Mental Health
Adolescents’ online pornography use and psychopathological symptoms: Insights from a systematic review and meta-analysis.
Open Access: No.
Abstract
The use of online pornography is widely prevalent among adolescents. This study presents a systematic review and meta-analysis to explore the relationship between online pornography use and psychopathological symptoms in this population. The study was conducted in accordance with the guidelines outlined in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). A comprehensive literature search was conducted in PubMed, Scopus and Web of Science for studies published between 2005 and 2024. Eligible studies included quantitative research examining the association between online pornography use and psychopathological symptoms as defined by the DSM-5-TR, with samples comprising adolescents aged 10–19 years. Fourteen studies were included in the systematic review, and twelve were incorporated into the meta-analysis. The meta-analyses revealed a moderate positive correlation between online pornography use and psychopathological symptoms among adolescents. Subgroup analyses indicated no significant differences based on gender. The findings suggest that, in its most problematic manifestations, online pornography use among adolescents may serve as a maladaptive coping strategy for managing underlying distress. An empathetic approach with adolescents displaying problematic online pornography use has the potential to improve the outcomes of therapeutic interventions. These interventions might enhance adolescents’ personal and relational resources, thus facilitating the discovery of healthier alternatives that effectively address their psychological needs.
Relevance
“The meta-analysis revealed a moderate positive correlation between OPU [online pornography use] and psychopathology…suggesting that higher levels of OPU may be associated with significant clinical difficulties across various domains of adolescent functioning.”
Adolescents using online pornography may experience greater difficulties in social relationships, using pornography to cope with loneliness; online pornography, too, seems to mutually reinforce depressive and anxious symptoms, thus reflecting and contributing to the escalation of emotional distress. The use of online pornography. “can exploit and amplify users’ underlying vulnerabilities”and thus “create a self-reinforcing system, in which excessive exposure intensifies emotional, cognitive, and behavioral difficulties, leading to compounded adverse outcomes.”
“Among the psychopathological symptoms examined in this systematic review and meta-analysis, internalizing problems were the most frequently associated with OPU” – especially depression, anxiety, and somatic complaints. OPU may serve as a”coping strategy for insecurity, loneliness, or feelings of inadequacy” or a “psychic retreat” that nonetheless potentially triggers “dissociative processes that alter perceptions of emotion, thought, and bodily sensation” which ultimately “reinforce avoidance and hinder adaptive emotional regulation.”
“It is advisable that clinical interventions transcend mere symptom alleviation and actively extend to promote more adaptive emotion regulation strategies. In particular, clinicians should prioritize supporting adolescents in the integration of bodily sensations, thereby fostering a deeper understanding of the psychological needs underlying their behaviors. This approach moves beyond a simplistic interpretation of OPU as a behavioral addiction, encouraging a comprehensive approach to this phenomenon and its maladaptive consequences.”
Citation
Di Caro, A., Cavallo, J., Marchese, E. V., Melita, A., Costanzo, A., & Schimmenti, A. (2025). Adolescents’ online pornography use and psychopathological symptoms: Insights from a systematic review and meta-analysis. European Child & Adolescent Psychiatry. https://doi.org/10.1007/s00787-025-02863-x
