A comprehensive international study involving tens of thousands of participants from dozens of countries suggests that problematic pornography use might have a prevalence rate as high as 16.6%. The findings, published in the journal Addiction, shed light on how problematic use of pornography is affecting people in different parts of the world, and across various genders and sexual orientations.
Problematic pornography use refers to a condition where individuals experience an uncontrollable urge to consume pornography, leading to significant distress or impairment in their daily functioning. This might manifest in various aspects of life, such as personal relationships, work, and mental health. The frequency of use alone does not determine problematic use; rather, it’s the compulsive nature of the behavior and its negative repercussions that are diagnostic of problematic pornography use.
The advent of the Compulsive Sexual Behavior Disorder in the latest International Statistical Classification of Diseases has brought problematic pornography use into greater focus. Despite extensive research spanning over two decades, critical gaps remained, particularly concerning the experiences of women, gender-diverse individuals, and people from non-Western cultures.
“We were interested in problematic pornography use worldwide for two reasons,” explained study author Beáta Bőthe, an assistant professor of psychology at the University of Montreal and director of the Sexuality, Technology, and Addictions Research Laboratory (STAR Lab).
“First, most people use pornography, but only a small group of them develop problems with it. So we wanted to see how many people may experience such problems worldwide and whether there are any country-, gender-, or sexual-orientation-based differences, as most previous studies focused on really specific populations (e.g., men from the United States).”
“Second, problematic pornography use can be considered one of the most common manifestations of Compulsive Sexual Behavior Disorder, which is a new diagnosis in the World Health Organization’s diagnostic manual (the International Classification of Diseases). Given that this is a manual used around the world, we found it important to provide reliable assessment tools in different languages to be able to measure problematic pornography use.”
The foundation of the research was the International Sex Survey (ISS), a pre-registered, self-report study executed across 42 countries. This monumental effort gathered data from 82,243 participants between October 2021 and May 2022. This sample included a significant representation of women (57.0%), men (39.6%), and gender-diverse individuals (3.4%), alongside a broad spectrum of sexual orientations, predominantly heterosexual individuals (68.2%). The mean age of participants was 32.39 years.
Central to the study were validated tools designed to assess problematic pornography use: the Problematic Pornography Consumption Scale (PPCS) and its short version (PPCS-6), along with the Brief Pornography Screen (BPS). These instruments measure various dimensions of PPU, such as the importance of pornography in one’s life, mood modification, tolerance, and withdrawal symptoms.
One of the study’s central revelations was the estimated prevalence of problematic pornography use, which ranged between 3.2% (based on PPCS scores) to 16.6% (based on BPS scores) among the surveyed populations. Men reported the highest levels of problematic pornography use, followed by gender-diverse individuals and women. However, interestingly, the study found no significant differences in problematic pornography use levels across different sexual orientations.
“I think one of the most important takeaway messages from our study is that problematic pornography use seems to be as common as other mental health issues (e.g., depression), so we need to better understand this problem and provide appropriate care for people experiencing this issue,” Bőthe told PsyPost. “Still, despite increasing moral panic around pornography, we should not consider pornography use in itself a public health crisis.”
Despite a noticeable percentage of participants scoring above the established cut-offs for problematic pornography use, only a small fraction had sought treatment. This finding highlights a gap between the need for support and the actual utilization of treatment services.
“Probably the most surprising finding of the study is that only 4-10% of individuals with problematic pornography sought help for this issue, with an additional 20–40% wanting to but did not do so for various reasons,” Bőthe explained. “Some of them didn’t know where or how to seek help, while others couldn’t afford therapy or would have felt embarrassed about their problem.”
“This result highlights that we, as researchers and practitioners in the field, still have a lot to do to promote better access to evidence-based treatment for problematic pornography use.”
In addition, countries like Taiwan, China, Malaysia, Turkey, and Brazil showed the highest problematic pornography use scores, hinting at the role of cultural, societal, and possibly regulatory environments in shaping individuals’ experiences with pornography.
However, “one major limitation of the study is that we were not able to collect data from as many participants as we planned from all countries, so we need to be careful when we want to generalize the study’s findings to specific countries or when comparing findings between countries,” Bőthe noted.
By providing a clearer picture of its prevalence and the factors that influence it, the research paves the way for more effective interventions for those struggling with pornography use.
“The ultimate goal of this line of research is to provide help and support for people who experience problems with their pornography use,” Bőthe said. “Now, as we identified specific groups of people who may be at a higher risk of developing such problems, we will focus on identifying risk and protective factors that may contribute to the development of problematic vs non-problematic pornography use.”
The study, “Problematic pornography use across countries, genders, and sexual orientations: Insights from the International Sex Survey and comparison of different assessment tools,” was authored by Beáta Bőthe, Léna Nagy, Mónika Koós, Zsolt Demetrovics, Marc N. Potenza, the International Sex Survey Consortium, and Shane W. Kraus.
