Symptom-based and self-identified pornography involvement: concordance, discordance, and multidomain correlates

Problematic pornography use (PPU) is increasingly studied, but different self-report operationalizations may not identify the same individuals. In this study, a structured symptom-checklist-based classification of pornography-watching disorder (PWD) was compared with direct self-identified pornography addiction (SIPA). The present study examined the overlap and divergence between these two classifications and compared their behavioral, sociodemographic, psychosexual, and psychosocial correlates.

Data were drawn from a large Hungarian web-based community survey. A total of 8,705 adults provided information on pornography use frequency (PUF) and SIPA, while multivariable analyses were conducted on a complete-case sample of 8,088 participants. Both classifications were based on self-report. PWD was operationalized using ten DSM-5-inspired symptom indicators, with four or more symptoms indicating PWD, whereas SIPA was measured using a single dichotomous self-identification item. Binary logistic regression models were used to identify factors associated with symptom-defined PWD and SIPA, followed by multinomial logistic regression examining concordant and discordant profiles.

Symptom-defined PWD was identified in 4.8% of participants, whereas 3.1% identified themselves as addicted to pornography. The overlap between the two classifications was moderate (φ = .430, p <.001). Among participants meeting symptom-based criteria for PWD, 63.7% did not identify themselves as addicted, whereas 43.7% of individuals with SIPA did not meet symptom-based criteria. Symptom-defined PWD was associated with PUF, male sex, greater religiosity, interpersonal difficulties, lower sexual-life satisfaction, earlier exposure to pornography, inadequate sexual education, self-reported sexual disorders, and self-reported paraphilic disorders. In contrast, SIPA was associated primarily with PUF, pornography-related symptom burden, and male sex. Multinomial analyses further showed that individuals who self-identified as addicted despite not meeting symptom-based criteria differed markedly from those with symptom-defined PWD and were distinguished mainly by higher PUF and male sex.

Symptom-defined PWD and SIPA represent related but non-equivalent operationalizations of problematic pornography involvement. Whereas the checklist-based PWD classification was associated with a broader range of sociodemographic, psychosexual, and psychosocial characteristics, SIPA was associated primarily with PUF and symptom burden. These findings highlight the importance of distinguishing between structured symptom-checklist-based classification and direct self-identification in both research and clinical assessment.