A new systematic review and meta-analysis of 111 samples has found that problematic pornography use is linked to a range of psychological traits, with cravings and sexual shame producing the strongest associations. The research was led by Sonay Sheikhi of Kharazmi University in Tehran and published in Addictive Behaviors Reports.
Problematic pornography use is not a formal psychiatric diagnosis. It is an umbrella term for self-reported difficulties such as a perceived loss of control, preoccupation with pornography, or distress about use, rather than a straightforward measure of how often pornography is viewed.
Researchers note that a constellation of factors has been studied in relation to problematic pornography use. These include impulsivity, emotion regulation, loneliness, stress, anxiety, depression, and using pornography as a coping mechanism for negative emotions. Sexual factors, such as high sexual desire or dissatisfaction with one’s sex life, also appear to play a role for some individuals. Moral or religious conflict about pornography can intensify guilt and distress, sometimes making use appear more problematic than the behaviour alone would suggest.
The study discusses two broad families of measurement: dysregulation-oriented tools that focus on loss of control and compulsive use, and distress-oriented tools that focus on guilt, shame, worry, or moral conflict. The authors examine how the strength of associations with psychological variables may differ depending on which type of measure a study employed.
In compiling the review, the researchers searched multiple databases and supplemented findings with searches of additional sources, including Iranian databases and grey literature. They included studies published in English or Persian between 2012 and 2025.
From an initial pool of more than 38,000 records, 925 full-text documents were reviewed, with 97 articles meeting the inclusion criteria. These described 111 independent samples comprising a total of 121,728 participants. The average participant age was about 27.5 years, and around 46% of participants were women. The studies were published between 2012 and 2025, with roughly 85% of participants drawn from studies published between 2017 and 2025, and nearly all data collected online.
The strongest associations were with craving and sexual shame, each averaging a correlation of 0.54. Other notable links included depression at 0.32, emotion dysregulation at 0.29, moral disapproval at 0.27, and loneliness at 0.23. It is worth noting that craving and sexual shame estimates were based on only four or five studies, whereas the other associations drew on between 12 and 21 studies.
Results varied widely across studies. For most psychological factors, future studies could reasonably be expected to yield a broad range of outcomes, sometimes near zero, suggesting that the identified patterns reflect average tendencies rather than universal effects.
The authors also report that measurement type seemed to influence some findings: dysregulation-oriented measures tended to show stronger links with impulsivity and craving, while distress-oriented measures tended to show stronger associations with shame and moral disapproval. They caution that these patterns should be considered descriptive, with formal statistical tests finding few reliable differences between the two measurement families. In one exception, religiousness appeared more strongly associated with problematic use in studies employing dysregulation-oriented measures.
“Across the available evidence, PPU [problematic pornography use] was associated with a broad range of psychological variables spanning behavioral self-regulation, emotional functioning, interpersonal processes, and evaluative distress. However, the magnitude of these associations varied considerably across psychological domains and across studies, indicating that PPU cannot be adequately characterized as a single, homogeneous construct,” the study authors concluded.
The paper highlights a spectrum of psychological characteristics linked to problematic pornography use, but it also notes limits. Most included studies were cross-sectional, preventing conclusions about causality or the direction of effects. Additionally, most data relied on self-report measures for both pornography use and psychological traits, which may have inflated some associations. The authors emphasise that their two categories of measures are rough groupings, with many instruments capturing both loss of control and distress, so differences between them should not be interpreted as evidence of distinct types of PPU.
The research was conducted by Sonay Sheikhi, Shahram Mohammadkhani, and Mehdi Akbari.
