Pornography addiction has been described as a behavioral addiction characterized by compulsive, repeated use of pornographic material until it causes serious negative consequences to one's physical, mental, social, and/or financial well-being. However, the existence of porn addiction has been hotly contested by scientists and clinicians. Addiction to Internet pornography is also a form of cybersex addiction. There is no diagnosis of pornography addiction in the current Diagnostic and Statistical Manual of Mental Disorders (DSM).
Problematic Internet pornography viewing is viewing of Internet pornography that is problematic for an individual for personal, or social reasons, or reasons such as time spent viewing or viewing in problematic situations. Individuals may report depression, social isolation, career loss or decreased productivity, and financial consequences as a result of their problematic Internet pornography viewing.
Most studies of prevalence use a convenience sample. The only estimates based on a nationally-representative sample place problems with this behavior around .5% of the population. One of the studies of a convenience sample suggested that 17% of people who viewed pornography on the Internet met criteria for problematic[clarification needed] sexual compulsivity. A survey found that 20–60% of a sample of college-age males who use pornography found it to be problematic. Research on Internet addiction disorder indicates rates may range from 1.5 to 8.2% in Europeans and Americans. Internet pornography users are included in Internet users, and Internet pornography has been shown to be the Internet activity most likely to lead to compulsive disorders.
Status as addiction
|Nicole Prause, Ph.D. (sexual physiologist).  CBS (July 18, 2013)|
|Debra Herbenick, Ph.D. (sexuality educator).  Katie Couric Show|
The status of addiction to visual sexual stimuli is strongly contested. The current Diagnostic and Statistical Manual of Mental Disorders (DSM-V) includes a new section for behavioral addictions, but includes only one disorder: pathological gambling. Other behavioral addictions were included in "Conditions for further study". Porn addiction is not currently a diagnosis and was specifically rejected from the most recent revision of the DSM. Psychiatrists cited a lack of research support for refusing to include it at this time.
In 2011, the American Society of Addiction Medicine published a definition of addiction that for the first time stated that addiction includes pathological pursuit of all kinds of external rewards and not just substance dependence. This definition is very controversial, as it is thought to represent overly broad descriptions. It does not explicitly include porn addiction.
However, Dr. Richard Krueger, DSM-5 work-group member (Sexual and Gender Identity Disorders) and associate clinical professor of psychiatry at Columbia University’s College of Physicians and Surgeons has said that he has little doubt that porn addiction is real and will eventually garner enough attention to be recognized as a mental illness by the DSM. Krueger also stated "most people would do it and it won’t become a problem" and recognized that there is yet no academic evidence for considering it a mental disorder.
Although no brain studies of "porn addiction" existed at the time, a 2011 paper by Donald Hilton and Clark Watts argued that studies demonstrating the effect of sexual experiences on neuroplasticity indicate the existence of process addiction, and specifically focused on pornography addiction as an area requiring further study. In a letter to the editor, Rory Reid, Bruce Carpenter, and Timothy Fong responded by arguing that the studies on neuroplasticity used correlational data, and thus could not be used to establish causation. In a commentary included with the letter to the editor, Hilton and Watts pointed to research connecting ∆FosB, a proposed marker of substance addictions, to sexual experience, and claimed that researchers who reject the research they cite are biased against research which connects neuromodulation to behavioral addictions. A later paper demonstrated that ∆FosB actually has never been tied to sex, and the animal model necessary to test it does not exist.
Symptoms and diagnosis
Accepted diagnostic criteria do not exist for pornography addiction or problematic pornography viewing. The only diagnostic criteria for a behavioral addiction in the current Diagnostic and Statistical Manual of Mental Disorders are for pathological gambling, and they are similar to those for substance abuse and dependence, such as preoccupation with the behavior, diminished ability to control the behavior, tolerance, withdrawal, and adverse psychosocial consequences. Diagnostic criteria have been proposed for other behavioral addictions, and these are usually also based on established diagnoses for substance abuse and dependence.
A proposed diagnosis for hypersexual disorder includes pornography as a sub-type of this disorder. It included such criteria as time consumed by sexual activity interfering with obligations, repetitive engagement in sexual activity in response to stress, repeated failed attempts to reduce these behaviors, and distress or impairment of life functioning. A study on problematic Internet pornography viewing used the criteria of viewing Internet pornography more than three times a week during some weeks, and viewing causing difficulty in general life functioning. Some have suggested that use can lead to erectile dysfunction, but this has never been demonstrated by any research.
A 2014 released study identified a connection between a subjects religious beliefs and their self perception of pornography addiction. The study's lead author is Case Western Reserve University psychology doctoral student Joshua Grubbs; the study is title "Transgression as Addiction: Religiosity and Moral Disapproval as Predictors of Perceived Addiction to Pornography" and will be published in the journal Archives of Sexual Behaviour. One of the findings of the study is that the results strongly indicate a predilection in religious people to believe they are addicted to pornography regardless of how much they watch or whether it negatively impacts their lives.
Cognitive-behavioral therapy has been suggested as a possible effective treatment for pornography addiction based on its success with Internet addicts, though no clinical trials have been performed to assess effectiveness among pornography addicts as of 2012. Acceptance and commitment therapy has also been shown to be a potentially effective treatment for problematic Internet pornography viewing.
Sex researcher Alvin Cooper and colleagues suggested several reasons for using filters as a therapeutic measure, including curbing accessibility that facilitates problematic behavior and encouraging clients to develop coping and relapse prevention strategies. Cognitive therapist Mary Anne Layden suggested that filters may be useful in maintaining environmental control. Internet behavior researcher David Delmonico noted that, despite their limitations, filters may serve as a "frontline of protection."
DSM-5 explicitly rejects qualifying online pornography consumption as an addiction.
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