The impact of Internet pornography on children and adolescents: A systematic review

OBJECTIVES

Young people's exposure to online pornographic material has increased in the past years. Its impact is a complex topic but an important issue due to growing concerns. Therefore, we reviewed the literature on Internet pornography consumption and its impact on children and adolescents. Furthermore, we examined young people's thoughts about pornography and their reasons for consumption.

METHOD

We performed a systematic literature search in the online databases ERIC, PsycARTICLES, PsycINFO, and PSYNDEX for peer-reviewed articles in English, published between 2000 and 2022 and additionally identified secondary references.

RESULTS

We could determine associations between pornography consumption and demographic variables (e.g., age, gender), personal characteristics (e.g., [sexual] sensation seeking, sexual interest and experience, general risk behavior), environmental variables (e.g., peers, family), attitudes (e.g., gender role attitudes, permissive sexual attitudes), behavior (e.g. sexual risk behaviour, sexting) and sexual aggression (e.g., sexual cybervictimization, grooming). Moreover, we found that girls have a more negative attitude towards pornography than boys who have an ambivalent opinion on the subject. Most adolescents are aware that the majority of pornographic material is exaggerated and unrealistic. Furthermore, pornography is not only watched out of curiosity and for sexual arousal but also used as a source of sexual information, especially by minority groups.

DISCUSSION

Many effects that impair children's development have been documented. The results found in this review are often contradictory. Therefore, further replication studies are needed. In addition, we propose several preventive measures, e.g., sexual health education at schools for both heterosexuals and LGBT (Lesbian, Gay, Bisexual, and Transgender) people.

Gambling and virtual reality: unraveling the illusion of near-misses effect

Introduction

Studying gambling behavior is a crucial element in reducing the impact of problem gambling. Nevertheless, most current research is carried out in controlled laboratory settings rather than real-life situations, which raises concerns about how applicable the findings are in the broader context. Virtual reality (VR) has proven to be a valuable tool and has been utilized in various experimental scenarios. A limited number of studies have employed VR to investigate gambling behaviors, and few have explored them in an older adolescent context.

Methods

This study examined the behavioral and physiological effects of gambling behavior, including problem gambling, gaming addiction, and risk-taking decision-making in a sample of 36 high-school students aged between 18 to 20 years using an ad-hoc constructed VR scenario designed to simulate a slot-machine platform.

Results

The behavioral results highlighted that participants reporting more problem gambling were sensitive to near-misses: i.e., they bet more after near-misses than after losses. This result may reflect the false belief that gamblers, after near-misses, are closer to winning. Physiological data showed that participants exhibited heart rate deceleration during the anticipation of the outcome, which has been suggested to represent a marker of feedback anticipation processing and hyposensitivity to losses.

Discussion

Overall, this study provides evidence for a new VR tool to assess gambling behaviors and new insights into gambling-related behavioral and physiological factors. Implications for the treatment of problem gambling are discussed.

Anxiety and Compulsive Sexual Behavior Disorder: A Systematic Review

The inclusion of the novel diagnosis of Compulsive Sexual Behavior Disorder in the forthcoming 11^th edition of the International Classification of Diseases has spurred increasing interest in the clinical profile of the disorder. Such attention has included a focus on potential comorbidities, risk factors, or symptoms resulting from such behaviors, including anxiety. Anxiety disorders have long been noted as comorbid with many other diagnoses, such as posttraumatic stress disorder, obsessive compulsive disorder, and substance use disorders. This review aims to understand the relationship between anxiety and compulsive sexual behavior in adults and adolescents, based on available quantitative studies. A search of PsycInfo and PubMed revealed 40 studies which quantitatively assessed a relationship between an anxiety measure and a Compulsive Sexual Behavior Disorder measure, including dissertations and published articles using clinical and community samples. A qualitative synthesis and risk of bias analysis of the studies was conducted, rather than a meta-analysis, due to the variety of methods. Overall, studies were primarily cross-sectional and the relationship between these two constructs was unclear, likely due to several factors, including inconsistent measurement of Compulsive Sexual Behavior Disorder, lack of gender diversity, and very little longitudinal data. Directions for future research are discussed.

Sexual addiction 25 years on: A systematic and methodological review of empirical literature and an agenda for future research

In 1998, Gold and Heffner authored a landmark review in Clinical Psychology Review on the topic of sexual addiction that concluded that sexual addiction, though increasingly popular in mental health settings, was largely based on speculation, with virtually no empirical basis. In the more than two decades since that review, empirical research around compulsive sexual behaviors (which subsumes prior research about sexual addiction) has flourished, ultimately culminating in the inclusion of a novel diagnosis of Compulsive Sexual Behavior Disorder in the eleventh edition of the World Health Organization's International Classification of Diseases. The present work details a systematic review of empirical research published between January 1st, 1995 and August 1st, 2020 related to compulsive sexual behaviors, with a specific focus on evaluating the methodologies of that literature. This review yielded 371 papers detailing 415 individual studies. In general, the present review finds that, although research related to compulsive sexual behaviors has proliferated, much of this work is characterized by simplistic methodological designs, a lack of theoretical integration, and an absence of quality measurement. Moreover, the present review finds a virtual absence of high-quality treatment-related research published within this time frame. Implications of these findings for both clinical practice and future research are discussed.

Sexual Desire and Subjective Distress among Pornography Consumers

Clients are increasingly seeking professional help related to pornography viewing in the digital age. Given distress is a key reason clients seek help, the purpose of this study was to identify variables associated with it. Drawing from recent literature, we examined the roles of solitary sexual desire, moral incongruence, feelings of dysregulation, and shame-proneness in predicting subjective distress among consumers. Surveys were administered through Amazon Mechanical Turk to US adults (n = 559). Structural equation models supported moderated mediation, where the positive relationship between sexual desire and subjective distress was fully mediated by feelings of dysregulation, and the relationship between sexual desire and feelings of dysregulation was moderated by moral incongruence. Moral incongruence was the largest direct predictor of subjective distress, while shame-proneness was not significantly associated with it. This study points to targets for intervention research, reinforces findings that values play an integral role in how individuals interpret their viewing and whether they feel distressed, and suggests that values may impact how individuals interpret their sexual desire. Implications for practitioners are discussed, including the need for person-in-environment assessment and more holistic care than has traditionally been proposed in the sex addiction field.

Pornography Problems Due to Moral Incongruence: An Integrative Model with a Systematic Review and Meta-Analysis

The notion of problematic pornography use remains contentious in both academic and popular literature. Although the mental health community at large is divided as to the addictive versus non-addictive nature of Internet pornography, substantial numbers of individuals report "feeling" as if their use of Internet pornography is problematic. The present work seeks to construct a model related to problematic pornography use that is clearly derived from empirical literature and that provides directions to be tested in future research. The focus of the present work is on those perceptions as they relate to the overarching experience of moral incongruence in pornography use, which is generally thought of as the experience of having one's behaviors be inconsistent with one's beliefs. To this end, we put forth a model of pornography problems due to moral incongruence. Within this model, we describe how pornography-related problems-particularly feelings of addiction to pornography-may be, in many cases, better construed as functions of discrepancies-moral incongruence-between pornography-related beliefs and pornography-related behaviors. A systematic review of literature and meta-analysis is conducted in order to evaluate support for this model, and the implications of this model for research and clinical practice are discussed.

Internet health scams-Developing a taxonomy and risk-of-deception assessment tool

The prevalence of health scams in Canada is increasing, facilitated by the rise of the Internet. However, little is known about the nature of this phenomena. This study sought to methodically identify and categorise Internet-based Health Scams (IHS) currently active in Canada, creating an initial taxonomy based on systematic Internet searches. A five-step Delphi approach, comprised of a multidisciplinary panel of health professionals from the University of British Columbia, in Vancouver, Canada, was used to establish consensus. The resulting taxonomy is the first to characterise the nature of IHS in North America. Five core areas of activity were identified: body image products, medical products, alternative health services, healthy lifestyle products, and diagnostic testing services. IHS purveyors relied on social expectations and psychological persuasion techniques to target consumers. Persuasion techniques included social engagement, claims of miraculous effects, scarcity, and the use of pseudoscientific language. These techniques exploited personality traits of sensation seeking, needing self-control, openness to taking risks, and the preference for uniqueness. The data gathered from the taxonomy allowed the Delphi panel to develop and pilot a simple risk-of-deception tool. This tool is intended to help healthcare professionals educate the public about IHS. It is suggested that, where relevant, healthcare professionals include a general discussion of IHS risks and marketing techniques with clients as a part of health promotion activities.

Predicting pornography use over time: Does self-reported "addiction" matter?

In recent years, several works have reported on perceived addiction to internet pornography, or the potential for some individuals to label their own use of pornography as compulsive or out of control. Such works have consistently found that perceived addiction is related to concerning outcomes such as psychological distress, relational distress, and other addictive behaviors. However, very little work has specifically examined whether or not perceived addiction is actually related to increased use of pornography, cross-sectionally or over time. The present work sought to address this deficit in the literature. Using two longitudinal samples (Sample 1, Baseline N = 3988; Sample 2, Baseline N = 1047), a variety of factors (e.g., male gender, lower religiousness, and lower self-control) were found to predict any use of pornography. Among those that acknowledged use (Sample 1, Baseline N = 1352; Sample 2, Baseline N = 793), perceived addiction to pornography consistently predicted greater average daily use of pornography. At subsequent longitudinal follow-ups (Sample 1, Baseline N = 265; Sample 2, One Month Later, N = 410, One Year Later, N = 360), only male gender and baseline average pornography use consistently predicted future use. These findings suggest that perceived addiction to pornography is associated with concurrent use of pornography, but does not appear to predict use over time, suggesting that perceived addiction may not always be an accurate indicator of behavior or addiction.

When Pornography Use Feels Out of Control: The Moderation Effect of Relationship and Sexual Satisfaction

There is an understudied, meaningful distinction between high frequency of pornography use and the subjective feeling that this behavior is out of control. We examined whether the quality of a couple's relationship and sex life can strengthen or weaken the association between frequency of Internet pornography use and perceived lack of control over this behavior. In a sample of 1,036 participants, results showed that frequency of pornography use was more strongly associated with feeling out of control when relationship and sexual satisfaction were lower. Findings suggest that couple dissatisfaction puts the individual at risk of reporting out-of-control pornography use.

Internet sex addiction: a licence to lust?

In this article we ask what kind of phenomenon is internet sex addiction. From the perspectives of two practising psychiatrists, one of whom has worked in a weekly sexual disorders clinic for 12 years, and an anthropologist we explore whether a moral panic is emerging over sexual behaviour and the internet, and whether internet sex addiction forms part of any such panic. We ask whether many individuals who diagnose themselves as addicted to internet-based sex do so more out of a media-activated sensibility than a clinical reality. We also consider what developments in DSM-5 hold for this area.

Clinicians' Beliefs, Observations, and Treatment Effectiveness Regarding Clients' Sexual Addiction and Internet Pornography Use

This study addressed how sex addiction and problematic IP use present to mental health professionals (MHPs), and how MHPs conceptualize and treat these issues. MHPs (N = 183) reported on beliefs about, experiences with, and treatment of problematic sexual behaviors (PBS). Most MHPs saw clients with PBS, but most do not feel competent to treat PBS. Specialized MHPs endorsed seeing more clients with PBS and feeling more effective than nonspecialists. Sexual addiction and problematic IP use share similarities, but differ in etiology and co-occurring problems. Diagnostic ambiguity, insufficient knowledge, and limited dissemination may hinder MHPs ability to assess and treat PBSs.

Internet Use for Searching Information on Medicines and Disease: A Community Pharmacy-Based Survey Among Adult Pharmacy Customers

Background

The Internet is increasingly used as a source of health-related information, and a vast majority of Internet users are performing health-related searches in the United States and Europe, with wide differences among countries. Health information searching behavior on the Internet is affected by multiple factors, including demographics, socioeconomic factors, education, employment, attitudes toward the Internet, and health conditions, and their knowledge may help to promote a safer use of the Internet. Limited information however exists so far about Internet use to search for medical information in Italy.

Objective

The objective of this study was to investigate the use of the Internet for searching for information on medicines and disease in adult subjects in Northern Italy.

Methods

Survey in randomly selected community pharmacies, using a self-administered questionnaire, with open and multiple choices questions, was conducted.

Results

A total of 1008 participants were enrolled (59.5% women; median age: 43 years; range: 14-88 years). Previous use of the Internet to search for information about medicines or dietary supplements was reported by 26.0% of respondents, more commonly by women (30.00% vs 20.10% men, P<.001), unmarried subjects (32.9% vs 17.4% widowed subjects, P=.022), and employed people (29.1% vs 10.4% retired people, P=.002). Use was highest in the age range of 26 to 35 (40.0% users vs 19.6% and 12.3% in the age range ≤25 and ≥56, respectively, P<.001) and increased with years of education (from 5.3% with 5 years, up to 41.0% with a university degree, P<.001). Previous use of the Internet to search for information about disease was reported by 59.1% of respondents, more commonly by women (64.5% vs 51.0% males, P<.001), unmarried subjects (64.2% vs 58.5% married or divorced subjects and 30.4% widowed subjects, P=.012), unemployed people (66.7% vs 64.0% workers and 29.9% retired people, P<.001). Use was highest in the age range of 26 to 35 (70.1% vs 64.4% in both 36-45 and 46-55 ranges and 35.1% in ≥56, P<.001) and increased with years of education (from 12.5% with 5 years up to 66.7% with 13 years and 68.6% with a university degree, P<.001). Retrieved information was rated as satisfactory by about 87.5% (88.1% women and 86.2% men, P=.562). Recent use of medicines or dietary supplements was associated with more frequent use of the Internet to search for disease and drugs.

Conclusions

The study provides detailed information on the use of the Internet for searching for information on medicines and disease in the Italian population. Gender, age, social status and level of education, and the previous use of medicines, affect searching behaviors and use patterns. Results can support educational interventions to promote the retrieval of high-quality information by Internet users and health professionals advising patients about appropriate use of Internet for health-related purposes.

Psychiatric-Mental Health Nurses' Exposure to Clients With Problematic Internet Experiences: A Mixed-Methods Pilot Study

The current study explored the type and number of problematic Internet experiences (PIE) encountered by psychiatric-mental health nurses (PMHN) in clinical practice and analyzed PMHNs' clinical cases of clients with PIE. A mixed-methods quantitative survey with a qualitative component measured the types and number of PIE cases via a descriptive survey and derived themes using narrative inquiry methodology from written case descriptions. A sample of 16 PMHNs provided quantitative data and nine participants summarized clinical cases. PMHNs reported 92 adult and 33 child cases of PIE. Six themes were derived from the narrative data: (a) searching for pornography; (b) developing online romantic relationships; (c) online gaming is ruining my life; (d) spending excessive time on the Internet; (e) coming to terms with online sexual behaviors and addiction; and (f) cyberbullying. Implications for PMHN practice include the need for further assessment and intervention as PIE increase in the future.

Internet pornography use: perceived addiction, psychological distress, and the validation of a brief measure

The authors aimed to validate a brief measure of perceived addiction to Internet pornography refined from the 32-item Cyber Pornography Use Inventory, report its psychometric properties, and examine how the notion of perceived addiction to Internet pornography might be related to other domains of psychological functioning. To accomplish this, 3 studies were conducted using a sample of undergraduate psychology students, a web-based adult sample, and a sample of college students seeking counseling at a university's counseling center. The authors developed and refined a short 9-item measure of perceived addiction to Internet pornography, confirmed its structure in multiple samples, examined its relatedness to hypersexuality more broadly, and demonstrated that the notion of perceived addiction to Internet pornography is very robustly related to various measures of psychological distress. Furthermore, the relation between psychological distress and the new measure persisted, even when other potential contributors (e.g., neuroticism, self-control, amount of time spent viewing pornography) were controlled for statistically, indicating the clinical relevance of assessing perceived addiction to Internet pornography.

Adolescent online gambling: the impact of parental practices and correlates with online activities

We present results from a cross-sectional study of the entire adolescent student population aged 12-19 of the island of Kos and their parents, on the relationship between their Internet gambling and respective parental practices, including aspects of psychological bonding and online security measures. The sample consisted of 2,017 students (51.8% boys, 48.2% girls). Our results indicate that gender, parenting practices as perceived by the adolescents and distinct patterns of adolescent Internet activities are among the best predictor variables for Internet gambling. Security practices exercised by the parents failed to make an impact on the extent of Internet gambling, demonstrating the need for specific measures to tackle this phenomenon since the provision of simple education on the dangers of the Internet is not sufficient to this regard.

Emerging adults' expectations for pornography use in the context of future committed romantic relationships: a qualitative study

Using qualitative content analysis from the written comments of 404 primarily heterosexual college students, we examined (1) their expectations for pornography use while married or in a committed long-term relationship and (2) variations by gender. Four prominent groups emerged. A majority of men (70.8 %) and almost half of women (45.5 %) reported circumstances (alone or with their partners) wherein pornography use was acceptable in a relationship and several conditions for, and consequences associated with, such use also emerged. Another group (22.3 % men; 26.2 % women) viewed pornography use as unacceptable because of being in a committed relationship whereas a third group (5.4 % men; 12.9 % women) reported that pornography use was unacceptable in any context or circumstance. A final group emerged of a few women (10.4 %) who stated that a partner's use of pornography was acceptable, but they did not expect to use it personally. Implications for relationship education among emerging adults and future research on pornography use within the context of romantic relationships are discussed.

Cyberstalking in the UK

The growth in the use of interconnected devices in the UK is well-documented. Society has embraced new technology allowing access to information, systems, and people; children are being described as digital natives and social networking, internet telephony, and accessing digital entertainment are a major part of their lives. However, whilst the ubiquitous nature of modern communication systems has brought many benefits, there exist a minority that uses the technology to harass others. This paper considers the phenomenon of Cyberstalking and presents an analysis of the problem and the responses provided on the first survey that addresses issue specifically. The paper discusses the nature of attacks, the victim-attacker relationship, the impact of the attacks and the actions taken to resolve the issue. The paper also considers both the legal and technological aspects and presents recommendations to help reduce the occurrence of Cyberstalking.

Sexuelle Außenkontakte und -beziehungen in heterosexuellen Partnerschaften

Zusammenfassung. In der Wertehierarchie hat „Treue” für eine überwiegende Mehrheit der Bevölkerung einen hohen Stellenwert in der Partnerschaft. Die Enthüllung sexueller Außenkontakte und -beziehungen ist daher für Paare eine große Herausforderung. Ziel des Beitrags ist es, die Auftretenshäufigkeit, assoziierten Merkmale und Auswirkungen einer Enthüllung sexueller Außenkontakte bzw. -beziehungen kritisch zusammenzufassen. Nach einer systematischen Literaturrecherche werden verschiedene methodische Aspekte und Einschränkungen der referierten Studien erörtert (u.a. mehrdeutige Operationalisierungen, fast ausschließlich Querschnittstudien). In Deutschland gaben 15–26% der Frauen bzw. 17–32% der Männer im reproduktiven Alter (16–45 Jahre) sexuelle Außenkontakte bzw. -beziehungen während der aktuellen Beziehung an. Damit lagen die Auftretenshäufigkeiten etwas höher als in den US-amerikanischen, aber im Bereich der europäischen Studien. Zusammenhänge ergaben sich zu soziodemographischen, psychischen und beruflichen Merkmalen sowie Bedingungen vor und während der primären Partnerschaft. Die Enthüllung einer Außenbeziehung führte meist zu einer erheblichen psychischen Belastung beider Partner und der Partnerschaft. Sexuelle Außenkontakte können als Verbreitungsweg sexuell übertragbarer Erkrankungen gelten. Basierend auf den methodischen Einschränkungen und den Ergebnissen werden Anregungen für verschiedene Teildisziplinen der Psychologie gegeben.

Treatment of compulsive cybersex behavior

Compulsive cybersex has become a significant problem for many men and women who have fallen prey to the accessibility, affordability, and anonymity of online sexual behaviors. Some patients develop problems with compulsive cybersex due to predisposition or accidental conditioning experiences. Other compulsive users of cybersex present with underlying trauma, depression, or addiction. Three case studies highlighted obsession, compulsion, and consequence in the pathogenesis of compulsive cybersex. While men and women differ somewhat in their use of cybersex, both genders exhibit maladaptive coping, conditioned behavior, dissociative reenactment of life trauma, courtship disorder, intimacy dysfunction, and addictive behavior. Comprehensive treatment of compulsive cybersex would include the following components: relapse prevention, intimacy enhancement, lovemap reconstruction, dissociative states therapy, arousal reconditioning, and coping skills training. Thanks to recent treatment advances in several fields, help is available for those caught in the dark side of the net.

Generation XXX

This study examined correlates of pornography acceptance and use within a normative (nonclinical) population of emerging adults (individuals aged 18—26). Participants included 813 university students (500 women; M age = 20 years) recruited from six college sites across the United States. Participants completed online questionnaires regarding their acceptance and use of pornography, as well as their sexual values and activity, substance use, and family formation values. Results revealed that roughly two thirds (67% ) of young men and one half (49%) of young women agree that viewing pornography is acceptable, whereas nearly 9 out of 10 (87%) young men and nearly one third (31%) of young women reported using pornography. Results also revealed associations between pornography acceptance and use and emerging adults' risky sexual attitudes and behaviors, substance use patterns, and nonmarital cohabitation values. The discussion considers the implications of pornography use during the transition to adulthood.

Problematic Internet experiences: Primary or secondary presenting problems in persons seeking mental health care?

This study utilizes data from clinical reports of 1441 youth and adults in the USA to examine the types of problematic Internet experiences mental health professionals report as clients' primary or secondary presenting problems. Overall, clients who present in treatment with an Internet problem are more likely to have problems related to overuse of the Internet; use of adult pornography; use of child pornography; sexual exploitation perpetration; and gaming, gambling, or role-playing. Other Internet-related problems, such as isolative-avoidant use, sexual exploitation victimization, harassment perpetration, and online infidelity were equally likely to present in treatment as a primary problem or secondary to other mental health concerns. Some differences between youth and adult clients were also identified. Findings suggest some initial support for the importance of including Internet use, experiences, and behavior as part of an initial clinical assessment.

Classification of Adults with Problematic Internet Experiences: Linking Internet and Conventional Problems from a Clinical Perspective

This article utilizes data from clinical reports of 929 adults to examine whether various problematic Internet experiences are distinctly different from or extensions of conventional problems. A TwoStep Cluster Analysis identified three mutually exclusive groups of adults, those with (1) online relationship problems and victimization; (2) online and offline problems; and (3) marital discord. Results suggest some initial support for the idea that problematic Internet experiences are often extensions of experiences and behaviors that pre-date the Internet. However, the Internet may be introducing some qualitatively new dimensions-such as an increased severity, an increased frequency, or unique dynamics-that require new responses or interventions.

European citizens' use of E-health services: a study of seven countries

Background

European citizens are increasingly being offered Internet health services. This study investigated patterns of health-related Internet use, its consequences, and citizens' expectations about their doctors' provision of e-health services.

Methods

Representative samples were obtained from the general populations in Norway, Denmark, Germany, Greece, Poland, Portugal and Latvia. The total sample consisted of 7934 respondents. Interviews were conducted by telephone.

Results

44 % of the total sample, 71 % of the Internet users, had used the Internet for health purposes. Factors that positively affected the use of Internet for health purposes were youth, higher education, white-collar or no paid job, visits to the GP during the past year, long-term illness or disabilities, and a subjective assessment of one's own health as good. Women were the most active health users among those who were online. One in four of the respondents used the Internet to prepare for or follow up doctors' appointments. Feeling reassured after using the Internet for health purposes was twice as common as experiencing anxieties. When choosing a new doctor, more than a third of the sample rated the provision of e-health services as important.

Conclusion

The users of Internet health services differ from the general population when it comes to health and demographic variables. The most common way to use the Internet in health matters is to read information, second comes using the net to decide whether to see a doctor and to prepare for and follow up on doctors' appointments. Hence, health-related use of the Internet does affect patients' use of other health services, but it would appear to supplement rather than to replace other health services.

Cyberspace Violence against Girls and Adolescent Females

Children and adolescents today are the first generation raised in a society in which technological literacy is essential for effective citizenship in the 21st century. With many more youth using digital technologies for educational and recreational purposes, there has been an increase in social problems in cyberspace, exposing them to different forms of cyberviolence. This article gives an overview of the developments in cyberspace, describes different types of cyberviolence, and focuses on cyberbullying among girls and adolescent females as both victims and perpetrators of cyberbullying. At-risk online activities among girls and adolescent females as well as strategies to promote cybersafety are presented. Current research and future directions for research are reviewed.