Mental health trajectories after juridical divorce: Does personality matter?

INTRODUCTION: This study investigated whether the Big Five personality dimensions were associated with mental health trajectories and/or intervention effects of a digital divorce intervention from juridical divorce to 12 months following juridical divorce. The study utilized a randomized controlled trial study design (N = 676) and measured mental health outcomes (anxiety, depression, somatization, and stress) at study inclusion (i.e., at juridical divorce) and 3-, 6-, and 12 months after juridical divorce. Big Five personality dimensions were measured 1 month post study inclusion. RESULTS: The study found that neuroticism is the personality dimension most predictive of post-divorce mental health outcomes. Specifically, divorcees with higher neuroticism scores indicated worse mental health immediately following divorce, but their symptom levels decreased more rapidly over a 12 months period after juridical divorce compared with lower neuroticism divorcees. It is also notable that their mean scores for the mental health outcomes remained higher at all time points (3, 6, and 12 months post baseline), relative to those lower in neuroticism. CONCLUSION: Findings are discussed in light of divorce-adjustment-theory and the stress-buffering model.

Symptoms of anxiety and depression in Denmark during the first year of the COVID-19 pandemic: A two-wave matched-control study.

Subsequent to the restriction measures taken to curb the COVID-19 infection rate, researchers theorized these would have detrimental mental health consequences. This two-wave matched-control study investigates depression and anxiety symptoms during the first 12 months of the pandemic (March 2020-March 2021) in Denmark with data from the I-SHARE and Project SEXUS studies. The I-SHARE study includes 1,302 (Time period 1 only n = 914, Time period 2 only n = 304, both time periods 1 and2 n = 84) Danish participants, and the sex and birth year-matched control participants from the Project SEXUS study comprise 9,980 Danes. During the first year of the pandemic, the study populations' anxiety and depression symptom mean levels did not significantly differ from pre-pandemic matched controls. Younger age, female gender, fewer children in the same household (depression only), lower education level, and not being in a relationship (depression only) were associated with increased anxiety and depression symptom scores. The key COVID-19-related variable linked with significantly higher anxiety and depression symptom scores was COVID-19-related loss of income. Contrary to initial concerns, we did not find a significant effect of the pandemic on anxiety and depression symptom scores. However, the results underscore the importance of structural resources to prevent income loss to safeguard mental health during crises such as a pandemic.

Prevalence of Masturbation and Associated Factors Among Older Adults in Four European Countries.

Solitary sexual activity is a free, safe, and accessible way to experience sexual pleasure. Despite these advantages, research on masturbation in later life is highly understudied. Using data from a cross-sectional probability-based survey of 3816 European adults (mean age 67 years; range 60-75 years), we explored several sociodemographic, health, attitudinal, and sexual behavioral factors associated with reported masturbation frequency. Across all countries, between 41% and 65% of men and 27% and 40% of women reported any masturbation in the preceding month. Satisfaction with sexual activity and attitudes related to disapproval of sex without love were significant predictors of reported masturbation in almost all countries and in both genders. Age, education, self-perceived health, and depression were for the most part predictive of men's reported masturbation, but not women's. Generally, those believing sex is beneficial to older people were more likely to masturbate, while less permissive attitudes decreased the likelihood of reporting masturbation. To improve healthy sexual aging, misinformation about masturbation and sexual attitudes in older people need to be addressed.

Anxiety, depression and associated factors among recently divorced individuals.

BACKGROUND: In divorce research, studies using large samples, very recently divorced individuals and validated measures of depression and anxiety with available background populations for comparison are missing. AIMS: This study aimed to investigate symptoms of depression and anxiety among recently divorced Danes and assess the explanatory power of relevant sociodemographic- and divorce-related variables on these symptoms. METHODS: The study utilized an online cross-sectional design and a total of 1856 Danish citizens recruited through the Danish State Administration. Average scores for depression and anxiety were compared to the Danish background population and regression analyses were conducted to assess the explanatory power of sociodemographic- and divorce characteristics on symptoms of depression and anxiety. RESULTS: Divorcees reported significantly higher levels of both depressive and anxiety symptoms than the background population with a large proportion of the sample scoring equal to or higher than generally recommended cut-off values for risk of suffering from a psychiatric diagnosable case of depression or anxiety. Both sociodemographic- and divorce characteristics were predictive of symptoms of depression and anxiety. CONCLUSION: The findings underline the relevance of public health intervention targeting symptoms of depression and anxiety among recently divorced individuals.

Appearance Satisfaction as a Predictor of Specific Sexual Problems and Associated Distress.

INTRODUCTION: Appearance dissatisfaction is a sensitive issue and has been tied to depression, dissatisfaction in romantic relationships, and reduced sexual satisfaction. AIM: This study sought to examine associations between appearance satisfaction and specific sexual problems and related distress, testing also the moderating role of relationship satisfaction. METHODS: A large web-sample of Norwegians in romantic relationships (N = 2,903) completed a one-time survey. OUTCOMES: Participants reported on their experience of five different sexual problems and associated level of distress. RESULTS: We found that appearance satisfaction was associated with reporting fewer sexual problems, and specifically, with a smaller likelihood of experiencing problems with lack of enjoyment, lack of excitement, and lack of climax. Furthermore, appearance satisfaction was unrelated to overall sexual problem-related distress, but was associated with feeling less distress about lack of excitement and lack of climax. Relationship satisfaction did not serve as a moderator of the associations. CLINICAL TRANSLATION: These findings suggest the importance of attending to appearance satisfaction when working with clients with multiple sexual problems, particularly those related to excitement and enjoyment. STRENGTHS AND LIMITATIONS: Strengths of the study include a large sample of partnered adults and assessment of specific sexual problems and associated distress. A limitation is that outcomes were assessed using single items, rather than multi-item scales. CONCLUSION: The study highlights the importance of examining the presence of sexual problems and associated distress separately, and to consider appearance satisfaction as a predictor of sexual functioning. Øverup CS, Strizzi JM, Cipric A, et al. Appearance Satisfaction as a Predictor of Specific Sexual Problems and Associated Distress. J Sex Med 2021;18:1532-1544.

"I Had Not Seen Star Wars" and Other Motives for Divorce in Denmark.

A total of 2,371 Danish residents participating in the Cooperation After Divorce randomized controlled trial study indicated the motives for their divorce. The most frequently given motives were lack of love/intimacy, communication problems, lack of sympathy/respect/trust, and growing apart. The least reported motives were violence, addiction, accident or illness, and personality. The results support global trends regarding an increased importance of emotional and psychological aspects of relationships. A factor analysis seeking to identify clusters in the motives did not yield statistically or theoretically strong results. This may indicate that experiences with and motives for divorce are heterogeneous and multifactorial.

Prevalence and Predictors of Sexual Difficulties and Associated Distress Among Partnered, Sexually Active Older Women in Norway, Denmark, Belgium, and Portugal.

There has been little comparative, cross-cultural research on sexual difficulties and associated distress, and factors associated with these, among older women. Therefore, the aim of this study was to investigate prevalence rates of sexual difficulties, distress related to these difficulties, and associated sociodemographic, relational, and health factors, among sexually active older women (60-75 years) in committed relationships across four European countries (Norway, Denmark, Belgium, and Portugal). These data could inform us about what differentiates women who do and do not experience distressing sexual difficulties and facilitate the identification of older women who might benefit from clinical interventions as well as the development of new interventions. In total, 1057 women (357 Norwegian; 322 Danish; 237 Belgian; 141 Portuguese) completed a cross-sectional questionnaire assessing six sexual difficulties-vaginal dryness, orgasmic difficulties, lacking interest in sex, lacking enjoyment in sex, pain during sex, and no excitement/arousal during sex-and associated distress. We found a high prevalence of sexual difficulties lasting 3 months or longer in the past year (between 23.5 and 50.2%, depending on the specific difficulty). With the exception of vaginal dryness and pain during sex, however, the majority of women reporting sexual difficulties (50.0% to 86.1%, depending on the specific difficulty) reported no or mild distress. There were relatively few cross-country differences, either in the prevalence of sexual difficulties or related distress. Few sociodemographic or health variables were associated with distressing sexual difficulties, but higher sexual intimacy, higher emotional intimacy, and better mental health were associated with less distress about some sexual difficulties. The findings underline the importance of healthcare professionals asking older women about sexual function and especially associated distress, and suggest that careful attention to the psychological and relationship context of these sexual difficulties is needed, as these could be important targets in the treatment process.

Prevalence of Sexual Problems and Associated Distress in Aging Men Across 4 European Countries.

BACKGROUND: Among older men, comparable cross-cultural investigations of sexual problems and associated distress that also include a multitude of relevant explanatory variables of these sexual problem and related distress are rare in the research literature. AIMS: To investigate prevalence rates of sexual problems and associated distress among older men across 4 European countries (Norway, Denmark, Belgium, and Portugal) and assess for associated mental and physical health-related factors. METHODS: Multinational cross-sectional questionnaire study using self-report measures. OUTCOMES: Prevalence rates of sexual problems and associated distress levels. RESULTS: We found a high prevalence of sexual problems persisting for months or longer across countries, but noted that many affected men experienced minimal or no distress related to these problems. We also found marked cross-cultural differences in reported distress about sexual problems, with southern European men (ie Portugal) reporting significantly more distress related to the majority of sexual problems investigated compared with northern European men (ie Denmark and Norway). Finally, we identified several relational, physical, and mental health problems associated with the reported number of sexual problems and the distress related to these problems. CLINICAL IMPLICATIONS: We suggest that healthcare professionals also target distress when considering sexual problems among older men and contextualize these considerations within a multifactorial approach to general health in which (other) mental and physical health factors relevant to these patients' sexual health and function are also jointly considered. STRENGTHS & LIMITATIONS: Strengths of this study include the large sample size, inclusion of participants from 4 European countries, assessment of distress associated with sexual problems, and similar research design and method of data collection across the 4 included countries. Limitations of the study include the cross-sectional design, which precludes causal conclusions; the low response rate in the Portuguese sample; the lack of homosexual participants; and the lack of comprehensive assessments of dyadic factors that may be of relevance to sexual problems and associated distress. CONCLUSION: This study identified a high prevalence of sexual problems persisting for 3 months or longer among older men across 4 European countries, but also found that many of the men with sexual problems experienced minimal or no distress related to these problems. G.M. Hald, C. Graham, A. Stulhofer, et al. Prevalence of Sexual Problems and Associated Distress in Aging Men Across 4 European Countries. J Sex Med 2019;16:1212-1225.

Measuring Self-Perceived Effects of Pornography: A Short-Form Version of the Pornography Consumption Effects Scale.

The Pornography Consumption Effects Scale (PCES) is a 47-item measure of self-perceived effects of pornography use. While the PCES is frequently used in the pornography research literature, its length may limit its applicability in some research situations. This study investigated if a short-form version of the PCES could be created for use with heterosexual men. The study employed an online sample of 312 self-identified heterosexual men. Confirmatory factor analysis was used to produce a 14-item version of the PCES. This short-form PCES (PCES-SF) showed excellent psychometric properties in terms of reliability, concurrent validity with the long-form PCES, and discriminant validity with respect to social desirability. Similar to the full-length PCES, the PCES-SF generates both an overall positive effect score and an overall negative effect score.

Sexual Activity and Sexual Satisfaction Among Older Adults in Four European Countries.

The aim of this article was to describe partnered and non-partnered sexual activity and sexual satisfaction in older men and women from Norway, Denmark, Belgium, and Portugal, and to explore sociodemographic correlates of sexual activity and satisfaction. Data were collected in 2016 using postal, anonymous questionnaires in probability samples of the population aged 60-75 years recruited by phone registers in Norway (676 men, 594 women), Denmark (530 men, 515 women), Belgium (318 men, 672 women), and Portugal (236 men, 273 women). In men, the percentage of sexually active participants in the past year ranged from 83% in Portugal to 91% in Norway. In women, the percentage of sexually active participants during the last year ranged from 61% in Belgium to 78% in Denmark. Regarding frequency of sexual intercourse activity during the past month, men in Norway, Denmark, and Belgium (23-24%) most often reported 2-3 times per month, whereas most men in Portugal (29%) reported 1-3 times per week. Masturbation was most commonly reported among Norwegian men (65%) and women (40%), and least commonly in Portugal. Concerning sexual satisfaction, across all countries, 40-60% of participants reported that they were sexually satisfied. Portuguese men and Danish women reported being most sexually satisfied. Having a partner was the most important positive predictor of sexual activity and sexual satisfaction in all subgroups except Portuguese men. In conclusion, partnered sexual activity was more frequent in the south of Europe, and solitary sexual activity more frequent in Northern Europe.

Successful Aging and Changes in Sexual Interest and Enjoyment Among Older European Men and Women.

INTRODUCTION: Despite the popularity and analytical relevance of the concept of successful aging, little efforts have been made to address its relationship to sexuality in older individuals. AIM: To explore the relationship between successful aging and the (retrospectively assessed) change in sexual interest and enjoyment in the past 10 years, using a new multidimensional model of successful aging. METHODS: The data for this study was collected in 2016 using national probability-based surveys in four European countries (Norway, Denmark, Belgium and Portugal). In total, information from 2,461 sexually active and inactive participants aged 60-75 years was used for analyses. Multigroup structural equation analysis was employed to address the associations between key constructs. MAIN OUTCOME MEASURE: The dependent variable was a composite (two-item) indicator of change in sexual interest and enjoyment in the past 10 years; a multifaceted model of successful aging predicted the change by country and gender. RESULTS: Tested cross-culturally, the proposed model of successful aging demonstrated a good fit to the data. Furthermore, its metric characteristics enabled direct comparisons across gender and national cultures. Controlling for sociodemographic characteristics, higher successful aging scores were consistently related to lower reduction in sexual interest/enjoyment among men and women across the 4 countries. CLINICAL IMPLICATIONS: Given an increased life-expectancy and focus on healthy aging in many countries, the findings about the associations between sexual expression, quality of life and aging well are valuable to professionals working in the area of healthy sexual aging. STRENGTH & LIMITATIONS: This is the first study to systematically address the relationship between successful aging and sexuality. Furthermore, it provides a multidimensional measure of successful aging for a wide range of sexologic studies. Among limitations, possible self-selection bias (toward more sexually permissive and sexually active participants) and the fact that the findings are restricted to older heterosexual individuals, should be considered. CONCLUSION: Without stigmatizing the absence of sexual expression in aging individuals, the findings from this cross-cultural study point out that sustained sexual interest and sexual enjoyment are linked to successful aging in both genders. Stulhofer A, Hinchliff S, Jurin T, Hald GM, Træen B. Successful Aging and Changes in Sexual Interest and Enjoyment Among Older European Men and Women. J Sex Med 2018;15:1393-1402.

Long-term follow-up of individuals undergoing sex reassignment surgery: Psychiatric morbidity and mortality.

BACKGROUND: There is a lack of long-term register-based follow-up studies of sex-reassigned individuals concerning mortality and psychiatric morbidity. Accordingly, the present study investigated both mortality and psychiatric morbidity using a sample of individuals with transsexualism which comprised 98% (n = 104) of all individuals in Denmark. AIMS: (1) To investigate psychiatric morbidity before and after sex reassignment surgery (SRS) among Danish individuals who underwent SRS during the period of 1978-2010. (2) To investigate mortality among Danish individuals who underwent SRS during the period of 1978-2010. METHOD: Psychiatric morbidity and mortality were identified by data from the Danish Psychiatric Central Research Register and the Cause of Death Register through a retrospective register study of 104 sex-reassigned individuals. RESULTS: Overall, 27.9% of the sample were registered with psychiatric morbidity before SRS and 22.1% after SRS (p = not significant). A total of 6.7% of the sample were registered with psychiatric morbidity both before and after SRS. Significantly more psychiatric diagnoses were found before SRS for those assigned as female at birth. Ten individuals were registered as deceased post-SRS with an average age of death of 53.5 years. CONCLUSIONS: No significant difference in psychiatric morbidity or mortality was found between male to female and female to male (FtM) save for the total number of psychiatric diagnoses where FtM held a significantly higher number of psychiatric diagnoses overall. Despite the over-representation of psychiatric diagnoses both pre- and post-SRS the study found that only a relatively limited number of individuals had received diagnoses both prior to and after SRS. This suggests that generally SRS may reduce psychological morbidity for some individuals while increasing it for others.

Experimental effects of exposure to pornography: the moderating effect of personality and mediating effect of sexual arousal.

Using a randomly selected community sample of 200 Danish young adult men and women in a randomized experimental design, the study investigated the effects of a personality trait (agreeableness), past pornography consumption, and experimental exposure to non-violent pornography on attitudes supporting violence against women (ASV). We found that lower levels of agreeableness and higher levels of past pornography consumption significantly predicted ASV. In addition, experimental exposure to pornography increased ASV but only among men low in agreeableness. This relationship was found to be significantly mediated by sexual arousal with sexual arousal referring to the subjective assessment of feeling sexually excited, ready for sexual activities, and/or bodily sensations associated with being sexually aroused. In underscoring the importance of individual differences, the results supported the hierarchical confluence model of sexual aggression and the media literature on affective engagement and priming effects.

Examining the relationship between use of sexually explicit media and sexual risk behavior in a sample of men who have sex with men in Norway.

The purpose of this study was to investigate consumption patterns of gay-oriented sexually explicit media (SEM) among men who have sex with men (MSM) in Norway, with a particular emphasis on a possible relationship between gay SEM consumption and HIV risk behavior. Participants included 529 MSM living in Norway recruited online to complete a SEM consumption and sexual risk survey. Of the 507 participants who responded to the all items measuring exposure to SEM, 19% reported unprotected anal intercourse with a casual partner (UAI) in last 90 days, and 14% reported having had sero-discordant UAI. Among those with UAI experience, 23% reported receptive anal intercourse (R-UAI) and 37% reported insertive anal intercourse (I-UAI). SEM consumption was found to be significantly associated with sexual risk behaviors. Participants with increased consumption of bareback SEM reported higher odds of UAI and I-UAI after adjusting for other factors using multivariable statistics. MSM who started using SEM at a later age reported lower odds of UAI and I-UAI than MSM who started earlier. Future research should aim at understanding how MSM develop and maintain SEM preferences and the relationship between developmental and maintenance factors and HIV sexual risk behavior.

Do Sex Toys Make Me Satisfied? The Use of Sex Toys in Denmark, Norway, Sweden, Finland, France, and the UK.

Sex toys are easily accessible in many countries in the Western world. Yet, cross-country studies on sex toy ownership and use and their association with relationship, sexual, and life satisfaction are rare. Using a cross-country convenience sample of 11,944 respondents from six European countries (Denmark, Sweden, Norway, Finland, France, UK), we investigated the rate and factors linked to sex toy ownership and use and their associations with sexual, relationship, and life satisfaction. Data were collected in May and June 2022 through respondent panels by Cint, a market research software platform. Participants received an e-mail invitation for the study and completed an online self-report survey. We found that more than half of respondents owned or had owned a sex toy, with the most common sex toys owned being dildos and vibrators, followed by handcuffs, penis rings, and anal sex toys. Across countries, the majority of sex toy owners reporting using these either alone or with a steady partner (55-65%) and a minority with casual partners (10-15%). Controlling for socio-demographics, parental status, sexual orientation, number of sex partners, and relationship status and length, we found that sex toy ownership and use were significantly associated with higher sexual and life satisfaction, while higher relationship satisfaction was only significantly associated with currently owning a sex toy (but not number of sex toys) and frequency of use with a partner (but not alone). Across results, we generally found little cross-country variation.

Perceived effects of sexually explicit media among men who have sex with men and psychometric properties of the pornography consumption effects scale (PCES).

INTRODUCTION: Researchers have proposed that consumption of Sexually Explicit Media (SEM) may not only adversely influence sexual attitudes and behaviors of Men Who Have Sex with Men (MSM) but (also) play a positive role in the development and sexual education of MSM, be a major source of sexual information for MSM, and provide validation, understanding, and confirmation of MSM's sexual orientation. However, such claims are in urgent need of empirical validation as is the development of psychometrically sound and easily implemented instruments able to reliably assist such validations. AIMS: To investigate how MSM who consume SEM self-perceive the impact of SEM on their sexually-transmitted-infections-related sexual risk behaviors (i.e., anal intercourse), sexual knowledge, enjoyment of sex, interest in sex, attitudes toward sex, and understanding of their sexual orientation. Further, to provide a thorough psychometric validation of a reduced and reworked version of the Pornography Consumption Effects Scale (PCES). Main Outcome Measure. A revised version of the PCES by Hald and Malamuth. METHODS: Online cross-sectional survey study of 1,333 US adult Men Who Have Sex with Men. RESULTS: This study found that 97% of MSM reported positive effects of SEM consumption on their sexual knowledge, enjoyment of and interest in sex, attitudes toward sex, and understanding of their sexual orientation. Only 3% reported any negative effects of their SEM consumption. SEM consumption was found to significantly increase consumers' interest in having protected anal intercourse while not significantly influencing their interests in having unprotected anal intercourse. The revised version of the PCES showed excellent psychometric performance. CONCLUSION: The study found that MSM generally report positive effects of their consumption of sexually explicit materials in areas related to their sexual knowledge, attitudes, behaviors, and orientation. This finding could have important implications for the sexual health and well-being of MSM by suggesting that SEM-based education and intervention might hold considerable overall health potential for MSM.

Does viewing explain doing? Assessing the association between sexually explicit materials use and sexual behaviors in a large sample of Dutch adolescents and young adults.

INTRODUCTION: Concerns have been voiced that the use of sexually explicit materials (SEMs) may adversely affect sexual behaviors, particularly in young people. Previous studies have generally found significant associations between SEM consumption and the sexual behaviors investigated. However, most of these studies have focused on sexual behaviors related to sexually transmitted infections or sexual aggression and/or failed to adequately control for relevant covariates. Thus, research more thoroughly investigating the association between SEM consumption and a broader range of sexual behaviors is needed. AIMS: The study aims to investigate SEM consumption patterns of young people, and to assess the strength of the association between SEM consumption and a range of sexual behaviors, controlling for a comprehensive array of variables previously shown to affect these relationships. METHODS: Online cross-sectional survey study of 4,600 young people, 15-25 years of age, in The Netherlands was performed. MAIN OUTCOMES MEASURES: The main outcome measures were self-reported SEM consumption and sexual practices. RESULTS: The study found that 88% of men and 45% of women had consumed SEM in the past 12 months. Using hierarchical multiple regression analyses to control for other factors, the association between SEM consumption and a variety of sexual behaviors was found to be significant, accounting for between 0.3% and 4% of the total explained variance in investigated sexual behaviors. CONCLUSIONS: This study suggests that, when controlling for important other factors, SEM consumption influences sexual behaviors. The small to moderate associations that emerged between SEM consumption and sexual behavior after controlling for other variables suggest that SEM is just one factor among many that may influence youth sexual behaviors. These findings contribute novel information to the ongoing debates on the role of SEM consumption in sexual behaviors and risk, and provide appropriate guidance to policy makers and program developers concerned with sexual education and sexual health promotion for young people.

The effects of gay sexually explicit media on the HIV risk behavior of men who have sex with men.

This study sought to study consumption patterns of gay-oriented sexually explicit media (SEM) by men who have sex with men (MSM); and to investigate a hypothesized relationship between gay SEM consumption and HIV risk behavior. Participants were 1,391 MSM living in the US, recruited online to complete a SEM consumption and sexual risk survey. Almost all (98.5 %) reported some gay SEM exposure over the last 90 days. While 41 % reported a preference to watch actors perform anal sex without condoms (termed "bareback SEM"), 17 % preferred to actors perform anal sex with condoms (termed "safer sex SEM") and 42 % reported no preference. Overall SEM consumption was not associated with HIV risk; however participants who watched more bareback SEM reported significantly greater odds of engaging in risk behavior. The results suggest that a preference for bareback SEM is associated with engaging in risk behavior. More research to understand how MSM develop and maintain preferences in viewing SEM, and to identify new ways to use SEM in HIV prevention, is recommended.

Pornography consumption and non-marital sexual behaviour in a sample of young Indonesian university students.

Using a sample of Indonesian university students and a cross sectional design, this study investigated prevalence rates and patterns of pornography consumption in Indonesia, a religious, sexually conservative, Muslim-majority nation with strict anti-pornography laws. Further, the association between pornography consumption and common non-marital sexual behaviours was explored. The study found that in this sample, pornography is as widely and readily consumed as in comparable international studies predominantly utilising Western background samples from more sexually liberal and less religious countries with very few laws on pornography. Gender differences in patterns of pornography consumption were pronounced and comparable with findings in international counterpart studies. For men only, pornography consumption was found to significantly predict common sexual behaviours in non-marital relations. The study is the first to provide insights into prevalence rates and patterns of pornography consumption and its association with common non-marital sexual behaviours in a sexually conservative, Muslim-majority nation with strict anti-pornography laws.

Using Pornography, Paying for Sex, and Violence: A Danish National Survey Study.

Only a few national cohort studies on using online pornography and buying sex have been published. The overall aim of this study, which analyzed data from a representative Danish national survey, was to provide an overview of incidence and associated population characteristics. The key aims were: first, to analyze frequencies of using online pornography and buying sex stratified by gender and other background characteristics; and, second, to investigate if and how using online pornography and buying sex were associated with sexual satisfaction, sexual activity, and violence. The findings revealed that having ever paid for sex and higher use of pornography were each associated with being male, younger, and not being in a relationship. Further, among men, having ever paid for sex and higher use of pornography were associated with not being sexually satisfied and, in part of the analysis, having committed violence to another person in the last year; however, these particular relationships were not statistically significant in the appropriately controlled regression analysis. We discuss gender, age, sexual aggression, and sexual satisfaction as factors associated with higher pornography use and buying sex.