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

Bőthe B.; Nagy L.; Koós M.; Demetrovics Z.; Potenza M.N.; Kraus S.W.; Demirgül S.A.; Gaudet É.; Ballester-Arnal R.; Batthyány D.; Bergeron S.; Billieux J.; Briken P.; Burkauskas J.; Cárdenas-López G.; Carvalho J.; Castro-Calvo J.; Chen L.; Ciocca G.; Corazza O.; Csako R.; Fernandez D.P.; Fernandez E.F.; Fujiwara H.; Fuss J.; Gabrhelík R.; Gewirtz-Meydan A.; Gjoneska B.; Gola M.; Grubbs J.B.; Hashim H.T.; Islam M.S.; Ismail M.; Jiménez-Martínez M.C.; Jurin T.; Kalina O.; Klein V.; Költő A.; Lee C.-T.; Lee S.-K.; Lewczuk K.; Lin C.-Y.; Lochner C.; López-Alvarado S.; Lukavská K.; Mayta-Tristán P.; Miller D.J.; Orosová O.; Orosz G.; Ponce F.P.; Quintana G.R.; Quintero Garzola G.C.; Ramos-Diaz J.; Rigaud K.; Rousseau A.; Scanavino M.D.T.; Schulmeyer M.K.; Sharan P.; Shibata M.; Shoib S.; Sigre-Leirós V.; Sniewski L.; Spasovski O.; Steibliene V.; Stein D.J.; Strizek J.; Štulhofer A.; Ünsal B.C.; Vaillancourt-Morel M.-P.; Van Hout M.C.; Ünsal B.C. · Addiction (2024) · DOI: 10.1111/add.16431

Resumen

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.

Instituciones: Universidad Científica del Sur; Universidad Privada del Norte