Publications

OBJECTIVE: There is a growing consensus that problematic pornography use (PPU), one of the most commonly reported compulsive sexual behaviors, is related to a number of internalizing psychiatric symptoms (e.g., anxiety, depression). However, little is known about the potential comorbidity of PPU and suicidal thoughts. Given known links between PPU and higher levels of guilt, shame, and moral disapproval, it may be that PPU may be related to suicidal thoughts.

METHOD: Using two independent samples, we cross-sectionally (Sample 1: undergraduates, n = 422) and longitudinally (Sample 2: nationally representative sample of U.S. adults, n = 1,455) tested for associations between PPU and past-month suicidal ideation and perceived likelihood of suicidal behaviors, while controlling for frequency of pornography use, moral disapproval, moral incongruence, and religiousness.

RESULTS: Cross-sectionally, PPU was related to higher levels of self-perceived likelihood of suicidal behaviors, but not past-month suicidal thoughts. Longitudinally, PPU was related to higher initial levels (i.e., intercept) of past-month suicidal thoughts and self-perceived likelihood of suicidal behaviors, but not changes in either (i.e., slope). The frequency of pornography use was statistically unrelated to each outcome for both samples, while moral beliefs about pornography use showed mixed relationships.

CONCLUSIONS: Clinicians working with patients reporting PPU may consider ways it may contribute to suicidal thinking. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Prior works note that identifying problematic play is a leading barrier to treatment seeking, contributing to low treatment rates in those with gambling problems (e.g., Bijker et al., 2022; Suurvali et al., 2012a). While research has looked at treatment seekers' motives for treatment (Gainsbury et al., 2014; Suurvali et al., 2012b), the situations or signs (anticipated motives) individuals look for that suggest they would need treatment in the future remains unknown. Participants were gamblers (N = 1,791) from a census-matched U.S. sample of adults who reported no concerns about their gambling. Participants completed questions assessing how much money they would have to lose while gambling to think they might have a problem and what factors might motivate them to pursue treatment for gambling problems in the future. Participants reported a wide range of financial loss that would suggest they had a problem, and higher income men who gambled more frequently reported higher necessary losses. There was little variation in endorsement (40-60%) of 14 situations that may lead them to seek treatment in the future (e.g., felt guilty). However, income, gender identity, and problem gambling behavior were linked to the endorsement of some of these anticipated motives, with some differences in endorsement between those engaging in high- and low-level problem gambling. Collectively, results are consistent with the inference that many individuals may not be aware of what problematic gambling would look like for them, though income, gender identity, and problem gambling behavior may impact their consideration of anticipated motives.

The inclusion of the novel diagnosis of Compulsive Sexual Behavior Disorder in the forthcoming 11th 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.