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Pornography addiction is the scientifically controversial^[1] application of an addiction model to the use of pornography.^[2] Pornography use may be part of compulsive behavior, with negative consequences to one's physical, mental, social, or financial well-being. While the World Health Organization's ICD-11 (2022) has recognized compulsive sexual behaviour disorder (CSBD) as an "impulsive control disorder",^[3] CSBD is not an addiction,^[4]^[5] and the American Psychiatric Association's DSM-5 (2013) and the DSM-5-TR (2022) do not classify compulsive pornography consumption as a mental disorder or a behavioral addiction.^[4]^[6]^[7]

Problematic Internet pornography viewing is the viewing of Internet pornography that is problematic for an individual due to personal or social reasons, including the excessive time spent viewing pornography instead of interacting with others and the facilitation of procrastination. Individuals may report depression, social isolation, career loss, decreased productivity, or financial consequences as a result of their excessive Internet pornography viewing impeding their social lives.^[8]

Symptoms and diagnosis

Universally accepted diagnostic criteria for pornography addiction or problematic pornography viewing do not exist.^{[citation needed]} Pornography addiction is often defined operationally by the frequency of pornography viewing and negative consequences.^[9] 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.^[10]

Pornography use has also been associated with many issues such as Sexual Satisfaction, Marital Quality, and Gender Violence. These are detailed in Opposition to Pornography.

A proposed diagnosis for hypersexual disorder includes pornography as a subtype of this disorder. It includes criteria such 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.^[11] 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.^{[citation needed]}

According to the American Society of Addiction Medicine, some psychological and behavioral changes characteristic of addiction brain changes include addictive cravings, impulsiveness, weakened executive function, desensitization, and dysphoria.^[12] BOLD fMRI results have shown that individuals diagnosed with compulsive sexual behavior (CSB) show enhanced cue reactivity in brain regions associated traditionally with drug-cue reactivity.^[13]^[14] These regions include the amygdala and the ventral striatum.^[13]^[14] Men without CSB who had a long history of viewing pornography exhibited a less intense response to pornographic images in the left ventral putamen, possibly suggestive of desensitization.^[13]

Neuropsychopharmacological and psychological researches on pornography addiction conducted between 2015 and 2021 have concluded that most studies have been focused entirely or almost exclusively on men in anonymous settings, and the findings are contradictory.^[14] Some researchers support the idea that pornography addiction qualifies as a form of behavioral addiction into the umbrella construct of hypersexual behavior and/or a subset of compulsive sexual behavior (CSB),^[15] and should be treated as such, whereas others have detected the increased activation of ventral striatal reactivity in men for cues predicting erotic but not monetary rewards and cues signaling erotic pictures, therefore suggesting similarities between pornography addiction and conventional addiction disorders.^[14]

Despite the fact that pornography is being spuriously^[16] indicted as a public health crisis in the United States and elsewhere,^[17]^[18] with problematic Internet and online pornography use reported to constitute an increasing burden on public mental health since the 2000s, psychopathological models and diagnostic criteria have lacked consensus, and the body of evidence on the effectiveness of therapeutic approaches is still scarce.^{[citation needed]}

The repeated cross-sectional surveys did not find any consistent associations across years between poor mental health and ever having watched pornography or the frequency of watching pornography.^[19]
— Svedin et. al. (2023)

Svedin et. al. found that moderate consumption of pornography is associated with good mental health in boys, while both extremes (too much or too few) yielded worse mental health.^[19] Watching deviant (non-mainstream) pornography was associated with worse mental health in boys, but girls were unaffected.^[19]

Diagnostic status

Pornography addiction is a controversial concept, since it appears to be "largely morally, ideologically, and politically motivated."^[20] Although it is a "nice theory", empirical support for it is largely missing,^[21] and the "industry of porn/sex addiction is based on conservative moral values around sexuality that intrude into clinical practice".^[21] Julie Sale stated "No-one refutes that clients access therapy for help with sexual behaviours that they feel they have no control over. The issue is how these client experiences are conceptualised and how the clinical formulation informs treatment."^[22]

The status of pornography addiction as an addictive disorder, rather than simply a compulsivity, has been hotly contested.^[23]^{[unreliable medical source?]}^[24]^{[unreliable medical source?]} Furthermore, research suggests that the use of a pornography addiction label may indicate a socially (as opposed to clinically) driven nosology.^[8]

It is worth considering whether the apparent epidemic of self-diagnosed pornography addicts seeking help today perhaps represents the ready uptake of a relatively new way to describe one's problematic behaviour, and not the development of a modern disease entity whose description should dictate its treatment.^[8]
— Kris Taylor, Nosology and metaphor: How pornography viewers make sense of pornography addiction

In November 2016, the American Association of Sexuality Educators, Counselors and Therapists (AASECT) issued a position statement on sex/porn addiction which states that AASECT "does not find sufficient empirical evidence to support the classification of sex addiction or porn addiction as a mental health disorder, and does not find the sexual addiction training and treatment methods and educational pedagogies to be adequately informed by accurate human sexuality knowledge. Therefore, it is the position of AASECT that linking problems related to sexual urges, thoughts or behaviors to a porn/sexual addiction process cannot be advanced by AASECT as a standard of practice for sexuality education delivery, counseling or therapy."^[25]

The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) includes a new section for behavioral addictions, but includes only one disorder: pathological gambling.^[26] One other behavioral addiction, internet gaming disorder, appears in the conditions proposed for further study in DSM-5.^[26] Psychiatrists cited a lack of research support for refusing to include other behavioral disorders, such as pornography, at the time.^[26]

Porn addiction is not a diagnosis in DSM-5 (or any previous version).^[6]^[7]^[27] "Viewing pornography online" is mentioned verbatim in the DSM-5,^[26] but it is not considered a mental disorder either.^[6]^[7]^[27]

When the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) was being drafted, experts considered a proposed diagnostic addiction called hypersexual disorder, which also included a pornography subtype. But in the end, reviewers determined that there wasn't enough evidence to include hypersexual disorder or its subtypes in the 2013 edition.^[6]
— Kirsten Weir, Is pornography addictive?

A number of studies have found neurological markers of addiction in internet porn users,^[28]^[29]^[30] which is consistent with a large body of research finding similar markers in other kinds of problematic internet users.^[29] Yet other studies found that critical biomarkers of addiction were missing,^[31] and most addiction biomarkers have never been demonstrated for pornography.^[32]^{[failed verification]}

The International Classification of Disorders 11 (ICD-11) rejected "pornography addiction".^[4]^[33]^[34] Specifically, the World Health Organization (WHO) wrote: "Based on the limited current data, it would therefore seem premature to include [problematic Internet use] in ICD-11."^[35]

However, ICD-11 does include the "Compulsive sexual behaviour disorder" (CSBD)^[36] in the "impulse control disorders" section. It is defined as "a persistent pattern of failure to control intense, repetitive sexual impulses or urges resulting in repetitive sexual behaviour." David J. Ley argued that that is not an endorsement of the concept of pornography addiction.^[37] ICD also specifically excludes anyone from this diagnosis whose distress is due to moral conflict alone, yet moral incongruence is the strongest predictor of believing one is addicted to porn.^[38] Note that two studies now contradict this, finding that narcissism,^[34] especially antagonist narcissism,^[39] predicts identification as a pornography addict.

Introductory psychology textbook authors Coon, Mitterer and Martini, passingly mentioning NoFap, speak of pornography as a "supernormal stimulus" but use the model of compulsion rather than addiction.^[40] Addiction and compulsion are models of mental disorders which cancel each other out,^[41]^[42]^[43] the term "addiction" being deprecated,^[44] but ICD-11 does not support the existence of "porn addiction"/"sex addiction".^[37]^[45]

DSM-5-TR, published in March 2022, does not recognize a diagnosis of sexual addiction/compulsion (which would include internet pornography viewing).^[4]^[46]^[47]

ICD-11 has added pornography to CSBD.^[48] However, this is categorized as an impulse control disorder, not an addictive disorder.^[48]^[45] It has been argued that the CSBD diagnosis is not based upon sex research.^[49]

Neither DSM-5, nor DSM-5-TR, nor ICD-10, nor ICD-11 recognize sex addiction or porn addiction as a valid diagnosis.^[4]^[34]^[45] Rothman has stated "pornography is not yet clearly established as a risk factor for multiple health outcomes".^[50]

However, pornography addiction is not presently considered a diagnosable condition according to the DSM. Alternatives to the DSM, such as the ICD-11, also have not subscribed to the addiction model for pornography, though they recognize that people may become compulsive about its use.
— Rothman 2021, p. 103

A 2022 book by McKee, Litsou, Byron, and Ingham casts serious doubts upon the model of "porn addiction", suggesting that sexual shame should be blamed, instead of pornography.^[51] They note that much of the research on the effects of pornography often confuses correlation with causation,^[52] and that much pornography research has been normative (i.e. moralistic) instead of descriptive.^[52]

Treatment

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.^[53] Acceptance and commitment therapy has also been shown to be a potentially effective treatment for problematic internet pornography viewing.^{[citation needed]}

Online pornography

Some clinicians and support organizations recommend voluntary use of Internet content-control software, internet monitoring, or both, to manage online pornography use.^[54]^[55]^[56] 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.^[54] Cognitive therapist Mary Anne Layden suggested that filters may be useful in maintaining environmental control.^[56] Internet behavior researcher David Delmonico stated that, despite their limitations, filters may serve as a "frontline of protection."^[55]

Medications

Studies of those with non-paraphilic expressions of hypersexuality have hypothesized that various mood disorders, as defined in the DSM, may occur more frequently in sexually compulsive men.^[57]^[58]^[59]

Compulsive sexual behavior has been treated with antidepressants including SSRIs and serotonin-norepinephrine reuptake inhibitors, Naltrexone (a medication used to inhibit reward mechanisms in opiate or alcohol addictions), other mood-stabilizers, and anti-androgens.

Epidemiology

A 2017 study using a representative sample of Australians researched distress about sex video use.^[60] It found that of 10,131 women surveyed, 0.5% of women agreed with the statement that they were "addicted" to pornography; 1.2% (of 4,218 who viewed) when limited to women who say they viewed sex films. The comparable figure limiting to men who view sex films was 4.4%. This was without any clinical screening that should eliminate primary disorders (e.g., depression) or religious-based concerns, so these should be considered high-end estimates for potential disorders, if any exist.

Most studies of rates use a convenience sample. One 2000 study of a convenience sample of 9,265 people found that 1% of Internet users have concerns about their Internet use and 17% of users meet criteria for problematic sexual compulsivity, meaning they score above one standard deviation of the mean on the Kalichman Sexual Compulsivity Scale.^[61] A survey of 84 college-age males found that 20–60% of a sample of college-age males who use pornography found it to be problematic.^[62] Research on internet addiction disorder indicates rates may range from 1.5 to 8.2% in Europeans and Americans.^[63]

A 2019 study found that the average frequency of use for those self-describing as addicted to porn was about ten times per year.^[64] The study found this identification correlated with male gender, higher frequency of use, and belief that pornography was morally wrong (whether for religious or other reasons).^[65]

A review paper about pornography consumption notes that sex addiction is correlated with narcissism.^[66]

Society and culture

Support groups

Several support groups exist for people who wish to quit pornography use and/or believe themselves to be addicted to pornography. Twelve-step programs such as Sex Addicts Anonymous (SAA), Sexaholics Anonymous (SA), Sex and Love Addicts Anonymous (SLAA), Sexual Recovery Anonymous (SRA), and Sexual Compulsives Anonymous (SCA) are fellowships of men and women who share their experience, strength and hope with each other so they may overcome their common problem and help others recover from addiction or dependency by using the twelve-step program borrowed from Alcoholics Anonymous (AA) and other recovery tools.^[67]

NoFap is website and community forum founded in 2011 that serves as a support group for those who wish to give up pornography and masturbation.^[68] It serves as a support group for those who wish to avoid the use of pornography, masturbation, and/or sexual intercourse.^[68]^[69]^[70] Recent peer-reviewed data highlighted considerable levels of misogyny along with a poor understanding of human sexuality and relationships within this online community.^[71] Sociologist Kelsy Burke, author of The Pornography Wars, believes that this misogyny arises from blaming the female-dominated profession of pornography for men's personal problems.^[64] The Daily Dot and Der Spiegel linked NoFap to recent gender-based murders and breeding domestic terrorism.^[72]^[73]

Fight the New Drug, a Salt Lake City-based non-profit organization founded by members of the Church of Jesus Christ of Latter-day Saints,^[74] is a non-legislative organization which claims to seek to inform and educate individuals regarding pornography usage with science and personal stories. It is aimed at the youth demographic. There is also a PornFree reddit group which focuses on giving up porn rather than masturbation.^[75]^[76]

Celebrate Recovery is a Christian inter-denominational twelve-step program with about 35,000 available groups and is open to any person who is struggling with life's bad habits, hurts, and hang-ups.^[77] Celebrate Recovery was started in 1991 at Saddleback Church in California, and their program is based on the Beatitudes from the biblical Sermon on the Plain and the twelve-step program from Alcoholics Anonymous.^[78]

Religious and political factors

According to professor E. T. M. Laan [nl], a sexologist working for the Academic Medical Center, it is usually the American religious right which claims the existence of pornography addiction and such claims are rare (scarce) among sexologists.^[79] A 2018 meta-analysis showed a correlation between a person being religious and perceiving themself as having a pornography addiction, possibly due to people using pornography despite their religion prohibiting it.^[80]^[81]^[82]

According to Addicted to Lust: Pornography in the Lives of Conservative Protestants (2019) written by Samuel L. Perry, professor of sociology at the University of Oklahoma, conservative Protestants in the United States are characterized by a "sexual exceptionalism" related to their consumption of pornography due to certain pervasive beliefs within the Conservative Protestant subculture, which entails cognitive dissonance associated with the unfounded conviction to be addicted to pornography, psychological distress, and intense feelings of guilt, shame, self-loathing, depression, and sometimes withdrawal from faith altogether.^[83]^[84]

Perry's book received widespread media coverage^[84]^[85] and his findings were criticized by Lyman Stone of the Evangelical magazine Christianity Today, which asserted that both the quantitative and qualitative statistical data collected by Perry demonstrate that the consumption of pornography in the United States is significantly lower among church-attending Protestant Christians compared to other religious groups, and declared that "Protestant men today who attend church regularly are basically the only men in America still resisting the cultural norm of regularized pornography use".^[85]

The overwhelming majority of all websites and YouTube channels devoted to anti-masturbation and anti-porn addiction propaganda, channels and websites supporting NoFap included, are, according to various sources, owned by far-right Christian fundamentalists and conservative biblical inerrantists, and also are entirely political in nature.^[68]^[86] Various psychologists, medical doctors, and social scientists have contended that traditional Christian concerns over combating sexual thoughts, desires, and activities, including masturbation,^[87]^[88]^[89]^[90]^[91] can be seen as unhealthy and unwholesome. This may also apply to secular advocacy of anti-pornography and anti-masturbation,^[17]^[18] including 16 U.S. states' legislatures which have declared that pornography is a "public health crisis".^[17]^[92]

The American Psychiatric Association had by then already dismissed such moral panic ("political stunt")^[17] in DSM-5 (published in 2013),^[6] and DSM-5-TR, published in March 2022, does not recognize a diagnosis of sexual addiction (which would include internet pornography viewing).^[46]^[47]

Emily F. Rothman, Professor of Community Health Sciences at the Boston University School of Public Health, stated in 2021 that "the professional public health community is not behind the recent push to declare pornography a public health crisis".^[16] The ideas supporting the "crisis" have been described as pseudoscientific.^[93]

Sexual violence, partner violence, anxiety, depression, compulsive pornography use, and commercial sexual exploitation are public health problems, and there is a possibility that pornography exacerbates these problems. Given that possibility, we need to know more about whether, how, and why pornography influences social norms as well as individuals’ behavior, and what we can do to address that influence if it is harmful. It is also important to be aware that framing pornography as a public health issue has been used as a rhetorical trick by right-wing groups to promote a conservative social agenda at odds with public health goals. Public health professionals should sponsor rigorous research on the possible negative effects of pornography on society and individuals, counter misinformation, and use evidence to move forward with policy decisions.
— Rothman 2021, p. 14

In many cases, sexual addiction therapy applied to gay men is akin to conversion therapy.^[94]

Mainstream media

In 2013, American actor Joseph Gordon-Levitt wrote, directed, and starred in the comedy-drama film Don Jon, in which the protagonist is addicted to pornography.^[95] In an interview to promote the film, Gordon-Levitt discussed what he referred to as the "fundamental difference between a human being and an image on a screen".^[96]

In 2014, American actor Terry Crews talked about his long-standing pornography addiction, which he said had seriously affected his marriage and life and which he was able to overcome only after entering rehab in 2009.^[97] He now takes an active role in speaking out about pornography addiction and its impact.^[98]^[99]^[100]

In 2015, English comedian Russell Brand appeared in videos by American anti-pornography group Fight the New Drug, in which he discussed pornography and its harmful effects.^[101]

In 2016, American comedian Chris Rock and his wife, Malaak Compton, divorced after 20 years of marriage,^[102] which Rock attributed to his infidelity and pornography addiction.^[103] He later discussed the details of his pornography addiction in his 2018 stand-up comedy special Tamborine.^[104]

References

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^ Gerymski, Rafał; Cisek, Aleksandra (2023). "Pornography: Addiction". Encyclopedia of Sexual Psychology and Behavior. Springer, Cham. pp. 1–8. doi:10.1007/978-3-031-08956-5_1867-1. ISBN 978-3-031-08956-5.
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^ ^a ^b ^c ^d ^e Martinez-Gilliard, Erin (2023). Sex, Social Justice, and Intimacy in Mental Health Practice: Incorporating Sexual Health in Approaches to Wellness. Taylor & Francis. p. unpaginated. ISBN 978-1-000-84578-5. Archived from the original on 4 April 2023. Retrieved 5 March 2023. 'Sex addiction' is also referred to as a diagnosis or presenting problem. Sex addiction is not a diagnosis in the DSM-5-TR and identified as Compulsive Sexual Behavior in the ICD-11 rather than an issue of addiction.
^
- Hall, Timothy M.; Bershad, Anya; Shoptaw, Steven (2024-02-15). "53. Compulsive Sexual Behaviors". In Miller, Shannon C.; Rosenthal, Richard N.; Levy, Sharon; Saxon, Andrew J.; Tetrault, Jeanette M.; Wakeman, Sarah E. (eds.). The ASAM Principles of Addiction Medicine. Philadelphia, PA: Lippincott Williams & Wilkins. p. unpaginated. ISBN 978-1-9752-0157-9. Proposals for two constructs related to compulsive sexual behaviors , sexual addiction and hypersexual disorder, have been repeatedly rejected from inclusion in recent editions of the Diagnostic and Statistical Manual of Mental Disorders (DSM) for lack of empirical support and lack of consensus as to definition. [...] (CSBD), has been included in the International Classification of Diseases, 11th edition (ICD-11), under impulse control disorders rather than as an addiction disorder. CSBD has significant differences from substance use disorders (SUD) [...]
- Dhuffar-Pottiwal, Manpreet (2022). Pontes, Halley M. (ed.). Behavioral Addictions: Conceptual, Clinical, Assessment, and Treatment Approaches. Studies in Neuroscience, Psychology and Behavioral Economics. Springer International Publishing. p. 163. ISBN 978-3-031-04772-5. Retrieved 27 July 2023. Given that we do not yet have definitive information on whether the processes involved in the onset and maintenance of the disorder are equivalent to substance abuse disorders, gambling, and gaming (Kraus et al. 2016), CSBD is not included in the grouping of disorders due to substance and addictive behaviors, but rather in that of impulse control disorders (Kraus et al. 2018).
- Bowman, Todd (2022). Reclaiming Sexual Wholeness: An Integrative Christian Approach to Sexual Addiction Treatment. Zondervan Academic. p. 161. ISBN 978-0-310-09311-4. Retrieved 27 July 2023.
- Ley, David J. (24 January 2018). "Compulsive Sexual Behavior Disorder in ICD-11". Psychology Today. Retrieved 27 March 2021.
- Sassover, Eli; Weinstein, Aviv (29 September 2020). "Should compulsive sexual behavior (CSB) be considered as a behavioral addiction? A debate paper presenting the opposing view". Journal of Behavioral Addictions. 11 (2). Akademiai Kiado Zrt.: 166–179. doi:10.1556/2006.2020.00055. ISSN 2062-5871. PMC 9295215. PMID 32997646. S2CID 222167039.
- Neves, Silva (2021). Compulsive Sexual Behaviours: A Psycho-Sexual Treatment Guide for Clinicians. Taylor & Francis. p. unpaginated. ISBN 978-1-000-38710-0. Archived from the original on 19 April 2023. Retrieved 26 March 2022. ... materials in ICD-11 make very clear that CSBD is not intended to be interchangeable with sex addiction, but rather is a substantially different diagnostic framework
^ ^a ^b ^c ^d ^e Weir, Kirsten (April 2014). "Is pornography addictive?". Monitor on Psychology. 45 (4): 46. ISSN 1529-4978. OCLC 612512821. Archived from the original on 2014-04-05.
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^ Grant, Jon E.; Potenza, Marc N.; Weinstein, Aviv; Gorelick, David A. (2010). "Introduction to behavioral addictions". The American Journal of Drug and Alcohol Abuse. 36 (5): 233–241. doi:10.3109/00952990.2010.491884. ISSN 1097-9891. PMC 3164585. PMID 20560821.
^ Kafka, M. P. (2009). "Hypersexual Disorder: A Proposed Diagnosis for DSM-V" (PDF). Archives of Sexual Behavior. 39 (2): 377–400. doi:10.1007/s10508-009-9574-7. PMID 19937105. S2CID 2190694. Archived (PDF) from the original on 2016-04-04. Retrieved 2016-11-30.
^ "ASAM Definition of Addiction". 19 April 2011. Archived from the original on 29 February 2016. Retrieved 7 November 2016.
^ ^a ^b ^c Kraus, Shane W.; Voon, Valerie; Potenza, Marc N. (December 2016). "Should compulsive sexual behavior be considered an addiction?". Addiction. 111 (12): 2097–2106. doi:10.1111/add.13297. ISSN 0965-2140. PMC 4990495. PMID 26893127. S2CID 11261106.
^ ^a ^b ^c ^d Gola, Mateusz; Wordecha, Małgorzata; Sescousse, Guillaume; Lew-Starowicz, Michał; Kossowski, Bartosz; Wypych, Marek; Makeig, Scott; Potenza, Marc N.; Marchewka, Artur (September 2017). "Can Pornography be Addictive? An fMRI Study of Men Seeking Treatment for Problematic Pornography Use" (PDF). Neuropsychopharmacology. 42 (10). Springer Nature: 2021–2031. doi:10.1038/npp.2017.78. eISSN 1740-634X. ISSN 0893-133X. OCLC 815994337. PMC 5561346. PMID 28409565. S2CID 13759729. Archived (PDF) from the original on 20 March 2019. Retrieved 1 August 2021.
^ Hilton, Donald L. (2013). "Pornography addiction – a supranormal stimulus considered in the context of neuroplasticity". Socioaffective Neuroscience & Psychology. 3 (1): 20767. doi:10.3402/snp.v3i0.20767. ISSN 2000-9011. PMC 3960020. PMID 24693354.
^ ^a ^b Rothman 2021, p. 2: "The professional public health community is not behind the recent push to declare pornography a public health crisis."
^ ^a ^b ^c ^d Nelson, Kimberly M.; Rothman, Emily F. (February 2020). Morabia, Alfredo (ed.). "Should Public Health Professionals Consider Pornography a Public Health Crisis?". American Journal of Public Health. 110 (2). American Public Health Association: 151–153. doi:10.2105/AJPH.2019.305498. ISSN 1541-0048. PMC 6951382. PMID 31913670. S2CID 210121251.
^ ^a ^b Rothman, Emily F. (2021). "Pornography as a US Public Health Problem". Pornography and Public Health. Oxford and New York: Oxford University Press. pp. 1–15. doi:10.1093/oso/9780190075477.003.0001. ISBN 978-0-19-007547-7. LCCN 2021013439. Archived from the original on 2023-04-19. Retrieved 2021-09-26.
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^ Williams, Thomas & Prior 2022.
^ ^a ^b Baird, Amee (2020). "9. PORN ON THE TRAIN (AND ON THE BRAIN)". Sex in the Brain: How Seizures, Strokes, Dementia, Tumors, and Trauma Can Change Your Sex Life. Columbia University Press. p. unpaginated. doi:10.7312/bair19590-010. ISBN 978-0-231-55155-7. Retrieved 7 November 2024. spoke with David Ley
^ Sale, Julie "Preface" in Neves 2021, p. 5
^ Steele, V.; Prause, N.; Staley, C.; Fong, G. W. (2013). "Sexual Desire, not Hypersexuality, is Related to Neurophysiological Responses Elicited by Sexual Images". Socioaffective Neuroscience & Psychology. 3: 20770. doi:10.3402/snp.v3i0.20770. PMC 3960022. PMID 24693355.
^ Hilton, Donald L. (21 February 2014). "'High desire', or 'merely' an addiction? A response to Steele et al". Socioaffective Neuroscience & Psychology. 4 (1): 23833. doi:10.3402/snp.v4.23833. PMC 3975913. PMID 24707350.
^ "AASECT Position on Sex Addiction". April 2018. Archived from the original on 28 March 2019. Retrieved 25 April 2019. AASECT 1) does not find sufficient empirical evidence to support the classification of sex addiction or porn addiction as a mental health disorder, and 2) does not find the sexual addiction training and treatment methods and educational pedagogies to be adequately informed by accurate human sexuality knowledge.
^ ^a ^b ^c ^d American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders (Fifth ed.). Arlington, VA: American Psychiatric Publishing. pp. 481, 797–798. ISBN 978-0-89042-555-8. In addition to the substance-related disorders, this chapter also includes gambling disorder, reflecting evidence that gambling behaviors activate reward systems similar to those activated by drugs of abuse and produce some behavioral symptoms that appear comparable to those produced by the substance use disorders. Other excessive behavioral patterns, such as Internet gaming, have also been described, but the research on these and other behavioral syndromes is less clear. Thus, groups of repetitive behaviors, which some term behavioral addictions, with such subcategories as "sex addiction," "exercise addiction," or "shopping addiction," are not included because at this time there is insufficient peer-reviewed evidence to establish the diagnostic criteria and course descriptions needed to identify these behaviors as mental disorders. ... Excessive use of the Internet not involving playing of online games (e.g., excessive use of social media, such as Facebook; viewing pornography online) is not considered analogous to Internet gaming disorder, and future research on other excessive uses of the Internet would need to follow similar guidelines as suggested herein. Excessive gambling online may qualify for a separate diagnosis of gambling disorder.
^ ^a ^b Since it is neither of two behavioral addictions mentioned above.
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^
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^ ^a ^b ^c
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External links

Pornography addiction at Medical News Today

[contro-1] 
Sale, Julie "Preface" in Neves 2021, p. 5
Williams, D.J.; Thomas, Jeremy N.; Prior, Emily (2022). "Are Sex and Pornography Addiction Valid Disorders? Adding a Leisure Science Perspective to the Sexological Critique". In Berdychevsky, Liza; Carr, Neil (eds.). Innovation and Impact of Sex as Leisure in Research and Practice. Taylor & Francis. pp. 306–321. doi:10.1080/01490400.2020.1712284. ISBN 978-1-000-58943-6. Retrieved 7 November 2024.
Marks, David F.; Murray, Michael; Estacio, Emee Vida (2018). Health Psychology: Theory, Research and Practice. SAGE Publications. p. 229. ISBN 978-1-5264-1206-5. Retrieved 7 November 2024.
Hunt, Adam; Merola, Giuseppe Pierpaolo; Carpenter, Tom; Jaeggi, Adrian V. (2024-04-01). "Evolutionary perspectives on substance and behavioural addictions: Distinct and shared pathways to understanding, prediction and prevention". Neuroscience & Biobehavioral Reviews. 159: 105603. doi:10.1016/j.neubiorev.2024.105603. ISSN 0149-7634.

[2] Sale, Julie "Preface" in Neves 2021, p. 5

[3] Williams, D.J.; Thomas, Jeremy N.; Prior, Emily (2022). "Are Sex and Pornography Addiction Valid Disorders? Adding a Leisure Science Perspective to the Sexological Critique". In Berdychevsky, Liza; Carr, Neil (eds.). Innovation and Impact of Sex as Leisure in Research and Practice. Taylor & Francis. pp. 306–321. doi:10.1080/01490400.2020.1712284. ISBN 978-1-000-58943-6. Retrieved 7 November 2024.

[4] Marks, David F.; Murray, Michael; Estacio, Emee Vida (2018). Health Psychology: Theory, Research and Practice. SAGE Publications. p. 229. ISBN 978-1-5264-1206-5. Retrieved 7 November 2024.

[5] Hunt, Adam; Merola, Giuseppe Pierpaolo; Carpenter, Tom; Jaeggi, Adrian V. (2024-04-01). "Evolutionary perspectives on substance and behavioural addictions: Distinct and shared pathways to understanding, prediction and prevention". Neuroscience & Biobehavioral Reviews. 159: 105603. doi:10.1016/j.neubiorev.2024.105603. ISSN 0149-7634.

[2] Gerymski, Rafał; Cisek, Aleksandra (2023). "Pornography: Addiction". Encyclopedia of Sexual Psychology and Behavior. Springer, Cham. pp. 1–8. doi:10.1007/978-3-031-08956-5_1867-1. ISBN 978-3-031-08956-5.

[3] "Compulsive sexual behavior disorder". World Health Organization (ICD-11). Archived from the original on 2018-08-01. Retrieved 2022-03-25.

[Martinez-Gilliard_2023_p._113-4] Martinez-Gilliard, Erin (2023). Sex, Social Justice, and Intimacy in Mental Health Practice: Incorporating Sexual Health in Approaches to Wellness. Taylor & Francis. p. unpaginated. ISBN 978-1-000-84578-5. Archived from the original on 4 April 2023. Retrieved 5 March 2023. 'Sex addiction' is also referred to as a diagnosis or presenting problem. Sex addiction is not a diagnosis in the DSM-5-TR and identified as Compulsive Sexual Behavior in the ICD-11 rather than an issue of addiction.

[Pontes_2022_p._163-5] 
Hall, Timothy M.; Bershad, Anya; Shoptaw, Steven (2024-02-15). "53. Compulsive Sexual Behaviors". In Miller, Shannon C.; Rosenthal, Richard N.; Levy, Sharon; Saxon, Andrew J.; Tetrault, Jeanette M.; Wakeman, Sarah E. (eds.). The ASAM Principles of Addiction Medicine. Philadelphia, PA: Lippincott Williams & Wilkins. p. unpaginated. ISBN 978-1-9752-0157-9. Proposals for two constructs related to compulsive sexual behaviors , sexual addiction and hypersexual disorder, have been repeatedly rejected from inclusion in recent editions of the Diagnostic and Statistical Manual of Mental Disorders (DSM) for lack of empirical support and lack of consensus as to definition. [...] (CSBD), has been included in the International Classification of Diseases, 11th edition (ICD-11), under impulse control disorders rather than as an addiction disorder. CSBD has significant differences from substance use disorders (SUD) [...]
Dhuffar-Pottiwal, Manpreet (2022). Pontes, Halley M. (ed.). Behavioral Addictions: Conceptual, Clinical, Assessment, and Treatment Approaches. Studies in Neuroscience, Psychology and Behavioral Economics. Springer International Publishing. p. 163. ISBN 978-3-031-04772-5. Retrieved 27 July 2023. Given that we do not yet have definitive information on whether the processes involved in the onset and maintenance of the disorder are equivalent to substance abuse disorders, gambling, and gaming (Kraus et al. 2016), CSBD is not included in the grouping of disorders due to substance and addictive behaviors, but rather in that of impulse control disorders (Kraus et al. 2018).
Bowman, Todd (2022). Reclaiming Sexual Wholeness: An Integrative Christian Approach to Sexual Addiction Treatment. Zondervan Academic. p. 161. ISBN 978-0-310-09311-4. Retrieved 27 July 2023.
Ley, David J. (24 January 2018). "Compulsive Sexual Behavior Disorder in ICD-11". Psychology Today. Retrieved 27 March 2021.
Sassover, Eli; Weinstein, Aviv (29 September 2020). "Should compulsive sexual behavior (CSB) be considered as a behavioral addiction? A debate paper presenting the opposing view". Journal of Behavioral Addictions. 11 (2). Akademiai Kiado Zrt.: 166–179. doi:10.1556/2006.2020.00055. ISSN 2062-5871. PMC 9295215. PMID 32997646. S2CID 222167039.
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[10] Hall, Timothy M.; Bershad, Anya; Shoptaw, Steven (2024-02-15). "53. Compulsive Sexual Behaviors". In Miller, Shannon C.; Rosenthal, Richard N.; Levy, Sharon; Saxon, Andrew J.; Tetrault, Jeanette M.; Wakeman, Sarah E. (eds.). The ASAM Principles of Addiction Medicine. Philadelphia, PA: Lippincott Williams & Wilkins. p. unpaginated. ISBN 978-1-9752-0157-9. Proposals for two constructs related to compulsive sexual behaviors , sexual addiction and hypersexual disorder, have been repeatedly rejected from inclusion in recent editions of the Diagnostic and Statistical Manual of Mental Disorders (DSM) for lack of empirical support and lack of consensus as to definition. [...] (CSBD), has been included in the International Classification of Diseases, 11th edition (ICD-11), under impulse control disorders rather than as an addiction disorder. CSBD has significant differences from substance use disorders (SUD) [...]

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[88] Gnuse, Robert K. (May 2015). "Seven Gay Texts: Biblical Passages Used to Condemn Homosexuality". Biblical Theology Bulletin. 45 (2). SAGE Publications on behalf of Biblical Theology Bulletin Inc.: 68–87. doi:10.1177/0146107915577097. ISSN 1945-7596. S2CID 170127256.

[89] Sauer, Michelle M. (2015). "The Unexpected Actuality: "Deviance" and Transgression". Gender in Medieval Culture. London: Bloomsbury Academic. pp. 74–78. doi:10.5040/9781474210683.ch-003. ISBN 978-1-4411-2160-8. Archived from the original on 2023-04-19. Retrieved 2022-01-12.

[90] Frontain, Raymond-Jean (2003). "Introduction". In Frontain, Raymond-Jean (ed.). Reclaiming the Sacred: The Bible in Gay and Lesbian Culture (2nd ed.). New York and London: Harrington Park Press. pp. 1–24, 53, 55. ISBN 978-1-56023-355-8. LCCN 2002068889. Archived from the original on 2023-04-19. Retrieved 2022-01-12.

[91] Palmer, Randall; Winner, Lauren F. (2005) [2002]. "Protestants and Homosexuality". Protestantism in America. Columbia Contemporary American Religion Series. New York: Columbia University Press. pp. 149–178. ISBN 978-0-231-11131-7. LCCN 2002023859. Archived from the original on 2023-04-19. Retrieved 2022-01-12.

[Governing_2019-92] Quinn, Mattie (17 July 2019). "Is Porn a Public Health Crisis? 16 States Say Yes". Governing. Archived from the original on 12 January 2022. Retrieved 12 January 2022.

[de_Jong_Faulkenberry_Konda_Joyner_2022_p.-93] Jong, David C.; Faulkenberry, Rachel S.; Konda, Olivia; Joyner, Berkley (2022). "Masturbation". Reference Module in Neuroscience and Biobehavioral Psychology. Elsevier. pp. 369–378. doi:10.1016/b978-0-323-91497-0.00075-8. ISBN 978-0-323-91498-7.

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Neves, Silva (2023). "Chapter 11. MSM and compulsive sexual behaviours. "Sex addiction" and conversion practices". In Neves, Silva; Davies, Dominic (eds.). Erotically Queer: A Pink Therapy Guide for Practitioners. Taylor & Francis. pp. 174–192. doi:10.4324/9781003260608-12. ISBN 978-1-000-86221-8. Retrieved 17 November 2024. When those aversion techniques are applied to MSM, they can be particularly harmful as they are akin to what I would consider conversion practices.
Neves 2021, p. unpaginated: "I don't believe that all therapists offering a 'sex addiction' treatment are unethical. But I think that it is possible that many well-meaning and excellent therapists can practice 'conversion therapy' accidentally [...] I fear that there are many more harmed clients who do not speak up."
Neves, Silva (2022). Sexology: The Basics. Taylor & Francis. p. unpaginated. ISBN 978-1-000-77488-7. Retrieved 17 November 2024. can be at high risk of crossing into "conversion therapy" because of their lack of robust knowledge in contemporary sexology, mistaking normative sexual behaviours for a pathology.
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Francis, Charles (2023). Archive Activism: Memoir of a "Uniquely Nasty" Journey. University of North Texas Press. p. 187. ISBN 978-1-57441-920-7. Retrieved 17 November 2024.
Meyer, Monica (2018). Bartlik, Barbara; Espinosa, Geovanni; Mindes, Janet; Weil, Andrew (eds.). Integrative Sexual Health. Weil Integrative Medicine Library. Oxford University Press. p. 348. ISBN 978-0-19-022590-2. Retrieved 17 November 2024.

[110] Neves, Silva (2023). "Chapter 11. MSM and compulsive sexual behaviours. "Sex addiction" and conversion practices". In Neves, Silva; Davies, Dominic (eds.). Erotically Queer: A Pink Therapy Guide for Practitioners. Taylor & Francis. pp. 174–192. doi:10.4324/9781003260608-12. ISBN 978-1-000-86221-8. Retrieved 17 November 2024. When those aversion techniques are applied to MSM, they can be particularly harmful as they are akin to what I would consider conversion practices.

[111] Neves 2021, p. unpaginated: "I don't believe that all therapists offering a 'sex addiction' treatment are unethical. But I think that it is possible that many well-meaning and excellent therapists can practice 'conversion therapy' accidentally [...] I fear that there are many more harmed clients who do not speak up."

[112] Neves, Silva (2022). Sexology: The Basics. Taylor & Francis. p. unpaginated. ISBN 978-1-000-77488-7. Retrieved 17 November 2024. can be at high risk of crossing into "conversion therapy" because of their lack of robust knowledge in contemporary sexology, mistaking normative sexual behaviours for a pathology.

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-{{short description|Compulsive sexual behaviour driven by use of pornography}}
-'''Pornography addiction''' is the scientifically controversial application of an addiction model to the use of pornography. Pornography may be part of [[compulsive behavior|compulsive]] sexual behavior with negative consequences to one's physical, mental, social, or financial well-being. While the World Health Organization's [[ICD-11]] (2022) has recognized [[compulsive sexual behaviour disorder]] (CSBD) as an "impulsive control disorder",<ref>{{Cite web |title=Compulsive sexual behavior disorder |url=https://icd.who.int/browse11/l-m/en#/http%253A%252F%252Fid.who.int%252Ficd%252Fentity%252F1630268048 |url-status=live |access-date=2022-03-25 |website=World Health Organization (ICD-11) |archive-date=2018-08-01 |archive-url=https://archive.today/20180801205234/https://icd.who.int/browse11/l-m/en%23/http://id.who.int/icd/entity/294762853#/http%253A%252F%252Fid.who.int%252Ficd%252Fentity%252F1630268048 }}</ref> CSBD is not an addiction,<ref name="Martinez-Gilliard 2023 p. 113">{{cite book | last=Martinez-Gilliard | first=Erin | title=Sex, Social Justice, and Intimacy in Mental Health Practice: Incorporating Sexual Health in Approaches to Wellness | publisher=Taylor & Francis | year=2023 | isbn=978-1-000-84578-5 | url=https://books.google.com/books?id=Y1yqEAAAQBAJ&pg=PT113 | access-date=5 March 2023 | page=unpaginated | quote='Sex addiction' is also referred to as a diagnosis or presenting problem. Sex addiction is not a diagnosis in the DSM-5-TR and identified as Compulsive Sexual Behavior in the ICD-11 rather than an issue of addiction. | archive-date=4 April 2023 | archive-url=https://web.archive.org/web/20230404230920/https://books.google.com/books?id=Y1yqEAAAQBAJ&pg=PT113 | url-status=live }}</ref><ref name="Pontes 2022 p. 163">{{cite book | editor-last=Pontes | editor-first=Halley M. | last=Dhuffar-Pottiwal | first=Manpreet | title=Behavioral Addictions: Conceptual, Clinical, Assessment, and Treatment Approaches | publisher=Springer International Publishing | series=Studies in Neuroscience, Psychology and Behavioral Economics | year=2022 | isbn=978-3-031-04772-5 | url=https://books.google.com/books?id=chuKEAAAQBAJ&pg=PA163 | access-date=27 July 2023 | page=163 | quote=Given that we do not yet have definitive information on whether the processes involved in the onset and maintenance of the disorder are equivalent to substance abuse disorders, gambling, and gaming (Kraus et al. 2016), CSBD is not included in the grouping of disorders due to substance and addictive behaviors, but rather in that of impulse control disorders (Kraus et al. 2018).}}</ref><ref name="Bowman 2022 p. 161">{{cite book | last=Bowman | first=Todd | title=Reclaiming Sexual Wholeness: An Integrative Christian Approach to Sexual Addiction Treatment | publisher=Zondervan Academic | year=2022 | isbn=978-0-310-09311-4 | url=https://books.google.com/books?id=9NFTEAAAQBAJ&pg=PA161 | access-date=27 July 2023 | page=161}}</ref><ref name="Psychology Today 2018">{{cite web | first=David J. | last=Ley | title=Compulsive Sexual Behavior Disorder in ICD-11 | website=Psychology Today | date=24 January 2018 | url=https://www.psychologytoday.com/blog/women-who-stray/201801/compulsive-sexual-behavior-disorder-in-icd-11 | access-date=27 March 2021 }}</ref><ref name="Sassover Weinstein p. ">{{cite journal | last1=Sassover | first1=Eli | last2=Weinstein | first2=Aviv | title=Should compulsive sexual behavior (CSB) be considered as a behavioral addiction? A debate paper presenting the opposing view | journal=Journal of Behavioral Addictions | publisher=Akademiai Kiado Zrt. | date=29 September 2020 | volume=11 | issue=2 | pages=166–179 | issn=2062-5871 | doi=10.1556/2006.2020.00055 | pmid=32997646 | pmc=9295215 | s2cid=222167039 }}</ref><ref name="Neves 2021 p. 14">{{cite book | last=Neves | first=Silva | title=Compulsive Sexual Behaviours: A Psycho-Sexual Treatment Guide for Clinicians | publisher=Taylor & Francis | year=2021 | isbn=978-1-000-38710-0 | url=https://books.google.com/books?id=31olEAAAQBAJ&pg=PT14 | access-date=26 March 2022 | page=14 | quote=... materials in ICD-11 make very clear that CSBD is not intended to be interchangeable with sex addiction, but rather is a substantially different diagnostic framework | archive-date=19 April 2023 | archive-url=https://web.archive.org/web/20230419164522/https://books.google.com/books?id=31olEAAAQBAJ&pg=PT14 | url-status=live }}</ref> and the American Psychiatric Association's [[DSM-5]] (2013) and the DSM-5-TR (2022) do not classify compulsive [[pornography]] consumption as a [[mental disorder]] or a behavioral [[addiction]].<ref name="Martinez-Gilliard 2023 p. 113"/>
+{{short description|Compulsive sexual behaviour}}
-'''Problematic Internet pornography viewing''' is viewing of [[Internet pornography]] that is problematic for an individual due to personal or social reasons, including the excessive time spent viewing pornography instead of interacting with others and the facilitation of [[procrastination]]. Individuals may report [[depression (mood)|depression]], [[Social isolation|social isolation]], career loss, decreased productivity, or financial consequences as a result of their excessive Internet pornography viewing impeding their social life.<ref name=Taylor/>
+'''Pornography addiction''' is the scientifically controversial<ref name="contro">{{Bulleted list|Sale, Julie "Preface" in {{harvnb|Neves|2021|p=5}}|{{cite book | first1=D.J. | last1=Williams | first2=Jeremy N. | last2=Thomas | first3=Emily | last3=Prior | editor-last1=Berdychevsky | editor-first1=Liza | editor-last2=Carr | editor-first2=Neil | title=Innovation and Impact of Sex as Leisure in Research and Practice | publisher=Taylor & Francis | year=2022 | isbn=978-1-000-58943-6 | chapter=Are Sex and Pornography Addiction Valid Disorders? Adding a Leisure Science Perspective to the Sexological Critique | chapter-url=https://books.google.com/books?id=tuFeEAAAQBAJ&pg=PT69 | access-date=7 November 2024 | pages=306–321 | doi=10.1080/01490400.2020.1712284}}|{{cite book | last1=Marks | first1=David F. | last2=Murray | first2=Michael | last3=Estacio | first3=Emee Vida | title=Health Psychology: Theory, Research and Practice | publisher=SAGE Publications | year=2018 | isbn=978-1-5264-1206-5 | url=https://books.google.com/books?id=wepIDwAAQBAJ&pg=PA229 | access-date=7 November 2024 | page=229}}|{{Cite journal |last=Hunt |first=Adam |last2=Merola |first2=Giuseppe Pierpaolo |last3=Carpenter |first3=Tom |last4=Jaeggi |first4=Adrian V. |date=2024-04-01 |title=Evolutionary perspectives on substance and behavioural addictions: Distinct and shared pathways to understanding, prediction and prevention |url=https://linkinghub.elsevier.com/retrieve/pii/S0149763424000721 |journal=Neuroscience & Biobehavioral Reviews |volume=159 |pages=105603 |doi=10.1016/j.neubiorev.2024.105603 |issn=0149-7634}}}}</ref> application of an [[addiction]] model to the use of [[pornography]].<ref>{{cite book |last1=Gerymski |first1=Rafał |last2=Cisek |first2=Aleksandra |title=Encyclopedia of Sexual Psychology and Behavior |date=2023 |publisher=[[Springer, Cham]] |isbn=978-3-031-08956-5 |pages=1–8 |url=https://link.springer.com/referenceworkentry/10.1007/978-3-031-08956-5_1867-1 |language=en |chapter=Pornography: Addiction |doi=10.1007/978-3-031-08956-5_1867-1}}</ref> Pornography use may be part of [[compulsive behavior]], with negative consequences to one's physical, mental, social, or financial well-being. While the World Health Organization's [[ICD-11]] (2022) has recognized [[compulsive sexual behaviour disorder]] (CSBD) as an "impulsive control disorder",<ref>{{Cite web |title=Compulsive sexual behavior disorder |url=https://icd.who.int/browse11/l-m/en#/http%253A%252F%252Fid.who.int%252Ficd%252Fentity%252F1630268048 |url-status=live |access-date=2022-03-25 |website=World Health Organization (ICD-11) |archive-date=2018-08-01 |archive-url=https://archive.today/20180801205234/https://icd.who.int/browse11/l-m/en%23/http://id.who.int/icd/entity/294762853#/http%253A%252F%252Fid.who.int%252Ficd%252Fentity%252F1630268048 }}</ref> CSBD is not an addiction,<ref name="Martinez-Gilliard 2023 p. 113">{{cite book | last=Martinez-Gilliard | first=Erin | title=Sex, Social Justice, and Intimacy in Mental Health Practice: Incorporating Sexual Health in Approaches to Wellness | publisher=Taylor & Francis | year=2023 | isbn=978-1-000-84578-5 | url=https://books.google.com/books?id=Y1yqEAAAQBAJ&pg=PT113 | access-date=5 March 2023 | page=unpaginated | quote='Sex addiction' is also referred to as a diagnosis or presenting problem. Sex addiction is not a diagnosis in the DSM-5-TR and identified as Compulsive Sexual Behavior in the ICD-11 rather than an issue of addiction. | archive-date=4 April 2023 | archive-url=https://web.archive.org/web/20230404230920/https://books.google.com/books?id=Y1yqEAAAQBAJ&pg=PT113 | url-status=live }}</ref><ref name="Pontes 2022 p. 163">{{Bulleted list|{{cite book | last1=Hall | first1=Timothy M. | last2=Bershad | first2=Anya | last3=Shoptaw | first3=Steven | editor-last1=Miller | editor-first1=Shannon C. | editor-last2=Rosenthal | editor-first2=Richard N. | editor-last3=Levy | editor-first3=Sharon | editor-last4=Saxon | editor-first4=Andrew J. | editor-last5=Tetrault | editor-first5=Jeanette M. | editor-last6=Wakeman | editor-first6=Sarah E. | title=The ASAM Principles of Addiction Medicine | publisher=Lippincott Williams & Wilkins | publication-place=Philadelphia, PA | date=2024-02-15 | isbn=978-1-9752-0157-9 | page=unpaginated | quote=Proposals for two constructs related to compulsive sexual behaviors , sexual addiction and hypersexual disorder, have been repeatedly rejected from inclusion in recent editions of the ''Diagnostic and Statistical Manual of Mental Disorders'' (DSM) for lack of empirical support and lack of consensus as to definition. [...] (CSBD), has been included in the International Classification of Diseases, 11th edition (ICD-11), under impulse control disorders rather than as an addiction disorder. CSBD has significant differences from substance use disorders (SUD) [...] | chapter=53. Compulsive Sexual Behaviors | chapter-url=https://books.google.com/books?id=vWf1EAAAQBAJ&pg=PT1931}}|{{cite book | editor-last=Pontes | editor-first=Halley M. | last=Dhuffar-Pottiwal | first=Manpreet | title=Behavioral Addictions: Conceptual, Clinical, Assessment, and Treatment Approaches | publisher=Springer International Publishing | series=Studies in Neuroscience, Psychology and Behavioral Economics | year=2022 | isbn=978-3-031-04772-5 | url=https://books.google.com/books?id=chuKEAAAQBAJ&pg=PA163 | access-date=27 July 2023 | page=163 | quote=Given that we do not yet have definitive information on whether the processes involved in the onset and maintenance of the disorder are equivalent to substance abuse disorders, gambling, and gaming (Kraus et al. 2016), CSBD is not included in the grouping of disorders due to substance and addictive behaviors, but rather in that of impulse control disorders (Kraus et al. 2018).}}|{{cite book | last=Bowman | first=Todd | title=Reclaiming Sexual Wholeness: An Integrative Christian Approach to Sexual Addiction Treatment | publisher=Zondervan Academic | year=2022 | isbn=978-0-310-09311-4 | url=https://books.google.com/books?id=9NFTEAAAQBAJ&pg=PA161 | access-date=27 July 2023 | page=161}}|{{cite web | first=David J. | last=Ley | author-link=David J. Ley | title=Compulsive Sexual Behavior Disorder in ICD-11 | website=Psychology Today | date=24 January 2018 | url=https://www.psychologytoday.com/blog/women-who-stray/201801/compulsive-sexual-behavior-disorder-in-icd-11 | access-date=27 March 2021 }}|{{cite journal | last1=Sassover | first1=Eli | last2=Weinstein | first2=Aviv | title=Should compulsive sexual behavior (CSB) be considered as a behavioral addiction? A debate paper presenting the opposing view | journal=Journal of Behavioral Addictions | publisher=Akademiai Kiado Zrt. | date=29 September 2020 | volume=11 | issue=2 | pages=166–179 | issn=2062-5871 | doi=10.1556/2006.2020.00055 | pmid=32997646 | pmc=9295215 | s2cid=222167039 }}|{{cite book | last=Neves | first=Silva | title=Compulsive Sexual Behaviours: A Psycho-Sexual Treatment Guide for Clinicians | publisher=Taylor & Francis | year=2021 | isbn=978-1-000-38710-0 | url=https://books.google.com/books?id=31olEAAAQBAJ&pg=PT14 | access-date=26 March 2022 | page=unpaginated | quote=... materials in ICD-11 make very clear that CSBD is not intended to be interchangeable with sex addiction, but rather is a substantially different diagnostic framework | archive-date=19 April 2023 | archive-url=https://web.archive.org/web/20230419164522/https://books.google.com/books?id=31olEAAAQBAJ&pg=PT14 | url-status=live }}}}</ref> and the American Psychiatric Association's [[DSM-5]] (2013) and the DSM-5-TR (2022) do not classify compulsive pornography consumption as a [[mental disorder]] or a [[behavioral addiction]].<ref name="Martinez-Gilliard 2023 p. 113"/><ref name=weir/><ref name="allez"/>
+'''Problematic Internet pornography viewing''' is the viewing of [[Internet pornography]] that is problematic for an individual due to personal or social reasons, including the excessive time spent viewing pornography instead of interacting with others and the facilitation of [[procrastination]]. Individuals may report [[depression (mood)|depression]], [[social isolation]], career loss, decreased productivity, or financial consequences as a result of their excessive Internet pornography viewing impeding their social lives.<ref name="Taylor"/>
 ==Symptoms and diagnosis==
 {{See also|Effects of pornography}}
-Universally accepted [[diagnostic criteria]] do not exist for pornography addiction or problematic pornography viewing.{{Citation needed|date=April 2023}} Pornography addiction is often defined operationally by the frequency of pornography viewing and negative consequences.<ref>{{cite journal|last1=Duffy|first1=A|last2=Dawson|first2=DL|last3=das Nair|first3=R|title=Pornography Addiction in Adults: A Systematic Review of Definitions and Reported Impact|journal=The Journal of Sexual Medicine|date=May 2016|volume=13|issue=5|pages=760–77|doi=10.1016/j.jsxm.2016.03.002|pmid=27114191|url=http://eprints.lincoln.ac.uk/23086/1/23086%20Duffy%20-%20Porn%20Addiction%20Review%202017%20repository.pdf|access-date=2019-01-27|archive-date=2018-07-19|archive-url=https://web.archive.org/web/20180719131654/http://eprints.lincoln.ac.uk/23086/1/23086%20Duffy%20-%20Porn%20Addiction%20Review%202017%20repository.pdf|url-status=live}}</ref> 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 [[substance dependence|dependence]], such as preoccupation with the behavior, diminished ability to control the behavior, [[Drug tolerance|tolerance]], [[Drug withdrawal|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.<ref>{{Cite journal | last1 = Grant | first1 = J. E. | last2 = Potenza | first2 = M. N. | last3 = Weinstein | first3 = A. | last4 = Gorelick | first4 = D. A. | title = Introduction to Behavioral Addictions | doi = 10.3109/00952990.2010.491884 | journal = The American Journal of Drug and Alcohol Abuse | volume = 36 | issue = 5 | pages = 233–241 | year = 2010 | pmid = 20560821| pmc =3164585 }}</ref>
+Universally accepted [[diagnostic criteria]] for pornography addiction or problematic pornography viewing do not exist.{{Citation needed|date=April 2023}} Pornography addiction is often defined operationally by the frequency of pornography viewing and negative consequences.<ref>{{cite journal|last1=Duffy|first1=A|last2=Dawson|first2=DL|last3=das Nair|first3=R|title=Pornography Addiction in Adults: A Systematic Review of Definitions and Reported Impact|journal=The Journal of Sexual Medicine|date=May 2016|volume=13|issue=5|pages=760–77|doi=10.1016/j.jsxm.2016.03.002|pmid=27114191|url=http://eprints.lincoln.ac.uk/23086/1/23086%20Duffy%20-%20Porn%20Addiction%20Review%202017%20repository.pdf|access-date=2019-01-27|archive-date=2018-07-19|archive-url=https://web.archive.org/web/20180719131654/http://eprints.lincoln.ac.uk/23086/1/23086%20Duffy%20-%20Porn%20Addiction%20Review%202017%20repository.pdf|url-status=live}}</ref> 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 [[substance dependence|dependence]], such as preoccupation with the behavior, diminished ability to control the behavior, [[Drug tolerance|tolerance]], [[Drug withdrawal|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.<ref name="r942">{{cite journal | last1=Grant | first1=Jon E. | last2=Potenza | first2=Marc N. | last3=Weinstein | first3=Aviv | last4=Gorelick | first4=David A. | title=Introduction to behavioral addictions | journal=The American Journal of Drug and Alcohol Abuse | volume=36 | issue=5 | date=2010 | issn=1097-9891 | pmid=20560821 | pmc=3164585 | doi=10.3109/00952990.2010.491884 | pages=233–241}}</ref>
-Pornography use has also been associated to many issues with Sexual Satisfaction, Marital Quality, and Gender Violence. These are detailed in [[Opposition to pornography|Opposition to Pornography]].
+Pornography use has also been associated with many issues such as Sexual Satisfaction, Marital Quality, and Gender Violence. These are detailed in [[Opposition to pornography|Opposition to Pornography]].
-A proposed diagnosis for [[hypersexual disorder]] includes pornography as a subtype 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.<ref>{{Cite journal | last1 = Kafka | first1 = M. P. | title = Hypersexual Disorder: A Proposed Diagnosis for DSM-V | doi = 10.1007/s10508-009-9574-7 | journal = Archives of Sexual Behavior | volume = 39 | issue = 2 | pages = 377–400 | year = 2009 | pmid = 19937105 | s2cid = 2190694 | url = http://dsm5.org/Research/Documents/Kafka_Hypersexual_ASB.pdf | access-date = 2016-11-30 | archive-date = 2016-04-04 | archive-url = https://web.archive.org/web/20160404071027/http://www.dsm5.org/Research/Documents/Kafka_Hypersexual_ASB.pdf | url-status = live }}</ref> 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.{{Citation needed|date=April 2023}}
+A proposed diagnosis for [[hypersexual disorder]] includes pornography as a subtype of this disorder. It includes criteria such 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.<ref>{{Cite journal | last1 = Kafka | first1 = M. P. | title = Hypersexual Disorder: A Proposed Diagnosis for DSM-V | doi = 10.1007/s10508-009-9574-7 | journal = Archives of Sexual Behavior | volume = 39 | issue = 2 | pages = 377–400 | year = 2009 | pmid = 19937105 | s2cid = 2190694 | url = http://dsm5.org/Research/Documents/Kafka_Hypersexual_ASB.pdf | access-date = 2016-11-30 | archive-date = 2016-04-04 | archive-url = https://web.archive.org/web/20160404071027/http://www.dsm5.org/Research/Documents/Kafka_Hypersexual_ASB.pdf | url-status = live }}</ref> 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.{{Citation needed|date=April 2023}}
-According to the [[American Society of Addiction Medicine]], some psychological and behavioral changes characteristic of addiction brain changes include addictive cravings, impulsiveness, [[Executive dysfunction|weakened executive function]], desensitization, and dysphoria.<ref>{{Cite web |date=19 April 2011 |title=ASAM Definition of Addiction |url=http://www.asam.org/quality-practice/definition-of-addiction |url-status=dead |archive-url=https://web.archive.org/web/20160229041605/http://www.asam.org/quality-practice/definition-of-addiction |archive-date=29 February 2016 |access-date=7 November 2016}}</ref> BOLD fMRI results have shown that individuals diagnosed with [[compulsive sexual behavior]] (CSB) show enhanced cue reactivity in brain regions associated traditionally with drug-cue reactivity.<ref name="Kraus 2097–2106">{{Cite journal|last1=Kraus|first1=Shane W.|last2=Voon|first2=Valerie|last3=Potenza|first3=Marc N.|date=December 2016|title=Should compulsive sexual behavior be considered an addiction?|journal=Addiction|volume=111|issue=12|pages=2097–2106|doi=10.1111/add.13297|issn=0965-2140|pmc=4990495|pmid=26893127|s2cid=11261106}}</ref><ref name="Neuropsychopharmacology">{{cite journal |last1=Gola |first1=Mateusz |last2=Wordecha |first2=Małgorzata |last3=Sescousse |first3=Guillaume |last4=Lew-Starowicz |first4=Michał |last5=Kossowski |first5=Bartosz |last6=Wypych |first6=Marek |last7=Makeig |first7=Scott |last8=Potenza |first8=Marc N. |last9=Marchewka |first9=Artur |date=September 2017 |title=Can Pornography be Addictive? An fMRI Study of Men Seeking Treatment for Problematic Pornography Use |url=https://www.nature.com/articles/npp201778.pdf |url-status=live |journal=[[Neuropsychopharmacology (journal)|Neuropsychopharmacology]] |publisher=[[Springer Nature]] |volume=42 |issue=10 |pages=2021–2031 |doi=10.1038/npp.2017.78 |doi-access=free |eissn=1740-634X |issn=0893-133X |oclc=815994337 |pmc=5561346 |pmid=28409565 |s2cid=13759729 |archive-url=https://web.archive.org/web/20190320222644/https://www.nature.com/articles/npp201778.pdf |archive-date=20 March 2019 |access-date=1 August 2021}}</ref> These regions include the [[amygdala]] and the [[ventral striatum]].<ref name="Kraus 2097–2106"/><ref name="Neuropsychopharmacology"/> Men without CSB who had a long history of viewing pornography exhibited a less intense response to pornographic images in the left ventral [[putamen]], possibly suggestive of desensitization.<ref name="Kraus 2097–2106"/> ASAMs position is inconsistent with the American Association of Sex Educators, Counselors, and Therapists, who cite lack of strong evidence for such classification, describing ASAM as not informed by "accurate human sexuality knowledge".<ref>{{Cite web|url=https://www.aasect.org/position-sex-addiction|title=AASECT Position on Sex Addiction|date=April 2018|access-date=25 April 2019|quote=AASECT 1) does not find sufficient empirical evidence to support the classification of sex addiction or porn addiction as a mental health disorder, and 2) does not find the sexual addiction training and treatment methods and educational pedagogies to be adequately informed by accurate human sexuality knowledge.|archive-date=28 March 2019|archive-url=https://web.archive.org/web/20190328083008/https://www.aasect.org/position-sex-addiction|url-status=live}}</ref>
+According to the [[American Society of Addiction Medicine]], some psychological and behavioral changes characteristic of addiction brain changes include addictive cravings, impulsiveness, [[Executive dysfunction|weakened executive function]], desensitization, and dysphoria.<ref>{{Cite web |date=19 April 2011 |title=ASAM Definition of Addiction |url=http://www.asam.org/quality-practice/definition-of-addiction |url-status=dead |archive-url=https://web.archive.org/web/20160229041605/http://www.asam.org/quality-practice/definition-of-addiction |archive-date=29 February 2016 |access-date=7 November 2016}}</ref> BOLD fMRI results have shown that individuals diagnosed with [[compulsive sexual behavior]] (CSB) show enhanced cue reactivity in brain regions associated traditionally with drug-cue reactivity.<ref name="Kraus 2097–2106">{{Cite journal|last1=Kraus|first1=Shane W.|last2=Voon|first2=Valerie|last3=Potenza|first3=Marc N.|date=December 2016|title=Should compulsive sexual behavior be considered an addiction?|journal=Addiction|volume=111|issue=12|pages=2097–2106|doi=10.1111/add.13297|issn=0965-2140|pmc=4990495|pmid=26893127|s2cid=11261106}}</ref><ref name="Neuropsychopharmacology">{{cite journal |last1=Gola |first1=Mateusz |last2=Wordecha |first2=Małgorzata |last3=Sescousse |first3=Guillaume |last4=Lew-Starowicz |first4=Michał |last5=Kossowski |first5=Bartosz |last6=Wypych |first6=Marek |last7=Makeig |first7=Scott |last8=Potenza |first8=Marc N. |last9=Marchewka |first9=Artur |date=September 2017 |title=Can Pornography be Addictive? An fMRI Study of Men Seeking Treatment for Problematic Pornography Use |url=https://www.nature.com/articles/npp201778.pdf |url-status=live |journal=[[Neuropsychopharmacology (journal)|Neuropsychopharmacology]] |publisher=[[Springer Nature]] |volume=42 |issue=10 |pages=2021–2031 |doi=10.1038/npp.2017.78 |doi-access=free |eissn=1740-634X |issn=0893-133X |oclc=815994337 |pmc=5561346 |pmid=28409565 |s2cid=13759729 |archive-url=https://web.archive.org/web/20190320222644/https://www.nature.com/articles/npp201778.pdf |archive-date=20 March 2019 |access-date=1 August 2021}}</ref> These regions include the [[amygdala]] and the [[ventral striatum]].<ref name="Kraus 2097–2106"/><ref name="Neuropsychopharmacology"/> Men without CSB who had a long history of viewing pornography exhibited a less intense response to pornographic images in the left ventral [[putamen]], possibly suggestive of desensitization.<ref name="Kraus 2097–2106"/>
-[[Neuropsychopharmacology|Neuropsychopharmacological]] and [[psychological research]]es on pornography addiction conducted between 2015 and 2021 have concluded that most studies have been focused entirely or almost exclusively on [[men]] in [[Anonymity|anonymous]] settings, and the findings are contradicting.<ref name="Neuropsychopharmacology"/> Some researchers support the idea that pornography addiction qualifies as a form of [[behavioral addiction]] into the umbrella construct of [[hypersexual behavior]] and/or a subset of [[compulsive sexual behavior]] (CSB),<ref>{{Cite journal |last=Hilton |first=Donald L. |date=2013 |title=Pornography addiction – a supranormal stimulus considered in the context of neuroplasticity |journal=Socioaffective Neuroscience & Psychology |language=en |volume=3 |issue=1 |pages=20767 |doi=10.3402/snp.v3i0.20767 |issn=2000-9011 |pmc=3960020 |pmid=24693354 }}</ref> and should be treated as such, whereas others have detected the increased activation of [[Ventral striatum|ventral striatal reactivity]] in men for cues predicting erotic but not monetary rewards and cues signaling [[Erotica|erotic pictures]], therefore suggesting similarities between pornography addiction and [[Substance use disorder|conventional addiction disorders]].<ref name="Neuropsychopharmacology"/>
+[[Neuropsychopharmacology|Neuropsychopharmacological]] and [[psychological research]]es on pornography addiction conducted between 2015 and 2021 have concluded that most studies have been focused entirely or almost exclusively on [[men]] in [[Anonymity|anonymous]] settings, and the findings are contradictory.<ref name="Neuropsychopharmacology"/> Some researchers support the idea that pornography addiction qualifies as a form of [[behavioral addiction]] into the umbrella construct of [[hypersexual behavior]] and/or a subset of [[compulsive sexual behavior]] (CSB),<ref>{{Cite journal |last=Hilton |first=Donald L. |date=2013 |title=Pornography addiction – a supranormal stimulus considered in the context of neuroplasticity |journal=Socioaffective Neuroscience & Psychology |language=en |volume=3 |issue=1 |pages=20767 |doi=10.3402/snp.v3i0.20767 |issn=2000-9011 |pmc=3960020 |pmid=24693354 }}</ref> and should be treated as such, whereas others have detected the increased activation of [[Ventral striatum|ventral striatal reactivity]] in men for cues predicting erotic but not monetary rewards and cues signaling erotic pictures, therefore suggesting similarities between pornography addiction and [[Substance use disorder|conventional addiction disorders]].<ref name="Neuropsychopharmacology"/>
-Despite the fact that pornography is being highly spuriously<ref name="Rothman 2021 p. 2"/> indicted as a [[public health]] crisis in the [[United States]] and elsewhere,<ref name="nelroth2020">{{cite journal |last1=Nelson |first1=Kimberly M. |last2=Rothman |first2=Emily F. |date=February 2020 |title=Should Public Health Professionals Consider Pornography a Public Health Crisis? |editor-last=Morabia |editor-first=Alfredo |editor-link=Alfredo Morabia |journal=[[American Journal of Public Health]] |publisher=[[American Public Health Association]] |volume=110 |issue=2 |pages=151–153 |doi=10.2105/AJPH.2019.305498 |doi-access=free |issn=1541-0048 |pmc=6951382 |pmid=31913670 |s2cid=210121251}}</ref><ref name="auto">{{cite book |last=Rothman |first=Emily F. |year=2021 |chapter=Pornography as a US Public Health Problem |chapter-url=https://books.google.com/books?id=M30_EAAAQBAJ |title=Pornography and Public Health |pages=1–15 |location=[[Oxford]] and [[New York City|New York]] |publisher=[[Oxford University Press]] |doi=10.1093/oso/9780190075477.003.0001 |isbn=9780190075477 |lccn=2021013439 |access-date=2021-09-26 |archive-date=2023-04-19 |archive-url=https://web.archive.org/web/20230419164505/https://books.google.com/books?id=M30_EAAAQBAJ |url-status=live }}</ref> with problematic Internet and [[online pornography]] use reported to constitute an increasing burden in public [[mental health]] since the 2000s, psychopathological models and diagnostic criteria have lacked consensus, and the body of evidence on the effectiveness of therapeutic approaches is still scarce.{{citation needed|date=August 2022}}
+Despite the fact that pornography is being spuriously{{sfn|Rothman|2021|p=2|ps=: "The professional public health community is not behind the recent push to declare pornography a public health crisis."}} indicted as a [[public health]] crisis in the [[United States]] and elsewhere,<ref name="nelroth2020">{{cite journal |last1=Nelson |first1=Kimberly M. |last2=Rothman |first2=Emily F. |date=February 2020 |title=Should Public Health Professionals Consider Pornography a Public Health Crisis? |editor-last=Morabia |editor-first=Alfredo |editor-link=Alfredo Morabia |journal=[[American Journal of Public Health]] |publisher=[[American Public Health Association]] |volume=110 |issue=2 |pages=151–153 |doi=10.2105/AJPH.2019.305498 |doi-access=free |issn=1541-0048 |pmc=6951382 |pmid=31913670 |s2cid=210121251}}</ref><ref name="auto">{{cite book |last=Rothman |first=Emily F. |year=2021 |chapter=Pornography as a US Public Health Problem |chapter-url=https://books.google.com/books?id=M30_EAAAQBAJ |title=Pornography and Public Health |pages=1–15 |location=[[Oxford]] and [[New York City|New York]] |publisher=[[Oxford University Press]] |doi=10.1093/oso/9780190075477.003.0001 |isbn=978-0-19-007547-7 |lccn=2021013439 |access-date=2021-09-26 |archive-date=2023-04-19 |archive-url=https://web.archive.org/web/20230419164505/https://books.google.com/books?id=M30_EAAAQBAJ |url-status=live }}</ref> with problematic Internet and [[online pornography]] use reported to constitute an increasing burden on public [[mental health]] since the 2000s, psychopathological models and diagnostic criteria have lacked consensus, and the body of evidence on the effectiveness of therapeutic approaches is still scarce.{{citation needed|date=August 2022}}
+{{blockquote|1=The repeated cross-sectional surveys did not find any consistent associations across years between poor mental health and ever having watched pornography or the frequency of watching pornography.<ref name="s687">{{cite journal | last1=Svedin | first1=C. G. | last2=Donevan | first2=M. | last3=Bladh | first3=M. | last4=Priebe | first4=G. | last5=Fredlund | first5=C. | last6=Jonsson | first6=L. S. | title=Associations between adolescents watching pornography and poor mental health in three Swedish surveys | journal=European Child & Adolescent Psychiatry | volume=32 | issue=9 | date=2023 | issn=1435-165X | pmid=35524827 | pmc=10460300 | doi=10.1007/s00787-022-01992-x | pages=1765–1780}}</ref>|2=Svedin et. al. (2023)}}
+Svedin et. al. found that moderate consumption of pornography is associated with good mental health in boys, while both extremes (too much or too few) yielded worse mental health.<ref name="s687"/> Watching deviant (non-mainstream) pornography was associated with worse mental health in boys, but girls were unaffected.<ref name="s687"/>
 ===Diagnostic status===
-The status of pornography addiction as an addictive disorder, rather than simply a [[compulsivity]], has been hotly contested.<ref name=Steeleetal2013>{{cite journal |last1=Steele |first1=V. |last2=Prause |first2=N. |last3=Staley |first3=C. |last4=Fong |first4=G. W. |title=Sexual Desire, not Hypersexuality, is Related to Neurophysiological Responses Elicited by Sexual Images |journal=Socioaffective Neuroscience & Psychology |volume=3 |page=20770 |year=2013 |doi=10.3402/snp.v3i0.20770 |pmid=24693355 |pmc=3960022}}</ref>{{medrs|date=July 2014}}<ref>{{cite journal|last1=Hilton |first1=Donald L. |title='High desire', or 'merely' an addiction? A response to Steele et al |journal=Socioaffective Neuroscience & Psychology |date=21 February 2014 |volume=4 |issue=1 |pages=23833 |doi=10.3402/snp.v4.23833 |pmid=24707350 |pmc=3975913}}</ref>{{medrs|date=July 2014}} Furthermore, research suggests that the use of a pornography addiction label may indicate a socially (as opposed to clinically) driven nosology.<ref name=Taylor>{{cite journal |last1=Taylor |first1=Kris |title=Nosology and metaphor: How pornography viewers make sense of pornography addiction |journal=Sexualities |pages=609–629 |date=May 7, 2019 |volume=23 |issue=4 |doi=10.1177/1363460719842136 |s2cid=164221337 }}</ref>
+Pornography addiction is a controversial concept, since it appears to be "largely morally, ideologically, and politically motivated."{{sfn|Williams|Thomas|Prior|2022}} Although it is a "nice theory", empirical support for it is largely missing,<ref name="z537"/> and the "industry of porn/sex addiction is based on conservative moral values around sexuality that intrude into clinical practice".<ref name="z537">{{cite book | last=Baird | first=Amee | title=Sex in the Brain: How Seizures, Strokes, Dementia, Tumors, and Trauma Can Change Your Sex Life | publisher=Columbia University Press | year=2020 | isbn=978-0-231-55155-7 | url=https://books.google.com/books?id=FtKXDwAAQBAJ | access-date=7 November 2024 | page=unpaginated | quote=spoke with David Ley | doi=10.7312/bair19590-010 | chapter=9. PORN ON THE TRAIN (AND ON THE BRAIN)}}</ref> Julie Sale stated "No-one refutes that clients access therapy for help with sexual behaviours that they feel they have no control over. The issue is how these client experiences are conceptualised and how the clinical formulation informs treatment."<ref>Sale, Julie "Preface" in {{harvnb|Neves|2021|p=5}}</ref>
-{{blockquote|It is worth considering whether the apparent epidemic of self-diagnosed pornography addicts seeking help today perhaps represents the ready uptake of a relatively new way to ''describe'' one's problematic behaviour, and not the development of a modern disease entity whose description should dictate its treatment.<ref name=Taylor/>|Kris Taylor|Nosology and metaphor: How pornography viewers make sense of pornography addiction}}
+The status of pornography addiction as an addictive disorder, rather than simply a [[compulsivity]], has been hotly contested.<ref name=Steeleetal2013>{{cite journal |last1=Steele |first1=V. |last2=Prause |first2=N. |last3=Staley |first3=C. |last4=Fong |first4=G. W. |title=Sexual Desire, not Hypersexuality, is Related to Neurophysiological Responses Elicited by Sexual Images |journal=Socioaffective Neuroscience & Psychology |volume=3 |page=20770 |year=2013 |doi=10.3402/snp.v3i0.20770 |pmid=24693355 |pmc=3960022}}</ref>{{medrs|date=July 2014}}<ref>{{cite journal|last1=Hilton |first1=Donald L. |title='High desire', or 'merely' an addiction? A response to Steele et al |journal=Socioaffective Neuroscience & Psychology |date=21 February 2014 |volume=4 |issue=1 |pages=23833 |doi=10.3402/snp.v4.23833 |pmid=24707350 |pmc=3975913}}</ref>{{medrs|date=July 2014}} Furthermore, research suggests that the use of a pornography addiction label may indicate a socially (as opposed to clinically) driven nosology.<ref name="Taylor">{{cite journal |last1=Taylor |first1=Kris |title=Nosology and metaphor: How pornography viewers make sense of pornography addiction |journal=Sexualities |pages=609–629 |date=May 7, 2019 |volume=23 |issue=4 |doi=10.1177/1363460719842136 |s2cid=164221337 }}</ref>
+{{blockquote|It is worth considering whether the apparent epidemic of self-diagnosed pornography addicts seeking help today perhaps represents the ready uptake of a relatively new way to ''describe'' one's problematic behaviour, and not the development of a modern disease entity whose description should dictate its treatment.<ref name="Taylor"/>|Kris Taylor|Nosology and metaphor: How pornography viewers make sense of pornography addiction}}
-In November 2016, the American Association of Sexuality Educators, Counselors and Therapists (AASECT) issued a position statement on sex/porn addiction which states that AASECT "does not find sufficient empirical evidence to support the classification of sex addiction or porn addiction as a mental health disorder, and does not find the sexual addiction training and treatment methods and educational pedagogies to be adequately informed by accurate human sexuality knowledge. Therefore, it is the position of AASECT that linking problems related to sexual urges, thoughts or behaviors to a porn/sexual addiction process cannot be advanced by AASECT as a standard of practice for sexuality education delivery, counseling or therapy."
+In November 2016, the American Association of Sexuality Educators, Counselors and Therapists (AASECT) issued a position statement on sex/porn addiction which states that AASECT "does not find sufficient empirical evidence to support the classification of sex addiction or porn addiction as a mental health disorder, and does not find the sexual addiction training and treatment methods and educational pedagogies to be adequately informed by accurate human sexuality knowledge. Therefore, it is the position of AASECT that linking problems related to sexual urges, thoughts or behaviors to a porn/sexual addiction process cannot be advanced by AASECT as a standard of practice for sexuality education delivery, counseling or therapy."<ref>{{Cite web|url=https://www.aasect.org/position-sex-addiction|title=AASECT Position on Sex Addiction|date=April 2018|access-date=25 April 2019|quote=AASECT 1) does not find sufficient empirical evidence to support the classification of sex addiction or porn addiction as a mental health disorder, and 2) does not find the sexual addiction training and treatment methods and educational pedagogies to be adequately informed by accurate human sexuality knowledge.|archive-date=28 March 2019|archive-url=https://web.archive.org/web/20190328083008/https://www.aasect.org/position-sex-addiction|url-status=live}}</ref>
-The ''[[Diagnostic and Statistical Manual of Mental Disorders]]'' ([[DSM-5]]) includes a new section for behavioral addictions, but includes only one disorder: [[pathological gambling]].<ref name="dsm-5">{{Cite book|last=American Psychiatric Association|year=2013|title=Diagnostic and Statistical Manual of Mental Disorders|edition=Fifth|publisher=American Psychiatric Publishing|location=Arlington, VA|pages=[https://archive.org/details/diagnosticstatis0005unse/page/481 481, 797–798]|isbn=978-0-89042-555-8|quote=In addition to the substance-related disorders, this chapter also includes gambling disorder, reflecting evidence that gambling behaviors activate reward systems similar to those activated by drugs of abuse and produce some behavioral symptoms that appear comparable to those produced by the substance use disorders. Other excessive behavioral patterns, such as Internet gaming, have also been described, but the research on these and other behavioral syndromes is less clear. Thus, groups of repetitive behaviors, which some term behavioral addictions, with such subcategories as "sex addiction," "exercise addiction," or "shopping addiction," are not included because at this time there is insufficient peer-reviewed evidence to establish the diagnostic criteria and course descriptions needed to identify these behaviors as mental disorders. ... Excessive use of the Internet not involving playing of online games (e.g., excessive use of social media, such as Facebook; viewing pornography online) is not considered analogous to Internet gaming disorder, and future research on other excessive uses of the Internet would need to follow similar guidelines as suggested herein. Excessive gambling online may qualify for a separate diagnosis of gambling disorder.|url=https://archive.org/details/diagnosticstatis0005unse/page/481}}</ref> One other behavioral addiction, [[internet gaming disorder]], appears in the conditions proposed for further study in DSM-5.<ref name="dsm-5" /> Psychiatrists cited a lack of research support for refusing to include other behavioral disorders at this time.<ref name="dsm-5" /><!--Hilton is a well-known anti-pornography crusader, and the now defunct journal was never indexed for MEDLINE, so according to [[WP:GEVAL]] it cannot give the lie to the DSM. Besides, that happened ten years ago, and meanwhile DSM-5-TR gave the lie to Hilton's article. -- a decision that has been criticized by some as being  “illogical” -- Not indexed for PubMed, let alone MEDLINE:<ref name="addiction-beyond-substance">{{Cite journal|doi=10.1080/10720162.2017.1306468|title=Addiction Beyond Substances—What's up with the DSM?|year=2017|last1=Hajela|first1=Raju|last2=Love|first2=Todd|journal=Sexual Addiction & Compulsivity|volume=24|issue=1–2|pages=11–22|s2cid=151857641}}</ref> and “inconsistent”.<ref name="addiction-beyond-substance"/><ref>{{Cite journal|doi=10.3402/snp.v3i0.20767|title=Pornography addiction – a supranormal stimulus considered in the context of neuroplasticity|year=2013|last1=Hilton|first1=Donald L.|journal=Socioaffective Neuroscience & Psychology|volume=3|page=20767|pmid=24693354|pmc=3960020}}</ref>-->
+The ''[[Diagnostic and Statistical Manual of Mental Disorders]]'' ([[DSM-5]]) includes a new section for behavioral addictions, but includes only one disorder: [[pathological gambling]].<ref name="dsm-5">{{Cite book|last=American Psychiatric Association|year=2013|title=Diagnostic and Statistical Manual of Mental Disorders|edition=Fifth|publisher=American Psychiatric Publishing|location=Arlington, VA|pages=[https://archive.org/details/diagnosticstatis0005unse/page/481 481, 797–798]|isbn=978-0-89042-555-8|quote=In addition to the substance-related disorders, this chapter also includes gambling disorder, reflecting evidence that gambling behaviors activate reward systems similar to those activated by drugs of abuse and produce some behavioral symptoms that appear comparable to those produced by the substance use disorders. Other excessive behavioral patterns, such as Internet gaming, have also been described, but the research on these and other behavioral syndromes is less clear. Thus, groups of repetitive behaviors, which some term behavioral addictions, with such subcategories as "sex addiction," "exercise addiction," or "shopping addiction," are not included because at this time there is insufficient peer-reviewed evidence to establish the diagnostic criteria and course descriptions needed to identify these behaviors as mental disorders. ... Excessive use of the Internet not involving playing of online games (e.g., excessive use of social media, such as Facebook; viewing pornography online) is not considered analogous to Internet gaming disorder, and future research on other excessive uses of the Internet would need to follow similar guidelines as suggested herein. Excessive gambling online may qualify for a separate diagnosis of gambling disorder.|url=https://archive.org/details/diagnosticstatis0005unse/page/481}}</ref> One other behavioral addiction, [[internet gaming disorder]], appears in the conditions proposed for further study in DSM-5.<ref name="dsm-5" /> Psychiatrists cited a lack of research support for refusing to include other behavioral disorders, such as pornography, at the time.<ref name="dsm-5" /><!--Hilton is a well-known anti-pornography crusader, and the now defunct journal was never indexed for MEDLINE, so according to [[WP:GEVAL]] it cannot give the lie to the DSM. Besides, that happened ten years ago, and meanwhile DSM-5-TR gave the lie to Hilton's article.--><!-- a decision that has been criticized by some as being  “illogical”.--><!-- Hajela is not indexed for PubMed, let alone MEDLINE:<ref name="addiction-beyond-substance">{{Cite journal|doi=10.1080/10720162.2017.1306468|title=Addiction Beyond Substances—What's up with the DSM?|year=2017|last1=Hajela|first1=Raju|last2=Love|first2=Todd|journal=Sexual Addiction & Compulsivity|volume=24|issue=1–2|pages=11–22|s2cid=151857641}}</ref> and “inconsistent”.<ref name="addiction-beyond-substance"/><ref>{{Cite journal|doi=10.3402/snp.v3i0.20767|title=Pornography addiction – a supranormal stimulus considered in the context of neuroplasticity|year=2013|last1=Hilton|first1=Donald L.|journal=Socioaffective Neuroscience & Psychology|volume=3|page=20767|pmid=24693354|pmc=3960020}}</ref>-->
 Porn addiction is not a diagnosis in DSM-5 (or any previous version).<ref name=weir>{{cite journal|last1=Weir|first1=Kirsten |title=Is pornography addictive? |url=http://www.apa.org/monitor/2014/04/pornography.aspx|url-status=dead|journal=Monitor on Psychology |date=April 2014 |volume=45 |issue=4 |page=46 |issn=1529-4978 |oclc=612512821 |archive-url=https://web.archive.org/web/20140405232028/http://www.apa.org/monitor/2014/04/pornography.aspx |archive-date=2014-04-05}}</ref><ref name="allez">{{cite book |editor-first=Glyn Hudson |editor-last=Allez |title=Sexual Diversity and Sexual Offending: Research, Assessment, and Clinical Treatment in Psychosexual Therapy |chapter-url=https://books.google.com/books?id=MXnAAwAAQBAJ&pg=PA161 |date=4 June 2014 |publisher=Karnac Books |isbn=978-1-78181-368-3 |page=161 |chapter=Chapter Ten. The pleasure, the power, and the perils of Internet pornography |access-date=27 April 2019 |archive-date=19 April 2023 |archive-url=https://web.archive.org/web/20230419164550/https://books.google.com/books?id=MXnAAwAAQBAJ&pg=PA161 |url-status=live }}</ref><ref name=othertwo>Since it is neither of two behavioral addictions mentioned above.</ref> "Viewing pornography online" is mentioned verbatim in the DSM-5,<ref name=dsm-5/> but it is not considered a mental disorder either.<ref name=weir/><ref name=allez/><ref name=othertwo/>
@@ Line 32: / Line 40: @@
 {{blockquote|When the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) was being drafted, experts considered a proposed diagnostic addiction called hypersexual disorder, which also included a pornography subtype. But in the end, reviewers determined that there wasn't enough evidence to include hypersexual disorder or its subtypes in the 2013 edition.<ref name=weir/>|Kirsten Weir|Is pornography addictive?}}
-A number of studies have found neurological markers of addiction in internet porn users,<ref name="Kraus 385–386">{{Cite journal|last1=Kraus |first1=Shane W |last2=Voon |first2=Valerie |last3=Potenza |first3=Marc N |date=2015-09-22 |title=Neurobiology of Compulsive Sexual Behavior: Emerging Science |journal=Neuropsychopharmacology |volume=41 |issue=1 |pages=385–386 |doi=10.1038/npp.2015.300 |issn=0893-133X |pmc=4677151 |pmid=26657963}}</ref><ref name=":0">{{Cite journal|last1=Brand |first1=Matthias |last2=Young |first2=Kimberly S. |last3=Laier |first3=Christian |last4=Wölfling |first4=Klaus |last5=Potenza |first5=Marc N. |date=2016-12-01 |title=Integrating psychological and neurobiological considerations regarding the development and maintenance of specific Internet-use disorders: An Interaction of Person-Affect-Cognition-Execution (I-PACE) model |journal=Neuroscience & Biobehavioral Reviews |volume=71 |pages=252–266 |doi=10.1016/j.neubiorev.2016.08.033 |pmid=27590829|doi-access=free }}</ref><ref>{{Cite book|journal=International Review of Neurobiology |last1=Kühn |first1=S. |last2=Gallinat |first2=J. |date=2016-01-01 |editor1-first=Natalie M. |editor1-last=Zahr |editor2-first=Eric T. |editor2-last=Peterson |volume=129 |pages=67–83 |doi=10.1016/bs.irn.2016.04.002 |pmid=27503448 |chapter=Neurobiological Basis of Hypersexuality |isbn=9780128039144|title=Imaging the Addicted Brain }}</ref> which is consistent with a large body of research finding similar markers in other kinds of problematic internet users.<ref name=":0" /> Yet other studies found that critical biomarkers of addiction were missing,<ref>{{cite journal|last1=Prause |first1=Nicole |last2=Steele |first2=Vaughn R. |last3=Staley |first3=Cameron |last4=Sabatinelli |first4=Dean |last5=Hajcak |first5=Greg |date=2015 |title=Modulation of late positive potentials by sexual images in problem users and controls inconsistent with 'porn addiction'|journal=Biological Psychology |volume=109 |pages=192–199 |doi=10.1016/j.biopsycho.2015.06.005|pmid=26095441 |s2cid=1446388 }}</ref> and most addiction biomarkers have never been demonstrated for pornography.<ref>{{cite journal|last1=Prause |first1=Nicole |last2=Janssen |first2=Erick |last3=Georgiadis |first3=Janniko |last4=Finn |first4=Peter |last5=Pfaus |first5=James |date=2017 |title=Data do not support sex as addictive |journal=The Lancet Psychiatry |volume=4 |issue=12 |pages=899 |doi=10.1016/S2215-0366(17)30441-8|pmid=29179928 |doi-access=free }}</ref>{{Failed verification|date=June 2021|reason=This reference does not address pornography at all.}}
+A number of studies have found neurological markers of addiction in internet porn users,<ref name="Kraus 385–386">{{Cite journal|last1=Kraus |first1=Shane W |last2=Voon |first2=Valerie |last3=Potenza |first3=Marc N |date=2015-09-22 |title=Neurobiology of Compulsive Sexual Behavior: Emerging Science |journal=Neuropsychopharmacology |volume=41 |issue=1 |pages=385–386 |doi=10.1038/npp.2015.300 |issn=0893-133X |pmc=4677151 |pmid=26657963}}</ref><ref name=":0">{{Cite journal|last1=Brand |first1=Matthias |last2=Young |first2=Kimberly S. |last3=Laier |first3=Christian |last4=Wölfling |first4=Klaus |last5=Potenza |first5=Marc N. |date=2016-12-01 |title=Integrating psychological and neurobiological considerations regarding the development and maintenance of specific Internet-use disorders: An Interaction of Person-Affect-Cognition-Execution (I-PACE) model |journal=Neuroscience & Biobehavioral Reviews |volume=71 |pages=252–266 |doi=10.1016/j.neubiorev.2016.08.033 |pmid=27590829|doi-access=free }}</ref><ref>{{Cite journal|journal=International Review of Neurobiology |last1=Kühn |first1=S. |last2=Gallinat |first2=J. |date=2016-01-01 |editor1-first=Natalie M. |editor1-last=Zahr |editor2-first=Eric T. |editor2-last=Peterson |volume=129 |pages=67–83 |doi=10.1016/bs.irn.2016.04.002 |pmid=27503448 |isbn=978-0-12-803914-4|title=Neurobiological Basis of Hypersexuality. Imaging the Addicted Brain }}</ref> which is consistent with a large body of research finding similar markers in other kinds of problematic internet users.<ref name=":0" /> Yet other studies found that critical biomarkers of addiction were missing,<ref>{{cite journal|last1=Prause |first1=Nicole |last2=Steele |first2=Vaughn R. |last3=Staley |first3=Cameron |last4=Sabatinelli |first4=Dean |last5=Hajcak |first5=Greg |date=2015 |title=Modulation of late positive potentials by sexual images in problem users and controls inconsistent with 'porn addiction'|journal=Biological Psychology |volume=109 |pages=192–199 |doi=10.1016/j.biopsycho.2015.06.005|pmid=26095441 |s2cid=1446388 }}</ref> and most addiction biomarkers have never been demonstrated for pornography.<ref>{{cite journal|last1=Prause |first1=Nicole |last2=Janssen |first2=Erick |last3=Georgiadis |first3=Janniko |last4=Finn |first4=Peter |last5=Pfaus |first5=James |date=2017 |title=Data do not support sex as addictive |journal=The Lancet Psychiatry |volume=4 |issue=12 |pages=899 |doi=10.1016/S2215-0366(17)30441-8|pmid=29179928 |doi-access=free }}</ref>{{Failed verification|date=June 2021|reason=This reference does not address pornography at all.}}
-The International Classification of Disorders 11 (ICD-11) rejected "pornography addiction". Specifically, the [[World Health Organization]] (WHO) wrote: "Based on the limited current data, it would therefore seem premature to include [Internet use] in ICD-11."<ref>{{cite journal|last1=Grant |first1=J. |year=2014 |title=Impulse control disorders and 'behavioural addictions' in the ICD‐11 |journal=World Psychiatry |volume=13 |issue=2 |pages=125–127 |doi=10.1002/wps.20115 |pmid=24890056 |pmc=4102276}}</ref>
+The International Classification of Disorders 11 (ICD-11) rejected "pornography addiction".<ref name="Martinez-Gilliard 2023 p. 113"/><ref>{{Bulleted list|{{harvnb|Dhuffar-Pottiwal|2022|p=163}}|{{harvnb|Bowman|2022|p=161}}|{{harvnb|Neves|2021|p=14}}}}</ref><ref name="Prause Binnie 2023"/> Specifically, the [[World Health Organization]] (WHO) wrote: "Based on the limited current data, it would therefore seem premature to include [problematic Internet use] in ICD-11."<ref name="h760">{{cite journal | last1=Grant | first1=Jon E. | last2=Atmaca | first2=Murad | last3=Fineberg | first3=Naomi A. | last4=Fontenelle | first4=Leonardo F. | last5=Matsunaga | first5=Hisato | last6=Janardhan Reddy | first6=Y. C. | last7=Simpson | first7=Helen Blair | last8=Thomsen | first8=Per Hove | last9=van den Heuvel | first9=Odile A. | last10=Veale | first10=David | last11=Woods | first11=Douglas W. | last12=Stein | first12=Dan J. | title=Impulse control disorders and "behavioural addictions" in the ICD-11 | journal=World Psychiatry| volume=13 | issue=2 | date=2014 | issn=1723-8617 | pmid=24890056 | pmc=4102276 | doi=10.1002/wps.20115 | pages=125–127}}</ref>
-However, ICD-11 does include the "Compulsive sexual behaviour disorder" (CSBD)<ref>{{cite book | last=World Health Organisation | year=2021 | title=ICD-11 for Mortality and Morbidity Statistics: 6C72 Compulsive sexual behaviour disorder | url=https://icd.who.int/browse11/l-m/en#/http%3a%2f%2fid.who.int%2ficd%2fentity%2f1630268048 | access-date=4 September 2021 | archive-date=1 August 2018 | archive-url=https://archive.today/20180801205234/https://icd.who.int/browse11/l-m/en%23/http://id.who.int/icd/entity/294762853#/http%3a%2f%2fid.who.int%2ficd%2fentity%2f1630268048 | url-status=live }}</ref> in the "impulse control disorders" section. It is defined as "a persistent pattern of failure to control intense, repetitive sexual impulses or urges resulting in repetitive sexual behaviour." David J. Ley argued that that is not an endorsement of the concept of pornography addiction.<ref name="Ph.D. 2018"/> ICD also specifically excludes anyone from this diagnosis whose distress is due to moral conflict alone, yet moral incongruence is the strongest predictor of believing one is addicted to porn.<ref name="Grubbs Perry Wilt Reid 2018 pp. 397–415">{{cite journal | last1=Grubbs | first1=Joshua B. | last2=Perry | first2=Samuel L. | last3=Wilt | first3=Joshua A. | last4=Reid | first4=Rory C. | title=Pornography Problems Due to Moral Incongruence: An Integrative Model with a Systematic Review and Meta-Analysis | journal=Archives of Sexual Behavior | publisher=Springer Science and Business Media LLC | volume=48 | issue=2 | date=2018-08-03 | issn=0004-0002 | doi=10.1007/s10508-018-1248-x | pages=397–415| pmid=30076491 | s2cid=51911309 }}</ref> Note that two studies now contradict this, finding that narcissism,<ref name="Prause Binnie 2023 p. 136346072311570">{{cite journal | last1=Prause | first1=Nicole | last2=Binnie | first2=James | title=Iatrogenic effects of Reboot/NoFap on public health: A preregistered survey study | journal=Sexualities | publisher=SAGE Publications | date=2023-02-22 | issn=1363-4607 | doi=10.1177/13634607231157070 | page=136346072311570| s2cid=257172274 | url=https://openresearch.lsbu.ac.uk/download/af044dbeb36aefcdb593641a18267139b810bb745d21ca4e8881f5e40472d2e8/1373447/Submission_Sexualities_12.13.2022.pdf }}</ref> especially antagonist narcissism,<ref name="Grubbs Tahk Fernandez Fernandez 2023 p. 104419">{{cite journal | last1=Grubbs | first1=Joshua B. | last2=Tahk | first2=Regina | last3=Fernandez | first3=David P. | last4=Fernandez | first4=Elaine F. | last5=Ley | first5=David | title=Pornography and Pride: Antagonism drives links between narcissism and perceived addiction to pornography | journal=Journal of Research in Personality | publisher=Elsevier BV | year=2023 | volume=107 | issn=0092-6566 | doi=10.1016/j.jrp.2023.104419 | page=104419| s2cid=260990191 }}</ref> predicts identification as a pornography addict.
+However, ICD-11 does include the "Compulsive sexual behaviour disorder" (CSBD)<ref>{{cite book | last=World Health Organisation | year=2021 | title=ICD-11 for Mortality and Morbidity Statistics: 6C72 Compulsive sexual behaviour disorder | url=https://icd.who.int/browse11/l-m/en#/http%3a%2f%2fid.who.int%2ficd%2fentity%2f1630268048 | access-date=4 September 2021 | archive-date=1 August 2018 | archive-url=https://archive.today/20180801205234/https://icd.who.int/browse11/l-m/en%23/http://id.who.int/icd/entity/294762853#/http%3a%2f%2fid.who.int%2ficd%2fentity%2f1630268048 | url-status=live }}</ref> in the "impulse control disorders" section. It is defined as "a persistent pattern of failure to control intense, repetitive sexual impulses or urges resulting in repetitive sexual behaviour." David J. Ley argued that that is not an endorsement of the concept of pornography addiction.<ref name="Ph.D. 2018"/> ICD also specifically excludes anyone from this diagnosis whose distress is due to moral conflict alone, yet moral incongruence is the strongest predictor of believing one is addicted to porn.<ref name="Grubbs Perry Wilt Reid 2018 pp. 397–415">{{cite journal | last1=Grubbs | first1=Joshua B. | last2=Perry | first2=Samuel L. | last3=Wilt | first3=Joshua A. | last4=Reid | first4=Rory C. | title=Pornography Problems Due to Moral Incongruence: An Integrative Model with a Systematic Review and Meta-Analysis | journal=Archives of Sexual Behavior | publisher=Springer Science and Business Media LLC | volume=48 | issue=2 | date=2018-08-03 | issn=0004-0002 | doi=10.1007/s10508-018-1248-x | pages=397–415| pmid=30076491 | s2cid=51911309 }}</ref> Note that two studies now contradict this, finding that narcissism,<ref name="Prause Binnie 2023">{{cite journal | last1=Prause | first1=Nicole | last2=Binnie | first2=James | title=Iatrogenic effects of Reboot/NoFap on public health: A preregistered survey study | journal=Sexualities | publisher=SAGE Publications | date=2023-02-22 | volume=27 | issue=8 | issn=1363-4607 | doi=10.1177/13634607231157070 | page=136346072311570| s2cid=257172274 | url=https://openresearch.lsbu.ac.uk/download/af044dbeb36aefcdb593641a18267139b810bb745d21ca4e8881f5e40472d2e8/1373447/Submission_Sexualities_12.13.2022.pdf }}</ref> especially antagonist narcissism,<ref name="Grubbs Tahk Fernandez Fernandez 2023 p. 104419">{{cite journal | last1=Grubbs | first1=Joshua B. | last2=Tahk | first2=Regina | last3=Fernandez | first3=David P. | last4=Fernandez | first4=Elaine F. | last5=Ley | first5=David | title=Pornography and Pride: Antagonism drives links between narcissism and perceived addiction to pornography | journal=Journal of Research in Personality | publisher=Elsevier BV | year=2023 | volume=107 | issn=0092-6566 | doi=10.1016/j.jrp.2023.104419 | page=104419| s2cid=260990191 }}</ref> predicts identification as a pornography addict.
-Introductory psychology textbook authors Coon, Mitterer and Martini, passingly mentioning [[NoFap]], speak of pornography as a "[[supernormal stimulus]]" but use the model of compulsion rather than addiction.<ref name="CoonMitterer2016">{{cite book|first1=Dennis|last1=Coon|first2=John O.|last2=Mitterer|first3=Tanya S.|last3=Martini|title=Psychology: Modules for Active Learning|url=https://books.google.com/books?id=oPS5DQAAQBAJ&pg=PA414|date=5 December 2016|publisher=Cengage Learning|isbn=978-1-337-51708-9|pages=413–414|access-date=8 May 2019|archive-date=19 April 2023|archive-url=https://web.archive.org/web/20230419164521/https://books.google.com/books?id=oPS5DQAAQBAJ&pg=PA414|url-status=live}}</ref> Addiction and compulsion are models of mental disorders which cancel each other out,<ref name="Heather 2017 pp. 15–38">{{cite journal | last=Heather | first=Nick | title=Is the concept of compulsion useful in the explanation or description of addictive behaviour and experience? | journal=Addictive Behaviors Reports | publisher=Elsevier BV | volume=6 | year=2017 | issn=2352-8532 | doi=10.1016/j.abrep.2017.05.002 | pages=15–38| pmid=29450234 | pmc=5800587 }}</ref><ref name="Go Ask Alice!">{{cite web | title=What's the difference between an addiction and a compulsion? | website=Go Ask Alice! | url=https://goaskalice.columbia.edu/answered-questions/whats-difference-between-addiction-and-compulsion | access-date=11 June 2021 | archive-date=11 June 2021 | archive-url=https://web.archive.org/web/20210611114716/https://goaskalice.columbia.edu/answered-questions/whats-difference-between-addiction-and-compulsion/ | url-status=live }}</ref><ref name="Munson Knauer 2014 p. 54">{{cite book | last1=Munson | first1=C. | last2=Knauer | first2=S.L. | title=Recovering from Sexual Abuse, Addictions, and Compulsive Behaviors: "Numb" Survivors | publisher=Taylor & Francis | year=2014 | isbn=978-1-317-78868-3 | url=https://books.google.com/books?id=pRvHBQAAQBAJ&pg=PT54 | access-date=11 June 2021 | page=54 | archive-date=19 April 2023 | archive-url=https://web.archive.org/web/20230419164524/https://books.google.com/books?id=pRvHBQAAQBAJ&pg=PT54 | url-status=live }}</ref> the term "addiction" being deprecated,<ref>{{Cite book|last=American Psychiatric Association|year=2013|title=Diagnostic and Statistical Manual of Mental Disorders| edition=Fifth|publisher=American Psychiatric Publishing|location=Arlington, VA|pages=485|isbn=978-0-89042-555-8|quote=Note that the word ''addiction'' is not applied as a diagnostic term in this classification, although it is in common usage in many countries to describe severe problems related to compulsive and habitual use of substances.}}</ref> but ICD-11 does not support the existence of "porn addiction"/"sex addiction".<ref name="Pontes 2022 p. 163"/><ref name="Bowman 2022 p. 161"/><ref name="Ph.D. 2018">{{cite web | last=Ley | first=David J. | title=Compulsive Sexual Behavior Disorder in ICD-11 | website=Psychology Today | date=24 January 2018 | url=https://www.psychologytoday.com/us/blog/women-who-stray/201801/compulsive-sexual-behavior-disorder-in-icd-11 | access-date=11 June 2021 }}</ref>
+Introductory psychology textbook authors Coon, Mitterer and Martini, passingly mentioning [[NoFap]], speak of pornography as a "[[supernormal stimulus]]" but use the model of compulsion rather than addiction.<ref name="CoonMitterer2016">{{cite book|first1=Dennis|last1=Coon|first2=John O.|last2=Mitterer|first3=Tanya S.|last3=Martini|title=Psychology: Modules for Active Learning|url=https://books.google.com/books?id=oPS5DQAAQBAJ&pg=PA414|date=5 December 2016|publisher=Cengage Learning|isbn=978-1-337-51708-9|pages=413–414|access-date=8 May 2019|archive-date=19 April 2023|archive-url=https://web.archive.org/web/20230419164521/https://books.google.com/books?id=oPS5DQAAQBAJ&pg=PA414|url-status=live}}</ref> Addiction and compulsion are models of mental disorders which cancel each other out,<ref name="Heather 2017 pp. 15–38">{{cite journal | last=Heather | first=Nick | title=Is the concept of compulsion useful in the explanation or description of addictive behaviour and experience? | journal=Addictive Behaviors Reports | publisher=Elsevier BV | volume=6 | year=2017 | issn=2352-8532 | doi=10.1016/j.abrep.2017.05.002 | pages=15–38| pmid=29450234 | pmc=5800587 }}</ref><ref name="Go Ask Alice!">{{cite web | title=What's the difference between an addiction and a compulsion? | website=Go Ask Alice! | url=https://goaskalice.columbia.edu/answered-questions/whats-difference-between-addiction-and-compulsion | access-date=11 June 2021 | archive-date=11 June 2021 | archive-url=https://web.archive.org/web/20210611114716/https://goaskalice.columbia.edu/answered-questions/whats-difference-between-addiction-and-compulsion/ | url-status=live }}</ref><ref name="Munson Knauer 2014 p. 54">{{cite book | last1=Munson | first1=C. | last2=Knauer | first2=S.L. | title=Recovering from Sexual Abuse, Addictions, and Compulsive Behaviors: "Numb" Survivors | publisher=Taylor & Francis | year=2014 | isbn=978-1-317-78868-3 | url=https://books.google.com/books?id=pRvHBQAAQBAJ&pg=PT54 | access-date=11 June 2021 | page=54 | archive-date=19 April 2023 | archive-url=https://web.archive.org/web/20230419164524/https://books.google.com/books?id=pRvHBQAAQBAJ&pg=PT54 | url-status=live }}</ref> the term "addiction" being deprecated,<ref>{{Cite book|last=American Psychiatric Association|year=2013|title=Diagnostic and Statistical Manual of Mental Disorders| edition=Fifth|publisher=American Psychiatric Publishing|location=Arlington, VA|pages=485|isbn=978-0-89042-555-8|quote=Note that the word ''addiction'' is not applied as a diagnostic term in this classification, although it is in common usage in many countries to describe severe problems related to compulsive and habitual use of substances.}}</ref> but ICD-11 does not support the existence of "porn addiction"/"sex addiction".<ref name="Ph.D. 2018">{{cite web | last=Ley | first=David J. | title=Compulsive Sexual Behavior Disorder in ICD-11 | website=Psychology Today | date=24 January 2018 | url=https://www.psychologytoday.com/us/blog/women-who-stray/201801/compulsive-sexual-behavior-disorder-in-icd-11 | access-date=11 June 2021 }}</ref><ref name="DPB">{{Bulleted list|{{harvnb|Dhuffar-Pottiwal|2022|p=163}}|{{harvnb|Bowman|2022|p=161}}}}</ref>
+DSM-5-TR, published in March 2022, does not recognize a diagnosis of sexual addiction/compulsion (which would include internet pornography viewing).<ref name="Martinez-Gilliard 2023 p. 113"/><ref name="American Psychiatric Association 2022 ch. 29">{{cite book | author=American Psychiatric Association | title=Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR(tm)) | publisher=American Psychiatric Association Publishing | series=G - Reference,Information and Interdisciplinary Subjects Series | year=2022 | isbn=978-0-89042-576-3 | url=https://books.google.com/books?id=PIGizgEACAAJ | chapter=Conditions for Further Study | page=916 | quote=Excessive use of the Internet not involving playing of online games (e.g., excessive use of social media, such as Facebook; viewing pornography online) is not considered analogous to Internet gaming disorder, and future research on other excessive uses of the Internet would need to follow similar guidelines as suggested herein. Excessive gambling online may qualify for a separate diagnosis of gambling disorder. | access-date=2022-04-15 | archive-date=2023-04-19 | archive-url=https://web.archive.org/web/20230419164506/https://books.google.com/books?id=PIGizgEACAAJ | url-status=live }}</ref><ref name="American Psychiatric Association 2022 ch. 19">{{cite book | author=American Psychiatric Association | title=Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR(tm)) | publisher=American Psychiatric Association Publishing | series=G - Reference,Information and Interdisciplinary Subjects Series | year=2022 | isbn=978-0-89042-576-3 | url=https://books.google.com/books?id=PIGizgEACAAJ | chapter=Substance-Related and Addictive Disorders | page=543 | quote=In addition to the substance-related disorders, this chapter also includes gambling disorder, reflecting evidence that gambling behaviors activate reward systems similar to those activated by drugs of abuse and that produce some behavioral symptoms that appear comparable to those produced by the substance use disorders. Other excessive behavioral patterns, such as Internet gaming (see “Conditions for Further Study”), have also been described, but the research on these and other behavioral syndromes is less clear. Thus, groups of repetitive behaviors, sometimes termed <em>behavioral addictions</em> (with subcategories such as “sex addiction,” “exercise addiction,” and “shopping addiction”), are not included because there is insufficient peer-reviewed evidence to establish the diagnostic criteria and course descriptions needed to identify these behaviors as mental disorders. | access-date=2022-04-15 | archive-date=2023-04-19 | archive-url=https://web.archive.org/web/20230419164506/https://books.google.com/books?id=PIGizgEACAAJ | url-status=live }}</ref>
-The role pornography plays in the neuropsychological development of adolescents is not well understood, due to a lack of empirical research.<ref name="Brown Wisco 2019 pp. 10–13">{{cite journal | last1=Brown | first1=Jennifer A. | last2=Wisco | first2=Jonathan J. | title=The components of the adolescent brain and its unique sensitivity to sexually explicit material | journal=Journal of Adolescence | publisher=Elsevier BV | volume=72 | year=2019 | issn=0140-1971 | pmid=30754014 | doi=10.1016/j.adolescence.2019.01.006 | pages=10–13| s2cid=73442225 }}</ref> While experimental research in the area presents considerable ethical challenges,<ref name="Dallas News 2014">{{cite web | first=David | last=Segal | author-link=David Segal (reporter) | title=Does porn harm children? | website=Dallas News | date=4 April 2014 | url=https://www.dallasnews.com/opinion/commentary/2014/04/04/does-porn-harm-children/ | access-date=14 April 2021 | archive-date=15 April 2021 | archive-url=https://web.archive.org/web/20210415220746/https://www.dallasnews.com/opinion/commentary/2014/04/04/does-porn-harm-children/ | url-status=live }}</ref> a 2021 review which compiled evidence from other empirical sources such as surveys found that representations of women in pornography may lead adolescent boys to view women mainly as sexual objects, with probable repercussions for gender equality.<ref name="Roman Garcia et al 2021">{{cite journal | last1=Román García | first1=Óscar | last2=Bacigalupe | first2=Amaia | last3=Vaamonde García | first3=Cristina | title=[Sexual and reproductive health effects of mainstream pornography use in adolescents] | journal=Revista Española de Salud Pública | volume=95 | issue=1 | year=2021 | pmid=34267175 | quote=También es necesario tener en cuenta que puede existir una limitación de causalidad inversa relacionada con los hallazgos actuales sobre la posibilidad de que padecer algún determinado problema de salud mental o tener conductas de agresividad puede conllevar a un aumento de consumo de pornografía mainstream.}}</ref> The review, however, nowhere claims that it has shown a causal relationship from mainstream pornography viewing to perspectives furthering gender inequality.<ref name="Roman Garcia et al 2021"/> Besides, it nowhere states if the correlation found is large or small, numbers for it are not given either.<ref name="Roman Garcia et al 2021"/>
+ICD-11 has added pornography to CSBD.<ref name="ICD-11 2022">{{cite web | title=ICD-11 for Mortality and Morbidity Statistics 6C72 Compulsive sexual behaviour disorder | website=ICD-11 | url=https://icd.who.int/browse11/l-m/en#/http%253A%252F%252Fid.who.int%252Ficd%252Fentity%252F1630268048 | access-date=19 April 2022 | archive-date=1 August 2018 | archive-url=https://archive.today/20180801205234/https://icd.who.int/browse11/l-m/en%23/http://id.who.int/icd/entity/294762853#/http%253A%252F%252Fid.who.int%252Ficd%252Fentity%252F1630268048 | url-status=live }}</ref> However, this is categorized as an impulse control disorder, not an addictive disorder.<ref name="ICD-11 2022"/><ref name="DPB" /> It has been argued that the CSBD diagnosis is not based upon sex research.<ref name="Briken Turner pp. 222–225">{{cite journal | last1=Briken | first1=Peer | last2=Turner | first2=Daniel | title=What does "Sexual" mean in compulsive sexual behavior disorder? • | journal=Journal of Behavioral Addictions | publisher=Akademiai Kiado Zrt. | volume=11 | issue=2 | date=13 July 2022 | issn=2062-5871 | doi=10.1556/2006.2022.00026 | pages=222–225| pmid=35895459 | pmc=9295231 }}</ref>
-Peter and Valkenburg (2016) 20 years systematic review: its [[positivism|positive]] conclusions are tentative, and causality cannot be shown.<ref name="Peter Valkenburg 2016 pp. 509–531">{{cite journal | last1=Peter | first1=Jochen | last2=Valkenburg | first2=Patti M. | title=Adolescents and Pornography: A Review of 20 Years of Research | journal=The Journal of Sex Research | publisher=Informa UK Limited | volume=53 | issue=4–5 | date=30 March 2016 | issn=0022-4499 | doi=10.1080/00224499.2016.1143441 | pages=509–531| pmid=27105446 | s2cid=205443959 | doi-access=free }}</ref> Brown and Wisco (2019) systematic review: idem ditto.<ref name="Brown Wisco 2019 pp. 10–13"/>
+Neither DSM-5, nor DSM-5-TR, nor ICD-10, nor ICD-11 recognize sex addiction or porn addiction as a valid diagnosis.<ref name="Martinez-Gilliard 2023 p. 113"/><ref name="Prause Binnie 2023"/><ref name="DPB" /> Rothman has stated "pornography is not yet clearly established as a risk factor for multiple health outcomes".{{sfn|Rothman|2021|p=9|ps=: "pornography is not yet clearly established as a risk factor for multiple health outcomes"}}
-DSM-5-TR, published in March 2022, does not recognize a diagnosis of sexual addiction/compulsion (which would include internet pornography viewing).<ref name="Martinez-Gilliard 2023 p. 113"/><ref name="American Psychiatric Association 2022 ch. 29">{{cite book | author=American Psychiatric Association | title=Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR(tm)) | publisher=American Psychiatric Association Publishing | series=G - Reference,Information and Interdisciplinary Subjects Series | year=2022 | isbn=978-0-89042-576-3 | url=https://books.google.com/books?id=PIGizgEACAAJ | chapter=Conditions for Further Study | page=916 | quote=Excessive use of the Internet not involving playing of online games (e.g., excessive use of social media, such as Facebook; viewing pornography online) is not considered analogous to Internet gaming disorder, and future research on other excessive uses of the Internet would need to follow similar guidelines as suggested herein. Excessive gambling online may qualify for a separate diagnosis of gambling disorder. | access-date=2022-04-15 | archive-date=2023-04-19 | archive-url=https://web.archive.org/web/20230419164506/https://books.google.com/books?id=PIGizgEACAAJ | url-status=live }}</ref><ref name="American Psychiatric Association 2022 ch. 19">{{cite book | author=American Psychiatric Association | title=Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR(tm)) | publisher=American Psychiatric Association Publishing | series=G - Reference,Information and Interdisciplinary Subjects Series | year=2022 | isbn=978-0-89042-576-3 | url=https://books.google.com/books?id=PIGizgEACAAJ | chapter=Substance-Related and Addictive Disorders | page=543 | quote=In addition to the substance-related disorders, this chapter also includes gambling disorder, reflecting evidence that gambling behaviors activate reward systems similar to those activated by drugs of abuse and that produce some behavioral symptoms that appear comparable to those produced by the substance use disorders. Other excessive behavioral patterns, such as Internet gaming (see “Conditions for Further Study”), have also been described, but the research on these and other behavioral syndromes is less clear. Thus, groups of repetitive behaviors, sometimes termed <em>behavioral addictions</em> (with subcategories such as “sex addiction,” “exercise addiction,” and “shopping addiction”), are not included because there is insufficient peer-reviewed evidence to establish the diagnostic criteria and course descriptions needed to identify these behaviors as mental disorders. | access-date=2022-04-15 | archive-date=2023-04-19 | archive-url=https://web.archive.org/web/20230419164506/https://books.google.com/books?id=PIGizgEACAAJ | url-status=live }}</ref>
+{{blockquote|1=However, pornography addiction is not presently considered a diagnosable condition according to the DSM. Alternatives to the DSM, such as the ICD-11, also have not subscribed to the addiction model for pornography, though they recognize that people may become compulsive about its use.|2={{harvnb|Rothman|2021|p=103}}}}
-ICD-11 has added pornography to CSBD.<ref name="ICD-11 2022">{{cite web | title=ICD-11 for Mortality and Morbidity Statistics 6C72 Compulsive sexual behaviour disorder | website=ICD-11 | url=https://icd.who.int/browse11/l-m/en#/http%253A%252F%252Fid.who.int%252Ficd%252Fentity%252F1630268048 | access-date=19 April 2022 | archive-date=1 August 2018 | archive-url=https://archive.today/20180801205234/https://icd.who.int/browse11/l-m/en%23/http://id.who.int/icd/entity/294762853#/http%253A%252F%252Fid.who.int%252Ficd%252Fentity%252F1630268048 | url-status=live }}</ref> However, this is categorized as an impulse control disorder, not an addictive disorder.<ref name="ICD-11 2022"/><ref name="Pontes 2022 p. 163"/><ref name="Bowman 2022 p. 161"/> It has been argued that the CSBD diagnosis is not based upon sex research.<ref name="Briken Turner pp. 222–225">{{cite journal | last1=Briken | first1=Peer | last2=Turner | first2=Daniel | title=What does "Sexual" mean in compulsive sexual behavior disorder? • | journal=Journal of Behavioral Addictions | publisher=Akademiai Kiado Zrt. | volume=11 | issue=2 | date=13 July 2022 | issn=2062-5871 | doi=10.1556/2006.2022.00026 | pages=222–225| pmid=35895459 | pmc=9295231 }}</ref>
+A 2022 book by McKee, Litsou, Byron, and Ingham casts serious doubts upon the model of "porn addiction", suggesting that sexual shame should be blamed, instead of pornography.{{sfn|McKee|Litsou|Byron|Ingham|2022|pp=101-103}} They note that much of the research on the effects of pornography often confuses [[Correlation does not imply causation|correlation with causation]],<ref name="McKee">{{cite book | last1=McKee | first1=Alan | last2=Litsou | first2=Katerina | last3=Byron | first3=Paul | last4=Ingham | first4=Roger | title=What Do We Know About the Effects of Pornography After Fifty Years of Academic Research? | publisher=Routledge | publication-place=London | date=10 June 2022 | isbn=978-1-003-23203-2 | doi=10.4324/9781003232032 | page=94}}</ref> and that much pornography research has been normative (i.e. moralistic) instead of descriptive.<ref name="McKee"/>
-Neither DSM-5, nor DSM-5-TR, nor ICD-10, nor ICD-11 recognize sex addiction or porn addiction as a valid diagnosis.<ref name="Martinez-Gilliard 2023 p. 113"/><ref name="Pontes 2022 p. 163"/><ref name="Bowman 2022 p. 161"/><ref name="Prause Binnie 2023 p=136346072311570">{{cite journal | last1=Prause | first1=Nicole | last2=Binnie | first2=James | title=Iatrogenic effects of Reboot/NoFap on public health: A preregistered survey study | journal=Sexualities | publisher=SAGE Publications | date=22 February 2023 | issn=1363-4607 | doi=10.1177/13634607231157070 | page=136346072311570| s2cid=257172274 | url=https://openresearch.lsbu.ac.uk/download/af044dbeb36aefcdb593641a18267139b810bb745d21ca4e8881f5e40472d2e8/1373447/Submission_Sexualities_12.13.2022.pdf }}</ref>
 ==Treatment==
@@ Line 64: / Line 72: @@
 ==Epidemiology==
-There is only one representative sample (published in 2017) to date concerning distress about sex video use.<ref>{{cite journal |last1= Rissel|first1= C |last2=Richters|first2=J.|last3=de Visser|first3=R.|last4= McKee|first4=A.|last5=Yeung|first5=A.|year=2017|title=A profile of pornography users in australia: Findings from the second australian study of health and relationships|journal=The Journal of Sex Research|volume=54|issue= 2 |pages=227–240|doi=10.1080/00224499.2016.1191597|pmid= 27419739 |hdl= 10453/48993 |s2cid= 11724798 |hdl-access=free}}</ref> They found that of 10,131 women surveyed, 0.5% of women agreed with the statement that they were "addicted" to pornography; 1.2% (of 4,218 who viewed) when limited to women who say they viewed sex films. The comparable figure limiting to men who view sex films was 4.4%. This was without any clinical screening that should eliminate primary disorders (e.g., depression) or religious-based concerns, so these should be considered high-end estimates for potential disorders, if any exist.
+A 2017 study using a [[representative sample]] of Australians researched distress about sex video use.<ref>{{cite journal |last1= Rissel|first1= C |last2=Richters|first2=J.|last3=de Visser|first3=R.|last4= McKee|first4=A.|last5=Yeung|first5=A.|year=2017|title=A profile of pornography users in Australia: Findings from the second Australian study of health and relationships|journal=The Journal of Sex Research|volume=54|issue= 2 |pages=227–240|doi=10.1080/00224499.2016.1191597|pmid= 27419739 |hdl= 10453/48993 |s2cid= 11724798 |hdl-access=free}}</ref> It found that of 10,131 women surveyed, 0.5% of women agreed with the statement that they were "addicted" to pornography; 1.2% (of 4,218 who viewed) when limited to women who say they viewed sex films. The comparable figure limiting to men who view sex films was 4.4%. This was without any clinical screening that should eliminate primary disorders (e.g., depression) or religious-based concerns, so these should be considered high-end estimates for potential disorders, if any exist.
-Most studies of rates use a [[convenience sample]]. One 2000 study of a convenience sample of 9,265 people found that 1% of Internet users have concerns about their Internet use and 17% of users meet criteria for problematic [[sexual compulsivity]], meaning they score above one [[standard deviation]] of the mean on the Kalichman [[Sexual Compulsivity Scale]].<ref>{{cite journal |author1=Cooper A. |author2=Delmonico D. L. |author3=Burg R. | year = 2000 | title = Cybersex user, abusers, and compulsives | journal = Sexual Addiction and Compulsivity | volume = 7 | issue = 1–2| pages = 5–29 | doi=10.1080/10720160008400205|s2cid=144124065 }}</ref>{{full citation needed|date=January 2016}} A survey of 84 college-age males found that 20{{ndash}}60% of a sample of college-age males who use pornography found it to be problematic.{{r|cp2}} Research on [[internet addiction disorder]] indicates rates may range from 1.5 to 8.2% in Europeans and Americans.{{r|cp3}}
+Most studies of rates use a [[convenience sample]]. One 2000 study of a convenience sample of 9,265 people found that 1% of Internet users have concerns about their Internet use and 17% of users meet criteria for problematic [[sexual compulsivity]], meaning they score above one [[standard deviation]] of the mean on the Kalichman [[Sexual Compulsivity Scale]].<ref>{{cite journal |author1=Cooper A. |author2=Delmonico D. L. |author3=Burg R. | year = 2000 | title = Cybersex user, abusers, and compulsives | journal = Sexual Addiction and Compulsivity | volume = 7 | issue = 1–2| pages = 5–29 | doi=10.1080/10720160008400205|s2cid=144124065 }}</ref> A survey of 84 college-age males found that 20{{ndash}}60% of a sample of college-age males who use pornography found it to be problematic.{{r|cp2}} Research on [[internet addiction disorder]] indicates rates may range from 1.5 to 8.2% in Europeans and Americans.{{r|cp3}}
+A 2019 study found that the average frequency of use for those self-describing as addicted to porn was about ten times per year.<ref name="Hagen">{{cite news |publisher=NPR |title=Masturbation abstinence is popular online. Doctors and therapists are worried |date=February 3, 2024 |author=Lisa Hagen |url=https://www.npr.org/2026/01/01/1198916105/mens-health-masturbation-abstinence}}</ref> The study found this identification correlated with male gender, higher frequency of use, and belief that pornography was morally wrong (whether for religious or other reasons).<ref>{{cite journal |author1=Grubbs, J. B. |author2=Grant, J. T. |author3=Engelman, J. |year=2018 |title=Self-identification as a pornography addict: examining the roles of pornography use, religiousness, and moral incongruence |journal=Sexual Addiction & Compulsivity |volume=25 |issue=4 |pages=269–292 |doi=10.1080/10720162.2019.1565848}}</ref>
+A review paper about pornography consumption notes that sex addiction is correlated with [[narcissism]].<ref>{{cite journal | last1=Privara | first1=Michal | last2=Bob | first2=Petr | title=Pornography Consumption and Cognitive-Affective Distress | journal=Journal of Nervous & Mental Disease | publisher=Ovid Technologies (Wolters Kluwer Health) | volume=211 | issue=8 | year=2023 | issn=1539-736X | doi=10.1097/nmd.0000000000001669 | doi-access=free | pages=641–646| pmid=37505898 | pmc=10399954 }}</ref>
 ==Society and culture==
@@ Line 72: / Line 84: @@
 Several [[support group]]s exist for people who wish to quit pornography use and/or believe themselves to be addicted to pornography. [[Twelve-step program]]s such as [[Sex Addicts Anonymous]] (SAA), [[Sexaholics Anonymous]] (SA), [[Sex and Love Addicts Anonymous]] (SLAA), [[Sexual Recovery Anonymous]] (SRA), and [[Sexual Compulsives Anonymous]] (SCA) are fellowships of men and women who share their experience, strength and hope with each other so they may overcome their common problem and help others recover from addiction or dependency by using the [[twelve-step program]] borrowed from [[Alcoholics Anonymous]] (AA) and other recovery tools.<ref>{{Cite journal |last1=Efrati |first1=Yaniv |last2=Gola |first2=Mateusz |date=2018 |title=Compulsive sexual behavior: A twelve-step therapeutic approach |journal=Journal of Behavioral Addictions |language=en |volume=7 |issue=2 |pages=445–453 |doi=10.1556/2006.7.2018.26 |issn=2062-5871 |pmc=6174596 |pmid=29787293}}</ref>
-[[NoFap]] is website and community forum founded in 2011 that serves as a support group for those who wish to give up pornography and [[masturbation]].<ref name="Burnett 2021">{{cite journal |last=Burnett |first=Scott |date=May 2021 |title=The Battle for "NoFap": Myths, Masculinity, and the Meaning of Masturbation Abstention |editor1-last=Barber |editor1-first=Kristen |editor2-last=Bridges |editor2-first=Tristan |editor3-last=Nelson |editor3-first=Joseph Derrick |journal=[[Men and Masculinities]] |volume=25 |issue=3 |publisher=[[SAGE Publications]] |pages=477–496 |doi=10.1177/1097184X211018256 |doi-access=free |issn=1552-6828 |lccn=98659253 |oclc=321242407 |s2cid=236603234 }}</ref> It serves as a support group for those who wish to avoid the use of pornography, masturbation, and/or [[sexual intercourse]].<ref name="Burnett 2021"/><ref>{{cite news|last1=Cowell|first1=Tom|title=No fapping, please, it's making us ill|url=https://www.telegraph.co.uk/men/thinking-man/10288240/No-fapping-please-its-making-us-ill.html |archive-url=https://ghostarchive.org/archive/20220112/https://www.telegraph.co.uk/men/thinking-man/10288240/No-fapping-please-its-making-us-ill.html |archive-date=2022-01-12 |url-access=subscription |url-status=live|access-date=22 May 2015|work=The Telegraph|publisher=Telegraph Media Group|date=17 September 2013|location=London, England}}{{cbignore}}</ref><ref>{{cite news|last1=McMahon|first1=Tamsin|title=Will quitting porn improve your life?: A growing 'NoFap' movement of young men are saying no to porn and masturbation|url=http://www.macleans.ca/society/life/can-swearing-off-porn-improve-your-life/|access-date=22 May 2015|work=Maclean's|publisher=Rogers Media|date=20 January 2014|location=Toronto, Canada|archive-date=2 May 2015|archive-url=https://web.archive.org/web/20150502065939/http://www.macleans.ca/society/life/can-swearing-off-porn-improve-your-life/|url-status=live}}</ref> Recent peer-reviewed data highlighted considerable levels of [[misogyny]] along with a poor understanding of [[human sexuality]] and [[Sexual relationship|relationships]] within this online community.<ref>{{cite journal|last1=Taylor |first1= K. | last2=Jackson|first2=S.|date=2018|title='I want that power back': Discourses of masculinity within an online pornography abstinence forum|journal=Sexualities|volume= 21 |issue= 4 |pages= 621–639 |doi=10.1177/1363460717740248|s2cid= 149306706 }}</ref> ''[[The Daily Dot]]'' and ''[[Der Spiegel]]'' linked NoFap to recent [[Violence against women|gender-based]] [[murder]]s and breeding [[domestic terrorism]].<ref name="The Daily Dot 2021">{{cite web | first=Ana | last=Valens | title=It's easy to see the role 'NoFap' played in yesterday's violence against Asian women | website=The Daily Dot | date=17 March 2021 | url=https://www.dailydot.com/debug/nofap-sex-addiction-whorephobia/ | access-date=25 March 2021 | archive-date=19 March 2021 | archive-url=https://web.archive.org/web/20210319203414/https://www.dailydot.com/debug/nofap-sex-addiction-whorephobia/ | url-status=live }}</ref><ref name="Rosenbach Müller Höfner Baumgärtner 2021">{{cite web | last1=Rosenbach | first1=Marcel | last2=Müller | first2=Ann-Katrin | last3=Höfner | first3=Roman | last4=Baumgärtner | first4=Maik | last5=Spiegel | first5=Der | title=Hatred Against Women: The Dark World of Extremist Misogyny | website=DER SPIEGEL | date=10 March 2021 | url=https://www.spiegel.de/international/germany/from-digital-hate-to-analog-violence-the-dark-world-of-extremist-misogyny-a-832ed3cb-21d1-4e84-8c28-089365e91a83 | access-date=25 March 2021 | archive-date=4 December 2021 | archive-url=https://web.archive.org/web/20211204130424/https://www.spiegel.de/international/germany/from-digital-hate-to-analog-violence-the-dark-world-of-extremist-misogyny-a-832ed3cb-21d1-4e84-8c28-089365e91a83 | url-status=live }}</ref>
+[[NoFap]] is website and community forum founded in 2011 that serves as a support group for those who wish to give up pornography and [[masturbation]].<ref name="Burnett 2021">{{cite journal |last=Burnett |first=Scott |date=May 2021 |title=The Battle for "NoFap": Myths, Masculinity, and the Meaning of Masturbation Abstention |editor1-last=Barber |editor1-first=Kristen |editor2-last=Bridges |editor2-first=Tristan |editor3-last=Nelson |editor3-first=Joseph Derrick |journal=[[Men and Masculinities]] |volume=25 |issue=3 |publisher=[[SAGE Publications]] |pages=477–496 |doi=10.1177/1097184X211018256 |doi-access=free |issn=1552-6828 |lccn=98659253 |oclc=321242407 |s2cid=236603234 }}</ref> It serves as a support group for those who wish to avoid the use of pornography, masturbation, and/or [[sexual intercourse]].<ref name="Burnett 2021"/><ref>{{cite news|last1=Cowell|first1=Tom|title=No fapping, please, it's making us ill|url=https://www.telegraph.co.uk/men/thinking-man/10288240/No-fapping-please-its-making-us-ill.html |archive-url=https://ghostarchive.org/archive/20220112/https://www.telegraph.co.uk/men/thinking-man/10288240/No-fapping-please-its-making-us-ill.html |archive-date=2022-01-12 |url-access=subscription |url-status=live|access-date=22 May 2015|work=The Telegraph|publisher=Telegraph Media Group|date=17 September 2013|location=London, England}}{{cbignore}}</ref><ref>{{cite news|last1=McMahon|first1=Tamsin|title=Will quitting porn improve your life?: A growing 'NoFap' movement of young men are saying no to porn and masturbation|url=http://www.macleans.ca/society/life/can-swearing-off-porn-improve-your-life/|access-date=22 May 2015|work=Maclean's|publisher=Rogers Media|date=20 January 2014|location=Toronto, Canada|archive-date=2 May 2015|archive-url=https://web.archive.org/web/20150502065939/http://www.macleans.ca/society/life/can-swearing-off-porn-improve-your-life/|url-status=live}}</ref> Recent peer-reviewed data highlighted considerable levels of [[misogyny]] along with a poor understanding of [[human sexuality]] and [[Sexual relationship|relationships]] within this online community.<ref>{{cite journal|last1=Taylor |first1= K. | last2=Jackson|first2=S.|date=2018|title='I want that power back': Discourses of masculinity within an online pornography abstinence forum|journal=Sexualities|volume= 21 |issue= 4 |pages= 621–639 |doi=10.1177/1363460717740248|s2cid= 149306706 |hdl=2292/41827|hdl-access=free}}</ref> Sociologist Kelsy Burke, author of ''The Pornography Wars'', believes that this misogyny arises from blaming the female-dominated profession of pornography for men's personal problems.<ref name="Hagen" /> ''[[The Daily Dot]]'' and ''[[Der Spiegel]]'' linked NoFap to recent [[Violence against women|gender-based]] [[murder]]s and breeding [[domestic terrorism]].<ref name="The Daily Dot 2021">{{cite web | first=Ana | last=Valens | title=It's easy to see the role 'NoFap' played in yesterday's violence against Asian women | website=The Daily Dot | date=17 March 2021 | url=https://www.dailydot.com/debug/nofap-sex-addiction-whorephobia/ | access-date=25 March 2021 | archive-date=19 March 2021 | archive-url=https://web.archive.org/web/20210319203414/https://www.dailydot.com/debug/nofap-sex-addiction-whorephobia/ | url-status=live }}</ref><ref name="Rosenbach Müller Höfner Baumgärtner 2021">{{cite web | last1=Rosenbach | first1=Marcel | last2=Müller | first2=Ann-Katrin | last3=Höfner | first3=Roman | last4=Baumgärtner | first4=Maik | last5=Spiegel | first5=Der | title=Hatred Against Women: The Dark World of Extremist Misogyny | website=DER SPIEGEL | date=10 March 2021 | url=https://www.spiegel.de/international/germany/from-digital-hate-to-analog-violence-the-dark-world-of-extremist-misogyny-a-832ed3cb-21d1-4e84-8c28-089365e91a83 | access-date=25 March 2021 | archive-date=4 December 2021 | archive-url=https://web.archive.org/web/20211204130424/https://www.spiegel.de/international/germany/from-digital-hate-to-analog-violence-the-dark-world-of-extremist-misogyny-a-832ed3cb-21d1-4e84-8c28-089365e91a83 | url-status=live }}</ref>
 [[Fight the New Drug]], a [[Salt Lake City]]-based non-profit organization founded by members of [[the Church of Jesus Christ of Latter-day Saints]],<ref name="beast">{{Cite news |url=https://www.thedailybeast.com/porn-kills-love-mormons-anti-smut-crusade |title='Porn Kills Love': Mormons' Anti-Smut Crusade |last=Allen |first=Samantha |date=October 20, 2015 |newspaper=The Daily Beast |access-date=April 4, 2023 |archive-date=April 4, 2023 |archive-url=https://web.archive.org/web/20230404035901/https://www.thedailybeast.com/porn-kills-love-mormons-anti-smut-crusade |url-status=live }}</ref> is a non-legislative organization which claims to seek to inform and educate individuals regarding pornography usage with science and personal stories. It is aimed at the youth demographic. There is also a PornFree reddit group which focuses on giving up porn rather than masturbation.<ref>{{cite news|last=Hosie|first=Rachel|date=3 May 2017|title=Inside the community of men who have given up porn|url=https://www.independent.co.uk/life-style/love-sex/porn-free-men-community-give-up-sex-videos-masturbation-reddit-pornfree-a7713841.html|website=The Independent|access-date=2 July 2018|archive-date=20 February 2018|archive-url=https://web.archive.org/web/20180220212512/http://www.independent.co.uk/life-style/love-sex/porn-free-men-community-give-up-sex-videos-masturbation-reddit-pornfree-a7713841.html|url-status=live}}</ref><ref>{{Cite web|url=http://www.independent.co.uk/life-style/porn-addiction-man-delete-18-terabyte-sex-videos-collection-to-help-a7893991.html|title=Man deletes 18 terabyte porn collection to try and end his addiction|date=2017-08-15|website=The Independent|language=en|access-date=2020-01-31|archive-date=2020-01-31|archive-url=https://web.archive.org/web/20200131161306/https://www.independent.co.uk/life-style/porn-addiction-man-delete-18-terabyte-sex-videos-collection-to-help-a7893991.html|url-status=live}}</ref>
@@ Line 78: / Line 90: @@
 [[Celebrate Recovery]] is a Christian inter-denominational twelve-step program with about 35,000 available groups and is open to any person who is struggling with life's bad habits, hurts, and hang-ups.<ref>{{Cite web |title=Issue Pamphlets - Celebrate Recovery® |url=https://www.celebraterecovery.com/resources/issue-pamphlets |access-date=2023-03-18 |website=www.celebraterecovery.com |archive-date=2023-03-18 |archive-url=https://web.archive.org/web/20230318201200/https://www.celebraterecovery.com/resources/issue-pamphlets |url-status=live }}</ref> Celebrate Recovery was started in 1991 at [[Saddleback Church]] in [[California]], and their program is based on the [[Beatitudes]] from the biblical [[Sermon on the Plain]] and the twelve-step program from Alcoholics Anonymous.<ref>{{Cite web |title=12 Steps - Celebrate Recovery® |url=https://www.celebraterecovery.com/resources/12-steps |access-date=2023-03-18 |website=www.celebraterecovery.com |archive-date=2023-03-18 |archive-url=https://web.archive.org/web/20230318201201/https://www.celebraterecovery.com/resources/12-steps |url-status=live }}</ref>
-===Religious factors===
+===Religious and political factors===
 {{Main|Opposition to pornography|Religion and sexuality|Religious views on pornography}}
 {{See also|Anti-pornography feminism|Anti-pornography movement in the United Kingdom|Anti-pornography movement in the United States}}
-According to professor {{ill|E. T. M. Laan|nl|Ellen Laan}}, a [[Sexology|sexologist]] working for the [[Academic Medical Center]], it is usually the [[American religious right]] which claims the existence of pornography addiction and such claims are rare (scarce) among sexologists.<ref>{{cite web|author=Casper van der Veen|title='Erectieproblemen bij jongeren door porno op internet' - NRC|url=https://www.nrc.nl/nieuws/2016/08/17/erectieproblemen-bij-jongeren-door-porno-op-internet-3826489-a1516755|access-date=20 September 2016|date=17 August 2016|archive-date=21 August 2016|archive-url=https://web.archive.org/web/20160821120655/http://www.nrc.nl/nieuws/2016/08/17/erectieproblemen-bij-jongeren-door-porno-op-internet-3826489-a1516755|url-status=live}}</ref> A 2018 [[meta-analysis]] showed a correlation between a person being religious and perceiving themself as having a pornography addiction, possibly due to people using pornography despite their religion prohibiting it.<ref name="stopped">{{cite web |last=Ley |first=David J. |date=21 August 2018 |title=Science Stopped Believing in Porn Addiction. You Should, Too |url=https://www.psychologytoday.com/us/blog/women-who-stray/201808/science-stopped-believing-in-porn-addiction-you-should-too |url-status=live |archive-url=https://archive.today/20180825052439/https://www.psychologytoday.com/us/blog/women-who-stray/201808/science-stopped-believing-in-porn-addiction-you-should-too |archive-date=25 August 2018 |access-date=28 March 2023 |website=Psychology Today}}</ref><ref>{{Cite journal|last1=Grubbs|first1=Joshua B.|last2=Perry|first2=Samuel L.|last3=Wilt|first3=Joshua A.|last4=Reid|first4=Rory C.|date=2018-08-03|title=Pornography Problems Due to Moral Incongruence: An Integrative Model with a Systematic Review and Meta-Analysis|journal=Archives of Sexual Behavior|volume=48|issue=2|pages=397–415|doi=10.1007/s10508-018-1248-x|pmid=30076491|s2cid=51911309|issn=0004-0002}}</ref><ref>{{Citation |last1=Štulhofer |first1=Aleksandar |title=Pornography Use in Adolescence and Young Adulthood |date=2022 |url=https://rdcu.be/djM1N |work=Gender and Sexuality Development: Contemporary Theory and Research |pages=387–389 |editor-last=VanderLaan |editor-first=Doug P. |access-date=2023-08-17 |series=Focus on Sexuality Research |place=Cham |publisher=Springer International Publishing |language=en |doi=10.1007/978-3-030-84273-4_14 |isbn=978-3-030-84273-4 |last2=Kohut |first2=Taylor |last3=Koletić |first3=Goran |editor2-last=Wong |editor2-first=Wang Ivy}}</ref>
+According to professor {{ill|E. T. M. Laan|nl|Ellen Laan}}, a [[Sexology|sexologist]] working for the [[Academic Medical Center]], it is usually the [[American religious right]] which claims the existence of pornography addiction and such claims are rare (scarce) among sexologists.<ref>{{cite news|author=Casper van der Veen|title='Erectieproblemen bij jongeren door porno op internet' - NRC|newspaper=NRC |url=https://www.nrc.nl/nieuws/2016/08/17/erectieproblemen-bij-jongeren-door-porno-op-internet-3826489-a1516755|access-date=20 September 2016|date=17 August 2016|archive-date=21 August 2016|archive-url=https://web.archive.org/web/20160821120655/http://www.nrc.nl/nieuws/2016/08/17/erectieproblemen-bij-jongeren-door-porno-op-internet-3826489-a1516755|url-status=live}}</ref> A 2018 [[meta-analysis]] showed a correlation between a person being religious and perceiving themself as having a pornography addiction, possibly due to people using pornography despite their religion prohibiting it.<ref name="stopped">{{cite web |last=Ley |first=David J. |date=21 August 2018 |title=Science Stopped Believing in Porn Addiction. You Should, Too |url=https://www.psychologytoday.com/us/blog/women-who-stray/201808/science-stopped-believing-in-porn-addiction-you-should-too |url-status=live |archive-url=https://archive.today/20180825052439/https://www.psychologytoday.com/us/blog/women-who-stray/201808/science-stopped-believing-in-porn-addiction-you-should-too |archive-date=25 August 2018 |access-date=28 March 2023 |website=Psychology Today}}</ref><ref>{{Cite journal|last1=Grubbs|first1=Joshua B.|last2=Perry|first2=Samuel L.|last3=Wilt|first3=Joshua A.|last4=Reid|first4=Rory C.|date=2018-08-03|title=Pornography Problems Due to Moral Incongruence: An Integrative Model with a Systematic Review and Meta-Analysis|journal=Archives of Sexual Behavior|volume=48|issue=2|pages=397–415|doi=10.1007/s10508-018-1248-x|pmid=30076491|s2cid=51911309|issn=0004-0002}}</ref><ref>{{Citation |last1=Štulhofer |first1=Aleksandar |title=Pornography Use in Adolescence and Young Adulthood |date=2022 |url=https://rdcu.be/djM1N |work=Gender and Sexuality Development: Contemporary Theory and Research |pages=387–389 |editor-last=VanderLaan |editor-first=Doug P. |access-date=2023-08-17 |series=Focus on Sexuality Research |place=Cham |publisher=Springer International Publishing |language=en |doi=10.1007/978-3-030-84273-4_14 |isbn=978-3-030-84273-4 |last2=Kohut |first2=Taylor |last3=Koletić |first3=Goran |editor2-last=Wong |editor2-first=Wang Ivy}}</ref>
-According to ''Addicted to Lust: Pornography in the Lives of Conservative Protestants'' (2019) written by Samuel L. Perry, professor of [[sociology]] at the [[University of Oklahoma]], conservative [[Protestantism in the United States|Protestants in the United States]] are characterized by a "sexual exceptionalism" related to their consumption of pornography due to certain pervasive beliefs within the Conservative Protestant subculture, which entails [[cognitive dissonance]] associated with the unfounded conviction to be addicted to pornography, [[psychological distress]], and intense feelings of [[Guilt (emotion)|guilt]], [[shame]], [[self-loathing]], [[Depression (mood)|depression]], and sometimes withdrawal from faith altogether.<ref>{{cite book |last=Perry |first=Samuel L. |year=2019 |title=Addicted to Lust: Pornography in the Lives of Conservative Protestants |chapter=Fleshly Lusts That War Against the Soul |pages=57–88 |chapter-url=https://books.google.com/books?id=9iePDwAAQBAJ |location=[[New York City|New York]] |publisher=[[Oxford University Press]] |doi=10.1093/oso/9780190844219.003.0004 |isbn=9780190844219 |lccn=2018054212 |oclc=1090397111 |access-date=2021-07-31 |archive-date=2023-04-19 |archive-url=https://web.archive.org/web/20230419164554/https://www.google.com/books/edition/Addicted_to_Lust/9iePDwAAQBAJ?hl=en |url-status=live }}</ref><ref name="Chotiner 2019">{{cite magazine |last=Chotiner |first=Isaac |date=3 May 2019 |title=A Sociologist of Religion on Protestants, Porn, and the "Purity Industrial Complex" |url=https://www.newyorker.com/culture/q-and-a/a-sociologist-of-religion-on-protestants-porn-and-the-purity-industrial-complex |url-status=live |magazine=[[The New Yorker]] |publisher=[[Condé Nast]] |location=[[New York City]] |issn=0028-792X |oclc=320541675 |archive-url=https://web.archive.org/web/20190503161914/https://www.newyorker.com/culture/q-and-a/a-sociologist-of-religion-on-protestants-porn-and-the-purity-industrial-complex |archive-date=3 May 2019 |access-date=25 October 2021}}</ref>
+According to ''Addicted to Lust: Pornography in the Lives of Conservative Protestants'' (2019) written by [[Samuel L. Perry]], professor of [[sociology]] at the [[University of Oklahoma]], conservative [[Protestantism in the United States|Protestants in the United States]] are characterized by a "sexual exceptionalism" related to their consumption of pornography due to certain pervasive beliefs within the Conservative Protestant subculture, which entails [[cognitive dissonance]] associated with the unfounded conviction to be addicted to pornography, [[psychological distress]], and intense feelings of [[Guilt (emotion)|guilt]], [[shame]], [[self-loathing]], [[Depression (mood)|depression]], and sometimes withdrawal from faith altogether.<ref>{{cite book |last=Perry |first=Samuel L. |year=2019 |title=Addicted to Lust: Pornography in the Lives of Conservative Protestants |chapter=Fleshly Lusts That War Against the Soul |pages=57–88 |chapter-url=https://books.google.com/books?id=9iePDwAAQBAJ |location=[[New York City|New York]] |publisher=[[Oxford University Press]] |doi=10.1093/oso/9780190844219.003.0004 |isbn=978-0-19-084421-9 |lccn=2018054212 |oclc=1090397111 |access-date=2021-07-31 |archive-date=2023-04-19 |archive-url=https://web.archive.org/web/20230419164554/https://www.google.com/books/edition/Addicted_to_Lust/9iePDwAAQBAJ?hl=en |url-status=live }}</ref><ref name="Chotiner 2019">{{cite magazine |last=Chotiner |first=Isaac |date=3 May 2019 |title=A Sociologist of Religion on Protestants, Porn, and the "Purity Industrial Complex" |url=https://www.newyorker.com/culture/q-and-a/a-sociologist-of-religion-on-protestants-porn-and-the-purity-industrial-complex |url-status=live |magazine=[[The New Yorker]] |publisher=[[Condé Nast]] |location=[[New York City]] |issn=0028-792X |oclc=320541675 |archive-url=https://web.archive.org/web/20190503161914/https://www.newyorker.com/culture/q-and-a/a-sociologist-of-religion-on-protestants-porn-and-the-purity-industrial-complex |archive-date=3 May 2019 |access-date=25 October 2021}}</ref>
 Perry's book received widespread [[media coverage]]<ref name="Chotiner 2019"/><ref name="Stone 2019">{{cite magazine |author-last=Stone |author-first=Lyman |date=26 June 2019 |title=Conservative Protestant Men Are Still Resisting Porn |url=https://www.christianitytoday.com/ct/2019/june-web-only/pornography-conservative-protestant-men-still-resisting.html |url-status=live |editor-last=Harrell |editor-first=Daniel M. |magazine=[[Christianity Today]] |location=[[Carol Stream, Illinois]] |issn=0009-5753 |archive-url=https://web.archive.org/web/20190627200105/https://www.christianitytoday.com/ct/2019/june-web-only/pornography-conservative-protestant-men-still-resisting.html |archive-date=27 June 2019 |access-date=31 July 2021}}</ref> and his findings were criticized by Lyman Stone of the Evangelical magazine ''[[Christianity Today]]'', which asserted that both the [[Quantitative research|quantitative]] and [[Qualitative research|qualitative]] statistical data collected by Perry demonstrate that the consumption of pornography in the United States is significantly lower among [[Church attendance|church-attending]] Protestant Christians compared to other [[Religion in the United States|religious groups]], and declared that "Protestant men today who attend church regularly are basically the only men in America still resisting the cultural norm of regularized pornography use".<ref name="Stone 2019"/>
-The overwhelming majority of all websites and YouTube channels devoted to anti-masturbation and anti-porn addiction propaganda, channels and websites supporting NoFap included, are, according to various sources, owned by [[Far-right politics|far-right]] [[Christian fundamentalism|Christian fundamentalists]] and [[Conservatism|conservative]] [[Biblical inerrancy|biblical inerrantists]], and also are entirely political in nature.<ref name="Burnett 2021"/><ref name="DLey 2018">{{cite web | last=Ley | first=David J. | title=Is One Sexual Behavior Triggering Certain Groups? | website=Psychology Today | date=27 October 2018 | url=https://www.psychologytoday.com/us/blog/women-who-stray/201810/is-one-sexual-behavior-triggering-certain-groups | access-date=12 January 2022 | archive-date=31 October 2018 | archive-url=https://archive.today/20181031163503/https://www.psychologytoday.com/us/blog/women-who-stray/201810/is-one-sexual-behavior-triggering-certain-groups | url-status=live }}</ref><!-- have been removed at NoFap: <ref name="ley">{{cite web|url=https://www.psychologytoday.com/blog/women-who-stray/201503/the-nofap-phenomenon|title=The NoFap Phenomenon|last1=Ley|first1=David|website=[[Psychology Today]]|access-date=10 June 2015|archive-date=March 4, 2015|archive-url=https://archive.today/20150304190158/https://www.psychologytoday.com/blog/women-who-stray/201503/the-nofap-phenomenon|url-status=live}}</ref><ref name="McBee 2018">{{cite web | last=McBee | first=Thomas | title=A Sociological Investigation of #NoWanks | website=The Cut | date=14 December 2018 | url=https://www.thecut.com/2018/12/a-sociological-investigation-of-nowanks.html | access-date=12 January 2022}}</ref><ref name="Alptraum 2018">{{cite web | last=Alptraum | first=Lux | title=Why Are The Proud Boys So Obsessed With Not Masturbating? | website=Medium | date=19 October 2018 | url=https://gen.medium.com/why-are-the-proud-boys-so-obsessed-with-masturbation-c9932364ebe2 | access-date=12 January 2022}}</ref><ref name="Dickson Dickson 2019">{{cite web | last=Dickson | first=EJ | last2=Dickson | first2=EJ | title=How a New Meme Exposes the Far-Right Roots of #NoNutNovember | website=Rolling Stone | date=8 November 2019 | url=https://www.rollingstone.com/culture/culture-features/coomer-meme-no-nut-november-nofap-908676/ | access-date=12 January 2022}}</ref>--> Various [[psychologist]]s, [[Doctor of Medicine|medical doctors]], and [[Social sciences|social scientists]] have contended that traditional Christian concerns over combating sexual thoughts, desires, and activities, including masturbation,<ref>{{cite book |author-last=Mbuwayesango |author-first=Dora R. |year=2016 |origyear=2015 |chapter=Part III: The Bible and Bodies – Sex and Sexuality in Biblical Narrative |editor-last=Fewell |editor-first=Danna N. |editor-link=Danna Nolan Fewell |title=The Oxford Handbook of Biblical Narrative |location=[[Oxford]] and [[New York City|New York]] |publisher=[[Oxford University Press]] |pages=456–465 |doi=10.1093/oxfordhb/9780199967728.013.39 |isbn=9780199967728 |lccn=2015033360 |s2cid=146505567}}</ref><ref>{{cite journal |last=Gnuse |first=Robert K. |date=May 2015 |title=Seven Gay Texts: Biblical Passages Used to Condemn Homosexuality |journal=[[Biblical Theology Bulletin]] |publisher=[[SAGE Publications]] on behalf of Biblical Theology Bulletin Inc. |volume=45 |issue=2 |pages=68–87 |doi=10.1177/0146107915577097 |issn=1945-7596 |s2cid=170127256}}</ref><ref>{{cite book |last=Sauer |first=Michelle M. |year=2015 |chapter=The Unexpected Actuality: “Deviance” and Transgression |chapter-url=https://books.google.com/books?id=U8mBCgAAQBAJ&pg=PA74 |title=Gender in Medieval Culture |location=[[London]] |publisher=[[Bloomsbury Academic]] |pages=74–78 |doi=10.5040/9781474210683.ch-003 |isbn=978-1-4411-2160-8 |access-date=2022-01-12 |archive-date=2023-04-19 |archive-url=https://web.archive.org/web/20230419164527/https://books.google.com/books?id=U8mBCgAAQBAJ&pg=PA74 |url-status=live }}</ref><ref>{{cite book |author-last=Frontain |author-first=Raymond-Jean |year=2003 |chapter=Introduction |chapter-url=https://books.google.com/books?id=7nVq0BLfVT4C&pg=PA1 |editor-last=Frontain |editor-first=Raymond-Jean |title=Reclaiming the Sacred: The Bible in Gay and Lesbian Culture |location=[[New York City|New York]] and [[London]] |publisher=[[Harrington Park Press]] |edition=2nd |pages=1–24, 53, 55 |isbn=9781560233558 |lccn=2002068889 |access-date=2022-01-12 |archive-date=2023-04-19 |archive-url=https://web.archive.org/web/20230419164531/https://books.google.com/books?id=7nVq0BLfVT4C&pg=PA1 |url-status=live }}</ref><ref>{{cite book |author1-last=Palmer |author1-first=Randall |author2-last=Winner |author2-first=Lauren F. |year=2005 |origyear=2002 |chapter=Protestants and Homosexuality |chapter-url=https://books.google.com/books?id=hMVH6upbI9QC&pg=PA149 |title=Protestantism in America |location=[[New York City|New York]] |publisher=[[Columbia University Press]] |series=Columbia Contemporary American Religion Series |pages=149–178 |isbn=9780231111317 |lccn=2002023859 |access-date=2022-01-12 |archive-date=2023-04-19 |archive-url=https://web.archive.org/web/20230419164554/https://books.google.com/books?id=hMVH6upbI9QC&pg=PA149 |url-status=live }}</ref> can be seen as unhealthy and unwholesome. This may also apply to secular advocacy of anti-pornography and anti-masturbation,<ref name="nelroth2020"/><ref name="auto"/> including 16 [[U.S. state]]s' legislatures which have declared that pornography is a "public health crisis".<ref name="nelroth2020"/><ref name="Governing 2019">{{cite web | first=Mattie | last=Quinn | title=Is Porn a Public Health Crisis? 16 States Say Yes. | website=Governing | date=17 July 2019 | url=https://www.governing.com/archive/gov-pornography-public-health-crisis-states.html | access-date=12 January 2022 | archive-date=12 January 2022 | archive-url=https://web.archive.org/web/20220112003856/https://www.governing.com/archive/gov-pornography-public-health-crisis-states.html | url-status=live }}</ref>
+The overwhelming majority of all websites and YouTube channels devoted to anti-masturbation and anti-porn addiction propaganda, channels and websites supporting NoFap included, are, according to various sources, owned by [[Far-right politics|far-right]] [[Christian fundamentalism|Christian fundamentalists]] and [[Conservatism|conservative]] [[Biblical inerrancy|biblical inerrantists]], and also are entirely political in nature.<ref name="Burnett 2021"/><ref name="DLey 2018">{{cite web | last=Ley | first=David J. | title=Is One Sexual Behavior Triggering Certain Groups? | website=Psychology Today | date=27 October 2018 | url=https://www.psychologytoday.com/us/blog/women-who-stray/201810/is-one-sexual-behavior-triggering-certain-groups | access-date=12 January 2022 | archive-date=31 October 2018 | archive-url=https://archive.today/20181031163503/https://www.psychologytoday.com/us/blog/women-who-stray/201810/is-one-sexual-behavior-triggering-certain-groups | url-status=live }}</ref><!-- have been removed at NoFap: <ref name="ley">{{cite web|url=https://www.psychologytoday.com/blog/women-who-stray/201503/the-nofap-phenomenon|title=The NoFap Phenomenon|last1=Ley|first1=David|website=[[Psychology Today]]|access-date=10 June 2015|archive-date=March 4, 2015|archive-url=https://archive.today/20150304190158/https://www.psychologytoday.com/blog/women-who-stray/201503/the-nofap-phenomenon|url-status=live}}</ref><ref name="McBee 2018">{{cite web | last=McBee | first=Thomas | title=A Sociological Investigation of #NoWanks | website=The Cut | date=14 December 2018 | url=https://www.thecut.com/2018/12/a-sociological-investigation-of-nowanks.html | access-date=12 January 2022}}</ref><ref name="Alptraum 2018">{{cite web | last=Alptraum | first=Lux | title=Why Are The Proud Boys So Obsessed With Not Masturbating? | website=Medium | date=19 October 2018 | url=https://gen.medium.com/why-are-the-proud-boys-so-obsessed-with-masturbation-c9932364ebe2 | access-date=12 January 2022}}</ref><ref name="Dickson Dickson 2019">{{cite web | last=Dickson | first=EJ | title=How a New Meme Exposes the Far-Right Roots of #NoNutNovember | website=Rolling Stone | date=8 November 2019 | url=https://www.rollingstone.com/culture/culture-features/coomer-meme-no-nut-november-nofap-908676/ | access-date=12 January 2022}}</ref>--> Various [[psychologist]]s, [[Doctor of Medicine|medical doctors]], and [[Social sciences|social scientists]] have contended that traditional Christian concerns over combating sexual thoughts, desires, and activities, including masturbation,<ref>{{cite book |author-last=Mbuwayesango |author-first=Dora R. |year=2016 |origyear=2015 |chapter=Part III: The Bible and Bodies – Sex and Sexuality in Biblical Narrative |editor-last=Fewell |editor-first=Danna N. |editor-link=Danna Nolan Fewell |title=The Oxford Handbook of Biblical Narrative |location=[[Oxford]] and [[New York City|New York]] |publisher=[[Oxford University Press]] |pages=456–465 |doi=10.1093/oxfordhb/9780199967728.013.39 |isbn=978-0-19-996772-8 |lccn=2015033360 |s2cid=146505567}}</ref><ref>{{cite journal |last=Gnuse |first=Robert K. |date=May 2015 |title=Seven Gay Texts: Biblical Passages Used to Condemn Homosexuality |journal=[[Biblical Theology Bulletin]] |publisher=[[SAGE Publications]] on behalf of Biblical Theology Bulletin Inc. |volume=45 |issue=2 |pages=68–87 |doi=10.1177/0146107915577097 |issn=1945-7596 |s2cid=170127256}}</ref><ref>{{cite book |last=Sauer |first=Michelle M. |year=2015 |chapter=The Unexpected Actuality: “Deviance” and Transgression |chapter-url=https://books.google.com/books?id=U8mBCgAAQBAJ&pg=PA74 |title=Gender in Medieval Culture |location=[[London]] |publisher=[[Bloomsbury Academic]] |pages=74–78 |doi=10.5040/9781474210683.ch-003 |isbn=978-1-4411-2160-8 |access-date=2022-01-12 |archive-date=2023-04-19 |archive-url=https://web.archive.org/web/20230419164527/https://books.google.com/books?id=U8mBCgAAQBAJ&pg=PA74 |url-status=live }}</ref><ref>{{cite book |author-last=Frontain |author-first=Raymond-Jean |year=2003 |chapter=Introduction |chapter-url=https://books.google.com/books?id=7nVq0BLfVT4C&pg=PA1 |editor-last=Frontain |editor-first=Raymond-Jean |title=Reclaiming the Sacred: The Bible in Gay and Lesbian Culture |location=[[New York City|New York]] and [[London]] |publisher=[[Harrington Park Press]] |edition=2nd |pages=1–24, 53, 55 |isbn=978-1-56023-355-8 |lccn=2002068889 |access-date=2022-01-12 |archive-date=2023-04-19 |archive-url=https://web.archive.org/web/20230419164531/https://books.google.com/books?id=7nVq0BLfVT4C&pg=PA1 |url-status=live }}</ref><ref>{{cite book |author1-last=Palmer |author1-first=Randall |author2-last=Winner |author2-first=Lauren F. |year=2005 |origyear=2002 |chapter=Protestants and Homosexuality |chapter-url=https://books.google.com/books?id=hMVH6upbI9QC&pg=PA149 |title=Protestantism in America |location=[[New York City|New York]] |publisher=[[Columbia University Press]] |series=Columbia Contemporary American Religion Series |pages=149–178 |isbn=978-0-231-11131-7 |lccn=2002023859 |access-date=2022-01-12 |archive-date=2023-04-19 |archive-url=https://web.archive.org/web/20230419164554/https://books.google.com/books?id=hMVH6upbI9QC&pg=PA149 |url-status=live }}</ref> can be seen as unhealthy and unwholesome. This may also apply to secular advocacy of anti-pornography and anti-masturbation,<ref name="nelroth2020"/><ref name="auto"/> including 16 [[U.S. state]]s' legislatures which have declared that pornography is a "public health crisis".<ref name="nelroth2020"/><ref name="Governing 2019">{{cite web | first=Mattie | last=Quinn | title=Is Porn a Public Health Crisis? 16 States Say Yes. | website=Governing | date=17 July 2019 | url=https://www.governing.com/archive/gov-pornography-public-health-crisis-states.html | access-date=12 January 2022 | archive-date=12 January 2022 | archive-url=https://web.archive.org/web/20220112003856/https://www.governing.com/archive/gov-pornography-public-health-crisis-states.html | url-status=live }}</ref>
 The [[American Psychiatric Association]] had by then already dismissed such [[moral panic]] ("political stunt")<ref name="nelroth2020"/> in [[DSM-5]] (published in 2013),<ref name=weir/> and DSM-5-TR, published in March 2022, does not recognize a diagnosis of sexual addiction (which would include internet pornography viewing).<ref name="American Psychiatric Association 2022 ch. 29"/><ref name="American Psychiatric Association 2022 ch. 19"/>
-Emily F. Rothman, Professor of Community Health Sciences at the [[Boston University School of Public Health]], stated in 2021 that "the professional public health community is not behind the recent push to declare pornography a public health crisis".<ref name="Rothman 2021 p. 2">{{cite book | last=Rothman | first=Emily F. | title=Pornography and Public Health | publisher=Oxford University Press | year=2021 | isbn=978-0-19-007549-1 | url=https://books.google.com/books?id=M30_EAAAQBAJ&pg=PT2 | access-date=31 May 2022 | page=2 | quote=The professional public health community is not behind the recent push to declare pornography a public health crisis. | archive-date=19 April 2023 | archive-url=https://web.archive.org/web/20230419164511/https://books.google.com/books?id=M30_EAAAQBAJ&pg=PT2 | url-status=live }}</ref>  The ideas supporting the "crisis" have been described as pseudoscientific.<ref name="de Jong Faulkenberry Konda Joyner 2022 p. ">{{cite book | last1=de Jong | first1=David C. | last2=Faulkenberry | first2=Rachel S. | last3=Konda | first3=Olivia | last4=Joyner | first4=Berkley | title=Reference Module in Neuroscience and Biobehavioral Psychology | chapter=Masturbation | publisher=Elsevier | year=2022 | pages=369–378 | doi=10.1016/b978-0-323-91497-0.00075-8 | isbn=9780323914987 }}</ref>
+Emily F. Rothman, Professor of Community Health Sciences at the [[Boston University School of Public Health]], stated in 2021 that "the professional public health community is not behind the recent push to declare pornography a public health crisis".{{sfn|Rothman|2021|p=2|ps=: "The professional public health community is not behind the recent push to declare pornography a public health crisis."}} The ideas supporting the "crisis" have been described as pseudoscientific.<ref name="de Jong Faulkenberry Konda Joyner 2022 p. ">{{cite book | last1=de Jong | first1=David C. | last2=Faulkenberry | first2=Rachel S. | last3=Konda | first3=Olivia | last4=Joyner | first4=Berkley | title=Reference Module in Neuroscience and Biobehavioral Psychology | chapter=Masturbation | publisher=Elsevier | year=2022 | pages=369–378 | doi=10.1016/b978-0-323-91497-0.00075-8 | isbn=978-0-323-91498-7 }}</ref>
+{{blockquote|1=Sexual violence, partner violence, anxiety, depression, compulsive pornography use, and commercial sexual exploitation are public health problems, and there is a possibility that pornography exacerbates these problems. Given that possibility, we need to know more about whether, how, and why pornography influences social norms as well as individuals’ behavior, and what we can do to address that influence if it is harmful. It is also important to be aware that framing pornography as a public health issue has been used as a rhetorical trick by right-wing groups to promote a conservative social agenda at odds with public health goals. Public health professionals should sponsor rigorous research on the possible negative effects of pornography on society and individuals, counter misinformation, and use evidence to move forward with policy decisions.|2={{harvnb|Rothman|2021|p=14}}}}
+In many cases, sexual addiction therapy applied to gay men is akin to [[conversion therapy]].<ref>{{Bulleted list|{{cite book | last=Neves | first=Silva | editor-last=Neves | editor-first=Silva | editor-last2=Davies | editor-first2=Dominic | title=Erotically Queer: A Pink Therapy Guide for Practitioners | publisher=Taylor & Francis | year=2023 | isbn=978-1-000-86221-8 | chapter=Chapter 11. MSM and compulsive sexual behaviours. "Sex addiction" and conversion practices | chapter-url=https://books.google.com/books?id=f7iqEAAAQBAJ&pg=PT133 | access-date=17 November 2024 | pages=174–192 | doi=10.4324/9781003260608-12 | quote=When those aversion techniques are applied to MSM, they can be particularly harmful as they are akin to what I would consider conversion practices.}}|{{harvnb|Neves|2021|p=unpaginated|ps=: "I don't believe that all therapists offering a 'sex addiction' treatment are unethical.  But I think that it is possible that many well-meaning and excellent therapists can practice 'conversion therapy' accidentally [...] I fear that there are many more harmed clients who do not speak up."}}|{{cite book | last=Neves | first=Silva | title=Sexology: The Basics | publisher=Taylor & Francis | year=2022 | isbn=978-1-000-77488-7 | url=https://books.google.com/books?id=42KSEAAAQBAJ&pg=PT111 | access-date=17 November 2024 | page=unpaginated | quote=can be at high risk of crossing into “conversion therapy” because of their lack of robust knowledge in contemporary sexology, mistaking normative sexual behaviours for a pathology.}}|{{cite book | last1=McGhee | first1=Jamie | last2=Hollowell | first2=Adam | title=You Mean It or You Don't: James Baldwin's Radical Challenge | publisher=Fortress Press | year=2022 | isbn=978-1-5064-7895-1 | url=https://books.google.com/books?id=9ww3EAAAQBAJ&pg=PA79 | access-date=17 November 2024 | page=79}}|{{cite book | last=Francis | first=Charles | title=Archive Activism: Memoir of a "Uniquely Nasty" Journey | publisher=University of North Texas Press | year=2023 | isbn=978-1-57441-920-7 | url=https://books.google.com/books?id=kaHXEAAAQBAJ&pg=PA187 | access-date=17 November 2024 | page=187}}|{{cite book | last=Meyer | first=Monica | editor-last=Bartlik | editor-first=Barbara | editor-last2=Espinosa | editor-first2=Geovanni | editor-last3=Mindes | editor-first3=Janet | editor-last4=Weil | editor-first4=Andrew | title=Integrative Sexual Health | publisher=Oxford University Press | series=Weil Integrative Medicine Library | year=2018 | isbn=978-0-19-022590-2 | url=https://books.google.com/books?id=UBBQDwAAQBAJ&pg=PA348 | access-date=17 November 2024 | page=348}}}}</ref>
 ===Mainstream media===
-In 2013, American actor [[Joseph Gordon-Levitt]] wrote, directed, and starred in the comedy-drama film ''[[Don Jon]]'', in which the protagonist is addicted to pornography.<ref>{{Cite web| url=https://www.imdb.com/title/tt2229499/| title=Don Jon| website=[[IMDb]]| access-date=2018-10-18| archive-date=2018-10-17| archive-url=https://web.archive.org/web/20181017100751/https://www.imdb.com/title/tt2229499/| url-status=live}}</ref> In an interview to promote the film, Gordon-Levitt discussed what he referred to as the "fundamental difference between a human being and an image on a screen".<ref name="Minow">{{cite web | last=Minow | first=Nell | title=Joseph Gordon-Levitt discusses "Don Jon" - Interviews | website=Roger Ebert | url=https://www.rogerebert.com/interviews/joseph-gordon-levitt-discusses-don-jon | access-date=31 December 2019 | archive-date=31 December 2019 | archive-url=https://web.archive.org/web/20191231075727/https://www.rogerebert.com/interviews/joseph-gordon-levitt-discusses-don-jon | url-status=live }}</ref>
+In 2013, American actor [[Joseph Gordon-Levitt]] wrote, directed, and starred in the comedy-drama film ''[[Don Jon]]'', in which the protagonist is addicted to pornography.<ref>{{Cite web| url=https://www.imdb.com/title/tt2229499/| title=Don Jon| website=[[IMDb]]| access-date=2018-10-18| archive-date=2018-10-17| archive-url=https://web.archive.org/web/20181017100751/https://www.imdb.com/title/tt2229499/| url-status=live}}</ref> In an interview to promote the film, Gordon-Levitt discussed what he referred to as the "fundamental difference between a human being and an image on a screen".<ref name="Minow">{{cite web | last=Minow | first=Nell | title=Joseph Gordon-Levitt discusses "Don Jon" - Interviews | website=Roger Ebert | date=23 September 2013 | url=https://www.rogerebert.com/interviews/joseph-gordon-levitt-discusses-don-jon | access-date=31 December 2019 | archive-date=31 December 2019 | archive-url=https://web.archive.org/web/20191231075727/https://www.rogerebert.com/interviews/joseph-gordon-levitt-discusses-don-jon | url-status=live }}</ref>
 In 2014, American actor [[Terry Crews]] talked about his long-standing pornography addiction, which he said had seriously affected his marriage and life and which he was able to overcome only after entering rehab in 2009.<ref>{{cite web|url=https://www.npr.org/2014/05/17/311911030/no-one-wants-to-be-with-the-marlboro-man-terry-crews-on-manhood|title=No One Wants To Be With The Marlboro Man: Terry Crews On 'Manhood'|date=May 17, 2014|website=NPR.org|access-date=October 10, 2018|archive-date=February 27, 2019|archive-url=https://web.archive.org/web/20190227225424/https://www.npr.org/2014/05/17/311911030/no-one-wants-to-be-with-the-marlboro-man-terry-crews-on-manhood|url-status=live}}</ref> He now takes an active role in speaking out about pornography addiction and its impact.<ref>{{cite web|url=http://blackamericaweb.com/2014/05/27/crews-control-terry-crews-new-book-details-his-struggle-with-porn-addiction/|archive-url=https://web.archive.org/web/20140528184748/http://blackamericaweb.com/2014/05/27/crews-control-terry-crews-new-book-details-his-struggle-with-porn-addiction/|title=Terry Crews' New Book Details Struggle With Porn Addiction - Black America Web|date=May 27, 2014|archive-date=May 28, 2014|website=Black America Web}}</ref><ref>{{cite web|url=https://abcnews.go.com/Entertainment/terry-crews-porn-addiction-ruined-life/story?id=37186200|title=Terry Crews Says Porn Addiction Nearly Ruined His Life|author=ABC News|website=ABC News|date=2016-02-25|access-date=2020-06-28|archive-date=2018-07-07|archive-url=https://web.archive.org/web/20180707201700/https://abcnews.go.com/Entertainment/terry-crews-porn-addiction-ruined-life/story?id=37186200|url-status=live}}</ref><ref>{{cite web|url=http://edition.cnn.com/2016/02/24/entertainment/terry-crews-porn-addition-feat/|title=Terry Crews: Porn addiction 'messed up my life'|author=Brandon Griggs|date=February 24, 2016|website=CNN|access-date=October 10, 2018|archive-date=August 10, 2018|archive-url=https://web.archive.org/web/20180810014901/https://edition.cnn.com/2016/02/24/entertainment/terry-crews-porn-addition-feat/|url-status=live}}</ref>
-In 2015, English comedian [[Russell Brand]] appeared in videos by American anti-pornography group [[Fight the New Drug]], in which he discussed pornography and its harmful effects.<ref>{{Cite web|url=https://www.youtube.com/watch?v=5kvzamjQW9MYouTube|archive-url=https://web.archive.org/web/20181010094829/https://www.youtube.com/watch?v=5kvzamjQW9M |url-status=dead |title=- YouTube|archive-date=October 10, 2018|website=www.youtube.com}}</ref> Later that year, American actress [[Rashida Jones]] produced the documentary ''[[Hot Girls Wanted]]'', which gave an in-depth look into the exploitation of women in the pornography industry.<ref>{{Cite web| url=https://www.imdb.com/title/tt4382552/| title=Hot Girls Wanted| website=[[IMDb]]| access-date=2018-10-18| archive-date=2020-03-11| archive-url=https://web.archive.org/web/20200311160320/https://www.imdb.com/title/tt4382552/| url-status=live}}</ref>
+In 2015, English comedian [[Russell Brand]] appeared in videos by American anti-pornography group [[Fight the New Drug]], in which he discussed pornography and its harmful effects.<ref>{{Cite web|url=https://www.washingtontimes.com/news/2015/mar/3/russell-brands-anti-porn-video-draws-kudos/| title=Russell Brand's anti-porn video draws kudos| website=[[Washington Times]]}}</ref>
-In 2016, American comedian [[Chris Rock]] and his wife Malaak Compton divorced after 20 years of marriage,<ref>{{cite news|url=http://www.people.com/article/chris-rock-divorce|first=Michele|last=Corriston|title=Chris Rock & Wife Malaak Compton-Rock Split|work=People|date=December 28, 2014|access-date=December 28, 2014|archive-date=September 19, 2018|archive-url=https://web.archive.org/web/20180919024220/https://people.com/article/chris-rock-divorce|url-status=live}}</ref> which Rock attributed to his infidelity and pornography addiction.<ref>{{cite news|url=http://www.nydailynews.com/entertainment/chris-rock-malaak-compton-divorce-20-years-article-1.2762085|first=Nicole|last=Bitette|title=Chris Rock, Malaak Compton finalize divorce after 20 years of marriage|work=New York Daily News|date=August 23, 2016|access-date=November 13, 2016|archive-date=June 23, 2018|archive-url=https://web.archive.org/web/20180623113000/http://www.nydailynews.com/entertainment/chris-rock-malaak-compton-divorce-20-years-article-1.2762085|url-status=live}}</ref> He later discussed the details of his pornography addiction in his 2018 stand-up comedy special ''[[Chris Rock: Tamborine|Tamborine]]''.<ref>{{cite web|url=http://www.indiewire.com/2018/02/chris-rock-porn-addiction-cheating-marriage-netflix-1201928637/|title=Chris Rock Gets Brutally Honest About Porn Addiction and Cheating on His Wife: 'I Wasn't a Good Husband'|website=Indiewire.com|author=Sharf, Zach|date=February 14, 2018|access-date=February 14, 2018|archive-date=June 23, 2018|archive-url=https://web.archive.org/web/20180623141035/http://www.indiewire.com/2018/02/chris-rock-porn-addiction-cheating-marriage-netflix-1201928637/|url-status=live}}</ref>
+In 2016, American comedian [[Chris Rock]] and his wife, Malaak Compton, divorced after 20 years of marriage,<ref>{{cite news|url=http://www.people.com/article/chris-rock-divorce|first=Michele|last=Corriston|title=Chris Rock & Wife Malaak Compton-Rock Split|work=People|date=December 28, 2014|access-date=December 28, 2014|archive-date=September 19, 2018|archive-url=https://web.archive.org/web/20180919024220/https://people.com/article/chris-rock-divorce|url-status=live}}</ref> which Rock attributed to his infidelity and pornography addiction.<ref>{{cite news|url=http://www.nydailynews.com/entertainment/chris-rock-malaak-compton-divorce-20-years-article-1.2762085|first=Nicole|last=Bitette|title=Chris Rock, Malaak Compton finalize divorce after 20 years of marriage|work=New York Daily News|date=August 23, 2016|access-date=November 13, 2016|archive-date=June 23, 2018|archive-url=https://web.archive.org/web/20180623113000/http://www.nydailynews.com/entertainment/chris-rock-malaak-compton-divorce-20-years-article-1.2762085|url-status=live}}</ref> He later discussed the details of his pornography addiction in his 2018 stand-up comedy special ''[[Chris Rock: Tamborine|Tamborine]]''.<ref>{{cite web|url=http://www.indiewire.com/2018/02/chris-rock-porn-addiction-cheating-marriage-netflix-1201928637/|title=Chris Rock Gets Brutally Honest About Porn Addiction and Cheating on His Wife: 'I Wasn't a Good Husband'|website=Indiewire.com|author=Sharf, Zach|date=February 14, 2018|access-date=February 14, 2018|archive-date=June 23, 2018|archive-url=https://web.archive.org/web/20180623141035/http://www.indiewire.com/2018/02/chris-rock-porn-addiction-cheating-marriage-netflix-1201928637/|url-status=live}}</ref>
 ==See also==