Problematic pornography use as an externalizing depression symptom in cisgender men: A cross-sectional questionnaire study.

Background and aim: Depression is characterized by feeling sad, empty, hopeless, and a markedly diminished interest or pleasure in almost all daily activities. However, men often exhibit externalizing depression symptoms, such as abusing alcohol or drugs, or displaying irritability or anger, which align with how men are expected to be and behave, thus conforming to masculinity ideologies. The present study investigates whether problematic pornography use (PPU), which is characterized by poor impulse control and distressing or problematic perceptions of one's pornography consumption, may function as an externalizing depression symptom.

Methods: We assessed depression, externalizing symptoms, conformity to masculinity ideologies, and PPU among 265 cisgender men (age: M = 31.8, SD = 7.0; 90.2% identified as heterosexual, 9.8% as sexual minority) living in German-speaking countries of Europe. A manifest mediation path model showed that more depressive symptoms (predictor) were associated with stronger conformity to masculinity ideologies (mediator), which in turn was linked to both more externalizing symptoms (Outcome 1) and increased PPU (Outcome 2).

Results: The correlation between conformity to masculinity ideologies and externalizing symptoms was not significant. The two indirect paths from depressive symptoms to the two outcomes through conformity to masculinity ideologies did not differ significantly in strength.

Discussion and conclusions: These findings suggest that PPU may serve a similar psychological function as other externalizing symptoms by allowing men to mask depressive symptoms through behaviors that align with masculinity ideologies. Future interventions should examine whether screening for PPU can help identify men experiencing mental health issues and employing maladaptive coping strategies.