Comment on: Is Pornography Use Associated with Sexual Difficulties and Dysfunctions among Younger Heterosexual Men? by Gert Martin Hald, PhD

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LINK - EDITORIAL COMMENT

by Gert Martin Hald

Article first published online: 14 MAY 2015

J Sex Med 2015;12:1140–1141

Surprisingly, given its potential clinical relevance, very few studies have attempted to investigate relationships between pornography consumption and common sexual dysfunctions and problems (in the following referred to as “sexual difficulties”). When having done so, the designs employed have predominantly been case study designs or focus group designs and the method of data collection qualitative. Alternatively, personal or clinical experiences have been utilized. Although important, such studies and experience alone may not be brought to bear on effects of the consumption of pornography. Consequently, the study by Landripet and Stulhofer offers a long and valuable cross-cultural beginning to the quantitative exploration of associations between pornography consumption and sexual difficulties.

More generally, elements of the study by Landripet and Stulhofer reflect critical issues in research on pornography. First, the sample most likely constitutes a non-probability sample. This is characteristic of much of the available research on pornography today [1]. This problem may somewhat be offset by including short, valid, and reliable measures of pornography consumption in future large population based national studies on sexuality and sexual behaviors. Considering the prevalence rates of pornography consumption and the frequency by which pornography is consumed, in particular among men, this seems both highly relevant and high time.

Second, the study finds only one significant association between pornography consumption and the outcomes studied (i.e., erectile dysfunction) and emphasizes that the size (magnitude) of this relationship is small. However, in pornography research, the interpretation of “size” may depend as much on the nature of the outcome studied as the magnitude of the relationship found. Accordingly, if the outcome is to be considered “sufficiently adverse” (e.g., sexual aggressive behaviors), even small effect sizes may carry considerable social and practical significance [2].

Third, the study does not address possible moderators or mediators of the relationships studied nor is it able to determine causality. Increasingly, in research on pornography, attention is given to factors that may influence the magnitude or direction of the relationships studied (i.e., moderators) as well as the pathways through which such influence may come about (i.e., mediators) [1,3]. Future studies on pornography consumption and sexual difficulties may also benefit from an inclusion of such focuses.

Fourth, in  their concluding statement, the authors suggest that a number of factors are more likely related to sexual difficulties than pornography consumption. To better assess this, as well as the relative contribution of each of these variables, the use of comprehensive models able to encompass both direct and indirect relationships between variables known or hypothesized to influence the outcome may be advised [3].

Overall, the study by Landripet and Stulhofer provides first and an interesting cross-cultural and quantitative insights into possible associations between pornography consumption and sexual difficulties. Hopefully comparable future studies may use this as a stepping stone to further advance the research on relationships between pornography consumption and sexual difficulties among both men and women.

Gert Martin Hald, Department of Public Health, University of Copenhagen, Copenhagen, Denmark

References

 1  Hald GM, Seaman C, Linz D. Sexuality and pornography. In: Tolman D, Diamond L, Bauermeister J, George W, Pfaus J, Ward M, eds. APA handbook of sexuality and psychology: Vol. 2. Contextual approaches. Washington, DC: American Psychological Association; 2014:3–35.

 2  Malamuth NM, Addison T, Koss M. Pornography and sexual aggression: Are there reliable effects and can we understand

 them? Annu Rev Sex Res 2000;11:26–91.

 3  Rosenthal R. Media violence, antisocial behavior, and the social consequences of small effects. J Soc Issues 1986;42:141–54.