, Grubbs et al., 2020, Lewczuk et al., 2020), with individuals with higher levels of morality and religiosity perhaps showing stronger associations between FPU and PPU than those with lower levels of morality and religiosity (Grubbs, Lee, Hoagland, Kraus, & Perry, 2020). As such, future studies should include assessments of moral incongruence in relation to pornography content (e.g., aggressive sexual behaviors often targeted towards women (Bridges, Wosnitzer, Scharrer, Sun, & Liberman, 2010), particularly Black women (Fritz, Malic, Paul, & Zhou, 2020), and rape, incest and other pornography genres (Rothman, Kaczmarsky, Burke, Jansen, & Baughman, 2015)and other domains in which people may experience morality-related conflicts. The present study examined a general, community sample. Given that stronger associations may be present between FPU and PPU in treatment-seeking and clinical populations (Bőthe et al., 2018, Bőthe et al., 2020, Brand et al., 2011, Gola et al., 2016, Gola et al., 2017, Grubbs et al., 2015, Grubbs et al., 2019, Lewczuk et al., 2017, Twohig et al., 2009, Voon et al., 2014), the findings of the present study concerning the associations between FPU, PPU, and sexual functioning problems may not generalize to treatment-seeking or clinical populations.
Longer-term longitudinal studies are needed to examine further the nature of the relationships and how they may change over time among both males (Grubbs & Gola, 2019) and females. Individuals who may have developed sexual functioning problems that could have been related to prior pornography viewing (before past-year) may potentially contribute to weakening relationships between FPU and sexual functioning problems. Also, individuals with sexual functioning problems may fear performance failure. Consequently, they may choose online pornography viewing instead of engaging in offline sexual behaviors with their partners (Miner et al., 2016). Additionally, while quantity and FPU are typically related, they are not equivalent and may relate differently to clinically relevant aspects of pornography use (e.g., when trying to abstain; (Fernandez, Tee, & Fernandez, 2017). Qualitatively analyzing narratives of the development and maintenance of one's PPU (Wordecha et al., 2018) and sexual functioning problems may be fruitful in identifying possible mediator and moderator variables such as moral incongruence (Brand et al., 2019, Grubbs and Perry, 2019), accessibility of pornography (Rissel et al., 2017), and other factors (Vaillancourt-Morel et al., 2019).
Posts
No comments:
Post a Comment