Mental Health
Psychological correlates of problematic pornography use: A systematic review and meta-analysis of measurement and conceptualization differences
Open Access: Yes.
Abstract
Problematic Pornography Use (PPU) has been linked to a wide range of psychological correlates, however findings across studies remain inconsistent. One possible explanation is that PPU has been operationalized using conceptually distinct approaches emphasizing either behavioral dysregulation or subjective distress, including moral incongruence and negative self-evaluation. This systematic review and meta-analysis synthesized psychological correlates of PPU and examined whether associations varied across different operationalizations of the construct.A systematic search identified 97 articles comprising 111 independent studies/samples. Random-effects meta-analyses were conducted, and studies were coded according to the dominant measurement orientation of PPU instruments, distinguishing dysregulation-oriented from distress-oriented operationalizations. Exploratory moderator and subgroup analyses examined whether differences in PPU operationalization and measurement orientation contributed to effect-size variability. Prediction intervals were calculated to characterize the expected dispersion of effects across future comparable studies.PPU was significantly associated with craving, emotion dysregulation, depression, loneliness, sexual shame, and moral disapproval. Substantial heterogeneity was observed, and prediction intervals were often wide. Dysregulation-oriented measures tended to show relatively stronger associations with craving and impulsivity, whereas distress-oriented measures tended to show relatively stronger associations with shame, religiosity, and moral conflict.Exploratory analyses suggested that measurement differences may partly contribute to variability in observed correlates.Psychological correlates of PPU appear to vary partly according to how the construct is conceptualized and measured. Distinguishing distress-oriented from dysregulation-oriented operationalizations may help clarify inconsistencies and improve theoretical precision in future research.
Relevance
“Overall, the findings indicate that PPU is associated with a broad range of psychological variables spanning domains related to behavioral self-regulation, emotional functioning, interpersonal processes, and evaluative distress.”
“Across the examined psychological variables, pornography craving and sexual shame demonstrated the strongest pooled associations with PPU” as well as – through “moderate associations” – “impulsivity, emotion regulation difficulties, and related self-regulatory constructs. These findings align with broader literature implicating deficits in inhibitory control, emotion regulation, and executive functioning across a range of addictive and compulsive behaviors…Likewise, smaller but generally consistent associations with depressive symptoms, stress, loneliness, and attachment-related variables suggest that PPU frequently co-occurs with broader affective and interpersonal vulnerabilities.”
“The present findings have several implications for both clinical assessment and future research…the results suggest that individuals reporting problematic pornography use may present with a diverse constellation of psychological characteristics rather than a single, uniform clinical profile. Across studies, PPU was associated with variables related to behavioral self-regulation (e.g., craving, impulsivity, emotion regulation difficulties), affective functioning (e.g., depression, anxiety, stress), and evaluative distress (e.g., shame and moral incongruence). This pattern highlights the importance of comprehensive psychological assessment rather than assuming a single underlying mechanism for all individuals reporting problematic pornography use.”
Citation
Sheikhi, S., Mohammadkhani, & Akbari, M. (2026). Psychological correlates of problematic pornography use: A systematic review and meta-analysis of measurement and conceptualization differences. Addictive Behaviors Reports, 24. https://doi.org/10.1016/j.abrep.2026.100741
