Introduction: To date, multiple models of problematic pornography use have been proposed, but attempts to validate them have been scarce. Aim: In our study, we aimed to evaluate the Pornography Problems due to Moral Incongruence model proposing that self-appraisals of pornography addiction stem from (i) general dysregulation, (ii) habits of use, and (iii) moral incongruence between internalized norms and behavior. We investigated whether the model can be used to adequately explain the self-perceptions of addiction to pornography (model 1) and a broader phenomenon of problematic pornography use (model 2). Methods: An online, nationally representative study was conducted on a sample of 1036 Polish adult participants, of whom, 880 declared a lifetime history of viewing pornography. Main Outcome Measure: The outcomes were self-perceived pornography addiction, problematic pornography use, avoidant coping, frequency of pornography use, religiosity, moral disapproval of pornography, and related variables. Results: Our results indicated that avoidant coping (an indicator of general dysregulation), frequency of pornography use (indicator of habits of use), and the distress connected with incongruence between own sexual behavior and internalized norms, attitudes and beliefs positively contributed to self-perceived addiction (model 1) as well as problematic pornography use (model 2). This broadly confirms the basic shape of the PPMI model. There were, however, notable differences between the models. Moral incongruence related distress was only weakly related to self-perceived addiction (b ¼ 0.15, P < .001), with a stronger relation for problematic pornography use (b ¼ 0.31, P < .001). When controlling for other factors, religiosity weakly predicted problematic pornography use (b ¼ 0.13, P < .001), but not self-perceived addiction to pornography (b ¼ 0.03, P ¼ .368). Frequency of pornography use was the strongest predictor of both self-perceived addiction (b ¼ 0.52, P < .001) and problematic pornography use (b ¼ 0.43, P < .001). Clinical Implications: Factors proposed within the PPMI model are distinctly relevant intervention targets, and they should be considered in the process of diagnosis and treatment. Strengths & Limitations: The presented study is the first to evaluate PPMI model. Its main limitation is that it has a cross-sectional design. Conclusion: The PPMI model is a promising framework for investigating the factors related to self-perceived addiction and problematic pornography use. Despite the differences between the models and in the strength of specific predictors, (i) dysregulation, (ii) habits of use, and (iii) moral incongruence all uniquely contribute to self-perceived addiction and problematic pornography use.

Previous research suggests that insecurely attached individuals may, in some cases, have a higher risk of developing negative health symptoms than securely attached ones. We conducted two studies (Study 1, n = 191; Study 2, n = 216) aimed at broadening this finding. We analysed the relationships between two distinct dimensions of insecure attachment (anxious and avoidant) and several classes of negative physical and mental health symptoms. Additionally, we placed emotion regulation difficulties in the role of potential mediator of these relationships. Our results indicated that both anxious and avoidant attachment were positively related to health symptoms on the level of bivariate correlations. However, when both of them were controlled within one mediation model, it was only attachment anxiety, and not attachment avoidance, that proved to be a significant, positive predictor of most health symptom classes: vegetative, agoraphobic, social phobia symptoms and global symptom severity index (which reflects a broad range of negative health symptoms). These relationships were indeed mediated by emotion regulation difficulties. Our results support the notion that (1) different dimensions of insecure attachment can have differential consequences for physical and mental health, and (2) emotion regulation can be one of the mechanisms that explain the links between attachment and health.

Background The addiction model of compulsive sexual behavior disorder (CSBD) and problematic pornography use (PPU) predicts the presence of withdrawal symptoms and increased tolerance for sexual stimuli in the disorder phenotype. However, clear empirical evidence supporting this claim has largely been lacking. Methods In the preregistered, nationally representative survey (n = 1,541, 51.2% women, age: M = 42.99, SD = 14.38), we investigated the role of self-reported withdrawal symptoms and tolerance with respect to CSBD and PPU severity. Results Both withdrawal and tolerance were significantly associated with the severities of CSBD (β = 0.34; P < 0.001 and β = 0.38; P < 0.001, respectively) and PPU (β = 0.24; P < 0.001 and β = 0.27; P < 0.001, respectively). Of the 21 withdrawal symptom types investigated, the most often reported symptoms were frequent sexual thoughts that were difficult to stop (for participants with CSBD: 65.2% and with PPU: 43.3%), increased overall arousal (37.9%; 29.2%), difficult to control level of sexual desire (57.6%; 31.0%), irritability (37.9%; 25.4%), frequent mood changes (33.3%; 22.6%), and sleep problems (36.4%; 24.5%). Conclusions Changes related to mood and general arousal noted in the current study were similar to the cluster of symptoms in a withdrawal syndrome proposed for gambling disorder and internet gaming disorder in DSM-5. The study provides preliminary evidence on an understudied topic, and present findings can have significant implications for understanding the etiology and classification of CSBD and PPU. Simultaneously, drawing conclusions about clinical importance, diagnostic utility and detailed characteristics of withdrawal symptoms and tolerance as a part of CSBD and PPU, as well as other behavioral addictions, requires further research efforts.