Gambling in a U.S. Census Matched Sample: Examining Interactions between Means and Motives in Predicting Problematic Outcomes.

The influence of socioeconomic status (SES) on risk of Problem Gambling (PG) is complex, particularly given recent evidence that SES should be understood in both objective and subjective terms. Likewise, financial gambling motives have been found to be predictive of PG; however, financial motives are less understood in comparison to other gambling motives. Preliminary findings on SES and gambling points towards a pattern of social inequality in which those with the least financial resources (e.g., income) or that feel financially deprived relative to others (e.g., perceived deprivation) experience greater harm and problems. In a weighted, census matched sample of adults in the U.S. (N = 1,348), the present study examined the interaction between financial gambling motives and income and financial gambling motives and perceived deprivation in predicting PG. Findings provided support for both financial gambling motives and perceived deprivation as robust predictors of PG. Further, results provided unique insights into the role subjective economic standing may play in the relationship between financial motives for gambling and risk of PG.

Anticipated Motives for Gambling Treatment in Adults from the U.S.

Prior works note that identifying problematic play is a leading barrier to treatment seeking, contributing to low treatment rates in those with gambling problems (e.g., Bijker et al., 2022; Suurvali et al., 2012a). While research has looked at treatment seekers' motives for treatment (Gainsbury et al., 2014; Suurvali et al., 2012b), the situations or signs (anticipated motives) individuals look for that suggest they would need treatment in the future remains unknown. Participants were gamblers (N = 1,791) from a census-matched U.S. sample of adults who reported no concerns about their gambling. Participants completed questions assessing how much money they would have to lose while gambling to think they might have a problem and what factors might motivate them to pursue treatment for gambling problems in the future. Participants reported a wide range of financial loss that would suggest they had a problem, and higher income men who gambled more frequently reported higher necessary losses. There was little variation in endorsement (40-60%) of 14 situations that may lead them to seek treatment in the future (e.g., felt guilty). However, income, gender identity, and problem gambling behavior were linked to the endorsement of some of these anticipated motives, with some differences in endorsement between those engaging in high- and low-level problem gambling. Collectively, results are consistent with the inference that many individuals may not be aware of what problematic gambling would look like for them, though income, gender identity, and problem gambling behavior may impact their consideration of anticipated motives.

Exploring the Differences in Positive Play among Various Sports Wagering Behaviors.

Recent technological advances and legislative changes have led to an increase of sports wagering across the United States, raising concerns about possible increases in problem gambling behaviors. This, in turn, points to an increased need to understand responsible gambling and how it relates to sports gambling behaviors. The present work utilizes the Positive Play Scale (PPS), a recent scale designed to measure the increasingly popular responsible gambling concept of Positive Play, to assess how various aspects of sports gambling relate to responsible gambling. Participants were recruited by YouGov Opinion polling and taken from two U.S. samples, and the present analyses look only at those who self-identified as sports gamblers (n = 561, Mage = 50.7). Gamblers' location of gambling, types of bets wagered on, timing of gambling, and website used to gamble were assessed. Those who bet online in any capacity, as well as participating in in-game wagering, were found to be significantly less positive in their gambling behaviors. In addition, certain types of sports wagers such as moneylines appeared to be associated with higher positive play, while other types such as parlays were associated with less positive play. Finally, certain websites, particularly offshore websites, were associated with lower positive play behavior. Collectively, these results suggest that there are various aspects of sports wagering behaviors that are associated with positive play variations in gambling.

Religiousness and Sexual Values Predict Sexual Incongruence: Results from a U.S. Nationally Representative Study.

The present work aimed to clarify commonly endorsed sexual values in the general U.S. population as well as the association between sexual values and incongruence. Study 1 recruited adults (N = 923; 51.8% women; Mage = 35.5, SD = 10.8) to answer a free response question about sexual values via Amazon's Mechanical Turk, while Study 2 posed the same question to a weighted, nationally representative U.S. sample (N = 2,519; 51.4% women; Mage = 48.2, SD = 17.8). Data collection was completed in 2017 and 2019, respectively. Results from these cross-sectional studies demonstrated that, although religiousness predicted sexual incongruence, conservative sexual values predicted variance in sexual incongruence, over and above the effects of religiousness.

Reasons for Moral-Based Opposition to Pornography in a U.S. Nationally Representative Sample.

Pornography use is a common-but-controversial activity that many people object to or morally disapprove of. Despite this, there is a limited understanding of the reasons for such moral opposition. Although some prior research has assessed characteristics that influence moral opposition to pornography, most research has done so using various forced-choice methods. The present study aimed to better understand the reasoning behind moral-based opposition to pornography by using open-ended questioning and exploring the relationship between these reasons and pornography use habits. To achieve these aims, we analyzed data from a nationally representative U.S. sample, specifically studying individuals who reported moral beliefs opposing pornography (N = 1,020). Results revealed 14 general themes (e.g., religion/spirituality; concerns about abuse; disgust) in the reasons participants reported for their moral disapproval of pornography, many of which were related to individual difference variables such as gender, age, religiousness, and political preferences. Implications, limitations, and directions for future research are also discussed.

The relative risks of different forms of sports betting in a U.S. sample: A brief report.

BACKGROUND: The 21st century has brought substantial changes to the manners in which people gamble and the types of things on which people gamble. These changes are particularly stark in the United States, where, over the past five years, sports betting has gone from being legal in only one location to being legal throughout the majority of the country, often via mobile applications and online betting websites. METHOD: In March of 2022, a sample of the U.S. population (n = 2806, Mage[SD] = 48.9[17.2]; 1365[48.6%] men; response rate = 87.6%) and an oversample of sports-wagering adults in the U.S. (n = 1557, Mage[SD] = 41.7[15.3]; 1043[67%] men; response rate = 78.7%) were recruited via YouGov. Participants completed measures of gambling activities, including various forms of sports betting, as well as measures of problem gambling activities. RESULTS: In general, people who gamble on sports, when compared to people who do not bet on sports, reported greater frequency of gambling engagement (averaging between monthly and weekly play),a wider variety of gambling activities (with the majority reporting past year engagement in four or more gambling activities), and higher rates of problem gambling. Multinomial logistics regression revealed no distinct associations between any specific form of sports gambling and higher risk, instead demonstrating that breadth and depth of gambling engagement were the best predictors of high-risk gambling behaviors. CONCLUSIONS: In general, sports gambling is broadly associated with greater engagement in both breadth of gambling activities and frequency of gambling play. Additionally, people who gamble on sports seem to be at higher risk of problem gambling than people who do not bet on sports. However, in analyses controlling for breadth and depth of gambling activities, these links are attenuated, suggesting that the risks associated with sports gambling behaviors are related to the greater degree of gambling engagement.

Psychometric properties of the Alcohol Use Disorders Identification Test (AUDIT) across cross-cultural subgroups, genders, and sexual orientations: Findings from the International Sex Survey (ISS).

INTRODUCTION: Despite being a widely used screening questionnaire, there is no consensus on the most appropriate measurement model for the Alcohol Use Disorders Identification Test (AUDIT). Furthermore, there have been limited studies on its measurement invariance across cross-cultural subgroups, genders, and sexual orientations. AIMS: The present study aimed to examine the fit of different measurement models for the AUDIT and its measurement invariance across a wide range of subgroups by country, language, gender, and sexual orientation. METHODS: Responses concerning past-year alcohol use from the participants of the cross-sectional International Sex Survey were considered (N = 62,943; Mage: 32.73; SD = 12.59). Confirmatory factor analysis, as well as measurement invariance tests were performed for 21 countries, 14 languages, three genders, and four sexual-orientation subgroups that met the minimum sample size requirement for inclusion in these analyses. RESULTS: A two-factor model with factors describing 'alcohol use' (items 1-3) and 'alcohol problems' (items 4-10) showed the best model fit across countries, languages, genders, and sexual orientations. For the former two, scalar and latent mean levels of invariance were reached considering different criteria. For gender and sexual orientation, a latent mean level of invariance was reached. CONCLUSIONS: In line with the two-factor model, the calculation of separate alcohol-use and alcohol-problem scores is recommended when using the AUDIT. The high levels of measurement invariance achieved for the AUDIT support its use in cross-cultural research, capable also of meaningful comparisons among genders and sexual orientations.

Understanding Differences in Problematic Pornography Use: Considerations for Gender and Sexual Orientation.

BACKGROUND: While preliminary research suggests non-heterosexual men and women view more pornography than their heterosexual counterparts, few studies have examined how problematic use differs across sexual and gender identity groups. AIM: We sought to test measurement invariance across popular measures of problematic pornography use (PPU) and examine mean PPU differences across heterosexual men, non-heterosexual men, heterosexual women, and non-heterosexual women. METHODS: We used 3 large archival datasets to examine psychometrics/group differences on the Brief Pornography Screen (BPS; N = 1,439), Problematic Pornography Use Scale (PPUS; N = 5,859), and Cyber Pornography Use Inventory-4 (CPUI-4; N = 893). OUTCOMES: Most PPU scales/subscales demonstrated acceptable fit, and non-heterosexual men and women tended to report more PPU than heterosexual men and women (though exceptions were evident). RESULTS: Confirmatory factor analyses revealed good fit across each group and instrument, with exception to sexual minority women on the CPUI-4. Each instrument demonstrated at least metric invariance between groups, with exception to one item between heterosexual and sexual minority men on the CPUI-4. Mean differences suggested that sexual minority men and women tend to report more PPU than heterosexual men and women, though several exceptions were evident depending on the PPU dimension. Men tended to report more PPU than women, though exceptions were also evident. Effect sizes ranged from large-to-non-significant depending on PPU dimension. CLINICAL IMPLICATIONS: Researchers and clinicians should consider sexual orientation, gender, and PPU dimension when addressing PPU concerns. STRENGTHS & LIMITATIONS: A primary strength of this study is the use of multiple large samples, meaning our results are likely highly generalizable. However, this study is limited in that it only examined sexual orientation groups broadly and did not account for non-cisgender identities. CONCLUSIONS: The BPS, PPUS, and CPUI-4 are all appropriate tools to measure PPU depending on researcher and clinician needs. Borgogna NC, Griffin KR, Grubbs JB, and Kraus SW. Understanding Differences in Problematic Pornography Use: Considerations for Gender and Sexual Orientation. J Sex Med 2022;19:1290-1302.

Cross-Sectional and Longitudinal Associations Between Posttraumatic Stress Symptoms and Hypersexual Behaviors Among Individuals Who have Gambled in Their Lifetimes.

BACKGROUND: Exposure to traumatic experiences represent one factor that may contribute to the development of hypersexual behaviors. AIM: We investigated the associations between posttraumatic stress symptoms and hypersexual behaviors by analyzing survey data from 2 samples. METHOD: The first sample consisted of n = 585 college students, and the second consisted of n = 786 adults recruited via Amazon's Mechanical Turk (MTurk), n = 337 of whom completed a 6-month follow-up survey. We conducted 3 hierarchical regression analyses adjusting for age, gender, sexual orientation, impulsivity, drug use, alcohol use, and gambling. OUTCOMES: The primary outcomes for this investigation were associations between posttraumatic stress symptoms, measured using the PTSD Checklist for DSM-IV and DSM-5 (PCL-C and PCL-5), and hypersexual behaviors, measured using the Hypersexual Behavior Inventory (HBI). RESULTS: A significant regression, R2 = 0.230, R2adjusted = 0.211, F (14,570) = 12.17, P < .001, revealed posttraumatic stress symptoms were associated with hypersexual behaviors in the university student sample (ß = 0.154). A significant regression using the MTurk sample, R2 = 0.403, R2adjusted = 0.392, F (14,771) = 37.13, P < .001, confirmed this finding (ß = 0.259). In addition, a significant regression, R2 = 0.562, R2adjusted = 0.541, F (15,321) = 27.42, P < .001, indicated that posttraumatic stress symptoms were longitudinally associated with increased hypersexual behaviors (ß = .190) after adjusting for all variables, including baseline hypersexuality. CLINICAL TRANSLATION: Results suggest that individuals experiencing posttraumatic stress symptoms are at increased risk for current and future hypersexual behaviors. STRENGTHS & LIMITATIONS: This investigation involved secondary analyses of adults who had gambled at least once in their lives and findings may not generalize to those who have never gambled. Furthermore, longitudinal findings may be impacted by selection bias (42% completion rate) and may not generalize to follow up periods longer than 6-months. CONCLUSION: This study provides support for the hypothesis that posttraumatic stress symptoms are associated with increased hypersexual behavior, and further research is indicated to explore the etiology and directionality of this relationship. Rosansky JA, Borgogna NC, Kraus SW, et al. Cross-Sectional and Longitudinal Associations Between Posttraumatic Stress Symptoms and Hypersexual Behaviors Among Individuals Who have Gambled in Their Lifetimes. J Sex Med 2022;19:1813-1823.

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

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.

The cost of crisis in clinical psychological science.

Yarkoni has argued that psychology is facing a generalizability crisis, but the real cost of this crisis is obscured by a focus on topics from psychology's most academic subfields. Psychology is also filled with applied subfields, and it is within those subfields - especially clinical science - where the cost of a generalizability crisis will be most severe.

Sex and Its Discontents: How Moral Incongruence Connects Same-Sex and Non-Marital Sexual Activity with Unhappiness.

A growing body of research has demonstrated how the link between pornography use and various manifestations of psychological distress and dissatisfaction is explained by moral incongruence-the experience of violating one's deeply held moral values. The predictive power of moral incongruence, however, has yet to be applied to other sexual activities. Drawing on data from available waves of the General Social Surveys (1988-2018: nmen = 6590, nwomen = 7047; 1989-2018: nmen = 3558, nwomen = 4841), this study extended moral incongruence theory by testing whether engaging in same-sex or non-marital sexual activity when one rejects either as morally wrong is associated with a greater likelihood of reporting unhappiness. Analyses demonstrated that American men (but not women) who reported engaging in same-sex sex in the previous year were more likely than other men to say they were unhappy, but only if they viewed homosexuality as "always wrong." Analyses also showed that American women (not men) who reported higher frequencies of non-marital sex in the previous year were more likely than other women to report being unhappy, but only if they viewed non-marital sex as "always wrong." Though nuanced by gender, findings affirmed expectations from moral incongruence research: Sexual behavior per se is not associated with unhappiness, but moral inconsistency or conflict regarding one's sexual behavior is.

Evaluating Pornography Problems Due to Moral Incongruence Model.

INTRODUCTION: To date, multiple models of problematic pornography use have been proposed, but attempts to validate them have been scarce. AIM: In our study, we aimed to evaluate the Pornography Problems due to Moral Incongruence model proposing that self-appraisals of pornography addiction stem from (i) general dysregulation, (ii) habits of use, and (iii) moral incongruence between internalized norms and behavior. We investigated whether the model can be used to adequately explain the self-perceptions of addiction to pornography (model 1) and a broader phenomenon of problematic pornography use (model 2). METHODS: An online, nationally representative study was conducted on a sample of 1036 Polish adult participants, of whom, 880 declared a lifetime history of viewing pornography. MAIN OUTCOME MEASURE: The outcomes were self-perceived pornography addiction, problematic pornography use, avoidant coping, frequency of pornography use, religiosity, moral disapproval of pornography, and related variables. RESULTS: Our results indicated that avoidant coping (an indicator of general dysregulation), frequency of pornography use (indicator of habits of use), and the distress connected with incongruence between own sexual behavior and internalized norms, attitudes and beliefs positively contributed to self-perceived addiction (model 1) as well as problematic pornography use (model 2). This broadly confirms the basic shape of the PPMI model. There were, however, notable differences between the models. Moral incongruence related distress was only weakly related to self-perceived addiction (ß = 0.15, P < .001), with a stronger relation for problematic pornography use (ß = 0.31, P < .001). When controlling for other factors, religiosity weakly predicted problematic pornography use (ß = 0.13, P < .001), but not self-perceived addiction to pornography (ß = 0.03, P = .368). Frequency of pornography use was the strongest predictor of both self-perceived addiction (ß = 0.52, P < .001) and problematic pornography use (ß = 0.43, P < .001). CLINICAL IMPLICATIONS: Factors proposed within the PPMI model are distinctly relevant intervention targets, and they should be considered in the process of diagnosis and treatment. STRENGTHS & LIMITATIONS: The presented study is the first to evaluate PPMI model. Its main limitation is that it has a cross-sectional design. CONCLUSION: The PPMI model is a promising framework for investigating the factors related to self-perceived addiction and problematic pornography use. Despite the differences between the models and in the strength of specific predictors, (i) dysregulation, (ii) habits of use, and (iii) moral incongruence all uniquely contribute to self-perceived addiction and problematic pornography use. Lewczuk, K., Glica, A., Nowakowska, I., et al. Evaluating Pornography Problems Due to Moral Incongruence Model. J Sex Med 2020;17:300-311.

Is Pornography Use Related to Erectile Functioning? Results From Cross-Sectional and Latent Growth Curve Analyses.

INTRODUCTION: Despite evidence to the contrary, a number of advocacy and self-help groups persist in claiming that internet pornography use is driving an epidemic of erectile dysfunction (ED). AIM: The present work sought to explore whether mere pornography use itself and self-reported problematic use of pornography are related to ED, both cross-sectionally and longitudinally. METHODS: A series of 3 samples of sexually active men who also used pornography were collected: a cross-sectional sample of undergraduate men in the United States (n = 147), an online sample of men derived from a larger sample that was matched to U.S. nationally representative norms (n = 297), and a 1-year, 4-wave longitudinal sample of adult men derived from an online convenience sample (Mechanical Turk: time 1, n = 433; time 2, n = 223; time 3, n = 202; time 4, n = 196). Pearson correlations and cross-sectional structural equation models were conducted in each sample. Latent growth curve analyses were conducted in the longitudinal sample. MAIN OUTCOME MEASURE: The primary outcomes of interest were cross-sectional and longitudinal reports of erectile functioning as measured by the International Index of Erectile Functioning 5. RESULTS: Across all 3 samples, there was evidence of a positive, cross-sectional association between self-reported problematic use and ED, but no consistent association between mere use itself and ED. In our longitudinal sample, there were correlations among baseline pornography use, baseline self-reported problematic use, and prospective ED at times 2-4; however, latent growth curve analyses demonstrated no significant relationships between any pornography-related variables and trajectories of ED. CLINICAL IMPLICATIONS: These results suggest that among non-treatment-seeking pornography users, self-reported problematic use likely is associated with concurrent reports of ED, but that the links between these variables are not directional or causal in nature. STRENGTH & LIMITATIONS: This work is the first work to systematically examine the links between self-reported problematic use of pornography and ED, and it did so in a variety of samples, using both cross-sectional and longitudinal methods. Even so, the work relied exclusively on self-report methods, and did not control for medical covariates that may be related to the experience of ED. CONCLUSION: In conjunction with prior literature, we conclude that there is little or no evidence of an association between mere pornography use and ED, consistent evidence of an association between self-reported problematic use and ED cross-sectionally, and no evidence of causal links between any pornography variables and ED. Grubbs JB, Gola M. Is Pornography Use Related to Erectile Functioning? Results From Cross-Sectional and Latent Growth Curve Analyses. J Sex Med 2019;16:111-125.

Pornography Problems Due to Moral Incongruence: An Integrative Model with a Systematic Review and Meta-Analysis.

The notion of problematic pornography use remains contentious in both academic and popular literature. Although the mental health community at large is divided as to the addictive versus non-addictive nature of Internet pornography, substantial numbers of individuals report "feeling" as if their use of Internet pornography is problematic. The present work seeks to construct a model related to problematic pornography use that is clearly derived from empirical literature and that provides directions to be tested in future research. The focus of the present work is on those perceptions as they relate to the overarching experience of moral incongruence in pornography use, which is generally thought of as the experience of having one's behaviors be inconsistent with one's beliefs. To this end, we put forth a model of pornography problems due to moral incongruence. Within this model, we describe how pornography-related problems-particularly feelings of addiction to pornography-may be, in many cases, better construed as functions of discrepancies-moral incongruence-between pornography-related beliefs and pornography-related behaviors. A systematic review of literature and meta-analysis is conducted in order to evaluate support for this model, and the implications of this model for research and clinical practice are discussed.

Internet Pornography Use, Perceived Addiction, and Religious/Spiritual Struggles.

Prior work has demonstrated that religious beliefs and moral attitudes are often related to sexual functioning. The present work sought to examine another possibility: Do sexual attitudes and behaviors have a relationship with religious and spiritual functioning? More specifically, do pornography use and perceived addiction to Internet pornography predict the experience of religious and spiritual struggle? It was expected that feelings of perceived addiction to Internet pornography would indeed predict such struggles, both cross-sectionally and over time, but that actual pornography use would not. To test these ideas, two studies were conducted using a sample of undergraduate students (N = 1519) and a sample of adult Internet users in the U.S. (N = 713). Cross-sectional analyses in both samples found that elements of perceived addiction were related to the experience of religious and spiritual struggle. Additionally, longitudinal analyses over a 1-year time span with a subset of undergraduates (N = 156) and a subset of adult web users (N = 366) revealed that perceived addiction to Internet pornography predicted unique variance in struggle over time, even when baseline levels of struggle and other related variables were held constant. Collectively, these findings identify perceived addiction to Internet pornography as a reliable predictor of religious and spiritual struggle.

Internet pornography use: perceived addiction, psychological distress, and the validation of a brief measure.

The authors aimed to validate a brief measure of perceived addiction to Internet pornography refined from the 32-item Cyber Pornography Use Inventory, report its psychometric properties, and examine how the notion of perceived addiction to Internet pornography might be related to other domains of psychological functioning. To accomplish this, 3 studies were conducted using a sample of undergraduate psychology students, a web-based adult sample, and a sample of college students seeking counseling at a university's counseling center. The authors developed and refined a short 9-item measure of perceived addiction to Internet pornography, confirmed its structure in multiple samples, examined its relatedness to hypersexuality more broadly, and demonstrated that the notion of perceived addiction to Internet pornography is very robustly related to various measures of psychological distress. Furthermore, the relation between psychological distress and the new measure persisted, even when other potential contributors (e.g., neuroticism, self-control, amount of time spent viewing pornography) were controlled for statistically, indicating the clinical relevance of assessing perceived addiction to Internet pornography.

Transgression as addiction: religiosity and moral disapproval as predictors of perceived addiction to pornography.

Perceived addiction to Internet pornography is increasingly a focus of empirical attention. The present study examined the role that religious belief and moral disapproval of pornography use play in the experience of perceived addiction to Internet pornography. Results from two studies in undergraduate samples (Study 1, N = 331; Study 2, N = 97) indicated that there was a robust positive relationship between religiosity and perceived addiction to pornography and that this relationship was mediated by moral disapproval of pornography use. These results persisted even when actual use of pornography was controlled. Furthermore, although religiosity was negatively predictive of acknowledging any pornography use, among pornography users, religiosity was unrelated to actual levels of use. A structural equation model from a web-based sample of adults (Study 3, N = 208) revealed similar results. Specifically, religiosity was robustly predictive of perceived addiction, even when relevant covariates (e.g., trait self-control, socially desirable responding, neuroticism, use of pornography) were held constant. In sum, the present study indicated that religiosity and moral disapproval of pornography use were robust predictors of perceived addiction to Internet pornography while being unrelated to actual levels of use among pornography consumers.