Comment: Visitors who are interested in the current state of the research on CSBD/PPU will appreciate this thorough account of the current research. There’s much work still to be done. It’s essential that problematic online porn use gets carved out of CSBD, that is, not lumped in with partnered sex and treated as an impulse-control disorder. Problematic online porn use must be put where it belongs, with online gaming and gambling addiction. We’d also like to see researchers ask participants to eliminate porn use in order to measure any effects, and we’d like to see more of a focus on Porn-Induced Sexual Dysfunctions.
As the authors state, the paper offers the first large-scale synthesis since ICD-11, and the first interdisciplinary review of the field as a whole. This is critical given that different disciplines consistently approach CSBD and PPU research from different angles. This review will likely promote cohesion and clarity as the field prepares for the DSM-6. Given the ongoing controversies regarding addiction models, the review summarizes the most recent theoretical and empirical knowledge regarding the addiction perspective, much of which has been overlooked in other recent publications. One takeaway is that PPU may operate through different mechanisms to broader/traditional forms of CSBD (“sex addiction”), and that PPU might have a greater addictive potential due to shared features with other technologically-mediated addictive behaviors (e.g., gambling, Internet gaming). This nuance is crucial given that numerous co-authors are historically skeptical toward (or even opposed to) an addiction conceptualization, especially for CSBD. Similarly, the authors call for greater attention toward subtyping to better differentiate PPU from other (primarily offline) forms of CSBD, and to distinguish between different forms of dysregulation (e.g., subtypes based on addictive, impulsive, compulsive, moral incongruence, and/or emotion dysregulation trajectories).
YBOP hopes that this herculean effort will put a stop to some of the egregious, industry-friendly propaganda posing as academic synthesis, which willfully ignores all of the addiction evidence.
Journal of Behavioral Addictions
Ince et al., 25 Mar 2026 DOI: https://doi.org/10.1556/2006.2025.00337
Abstract
Background and aims
The nature and classification of dysregulated sexual behaviors remain widely debated. Compulsive Sexual Behavior Disorder (CSBD) and Problematic Pornography Use (PPU) are the two most commonly studied constructs in this area, each carrying significant implications for mental health, interpersonal functioning, and broader well-being. Although scientific output on these topics has expanded rapidly in the past decade, recent reviews have tended to focus on specific subthemes, single constructs, or narrow disciplinary perspectives. Accordingly, this review provides an updated and interdisciplinary overview of empirical and theoretical knowledge.
Methods
In this narrative review, we summarize current knowledge regarding CSBD and PPU, with contributions from diverse experts across multiple disciplines (e.g., psychology, psychiatry, sexology, addiction science, neuroscience). We provide research and clinical perspectives to ensure a comprehensive and balanced discussion.
Results
We extensively summarize eleven key areas, namely historical context, conceptualization and symptomatology, assessment and measurement, epidemiology, co-occurring disorders, etiology, potential negative consequences, intervention, treatment, and policy considerations. Additionally, we consider underrepresented populations and contexts, including adolescents, LGBTQ+ (i.e., lesbian, gay, bisexual, trans, queer, and other diverse identities) individuals, women, and cultural factors. The review concludes with a critical discussion of prevailing controversies, methodological challenges, and key directions for future research.
Discussion and Conclusions
By providing a comprehensive and integrative overview, this work aims to advance scientific discourse, promote interdisciplinary collaborations, inform clinical practice, and support public health initiatives in the field of CSBD and PPU.