{ "abstract": "Introduction\n\nProblematic pornography use (PPU) has been associated with symptoms of depression and anxiety. These associations have been studied in clinical and adolescent samples, but little attention has been paid to gender differences in international general population samples. This study examined relationships between PPU, anxiety symptoms, and depression symptoms, with a focus on potential gender differences.Method\n\nData were obtained from the International Sex Survey (ISS), a large-scale, cross-sectional study conducted across 42 countries. It involved 82,243 participants (Meanage = 32.39 years, SD = 12.52; 39.6% men, 57.0% women, 3.4% gender diverse). Participants completed validated measures, including the Problematic Pornography Consumption Scale (PPCS) and the Brief Symptom Inventory's (BSI-18) depression and anxiety symptoms subscales. A one-way ANOVA was used to assess gender differences, while regression analysis examined the role of gender (i.e., men, women, and gender-diverse individuals) in the associations between psychological distress (i.e., depression and anxiety symptoms) and PPU.Results\n\nMen reported the highest PPU levels, whereas gender-diverse participants reported the highest anxiety and depression levels, followed by women. PPU was positively correlated with anxiety and depression symptoms, with small-to-moderate associations (r = 0.207 and r = 0.249, respectively). Gender significantly moderated both associations, with the steepest positive slopes among men, suggesting that they might rely more heavily on pornography as a maladaptive coping mechanism.Conclusions\n\nThis study highlights differences between PPU and mental health across gender identities. While gender-diverse individuals experience the highest levels of psychological distress, men demonstrate the strongest link between such distress and PPU. These findings highlight the need for gender-sensitive mental-health interventions addressing PPU and its psychological implications.", "abstract_shown": true, "affiliations": [ "Department of Clinical Pharmaceutical and Biological Sciences University of Hertfordshire Hatfield UK herts.ac.uk.", "Section of Sexual Psychopathology Department of Dynamic and Clinical Psychology, and Health Studies Sapienza University of Rome Rome Italy uniroma1.it.", "Department of Psychology and Cognitive Science University of Trento Trento Italy unitn.it.", "Department of Humanities Philosophy and Education University of Salerno Salerno Italy unisa.it.", "Institute of Forensic Psychiatry and Sex Research Center for Translational Neuro-and Behavioral Science University of Duisburg-Essen Essen Germany uni-due.de.", "Doctoral School of Psychology ELTE Eötvös Loránd University Budapest Hungary elte.hu.", "Institute of Psychology ELTE Eötvös Loránd University Budapest Hungary elte.hu.", "College of Human Sciences and Culture Flinders University Institute for Mental Health and Wellbeing Flinders University Bedford Park South Australia Australia flinders.edu.au.", "Centre of Excellence in Responsible Gaming University of Gibraltar Gibraltar Gibraltar.", "Department of Psychology University of Nevada Las Vegas Nevada USA unlv.edu.", "Yale University School of Medicine New Haven Connecticut USA yale.edu.", "Connecticut Council on Problem Gambling Wethersfield Connecticut USA.", "Connecticut Mental Health Center New Haven Connecticut USA.", "Département de Psychologie Université de Montréal Montréal Canada umontreal.ca.", "Centre de Recherche Interdisciplinaire sur les Problèmes Conjugaux et les Agressions Sexuelles (CRIPCAS) Montréal Canada." ], "article_type": "research article", "arxiv": null, "author_total": 12, "authors": [ { "affs": [ 0 ], "name": "Ilaria De Luca", "orcid": "0000-0001-5051-5262" }, { "affs": [ 1 ], "name": "Giacomo Ciocca", "orcid": "0000-0002-4256-1776" }, { "affs": [ 0, 2 ], "name": "Ornella Corazza", "orcid": "0000-0001-7371-319X" }, { "affs": [ 2 ], "name": "Gianluca Esposito", "orcid": "0000-0002-9442-0254" }, { "affs": [ 3 ], "name": "Luigi Tinella", "orcid": "0000-0003-4296-5233" }, { "affs": [ 4 ], "name": "Mónika Koós", "orcid": "0000-0002-9961-9174" }, { "affs": [ 5, 6 ], "name": "Léna Nagy", "orcid": "0000-0002-7947-2988" }, { "affs": [ 6, 7, 8 ], "name": "Zsolt Demetrovics", "orcid": "0000-0001-5604-7551" }, { "affs": [ 9 ], "name": "Shane W Kraus", "orcid": "0000-0002-0404-9480" }, { "affs": [ 10, 11, 12 ], "name": "Marc N Potenza", "orcid": "0000-0002-6323-1354" }, { "name": "International Sex Survey Consortium" }, { "affs": [ 13, 14 ], "name": "Beáta Bőthe", "orcid": "0000-0003-2718-4703" } ], "bibtex": "https://research.draconitic.com/paper/6bw77ta631s33.bib", "cited_by": 0, "doi": "10.1155/da/5293861", "fulltext_url": "https://europepmc.org/articles/PMC13724184", "id": "6bw77ta631s33", "issns": [ "1091-4269", "1520-6394" ], "landing_url": "https://europepmc.org/article/MED/42968999", "language": "eng", "licence": "CC-BY", "licence_label": "CC BY", "licence_source": "article", "licence_url": "https://creativecommons.org/licenses/by/4.0/", "metadata_licence": null, "native_subjects": [ [ "heading", "Article" ], [ "heading", "Research Article" ], [ "openalex", "3203|Sexuality, Behavior, and Technology" ] ], "openalex": "W7225063007", "pdf_url": "https://europepmc.org/articles/PMC13724184?pdf=render", "pmcid": "PMC13724184", "pmid": "42968999", "published": "2026-11-01", "publisher": "Wiley", "ris": "https://research.draconitic.com/paper/6bw77ta631s33.ris", "sources": [ { "first_seen": "2026-11-03T15:20:53Z", "native_id": "MED:42968999", "source": "europepmc", "url": "https://europepmc.org/article/MED/42968999" }, { "first_seen": "2026-11-04T12:22:41Z", "native_id": "PMC13724184", "source": "pmc", "url": "https://doi.org/10.1155/da/5293861" } ], "subjects": [ { "field": "medicine", "origin": "openalex:3203|Sexuality, Behavior, and Technology", "subfield": "psychiatry" } ], "title": "Gender Differences in Associations Between Problematic Pornography Use and Symptoms of Depression and Anxiety: Insights From a Large-Scale Study.", "title_text": "Gender Differences in Associations Between Problematic Pornography Use and Symptoms of Depression and Anxiety: Insights From a Large-Scale Study.", "type": "peer-reviewed", "updated_at": "2026-11-05T12:20:52Z", "url": "https://research.draconitic.com/paper/6bw77ta631s33", "venue": "Depression and anxiety", "versions": [] }