Pornography Use and Violence: A Systematic Review of the Last 20 Years.

Pornography use is one of the factors that has been proposed to be associated with violence. We aimed to explore the literature of the last 20 years, with the objective of understanding the possible association between pornography use and violence. Two electronic databases (PsycINFO/PsycARTICLES and PubMed/Medline) were used. We included members of the general population, of any sex, age, and sexual orientation, who were direct users of pornography or have a partner who uses pornography. Only studies with pornography use and violence assessments, and that specifically evaluated the association between both factors, were included. In all, 59 studies met the inclusion criteria. An association between pornography use and nonsexual violence seems to exist, although the causality of this association remains unclear. Heterogeneity of results exists regarding the association between pornography use and intimate partner sexual assault and coercion: some studies have failed to demonstrate this association, while others have observed it partially or significantly. Contradictory results have also been observed when examining the association between pornography use, rape myths, and other beliefs/attitudes. The main limitation is the heterogeneity in the conceptualization of both constructs (pornography and violence). Multiple theoretical models, methodologies, and categorizations have been used in the studies, complicating the comparability of the findings. The association between different types of violence and pornography use requires further in-depth research to better understand the specific link between both constructs.CRD42021259874.

Spanish Validation of the Long and Short Versions of the Problematic Pornography Consumption Scale (PPCS and PPCS-6) in Adolescents.

Although 1-14% of adolescents may experience problematic pornography use (PPU), psychometrically sound instruments for assessing PPU in Spanish-speaking adolescents are scarce. Given the advantages of the different forms of the Problematic Pornography Consumption Scale (PPCS), the aim of the present study was to assess the psychometric properties of the PPCS and PPCS-6, and to examine associations between PPU and age among boys and girls. Two school-based adolescent samples were recruited in Spain (n = 650; Mage = 16.0 [SD = 1.1]; 50% girls and 50% boys) and Mexico (n1, 160; Mage = 15.8 [SD = 1.1]; 68% girls) to assess the psychometric properties of the PPCS and PPCS-6. Confirmatory factor analysis was applied and convergent and discriminant validity with other measures related to PPU was also tested. The results provided empirical support for the six-factor structure of the PPCS and the one-factor structure of the PPCS-6. Boys with older age showed higher levels of tolerance than girls on the PPCS in both countries. Both the PPCS and the PPCS-6 may be considered valid psychometric instruments for the assessment of PPU in Spanish-speaking adolescents from Spain and Mexico.

Understanding the Co-occurrence of Gambling Disorder and Problematic Pornography Use: Exploring Sociodemographic and Clinical Factors.

The co-occurrence between gambling disorder (GD) and problematic pornography use (PPU) has not yet been explored. Therefore, the present study compared (a) sociodemographic variables, (b) GD-related factors, (c) substance use, (d) psychopathology, (e) personality features, (f) impulsivity, and (g) emotion regulation between individuals with GD (GD group) and those with co-occurring GD and PPU (GD+PPU group). The sample consisted of 359 treatment-seeking individuals with GD: n = 332 individuals had GD only (GD group) and n = 37 individuals had GD and co-occurring PPU (GD+PPU group). GD severity, impulsivity, psychopathology, personality, emotion regulation, and other sociodemographic and clinical variables were assessed. No between-group differences in sociodemographic measures were observed. The GD+PPU group demonstrated greater GD severity and a higher likelihood of substance use compared to those without PPU. Furthermore, the presence of PPU was associated with worse psychopathology, higher impulsivity (except for lack of premeditation and positive urgency), more difficulties in emotion regulation (except for non-acceptance of emotions and limited access to emotions), and a personality profile characterized by lower levels of self-directedness and cooperativeness. The co-occurrence of GD and PPU seems associated with a more dysfunctional clinical profile.

Mediterranean diet-based intervention to improve depressive symptoms: analysis of the PREDIDEP randomized trial.

BACKGROUND: The effect of an intervention based on Mediterranean diet on reducing recurrence risk or subsyndromal depressive symptoms in recovered depressed patients has not been explored. METHODS: The PREDIDEP study was a two-year randomized trial designed to assess the effect of the Mediterranean Diet enriched with extra virgin olive oil on depression recurrence. At baseline and at four, eight, 16, 20, and 24 months of follow-up, depressive symptoms were evaluated through the Beck Depression inventory. Cox regression analysis was fitted to assess the role of dietary intervention on the risk of depression recurrence. Mixed effects linear models were used to assess changes in depressive subsyndromal symptoms according to the intervention. RESULTS: After two years of intervention, the dietary intervention group (n = 103) compared to the control group (n = 93) showed no differences regarding depression recurrence risk as main outcome. As secondary outcomes, an improvement of depressive symptoms was yielded at four (-2.15; 95% CI = -4.00 to -0.29) and eight months (-2.42; 95% CI = -4.17 to -0.67) in the intervention group, with no changes in control group. Moreover, at 20 months, significant differences were found between groups (-3.35; 95% CI = -6.08 to -0.61). CONCLUSIONS: An intervention with Mediterranean diet in patients with previous depressive episodes might contribute to the reduction of depressive subsyndromal symptoms.

The use of 'sex' and 'gender' in medical research.

There is a widespread practice of using 'sex' and 'gender' interchangeably. The World Health Organization considers that they are not. It defines sex as a set of chromosome-dependent biological variables that show unique hormone profiles and anatomy. Conversely, gender refers to socially constructed sex attributions with differential roles, behavioral expressions, identity, etc. Researchers and institutions have proposed guidelines to ensure that good science is not compromised by ideologies, media or social pressures, morality, religion or economic interests. Sex differences are immune to any ideology or socio-cultural interest, because they are governed by biologically determined genetic parameters. Considering men and women to be alike is very valuable from a moral or social perspective, but ignoring differences could be wrong and unacceptable from a biomedical perspective. The organization of health and/or research systems that does not consider the different morbidity, evolution or treatment response depending on sex would generate biases and mistakes. To work on medical innovation with a gender perspective should need to take sex differences into account and integrate them properly, recognizing diversity. The controversy is not just about sex or gender, but about sex and gender and how they may influence each other. Maintaining a scientific and academic approach will help both to advance science and enrich laws and/or ideologies.

'Effectiveness of a remote nutritional intervention to increase the adherence to the Mediterranean diet among recovered depression patients'.

BACKGROUND: There is substantial evidence supporting that remote interventions are useful to change dietary habits. However, the effect of a remote intervention based on Mediterranean diet (MD) in depressive patients has been less explored. OBJECTIVE: This study aims to assess the effectiveness of a remotely provided Mediterranean diet-based nutritional intervention in the context of a secondary prevention trial of depression. METHODS: The PREDIDEP study was a 2-year multicenter, randomized, single-blinded trial designed to assess the effect of the MD enriched with extra virgin olive oil (EVOO) on the prevention of depression recurrence. The intervention group received usual care for depressed patients and remote nutritional intervention every three months which included phone contacts and web-based interventions; and the control group, usual care. At baseline and at 1-year and 2-year follow-up, the 14-item MD Adherence Screener (MEDAS) questionnaire and a semiquantitative food frequency questionnaire (FFQ) were collected by a dietitian. Mixed effects linear models were used to assess changes in nutritional variables according to the group of intervention. The trial was registered at ClinicalTrials.gov NCT03081065. RESULTS: Compared with control group, the MD intervention group showed more adherence to MD (between-group difference: 2.76; 95% CI 2.13-3.39; p < 0.001); and a healthier diet pattern with a significant increase in the consumption of olive oil (p < 0.001), and a significant reduction in refined cereals (p = 0.031) after 2 years of intervention. CONCLUSIONS: The remote nutritional intervention increases adherence to the MD among recovered depression patients.Trial registration: ClinicalTrials.gov identifier: NCT03081065.

Treatments for Persistent Genital Arousal Disorder in Women: A Scoping Review.

BACKGROUND: Persistent genital arousal disorder (PGAD) is characterized by elevated discomfort associated with persistent genital arousal in the absence of sexual desire. AIM: To perform a scoping review of the proposed treatments for PGAD and their efficacy. METHODS: A scoping review was carried out (PRISMA-Scr) that included articles on PGAD as the main disorder, only in women, which explained, in detail, the treatment and its efficacy, was empirical, was written in English and Spanish. No prior filtering by years was performed. OUTCOMES: Three different effective treatments were found (Physical therapies, pharmacological therapies, and psychotherapeutics in combination with other therapies). RESULTS: Thirty-eight articles were selected. From physical therapies, treatments using neuromodulation, transcutaneous electrical stimulation, Botox, surgery, electroconvulsive therapy, manual therapy, pelvic floor therapy, dietary changes, and transcranial magnetic stimulation showed effectiveness. Using the pharmacological approach, paroxetine, duloxetine, pramipexole, ropinirole, and clonazepam treatments were effective. Psychotherapy treatments showed effectiveness only in combination with other types of treatments, specifically a combination of cognitive-behavioral strategies with pharmacological treatment. CLINICAL IMPLICATIONS: Pharmacological treatment, specifically SSRIs, have proven to be the therapy of choice for different subtypes of patients. STRENGTHS AND LIMITATIONS: This study analyzed treatment effectiveness with different approaches and took into consideration those articles where psychotherapy was used as a combination treatment with pharmacological and physical therapy. The main limitation is that it was focused exclusively on women, and the results cannot be generalized to include men. CONCLUSIONS: To date, a combination of pharmacological interventions with physical therapy and, in some occasions, with psychological therapy is main strategy followed to accomplish effective treatment of PGAD. Martín-Vivar M, Villena-Moya A, Mestre-Bach G, et al. Treatments for Persistent Genital Arousal Disorder in Women: A Scoping Review. J Sex Med 2022;19:961-974.

Associations between pornography exposure, body image and sexual body image: A systematic review.

There is evidence for associations between pornography exposure and sexual behaviors of adults and adolescents. Here, we review associations between pornography exposure and body image/sexual body image. Using a systematic search, we found 26 studies meeting inclusion criteria. Compelling evidence shows that frequency of pornography exposure is associated with negatively perceived body image and sexual body image; both heterosexual men and women appear to be affected. Due to scarcity of studies in adolescents and non-heterosexual samples, findings cannot be generalized to adolescents or individuals who identify as sexual minorities. Implications and future directions are discussed.

Pornography Use in Adolescents and Its Clinical Implications.

(1) Background: The Differential Susceptibility to Media Effects Model (DSMM) suggests that pornography use effects are conditional and they depend on dispositional, developmental, and social differential susceptibility variables. This framework also highlights that the differential susceptibility variables act as predictors of pornography use and as moderators of the effect of pornography on criterion variables. (2) Methods: By administering a survey to n = 1500 adolescents, we tested whether these assumptions were met. (3) Results: Pornography use was related to being male and older, having a bisexual or undefined sexual orientation, higher substance use, being non-Muslim, and reporting sexual interest and the use of the media to obtain sexual information. Structural Equation Modeling (SEM) showed that higher levels in the criterion variables were directly related to pornography use, older age, substance use, and being women. Some mediational links also emerged. Pornography use mediated between the age and criterion variables. Moreover, substance use mediated the association between age and gender with the criterion variables. (4) Conclusions: Our findings support the clinical applicability of the theoretical DSMM framework. Knowing adolescent pornography consumers' profiles and the impact of pornography on this population would allow for the designing of more effective prevention and regulation proposals.

Addictive phenomenon during the COVID-19 pandemic / El fenómeno adictivo durante la pandemia de COVID-19

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Factors Influencing Couples' Sexuality in the Puerperium: A Systematic Review.

INTRODUCTION: The puerperium is a period of adaptation in which various transformations take place in the lives of women and men on their way to becoming mothers and fathers. These changes can also have repercussions on their sexual relations. How the couple deals with this transition is crucial to the well-being of the couple and affects how parents relate to the baby. AIM: This study aimed to explore the factors that influence sexuality in both women and men during postpartum. METHODS: We conducted a bibliographic review of 236 articles found on the PubMed database and published from 2008 to January 2019. MAIN OUTCOME MEASURE: The main outcome measure was the impact of various physical, psychological, and sociocultural factors on couples' sexual functioning during postpartum. RESULTS: The main problems that couples face after childbirth can be classified as (i) psychological changes, such as loss of a sense of self, transitioning to parenthood, taking on the new roles of mother and father, and feelings of abandonment among men; (ii) body changes in women that affect their self-image and perineal trauma; (iii) hormonal changes in women and men that can lead to reduced sexual desire in both and vaginal dryness or dyspareunia in women; (iv) changes in the marital relationship, including changes in each other's roles, taking time for intimacy, and initiating sexual intercourse; (v) sociocultural influences, such as social support, culturally expected roles, and beliefs regarding when to resume sex; and (vi) lifestyle changes, especially with regard to baby care. CONCLUSION: Sexuality during postpartum is influenced by multiple factors: physical, psychological, and sociocultural. Our findings offer a deeper understanding of how the transition to parenthood affects sexual relationships during the postpartum period. Implications regarding caring for and promoting the sexual health of individuals and couples after childbirth are discussed, and some medical recommendations for parents are offered. Serrano Drozdowskyj E, Gimeno Castro E, Trigo López E, et al. Factors Influencing Couples' Sexuality in the Puerperium: A Systematic Review. Sex Med Rev 2020;8:38-47.

Diagnóstico y prevalencia de trastornos de la personalidad en atención ambulatoria. Estudio descriptive / The diagnosis and prevalence of personality disorders in outpatient services. A descriptive study

Introducción: los trastornos de personalidad (TP) son difíciles de diagnosticar. La literatura científica informa de su elevada prevalencia en muestras clínicas, pero en la práctica clínica diaria su diagnóstico es muy poco frecuente. Objetivos: Este estudio pretende estimar la prevalencia de TP en una Unidad ambulatoria de Salud Mental (USM), en situación real, para primeras citas. Método: Se aplicó el Cuestionario Salamanca (CS) como instrumento de cribado y, con los puntos de corte mínimo (2/3) y máximo (5/6), se comparó con el diagnóstico clínico realizado por un psicólogo clínico o psiquiatra, sin conocer el resultado del cribado con CS. Resultados: El diagnóstico de TP realizado por un profesional fue de un 7%, frente al 100% de positivos obtenido por el CS en el punto de corte mínimo y el 53% con el máximo: 11,8% para Cluster A, 19,8% Cluster B y 21,4% en el C. Conclusiones: La elevada prevalencia de TPs en los centros de salud mental, junto con el infradiagnóstico clínico, son otros factores que ensombrecen el pronóstico de estos pacientes (AU)

Introduction: Personality disorders (PD) are difficult to diagnose. Scientific literature shows a high prevalence in outpatient mental health services, but in daily practice the diagnosis of a PD is infrequent. Objectives: This study aims to calculate the prevalence of PD in outpatient mental health services in real clinic situation among patients who come for the first time. Method: Salamanca Questionnaire (SQ) was used as a screening method with the minimum score cut (2/3) and the maximum score cut (5/6). The results were compared with the clinical diagnose proposed by the psychiatrist or psychologyst, who did not know the result of SQ. Results: Only 7% of patients received PD diagnose although 100% of patients had pathological results with SQ using the lowest score proposed and 53% using the highest score proposed: 11,8% Clúster A, 19,8%, Clúster B and 21,4% Cluster C. Conclusions: The high prevalence of PD in outpatient mental health services and the low diagnosis rate are elements that worsen the prognosis of these patients (AU)