The Short Version of the Problematic Pornography Consumption Scale (PPCS-6): A Reliable and Valid Measure in General and Treatment-Seeking Populations

Abstract

To date, no short scale existed that could assess problematic pornography use (PPU) having a solid theoretical background and strong psychometric properties. Having such a short scale may be advantageous when scarce resources are available and/or when respondents’ attention spans are limited. The aim of the present investigation was to develop a short scale that can be utilized to screen for PPU. The Problematic Pornography Consumption Scale (PPCS-18) was used as a basis for the development of a short measure of PPU (PPCS-6). A community sample (N1=15,051), a sample of pornography site visitors (N2=760), and a sample of treatment-seeking individuals (N3=266) were recruited to investigate the reliability and validity of the PPCS-6. Also, its association was tested to theoretically-relevant correlates (e.g., hypersexuality, frequency of masturbation), and a cut-off score was determined. The PPCS-6 yielded strong psychometric properties in terms of factor structure, measurement invariance, reliability, correlated reasonably with the assessed variables, and an optimal cut-off was identified that could reliably distinguish between PPU and non-problematic pornography use. PPCS-6 can be considered as a short, reliable, and valid scale to assess PPU in studies when the length of a questionnaire is essential or when a brief screening for PPU is necessary.

Full text

PPCS-6 1
The Short Version of the Problematic Pornography Consumption Scale (PPCS-6): A Reliable and
Valid Measure in General and Treatment-seeking Populations
Beáta Bőthe1,2*, István Tóth-Király3, Zsolt Demetrovics1, and Gábor Orosz4,1
1 Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
2Département de Psychologie, Université de Montréal, Montréal, Canada
3Substantive-Methodological Synergy Research Laboratory, Department of Psychology, Concordia
University, Canada
4Department of Psychology, Stanford University, Stanford, CA, USA
*Corresponding author
Beáta Bőthe, Ph.D., Department of Psychology, Université de Montréal, C.P. 6128, Succursale Centre-Ville,
Montréal, QC, H3C 3J7, Canada
E-mail: beata.bothe@umontreal.ca; bothe.beata@ppk.elte.hu
Tel.: +1 438-833-3038
Acknowledgements and funding sources: The research was supported by the Hungarian National
Research, Development and Innovation Office (Grant numbers: KKP126835, NKFIH-1157-8/2019-DT).
BB was supported by the ÚNKP-18-3 New National Excellence Program of the Ministry of Human
Capacities. BB was funded by a postdoctoral fellowship award by Team SCOUP – Sexuality and Couples
– Fonds de recherche du Québec, Société et Culture. ITK author was supported by a Horizon Postdoctoral
Fellowship from Concordia University and by funding from the Social Sciences and Humanities Research
Council of Canada (435-2018-0368) in the preparation of the manuscript. The funding agencies did not have
input into the content of the manuscript and the views described in the manuscript reflect those of the authors
and not necessarily those of the funding agencies.
Conflict of interest: The authors declare no conflict of interest with respect to the content of this
manuscript.
This document is a pre-publication version of the following manuscript:
Bőthe, B., Tóth-Király, I., Demetrovics, Zs., & Orosz, G. (In Press, Accepted: 7 January 2020). The Short
Version of the Problematic Pornography Consumption Scale (PPCS-6): A Reliable and Valid Measure in
General and Treatment-seeking Populations. Journal of Sex Research. doi:
10.1080/00224499.2020.1716205
© 2020. This paper is not the copy of record and may not exactly replicate the final, authoritative version
of the article published in Journal of Sex Research. The final authenticated version is available online at
https://doi.org/ 10.1080/00224499.2020.1716205

PPCS-6 1
The Short Version of the Problematic Pornography Consumption Scale (PPCS-6): A Reliable and
Valid Measure in General and Treatment-Seeking Populations
Abstract
To date, no short scale existed that could assess problematic pornography use (PPU) having a solid
theoretical background and strong psychometric properties. Having such a short scale may be
advantageous when scarce resources are available and/or when respondents’ attention spans are limited.
The aim of the present investigation was to develop a short scale that can be utilized to screen for PPU.
The Problematic Pornography Consumption Scale (PPCS-18) was used as a basis for the development of a
short measure of PPU (PPCS-6). A community sample (N1=15,051), a sample of pornography site visitors
(N2=760), and a sample of treatment-seeking individuals (N3=266) were recruited to investigate the
reliability and validity of the PPCS-6. Also, its association was tested to theoretically-relevant correlates
(e.g., hypersexuality, frequency of masturbation), and a cut-off score was determined. The PPCS-6 yielded
strong psychometric properties in terms of factor structure, measurement invariance, reliability, correlated
reasonably with the assessed variables, and an optimal cut-off was identified that could reliably
distinguish between PPU and non-problematic pornography use. PPCS-6 can be considered as a short,
reliable, and valid scale to assess PPU in studies when the length of a questionnaire is essential or when a
brief screening for PPU is necessary.
Keywords: pornography; problematic pornography use; Problematic Pornography Consumption Scale
(PPCS); PPCS-6; screening

PPCS-6 2
The Short Version of the Problematic Pornography Consumption Scale (PPCS-6): A Reliable and
Valid Measure in General and Treatment-seeking Populations
Pornography consumption among young adults and even among pre-adolescent children has
started to increase in the past decades (Lewczuk, Wojcik, & Gola, 2019; Price, Patterson, Regnerus, &
Walley, 2016). According to the latest statistics of a popular pornography website (Pornhub.com, 2019),
on average, 115 million people visited this website daily, and more than 1300 searches were conducted
every second. Not only has public interest started to increase concerning pornography use, but an
increasing number of scientific studies has been published in this topic in the recent years (e.g., Blais-
Lecours, Vaillancourt-Morel, Sabourin, & Godbout, 2016; Bőthe, Tóth-Király, & Orosz, 2015; Kraus &
Rosenberg, 2014). However, to date, no short scale existed that could assess problematic pornography use
adequately (Fernandez & Griffiths, 2019).
Having such a short scale to assess and screen for problematic pornography use may be
advantageous when scarce resources are available. For example, in large-scale, nationally representative
data collection (Cunny & Perri, 1991) which is a gap in the literature given that only a handful of studies
were conducted in Western countries (Grubbs, Kraus, & Perry, 2019; Rissel et al., 2017). Moreover, the
use of a short scale is also beneficial when respondents’ attention spans are limited (Konrath, Meier, &
Bushman, 2014). Previous studies reported positive associations between problematic pornography use
and impulsivity (Antons & Brand, 2018; Bőthe, Tóth-Király, Potenza, et al., 2019) and attention deficit
hyperactivity disorder (ADHD, Bőthe, Koós, Tóth-Király, Orosz, & Demetrovics, 2019) indicating that
individuals with problematic pornography use may experience difficulties with sustained attention. Thus,
using a short scale would be adequate to assess problematic pornography use. Therefore, the aim of the
present study was to develop a short, reliable, and valid scale that could assess problematic pornography
use based on an overarching and well-studied (Andreassen, Pallesen, Griffiths, Torsheim, & Sinha, 2018;
Andreassen, Griffiths, Hetland, & Pallesen, 2012; Orosz, Bőthe, & Tóth-Király, 2016; Orosz, Tóth-Király,
Bőthe, & Melher, 2016) theoretical framework of addictions and problematic behaviors, namely,
Griffiths’ six-component model (Griffiths, 2005). The Problematic Pornography Consumption Scale
(PPCS-18; Bőthe, Tóth-Király, Zsila, et al., 2018) served as a basis for this purpose. Then, the
psychometric properties of the developed scale (PPCS-6) were examined on three independent samples of
pornography users with the inclusion of theoretically-relevant correlates (Marsh, Ellis, Parada, Richards,
& Heubeck, 2005) and a potential cut-off score was determined.
Assessment of Problematic Pornography Use
Despite the inclusion of the diagnosis of Compulsive Sexual Behavior Disorder (CSBD) in the
11th version of International Statistical Classification of Diseases and Related Health Problems (ICD-11)
(World Health Organization, 2019), there is no official diagnostic criteria and classification for
problematic pornography use, resulting in diverse definitions and measurements of the given phenomenon
(Fernandez & Griffiths, 2019). However, as problematic pornography use may be subsumed as a
manifestation or subcategory of CSBD, the same diagnostic criteria may be applied to define problematic
pornography use. Thus, in the case of problematic pornography use, pornography is the central focus of
the users’ life; problematic users experience failures when trying to control their use with recurring
unsuccessful efforts to regulate or reduce it; and they engage in pornography use despite the negative
consequences and deriving little or no satisfaction from it anymore (World Health Organization, 2019).
Also, it has to be noted that problematic pornography use and frequency of pornography use are related
but yet may be considered as distinct domains of pornography use, as they showed positive, but only
small-to-moderate associations in previous studies (Bőthe, Tóth-Király, Zsila, et al., 2018; Gola, Lewczuk,
& Skorko, 2016; Grubbs & Perry, 2019; Grubbs, Perry, Wilt, & Reid, 2019; Kor et al., 2014). Thus, it
may be assumed that there are individuals who use pornography frequently and experience no related
problems at all. At the same time, others may use pornography just as frequently as non-problematic
users, but at the same time experience severe adverse consequences (e.g., non-problematic highly-engaged
users vs. problematic users) (Ferguson, Coulson, & Barnett, 2011).
Studies examining the prevalence rates of pornography use frequency and problematic
pornography use often apply only one item assessing the subjective feeling of “pornography addiction”

PPCS-6 3
without further indicators of problems related to it (e.g., Rissel et al., 2017). These results might be prone
to biases due to moral incongruence regarding pornography use (Grubbs, Perry, Wilt, & Reid, 2018).
Although individuals with religious beliefs may oppose pornography use, they tend to engage in this
activity, potentially leading to moral incongruence and reporting lower levels of pornography use. In
addition, they may attribute any amount of pornography use to control problems, and they may interpret it
as an “addiction” to pornography use (Grubbs et al., 2018; Grubbs, Perry, et al., 2019; Kraus & Sweeney,
2019). To address these limitations, studies should be carried out with psychometrically appropriate and
theoretically solid measures to gain a better knowledge of the phenomenon of problematic pornography
use. As the first step in this process, reliable and valid measures are needed that can assess problematic
pornography use, not only the subjective feelings of “pornography addiction” (Fernandez & Griffiths,
2019). According to a recent systematic review evaluating the psychometrics instruments measuring
problematic pornography use (Fernandez & Griffiths, 2019), more than 20 scales were developed or
adapted to assess problematic pornography use or some characteristics of problematic pornography use.
However, most of them showed theoretical and/or methodological shortcomings that limited their
applications to develop a shorter version from them. For example, some scales only covered a narrow
range of the components of problematic pornography use (e.g., craving or negative effects of pornography
use), others were validated on specific samples (e.g., men who have sex with men, or men with
hypersexuality), or were restricted by the phrasing of the original item set assessing different behaviors
(e.g., scales adapted from prior instruments assessing compulsive internet use may not be appropriately
applied in the case of problematic pornography use) (Fernandez & Griffiths, 2019).
When taking into consideration the strengths and limitations of these scales, the PPCS-18 (Bőthe,
Tóth-Király, Zsila, et al., 2018) and the Problematic Pornography Use Scale (PPUS) (Kor et al., 2014)
demonstrated the strongest psychometric properties, and they were recommended to be used in both
research and clinical settings (Fernandez & Griffiths, 2019). For the purpose of the present study, we
chose the PPCS-18 as a basis for a short scale in opposition to the PPUS because the PPCS-18 explicitly
measures tolerance as opposed to the PPUS, its items are short and concise, and the items provide clear
information regarding the areas that are aimed to be measured (i.e., some items of the PPUS are long and
include several areas of functioning hindering clear information which of them are affected by
pornography use) (Fernandez & Griffiths, 2019).
The PPCS-18 includes six factors assessing the dimensions of problematic pornography use based
on Griffiths’ six-component model of addiction (Griffiths, 2005): salience (importance of pornography use
in one’s life), tolerance (gradual increase of pornography use without reaching satisfaction), mood
modification (pornography use as a tool to reduce negative feelings), conflict (intra- and interpersonal
problems as a result of pornography use), withdrawal (psychological distress and/or withdrawal symptoms
appearing when pornography use is inhibited), and relapse (unsuccessful efforts to reduce or stop
pornography use). According to the six-component model, problematic use may only be present if all the
characteristics of problematic use appear regarding the given behavior. Someone may demonstrate some
(but not all) of these characteristics without real problematic use. For example, pornography use may
cause significant distress in people’s life (i.e., conflict component) because their partner may consider
pornography use as a form of cheating (Bechara et al., 2003). In this case, individuals would score higher
on the conflict component, but they did not display other characteristics of problematic pornography use.
Thus, they may not be considered as problematic users. If we separate the items and examine them
independently from the other characteristics, they may not seem the most unambiguous indicators of
problematic use (e.g., salience or mood modification). However, when all the six components are
considered as characteristics of problematic use, and all these components are present regularly at the
same time, then they represent the most important criteria of problematic use (Griffiths, 2005). Moreover,
applying the six-component model is in line with recent considerations that problematic use or potentially
addictive behaviors should be classified based on the same criteria (e.g., the six-component model)
because the use of these similar characteristics will unify the examination of the different problematic
behaviors and would lead to a more unified view of them (Griffiths, 2019).

PPCS-6 4
The PPCS-18 demonstrated strong psychometric properties in terms of good confirmatory factor
analysis as well as high levels of measurement invariance and reliability; in addition, a reliable cut-off
score with high sensitivity, specificity, positive predictive value, negative predictive value, and accuracy
was determined for this scale (Bőthe, Tóth-Király, Zsila, et al., 2018). The validity of the PPCS-18 was
established in relation to sexuality-related (i.e., hypersexuality, sexual motivations, sexual satisfaction, sex
mindset, and relationship satisfaction), personality-related variables (i.e., impulsivity and compulsivity),
and psychiatric disorders (i.e., adult ADHD symptoms) (Bőthe, Tóth-Király, Zsila, et al., 2018; Bőthe,
Koós, Tóth-Király, Orosz, & Demetrovics, 2019; Bőthe et al., 2017; Bőthe, Tóth-Király, Potenza, et al.,
2018; Tóth-Király, Vallerand, Bőthe, Rigó, & Orosz, 2019). In sum, the PPCS-18 is a robust
multidimensional scale lying on a solid theoretical background (Griffiths, 2005), and demonstrating strong
psychometric properties in terms of reliability, measurement invariance, construct validity, and convergent
and divergent validity as well (Bőthe, Tóth-Király, Zsila, et al., 2018; Bőthe, Koós, et al., 2019; Bőthe et
al., 2017; Bőthe, Tóth-Király, Potenza, et al., 2018; Tóth-Király et al., 2019). Therefore, the PPCS-18 may
be considered as an adequate basis for further analysis to develop a short scale assessing problematic
pornography use.
When to Use Brief Versions of Scales
The utilization of brief scales is highly welcomed both in clinical settings for quick screening
purposes as well as in research, especially in the case of surveys when there is no room for longer
measures. However, some issues need to be considered before using short versions of given scales. First,
only those short scales should be utilized that were adequately tested in terms of psychometric properties
through independent studies (i.e., within-network and between-network investigations were carried out)
and had a solid theory behind them (Marsh et al., 2005). Second, short measures or even single-item
measures may be more adequate to use when researchers or therapists have limited resources, such as
having only a short period of time to administer the scale or having other scales that should be included in
a questionnaire battery (Cunny & Perri, 1991; Danner, Treiber, & Bosnjak, 2019). Moreover, short
measures may be less expensive than full-length scales (Dolan et al., 2015). Third, short scales may be
more appropriate in studies when the given constructs are measured multiple times (e.g., experience
sampling studies or diary studies), or when exploratory (e.g., when new methods or theories are pilot
tested) or experimental studies are conducted (Danner et al., 2019; Konrath, Meier, & Bushman, 2014,
2018). Fourth, from the perspective of respondents, short scales or single-item measures can be fruitful in
cases when participants have a limited attention span (e.g., online studies) or when the original, longer
version of the given scale includes several, repetitive items that may potentially result in reduced
motivation which, in turn, can lead to higher dropout rates (Danner et al., 2019; Konrath et al., 2014,
2018). However, there are cases when the use of longer scales may be more appropriate. Longer scales are
suggested when the small differences between the individuals or in the severity of the given condition
have high importance.
The aim of the present work was to develop a new, short version of the PPCS-18 that preserves
the strong psychometric qualities of the PPCS-18 despite the brevity of the new measure (Marsh et al.,
2005). Three independent samples were recruited (i.e., a large community sample, visitors of a
pornography site, and treatment-seeking individuals) and theoretically-relevant constructs were assessed
as correlates (i.e., frequency and duration of pornography use, frequency of masturbation, frequency of
pornography use during masturbation, and hypersexuality) to increase the reliability and validity of the
findings. Given that important gender-based (Grubbs, Kraus, et al., 2018; Rissel et al., 2017) and sexual
orientation-based (Bőthe, Bartók, et al., 2018) differences have been reported in the literature with respect
to pornography use; it was deemed necessary, similar to Bőthe, Tóth-Király, Zsila et al. (2018), to test via
measurement invariance whether the PPCS-6 functions the same way in these subgroups. Moreover,
measurement invariance testing was conducted to examine whether the PPCS-6 functions the same way in
treatment-seeking and in general populations. Similarly to the original validation study (Bőthe, Tóth-
Király, Zsila, et al., 2018), a potential cut-off score was determined for the PPCS-6 that can distinguish
between problematic and non-problematic pornography users. Overall, it was expected that the short

PPCS-6 5
version of the scale would demonstrate similar construct validity, reliability, and association patterns with
the assessed correlates like the long one. Methods
Participants and Procedure
The present work was approved by the Institutional Ethical Review Board of the research team’s
university and was conducted in accordance with the Helsinki Declaration. Data collection was conducted
via online surveys, completing them took 15-30 minutes as the present study was part of a larger project.
Participants were informed about the aims of the study, and informed consent was obtained from them
prior to data collection. Before presenting the pornography-related measures, this previously established
definition of pornography (Bőthe, Tóth-Király, Zsila, et al., 2018; Hald & Malamuth, 2008; Reid, Li,
Gilliland, Stein, & Fong, 2011) was provided to the participants to avoid potential biases deriving from
individual differences (Willoughby & Busby, 2016): “Pornography is defined as material (text, picture,
video, etc.) that (1) creates or elicits feelings or thoughts and (2) contains explicit exposure or
descriptions of sexual acts involving the genitals, such as vaginal or anal intercourse, oral sex, or
masturbation”. Only individuals aged 18 years or older were allowed to participate. In the case of Sample
1, respondents were invited to participate via advertisements on one of the largest Hungarian news portal
in January 2017. The survey was advertised as a study examining sexual activities. As for Sample 2,
participants were invited to take part in the study via a popular Hungarian pornography site in December
2017. The survey was advertised as a study examining pornography use. Regarding Sample 3, participants
were recruited on an English-language website presenting the latest findings in diverse psychological
topics (i.e., PsyPost) in an easily understandable way in July 2019. The advertisement targeted those
people who may experience problems related to their pornography use and wanted to participate in the
pretest of a new online program aiming to reduce problematic pornography use (i.e., treatment-seeking
individuals). In the advertisement, first, prior findings of problematic pornography use were presented.
Then, a new online cognitive-behavioral therapy-based program that we had developed was shortly
described. We asked the participants to complete a short survey about their pornography use and
willingness to participate in the online program if they wanted to reduce their pornography use-related
problems. We also informed the participants that the study was approved by the related university’s
ethical review board; their data will be kept confidential and will only be used for scientific purposes.
Sample 1. A total number of 15,051 individuals (29.7% female) participated in the present study
aged between 18 and 76 years (Mage = 33.2 years, SDage = 11.0). As for sexual orientation, 12,412 were
heterosexual (82.5%), 1,519 were heterosexual with homosexuality to some extent (10.1%), 438 were
bisexual (2.9%), 106 were homosexual with heterosexuality to some extent (0.7%), 420 were homosexual
(2.8%), 23 were asexual (0.2%), 93 were unsure about their sexual orientation (0.6%), and 40 indicated
the “other” option (0.3%). Regarding relationship status, 4,293 were single (28.5%), 5,932 were in any
kind of romantic relationship (i.e., being in a relationship, engaged, or married) (70.0%), and 219
indicated the “other” option (1.5%). Regarding past-year pornography use, participants watched online
pornography weekly and reported spending 26.6 minutes with it per each session (SD = 20.9). Regarding
masturbation, participants masturbated two to three times a week, and they used pornography more than
75% of these occasions.
Sample 2. A total number of 760 individuals (6.3% female) participated in the present study aged
between 19 and 75 years (Mage = 39.6 years, SDage = 9.7). As for sexual orientation, 603 were heterosexual
(79.3%), 87 were heterosexual with homosexuality to some extent (11.4%), 45 were bisexual (5.9%), five
were homosexual with heterosexuality to some extent (0.7%), 12 were homosexual (1.6%), two were
asexual (0.3%), five were unsure about their sexual orientation (0.7%), and 1 indicated the “other” option
(0.1%). Regarding relationship status, 159 were single (20.9%), 597 were in any kind of romantic
relationship (i.e., being in a relationship, engaged, or married) (78.6%), and four indicated the “other”
option (0.5%). Regarding past-year pornography use, participants watched online pornography weekly
and reported spending 38.3 minutes with it per each session (SD = 28.1). Regarding masturbation,
participants masturbated two to three times a week, and they used pornography more than 75% of these
occasions.

PPCS-6 6
Sample 3. A total number of 266 individuals (3.0% female) participated in the present study aged
between 18 and 76 years (Mage = 37.2 years, SDage = 12.3). As for sexual orientation, 184 were
heterosexual (69.2%), 46 were heterosexual with homosexuality to some extent (17.3%), 13 were bisexual
(4.9%), three were homosexual with heterosexuality to some extent (1.1 %), 16 were homosexual (6.0%),
no one was asexual (0.0%), two were unsure about their sexual orientation (0.8%), and two indicated the
“other” option (0.8%). Regarding relationship status, 81 were single (30.4%), 180 were in any kind of
romantic relationship (i.e., being in a relationship, engaged, or married) (67.4%), and five indicated the
“other” option (1.9%). Regarding past-year pornography use, participants watched online pornography six
to seven times a week and reported spending 47.9 minutes with it per each session (SD = 41.0). Regarding
masturbation, participants masturbated four to five times a week, and they almost always used
pornography during these occasions.
Measures
Problematic Pornography Consumption Scale (PPCS-18, Bőthe, Tóth-Király, Zsila, et al.,
2018). The PPCS-18 assesses problematic pornography use via six factors (three items each) based on the
proposed six-component addiction model (Griffiths, 2005): salience, tolerance, mood modification,
relapse, withdrawal, and conflict. Participants indicated their answers on a seven-point scale (1 = never; 7
= very often) regarding the past six months. The short version is available in Appendix 1.
Masturbation and Pornography Use-Related Questions (Bőthe, Bartók, et al., 2018).
Respondents indicated their frequency of online pornography use and their frequency of masturbation on a
10-point scale (1 = “never”, 10 = “6 or 7 times a week”)
1
. Also, they reported their time spent with
accessing pornography per session (in minutes) over the past year and the frequency of their pornography
use during masturbation on an eight-point scale (1 = “never”, 8 = “always”).
Hypersexual Behavior Inventory (HBI, Bőthe, Kovács, et al., 2019; Reid, Garos, & Carpenter,
2011). HBI assesses the level of hypersexuality via three factors (coping, control, and consequences) with
19-items. Participants indicated their answers on a five-point scale (1 = “never”; 5 = “very often”). The
HBI demonstrated excellent reliability in the present study (α = .90).
Statistical Analysis
For statistical analysis, SPSS 22 and Mplus 7.3 (Muthén & Muthén, 1998-2015) were utilized.
Initially, the PPCS-18 was examined to select the best items representing each factor with one item. Based
on the combined guidelines of prior work (Haynes, Richard, & Kubany, 1995; Marsh et al., 2005; Orosz,
Tóth-Király, & Bőthe, 2016; Orosz et al., 2018), each item was evaluated by the following criteria: (a)
having adequate corrected item-total correlations, (b) having adequate standardized factor loadings, (c)
having the lowest skewness and kurtoses values, and (d) best covering the breadth of the content
determined by separate subjective evaluations from the authors (i.e., evaluation of an expert in clinical
psychology and addiction, evaluation of an expert in pornography research, and evaluation of two experts
in scale development). First, the psychometric properties of each item were examined, and then the four
evaluators independently rated and selected the items that they found the most appropriate assessing the
given criterion. After these evaluations, those items were selected that had strong psychometric properties
and represented best the factors’ content. Six items were selected (each representing one factor from the
original PPCS-18) for further analyses.
Confirmatory factor analysis (CFA) was conducted on Sample 1 and then on Sample 2 and
Sample 3 to cross-validate the results. Commonly used goodness-of-fit indices were used to evaluate the
models (Brown, 2015; Hu & Bentler, 1999): Comparative Fit Index (CFI; ≥ .95 for good, ≥ .90 for
acceptable), the Tucker–Lewis index (TLI; ≥ .95 for good, ≥ .90 for acceptable), and the Root-Mean-
Square Error of Approximation (RMSEA; ≤ .06 for good, ≤. 08 for acceptable) with its 90% confidence
interval. Items were treated as categorical indicators, and the mean- and variance-adjusted weighted least-
squares estimator (WLSMV) was applied (Finney & DiStefano, 2006). To test measurement invariance
between gender-based groups (men vs. women) and sexual orientation-based groups (exclusively
1
In Sample 3, frequency of pornography use and frequency of masturbation were measured on an 11-point scale
ranging from 1 = „never” to 11 = „more than 7 times a week”.

PPCS-6 7
heterosexual vs. sexual minority individuals), multi-group CFAs were carried out (Tóth-Király, Bőthe,
Rigó, & Orosz, 2017; Vandenberg & Lance, 2000) on Sample 1. Additionally, to test measurement
invariance between general populations (Sample 1 and Sample 2) and treatment-seeking individuals
(Sample 3), multi-group CFAs were conducted on Sample 1, Sample 2, and Sample 3. A total of six levels
of invariance were tested and compared in each case: configural, metric, scalar, residual, latent variance
and latent mean (such as in the case of hypersexuality in a previous study – Bőthe, Bartók, et al., 2018).
When comparing the increasingly constrained models, relative change in fit indices was observed (Chen,
2007; Cheung & Rensvold, 2002; Marsh et al., 2009): ΔCFI ≤ .010; ΔTLI ≤ .010; and ΔRMSEA ≤ .015.
Cronbach’s alpha (Nunnally, 1978) was calculated for estimated internal consistency with its
acceptable (≥. 70) or good (≥. 80) thresholds. Following prior recommendations (Sijtsma, 2009),
composite reliability (CR) was also calculated following the formula of Raykov (1997) as CR represents
the construct more adequately by taking into account the factor loadings with their respective
measurement errors. Values > .60 are considered acceptable and values > .70 are considered good
(Bagozzi & Yi, 1988). Apart from the correlations between the long and short forms, associations between
pornography use frequency, pornography use duration per occasion, masturbation frequency, pornography
use frequency during masturbation, and the PPCS-6 were assessed to corroborate the validity of the PPCS-
6. Lastly, sensitivity and specificity analysis were conducted to calculate a cut-off score for the
PPCS-6 based on treatment-seeking status (i.e., Sample 3 (treatment-seeking individuals) vs. Sample 2
(non-treatment-seeking individuals)). The sensitivity, specificity, positive predictive value, negative
predictive value, and accuracy values for potential cut-off scores on the PPCS-6 cut-off scores were
calculated. Sensitivity was defined as the proportion of true positives belonging to the treatment-seeking
group, while specificity was defined as the proportion of the true negatives belonging to the non-
treatment-seeking group (Altman & Bland, 1994a; Glaros & Kline, 1988). Positive predictive value was
calculated as the proportion of the “true positive” cases (individuals with positive test results who were
correctly diagnosed as problematic users), while negative predictive value was calculated as the
proportion of “true negative” cases (individuals with negative test results who were correctly diagnosed as
non-problematic users) (Altman & Bland, 1994b; Glaros & Kline, 1988).
Results
Item Selection
First, on Sample 1, CFA was conducted on the PPCS-18 to obtain standardized factor loadings for
the items. The model had adequate fit to the data (Table 1). The standardized factor loadings of the items,
corrected item-total correlations, skewness, and kurtosis values can be seen in Table 2. Based on the
aforementioned indices and the subjective content evaluation of the items by experts, six items (one per
factor) were selected for further analysis.
More precisely, in the process of item selection, the authors considered both theoretical and
empirical approaches. Selecting items solely on statistical information could be biased as we might lose
important aspects or content from the theoretical conceptualization of the factor. Indeed, apart from the
reported statistical information, we also considered the theoretical adequacy of the items (as proposed by
Hu & Bentler, 1998; Marsh, Hau, & Wen, 2004; Morin, Katrin Arens, & Marsh, 2015). In the case of the
salience factor, we decided to choose the item “I felt that porn is an important part of my life” (Item S1)
for the following reasons. First, all items in the salience factor had appropriate standardized factor
loadings, corrected item-total correlations, and had adequate skewness and kurtosis values. These values
for all three items suggest that all are adequate representations of the salience factor. For this reason,
secondly, the content of the items was evaluated regarding what extent each item covers the definition of
the salience factor by independent experts in the field of clinical psychology and addiction, pornography
research, and scale development, thus making sure that the most optimal item is selected. Third, from a
theoretical perspective, the content of Item S1 describes best the salience component of problematic
behaviors based on Griffiths’ definition of salience (Griffiths, 2005). Thus, as all the items on the salience
factor had appropriate psychometric properties, we chose the most appropriate item on a theoretical basis,
which aligned with the actual definition provided by Griffiths. Item S1 is a better choice than Item S7 and

PPCS-6 8
Item S13 that are more restricted in their content and only assess the more peripheral characteristics of
salience. Therefore, Item S1 was retained for the short version of the PPCS. The same process was
followed in the case of all items.
Validity and Reliability of the PPCS-6
In the next step of the analysis, CFA was conducted on the selected items to investigate the
construct validity of the six-item version of the PPCS (PPCS-6). The model had an excellent fit to the data
on all samples (Table 1). The PPCS-6 had adequate reliability in terms of Cronbach’s alpha and composite
reliability values on each sample (see Table 3). The PPCS-6 and PPCS-18 had strong, positive
associations with each other, and the PPCS-6 showed adequate (positive, weak-to-moderate) associations
with pornography use frequency, pornography use duration, masturbation frequency, and frequency of
pornography use during masturbation on each sample (see Table 4). Also, both the PPCS-6 and the PPCS-
18 showed positive, moderate associations with the level of hypersexuality in Sample 1. The differences
between the associations of the PPCS-6 and the PPCS-18 with respect to the theoretically-relevant
correlates were highly similar; the highest absolute difference between the correlations was .05, indicating
no significant loss of information.
To ensure the validity of the PPCS-6 and to ensure that gender-based comparisons are meaningful,
measurement invariance testing was conducted to examine the factor structure of the PPCS-6 across two
subgroups (men vs. women) on Sample 1. Baseline models were estimated for each group and, then,
parameters were gradually constrained. Fit indices suggested that configural, metric, and scalar invariance
was achieved (i.e., ΔCFI ≤ .010; ΔTLI ≤ .010; and ΔRMSEA ≤ .015). For residual invariance, although
the change in TLI was acceptable, changes in CFI and RMSEA were higher than the recommended
threshold values. Therefore, based on the examination of modification indices, we relaxed the equality
constraint on the residual variance of item 6, thus achieving a model of partial residual invariance, which
demonstrated adequate changes in the fit indices. Latent variance invariance was also achieved, but latent
mean invariance was not, suggesting the presence of latent mean differences between men and women
(see Table 5). Using the variance model, latent mean differences are expressed in SD units and are
accompanied by tests of statistical significance. When men’s latent mean differences were constrained to
zero for the purpose of model identification, women’s latent means proved to be substantially lower (-1.16
SD, p < .001).
To lend further support for the validity of the PPCS-6 and to ensure that sexual orientation-based
comparisons are meaningful, we examined the invariance of the factor structure of the PPCS-6 across two
subgroups (exclusively heterosexual vs. sexual minority individuals) on Sample 1. Baseline models were
estimated for each group and, then, parameters were gradually constrained. Fit indices suggested that
configural, metric, scalar, residual, latent variance, and latent mean invariance was achieved (i.e., ΔCFI ≤
.010; ΔTLI ≤ .010; and ΔRMSEA ≤ .015). These results indicate sexual orientation-related invariance on
the level of latent means, and the PPCS-6 appears to function the same way in both groups, demonstrating
the equality of factor loadings, thresholds, and uniquenesses.
To ensure that the PPCS-6 can be reliably used in both general and treatment-seeking populations,
and these comparisons are meaningful, measurement invariance testing was conducted to examine the
factor structure of the PPCS-6 across the three samples. Baseline models were estimated for each group
and, then, parameters were gradually constrained. Fit indices suggested that configural and metric
invariance was achieved (i.e., ΔCFI ≤ .010; ΔTLI ≤ .010; and ΔRMSEA ≤ .015). For scalar invariance,
although the change in TLI and RMSEA was acceptable, changes in CFI were slightly higher than the
recommended threshold values (i.e., ΔCFI = -.011). Thus, we retained this model for the further steps of
invariance testing. Residual and latent variance invariance was also achieved, but latent mean invariance
was not, suggesting the presence of latent mean differences between the samples (see Table 5). When
treatment-seeking individuals’ latent mean differences were constrained to zero for the purpose of model
identification, treatment-seeking individuals’ latent means were substantially higher than participants’
latent means in Sample 1 and Sample 2 (Sample 1: -1.81 SD, p < .001; Sample 2: -1.76 SD, p < .001),
indicating that treatment-seeking individual have significantly higher scores on the PPCS-6 than general,
non-treatment-seeking people.

PPCS-6 9
Distinguishing Problematic and Non-Problematic Pornography Use: Determination of a Cut-off
Score As the last step, a potential cut-off score was calculated for the PPCS-6 based on treatment-
seeking status (i.e., treatment-seeking individuals versus non-treatment-seeking/control individuals).
Individuals in Sample 3 were considered treatment-seeking participants, while participants from Sample 2
who has never sought help for problematic pornography use (698 participants, 92% of the sample) were
included in the non-treatment-seeking/control group. The sensitivity, specificity, positive predictive value
(PPV), negative predictive value (NPV), and the accuracy of the PPCS-6 at possible cut-off scores were
calculated (Table 6). A score of 20 (out of 42) can be considered as an optimal cut-off score to be
classified as a problematic pornography user. The accuracy of the PPCS-6 was 89%. The sensitivity and
specificity values suggest that 16% of the treatment-seeking individuals were not recognized, while only
10% of non-treatment-seeking individuals were identified as potentially problematic users at this cut-off
score. Based on the PPV and NPV, 24% of the individuals with a positive test result (i.e., having 20 points
or higher) were identified mistakenly as problematic users, while only 6% of the participants with a
negative test result (i.e., having 19 points or lower) were identified mistakenly as non-problematic users.
Discussion
With the increase of pornography consumption (Lewczuk et al., 2019; Price et al., 2016), the
clinical and scientific interest in the examination of pornography use—especially with respect to
problematic pornography use—has started to increase (e.g., Blais-Lecours et al., 2016; Ford et al., 2012;
Grubbs et al., 2015). Despite this increased interest in problematic pornography use (Kraus, Voon, &
Potenza, 2016), no short scale existed in the literature that could reliably and validly assess the extent of
problematic pornography use and could be used as a screener to distinguish between potentially
problematic and non-problematic pornography users, limiting the adequate assessment of problematic
pornography use in large-scale survey studies (Fernandez & Griffiths, 2019). Thus, the present study
sought to address this shortcoming with the development of the PPCS-6, a short, reliable, and valid scale
assessing problematic pornography use with six items based on a solid theoretical background (Griffiths,
2005).
Following previous guidelines and studies developing short measures (Danner et al., 2019;
Perreira et al., 2018; Schaufeli, Shimazu, Hakanen, Salanova, & De Witte, 2017), one item was selected
from each factor representing the given factor best, and the resulting model demonstrated as strong
psychometric properties as the original 18-item scale (Bőthe, Tóth-Király, Zsila, et al., 2018). The PPCS-6
showed a strong, positive association with the PPCS-18, further demonstrating the appropriateness of the
scale. Moreover, the construct validity and reliability of the PPCS-6 were cross-validated on two
independent and distinct samples, including treatment-seeking individuals as well. Not only the construct
validity of the PPCS-6 was supported, but its convergent validity was also established by reporting its
associations with pornography use frequency, pornography use duration, masturbation frequency,
pornography use frequency during masturbation, and hypersexuality.
In line with previous studies (Bőthe, Tóth-Király, Zsila et al., 2018; Grubbs, Perry, et al., 2018),
pornography use frequency and problematic pornography use (measured by PPCS-6) had moderate,
positive associations. Moreover, duration of pornography use per occasion, frequency of masturbation,
and frequency of pornography use during masturbation demonstrated weak-to-moderate, positive
associations with the PPCS-6 (Baćak a & Štulhofer, 2011; Bőthe et al., 2017; Bőthe, Tóth-Király, Zsila, et
al., 2018; Carvalheira, Træen, & Stulhofer, 2015; Wéry & Billieux, 2016). In line with previous studies
(Bőthe, Koós, et al., 2019; Bőthe, Tóth-Király, Potenza, et al., 2018; Grubbs, Exline, Pargament, Hook, &
Carlisle, 2015; Grubbs, Volk, et al., 2015; Kor et al., 2014), the level of hypersexuality showed a
moderate-to-strong association with problematic pornography use (both measured by the PPCS-18 and the
PPCS-6) supporting the validity of the this new, short scale.
Measurement invariance testing indicated that the latent mean of problematic pornography use
was higher among men than women, corroborating previous findings (Bőthe, Tóth-Király, Zsila et al.,
2018; Grubbs, Kraus, et al., 2018; Rissel et al., 2017). When sexual orientation was included in
measurement invariance testing as a grouping variable, there were no latent means differences between

PPCS-6 10
exclusively heterosexual and sexual minority individuals indicating that heterosexual and sexual minority
individuals demonstrate similar levels of problematic pornography use in general. Moreover, treatment-
seeking individuals (Sample 3) reported elevated scores on the PPCS-6 and on all the items of the scale
compared to general populations (Sample 1 and Sample 2), further supporting its validity and
demonstrating the scale’s potential clinical utility. In addition, the sensitivity and specificity analyses, and
the positive and negative predictive values suggested an optimal cut-off of 20 out of 42 points on the
PPCS-6 for distinguishing between problematic and non-problematic pornography use. Despite the high-
accuracy of the recommended cut-off score, it should be noted that self-report scales (such as the PPCS-6)
could and should only be used as a first step (screening) of the diagnostic process followed by clinical
interviews. To summarize, the PPCS-6 was developed by following a rigorous guideline (Marsh et al.,
2005), yielded strong psychometric properties, showed differentiated results in the case of general and
treatment-seeking samples, and thus, it may be utilized as a short measure of problematic pornography use
in future studies.
Potentially, the PPCS-6 may be applied in cases when only limited resources are available (e.g.,
time is limited to administer a scale) (Cunny & Perri, 1991; Danner et al., 2019). Moreover, the PPCS-6
might be appropriate in the future in exploratory investigations (Wright, 2013), in multiple assessment
studies, such as in diary studies (Wordecha et al., 2018), or in experimental studies (Hald & Malamuth,
2015). Moreover, the PPCS-6 may be used when respondents have a limited attention span, such as in the
case of large-scale or nationally-representative studies (Bőthe, Tóth-Király, Demetrovics, & Orosz, 2017;
Rissel et al., 2017) or in the case of individuals with psychiatric problems (e.g., depression or attention-
deficit hyperactivity disorder – Bőthe, Koós, et al., 2019; Kraus, Potenza, Martino, & Grant, 2015).
However, it has to be mentioned that the multidimensional nature of the PPCS-18 has been
sacrificed for brevity, such as in previous studies constructing short measures (Gosling, Rentfrow, &
Swann, 2003; Schaufeli et al., 2017). Thus, in cases when the dimensions of problematic pornography use
are to be examined or when profiles of users are to be compared, using the PPCS-18 is advised in
opposition to the PPCS-6. To conclude, the PPCS-6 and the PPCS-18 have their advantages and
disadvantages, but both scales have their niches in research and potentially in clinical settings as well.
Limitations and Future Studies
The present work had some limitations that need to be addressed. The study used cross-sectional,
self-reported data on self-selected samples; thus, the results may be prone to biases (e.g., social
desirability). The samples were large and comprehensive, but they were not representative of the
population, limiting the generalization of the findings. The samples included males predominantly
potentially due to the advertisement of the studies (i.e., surveys on sexuality and pornography use) and the
websites used for recruitment (e.g., Sample 2 was collected on a website providing pornographic
materials). Therefore, the application of the findings to female populations should be made with caution
due to fundamental differences in men’s and women’s pornography use (Bőthe, Koós, et al., 2019;
Lewczuk, Szmyd, Skorko, & Gola, 2017). Future studies are needed to examine further the construct and
clinical validity of the PPCS-6 conducting within-network and between-network studies on different
populations (e.g., in clinical settings or in different cultures – (Marsh et al., 2005; Schaufeli et al., 2017).
Longitudinal studies would be fruitful to investigate the temporal stability of the PPCS-6 (Fernandez &
Griffiths, 2019) and to examine the natural course of problematic pornography use.
Conclusions
The PPCS-6 is a short, valid, and reliable measure of problematic pornography use that can be
included in large-scale survey studies, can reliably distinguish between problematic and non-problematic
users, and may be reliably used among treatment-seeking individuals as well. Short measures, such as the
PPCS-6, may be adequate to use when researchers or therapists have scarce resources and/or when
participants have limited attention spans. In future studies, the PPCS-6 may be applied in nationally-
representative studies accompanied by one-item measures of subjective feelings of problematic
pornography use to gain better knowledge on the prevalence of problematic pornography use.

PPCS-6 11
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PPCS-6 15
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PPCS-6 16
Table 1
Confirmatory Factor Analyses (CFA) the Short Version of the Problematic Pornography Consumption Scale (PPCS-6)
Model
WLSMV χ2 (df)
CFI
TLI
RMSE
A
90% CI
1-factor first-order CFA (PPCS-18, Sample 1)
10542.544* (120)
.975
.968
.076
.075-.077
1-factor first-order CFA (PPCS-6, Sample 1)
214.786* (9)
.997
.994
.039
.035-.044
1-factor first-order CFA (PPCS-6, Sample 2)
23.436* (9)
.996
.994
.046
.023-.069
1-factor first-order CFA (PPCS-6, Sample 3)
23.736* (9)
.977
.961
.078
.041-.118
Note. WLSMV = weighted least squares mean- and variance-adjusted estimator; χ2 = Chi-square; df = degrees of freedom; CFI = comparative fit
index; TLI = Tucker-Lewis Index; RMSEA = root-mean-square error of approximation; 90% CI = 90% confidence interval of the RMSEA. *p <
.001

PPCS-6 17
Table 2
Initial Item Set of the Problematic Pornography Consumption Scale with Normality Indices and Corrected Item-Total Correlations on Sample 1 (N
= 15,051)
Items (Number of the item from the original scale)
Factor
Loadings
CITC
Skewness
(SE)
Kurtosis
(SE)
I felt that porn is an important part of my life. (S1)
.790
.577
0.824 (.02)
-0.527 (.04)
I thought about how good it would be to watch porn. (S7)
.873
.739
0.694 (.02)
-0.460 (.04)
I continually planned when to watch porn. (S13)
.827
.673
1.193 (.02)
0.640 (.04)
I used porn to restore the tranquility of my feelings. (M2)
.816
.692
1.448 (.02)
1.219 (.04)
Watching porn got rid of my negative feelings. (M8)
.873
.722
1.099 (.02)
0.192 (.04)
I released my tension by watching porn. (M14)
.871
.737
1.193 (.02)
0.484 (.04)
I felt porn caused problems in my sexual life. (C3)
.785
.583
2.414 (.02)
5.693 (.04)
Watching porn prevented me from bringing out the best in me. (C9)
.852
.686
2.776 (.02)
7.644 (.04)
I neglected other leisure activities as a result of watching porn. (C15)
.852
.569
2.200 (.02)
4.407 (.04)
I felt that I had to watch more and more porn for satisfaction. (T4)
.929
.695
2.240 (.02)
4.643 (.04)
I felt that I needed more and more porn in order to satisfy my needs. (T10)
.938
.697
2.649 (.02)
6.960 (.04)
I gradually watched more “extreme” porn, because the porn I watched before was less satisfying.
(T16)
.690
.484
1.418 (.02)
0.984 (.04)
I unsuccessfully tried to reduce the amount of porn I watch. (R5)
.917
.796
1.922 (.02)
2.741 (.04)
When I vowed not to watch porn anymore, I could only do it for a short period of time. (R11)
.924
.851
1.731 (.02)
1.839 (.04)
I resisted watching porn for only a little while before I relapsed. (R17)
.965
.845
1.840 (.02)
2.410 (.04)
I became stressed when something prevented me from watching porn. (W6)
.914
.776
2.273 (.02)
4.859 (.04)
I became agitated when I was unable to watch porn. (W12)
.901
.747
2.397 (.02)
5.428 (.04)
I missed porn greatly when I didn’t watch it for a while. (W18)
.913
.632
1.664 (.02)
1.943 (.04)
Note. S = Salience; M = Mood Modification; C = Conflict; T = Tolerance; R = Relapse; W = Withdrawal; Factor Loadings = Factor loadings
assessed by confirmatory factor analysis; CITC = Corrected Item-Total Correlation; SE = standard error. Bold letters indicate the final items.

PPCS-6 18
Table 3
Standardized Factor Loadings, Reliability Indices, and Descriptive Statistics of the Short Version of the Problematic Pornography Consumption
Scale (PPCS-6) on Sample 1, Sample 2, and Sample 3
Items
Sample 1
(N = 15,051)
Sample 2
(N = 760)
Sample 3
(N = 266)
Factor Loadings
1. I felt that porn is an important part of my life.
.71
.68
.43
2. I released my tension by watching porn.
.73
.73
.68
3. I neglected other leisure activities as a result of watching porn.
.80
.81
.70
4. I felt that I had to watch more and more porn for satisfaction.
.80
.85
.62
5. When I vowed not to watch porn anymore, I could only do it for a short period of time.
.74
.73
.60
6. I became stressed when something prevented me from watching porn.
.82
.89
.73
Reliability Indices
α (95% CI)
.84 (.84-.84)
.84 (.82-.86)
.75 (.70-.79)
Composite Reliability
.90
.90
.80
Descriptive Statistics
Total Score Mean (SD)
1.96 (1.09)
2.01 (1.09)
4.32 (1.16)
Total Score Skewness (SE)
1.55 (0.02)
1.56 (0.09)
-0.40 (0.15)
Total Score Kurtosis (SE)
2.30 (0.04)
2.29 (0.18)
0.12 (0.30)
Item 1 Mean (SD)
2.63 (1.81)
2.99 (1.80)
3.89 (1.88)
Item 2 Mean (SD)
2.27 (1.59)
2.20 (1,57)
5.11 (1.50)
Item 3 Mean (SD)
1.65 (1.26)
1.74 (1.35)
4.45 (1.85)
Item 4 Mean (SD)
1.63 (1.24)
1.65 (1.26)
4.21 (1.74)
Item 5 Mean (SD)
1.91 (1.61)
1.93 (1.56)
5.26 (1.72)
Item 6 Mean (SD)
1.64 (1.23)
1.57 (1.17)
3.01 (1.66)
Note. All factor loadings are standardized. Loadings are statistically significant at p < .001. CI = confidence interval; SD = standard deviation; SE
= standard error.

PPCS-6 19
Table 4
Associations between the Long (PPCS-18) and Short (PPCS-6) Version of the Problematic Pornography Consumption Scale with Pornography
Use and Sexuality-Related Variables on Sample 1, Sample 2, and Sample 3
Sample 1
(N = 15,051)
Sample 2
(N = 760)
Sample 3
(N = 266)
PPCS-18
PPCS-6
PPCS-18
PPCS-6
PPCS-18
PPCS-6
1. Problematic Pornography Consumption Scale (PPCS-18)
̶
.97*
̶
.97*
̶
.96*
2. PPCS-18 without the Items of PPCS-6
̶
.93*
̶
.94*
̶
.90*
3. Frequency of Pornography Use
.51*
.52*
.30*
.31*
.27*
.31*
4. Duration of Pornography Use
.30*
.30*
.25*
.24*
.23*
.23*
5. Frequency of Masturbation
.42*
.42*
.31*
.31*
.23*
.28*
6. Frequency of Pornograpy Use during Masturbation
.39*
.39*
.30*
.29*
.21*
.24*
6. Hypersexual Behavior Inventory
.58*
.57*
̶
̶
̶
̶
Note. PPCS-18 = Problematic Pornography Consumption Scale Long Version; PPCS-6 = Problematic Pornography Consumption Scale Short
Version; * p < .001.

PPCS-6 20
Table 5
Tests of Measurement Invariance on the Short Version of the Problematic Pornography Consumption Scale (PPCS-6)
Model
WLSMV χ2 (df)
CFI
TLI
RMSEA
90% CI
Comparison
Δχ2 (df)
ΔCFI
ΔTLI
ΔRMSEA
Gender invariance (Sample 1)
Baseline men
203.576*(9)
.995
.992
.045
.040-.051
—
—
—
—
—
Baseline women
70.370*(9)
.991
.985
.039
.031-.048
—
—
—
—
—
M1. Configural
279.741*(18)
.995
.991
.044
.039-.049
—
—
—
—
—
M2. Metric
565.884*(23)
.989
.985
.056
.052-.060
M2-M1
233.431* (5)
-.006
-.006
+.012
M3. Scalar
554.853*(52)
.989
.994
.036
.033-.039
M3-M2
96.721* (29)
.000
+.009
-.020
M4a. Residual
1314.779*(58)
.974
.986
.054
.051-.056
M4a-M3
494.738* (6)
-.015
-.008
+.018
M4b. Residual partiala
1006.871* (57)
.980
.990
.047
.045-.050
M4b-M3
300.781* (5)
-.009
-.004
+.011
M5. Latent variance
787.573*(58)
.985
.992
.041
.038-.043
M5-M4
7.421* (1)
+.005
+.002
-.006
M6. Latent means
10467.123*(59)
.782
.889
.153
.151-.156
M6-M5
2107.182* (1)
-.203
-.103
+.112
Sexual orientation invariance (Sample 1)
Baseline heterosexual individuals
201.777*(9)
.996
.994
.039
.035-.044
—
—
—
—
—
Baseline sexual minority individuals
21.279*(9)
.997
.996
.035
.016-.054
—
—
—
—
—
M1. Configural
221.511*(18)
.997
.994
.039
.034-.043
—
—
—
—
—
M2. Metric
225.889*(23)
.997
.996
.034
.030-.038
M2-M1
18.345*(5)
.000
+.002
-.005
M3. Scalar
197.058*(52)
.998
.999
.019
.016-.022
M3-M2
36.891(29)
+.001
+.003
-.015
M4. Residual
22.399*(58)
.997
.999
.020
.017-.022
M4-M3
32.659*(6)
-.001
.000
+.001
M5. Latent variance
162.335*(59)
.998
.999
.015
.012-.018
M5-M4
1.102(1)
+.001
.000
-.005
M6. Latent means
437.974*(60)
.994
.997
.029
.026-.032
M6-M5
55.003*(1)
-.004
-.002
+.014
Invariance between general and treatment-seeking populations (Sample 1, Sample 2, and Sample 3)
M1. Configural
342.364* (27)
.995
.992
.047
.042-.051
—
—
—
—
—
M2. Metric
372.221* (37)
.995
.994
.041
.037-.045
M2-M1
70.726* (10)
.000
+.002
-.006
M3. Scalar
1109.172* (95)
.984
.992
.045
.042-.047
M3-M2
773.760* (58)
-.011
-.002
+.004
M4. Residual
1342.091* (107)
.981
.992
.046
.044-.049
M4-M3
255.158* (12)
-.003
.000
+.001
M5. Latent variance
1147.172* (109)
.984
.993
.042
.040-.044
M5-M4
38.928* (2)
.003
+.001
-.004
M6. Latent means
5127.744* (111)
.922
.968
.092
.090-.094
M6-M5
834.956* (2)
-.062
-.025
+.050
Note. WLSMV = weighted least squares mean- and variance-adjusted estimator; χ2 = Chi-square; df = degrees of freedom; CFI = comparative fit
index; TLI = Tucker-Lewis Index; RMSEA = root-mean-square error of approximation; 90% CI = 90% confidence interval of the RMSEA; ΔCFI
= change in CFI value compared to the preceding model; ΔTLI = change in the TLI value compared to the preceding model; ΔRMSEA = change in
the RMSEA value compared to the preceding model; a = The residual variance of item 6 was freed; Bold letters indicate the final levels of
invariance that were achieved. *p < .01

PPCS-6 21
Table 6
Calculation of Cut-off Thresholds for the Short Version of the Problematic Pornography Consumption Scale
(PPCS-6)
cut-off
score
true
positive
true
negative
false
positive
false
negative
sensitivity
(%)
specificity
(%)
PPV
(%)
NPV
(%)
accuracy
(%)
16
245
566
132
21
92.1%
81.1%
65.0%
96.4%
84.1%
17
239
582
116
27
89.8%
83.4%
67.3%
95.6%
85.2%
18
238
600
98
28
89.5%
86.0%
70.8%
95.5%
86.9%
19
232
614
84
34
87.2%
88.0%
73.4%
94.8%
87.8%
20
224
629
69
42
84.2%
90.1%
76.5%
93.7%
88.5%
21
213
636
62
53
80.1%
91.1%
77.5%
92.3%
88.1%
22
206
642
56
60
77.4%
92.0%
78.6%
91.5%
88.0%
23
195
650
48
71
73.3%
93.1%
80.3%
90.2%
87.7%
Note. The bolded row indicates the suggested cut-off threshold. Possible scores on PPCS-6 range from 6
to 42.

PPCS-6 22
Appendix 1. Short Problematic Pornography Consumption Scale (PPCS-6) Versions
English Version – Short Problematic Pornography Consumption Scale (PPCS-6)
“Pornography is defined as material (text, picture, video, etc.) that (1) creates or elicits sexual feelings or thoughts
and (2) contains explicit exposure or descriptions of sexual acts involving the genitals, such as vaginal or anal
intercourse, oral sex, or masturbation.”
Please think back to the past six months and indicate on the following 7-point scale how often or to what extent the
statements apply to you. There is no right or wrong answer. Please indicate the answer that most applies to you.
1 –
Never
2 –
Rarely
3 –
Occasionally
4 –
Sometimes
5 –
Often
6 –
Very often
7 –
All the time
1
2
3
4
5
6
7
1. I felt that porn is an important part of my life.
O
O
O
O
O
O
O
2. I released my tension by watching porn.
O
O
O
O
O
O
O
3. I neglected other leisure activities as a result of watching porn.
O
O
O
O
O
O
O
4. I felt that I had to watch more and more porn for satisfaction.
O
O
O
O
O
O
O
5. When I vowed not to watch porn anymore, I could only do it for a
short period of time.
O
O
O
O
O
O
O
6. I became stressed when something prevented me from watching
porn.
O
O
O
O
O
O
O
Scoring: Add the scores of the items. 20 points or more indicate possible problematic pornography use.
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
Hungarian Version – Rövid Problémás Pornográfia-használat Skála (PPCS-6)
A pornográfia úgy definiálható, mint egy tartalom (szöveg, kép, videó, stb.), (1) amely szexuális érzéseket vagy
gondolatokat hoz létre vagy erősít meg, (2) és olyan szexuális cselekvések explicit bemutatását vagy leírását
tartalmazza, amelyekben megjelennek a nemi szervek, mint például a vagina, valamint az anális közösülés, az orális
szex vagy a maszturbáció.
Gondolj vissza az elmúlt hat hónapra és az alábbi hétfokozatú skálán jelöld, hogy milyen gyakorisággal vagy milyen
mértékben érvényesek rád az alábbi állítások! Válaszolj az alábbi skála segítségével!
1 –
Soha
2 –
Ritkán
3 –
Inkább ritkán
4 –
Előfordul
5 –
Inkább gyakran
6 –
Gyakran
7 –
Nagyon gyakran
1
2
3
4
5
6
7
1. Úgy éreztem, a pornó az életem fontos része.
O
O
O
O
O
O
O
2. Pornónézéssel vezettem le a feszültségem.
O
O
O
O
O
O
O
3. A pornó miatt elhanyagoltam más szabadidős tevékenységeket.
O
O
O
O
O
O
O
4. Úgy éreztem, egyre több pornót kell néznem, hogy kielégítsen.
O
O
O
O
O
O
O
5. Amikor megfogadtam, hogy nem nézek több pornót, akkor csak rövid
ideig tudtam ezt betartani.
O
O
O
O
O
O
O
6. Ideges lettem, amikor megakadályoztak a pornónézésben.
O
O
O
O
O
O
O
Kiértékelés: A tételek pontszámait össze kell adni. 20 pont vagy annál magasabb pontszám lehetséges problémás
pornográfia-használatot jelez.