BACKGROUND AND AIMS: The Moral Incongruence Model of Pornography Use proposes that pornography-use-related problems may be present due to problematic pornography use (PPU) and/or moral disapproval (MD) of pornography use. Despite some supporting empirical evidence, no study has tested the presence of different pornography-use profiles based on individuals' behavioral dysregulation (i.e., PPU) and moral values concerning pornography use. The generalizability of previous findings to diverse populations has also been limited given the scarcity of studies conducted outside of Western countries. METHODS: Using data from the International Sex Survey (42 countries, N = 66,994; Mage = 32.16 years, SD = 12.27), we conducted latent profile analysis to identify pornography-use profiles based on individuals' frequency of use, MD, and PPU. The profiles were compared along a wide range of pornography-use-related, sexuality-related, and psychological correlates. RESULTS: Six pornography-use profiles were identified, including two increased risk groups (i.e., Increased risk of PPU without MD and Increased risk of PPU with some MD). Several factors differentiated between the increased risk vs. no/low risk profiles (e.g., relatedness satisfaction) as well as between the two increased risk profiles (e.g., religiosity). Apart from behavioral dysregulation, moral values concerning pornography use played an important role in distinguishing pornography-use profiles and demonstrated the importance of inquiring about MD when working with individuals with pornography-use-related problems. CONCLUSION: Findings also support recent calls for better-integrated sex therapy and sexual medicine perspectives into pornography-use-related problems research and care.

Artois University France

Biostatistics Consulting Center National Cheng Kung University Hospital College of Medicine National Cheng Kung University Tainan Taiwan

Center for Excessive Gambling Addiction Medicine Lausanne University Hospitals Lausanne Switzerland

Center on Alcohol Substance Use And Addictions University of New Mexico Albuquerque USA

Centre de recherche interdisciplinaire sur les problèmes conjugaux et les agressions sexuelles Canada

Centre for Advanced Research Excellence in Public Health Savar Dhaka 1342 Bangladesh

Centre of Excellence in Responsible Gaming University of Gibraltar Gibraltar Gibraltar

Charles University 1st Faculty of Medicine Department of Addictology Prague Czech Republic

Chuncheon Addiction Management Center South Korea

College of Healthcare Sciences James Cook University Australia

Compassionate Inquiry New Zealand

Connecticut Council on Problem Gambling Wethersfield CT USA

Connecticut Mental Health Center New Haven CT USA

Decentralized Big Data Team RIKEN Center for Advanced Intelligence Project Tokyo Japan and The General Research Division Osaka University Research Center on Ethical Legal and Social Issues Osaka Japan

Departamento de Psicología y Filosofía Facultad de Ciencias Sociales Universidad de Tarapacá Arica Arica y Parinacota Chile

Département de Psychologie Université de Montréal Montréal Canada

Département de Psychologie Université du Québec à Trois Rivières Trois Rivières Canada

Department of Clinical Pharmaceutical and Biological Sciences University of Hertfordshire United Kingdom

Department of Educational Psychology and Psychology of Health Pavol Jozef Safarik University in Kosice Slovakia

Department of Family Medicine National Cheng Kung University Hospital College of Medicine National Cheng Kung University Tainan Taiwan

Department of Health Services Srinagar 190001 India

Department of Neuropsychiatry Graduate School of Medicine Kyoto University Kyoto Japan

Department of Personality Assessment and Psychological Treatments University of Valencia Spain

Department of Psychiatry All India Institute of Medical Sciences New Delhi 110029 India

Department of Psychiatry Faculdade de Medicina Universidade de São Paulo Hospital das Clinicas Instituto de Psiquiatria Excessive Sexual Drive and Prevention of Negative Outcomes associated to Sexual Behavior Outpatient Unit Brazil

Department of Psychiatry Graduate School of Medicine Kyoto University Kyoto Japan

Department of Psychiatry Hallym University Chuncheon Sacred Heart Hospital South Korea

Department of Psychiatry Schulich School of Medicine and Dentistry Western University London Health Sciences Centre and St Joseph's Health Care London London ON Canada Lawson Health Research Institute London Ontario Canada

Department of Psychology and Cognitive Science University of Trento Italy

Department of Psychology and Neuroscience Auckland University of Technology Auckland New Zealand

Department of Psychology College of Humanity and Social Science Fuzhou University China

Department of Psychology Faculty of Education Charles University Prague Czech Republic

Department of Psychology Humanities and Social Sciences University of Zagreb Croatia

Department of Psychology Shardha University India

Department of Psychology University of Nevada Las Vegas Las Vegas NV USA

Department of Psychology University of New Mexico Albuquerque USA

Department of Public Health and Informatics Jahangirnagar University Savar Dhaka 1342 Bangladesh

Department of Sociology Faculty of Humanities and Social Sciences University of Zagreb Croatia

Departmento de Psicología Básica Clínica y Psicobiología University Jaume 1 of Castellón Spain

Doctoral School of Psychology ELTE Eötvös Loránd University Budapest Hungary

Experimental Pathophysiology Post Graduation Program Faculdade de Medicina Universidade de São Paulo Brazil

Facultad de Ciencias de la Salud Universidad Privada del Norte Lima Perú

Facultad de Medicina Universidad Científica del Sur Lima Perú

Facultad de Psicología Universidad de Talca Chile

Faculty of Philosophy Ss Cyril and Methodius University in Skopje Republic of North Macedonia

Faculty of Psychology University of Cuenca Ecuador

Florida State University Republic of Panama

General University Hospital Prague Department of Addictology Czech Republic

Health Promotion Research Centre University of Galway Ireland

HELP University Malaysia

Institute for Behavioural Addictions Sigmund Freud University Vienna Austria

Institute for Mental Health and Wellbeing College of Education Psychology and Social Work Flinders University Adelaide Australia

Institute for Neural Computations University of California San Diego USA

Institute for Sex Research SexualMedicine and Forensic Psychiatry University Medical Centre Hamburg Eppendorf Hamburg Germany

Institute of Allied Health Sciences College of Medicine National Cheng Kung University Tainan Taiwan

Institute of Forensic Psychiatry and Sex Research Center for Translational Neuro and Behavioral Science University of Duisburg Essen Essen Germany

Institute of Forensic Psychiatry and Sex Research Center for Translational Neuro and Behavioral Sciences University of Duisburg Essen Essen Germany

Institute of Psychology Cardinal Stefan Wyszynski University Warsaw Poland

Institute of Psychology ELTE Eötvös Loránd University Budapest Hungary

Institute of Psychology Polish Academy of Sciences Poland

Institute of Psychology University of Lausanne Lausanne Switzerland

Laboratory of Behavioral Medicine Neuroscience Institute Lithuanian University of Health Sciences Palanga Lithuania

Leuven School For Mass Communication KU Leuven Leuven Belgium

Macedonian Academy of Sciences and Arts Republic of North Macedonia

Nottingham Trent University United Kingdom

Psychosis Research Centre University of Social Welfare and Rehabilitation Sciences Tehran Iran

Public Health Institute Faculty of Health Liverpool John Moores University United Kingdom

SAMRC Unit on Risk and Resilience in Mental Disorders Dept of Psychiatry and Neuroscience Institute University of Cape Town

SAMRC Unit on Risk and Resilience in Mental Disorders Stellenbosch University South Africa

School of Psychology University of Southampton United Kingdom

School of Social Work Faculty of Social Welfare and Health Sciences University of Haifa Israel

Section of Sexual Psychopathology Department of Dynamic and Clinical Psychology and Health Studies Sapienza University of Rome Rome Italy

Sistema Nacional de Investigación SENACYT Panama

Substantive Methodological Synergy Research Laboratory Department of Psychology Concordia University Montreal Canada

Universidad Pedagógca y Tecnológica de Colombia Colombia

Universidad Privada de Santa Cruz de la Sierra Bolivia

University of Baghdad College of Medicine Iraq

University of Warith Al Anbiyaa College of Medicine Karbala Iraq

Virtual Teaching and Cyberpsychology Laboratory School of Psychology National Autonomous University of Mexico Mexico

William James Center for Research Departamento de Educação e Psicologia Universidade de Aveiro Aveiro Portugal

Yale University School of Medicine New Haven CT USA

See more in PubMed

Ahorsu, D. K., Adjorlolo, S., Nurmala, I., Ruckwongpatr, K., Strong, C., & Lin, C. Y. (2023). Problematic porn use and cross-cultural differences: A brief review. Current Addiction Reports, 1, 1–9. 10.1007/S40429-023-00505-3. DOI

Asner-Self, K. K., Schreiber, J. B., & Marotta, S. A. (2006). A cross-cultural analysis of the brief symptom inventory-18. Cultural Diversity and Ethnic Minority Psychology, 12(2), 367–375. 10.1037/1099-9809.12.2.367. PubMed DOI

Babor, T. F., Higgins-Biddle, J. C., Saunders, J. B., & Monteiro, M. G. (2001). AUDIT: The alcohol use disorders identification test – Guidelines for use in primary care (Second). World Health Organization.

Ballester-Arnal, R., Castro-Calvo, J., Giménez-García, C., Gil-Juliá, B., & Gil-Llario, M. D. (2020). Psychiatric comorbidity in compulsive sexual behavior disorder (CSBD). Addictive Behaviors, 107. 10.1016/j.addbeh.2020.106384. PubMed DOI

Billieux, J., Rochat, L., Ceschi, G., Carré, A., Offerlin-Meyer, I., Defeldre, A.-C., … Van der Linden, M. (2012). Validation of a short French version of the UPPS-P impulsive behavior scale. Comprehensive Psychiatry, 53(5), 609–615. 10.1016/J.COMPPSYCH.2011.09.001. PubMed DOI

Borgogna, N. C., Griffin, K. R., Grubbs, J. B., & Kraus, S. W. (2022). Understanding differences in problematic pornography use: Considerations for gender and sexual orientation. Journal of Sexual Medicine, 19(8), 1290–1302. 10.1016/J.JSXM.2022.05.144. PubMed DOI

Borgogna, N. C., Mcdermott, R. C., Aita, S. L., & Kridel, M. M. (2019). Anxiety and depression across gender and sexual minorities: Implications for transgender, gender nonconforming, pansexual, demisexual, asexual, queer, and questioning individuals. Psychology of Sexual Orientation and Gender Diversity, 6(1), 54–63. 10.1037/sgd0000306. DOI

Bőthe, B., Koós, M., Nagy, L., Kraus, S. W., Potenza, M. N., & Demetrovics, Z. (2021). International Sex Survey: Study protocol of a large, cross-cultural collaborative study in 45 countries. Journal of Behavioral Addictions, 10(3), 632–645. 10.1556/2006.2021.00063. PubMed DOI PMC

Bőthe, B., Koós, M., Tóth-Király, I., Orosz, G., & Demetrovics, Z. (2019). Investigating the associations of adult ADHD symptoms, hypersexuality, and problematic pornography use among men and women on a largescale, non-clinical sample. Journal of Sexual Medicine, 16(4), 489–499. 10.1016/j.jsxm.2019.01.312. PubMed DOI

Bőthe, B., Lonza, A., Štulhofer, A., & Demetrovics, Z. (2020). Symptoms of problematic pornography use in a sample of treatment considering and treatment non-considering men: A network approach. Journal of Sexual Medicine, 17(10), 2016–2028. 10.1016/j.jsxm.2020.05.030. PubMed DOI

Bőthe, B., Nagy, L., Koós, M., Demetrovics, Z., Potenza, M. N., International Sex Survey Consortium, & Kraus, S. W. (2024). Problematic pornography use across countries, genders, and sexual orientations: Insights from the International Sex Survey and comparison of different assessment tools. Addiction, 1–23. 10.1111/ADD.16431. PubMed DOI

Bőthe, B., Potenza, M. N., & Demetrovics, Z. (2024). Debates on compulsive sexual behavior disorder: A call for global and interdisciplinary perspectives. Archives of Sexual Behavior, 53(4), 1215–1220. 10.1007/S10508-024-02836-2/METRICS. PubMed DOI

Bőthe, B., Tóth-Király, I., Bella, N., Potenza, M. N., Demetrovics, Z., & Orosz, G. (2021). Why do people watch pornography? The motivational basis of pornography use. Psychology of Addictive Behaviors, 35(2), 172–186. 10.1037/adb0000603. PubMed DOI

Bőthe, B., Tóth-Király, I., Demetrovics, Z., & Orosz, G. (2021). The short version of the problematic pornography consumption scale (PPCS-6): A reliable and valid measure in general and treatment-seeking populations. Journal of Sex Research, 58(3), 342–352. 10.1080/00224499.2020.1716205. PubMed DOI

Bőthe, B., Tóth-Király, I., Griffiths, M. D., Potenza, M. N., Orosz, G., & Demetrovics, Z. (2021). Are sexual functioning problems associated with frequent pornography use and/or problematic pornography use? Results from a large community survey including males and females. Addictive Behaviors, 112, 1–9. 10.1016/j.addbeh.2020.106603. PubMed DOI

Bőthe, B., Tóth-Király, I., Potenza, M. N., Griffiths, M. D., Orosz, G., & Demetrovics, Z. (2019). Revisiting the role of impulsivity and compulsivity in problematic sexual behaviors. Journal of Sex Research, 56(2), 166–179. 10.1080/00224499.2018.1480744. PubMed DOI

Bőthe, B., Tóth-Király, I., Potenza, M. N., Orosz, G., & Demetrovics, Z. (2020). High-frequency pornography use may not always be problematic. Journal of Sexual Medicine, 17(4), 793–811. 10.1016/j.jsxm.2020.01.007. PubMed DOI

Bőthe, B., Tóth-Király, I., Zsila, Á., Griffiths, M. D., Demetrovics, Z., & Orosz, G. (2018). The development of the problematic pornography consumption scale (PPCS). Journal of Sex Research, 55(3), 395–406. 10.1080/00224499.2017.1291798. PubMed DOI

Bőthe, B., Vaillancourt-Morel, M.-P., Bergeron, S., Hermann, Z., Ivaskevics, K., Kraus, S. W., … The Problematic Pornography Use Machine Learning Study Consortium (2024). Uncovering the most robust predictors of problematic pornography use: A large-scale machine learning study across 16 countries. Journal of Psychopathology and Clinical Science, 133(6), 489–502. 10.1037/abn0000913. PubMed DOI

Bőthe, B., Vaillancourt-Morel, M.-P., Dion, J., Štulhofer, A., & Bergeron, S. (2021). Validity and reliability of the short version of the problematic pornography consumption scale (PPCS-6-A) in adolescents. Psychology of Addictive Behaviors, 35(4), 486–500. 10.1037/adb0000722. PubMed DOI

Briken, P., Bőthe, B., Carvalho, J., Coleman, E., Giraldi, A., Kraus, S. W., … Pfaus, J. G. (2024). Assessment and treatment of compulsive sexual behavior disorder: A sexual medicine perspective. Sexual Medicine Reviews, 2024, 1–16. 10.1093/SXMREV/QEAE014. PubMed DOI PMC

Briken, P., & Turner, D. (2022). What does ‘sexual’ mean in compulsive sexual behavior disorder? • Commentary to the debate: ‘Behavioral addictions in the ICD-11’. Journal of Behavioral Addictions, 11(2), 222–225. 10.1556/2006.2022.00026. PubMed DOI PMC

Briken, P., Wiessner, C., Štulhofer, A., Klein, V., Fuss, J., Reed, G. M., & Dekker, A. (2022). Who feels affected by “out of control” sexual behavior? Prevalence and correlates of indicators for ICD-11 compulsive sexual behavior disorder in the German health and sexuality survey (GeSiD). Journal of Behavioral Addictions, 11(3), 900–911. 10.1556/2006.2022.00060. PubMed DOI PMC

Butler, M. H., Pereyra, S. A., Draper, T. W., Leonhardt, N. D., & Skinner, K. B. (2018). Pornography use and loneliness: A bidirectional recursive model and pilot investigation. Journal of Sex and Marital Therapy, 44(2), 127–137. 10.1080/0092623X.2017.1321601. PubMed DOI

Carvalho, J., Štulhofer, A., Vieira, A. L., & Jurin, T. (2015). Hypersexuality and high sexual desire: Exploring the structure of problematic sexuality. Journal of Sexual Medicine, 12(6), 1356–1367. 10.1111/jsm.12865. PubMed DOI

Chen, L., Jiang, X., Luo, X., Kraus, S. W., & Bőthe, B. (2021). The role of impaired control in screening problematic pornography use: Evidence from cross-sectional and longitudinal studies in a large help-seeking male sample. Psychology of Addictive Behaviors, 36(5), 1–10. 10.1037/adb0000714. PubMed DOI

Chen, L., Jiang, X., Wang, Q., Bőthe, B., Potenza, M. N., & Wu, H. (2022). The association between the quantity and severity of pornography use: A meta-analysis. Journal of Sex Research, 509(6), 704–719. 10.1080/00224499.2021.1988500. PubMed DOI

Chen, B., Vansteenkiste, M., Beyers, W., Boone, L., Deci, E. L., Van der Kaap-Deeder, J., … Verstuyf, J. (2015). Basic psychological need satisfaction, need frustration, and need strength across four cultures. Motivation and Emotion, 39(2), 216–236. 10.1007/s11031-014-9450-1. DOI

Derogatis, L. R., Rosen, R., Leiblum, S., Burnett, A., Derogatis, L. R., Rosen, R., … Burnett, A. (2011). The Female Sexual Distress Scale (FSDS): Initial validation of a standardized scale for assessment of sexually related personal distress in women. Journal of Sex and Marital Therapy, 28(4), 317–330. 10.1080/0092623029000144. PubMed DOI

Diallo, T. M. O., Morin, A. J. S., & Lu, H. Z. (2016). Impact of misspecifications of the latent variance-covariance and residual matrices on the class enumeration accuracy of growth mixture models. Structural Equation Modeling: A Multidisciplinary Journal, 23(4), 507–531. 10.1080/10705511.2016.1169188. DOI

Diallo, T. M. O., Morin, A. J. S., & Lu, H. Z. (2017). The impact of total and partial inclusion or exclusion of active and inactive time invariant covariates in growth mixture models. Psychological Methods, 22(1), 166–190. 10.1037/MET0000084. PubMed DOI

Dwulit, A. D., & Rzymski, P. (2019). The potential associations of pornography use with sexual dysfunctions: An integrative literature review of observational studies. Journal of Clinical Medicine, 8(7), 914. 10.3390/jcm8070914. PubMed DOI PMC

Elsey, J. W. B., van Andel, K., Kater, R. B., Reints, I. M., & Spiering, M. (2019). The impact of virtual reality versus 2D pornography on sexual arousal and presence. Computers in Human Behavior, 97, 35–43. 10.1016/J.CHB.2019.02.031. DOI

Fineberg, N. A., Sharma, P., Sivakumaran, T., Sahakian, B., & Chamberlain, S. (2007). Does obsessive-compulsive personality disorder belong within the obsessive-compulsive spectrum? CNS Spectrums, 12(6), 467–482. 10.1017/s1092852900015340. PubMed DOI

Fournier, L., Bőthe, B., Demetrovics, Z., Koós, M., Kraus, S. W., Nagy, L., … Billieux, J. (2024). Evaluating the factor structure and measurement invariance of the 20-item short version of the UPPS-P Impulsive Behavior Scale across multiple countries, languages, and gender identities. 10.1177/10731911241259560. PubMed DOI

Gola, M., Lewczuk, K., Potenza, M. N., Kingston, D. A., Grubbs, J. B., Stark, R., & Reid, R. C. (2020). What should be included in the criteria for compulsive sexual behavior disorder? Journal of Behavioral Addictions, 11(2), 160–165. 10.1556/2006.2020.00090. PubMed DOI PMC

Grant Weinandy, J. T., Lee, B., Hoagland, K. C., Grubbs, J. B., & Bőthe, B. (2023). Anxiety and compulsive sexual behavior disorder: A systematic review. Journal of Sex Research, 60(4), 545–557. 10.1080/00224499.2022.2066616. PubMed DOI

Grubbs, J. B., Floyd, C. G., Griffin, K. R., Jennings, T. L., & Kraus, S. W. (2022). Moral incongruence and addiction: A registered report. Psychology of Addictive Behaviors, 36(7), 749–761. 10.1037/ADB0000876. PubMed DOI

Grubbs, J. B., Floyd, C. G., & Kraus, S. W. (2023). Pornography use and public health: Examining the importance of online sexual behavior in the health sciences. American Journal of Public Health, 113(1), 22–26. 10.2105/AJPH.2022.307146. PubMed DOI PMC

Grubbs, J. B., & Gola, M. (2019). Is pornography use related to erectile functioning? Results from cross-sectional and latent growth curve analyses. Journal of Sexual Medicine, 16(1), 111–125. 10.1016/j.jsxm.2018.11.004. PubMed DOI

Grubbs, J. B., Hoagland, C., Lee, B., Grant, J., Davison, P. M., Reid, R., & Kraus, S. W. (2020). Sexual addiction 25 years on: A systematic and methodological review of empirical literature and an agenda for future research. Clinical Psychology Review, 82(101925), 1–15. 10.1016/j.cpr.2020.101925. PubMed DOI

Grubbs, J. B., & Kraus, S. W. (2021). Pornography use and psychological science: A call for consideration. Current Directions in Psychological Science, 30(1), 68–75. 10.1177/0963721420979594. DOI

Grubbs, J. B., Kraus, S. W., & Perry, S. L. (2019). Self-reported addiction to pornography in a nationally representative sample: The roles of use habits, religiousness, and moral incongruence. Journal of Behavioral Addictions, 8(1), 88–93. 10.1556/2006.7.2018.134. PubMed DOI PMC

Grubbs, J. B., Kraus, S. W., Perry, S. L., Lewczuk, K., & Gola, M. (2020). Moral incongruence and compulsive sexual behavior: Results from cross-sectional interactions and parallel growth curve analyses. Journal of Abnormal Psychology, 129(3), 266–278. 10.1037/abn0000501. PubMed DOI

Grubbs, J. B., & Perry, S. L. (2019). Moral incongruence and pornography use: A critical review and integration. Journal of Sex Research, 56(1), 29–37. 10.1080/00224499.2018.1427204. PubMed DOI

Grubbs, J. B., Perry, S. L., Wilt, J. A., & Reid, R. C. (2019). Pornography problems due to moral incongruence: An integrative model with a systematic review and meta-analysis. Archives of Sexual Behavior, 48(2), 397–415. 10.1007/s10508-018-1248-x. PubMed DOI

Grubbs, J. B., Reid, R. C., Bőthe, B., Demetrovics, Z., Coleman, E., Gleason, N., … Kraus, S. W. (2023). Assessing compulsive sexual behavior disorder: The development and international validation of the compulsive sexual behavior disorder-diagnostic inventory (CSBD-DI). Journal of Behavioral Addictions, 12(1), 242–260. 10.1556/2006.2023.00005. PubMed DOI PMC

Grubbs, J. B., Wright, P. J., Braden, A. L., Wilt, J. A., & Kraus, S. W. (2019). Internet pornography use and sexual motivation: A systematic review and integration. Annals of the International Communication Association, 43(2), 117–155. 10.1080/23808985.2019.1584045. DOI

Herbenick, D., Fu, T.-C., Wright, P., Paul, B., Gradus, R., Bauer, J., & Jones, R. (2020). Diverse sexual behaviors and pornography use: Findings from a nationally representative probability survey of Americans aged 14 to 60 years. Journal of Sexual Medicine, 17(4), 623–633. 10.1016/j.jsxm.2020.01.013. PubMed DOI

Hoagland, K. C., & Grubbs, J. B. (2021). Pornography use and holistic sexual functioning: A systematic review of recent research. Current Addiction Reports, 8(3), 408–421. 10.1007/S40429-021-00378-4/TABLES/1. DOI

Hoagland, K. C., Rotruck, H. L., Moore, J. N., & Grubbs, J. B. (2023). Reasons for moral-based opposition to pornography in a U.S. nationally representative sample. Journal of Sex & Marital Therapy, 49(7), 717–738. 10.1080/0092623X.2023.2186992. PubMed DOI

Horváth, Z., Nagy, L., Koós, M., Kraus, S. W., Demetrovics, Z., Potenza, M. N., … Bőthe, B. (2023). Psychometric properties of the alcohol use disorders identification test (AUDIT) across cross-cultural subgroups, genders, and sexual orientations: Findings from the international sex survey (ISS). Comprehensive Psychiatry, 127, 152427. 10.1016/J.COMPPSYCH.2023.152427. PubMed DOI

Humeniuk, R., Henry-Edwards, S., Ali, R., Poznyak, V., & Monteiro, M. G., & World Health Organization (2010). The alcohol, smoking and substance involvement screening test (ASSIST) – Manual for use in primary care. World Health Organization. www.who.int/substance_abuse.

IBM Corp (2021). IBM SPSS statistics for windows, version 28.0. IBM Corp.

Ince, C., Albertella, L., Liu, C., Tiego, J., Fontenelle, L. F., Chamberlain, S. R., … Rotaru, K. (2024). Problematic pornography use and novel patterns of escalating use: A cross-sectional network analysis with two independent samples. Addictive Behaviors, 156, 108048. 10.1016/J.ADDBEH.2024.108048. PubMed DOI PMC

Jennings, T. L., Gleason, N., & Kraus, S. W. (2022). Assessment of compulsive sexual behavior disorder among lesbian, gay, bisexual, transgender, and queer clients •: Commentary to the debate: “Behavioral addictions in the ICD-11”. Journal of Behavioral Addictions, 11(2), 216–221. 10.1556/2006.2022.00028. PubMed DOI PMC

Jennings, T. L., Gleason, N., Pachankis, J. E., Bőthe, B., & Kraus, S. W. (2024). LGBQ-affirming clinical recommendations for compulsive sexual behavior disorder. Journal of Behavioral Addictions, 1–16. 10.1556/2006.2024.00012. PubMed DOI PMC

Jiang, X., Wu, Y., Zhang, K., Bothe, B., Hong, Y., & Chen, L. (2022). Symptoms of problematic pornography use among help-seeking male adolescents: Latent profile and network analysis. Journal of Behavioral Addictions, 11(3), 912–927. 10.1556/2006.2022.00065. PubMed DOI PMC

Kessler, R. C., Adler, L., Ames, M., Demler, O., Faraone, S., Hiripi, E., … Walters, E. E. (2005). The World health organization adult ADHD self-report scale (ASRS): A short screening scale for use in the general population. Psychological Medicine, 35(2), 245–256. 10.1017/S0033291704002892. PubMed DOI

Klein, V., Savaş, Ö., & Conley, T. D. (2021). How WEIRD and androcentric is sex research? Global inequities in study populations. Journal of Sex Research, 59(7), 810–817. 10.1080/00224499.2021.1918050. PubMed DOI

Koós, M., Nagy, L., Kraus, S. W., Demetrovics, Z., Potenza, M. N., Gaudet, É., … Bőthe, B. (2024). Why do people watch pornography? Cross-cultural validation of the pornography use motivations scale (PUMS) and its short form (PUMS-8). The Journal of Sex Research, 1–16. 10.1080/00224499.2024.2359641. PubMed DOI

Kowalewska, E., Gola, M., Kraus, S. W., & Lew-Starowicz, M. (2020). Spotlight on compulsive sexual behavior disorder: A systematic review of research on women. Neuropsychiatric Disease and Treatment, 16, 2025–2043. 10.2147/NDT.S221540. PubMed DOI PMC

Kraus, S. W., Krueger, R. B., Briken, P., First, M. B., Stein, D. J., Kaplan, M. S., … Reed, G. M. (2018). Compulsive sexual behaviour disorder in the ICD-11. World Psychiatry, 17(1), 109–110. 10.1002/wps.20499. PubMed DOI PMC

Kraus, S. W., Potenza, M. N., Martino, S., & Grant, J. E. (2015). Examining the psychometric properties of the Yale-Brown Obsessive-Compulsive Scale in a sample of compulsive pornography users. Comprehensive Psychiatry, 59, 117–122. 10.1016/j.comppsych.2015.02.007. PubMed DOI

Kraus, S. W., & Sweeney, P. J. (2019). Hitting the target: Considerations for differential diagnosis when treating individuals for problematic use of pornography. Archives of Sexual Behavior, 48(2), 431–435. 10.1007/s10508-018-1301-9. PubMed DOI

Lawrance, K.-A., & Byers, E. S. (1998). Interpersonal exchange model of sexual satisfaction questionnaire. In Davis C. M., Yarber W. L., Baureman R., Schreer G., & Davis S. L. (Eds.), Sexuality related measures: A compendium (second, pp. 514–519). Gage.

Lee, C. T., Lin, C. Y., Koós, M., Nagy, L., Kraus, S. W., Demetrovics, Z., … Bőthe, B. (2023). The eleven-item alcohol, smoking and substance involvement screening test (ASSIST-11): Cross-cultural psychometric evaluation across 42 countries. Journal of Psychiatric Research, 165, 16–27. 10.1016/J.JPSYCHIRES.2023.06.033. PubMed DOI

Lewczuk, K., Glica, A., Nowakowska, I., Gola, M., & Grubbs, J. B. (2020). Evaluating pornography problems due to moral incongruence model. Journal of Sexual Medicine, 17(2), 300–311. 10.1016/j.jsxm.2019.11.259. PubMed DOI

Lewczuk, K., Marcowski, P., Wizła, M., Gola, M., Nagy, L., Koós, M., … Bőthe, B. (2024). Cross-cultural adult ADHD assessment in 42 countries using the adult ADHD self-report scale screener. Journal of Attention Disorders, 28(4), 512–530. 10.1177/10870547231215518/ASSET/IMAGES/LARGE/10.1177_10870547231215518-FIG2.JPEG. PubMed DOI

Lew-Starowicz, M., & Coleman, E. (2022). Mental and sexual health perspectives of the international classification of Diseases (ICD-11) compulsive sexual behavior disorder • Commentary to the debate: ‘Behavioral addictions in the ICD-11’. Journal of Behavioral Addictions, 11(2), 226–229. 10.1556/2006.2022.00032. PubMed DOI PMC

Lew-Starowicz, M., Lewczuk, K., Nowakowska, I., Kraus, S. W., & Gola, M. (2020). Compulsive sexual behavior and dysregulation of emotion. Journal of Sexual Medicine, 8(2), 191–205. 10.1016/j.sxmr.2019.10.003. PubMed DOI

Lin, C. Y., Tsai, M. C., Koós, M., Nagy, L., Kraus, S. W., Demetrovics, Z., … Bőthe, B. (2024). The short version of the Sexual Distress Scale (SDS-3): Measurement invariance across countries, gender identities, and sexual orientations. International Journal of Clinical and Health Psychology, 24(2), 100461. 10.1016/J.IJCHP.2024.100461. PubMed DOI PMC

McGahuey, C. A., Gelenberg, A. J., Laukes, C. A., Moreno, F. A., Delgado, P. L., McKnight, K. M., & Manber, R. (2000). The Arizona sexual experience scale (ASEX): Reliability and validity. Journal of Sex and Marital Therapy, 26(1), 25–38. 10.1080/009262300278623. PubMed DOI

Morin, A. J. S. (2016). Person-centered research strategies in commitment research. In Meyer J. P. (Ed.), The handbook of employee commitment (pp. 490–508). Cheltenham. 10.4337/9781784711740.00050. DOI

Morin, A. J. S. (2023). Exploratory structural equation modeling. In Hoyle R. H. (Ed.), Handbook of structural equation modeling (Second, pp. 503–524). Guilford.

Morin, A. J. S., McLarnon, M. J. W., & Litalien, D. (2020). Mixture modeling for organizational behavior research. In Griep Y., & Hansen S. D. (Eds.), Handbook on the temporal dynamics of organizational behavior (pp. 351–379). Edward Elgar.

Muthén, L. K., & Muthén, B. O. (2022). MPlus user’s guide. Eighth Edition.

Nelson, K. M., & Rothman, E. F. (2020). Should public health professionals consider pornography a public health crisis? American Journal of Public Health, 110(2), 151–153. 10.2105/AJPH.2019.305498. PubMed DOI PMC

Pâquet, M., Rosen, N. O., Steben, M., Mayrand, M. H., Santerre-Baillargeon, M., & Bergeron, S. (2018). Daily anxiety and depressive symptoms in couples coping with vulvodynia: Associations with women’s pain, women’s sexual function, and both partners’ sexual distress. Journal of Pain, 19(5), 552–561. 10.1016/j.jpain.2017.12.264. PubMed DOI

Parker, R. (2009). Sexuality, culture and society: Shifting paradigms in sexuality research. Culture, Health, & Sexuality, 11, 251–266. 10.1080/13691050701606941. PubMed DOI

Peugh, J., & Fan, X. (2013). Modeling unobserved heterogeneity using latent profile analysis: A Monte Carlo simulation. Structural Equation Modeling, 20(4), 616–639. 10.1080/10705511.2013.824780. DOI

Qualtrics (2022). Qualtrics research suite.

Quintana, G. R., Ponce, F. P., Escudero-Pastén, J. I., Santibáñez-Palma, J. F., Nagy, L., Koós, M., … Bőthe, B. (2024). Cross-cultural validation and measurement invariance of anxiety and depression symptoms: A study of the brief symptom inventory (BSI) in 42 countries. Journal of Affective Disorders, 350, 991–1006. 10.1016/J.JAD.2024.01.127. PubMed DOI

Reed, G. M., First, M. B., Billieux, J., Cloitre, M., Briken, P., Achab, S., … Bryant, R. A. (2022). Emerging experience with selected new categories in the ICD-11: Complex PTSD, prolonged grief disorder, gaming disorder, and compulsive sexual behaviour disorder. World Psychiatry, 21(2), 189–213. 10.1002/WPS.20960. PubMed DOI PMC

Reid, R. C., Carpenter, B. N., Hook, J. N., Garos, S., Manning, J. C., Gilliland, R., … Fong, T. (2012). Report of findings in a DSM-5 field trial for hypersexual disorder. Journal of Sexual Medicine, 9(11), 2868–2877. 10.1111/j.1743-6109.2012.02936.x. PubMed DOI

Rissel, C., Richters, J., de Visser, R. O., McKee, A., Yeung, A., & Caruana, T. (2017). A profile of pornography users in Australia: Findings from the second Australian study of health and relationships. Journal of Sex Research, 54(2), 227–240. 10.1080/00224499.2016.1191597. PubMed DOI

Rogers, S. M., Pinedo, M., Villatoro, A. P., & Zemore, S. E. (2019). “I don’t feel like I have a problem because I can still go to work and function”: Problem recognition among persons with substance use disorders. Substance Use & Misuse, 54(13), 2108–2116. 10.1080/10826084.2019.1630441. PubMed DOI PMC

Skrondal, A., & Laake, P. (2001). Regression among factor scores. Psychometrika, 66(4), 563–575. 10.1007/BF02296196/METRICS. DOI

Sniewski, L., & Farvid, P. (2020). Hidden in shame: Heterosexual men’s experiences of self-perceived problematic pornography use. Psychology of Men and Masculinity, 21(2), 201–212. 10.1037/men0000232. DOI

Spector, I. P., Carey, M. P., & Steinberg, L. (1996). The sexual desire inventory: Development, factor structure, and evidence of reliability. Journal of Sex and Marital Therapy, 22(3), 175–190. 10.1080/00926239608414655. PubMed DOI

Štulhofer, A., Bergeron, S., & Jurin, T. (2016). Is high sexual desire a risk for women’s relationship and sexual well-being? Journal of Sex Research, 53(7), 882–891. 10.1080/00224499.2015.1084984. PubMed DOI

Štulhofer, A., Jurin, T., & Briken, P. (2016). Is high sexual desire a facet of male hypersexuality? Results from an online study. Journal of Sex and Marital Therapy, 42(8), 665–680. 10.1080/0092623X.2015.1113585. PubMed DOI

Štulhofer, A., Rousseau, A., & Shekarchi, R. (2020). A two-wave assessment of the structure and stability of self-reported problematic pornography use among male Croatian adolescents. International Journal of Sexual Health, 32(2), 151–164. 10.1080/19317611.2020.1765940. DOI

Vaillancourt-Morel, M.-P., & Bergeron, S. (2019). Self-perceived problematic pornography use: Beyond individual differences and religiosity. Archives of Sexual Behavior, 48(2), 437–441. 10.1007/s10508-018-1292-6. PubMed DOI

Vaillancourt-Morel, M.-P., Blais-Lecours, S., Labadie, C., Bergeron, S., Sabourin, S., & Godbout, N. (2017). Profiles of cyberpornography use and sexual well-being in adults. Journal of Sexual Medicine, 14(1), 78–85. 10.1016/j.jsxm.2016.10.016. PubMed DOI

Vansteenkiste, M., & Ryan, R. M. (2013). On psychological growth and vulnerability: Basic psychological need satisfaction and need frustration as a unifying principle. Journal of Psychotherapy Integration, 23(3), 263–280. 10.1037/a0032359. DOI

Werner, M., Štulhofer, A., Waldorp, L., & Jurin, T. (2018). A network approach to hypersexuality: Insights and clinical implications. Journal of Sexual Medicine, 15(3), 410–415. 10.1016/j.jsxm.2018.01.009. PubMed DOI

Wéry, A., Vogelaere, K., Challet-Bouju, G., Poudat, F.-X., Caillon, J., Lever, D., … Grall-Bronnec, M. (2016). Characteristics of self-identified sexual addicts in a behavioral addiction outpatient clinic. Journal of Behavioral Addictions, 5(4), 623–630. 10.1556/2006.5.2016.071. PubMed DOI PMC

Wordecha, M., Wilk, M., Kowalewska, E., Skorko, M., Łapiński, A., & Gola, M. (2018). “Pornographic binges” as a key characteristic of males seeking treatment for compulsive sexual behaviors: Qualitative and quantitative 10-week-long diary assessment. Journal of Behavioral Addictions, 7(2), 433–444. 10.1556/2006.7.2018.33. PubMed DOI PMC

World Health Organization (2022). International statistical classification of diseases and related health problems (11th ed.). https://icd.who.int/.