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Porndemic? A Longitudinal Study of Pornography Use Before and During the COVID-19 Pandemic in a Nationally Representative Sample of Americans

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Archives of Sexual Behavior
Authors:
Joshua B. Grubbs at Bowling Green State University
Joshua B. Grubbs
Samuel Perry at University of Oklahoma
Samuel Perry
Jennifer Grant Weinandy at Ohio University
Jennifer Grant Weinandy
Shane W Kraus at University of Nevada, Las Vegas
Shane W Kraus
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Abstract and Figures

Of the many changes in daily life brought about by the COVID-19 pandemic, social distancing efforts and governmentally mandated lockdowns were among the most drastic. Coinciding with these changes, popular pornography websites made some previously premium content available for free, spurring dramatic increases in traffic to these websites. This increase in time spent at home and reported increases in traffic to specific pornographic websites led to some speculation that pornography use might generally increase over the course of the pandemic and that problematic use might also increase. To test these speculations and quantify the effects of the pandemic and its associated restrictions on social behaviors on pornography use, we analyzed data from a longitudinal sample of American adults. Baseline, nationally representative data were collected in August 2019 via YouGov (N = 2518). Subsequent data were collected in February 2020 (n = 1677), May 2020 (n = 1533), August 2020 (n = 1470), and October 2020 (n = 1269). Results indicated that, in May 2020, immediately following the height of the first wave of pandemic-related lockdowns, more people reported past-month pornography use than at other follow-up time points, but less did so than at baseline. Among those who reported use in May 2020, only 14% reported increases in use since the start of the pandemic, and their use returned to levels similar to all other users by August 2020. In general, pornography use trended downward over the pandemic, for both men and women. Problematic pornography use trended downward for men and remained low and unchanged in women. Collectively, these results suggest that many fears about pornography use during pandemic-related lockdowns were largely not supported by available data.
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Vol.:(0123456789)
1 3
Archives of Sexual Behavior (2022) 51:123–137
https://doi.org/10.1007/s10508-021-02077-7
SPECIAL SECTION: IMPACT OFCOVID-19 ONSEXUAL HEALTH ANDBEHAVIOR
Porndemic? ALongitudinal Study ofPornography Use Before
andDuring theCOVID‑19 Pandemic inaNationally Representative
Sample ofAmericans
JoshuaB.Grubbs1 · SamuelL.Perry2· JenniferT.GrantWeinandy1· ShaneW.Kraus3
Received: 17 December 2020 / Revised: 1 June 2021 / Accepted: 9 June 2021 / Published online: 19 July 2021
© The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2021
Abstract
Of the many changes in daily life brought about by the COVID-19 pandemic, social distancing efforts and governmentally
mandated lockdowns were among the most drastic. Coinciding with these changes, popular pornography websites made some
previously premium content available for free, spurring dramatic increases in traffic to these websites. This increase in time
spent at home and reported increases in traffic to specific pornographic websites led to some speculation that pornography
use might generally increase over the course of the pandemic and that problematic use might also increase. To test these
speculations and quantify the effects of the pandemic and its associated restrictions on social behaviors on pornography use,
we analyzed data from a longitudinal sample of American adults. Baseline, nationally representative data were collected in
August 2019 via YouGov (N = 2518). Subsequent data were collected in February 2020 (n = 1677), May 2020 (n = 1533),
August 2020 (n = 1470), and October 2020 (n = 1269). Results indicated that, in May 2020, immediately following the height
of the first wave of pandemic-related lockdowns, more people reported past-month pornography use than at other follow-up
time points, but less did so than at baseline. Among those who reported use in May 2020, only 14% reported increases in use
since the start of the pandemic, and their use returned to levels similar to all other users by August 2020. In general, pornog-
raphy use trended downward over the pandemic, for both men and women. Problematic pornography use trended downward
for men and remained low and unchanged in women. Collectively, these results suggest that many fears about pornography
use during pandemic-related lockdowns were largely not supported by available data.
Keywords Problematic pornography use· Sexual media· Addiction· Compulsive sexual behavior disorder· COVID-19
Introduction
In 2020, the spread of the novel SARS-CoV-2 virus and the
resulting COVID-19 pandemic disrupted life across the globe.
Coinciding with efforts to “flatten the curve” (i.e., a refer-
ence to slowing the spread of the novel coronavirus so as to
avoid overwhelming limited healthcare resources; Matrajt &
Leung, 2020), one of the world’s largest pornographic websites,
Pornhub.com, announced plans to make their premium content
free to individuals living in parts of the world where lockdowns
were in place (Wilson, 2020). As a result of this free access,
Pornhub reported increases (38–61%) in web-traffic to their
website from regions affected by severely restrictive stay-at-
home orders and lockdowns (Pornhub Insights, 2020). These
increases were above and beyond Pornhub’s already incred-
ible average in 2019 of over 115,000,000 unique visits per day
(Grubbs & Kraus, 2021; The 2019 Year in Review—Pornhub
Insights, 2019). Similarly, internet search data from Google
suggested that there was an increased interest in pornography
during the most restrictive phases of many countries’ lock-
downs (Zattoni etal., 2020).
The above described increases in internet pornography use
garnered international media attention (Turak, 2020), as well
as attention from scholars studying the use and effects of por-
nography (Grubbs, 2020). Additionally, there were calls from
mental health researchers and professionals warning of the
* Joshua B. Grubbs
GrubbsJ@BGSU.edu
1 Department ofPsychology, Bowling Green State University,
400 E. Merry Street, BowlingGreen, OH43403, USA
2 Department ofSociology, University ofOklahoma, Norman,
USA
3 Department ofPsychology, University ofNevada, Las Vegas,
LasVegas, USA
Content courtesy of Springer Nature, terms of use apply. Rights reserved.
... Regarding pornography exposure, Hossain et al. (2022a) indicated that more than 75% of the students in Bangladesh watched pornographic content during COVID-19. A similar situation is reported in other parts of the world, mainly in the USA (Bőthe et al., 2022;Camilleri et al., 2020;Grubbs et al., 2022;Yarger et al., 2021), and different parts of Europe (Hernandez-Mora & Varescon, 2022) and Asia Jiang et al., 2022). To the best of the authors' knowledge, there is not a single empirical study that explores the problematic pornography use (PPU) among students in Bangladesh during the COVID-19 pandemic. ...
... Several studies noted a rise in pornography exposure during the COVID-19 pandemic. For example, Grubbs et al. (2022) found a higher frequency of pornography viewing during the initial wave of the COVID-19 pandemic compared to the following four waves. ...
... In addition, the current study findings suggest that students exposed to pornography three times or more per week were likely to be engaged in PPU. A similar result is observed by Grubbs et al. (2022), who found a higher frequency of pornography viewing during the first wave of COVID-19 compared to subsequent waves. In addition to that, Sallie et al. (2021) noted a significant increase in weekly pornography consumption during the quarantine period of COVID-19. ...
"Seen, Yet Unseen": Predictors of Problematic Pornography Use Among Students During the COVID-19 Pandemic in Bangladesh
Article
  • Sep 2024
In Bangladesh, studies explored mental health status and associated addictive behavior of students during the pandemic, but none has examined problematic pornography use (PPU) and its associated risk factors. This study attempted to explore the pre-dictors of PPU among students. Data were collected conveniently from 490 students during mid-2022. Findings indicate that students engaged in a relationship or married (B = −5.09, p < 0.001) experienced less PPU, while bisexual or homosexual students (B = 6.91, p = 0.009) had higher PPU during the COVID-19 pandemic. It is also apparent that higher exposure to pornography ((≥ 3 times) (B = 4.00, p = 0.007), especially during the COVID-19 (B = 7.13, p < 0.001), and intention to masturbate (B = 5.48, p = 0.003) were positively and significantly associated with PPU. Surprisingly, it is evident that despite a negative attitude toward pornography, students experienced an increase in PPU (B = 0.39, p < 0.001). Hence, educators and policymakers should devise effective monitoring mechanisms to prevent young people from accessing it, while providing alternative forms of entertainment, developing healthy coping strategies, and engaging in non-addictive physical activities as deterrent measures for refraining oneself from the use of pornography.
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... Research evaluating engagement in online sexual activities is more limited. Grubbs et al. (2022) found that pornography use trended downwards over the course of the pandemic, whereas Ballester-Arnal et al. (2020) found that average time spent engaging in online sexual activities increased as compared to before the pandemic. However, neither study considered whether online sexual activities differed based on relationship status. ...
... This finding is consistent with research that examined trends in pornography use across the pandemic. Grubbs et al. (2022) also reported that in May of 2020 (around the time of the "first wave" of the pandemic and Time 1 of the current study), more people in their sample reported using pornography in the past month compared to August and October of 2020 (i.e., later timepoints). Similar to results observed in the current study, pornography usage trended downward in the months that followed (Grubbs et al., 2022). ...
... Grubbs et al. (2022) also reported that in May of 2020 (around the time of the "first wave" of the pandemic and Time 1 of the current study), more people in their sample reported using pornography in the past month compared to August and October of 2020 (i.e., later timepoints). Similar to results observed in the current study, pornography usage trended downward in the months that followed (Grubbs et al., 2022). ...
A Prospective, Longitudinal Comparison of Sexual Distress Across Relationship Status During the COVID-19 Pandemic
Article
Full-text available
Numerous studies have described declines in sexual well-being during the COVID-19 pandemic, although experiences of sexual distress during this time appear to be mixed. Previous research has relied on cross-sectional methodology and focused on individuals in relationships. Furthermore, little is known about the frequency of “COVID-safe” sexual behaviors, such as online sexual activities. These gaps in the literature were addressed using a prospective, longitudinal online study examining sexual distress, predictors of sexual distress (i.e., perceived stress), and online sexual activities over time in single and partnered individuals. Participants were single (N = 64) and partnered (N = 60) individuals who completed surveys at three timepoints over a 6-month period during the COVID-19 pandemic. Mean age across the two groups was 29 years, and approximately half were women (51.6% and 50%, respectively). Results indicated that single individuals reported significantly higher sexual distress than partnered individuals at Times 1 and 2, but not at Time 3. Sexual distress significantly decreased over time for individuals in the single group but remained stable for partnered individuals. At each timepoint, there was a conditional effect of perceived stress on sexual distress depending on one’s relationship status, and the nature of these conditional effects changed throughout the course of the study. Results suggested that single individuals demonstrated improvements in sexual distress over time. Perceived stress is an important predictor of sexual distress but may operate differently depending on relationship status. Results highlight the resiliency of both single and partnered individuals during the COVID-19 pandemic.
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... 15,16 Several studies demonstrated an increased prevalence of pornography use during the COVID-19 pandemic. [17][18][19] Numerous research has been undertaken to examine the effects of the COVID-19 epidemic on the mental health of students in Bangladesh. A notable incidence of IA, PA, depression, anxiety, stress, and PTSD was observed among students during the duration of the COVID-19 pandemic. ...
Post‐COVID‐19 internet addiction, depression, and pornography addiction among adolescents: Findings from a nationwide study in Bangladesh
Article
Full-text available
  • Jul 2024
Background and Aims Regulations response to COVID‐19 has increased internet addiction (IA), depression, and pornography addiction (PA) among adolescents worldwide. The objective of this nationwide study was to assess the current prevalence rate of IA, depression, and PA after the post‐COVID‐19 period among school‐going adolescents in Bangladesh. Methods A total of 8832 male and female adolescents participated in this research. The cross‐sectional study was conducted online using a simple random sampling method. Including the sociodemographic variables, Young's IA Test (IAT‐20) Scale, Patient Health Questionnaire (PHQ‐9), and Pornography Craving Questionnaire (PCQ‐12) were used to measure IA, depression, and PA. By SPSS version 25.0, the prevalence and correlation between IA, depression, and PA were analyzed using the Chi‐square test, binary logistic regression, and a bivariate co‐relation matrix. Results Sixty‐three percent, 76.6%, and 62.9% of the students were suffering from IA, depression, and PA respectively. Depressive and anxious symptoms were significantly associated with IA. Female students were more depressed than males. Males were more addicted to pornography than females. Students who utilized social media but didn't exercise had greater depression and PA. IA, depression, and PA were correlated. Conclusion The research emphasizes the need for comprehensive mental health treatments, digital literacy programs, and family and teacher participation to reduce IA, depression, and PA among adolescents post‐COVID‐19. Promotion of physical exercise and supporting policies to build safer online settings for adolescents are also encouraged.
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... A cutoff score of 4 was used to identify participants with problematic pornography usage. A greater level of problematic pornography consumption is demonstrated by higher scores [41]. The Cronbach's alpha coe cient for the BPS was 0.84. ...
Childhood sexual abuse, internet addiction, problematic pornography use, and depression among medical students in Bangladesh
Preprint
Full-text available
  • Jun 2024
Background Due to several factors (eg. sexual abuse, academic pressure), medical students go through significant mental health issues such as internet addiction (IA), problematic use of pornography (PPU), and depression. This study aimed to assess the prevalence of childhood sexual abuse (CSA) history, IA, PPU, and depression among medical students and associated factors. Methodology: Childhood sexual abuse history, Young’s Internet Addiction Test (IAT-20), Brief Pornography Screener (BPS), Patient Health Questionnaire (PHQ-9), and other sociodemographic information were collected through an online Google form across Bangladesh in this cross-sectional study. Descriptive analysis, Pearson chi-square test, and ordinal logistic regression were employed to assess the prevalence, significant factors, and gender-based assessment. Later, to assess the correlation between the dependent variables, a bivariate co-relation matrix was employed. Results A total of 3264 students participated with a mean age of 21.5 years old. we found that 28.3% of students had a history of CSA, among them 7.35% were male, and 20.96% were female. 70.2% of students had PPU, 62.1% of them were addicted to the internet and 50.4% of them were depressed. Gender, medical college type, marital status, CSA, IA, and PPU had a significant effect on increasing depression among the participants and positively related with each other. Conclusion The study found many medical students with IA, PPU, and depression. Students must discuss their CSA-related experiences. To protect children from CSA, lawmakers should pass legislation. Eliminating IA and PPU requires psychological therapy for students. Marriage may reduce depression, encouraging stakeholders to explore its effects. Finally, public awareness is essential.
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... Research regarding attachment insecurity's role in CSBD would also benefit from distinguishing between different kinds of online and offline sexual activities as they may be driven by specific mechanisms (Efrati & Amichai-Hamburger, 2021). Another issue to consider is the context of the Covid-19 pandemic that might have affected the results of the present study, as the impact of this context on CSBD/PPU symptoms is inconsistent Grubbs et al., 2022;Koós et al., 2022;Xiong et al., 2020;Zattoni et al., 2020). Therefore, future studies should aim to replicate our results when the epidemic situation is different. ...
The Associations Between Attachment Insecurity and Compulsive Sexual Behavior Disorder or Problematic Pornography Use: The Mediating Role of Emotion Regulation Difficulties
Article
Full-text available
Compulsive sexual behavior disorder (CSBD) was previously considered an attachment disorder, while emotion dysregulation was thought to potentially be a key characteristic of it. However, this theoretical model was not tested in previous empirical research. In our cross-sectional study, we tested whether emotional regulation (ER) difficulties can be adopted as an explanatory mechanism for the relationships between attachment avoidance and anxiety, as well as CSBD and its most prevalent behavioral presentation—problematic pornography use (PPU). Participants (n = 1002; Mage = 50.49 years, SD = 13.32; men: 50.2%) completed an online survey regarding the investigated variables. In mediation analyses, attachment avoidance and anxiety were treated as simultaneous predictors, ER difficulties as a mediating variable, with CSBD/PPU severity as dependent variables. Emotion regulation difficulties and attachment anxiety had a direct positive effect on both CSBD and PPU. The direct effect of attachment avoidance on PPU was non-significant, and significant for CSBD depending on the measure used. Moreover, all the relationships between both insecure attachment dimensions and CSBD/PPU symptom severity were at least partially mediated by ER difficulties. Our results corroborate the theoretical claim that ER difficulties may be a useful framework for explaining the impact of attachment insecurity on CSBD/PPU. Theoretical and practical implications of the findings are discussed.
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... Therefore, these factors may contribute to the observed decrease in perceived control over sexual activities during the lockdown. Despite this evidence, some studies did not find significant changes in pornography use (including problematic use) and only observed an increase in pornography consumption among a small number of participants (Bőthe et al., 2022;Grubbs et al., 2021). These data suggest that the increase in time and frequency is probably not so closely linked to pornography, but also to OSAs that require the interaction of other people, such as sexting or the use of sexual chats. ...
Changes in Online Sexual Activities During the Lockdown Caused by COVID-19 in Spain: “INSIDE” Project
Article
Full-text available
  • Jun 2024
  • Sex Res Soc Pol
Introduction The lockdown, as a measure to stop the spread of COVID-19, has had an impact on different areas of our life, including sexuality. This study aims to analyze its impact on online sexual activities (OSAs) in people who lived in Spain during confinement. Methods This study involved 1448 people aged 18–60 years who were assessed through an online survey during confinement in Spain (April, 2020). The design of this study was a cross-sectional design, in which information on OSA before confinement and OSA, physical and social environment, and other variables related to gender and negative mood during confinement were collected at a single point in time. Results Our results show that both men and women, regardless of their sexual orientation, have experienced an increase in time and frequency invested in OSAs. In addition, individuals have also innovated their OSAs, for example, contacting sex workers. Factors such as high sexual desire, being a man, and consuming pornography were positively related to the frequency of ASOs during confinement, while high sexual desire and sexting were related to the time spent on ASOs during confinement. Conclusions The COVID-19 lockdown has had an impact on online sexuality. Both men and women have experienced an increase in their online sexual activity during confinement. In addition, some factors related to the increase in the time and frequency of OSAs are identified. Policy Implications Identifying how these changes have been during this very restrictive period and what factors related to the increase in OSAs can help us prevent possible consequences in similar scenarios.
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... However, if the usage becomes excessive and persistent, it may lead to distress or impairment. Prevalence estimates for problematic pornography use (PPU) range between 1% and 3% in women and 4% and 11% in men (Grubbs, Perry, Grant Weinandy, & Kraus, 2022;Grubbs, Kraus, & Perry, 2019;Rissel et al., 2017). PPU is not a formal diagnosis in the International Statistical Classification of Diseases and Related Health Problems (ICD) or the Diagnostic and Statistical Manual of Mental Disorders (DSM). ...
Reducing problematic pornography use with imaginal retraining-A randomized controlled trial
Article
Full-text available
  • Apr 2024
Background and aim Problematic pornography use (PPU) can be a manifestation of compulsive sexual behavior disorder (CSBD). Studies investigating PPU confirm approach-avoidance tendencies in response to pornographic stimuli in this population. This study show indications of the significance of the efficacy of imaginal retraining, a variant of approach bias modification, as an intervention for PPU. Methods A total of 274 participants (86.5% male; mean age = 30.65, SD = 10.13) with self-reported PPU were randomized to imaginal retraining (instruction video) or a waitlist control group. Assessments were conducted online at baseline and after the six-week intervention period. The primary outcome was a reduction in problematic pornography use. Compulsive sexual behavior, sexual desire, depressiveness, and satisfaction with the intervention served as secondary outcomes. Results Retention was low (51.7%), but comparable between groups. The retraining was performed at least once a week (the per-protocol [PP] criterion) by 51.4% of participants. The PP analyses of 111 participants showed a significant reduction in problematic pornography use (primary outcome) in the intervention compared to the control group. The intention-to-treat analyses (ITT), however, did not corroborate this result. Despite low adherence, participants rated their satisfaction with the intervention positively. Discussion and Conclusion Imaginal retraining can function as a low-threshold self-help intervention for PPU to overcome help-seeking barriers and may reduce PPU in a subgroup of users. Low adherence limits the results of this trial. Given the need for low-threshold interventions for PPU and/or CSBD, further research should focus on increasing adherence and should evaluate retraining for clinical groups. Modifications to augment efficacy are suggested.
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... Besides, during the Covid-19 pandemic, an 11% surge in Pornhub's viewership within just one month from February 2020 to March 2020 was recorded in America. These trends highlight the intricate relationships between individual behaviors and external factors in shaping pornography consumption practices over time (Grubbs et al., 2022). Furthermore, an exceptionally high prevalence rate of up to 98% have been reported in countries like Croatia (Štulhofer et al., 2019) and Poland (Dwulit & Rzymski, 2019). ...
Apprehending Parental Perceptions and Responses to Accidental Online Pornography Exposure Among Children in Pakistan: A Qualitative Investigation
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Full-text available
  • Apr 2024
This qualitative study examines parental perceptions of children’s Internet usage and accidental exposure to online pornography in Pakistan. Through telephonic interviews with 26 participants, the research primarily questions parental awareness of online risks and their reactions to such incidents. Results show concerns about the accessibility and impacts of online pornography, with mixed responses from parents. While children mainly use the internet for entertainment, some parents recognize its educational value. Parents express awareness of probable accidental exposure to online pornography and its physical and psychological impacts on children. Responses to accidental exposure range from silence to educating children about the inappropriateness of pornographic content. However, awareness of gender differences in reactions remains limited among parents. Finally, the researchers provide recommendations for parents, government, policymakers, and law enforcement agencies to ensure security measures, including content filtration and monitoring children’s internet usage in Pakistan.
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... As dependence on social media for gratification grows, individuals may experience adverse outcomes such as reduced productivity, disrupted sleep, and impaired cognition (Samari et al., 2022;Santos et al., 2024;Throuvala et al., 2021). Furthermore, the progression from social media addiction to pornography addiction can stem from various factors, including the accessibility of explicit content, the normalization of sexual material online, and the reinforcement of addictive behaviors (Fineberg et al., 2022;Grubbs et al., 2022;Simak et al., 2023). Pornography addiction, characterized by compulsive consumption of sexual content, can adversely affect mental health, relationships, and overall well-being (Camilleri et al., 2021;Mauer-Vakil & Bahji, 2020;Vaillancourt-Morel et al., 2017;Wizła & Lewczuk, 2024). ...
Mapping the Landscape of Internet Pornography, Loneliness, and Social Media Addiction: A CiteSpace Bibliometric Analysis
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Full-text available
  • Apr 2024
  • Int J Ment Health Addiction
A comprehensive bibliometric analysis using CiteSpace explores global scientific research trends concerning internet pornography, loneliness, and social media addiction from 1993 to 2023. The study reveals disciplinary distributions, evolving patterns, influential scholars, and contributing institutions. Notably, the United States accounts for over 29% of publications, with Griffiths MD and Beutel ME emerging as leading contributors with 22.7% and 18.2% respectively. A remarkable 2750% surge in scholarly publications from 2020 to 2023 underscores increasing interest in the subject. Keyword analysis identifies emerging trends and focal points, with terms such as “acquired immunodeficiency syndrome,” “pornography use,” and “addiction” showing significant citation activity. Leading institutions include New York University and University College London. Key metrics like sigma value (0.98), centrality (1.00), and citation burstness (32) provide valuable insights into the importance and influence of identified clusters within the academic landscape. This analysis sheds light on scholarly discussions, aiding in the comprehension of internet pornography, loneliness, and social media addiction.
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Quantifying the Affective Dynamics of Pornography Use and Masturbation: An Ecological Momentary Assessment Study
Preprint
Full-text available
  • Sep 2024
The causal relationships between pornography use, masturbation, moral incongruence, and mental health are poorly understood. While the link between problematic pornography use (PPU) and depression is well documented, the affective dynamics (i.e., emotional shifts over time) associated with pornography use and masturbation have not yet been quantified. Utilizing an Ecological Momentary Assessment (EMA) design, we measured the affective dynamics of mental health variables collected from 22 participants before, during and after pornography use and masturbation, and examined the moderating role of moral incongruence in these relationships. Participants completed an initial survey followed by a four-week EMA, capturing data on sexual activities and mental health variables. Bayesian hierarchical mixed-effects models were employed to analyse affective dynamics. Findings suggest that pornography use and masturbation were linked to changes in affective states that spiked both before and after sexual episodes. The magnitude of these state changes was greater in participants with high moral incongruence, who experienced increases in guilt, shame, loneliness, and difficulty thinking, along with decreased hedonic mood and perception of relationship connectedness, either before or after sexual episodes. Our findings signalled the potential for intermittent spiking effects in craving prior to sexual episodes, as well as potential evidence for ‘brain fog’ following pornography use in both low and high moral incongruence participants. Further, we discovered opponent process dynamics in the mood of high moral incongruence participants, providing a possible causal mechanism that may explain how PPU can lead to depression.
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Psychological distress and adaptation to the COVID-19 crisis in the United States
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There is growing concern that the COVID-19 crisis may have long-standing mental health effects across society particularly amongst those with pre-existing mental health conditions. In this observational population-based study, we examined how psychological distress changed following the emergence of the COVID-19 crisis in the United States and tested whether certain population subgroups were vulnerable to persistent distress during the crisis. We analyzed longitudinal nationally representative data from eight waves of the Understanding America Study (UAS) collected between March 10th and July 20th, 2020 (N = 7319 Observations = 46,145). Differences in distress trends were examined by age, sex, race/ethnicity, and household income and by the presence of a pre-existing mental health diagnosis. Psychological distress was assessed using the standardized total score on the Patient Health Questionnaire-4 (PHQ-4). On average psychological distress increased significantly by 0.27 standard deviations (95% CI [0.23,0.31], p < .001) from March 10-18 to April 1-14, 2020 as the COVID-19 crisis emerged and lockdown restrictions began in the US. Distress levels subsequently declined to mid-March levels by June 2020 (d = -0.31, 95% CI [-0.34, -0.27], p < .001). Across the sociodemographic groups examined and those with pre-existing mental health conditions we observed a sharp rise in distress followed by a recovery to baseline distress levels. This study identified substantial increases in distress in the US during the emergence of the COVID-19 crisis that largely diminished in the weeks that followed and suggests that population level resilience in mental health may be occurring in response to the pandemic.
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The impact of COVID-19 pandemic on pornography habits: a global analysis of Google Trends
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Full-text available
  • Sep 2020
Importance: The coronavirus disease 2019 (COVID-19) pandemic and the policies to contain it have been a near ubiquitous exposure in the US with unknown effects on depression symptoms. Objective: To estimate the prevalence of and risk factors associated with depression symptoms among US adults during vs before the COVID-19 pandemic. Design, setting, and participants: This nationally representative survey study used 2 population-based surveys of US adults aged 18 or older. During COVID-19, estimates were derived from the COVID-19 and Life Stressors Impact on Mental Health and Well-being study, conducted from March 31, 2020, to April 13, 2020. Before COVID-19 estimates were derived from the National Health and Nutrition Examination Survey, conducted from 2017 to 2018. Data were analyzed from April 15 to 20, 2020. Exposures: The COVID-19 pandemic and outcomes associated with the measures to mitigate it. Main outcomes and measures: Depression symptoms, defined using the Patient Health Questionnaire-9 cutoff of 10 or higher. Categories of depression symptoms were defined as none (score, 0-4), mild (score, 5-9), moderate (score, 10-14), moderately severe (score, 15-19), and severe (score, ≥20). Results: A total of 1470 participants completed the COVID-19 and Life Stressors Impact on Mental Health and Well-being survey (completion rate, 64.3%), and after removing those with missing data, the final during-COVID-19 sample included 1441 participants (619 participants [43.0%] aged 18-39 years; 723 [50.2%] men; 933 [64.7%] non-Hispanic White). The pre-COVID-19 sample included 5065 participants (1704 participants [37.8%] aged 18-39 years; 2588 [51.4%] women; 1790 [62.9%] non-Hispanic White). Depression symptom prevalence was higher in every category during COVID-19 compared with before (mild: 24.6% [95% CI, 21.8%-27.7%] vs 16.2% [95% CI, 15.1%-17.4%]; moderate: 14.8% [95% CI, 12.6%-17.4%] vs 5.7% [95% CI, 4.8%-6.9%]; moderately severe: 7.9% [95% CI, 6.3%-9.8%] vs 2.1% [95% CI, 1.6%-2.8%]; severe: 5.1% [95% CI, 3.8%-6.9%] vs 0.7% [95% CI, 0.5%-0.9%]). Higher risk of depression symptoms during COVID-19 was associated with having lower income (odds ratio, 2.37 [95% CI, 1.26-4.43]), having less than $5000 in savings (odds ratio, 1.52 [95% CI, 1.02-2.26]), and exposure to more stressors (odds ratio, 3.05 [95% CI, 1.95-4.77]). Conclusions and relevance: These findings suggest that prevalence of depression symptoms in the US was more than 3-fold higher during COVID-19 compared with before the COVID-19 pandemic. Individuals with lower social resources, lower economic resources, and greater exposure to stressors (eg, job loss) reported a greater burden of depression symptoms. Post-COVID-19 plans should account for the probable increase in mental illness to come, particularly among at-risk populations.
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Why Do People Watch Pornography? The Motivational Basis of Pornography Use
Article
Full-text available
  • Jul 2020
Although pornography viewing is widespread among Internet users, no scales for measuring pornography use motivations (PUM) have been developed and psychometrically tested for use in general populations. The present work aimed to construct a measure that could reliably assess a wide range of PUM in nonspecific populations. Self-report data of 3 separate samples (N1 = 772 [51% women], N2 = 792 [6% women], N3 = 1,082 [50% women]) were collected and analyzed using confirmatory factor analysis, measurement invariance testing, and structural equation modeling (SEM). The most common PUM were identified based on a literature review and qualitative analysis (N1): sexual pleasure, sexual curiosity, emotional distraction or suppression, stress reduction, fantasy, boredom avoidance, lack of sexual satisfaction, and self-exploration. Items were constructed, and confirmatory factor analyses (N2 and N3) yielded strong psychometric properties. Further corroborating the structural validity of the Pornography Use Motivations Scale (PUMS), gender-based measurement invariance was tested, and associations of the frequency of pornography use (FPU), problematic pornography use (PPU), and PUM were examined. Men—compared to women—demonstrated higher scores on all motivations except for sexual curiosity and self-exploration. Based on the results of SEM, we found that sexual pleasure, boredom avoidance, and stress reduction motivations showed positive, weak-to-moderate associations with FPU. Motivations relating to stress reduction, emotional distraction or suppression, boredom avoidance, fantasy, and sexual pleasure had positive, weak-to-moderate associations with PPU. The PUMS is a reliable scale to assess the most common PUM in general populations.
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Tracking Mental Health and Symptom Mentions on Twitter During COVID-19
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Full-text available
  • Jul 2020
The magnitude of novel coronavirus (COVID-19) pandemic has led to considerable economic hardships, stress, anxiety, and concerns about the future. Social media can provide a place for measuring a pulse of mental health in communities. Evaluating the changing use of language on social media can complement traditional survey-based approaches and provide new insights into the well-being of a country or region during a public health crisis. Social media could also enable early symptom discovery for diseases where the pathology is not completely known and is evolving.1 We, therefore, created a dashboard (https://bit.ly/penncovidmap) to monitor and analyze changes in language expressed on Twitter over the course of the COVID-19 pandemic within the USA with a specific focus on mental health and symptom mentions.
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Pornography Use and Psychological Science: A Call for Consideration
Article
  • Jan 2021
Pornography use is both ubiquitous and controversial in developed nations. Although research related to pornography use has flourished in topical and special-interest journals for several decades, much of this work has remained in the periphery of mainstream interests. The current article reviews how pornography use is likely relevant to various domains within psychological science, particularly emphasizing its significance in relationship research, adolescent-development research, and clinical science. Specifically, pornography use is likely salient to research examining both sexual and romantic satisfaction. Additionally, it is also likely relevant to understanding adolescent sexual development, particularly among sexual-minority populations. Finally, a large body of research suggests that pornography use may become problematic, either because of excessive use or moral incongruence about such use, illustrating its salience in clinical psychological science. Collectively, the current research related to pornography use suggests that it is of interest to multiple domains in psychological science and that its effects can range from positive to neutral to negative.
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Sexual Desire and Subjective Distress among Pornography Consumers
Article
Clients are increasingly seeking professional help related to pornography viewing in the digital age. Given distress is a key reason clients seek help, the purpose of this study was to identify variables associated with it. Drawing from recent literature, we examined the roles of solitary sexual desire, moral incongruence, feelings of dysregulation, and shame-proneness in predicting subjective distress among consumers. Surveys were administered through Amazon Mechanical Turk to US adults (n = 559). Structural equation models supported moderated mediation, where the positive relationship between sexual desire and subjective distress was fully mediated by feelings of dysregulation, and the relationship between sexual desire and feelings of dysregulation was moderated by moral incongruence. Moral incongruence was the largest direct predictor of subjective distress, while shame-proneness was not significantly associated with it. This study points to targets for intervention research, reinforces findings that values play an integral role in how individuals interpret their viewing and whether they feel distressed, and suggests that values may impact how individuals interpret their sexual desire. Implications for practitioners are discussed, including the need for person-in-environment assessment and more holistic care than has traditionally been proposed in the sex addiction field.
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Mental health before and during the COVID-19 pandemic: a longitudinal probability sample survey of the UK population
Article
  • Jul 2020
Background The potential impact of the COVID-19 pandemic on population mental health is of increasing global concern. We examine changes in adult mental health in the UK population before and during the lockdown. Methods In this secondary analysis of a national, longitudinal cohort study, households that took part in Waves 8 or 9 of the UK Household Longitudinal Study (UKHLS) panel, including all members aged 16 or older in April, 2020, were invited to complete the COVID-19 web survey on April 23–30, 2020. Participants who were unable to make an informed decision as a result of incapacity, or who had unknown postal addresses or addresses abroad were excluded. Mental health was assessed using the 12-item General Health Questionnaire (GHQ-12). Repeated cross-sectional analyses were done to examine temporal trends. Fixed-effects regression models were fitted to identify within-person change compared with preceding trends. Findings Waves 6–9 of the UKHLS had 53 351 participants. Eligible participants for the COVID-19 web survey were from households that took part in Waves 8 or 9, and 17 452 (41·2%) of 42 330 eligible people participated in the web survey. Population prevalence of clinically significant levels of mental distress rose from 18·9% (95% CI 17·8–20·0) in 2018–19 to 27·3% (26·3–28·2) in April, 2020, one month into UK lockdown. Mean GHQ-12 score also increased over this time, from 11·5 (95% CI 11·3–11·6) in 2018–19, to 12·6 (12·5–12·8) in April, 2020. This was 0·48 (95% CI 0·07–0·90) points higher than expected when accounting for previous upward trends between 2014 and 2018. Comparing GHQ-12 scores within individuals, adjusting for time trends and significant predictors of change, increases were greatest in 18–24-year-olds (2·69 points, 95% CI 1·89–3·48), 25–34-year-olds (1·57, 0·96–2·18), women (0·92, 0·50–1·35), and people living with young children (1·45, 0·79–2·12). People employed before the pandemic also averaged a notable increase in GHQ-12 score (0·63, 95% CI 0·20–1·06). Interpretation By late April, 2020, mental health in the UK had deteriorated compared with pre-COVID-19 trends. Policies emphasising the needs of women, young people, and those with preschool aged children are likely to play an important part in preventing future mental illness. Funding None.
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Evaluating the Effectiveness of Social Distancing Interventions to Delay or Flatten the Epidemic Curve of Coronavirus Disease
Article
  • Apr 2020
By April 2, 2020, >1 million persons worldwide were infected with severe acute respiratory syndrome coronavirus 2. We used a mathematical model to investigate the effectiveness of social distancing interventions in a mid-sized city. Interventions reduced contacts of adults >60 years of age, adults 20–59 years of age, and children <19 years of age for 6 weeks. Our results suggest interventions started earlier in the epidemic delay the epidemic curve and interventions started later flatten the epidemic curve. We noted that, while social distancing interventions were in place, most new cases, hospitalizations, and deaths were averted, even with modest reductions in contact among adults. However, when interventions ended, the epidemic rebounded. Our models suggest that social distancing can provide crucial time to increase healthcare capacity but must occur in conjunction with testing and contact tracing of all suspected cases to mitigate virus transmission.
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