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Background and aimsCompulsive sexual behaviour disorder (CSBD) is a medical condition that can impair social and occupational functioning and lead to severe distress. To date, treatment effectiveness studies of CSBD are under-developed; typically, treatment for CSBD is based on guidelines for substance or other behavioural addictions. Mindfulness-based relapse prevention (MBRP) is an evidence-based treatment for substance addiction aimed at, among other things, reducing craving and negative affect—i.e. processes that are implicated in the maintenance of problematic sexual behaviours. However, to our knowledge no prior research has been published evaluating mindfulness-based intervention (MBI) in the treatment of CSBD, except two clinical case reports. Therefore, the aim of the current pilot study was to examine whether MBRP can lead to clinical improvement in CSBD. Methods: Participants were 13 adult males with a diagnosis of CSBD. Before and after the eight-week MBRP intervention, participants completed a booklet of questionnaires including measurements of porn viewing, masturbation and emotional distress. Results: As expected, we found that after MBRP participants spent significantly less time engaging in problematic pornography use and exhibited a decrease in anxiety, depression and obsessive-compulsive (OC) symptoms. Discussion and Conclusions: The findings indicate that MBRP could be beneficial for CSBD individuals. Further clinical effectiveness studies with bigger sample sizes, delayed post-training measurements and randomised control trial design are warranted. In conclusion, MBRP leads to a decrease in time spent watching porn and a decrease in emotional distress in CSBD patients.

BACKGROUND AND AIMS Moral incongruence involves disapproval of a behavior in which people engage despite their moral beliefs. Although considerable research has been conducted on how moral incongruence relates to pornography use, potential roles for moral incongruence in other putative behavioral addictions have not been investigated. The aim of this study was to investigate the role of moral incongruence in self-perceived addiction to: (i) pornography; (ii) internet addiction; (iii) social networking; and (iv) online gaming. DESIGN A cross-sectional, preregistered, online survey using multivariable regression. SETTING Online study conducted in Poland. PARTICIPANTS 1036 Polish adults aged between 18 and 69 years. MEASUREMENTS Measures included self-perceived behavioral addiction to pornography, internet use, social networking and online gaming and their hypothesized determinants (moral incongruence, frequency of use, time of use, religiosity, age and gender). FINDINGS Higher moral incongruence (β = 0.20, P < 0.001) and higher religiosity (β = 0.08, P < 0.05) were independently associated with higher self-perceived addiction to pornography. Additionally, frequency of pornography use was the strongest of the analyzed predictors (β = 0.43, P < 0.001). A similar, positive relationship between high moral incongruence and self-perceived addiction was also present for internet (β = 0.16, P < 0.001), social networking (β = 0.18, P < 0.001) and gaming addictions (β = 0.16, P < 0.001). Religiosity was uniquely, although weakly, connected to pornography addiction, but not to other types of addictive behaviors. CONCLUSIONS Moral incongruence may be positively associated with self-perception of behavioral addictions including not only pornography viewing, but also internet use, social networking and online gaming.

In this research we examined relationships between Big Five personality traits, emotion regulation strategies and subjective well-being. In two studies we explored the mediational role of habitual use of two regulation strategies: reappraisal and suppression in the relationship between personality traits and two aspects of well-being (i.e., life satisfaction and experience of positive affect and negative affect). In Study 1 (n = 233) we found that the most robust predictors of higher life satisfaction were higher extraversion, conscientiousness, emotional stability (lower neuroticism) and reappraisal, as well as lower suppression of emotions. We obtained similar pattern of results in Study 2 (n = 265) which showed that higher positive affect was significantly predicted by higher extraversion, conscientiousness, emotional stability, and reappraisal. Negative affect was negatively predicted only by emotional stability. Additional analyses indicated that suppression mediated the link between extraversion and life satisfaction, whereas reappraisal mediated associations of emotional stability with life satisfaction and positive affect. The studies reveal the role of emotion regulation for extraversion and emotional stability and their association with well-being.

Introduction Dysregulation of emotion (DE) is commonly seen in individuals suffering from compulsive sexual behavior (CSB), as well as represents a crucial element of its common comorbidities like mood, anxiety, and substance use disorders. Aim To investigate the links between CSB and DE. Methods A review of pertinent literature on CSB and DE was performed using EBSCO, PubMed, and Google Scholar databases. Main Outcome Measure Patterns of DE were evaluated as a common clinical feature, underlying mechanisms, as well as a target for psychological and pharmacological interventions in CSB. Results Across different conceptualizations of CSB, DE represents the core element of a failure to cope with sexual impulses, thoughts, urges, or resulting uncontrolled sexual behaviors. DE may contribute to the occurrence of CSB while for individuals affected by this condition, sexual arousal and release act as an easier/learned (yet uncontrolled and leading to negative consequences) way of coping with negative mood states. CSB may represent a delusive form of self-regulation. Experience of child sexual abuse and insecure attachment patterns are considered risk factors for CSB (likely to be mediated by DE) but require further investigation. DE is also positively associated with CSB symptom severity. Pharmacological treatments affecting mood regulation, anxiety, impulsivity, and regulation within the brain reward system have been reported to help people with CSB achieve better control over their sexual urges and behavior. However, the available data are scarce and well-powered randomized controlled trials are needed to support these observations. Although improvement in one's emotional self-regulation is considered as an important healing factor in treatment, its benefit in psychological therapies specific to CSB requires further investigation. Conclusion DE represents a core symptom of compulsive sexual behavior disorder and related comorbidities as well as a predisposing factor to the development of compulsive sexual behavior disorder. Addressing DE may facilitate better treatment outcomes for patients with CSB. Lew-Starowicz M, Lewczuk K, Nowakowska I, et al. Compulsive Sexual Behavior and Dysregulation of Emotion. J Sex Med 2020;8:191–205.

Despite the considerable amount of attention presently devoted to the high accessibility of online pornography, very little formal analyses have been carried out to show how the advent and proliferation of Internet technology has changed the prevalence of pornography use in populations. We conducted an analysis based on objective website traffic data, representing the changes in the number of (1) Internet users generally, and (2) online pornography users specifically, between the years 2004 and 2016 in Poland. We observed a clear increase in the estimated number of people using online pornography in the analyzed period. The observed increase was much faster than, for example, the change indicated in similar analyses based on General Social Survey data. The estimated number of people viewing pornography on the Internet increased over three times (310%) between October 2004 and October 2016 – starting from an estimated 2.76 million in the first period, to 8.54 million in the last. Additionally, pornography viewership on the Internet was almost 2 times more prevalent among male (47%) than female Internet users (27%), and most popular in the 18-27 age group. Importantly, based on our data, a relatively high percentage (25%) of young Internet users aged 7 to 12 accessed online pornography during a distinct monthly period. Interestingly for this single age group, we did not obtain a strong difference in the prevalence of online pornography use between sexes – viewing pornographic websites was as frequent among young girls as young boys. Since our analysis is based on objective data, it does not share the limitations inherent of self-reports. However, our approach also has a few important limitations (e.g. the analysis does not include online activity generated on mobile devices and under the private browsing mode) which may lead to the underestimation of pornography use indices.

Introduction Most of the previous studies on problematic pornography use and related behavior have focused on such descriptors of pornography use habits as frequency or time devoted to pornography use. Aim We argue that this constitutes a narrow view and indicators that characterize other aspects of explicit content consumption, namely (i) longest session of pornography viewing (which may be related to binge behavior), as well as (ii) variability of consumed pornographic content, can also be useful indicators. Methods An online study based on a sample of 132 heterosexual men seeking treatment for problematic pornography use, referred by therapists after their initial visit and 437 non-treatment seekers in the control group. Main Outcome Measures The main outcomes of this study are reported longest, non-stop session of viewing pornography, variability in consumed pornographic content (including paraphilic and violent pornography), actual treatment seeking for problematic pornography use and severity of symptoms, and average weekly time devoted to pornography use. Results Our analysis showed that longest session of viewing pornographic content as well as the variety of consumed pornography influenced the decision to seek treatment and the severity of symptoms even when the sheer amount of time devoted to pornography use was controlled. Conclusion This is one of the few studies examining the role of engagement in prolonged sessions of pornography use and the variability of consumed pornographic content in the clinical context of problematic sexual behavior. The study's main limitations are its relatively narrow method of operationalization of variability of pornographic content and longest session of pornography viewing, as well as its cross-sectional, online, and anonymous character. As the described factors have an important influence on treatment seeking and the severity of experienced symptoms, they should be considered in the process of assessing compulsive sexual behavior disorder and related symptoms.

Preliminary evidence concerning emotional intelligence (EI) and working memory (WM) showed that the relationship between them is dependent on the emotional content (‘hot’ or ‘cool’) of tasks involving WM. In this paper, we continue investigating the relationship between EI and WM, focusing on a crucial function of WM, i.e., the efficacy of updating its content. WM updating shows substantial correlations with general fluid intelligence (gF) and seems to be a significant predictor of cognitive performance and achievement. We assume that if updating is important for a wide range of higher-order processes, updating emotional content in WM could be essential for emotionally intelligent behavior. To test this hypothesis, we constructed two parallel versions of a task that requires WM updating: one with neutral and the other with emotional stimuli. In addition, performance-based measures of both gF and EI were used in the research. Using the structural equation approach, we sought to demonstrate that gF is dependent on the efficiency of WM updating for both emotional and neutral stimuli, whereas EI might depend only on the updating efficacy in the emotional context. The results are discussed in terms of the domain specificity of EI and the domain generality of gF. The main constraint of the study is its limited sample size (n = 123 for intelligence measures, n = 69 for WM updating tasks). Moreover, the study was based on a female sample; thus, the conclusions can be extrapolated only to women.

Compulsive sexual behavior disorder (CSBD) is currently defined in the eleventh revision of the International Classification of Diseases (ICD-11) as an impulse control disorder. Criteria for hypersexual disorder (HD) had been proposed in 2010 for the fifth revision of Diagnostic and Statistical Manual (DSM-5). In this article, we compare differences between HD and CSBD and discuss their relevance. Significant differences between HD and CSBD criteria include: (1) the role of sexual behavior as a maladaptive coping and emotion regulation strategy listed in criteria for HD but not in those for CSBD; (2) different exclusionary criteria including bipolar and substance use disorders in HD but not in CSBD, and (3) inclusion of new considerations in CSBD, such as moral incongruence (as an exclusion criterion), and diminished pleasure from sexual activity. Each of these aspects has clinical and research-related implications. The inclusion of CSBD in the ICD-11 will have a significant impact on clinical practice and research. Researchers should continue to investigate core and related features of CSBD, inlcuding those not included in the current criteria, in order to provide additional insight into the disorder and to help promote clinical advances.

Background and aims: Compulsive sexual behaviour disorder (CSBD) is a medical condition that can impair social and occupational functioning and lead to severe distress. To date, treatment effectiveness studies of CSBD are under-developed; typically, treatment for CSBD is based on guidelines for substance or other behavioural addictions. Mindfulness-based relapse prevention (MBRP) is an evidence-based treatment for substance addiction aimed at, among other things, reducing craving and negative affect—i.e. processes that are implicated in the maintenance of problematic sexual behaviours. However, to our knowledge no prior research has been published evaluating mindfulness-based intervention in the treatment of CSBD, except two clinical case reports. Therefore, the aim of the current preliminary research was to examine whether MBRP can lead to clinical improvement in CSBD. Methods: Participants were 13 adult males with a diagnosis of CSBD. Before and after the eight-week MBRP intervention, participants completed a booklet of questionnaires including measurements of porn viewing, masturbation and emotional distress. Results: As expected, we found that after MBRP participants spent significantly less time engaging in problematic pornography use and exhibited a decrease in anxiety, depression and obsessive-compulsive symptoms. Discussion and Conclusions: The findings indicate that MBRP could be beneficial for CSBD individuals. Further clinical effectiveness studies with bigger sample sizes, delayed post-training measurements and randomised control trial design are warranted. In conclusion, MBRP leads to a decrease in time spent watching porn and a decrease in emotional distress in CSBD patients.

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.

In two studies, we analysed the relationships between different types of self-evaluation (i.e., narcissism and self-esteem) and support for democracy. Support for democracy requires the ability to respect the views and opinions of others, even if one disagrees with them. Classic studies have linked support for democracy with high self-evaluation, which should assume psychological security and, thus, the ability to trust others. However, not all forms of high self-evaluation are secure. Narcissists have high feelings of self-worth, but tend to be defensive: They are easily threatened by criticisms or conflicting views. We then expected that while support for democracy should be positively predicted by secure, non-narcissistic self-evaluation, it should be negatively predicted by narcissistic self-evaluation. In two studies, conducted in the United States (Study 1, n = 407) and in Poland (Study 2, n = 405), support for democracy was positively predicted by self-esteem and negatively predicted by narcissism. Study 2 additionally demonstrated that interpersonal trust mediated the effects of self-esteem on support for democracy. We discuss the role of psychological predispositions in understanding support for democratic systems.

Despite controversies about the diagnosis, the World Health Organization recently elected to include compulsive sexual behavior disorder in the 11th edition of the International Classification of Diseases. Both recent and remote works have suggested that various cultural factors such as personal religiousness and morality can influence both the experience and expression of compulsive sexual behaviors. Because prior works have indicated that pornography use is likely to be the most common expression of compulsive sexual behavior, the present work sought to examine whether moral incongruence about pornography use may account for a substantive part of self-reports of compulsive sexual behavior. In 2 studies involving 4 samples, the present work tested the hypothesis that moral incongruence would positively predict self-reported compulsivity in pornography use. In Study 1, across 3 samples (Sample 1, N = 467; Sample 2, N = 739; Sample 3, N = 1,461), including 2 matched to U.S. nationally representative norms (Samples 2 and 3), results indicated that moral incongruence was a substantive and robust predictor of self-reported compulsivity. In Study 2 (baseline N = 850), parallel process latent growth curve analyses over the course of 1 year revealed that the trajectories of pornography use, self-reported compulsivity, and moral disapproval of such use covaried together over time. Collectively, these results underscore the contention that personal morality may influence individuals' self-perceptions of their sexual behaviors, which, in turn, may complicate efforts to accurately diagnose compulsive sexual behavior disorder. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

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 (β = 0.15, P < .001), with a stronger relation for problematic pornography use (β = 0.31, P < .001). When controlling for other factors, religiosity weakly predicted problematic pornography use (β = 0.13, P < .001), but not self-perceived addiction to pornography (β = 0.03, P = .368). Frequency of pornography use was the strongest predictor of both self-perceived addiction (β = 0.52, P < .001) and problematic pornography use (β = 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.

The purpose of the present study was to examine if the length of yoga training may influence the use of cognitive reappraisal and expressive suppression (as emotion regulation strategies) and whether this relationship may be moderated by personality traits. Based on previous studies, we hypothesized that the link between the length of yoga practice and emotion regulation can rely most heavily on participants’ conscientiousness and extraversion levels. Ninety women in two groups participated in the study: those who have been practicing yoga for over a year and those who have been practicing for a shorter period of time. An Emotion Regulation Questionnaire was applied to measure the use the strategies of cognitive reappraisal and expressive suppression. Moreover, personality traits, based on the Big Five model were assessed. The results of the study provided support for our prediction: participants who engaged in yoga practice for a longer period of time (as compared to participants who practiced yoga for a shorter duration), reported using cognitive reappraisal more often. Furthermore, longer yoga practice was more beneficial than shorter practice especially for individuals with low levels of conscientiousness and extraversion. Thus, extraversion and conscientiousness seem to facilitate the process of drawing benefits from practicing yoga.

Background and aims Previous studies examined psychological factors related to treatment seeking for problematic pornography use (PU) among males. In this study, we focused on females who seek treatment for problematic PU and compared them with non-problematic pornography users with regard to variables related to problematic PU. Second, we investigated the relationships between critical constructs related to problematic PU with the path analysis method, emphasizing the predictors for treatment seeking among women. We also compared our results with previous studies on males. Methods A survey study was conducted on 719 Polish-speaking Caucasian females, 14–63 years old, including 39 treatment seekers for problematic PU. Results The positive relationship between the mere amount of PU and treatment seeking loses its significance after introducing two other predictors of treatment-seeking: religiosity and negative symptoms associated with PU. This pattern is different from the results obtained in previous studies on males. Discussion Different from previous studies on male samples, our analysis showed that in the case of women, mere amount of PU may be related to treatment-seeking behavior even after accounting for negative symptoms associated with PU. Moreover, religiousness is a significant predictor of treatment seeking among women, which may indicate that in the case of women, treatment seeking for problematic PU is motivated not only by experienced negative symptoms of PU but also by personal beliefs about PU and social norms. Conclusion For females, negative symptoms associated with PU, the amount of PU and religiosity is associated with treatment seeking. Those factors should be considered in treatment.

Introduction Pornography has become popular with Internet technology. For most people, pornography use (PU) is entertainment; for some, it can result in seeking treatment for out-of-control behavior. Previous studies have suggested that PU can influence sexual behaviors, but the direct relation between frequency of PU and treatment-seeking behaviors has not been examined. Aims To investigate whether individuals seeking treatment as a consequence of their problematic PU do so because of their quantity of pornography consumption or because of more complex psychological and behavioral factors related to PU, such as the severity of negative symptoms associated with PU and/or subjective feeling of loss of control over one's behavior. Methods A survey study was conducted of 569 heterosexual Caucasian men 18 to 68 years old, including 132 seeking treatment for problematic PU (referred by psychotherapists after their initial visit). Main Outcomes Measures The main outcome measures were self-reported PU, its negative symptoms, and actual treatment-seeking behavior. Results We tested models explaining sources of seeking treatment for problematic PU with negative symptoms associated with PU and additional factors (eg, onset and number of years of PU, religiosity, age, dyadic sexual activity, and relationship status). Seeking treatment was significantly, yet weakly, correlated solely with the frequency of PU (r = 0.21, P < .05) and this relation was significantly mediated by negative symptoms associated with PU (strong, nearly full mediation effect size; k2 = 0.266). The relation between PU and negative symptoms was significant and mediated by self-reported subjective religiosity (weak, partial mediation; k2 = 0.066) in those not seeking treatment. Onset of PU and age appeared to be insignificant. Our model was fairly fitted (comparative fit index = 0.989; root mean square error of approximation = 0.06; standardized root mean square residual = 0.035) and explained 43% of the variance in treatment-seeking behavior (1% was explained by frequency of PU and 42% was explained by negative symptoms associated with PU). Conclusion Negative symptoms associated with PU more strongly predict seeking treatment than mere quantity of pornography consumption. Thus, treatment of problematic PU should address qualitative factors, rather than merely mitigating the frequency of the behavior, because frequency of PU might not be a core issue for all patients. Future diagnostic criteria for problematic PU should consider the complexity of this issue.