Problematic pornography use and psychological distress: A longitudinal study in a large US sample

Problematic pornography use (PPU) has been positively associated with psychological distress (i.e., anxiety and depression) in numerous cross-sectional studies. In the present study, we examined the trajectory of PPU and its association with psychological distress over time. We conducted a one-year, three-wave longitudinal study among US adults (n = 4363, 46.4 % women, M_(Age) = 50, SD_(Age) = 16.15) and examined changes in PPU and psychological distress. Specifically, we assessed bivariate correlations and a random-intercept autoregressive cross-lagged panel model. PPU was assessed by the Brief Pornography Screen (BPS), and psychological distress was assessed by the Generalized Anxiety Disorder-2 (GAD-2) and the Patient Health Questionnaire-9 (PHQ-9). Between each six-month period, we found that BPS bivariate intercorrelations were strong (ρ = 0.712, 0.726) and BPS autoregressive paths remained moderate (β = 0.370, 0.408). Surprisingly, the positive associations between BPS and psychological distress scores from descriptive correlations were determined by a strong random-intercept correlation (r = 0.962), while cross-lagged paths remained small and negative (β=-0.189, -0.211, -0.214, -0.230, respectively). This suggested a robust trait-like between-person association between PPU and psychological distress, with negligibly small time-dependent within-person inhibitory effects occurring. PPU appears time-consistent (e.g., most participants remained in their initial clinical category) and robustly associated with psychological distress over time. We speculate that inhibitory within-person effects may possibly reflect short-term coping behavior and depressive drive inhibition, while in the long term, further manifesting PPU.