Friday, December 9, 2022

How much do we really know about pornography?

By David S. Prescott, LICSW Kasia Uzieblo PhD, & Kieran McCartan, PhD 

Three research papers came up in a recent social-media discussion of pornography use. In the first, Beáte Böthe and her colleagues produced results from a large community survey of males and females. They differentiated between Problematic Pornography Use (PPU) and Frequent Pornography Use). The highlights of their findings were that:

·        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.

As the researchers point out, high engagement with pornography is not necessarily the same as problematic engagement. In the authors’ words:

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.

In a 2020 study, Beáte Böthe and her colleagues examined three non-clinical samples (of 14,006, 483, and 672 participants). From their abstract:

Results were consistent across all studies. 3 distinct pornography-use profiles emerged: nonproblematic low-frequency pornography use (68–73% of individuals), nonproblematic high-frequency pornography use (19–29% of individuals), and problematic high-frequency use (3–8% of individuals). Nonproblematic and problematic high-frequency-use groups showed differences in several constructs (ie, hypersexuality, depressive symptoms, boredom susceptibility, self-esteem, uncomfortable feelings regarding pornography, and basic psychological needs).

Of particular note was that the number of non-problematic high-frequency users far outnumbered the high-frequency users with problematic use, as defined by the Problematic Pornography Consumption Scale. Set against the backdrop of earlier studies, such as Kingston et al. in 2008, who found that “Statistical interactions indicated that frequency of pornography use was primarily a risk factor for higher-risk offenders, when compared with lower-risk offenders, and that content of pornography (i.e., pornography containing deviant content) was a risk factor for all groups,” these studies appear to confirm that “mainstream” pornography use is problematic for those already pre-disposed to repeated sexual abuse. It seems that the effects of pornography can vary and are dependent on factors beyond simply how much one views.

At the same time, however, a more recent study published last month is also very important. Katherine Jongsma and Patti Timmons Fritz examined the relationship of pornography use and intimate partner violence. From the abstract:

Two longitudinal actor-partner interdependence models using a structural equation framework to conduct path analyses demonstrated that (a) higher FPU among men at baseline predicted increases in IPV perpetration and victimization from baseline to 4-month follow-up for both men and women and (b) women's baseline FPU did not predict change in IPV over time for themselves or their partners. These findings suggest that frequent pornography use among male partners in different-sex romantic relationships may represent an under-recognized risk factor for IPV, and further research is needed to identify latent factors that may be contributing to this relation. Although women's baseline FPU did not predict changes in IPV over time, this may be because women used pornography less frequently than men.

Once again, the research is surprising with respect to the contributions of pornography to harm. As always, the full scope of the issues and implications is broader than can fit into a single blog post. 

While research has not found the clear link between pornography and sexual violence that one would expect, we now have a study providing some association between pornography and intimate partner violence. It is just one study, but this paper highlights the importance of continued caution and research in this area.

Taking these studies together, perhaps the greatest surprise is that frequency of pornography use is not particularly straightforwardly linked to impairment of functioning. It appears not to be like alcohol use, where drinking over a certain amount is statistically linked to poor health outcomes in a more linear fashion.  A considerable amount of high-frequency pornography use seems to have no appreciable effect for many. One implication of this is that while many politicians and activists argue that pornography is a public health issue, the data do not appear to support this.

Of course, within the field of treating sexual violence, there remain questions about high-frequency pornography use among those predisposed to acts of sexual violence. A scan of the Problematic Pornography Consumption Scale illustrates possible avenues of inquiry and the need to understand the context, values, and nature of the individual as well as what they get out of porn use.

However, it is clear that many men experience challenges in their lives as a result of their porn use and that many ask for help. Further study may reveal a deeper understanding of pornography as a precursor to intimate partner violence. It is still not clear that historical models or ideas (e.g., pornography addiction) are as comprehensive as they could be. For example, is reported erectile dysfunction really “porn-induced” or is it a combination of features such as frequency of porn use, moral incongruity, personal values and beliefs, and other aspects of the individual’s coping style and self-regulation that coalesce to form problems? If that is the case, shouldn’t we address these issues from that perspective instead of relying on more reductionist approaches?

As each of the papers highlighted in this blog post point out, more research is needed.

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