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Peer-reviewedCC BYDepression and anxiety

Gender Differences in Associations Between Problematic Pornography Use and Symptoms of Depression and Anxiety: Insights From a Large-Scale Study.

  • Ilaria De Luca1
  • Giacomo Ciocca2
  • Ornella Corazza1,3
  • Gianluca Esposito3
  • Luigi Tinella4
  • Mónika Koós5
  • Léna Nagy6,7
  • Zsolt Demetrovics7,8,9
  • Shane W Kraus10
  • Marc N Potenza11,12,13
  • International Sex Survey Consortium
  • Beáta Bőthe14,15
15 affiliations
  1. 1Department of Clinical Pharmaceutical and Biological Sciences University of Hertfordshire Hatfield UK herts.ac.uk.
  2. 2Section of Sexual Psychopathology Department of Dynamic and Clinical Psychology, and Health Studies Sapienza University of Rome Rome Italy uniroma1.it.
  3. 3Department of Psychology and Cognitive Science University of Trento Trento Italy unitn.it.
  4. 4Department of Humanities Philosophy and Education University of Salerno Salerno Italy unisa.it.
  5. 5Institute of Forensic Psychiatry and Sex Research Center for Translational Neuro-and Behavioral Science University of Duisburg-Essen Essen Germany uni-due.de.
  6. 6Doctoral School of Psychology ELTE Eötvös Loránd University Budapest Hungary elte.hu.
  7. 7Institute of Psychology ELTE Eötvös Loránd University Budapest Hungary elte.hu.
  8. 8College of Human Sciences and Culture Flinders University Institute for Mental Health and Wellbeing Flinders University Bedford Park South Australia Australia flinders.edu.au.
  9. 9Centre of Excellence in Responsible Gaming University of Gibraltar Gibraltar Gibraltar.
  10. 10Department of Psychology University of Nevada Las Vegas Nevada USA unlv.edu.
  11. 11Yale University School of Medicine New Haven Connecticut USA yale.edu.
  12. 12Connecticut Council on Problem Gambling Wethersfield Connecticut USA.
  13. 13Connecticut Mental Health Center New Haven Connecticut USA.
  14. 14Département de Psychologie Université de Montréal Montréal Canada umontreal.ca.
  15. 15Centre de Recherche Interdisciplinaire sur les Problèmes Conjugaux et les Agressions Sexuelles (CRIPCAS) Montréal Canada.
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Abstract

Introduction

Problematic 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

Data 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

Men 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

This 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.

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Cite

BibTeXRIS
BibTeX
@article{luca2026gender,
  title = {{Gender Differences in Associations Between Problematic Pornography Use and Symptoms of Depression and Anxiety: Insights From a Large-Scale Study.}},
  author = {Ilaria De Luca and Giacomo Ciocca and Ornella Corazza and Gianluca Esposito and Luigi Tinella and Mónika Koós and Léna Nagy and Zsolt Demetrovics and Shane W Kraus and Marc N Potenza and International Sex Survey Consortium and Beáta Bőthe},
  journal = {Depression and anxiety},
  year = {2026},
  month = nov,
  doi = {10.1155/da/5293861},
  url = {https://europepmc.org/article/MED/42968999},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - Gender Differences in Associations Between Problematic Pornography Use and Symptoms of Depression and Anxiety: Insights From a Large-Scale Study.
AU  - Ilaria De Luca
AU  - Giacomo Ciocca
AU  - Ornella Corazza
AU  - Gianluca Esposito
AU  - Luigi Tinella
AU  - Mónika Koós
AU  - Léna Nagy
AU  - Zsolt Demetrovics
AU  - Shane W Kraus
AU  - Marc N Potenza
AU  - International Sex Survey Consortium
AU  - Beáta Bőthe
PY  - 2026
DA  - 2026/11/01
JO  - Depression and anxiety
DO  - 10.1155/da/5293861
UR  - https://europepmc.org/article/MED/42968999
AB  - Introduction  Problematic 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  Data 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  Men 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  This 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.
SN  - 1091-4269
SN  - 1520-6394
ER  -