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Reducing problematic pornography use with imaginal retraining-A randomized controlled trial.

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Imaginal retraining may help reduce problematic pornography use (PPU) by modifying approach tendencies. While adherence was low, participants reported positive satisfaction, suggesting potential as a low-threshold intervention for compulsive sexual behavior disorder (CSBD).

Keywords:
approach bias modificationcompulsive sexual behavior disorderonline interventionproblematic pornography use

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Area of Science:

  • Psychology
  • Clinical Psychology
  • Behavioral Science

Background:

  • Problematic pornography use (PPU) is often linked to compulsive sexual behavior disorder (CSBD).
  • Individuals with PPU exhibit approach-avoidance tendencies towards pornographic stimuli.
  • This study explores imaginal retraining as a potential intervention for PPU.

Purpose of the Study:

  • To investigate the efficacy of imaginal retraining, a form of approach bias modification, in reducing problematic pornography use.
  • To assess the impact of imaginal retraining on compulsive sexual behavior, sexual desire, and depressiveness.
  • To evaluate participant satisfaction with the imaginal retraining intervention.

Main Methods:

  • 274 participants with self-reported PPU were randomized into an imaginal retraining group or a waitlist control group.
  • The intervention involved a six-week online imaginal retraining program.
  • Primary outcome was reduction in PPU; secondary outcomes included CSBD, sexual desire, depressiveness, and satisfaction.

Main Results:

  • Per-protocol analyses (n=111) indicated a significant reduction in PPU for the intervention group compared to the control.
  • Intention-to-treat analyses did not confirm these findings, possibly due to low adherence (51.7% retention).
  • Participants reported positive satisfaction with the intervention despite low adherence.

Conclusions:

  • Imaginal retraining shows promise as a low-threshold self-help intervention for PPU, potentially aiding individuals with CSBD.
  • Low adherence is a significant limitation, necessitating further research to improve engagement.
  • Future studies should focus on enhancing adherence and testing imaginal retraining in clinical populations.