Pornography use, development of addiction symptoms and treatment seeking associated with addictive sexual behaviors

Prezentowana praca dotyczy zagadnień związanych z (1) problematycznym korzystaniem z pornografii, (2) symptomami nałogowymi mogącymi towarzyszyć korzystaniu z pornografii oraz (3) poszukiwaniem pomocy psychologicznej w związku z trudnościami w kontroli własnych zachowań seksualnych. Praca obejmuje analizy wyników 3 badań. Pierwsza z nich to analiza zmian we wskaźnikach rozpowszechnienia pornografii internetowej w populacji polskiej w przedziale czasowym od 2004 do 2016, wraz z charakterystyką demograficzną osób odwiedzających internetowe strony pornograficzne. Są to pierwsze dostępne analizy dotyczące zmian w rozpowszechnieniu pornografii bazujące nie na danych deklaratywnych, a na danych obiektywnych, niosących informacje o aktywności na stronach internetowych. Przeprowadzone analizy wykazały wzrastającą popularność pornografii online w analizowanym okresie – co, w połączeniu z raportami o wzrastającej liczbie osób zgłaszających zapotrzebowanie na pomoc psychologiczną w związku z problematycznym korzystaniem z pornografii, wskazuje na konieczność badań nad mechanizmami leżącymi u podłoża tych problemów. Badania 2 oraz 3 dotyczą właśnie tego zagadnienia i stanowią trzon pracy. W ramach tych badań zestawiono grupę osób poszukujących pomocy psychologicznej w związku z problematycznym korzystaniem z pornografii z grupą kontrolną. Badanie 2 przeprowadzono na grupie mężczyzn, natomiast Badanie 3 na grupie kobiet. Uzyskane wyniki wskazują między innymi, że osoby poszukujące pomocy psychologicznej cechowało (1) zdecydowanie wyższe nasilenie negatywnych symptomów związanych z nałogowymi zachowaniami seksualnymi, (2) poświęcanie większej ilości czasu na korzystanie z pornografii, ale także (3) wyższy poziom religijności, (4) niższe prawdopodobieństwo zaangażowania w związek intymny (dla mężczyzn), (5) dłuższy czas od ostatniej aktywności seksualnej z drugą osobą (w przypadku mężczyzn) oraz (6) dłuższe ciągi oglądania pornografii i ciągi masturbacyjne (w przypadku kobiet). Zweryfikowane zostały również relacje pomiędzy kluczowymi zmiennymi, ze szczególnym uwzględnieniem predyktorów poszukiwania pomocy. Czas poświęcany na korzystanie z pornografii był pozytywnie związany z prawdopodobieństwem poszukiwania pomocy, jednak najsilniejszymi predyktorami poszukiwania pomocy okazały się negatywne symptomy (dla mężczyzn i kobiet) oraz zmienna będąca wskaźnikiem poziomu religijności – czas poświęcany na praktyki religijne (dla kobiet). W ostatniej części pracy dyskutowane jest naukowe znaczenie uzyskanych wyników jak i ich implikacje dla pracy terapeutycznej z osobami doświadczającymi trudności z kontrolą własnych zachowań seksualnych.Scope of this project refers to (1) problematic pornography use, (2) addictive symptoms associated with pornography use and (3) treatment seeking due to out-of-control sexual behaviors. The project consists of three studies. For Study 1, changes in indicators of internet pornography prevalence in Polish population between years 2004 and 2016 were analyzed, along with demographic characteristics of internet pornography viewers. This is the first available analysis of online pornography use prevalence based not on declarative, but on objective internet traffic data. Results showed growing popularity of online pornography during analyzed period. This results, in conjunction with reports of growing number of people seeking treatment due to problematic pornography use and difficulties in controlling their own sexual behaviors, indicates the need of research on mechanisms underlying these problems. Studies 2 and 3 are aimed at this issue and constitute a core of this project. In Studies 2 and 3 people seeking treatment for problematic pornography use were compared to healthy controls. Analysis showed that treatment-seekers had (1) higher level of negative symptoms associated with addictive sexual behaviors, (2) spent more time on pornography use but also (3) declared higher religiosity, had (4) lower probability of being in an intimate relationship (for males), reported (5) longer period from last dyadic sexual activity (for males) and experienced (6) more severe pornography and masturbation binge periods (for females). The structure of relationships between key variables was also determined, with a focus on predictors of treatment seeking. Time spent on pornography consumption was positively related to probability of seeking treatment. However, analysis revealed that the strongest predictors of seeking treatment were negative symptoms associated with addictive sexual behaviors (for males and for females) and a variable that was an indicator of religiosity – time spent on religious practices (for females). In the last part of this work, scientific significance of obtained results and implications for therapy of out of control sexual behaviors are discussed

Working memory updating of emotional stimuli predicts emotional intelligence in females

Preliminary evidence concerning emotional intelligence (EI) and working memory (WM) showed that the relationship between them is dependent on the emotional content (‘hot’ or ‘cool’) of tasks involving WM. In this paper, we continue investigating the relationship between EI and WM, focusing on a crucial function of WM, i.e., the efficacy of updating its content. WM updating shows substantial correlations with general fluid intelligence (gF) and seems to be a significant predictor of cognitive performance and achievement. We assume that if updating is important for a wide range of higher-order processes, updating emotional content in WM could be essential for emotionally intelligent behavior. To test this hypothesis, we constructed two parallel versions of a task that requires WM updating: one with neutral and the other with emotional stimuli. In addition, performance-based measures of both gF and EI were used in the research. Using the structural equation approach, we sought to demonstrate that gF is dependent on the efficiency of WM updating for both emotional and neutral stimuli, whereas EI might depend only on the updating efficacy in the emotional context. The results are discussed in terms of the domain specificity of EI and the domain generality of gF. The main constraint of the study is its limited sample size (n = 123 for intelligence measures, n = 69 for WM updating tasks). Moreover, the study was based on a female sample; thus, the conclusions can be extrapolated only to women

Evaluating Pornography Problems Due to Moral Incongruence Model

INTRODUCTION: To date, multiple models of problematic pornography use have been proposed, but attempts to validate them have been scarce. AIM: In our study, we aimed to evaluate the Pornography Problems due to Moral Incongruence model proposing that self-appraisals of pornography addiction stem from (i) general dysregulation, (ii) habits of use, and (iii) moral incongruence between internalized norms and behavior. We investigated whether the model can be used to adequately explain the self-perceptions of addiction to pornography (model 1) and a broader phenomenon of problematic pornography use (model 2). METHODS: An online, nationally representative study was conducted on a sample of 1036 Polish adult participants, of whom, 880 declared a lifetime history of viewing pornography. MAIN OUTCOME MEASURE: The outcomes were self-perceived pornography addiction, problematic pornography use, avoidant coping, frequency of pornography use, religiosity, moral disapproval of pornography, and related variables. RESULTS: Our results indicated that avoidant coping (an indicator of general dysregulation), frequency of pornography use (indicator of habits of use), and the distress connected with incongruence between own sexual behavior and internalized norms, attitudes and beliefs positively contributed to self-perceived addiction (model 1) as well as problematic pornography use (model 2). This broadly confirms the basic shape of the PPMI model. There were, however, notable differences between the models. Moral incongruence related distress was only weakly related to self-perceived addiction (β = 0.15, P \u3c .001), with a stronger relation for problematic pornography use (β = 0.31, P \u3c .001). When controlling for other factors, religiosity weakly predicted problematic pornography use (β = 0.13, P \u3c .001), but not self-perceived addiction to pornography (β = 0.03, P = .368). Frequency of pornography use was the strongest predictor of both self-perceived addiction (β = 0.52, P \u3c .001) and problematic pornography use (β = 0.43, P \u3c .001). CLINICAL IMPLICATIONS: Factors proposed within the PPMI model are distinctly relevant intervention targets, and they should be considered in the process of diagnosis and treatment. STRENGTHS & LIMITATIONS: The presented study is the first to evaluate PPMI model. Its main limitation is that it has a cross-sectional design. CONCLUSION: The PPMI model is a promising framework for investigating the factors related to self-perceived addiction and problematic pornography use. Despite the differences between the models and in the strength of specific predictors, (i) dysregulation, (ii) habits of use, and (iii) moral incongruence all uniquely contribute to self-perceived addiction and problematic pornography use. Lewczuk, K., Glica, A., Nowakowska, I., et al. Evaluating Pornography Problems Due to Moral Incongruence Model. J Sex Med 2020;17:300-311

Treatment seeking for problematic pornography use among women

Background and aims Previous studies examined psychological factors related to treatment seeking for problematic pornography use (PU) among males. In this study, we focused on females who seek treatment for problematic PU and compared them with non-problematic pornography users with regard to variables related to problematic PU. Second, we investigated the relationships between critical constructs related to problematic PU with the path analysis method, emphasizing the predictors for treatment seeking among women. We also compared our results with previous studies on males. Methods A survey study was conducted on 719 Polish-speaking Caucasian females, 14–63 years old, including 39 treatment seekers for problematic PU. Results The positive relationship between the mere amount of PU and treatment seeking loses its significance after introducing two other predictors of treatment-seeking: religiosity and negative symptoms associated with PU. This pattern is different from the results obtained in previous studies on males. Discussion Different from previous studies on male samples, our analysis showed that in the case of women, mere amount of PU may be related to treatment-seeking behavior even after accounting for negative symptoms associated with PU. Moreover, religiousness is a significant predictor of treatment seeking among women, which may indicate that in the case of women, treatment seeking for problematic PU is motivated not only by experienced negative symptoms of PU but also by personal beliefs about PU and social norms. Conclusion For females, negative symptoms associated with PU, the amount of PU and religiosity is associated with treatment seeking. Those factors should be considered in treatment

Withdrawal and tolerance as related to compulsive sexual behavior disorder and problematic pornography use – Preregistered study based on a nationally representative sample in Poland

Background: The addiction model of compulsive sexual behavior disorder (CSBD) and problematic pornography use (PPU) predicts the presence of withdrawal symptoms and increased tolerance for sexual stimuli in the disorder phenotype. However, clear empirical evidence supporting this claim has largely been lacking. Methods: In the preregistered, nationally representative survey (n 5 1,541, 51.2% women, age: M 5 42.99, SD 5 14.38), we investigated the role of selfreported withdrawal symptoms and tolerance with respect to CSBD and PPU severity. Results: Both withdrawal and tolerance were significantly associated with the severities of CSBD (β 5 0.34; P < 0.001 and β 5 0.38; P < 0.001, respectively) and PPU (β 5 0.24; P < 0.001 and β 5 0.27; P < 0.001, respectively). Of the 21 withdrawal symptom types investigated, the most often reported symptoms were frequent sexual thoughts that were difficult to stop (for participants with CSBD: 65.2% and with PPU: 43.3%), increased overall arousal (37.9%; 29.2%), difficult to control level of sexual desire (57.6%; 31.0%), irritability (37.9%; 25.4%), frequent mood changes (33.3%; 22.6%), and sleep problems (36.4%; 24.5%). Conclusions: Changes related to mood and general arousal noted in the current study were similar to the cluster of symptoms in a withdrawal syndrome proposed for gambling disorder and internet gaming disorder in DSM-5. The study provides preliminary evidence on an understudied topic, and present findings can have significant implications for understanding the etiology and classification of CSBD and PPU. Simultaneously, drawing conclusions about clinical importance, diagnostic utility and detailed characteristics of withdrawal symptoms and tolerance as a part of CSBD and PPU, as well as other behavioral addictions, requires further research efforts

Reducing craving and lapse risk in alcohol and stimulants dependence using mobile app involving ecological momentary assessment and self-guided psychological interventions: Protocol for a randomized controlled trial

BackgroundThe prevalence of alcohol consumption in Poland is estimated to be as high as 80% of the adult population. The use of stimulants is the second most common reason for seeking addiction treatment. However, treatment outcomes remain unsatisfactory, as 40–85% of individuals who complete various treatment programs relapse and fall back into addiction within 2 years following program completion.MethodsThe 13-armed randomized controlled trial aimed to assess the effectiveness of a mobile app-based self-guided psychological intervention delivered via a smartphone app (Nałogometr) in reducing craving and lapse risk in problematic alcohol or stimulants use. Participant recruitment and data collection will be performed from June 2022 to September 2022. The 4-week mobile intervention program will include short-term and long-term intervention modules based mainly on mindfulness and cognitive-behavioral therapy. Intervention effectiveness assessment will include Ecological Momentary Assessment. That is, we will collect longitudinal data on a set of characteristics of day-to-day functioning. The primary outcomes will include a self-reported number of lapses and addiction craving level. In contrast, the secondary outcomes will be the severity of problematic substance use, anxiety and depression scores, and life satisfaction scores.ConclusionThis study will establish how mobile app-based self-guided psychological interventions can help reduce craving and lapse risk in alcohol and stimulant dependence. If successful, this randomized controlled trial (RCT) may provide an innovative, easily available, and cost-effective mHealth approach for craving and lapse risk in substance addictions.Clinical trial registration[https://clinicaltrials.gov/], identifier [NCT054 34429]

The landscape of open science in behavioral addiction research: Current practices and future directions

Open science refers to a set of practices that aim to make scientific research more transparent, accessible, and reproducible, including pre-registration of study protocols, sharing of data and materials, the use of transparent research methods, and open access publishing. In this commentary, we describe and evaluate the current state of open science practices in behavioral addiction research. We highlight the specific value of open science practices for the field; discuss recent field-specific meta-scientific reviews that show the adoption of such practices remains in its infancy; address the challenges to engaging with open science; and make recommendations for how researchers, journals, and scientific institutions can work to overcome these challenges and promote high-quality, transparently reported behavioral addiction research. By collaboratively promoting open science practices, the field can create a more sustainable and productive research environment that benefits both the scientific community and society as a whole

Psychometric properties of the Alcohol Use Disorders Identification Test (AUDIT) across cross-cultural subgroups, genders, and sexual orientations: Findings from the International Sex Survey (ISS)

© 2023 The Authors. Published by Elsevier Inc. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/bync-nd/4.0/).INTRODUCTION: Despite being a widely used screening questionnaire, there is no consensus on the most appropriate measurement model for the Alcohol Use Disorders Identification Test (AUDIT). Furthermore, there have been limited studies on its measurement invariance across cross-cultural subgroups, genders, and sexual orientations. AIMS: The present study aimed to examine the fit of different measurement models for the AUDIT and its measurement invariance across a wide range of subgroups by country, language, gender, and sexual orientation. METHODS: Responses concerning past-year alcohol use from the participants of the cross-sectional International Sex Survey were considered (N = 62,943; M age: 32.73; SD = 12.59). Confirmatory factor analysis, as well as measurement invariance tests were performed for 21 countries, 14 languages, three genders, and four sexual-orientation subgroups that met the minimum sample size requirement for inclusion in these analyses. RESULTS: A two-factor model with factors describing 'alcohol use' (items 1-3) and 'alcohol problems' (items 4-10) showed the best model fit across countries, languages, genders, and sexual orientations. For the former two, scalar and latent mean levels of invariance were reached considering different criteria. For gender and sexual orientation, a latent mean level of invariance was reached. CONCLUSIONS: In line with the two-factor model, the calculation of separate alcohol-use and alcohol-problem scores is recommended when using the AUDIT. The high levels of measurement invariance achieved for the AUDIT support its use in cross-cultural research, capable also of meaningful comparisons among genders and sexual orientations.Peer reviewe

Psychometric properties of the Alcohol Use Disorders Identification Test (AUDIT) across cross-cultural subgroups, genders, and sexual orientations: Findings from the International Sex Survey (ISS)

Introduction. Despite being a widely used screening questionnaire, there is no consensus on the most appropriate measurement model for the Alcohol Use Disorders Identification Test (AUDIT). Furthermore, there have been limited studies on its measurement invariance across cross-cultural subgroups, genders, and sexual orientations. Aims. The present study aimed to examine the fit of different measurement models for the AUDIT and its measurement invariance across a wide range of subgroups by country, language, gender, and sexual orientation. Methods. Responses concerning past-year alcohol use from the participants of the cross-sectional International Sex Survey were considered (N = 62,943; Mage: 32.73; SD = 12.59). Confirmatory factor analysis, as well as measurement invariance tests were performed for 21 countries, 14 languages, three genders, and four sexual-orientation subgroups that met the minimum sample size requirement for inclusion in these analyses. Results. A two-factor model with factors describing ‘alcohol use’ (items 1–3) and ‘alcohol problems’ (items 4–10) showed the best model fit across countries, languages, genders, and sexual orientations. For the former two, scalar and latent mean levels of invariance were reached considering different criteria. For gender and sexual orientation, a latent mean level of invariance was reached. Conclusions. In line with the two-factor model, the calculation of separate alcohol-use and alcohol-problem scores is recommended when using the AUDIT. The high levels of measurement invariance achieved for the AUDIT support its use in cross-cultural research, capable also of meaningful comparisons among genders and sexual orientations