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Profiles of Cyberpornography Use and Sexual Well-Being in Adults

Published:December 21, 2016DOI:https://doi.org/10.1016/j.jsxm.2016.10.016

      Abstract

      Introduction

      Although findings concerning sexual outcomes associated with cyberpornography use are mixed, viewing explicit sexual content online is becoming a common activity for an increasing number of individuals.

      Aim

      To investigate heterogeneity in cyberpornography-related sexual outcomes by examining a theoretically and clinically based model suggesting that individuals who spend time viewing online pornography form three distinct profiles (recreational, at-risk, and compulsive) and to examine whether these profiles were associated with sexual well-being, sex, and interpersonal context of pornography use.

      Methods

      The present cluster-analytic study was conducted using a convenience sample of 830 adults who completed online self-reported measurements of cyberpornography use and sexual well-being, which included sexual satisfaction, compulsivity, avoidance, and dysfunction.

      Main Outcomes Measures

      Dimensions of cyberpornography use were assessed using the Cyber Pornography Use Inventory. Sexual well-being measurements included the Global Measure of Sexual Satisfaction, the Sexual Compulsivity Scale, the Sexual Avoidance Subscale, and the Arizona Sexual Experiences Scale.

      Results

      Cluster analyses indicated three distinct profiles: recreational (75.5%), highly distressed non-compulsive (12.7%), and compulsive (11.8%). Recreational users reported higher sexual satisfaction and lower sexual compulsivity, avoidance, and dysfunction, whereas users with a compulsive profile presented lower sexual satisfaction and dysfunction and higher sexual compulsivity and avoidance. Highly distressed less active users were sexually less satisfied and reported less sexual compulsivity and more sexual dysfunction and avoidance. A larger proportion of women and of dyadic users was found among recreational users, whereas solitary users were more likely to be in the highly distressed less active profile and men were more likely to be in the compulsive profile.

      Conclusion

      This pattern of results confirms the existence of recreational and compulsive profiles but also demonstrates the existence of an important subgroup of not particularly active, yet highly distressed consumers. Cyberpornography users represent a heterogeneous population, in which each subgroup is associated with specific sexual outcomes.

      Key Words

      Introduction

      Of the vast repertoire of sexual behaviors, cyberpornography is increasingly becoming a reliable, easily available, constantly renewed source of sexual gratification. Indeed, most men and an increasing number of women watch cyberpornography, which refers to sexually explicit internet videos or images intended to sexually arouse the viewer.
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      Documenting pornography use in America: a comparative analysis of methodological approaches.
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      Associations between young adults' use of sexually explicit materials and their sexual preferences, behaviors, and satisfaction.
      The effect of cyberpornography use on sexual well-being, which encompasses the subjective (eg, satisfaction) and objective (eg, dysfunction and behaviors) evaluation of an individual's sexuality,
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      Well-being: subjective and objective aspects.
      is highly debated and under-researched.
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      The emperor has no clothes: a review of the ‘pornography addiction’ model.
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      How the popular media rushes to judgment about pornography and relationships while research lags behind.
      Most consumers consider that their use of pornography has never been a problem and report positive sexual effects, including sexual entertainment, a richer sexual repertoire, stronger desire and arousal, and increased sexual knowledge.
      • Morgan E.M.
      Associations between young adults' use of sexually explicit materials and their sexual preferences, behaviors, and satisfaction.
      • Cooper A.
      • Morahan-Martin J.
      • Mathy R.M.
      • et al.
      Toward an increased understanding of user demographics in online sexual activities.
      • Prause N.
      • Pfaus J.
      Viewing sexual stimuli associated with greater sexual responsiveness, not erectile dysfunction.
      • Hald G.M.
      • Malamuth N.M.
      Self-perceived effects of pornography consumption.
      • Hald G.M.
      • Smolenski D.
      • Rosser B.R.
      Perceived effects of sexually explicit media among men who have sex with men and psychometric properties of the Pornography Consumption Effects Scale (PCES).
      Recent studies have shown that pornography use does not significantly predict sexual satisfaction over time or male sexual dysfunction.
      • Muusses L.D.
      • Kerkhof P.
      • Finkenauer C.
      Internet pornography and relationship quality: a longitudinal study of within and between partner effects of adjustment, sexual satisfaction and sexually explicit Internet material among newly-weds.
      • Landripet I.
      • Štulhofer A.
      Is pornography use associated with sexual difficulties and dysfunctions among younger heterosexual men?.
      In contrast, cross-sectional and longitudinal evidence has suggested that pornography use might be associated with sexual dissatisfaction, addiction or compulsion, unrealistic expectations, poor sexual decision making, and personal distress.
      • Ley D.
      • Prause N.
      • Finn P.
      The emperor has no clothes: a review of the ‘pornography addiction’ model.
      • Grubbs J.B.
      • Stauner N.
      • Exline J.J.
      • et al.
      Perceived addiction to Internet pornography and psychological distress: examining relationships concurrently and over time.
      • Döring N.M.
      The Internet's impact on sexuality: a critical review of 15 years of research.
      The present study examined whether there are different profiles of pornography users and whether these are associated with specific sexual outcomes.
      Cyberpornography users could represent a heterogeneous population with distinct profiles of consumers, although this hypothesis has not been examined thoroughly. Drawing from preliminary research findings and clinical experience, Cooper et al
      • Cooper A.
      • Putnam D.E.
      • Planchon L.A.
      • et al.
      Online sexual compulsivity: getting tangled in the net.
      put forth a model describing three distinct categories of individuals who use online cyberpornography: (i) recreational users with neutral or positive outcomes, (ii) at-risk users for whom cyberpornography is a self-regulation strategy to cope with anxious-depressive symptoms or situational stressors, and (iii) compulsive users reporting comorbid, recurring, and uncontrollable sexual concerns or practices and adverse relational, occupational, and financial outcomes. The existence of these three distinct profiles could explain the variability in cyberpornography-related sexual outcomes,
      • Hald G.M.
      • Seaman C.
      • Linz D.
      Sexuality and pornography.
      • Döring N.M.
      The Internet's impact on sexuality: a critical review of 15 years of research.
      with recreational users reporting more positive effects than at-risk or compulsive users.
      Research findings tend to support this three-profile hypothesis of cyberpornography users and sexual well-being correlates. First, based on the few available studies of cyberpornography users, 75% to 90% of individuals might be classified as recreational users searching online for sexually explicit material out of curiosity, to improve sexual skills and knowledge, or to increase their sexual enjoyment of and interest in sex, thus reporting increased subjective sexual well-being.
      • Cooper A.
      • Morahan-Martin J.
      • Mathy R.M.
      • et al.
      Toward an increased understanding of user demographics in online sexual activities.
      • Hald G.M.
      • Malamuth N.M.
      Self-perceived effects of pornography consumption.
      • Hald G.M.
      • Smolenski D.
      • Rosser B.R.
      Perceived effects of sexually explicit media among men who have sex with men and psychometric properties of the Pornography Consumption Effects Scale (PCES).
      • Rosser B.R.S.
      • Noor S.W.B.
      • Iantaffi A.
      Normal, problematic and compulsive consumption of sexually explicit media: clinical findings using the Compulsive Pornography Consumption (CPC) scale among men who have sex with men.
      • Wetterneck C.T.
      • Burgess A.J.
      • Short M.B.
      • et al.
      The role of sexual compulsivity, impulsivity, and experiential avoidance in Internet pornography use.
      • Ballester-Arnal R.
      • Castro-Calvo J.
      • Gil-Llario M.D.
      • et al.
      Relationship status as an influence on cybersex activity: cybersex, youth, and steady partner.
      Second, in a study of men who have sex with men, 14% of participants met the criteria for an at-risk intermediate profile.
      • Rosser B.R.S.
      • Noor S.W.B.
      • Iantaffi A.
      Normal, problematic and compulsive consumption of sexually explicit media: clinical findings using the Compulsive Pornography Consumption (CPC) scale among men who have sex with men.
      These individuals reported more sexual partners, more alcohol use, lower odds of being in a long-term relationship, and less sexual satisfaction. Other studies of community or undergraduate samples have reported that some individuals use cyberpornography as a form of avoidant coping or self-treatment for anxious-depressive symptoms or in response to stressors or attachment-related insecurities.
      • Wetterneck C.T.
      • Burgess A.J.
      • Short M.B.
      • et al.
      The role of sexual compulsivity, impulsivity, and experiential avoidance in Internet pornography use.
      • Paul B.
      • Shim J.W.
      Gender, sexual affect, and motivations for Internet pornography use.
      Given this tendency of dealing with emotional issues through pornography use, individuals with this intermediate profile might be at risk of developing a compulsive viewing style.
      • Cooper A.
      • Putnam D.E.
      • Planchon L.A.
      • et al.
      Online sexual compulsivity: getting tangled in the net.
      Third, cross-sectional studies have indicated that a small group of individuals shows clinically significant sexual compulsions in which cyberpornography plays an important role. General estimates vary from 5% to 9% and these individuals evidence a large array of sexual behaviors, moderate to severe self-destructive impulses, and a lack of concern for the adverse effects of their cyberpornography use.
      • Cooper A.
      • Morahan-Martin J.
      • Mathy R.M.
      • et al.
      Toward an increased understanding of user demographics in online sexual activities.
      • Rosser B.R.S.
      • Noor S.W.B.
      • Iantaffi A.
      Normal, problematic and compulsive consumption of sexually explicit media: clinical findings using the Compulsive Pornography Consumption (CPC) scale among men who have sex with men.
      • Paul B.
      • Shim J.W.
      Gender, sexual affect, and motivations for Internet pornography use.
      Yet, to better understand cyberpornography-related sexual outcomes, a multidimensional perspective is needed, using subjective and objective indicators of sexual well-being such as sexual satisfaction, compulsivity, avoidance, and dysfunction.
      • Snell W.E.J.
      Measuring multiple aspects of the sexual self-concept: the Multidimensional Sexual Self-Concept Questionnaire.
      Some studies have classified cyberpornography users into different groups based on time spent viewing sexually explicit material, qualitative pathologic indicators, or type of pornographic content.
      • Prause N.
      • Pfaus J.
      Viewing sexual stimuli associated with greater sexual responsiveness, not erectile dysfunction.
      • Rosser B.R.S.
      • Noor S.W.B.
      • Iantaffi A.
      Normal, problematic and compulsive consumption of sexually explicit media: clinical findings using the Compulsive Pornography Consumption (CPC) scale among men who have sex with men.
      • Ballester-Arnal R.
      • Castro-Calvo J.
      • Gil-Llario M.D.
      • et al.
      Relationship status as an influence on cybersex activity: cybersex, youth, and steady partner.
      • Hald G.M.
      • Štulhofer A.
      What types of pornography do people use and do they cluster? Assessing types and categories of pornography consumption in a large-scale online sample.
      However, these subgroups are generally formed using cutoff scores based on a single criterion. In addition, the amount of time spent watching pornography might not fully differentiate between potential subgroups because viewing time does not take into account the perceived affective, cognitive, and behavioral reactions to consumption. The simultaneous analysis of affective, cognitive, and behavioral indicators using classification analyses might allow a more in-depth examination of the distinct profiles hypothesis that parallels the categories of Cooper et al.
      • Cooper A.
      • Putnam D.E.
      • Planchon L.A.
      • et al.
      Online sexual compulsivity: getting tangled in the net.
      Sex and interpersonal context of use might be under- or over-represented in specific profiles. Compared with women, men use pornography more often, more intensely, and for different reasons.
      • Paul B.
      • Shim J.W.
      Gender, sexual affect, and motivations for Internet pornography use.
      • Hald G.M.
      Gender differences in pornography consumption among young heterosexual Danish adults.
      Previous studies have documented that women tend to view pornography with their partners, whereas men's viewing is more often solitary.
      • Hald G.M.
      Gender differences in pornography consumption among young heterosexual Danish adults.
      • Traeen B.
      • Nilson T.S.
      Use of pornography in traditional media and on the Internet in Norway.
      • Maddox A.M.
      • Rhoades G.K.
      • Markman H.J.
      Viewing sexually-explicit materials alone or together: associations with relationship quality.
      These differences in consumption patterns associated with findings stating that men's solitary pornography use might be associated with negative couple and sexual outcomes, whereas women's dyadic use is not,
      • Muusses L.D.
      • Kerkhof P.
      • Finkenauer C.
      Internet pornography and relationship quality: a longitudinal study of within and between partner effects of adjustment, sexual satisfaction and sexually explicit Internet material among newly-weds.
      • Maddox A.M.
      • Rhoades G.K.
      • Markman H.J.
      Viewing sexually-explicit materials alone or together: associations with relationship quality.
      • Bridges A.J.
      • Morokoff P.J.
      Sexual media use and relational satisfaction in heterosexual couples.
      suggest that men and solitary users might be over-represented in the compulsive profile, whereas women and dyadic users might be more prevalent in the recreational profile.
      • Ballester-Arnal R.
      • Castro-Calvo J.
      • Gil-Llario M.D.
      • et al.
      Relationship status as an influence on cybersex activity: cybersex, youth, and steady partner.

      Aims

      The aim of this study was to test the hypothesis of distinct profiles of cyberpornography users using three dimensions of personal reactions toward viewing sexually explicit videos or images on the internet: compulsivity, intensity of efforts to access pornography, and emotional distress associated with consumption. Based on the categories proposed by Cooper et al,
      • Cooper A.
      • Putnam D.E.
      • Planchon L.A.
      • et al.
      Online sexual compulsivity: getting tangled in the net.
      we hypothesized that three distinct profiles of cyberpornography users would emerge: recreational, at-risk, and compulsive. We expected that individuals in the recreational profile would report lower scores on the dimensions of cyberpornography use and on time spent viewing cyberpornography, those in the at-risk profile would have moderate scores, and those in the compulsive profile would have higher scores. Individuals in the recreational profile were expected to report higher sexual well-being (ie, higher sexual satisfaction and lower compulsivity, avoidance, and dysfunction) than individuals in the two other profiles, whereas individuals in the compulsive profile would report lower sexual well-being than individuals in the two other profiles. Further, we hypothesized that the proportion of women and dyadic users would be larger in the recreational profile, whereas the proportion of men and solitary users would be larger in the compulsive profile.

      Methods

       Participants and Procedure

      A convenience sample of North American men and women at least 18 years old was recruited through university electronic lists, classified advertisement web sites, and social networks. Interested participants signed a consent form electronically, which guaranteed confidentiality and specified that the online survey examined the determinants of sexuality in adulthood. The study protocol was approved by an institutional review board. Of the 1,329 eligible participants who began the survey, 830 (62.5%) completed the Cyber Pornography Use Inventory. No significant differences were observed between responders and non-responders on sociodemographic characteristics. In the final sample, 71.8% were women (n = 596) and 28.2% were men (n = 234) 18 to 78 years old (mean = 25.20, SD = 8.00). Most participants self-identified as heterosexual (81.8%, n = 679), 5.8% as homosexual (n = 48; 21 lesbians and 27 gays), and 11.6% as bisexual or as endorsing other sexual orientations (n = 96). A total of 35.8% were in a committed relationship (ie, married or cohabiting; n = 297), 29.0% were dating (n = 241), and 35.2% were single (n = 292).

       Measurements

       Cyberpornography Use

      The Cyber Pornography Use Inventory
      • Grubbs J.B.
      • Volk F.
      • Exline J.J.
      • et al.
      Internet pornography use: perceived addiction, psychological distress, and the validation of a brief measure.
      was used to assess the three dimensions of pornography use: compulsivity to pornography (three items; eg, I believe I am addicted to internet pornography), intensity of efforts to access pornography (three items; eg, At times, I rearrange my schedule to be alone to view pornography), and emotional distress (ie, ashamed, disgusted, and depressed) associated with pornography use (three items; eg, I feel ashamed after viewing pornography). These subscales demonstrated good internal consistency (Cronbach α range = 0.65–0.94).
      • Grubbs J.B.
      • Stauner N.
      • Exline J.J.
      • et al.
      Perceived addiction to Internet pornography and psychological distress: examining relationships concurrently and over time.
      • Grubbs J.B.
      • Volk F.
      • Exline J.J.
      • et al.
      Internet pornography use: perceived addiction, psychological distress, and the validation of a brief measure.
      The three dimensions are related to hypersexuality and psychological distress even when controlling for social desirability and time spent viewing pornography.
      • Grubbs J.B.
      • Stauner N.
      • Exline J.J.
      • et al.
      Perceived addiction to Internet pornography and psychological distress: examining relationships concurrently and over time.
      • Grubbs J.B.
      • Volk F.
      • Exline J.J.
      • et al.
      Internet pornography use: perceived addiction, psychological distress, and the validation of a brief measure.
      In the present study, Cronbach α ranged from 0.68 to 0.91. Participants also indicated the average time (in minutes) spent weekly consuming cyberpornography based on the past 6 months and whether they viewed cyberpornography with their partner (0 = never and 1 = sometimes to always).

       Sexual Satisfaction

      The Global Measure of Sexual Satisfaction
      • Lawrance K.-A.
      • Byers S.E.
      Sexual satisfaction in long-term heterosexual relationships: the interpersonal exchange model of sexual satisfaction.
      was used to evaluate global satisfaction with one's sexual life. This questionnaire included five items (good-bad, pleasant-unpleasant, positive-negative, satisfying-unsatisfying, valuable-worthless) that are rated on a seven-point bipolar scale to provide a sum ranging from 5 to 35, where higher scores indicate greater sexual satisfaction. This scale demonstrated good internal consistency (Cronbach α = 0.94), good 2-week and 2-month test-retest reliability (r = 0.84 and 0.72), and good convergent validity.
      • Lawrance K.-A.
      • Byers S.E.
      Sexual satisfaction in long-term heterosexual relationships: the interpersonal exchange model of sexual satisfaction.
      • Mark K.P.
      • Herbenick D.
      • Fortenberry J.D.
      • et al.
      A psychometric comparison of three scales and a single-item measure to assess sexual satisfaction.
      In the present study, Cronbach α was 0.91.

       Sexual Compulsivity

      The Sexual Compulsivity Scale
      • Kalichman S.C.
      • Johnson J.R.
      • Adair V.
      • et al.
      Sexual sensation seeking: scale development and predicting AIDS-risk behavior among homosexually active men.
      was used to assess a unidimensional construct that included difficulties to manage sexual thoughts, intrusive preoccupations or behaviors, and the effects of these on daily functioning. Rated on a four-point Likert-type scale (1 = not at all like me to 4 = very much like me), the 10 items are summed to provide a total score ranging from 10 to 40, with a higher score indicating higher levels of sexual compulsivity. This scale demonstrated good internal consistency (Cronbach α = 0.89 and 0.92), high 3-month test-retest reliability (r = 0.80), and good construct validity.
      • Kalichman S.C.
      • Rompa D.
      Sexual sensation seeking and sexual compulsivity scales: reliability, validity, and predicting HIV risk behavior.
      • Ventuneac A.
      • Rendina H.J.
      • Grov C.
      • et al.
      An item response theory analysis of the sexual compulsivity scale and its correspondence with the hypersexual disorder screening inventory among a sample of highly sexually active gay and bisexual men.
      • Kalichman S.C.
      • Rompa D.
      The sexual compulsivity scale: further development and use with HIV-positive persons.
      In the present study, Cronbach α was 0.83.

       Sexual Avoidance

      The Sexual Avoidance Subscale
      • Katz R.C.
      • Gipson M.
      • Turner S.
      Brief report: recent findings on the Sexual Aversion Scale.
      was used to evaluate the general tendency to avoid sexual situations and interactions with a partner. Rated on a four-point Likert-type scale (1 = not at all like me to 4 = very much like me), the 10 items are summed to provide a total score ranging from 10 to 40, with a higher score corresponding to a greater tendency to avoid sexual activity. This subscale showed good internal consistency (Cronbach α = 0.87), high 1-month test-retest reliability (r = 0.90), and good construct validity.
      • Katz R.C.
      • Gipson M.
      • Turner S.
      Brief report: recent findings on the Sexual Aversion Scale.
      • Reissing E.D.
      • Andruff H.L.
      • Wentland J.J.
      Looking back: the experience of first sexual intercourse and current sexual adjustment in young heterosexual adults.
      • La Rocque C.L.
      • Cioe J.
      An evaluation of the relationship between body image and sexual avoidance.
      In the present study, Cronbach α was 0.86.

       Sexual Dysfunction

      The Arizona Sexual Experiences Scale
      • McGahuey C.A.
      • Gelenberg A.J.
      • Laukes C.A.
      • et al.
      The Arizona Sexual Experience Scale (ASEX): reliability and validity.
      • Brassard A.
      • Bourassa M.
      Taduction française du Arizona Sexual Experiences Scale (ASEX) [French translation of the Arizona Sexual Experiences Scale (ASEX)].
      was used to assess six types of sexual difficulties experienced in the previous week: strength of sex drive, ability to be aroused (eg, How easily are you sexually aroused?), ability to have vaginal lubrication or penile erection, ability to reach orgasm, satisfaction with orgasm, and frequency of sexual pain. Rated on a six-point Likert type scale (eg, 1 = extremely easily to 6 = never), the six items are summed to provide a total score ranging from 6 to 36, with a higher score indicating more sexual dysfunction. This scale achieved good internal consistency (Cronbach α = 0.91), good 2-week test-retest reliability (r = 0.80 and 0.89), and good construct validity.
      • McGahuey C.A.
      • Gelenberg A.J.
      • Laukes C.A.
      • et al.
      The Arizona Sexual Experience Scale (ASEX): reliability and validity.
      In the present study, Cronbach α was 0.73.

       Statistical Analyses

      The software program SAS (SAS Institute, Cary, NC, USA) was used to perform a cluster analysis using a hierarchical clustering algorithm with the Ward minimum variance method. This method separated participants into groups (ie, clusters) based on their similarities (ie, distance similarity) on the three dimensions of cyberpornography use: compulsivity, intensity of efforts to access sexual material, and emotional distress associated with consumption. Before profile formation, data were Z-transformed and screened for multivariate outliers and multicollinearity (r = 0.11–0.62). To determine the best number of homogeneous profiles (1 to 15), three fit statistics were examined: the cubic clustering criterion (CCC) for within-profile homogeneity, the pseudo F statistic, and the pseudo t2 statistic for between-profile heterogeneity. The best combination of these three indices (local peaks of the CCC and pseudo F with a small pseudo t2 and a larger pseudo t2 for the next cluster) indicated the number of profiles that best fitted the data and this conclusion was confirmed by an examination of the dendrogram.
      SPSS software (SPSS, Inc, Chicago, IL, USA) was used to examine the distinctive features of the identified profiles. First, a multivariate analysis of variance (MANOVA) followed by least-significant-difference comparisons was conducted to compare means among profiles on the three dimensions of pornography use. Second, an analysis of variance (ANOVA) was performed to compare average time spent viewing pornography. Third, a second MANOVA was conducted to compare means among profiles on sexual well-being variables (sexual satisfaction, compulsivity, avoidance, and dysfunction). Fourth, χ2 analyses were conducted to compare the proportion of men vs women and dyadic vs solitary users across profiles.

      Results

       Identification and Description of Profiles

      The fit statistics of the cluster analysis showed that a three-profile solution was the most suitable (CCC = −2.9; pseudo F = 560; pseudo t2 = 65.2) compared with the two-profile option (CCC = −3.8; pseudo F = 514; pseudo t2 = 600) and the four-profile option (CCC = −2.9; pseudo F = 517; pseudo t2 = 386). The visual examination of the dendrogram confirmed the presence of three distinct profiles that were parsimonious while capturing distinct underlying clusters. Means and SDs of pornography use dimensions for each profile are presented in Table 1. The first profile, designated as a recreational profile, included 75.5% of the sample (n = 627) and was characterized by low scores on the three dimensions of pornography use. The second profile, labeled a highly distressed non-compulsive profile, defined 12.7% of the sample (n = 105) and was represented by low scores on compulsivity to pornography and intensity of efforts to access pornography but high scores on emotional distress associated with pornography use. The third profile, named the compulsive profile, included 11.8% of the sample (n = 98) and was characterized by high scores on compulsivity to pornography and intensity of efforts to access pornography and moderate scores on emotional distress associated with pornography use.
      Table 1Pornography use, sexual well-being, sex, and interpersonal context of use across pornography use profiles
      Means with different superscript letters (a vs b vs c) differ at P < .05.
      Recreational profileHighly distressed non-compulsive profileCompulsive profile
      Dimensions of pornography use, mean (SD)F2,827η2
       Compulsivity1.41 (0.83)a1.49 (0.78)a4.57 (1.12)b580.360.584
       Efforts to access1.09 (0.27)a1.08 (0.25)a2.62 (1.20)b423.930.511
       Emotional distress1.47 (0.72)a4.85 (0.97)b3.00 (1.57)c705.230.630
      Pornography time use, mean (SD)F2,825η2
       Weekly time use24.00 (51.65)a16.74 (29.42)a110.07 (97.82)b101.450.197
      Sexual well-being, mean (SD)F2,818η2
       Sexual satisfaction27.28 (6.09)a24.78 (7.41)b24.01 (6.44)b16.030.038
       Sexual compulsivity14.15 (3.98)a14.52 (4.14)a20.22 (6.08)b84.150.171
       Sexual avoidance12.24 (3.52)a14.77 (5.92)b14.65 (5.60)b26.460.061
       Sexual dysfunction15.86 (4.16)a18.03 (4.91)b14.90 (4.11)c15.230.036
      Sex, % (n)χ22φ
       Women77.5 (486)a78.1 (82)a28.6 (28)b102.620.352
       Men22.5 (141)a21.9 (23)a71.4 (70)b
      Interpersonal context of use, % (n)χ22φ
       Solitary use64.8 (386)a82.3 (79)b75.8 (69)ab14.470.136
       Dyadic use35.2 (21)a17.7 (17)b24.2 (22)ab
      Relationship status, % (n)χ24φ
       Committed relationship35.9 (225)33.3 (35)37.8 (37)
       Dating30.5 (191)30.5 (32)18.4 (18)7.190.093
       Single33.7 (211)36.2 (38)43.9 (43)
      Orientation status, % (n)χ24φ
       Heterosexual83.8 (521)84.5 (87)72.4 (71)
       Homosexual5.1 (32)6.8 (7)9.2 (9)8.630.102
       Bisexual or others11.1 (69)8.7 (9)18.4 (18)
      P < .001.
      Means with different superscript letters (a vs b vs c) differ at P < .05.
      This classification was validated through a MANOVA comparing mean scores on compulsivity to pornography, intensity of efforts to access pornography, and emotional distress associated with pornography use among the three profiles (Table 1). Results yielded a significant multivariate large effect (F6,1650 = 513.92, P < .001, η2 = 0.651, Wilks λ = 0.122). Post hoc univariate analyses indicated that individuals with the compulsive profile compared with those with the two other profiles reported higher compulsivity to pornography (P < .001) and higher intensity of efforts to access pornography (P < .001). Individuals with the highly distressed non-compulsive profile reported higher emotional distress associated with pornography use compared with those with the two other profiles (P < .001). Participants with the compulsive profile reported higher emotional distress associated with pornography use than those with the recreational profile (P < .001). Results of an ANOVA indicated that, compared with individuals with the two other profiles (P < .001), those with the compulsive profile spent significantly more time viewing pornography.

       Sexual Well-Being Across Profiles

      A MANOVA comparing mean differences in the three profiles on sexual satisfaction, compulsivity, avoidance, and dysfunction yielded a significant multivariate effect (F8,1630 = 28.40, P < .001, η2 = 0.122, Wilks λ = 0.770; Table 1). Post hoc univariate analyses indicated that participants with the recreational profile reported higher sexual satisfaction and lower sexual avoidance than those with the two other profiles (P < .001). As expected, participants with the compulsive profile reported higher sexual compulsivity than those with the two other profiles (P < .001). Individuals with the highly distressed non-compulsive profile reported more sexual dysfunction than those with the two other profiles (P < .001), whereas individuals with the recreational profile reported more sexual dysfunction than those with the compulsive profile (P = .039).

       Sex and Interpersonal Context of Use Across Profiles

      χ2 analyses compared the distribution of women vs men and of dyadic vs solitary users among the three profiles (Table 1). Results indicated that the proportion of women and of dyadic users was significantly larger in the recreational profile. The proportion of men was significantly larger in the compulsive profile and the proportion of solitary users was significantly larger in the highly distressed non-compulsive profile. Exploratory χ2 analyses showed that the distribution of relationship status and sexual orientations did not vary significantly across profiles.

      Discussion

      Contemporary views of cyberpornography are often polarized, sometimes referring to self-centered activities that impair sexuality with a partner and foster unhealthy sexual attitudes and other times to a modern digital way to expand one's sexual repertoire and fulfill sexual needs.
      • Griffiths M.D.
      Internet sex addiction: a review of empirical research.
      The aims of the present study were to investigate the variability in cyberpornography-related sexual outcomes by examining the presence of different profiles of pornography use and their associations with specific sexual outcomes, sex, and the interpersonal context of use. The present results partly support the proposal of Cooper et al
      • Cooper A.
      • Putnam D.E.
      • Planchon L.A.
      • et al.
      Online sexual compulsivity: getting tangled in the net.
      in yielding three distinct profiles: recreational users, highly distressed non-compulsive users, and users with a compulsive profile. These results suggest a conceptualization of cyberpornography use based on a continuum, ranging from recreational to compulsive, with an important distinct subgroup of highly distressed, less active individuals whose pornography use tends to result in shame and self-disgust. Recreational users reported more positive sexual outcomes than the two other groups, with highly distressed non-compulsive users reporting more sexual dysfunction and users with a compulsive profile being more generally sexually compulsive. Women and dyadic users were more prevalent in the recreational profile, whereas men were over-represented in the compulsive profile and solitary users were over-represented in the highly distressed non-compulsive profile.
      The recreational profile was composed of a larger proportion of women and dyadic users who spent a moderate amount of time viewing pornography (ie, mean = 24 minutes weekly). They reported low levels on the three dimensions of problematic pornography use. Compared with participants with the other profiles, these individuals reported higher sexual satisfaction and lower levels of sexual compulsivity, avoidance, and dysfunction. These findings suggest that, for most people, pornography use might promote an active and open sexuality or, at the very least, not compromise general sexual well-being. This is consistent with past findings identifying a non-compulsive or non-problematic subgroup
      • Rosser B.R.S.
      • Noor S.W.B.
      • Iantaffi A.
      Normal, problematic and compulsive consumption of sexually explicit media: clinical findings using the Compulsive Pornography Consumption (CPC) scale among men who have sex with men.
      • Wetterneck C.T.
      • Burgess A.J.
      • Short M.B.
      • et al.
      The role of sexual compulsivity, impulsivity, and experiential avoidance in Internet pornography use.
      and those reporting positive or neutral sexual outcomes of pornography use.
      • Prause N.
      • Pfaus J.
      Viewing sexual stimuli associated with greater sexual responsiveness, not erectile dysfunction.
      • Muusses L.D.
      • Kerkhof P.
      • Finkenauer C.
      Internet pornography and relationship quality: a longitudinal study of within and between partner effects of adjustment, sexual satisfaction and sexually explicit Internet material among newly-weds.
      • Landripet I.
      • Štulhofer A.
      Is pornography use associated with sexual difficulties and dysfunctions among younger heterosexual men?.
      The compulsive profile consisted of a larger proportion of men who spent the most time using pornography (ie, mean = 110 minutes weekly). They reported the highest level of compulsivity to pornography, intensity of efforts to access sexual material, and higher emotional distress associated with pornography use. Previous studies have described these cyberpornography users as having poor sexual coping strategies, less effective emotion regulation skills, and being prone to enter into a compulsive cycle of recurrent and intense sexual urges, which are associated with significant personal distress and/or impairments in important areas of functioning.
      • Kafka M.P.
      Hypersexual disorder: a proposed diagnosis for DSM-V.

      Kraus SW, Voon V, Potenza MN. Should compulsive sexual behavior be considered an addiction? Addiction doi:10.1111/add.13297. E-pub ahead of print.

      The present findings show that individuals with a compulsive profile evidenced higher sexual avoidance and lower sexual satisfaction than recreational users and higher general sexual compulsivity and lower sexual dysfunction than individuals with the other profiles. Sexual behaviors reported by these individuals suggest that their pornography use might be framed into a broader pattern of compulsive sexuality that includes avoidance of sexual interactions with a partner.
      • Szymanski D.M.
      • Stewart-Richardson D.N.
      Psychological, relational, and sexual correlates of pornography use on young adult heterosexual men in romantic relationships.
      This pattern of activity was associated with sexual dissatisfaction but was not related to sexual dysfunction, a result that disconfirms our hypothesis and might seem counterintuitive. As Hald
      • Hald G.M.
      Comment on: Is pornography use associated with sexual difficulties and dysfunctions among younger heterosexual men?.
      suggested, very few studies have investigated the relation between pornography use and common sexual dysfunctions. Our result is in line with those from such studies in men reporting that a higher frequency of pornography use is not associated with erectile dysfunction and might even improve desire and arousal.
      • Prause N.
      • Pfaus J.
      Viewing sexual stimuli associated with greater sexual responsiveness, not erectile dysfunction.
      • Landripet I.
      • Štulhofer A.
      Is pornography use associated with sexual difficulties and dysfunctions among younger heterosexual men?.
      The highly distressed non-compulsive profile was composed of a larger proportion of solitary users who spent the least time viewing cyberpornography (ie, mean = 17 minutes weekly). Although they presented lower levels of compulsivity to pornography and intensity of efforts to access sexual material, they reported the highest level of emotional distress associated with pornography use. This suggests that distress associated with viewing cyberpornography is not necessarily a function of frequency of use. This runs counter to the traditional conceptualization of sexual addiction or compulsion
      • Kafka M.P.
      Hypersexual disorder: a proposed diagnosis for DSM-V.
      but is in line with results of an online survey of Croatian women reporting that distress associated with one's sexual behaviors was not related to frequency of sexual activities.
      • Štulhofer A.
      • Bergeron S.
      • Jurin T.
      Is high sexual desire a risk for women's relationship and sexual well-being?.
      For this significant minority of users, high distress might be the result of shame, self-disgust, and self-punishment after watching pornography. This internalized shame state, potentially based on strict societal, moral, relational, or religious disapproval, is associated with less sexual satisfaction and compulsivity and more sexual dysfunction and avoidance. Thus, the association between sexual dysfunction and pornography use might be determined more by emotional reactions after consumption than by the compulsive nature of the experience. This could explain past incoherent results about this association, with some studies reporting that pornography use is related to sexual dysfunction and others showing no significant association, suggesting that outcomes would be predicted more by distress than by frequency of use.
      • Prause N.
      • Pfaus J.
      Viewing sexual stimuli associated with greater sexual responsiveness, not erectile dysfunction.
      • Landripet I.
      • Štulhofer A.
      Is pornography use associated with sexual difficulties and dysfunctions among younger heterosexual men?.
      The over-representation of women in the recreational profile and of men in the compulsive profile is coherent with past studies
      • Ballester-Arnal R.
      • Castro-Calvo J.
      • Gil-Llario M.D.
      • et al.
      Relationship status as an influence on cybersex activity: cybersex, youth, and steady partner.
      and confirms that women and men display differences on duration and frequency of consumption.
      • Morgan E.M.
      Associations between young adults' use of sexually explicit materials and their sexual preferences, behaviors, and satisfaction.
      • Cooper A.
      • Morahan-Martin J.
      • Mathy R.M.
      • et al.
      Toward an increased understanding of user demographics in online sexual activities.
      • Traeen B.
      • Spitznogle K.
      • Beverfjord A.
      Attitudes and use of pornography in the Norwegian population 2002.
      • Cooper A.
      • Månsson S.-A.
      • Daneback K.
      • et al.
      Predicting the future of Internet sex: online sexual activities in Sweden.
      The interpersonal context of use also might help explain between-profile differences because dyadic use was more prevalent in the recreational profile. These results are in line with sex differences reported in consumption patterns; compared with women who tend to use pornography with their partner as part of their sexual activities, men are more attracted to a wider range of materials and prefer to use pornography for arousal and masturbation.
      • Morgan E.M.
      Associations between young adults' use of sexually explicit materials and their sexual preferences, behaviors, and satisfaction.
      • Hald G.M.
      Gender differences in pornography consumption among young heterosexual Danish adults.
      • Bridges A.J.
      • Morokoff P.J.
      Sexual media use and relational satisfaction in heterosexual couples.
      These past results could help explain why women tend to use pornography in a more recreational manner, whereas men might be more easily trapped in a compulsive cycle. The larger proportion of solitary users in the highly distressed non-compulsive profile confirms past results reporting that, compared with dyadic use, solitary use is particularly detrimental to sexual satisfaction and relationship functioning.
      • Maddox A.M.
      • Rhoades G.K.
      • Markman H.J.
      Viewing sexually-explicit materials alone or together: associations with relationship quality.
      • Bridges A.J.
      • Morokoff P.J.
      Sexual media use and relational satisfaction in heterosexual couples.
      • Campbell L.
      • Kohut T.
      The use and effects of pornography in romantic relationships.
      Even if the results of the present study are consistent with previous theoretical and clinical proposals,
      • Cooper A.
      • Putnam D.E.
      • Planchon L.A.
      • et al.
      Online sexual compulsivity: getting tangled in the net.
      it is important to interpret them in light of potential limitations. The use of a convenience sample with an over-representation of women limits the generalizability of our results. Profiles can vary within a representative sample that includes participants more ethnically diverse, older, less educated, in longer-term relationships, and engaging in more pornography use. Some biases also can be induced by the use of self-report measurements and the potential circularity between variables used to create profiles and sexual outcomes. In addition, other factors overlooked in the present study might explain the pattern of results. Emotions associated with cyberpornography use in the highly distressed non-compulsive profile could be explained by the content of pornography viewed, secrecy surrounding the solitary use, or even factors unrelated to pornography such as psychopathology, personality, and cultural or religious backgrounds.
      Despite these limitations, the present cross-sectional findings suggest that cyberpornography users represent a heterogeneous population in which engaging in this activity does not appear maladaptive for most individuals, whereas a small proportion might benefit from interventions targeting the presence or absence of compulsions and associated distress. Future studies using a representative sample need to replicate the observed profiles and sexual well-being correlates but also take into account the amount of time spent on the internet, socioemotional adjustment, the environmental context in which viewing occurs, and personality characteristics. Longitudinal studies could help determine whether pornography use follows a stable trajectory or whether it represents a continually evolving phenomenon in which some users progress from one profile to another.

      Statement of authorship

        Category 1

      • (a)
        Conception and Design
        • Marie-Pier Vaillancourt-Morel; Sarah Blais-Lecours; Chloé Labadie; Stéphane Sabourin; Natacha Godbout
      • (b)
        Acquisition of Data
        • Marie-Pier Vaillancourt-Morel; Sarah Blais-Lecours; Chloé Labadie; Stéphane Sabourin; Natacha Godbout
      • (c)
        Analysis and Interpretation of Data
        • Marie-Pier Vaillancourt-Morel; Sarah Blais-Lecours; Chloé Labadie; Sophie Bergeron; Stéphane Sabourin; Natacha Godbout

        Category 2

      • (a)
        Drafting the Article
        • Marie-Pier Vaillancourt-Morel; Sarah Blais-Lecours; Chloé Labadie; Stéphane Sabourin; Natacha Godbout
      • (b)
        Revising It for Intellectual Content
        • Marie-Pier Vaillancourt-Morel; Sophie Bergeron; Stéphane Sabourin; Natacha Godbout

        Category 3

      • (a)
        Final Approval of the Completed Article
        • Marie-Pier Vaillancourt-Morel; Sarah Blais-Lecours; Chloé Labadie; Sophie Bergeron; Stéphane Sabourin; Natacha Godbout

      Acknowledgment

      We thank Hélène Paradis and Bei Feng for their assistance with the statistical analyses.

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      Linked Article

      • Response to Editorial Comment: “Profiles of Cyberpornography Use and Sexual Well-Being in Adults”
        The Journal of Sexual MedicineVol. 14Issue 1
        • Preview
          We thank the author of the editorial comment for the thoughtful remarks on our study. Research on the effects of pornography is still in its infancy. Despite strong social pressure for rapid closure, we should be cautious before concluding that pornography use is universally harmful or beneficial.1 Our contribution shows that subgroups of pornography users report differential sexual outcomes. Most of our sample was composed of recreational users reporting positive sexual outcomes, including higher sexual satisfaction.
        • Full-Text
        • PDF
      • Editorial Comment on “Profiles of Cyberpornography Use and Sexual Well-Being in Adults”
        The Journal of Sexual MedicineVol. 14Issue 1
        • Preview
          The use of sexually explicit material has come to the spotlight since the internet made it readily available and cyberpornography has become a popular research topic. Research has focused mainly on the negative impact of cyberpornography use1 and has been frequently framed on the addiction model, a model that has been questioned by empirical research.2 Major questions posed are whether cyberpornography use can be considered an addiction and/or is linked to compulsivity or if pornography use damages intimate relationships.
        • Full-Text
        • PDF