Problematic Pornography Use and Mental Health: A Systematic Review

Abstract

The present review aimed to synthesize the empirical evidence regarding the association between problematic pornography use (PPU) and mental health. A comprehensive literature search using keywords and subject headings was performed with three electronic databases, resulting in 20 studies that met the inclusion criteria. The patterns of association between PPU and mental health were examined, and the limitations of these studies were discussed. The overall findings suggest the relationship between PPU and mental health outcomes is not clear-cut, and it is often mediated by other factors such as loneliness, anxiety, and self-esteem. Further studies are required to evaluate the prevalence of PPU and both risk and protective factors which are associated with exposure to online pornography. Most studies relied on homogenous samples which have limited the generalizability of findings. The use of representative samples, including both males and females with different sexual orientations and from diverse cultural and ethnic backgrounds, would strengthen our understanding of PPU and go further to expound on its controversies. Clinical recommendations and future directions are also discussed.