[On-line pornography and minors. Diagnosis, challenges and proposals]. / Pornografía on-line y menores. Diagnóstico, desafíos y propuestas.

The consumption of pornography over the Internet by minors has been increasing exponentially in recent years. The use of digital technologies and the ease of access to these contents are causes that explain this event. Simultaneously, there is concern about the increase in sexual violence, associated with discriminatory behavior, despite the efforts of laws and programs that promote sexual reproductive health (SRH) and the principle of equality. From a bioethical point of view, it is urgent to address this issue, which affects the physical and psychological health of minors and their affective-sexual education. The study addresses whether it is possible to relate the consumption of online pornography by minors and sexual violence. To do this, legal sources, reports from associations, audiovisual councils and scientific studies are consulted. In all of them, the relationship between the consumption of online pornography by adolescents and risky behavior in emotional-sexual matters and gender inequality is evident. In the legal and fiscal sphere, it is alerted to the damage that is occurring and points out the need to propose lines of action that reverse this situation. We propose measures to technically regulate access to content. These measures are based on the precautionary principle, a tool that has been applied in fields such as health and the environment. More studies and political actions are needed to make the Internet a safe place for minors.

Adolescents' pornography viewing frequency and its relationship with condom attitudes.

Background This study examined adolescent pornography viewing and its' relationship with condom attitudes. Methods Data were from 457 adolescents aged 13-18years old who completed an online survey assessing pornography viewing frequency and condom attitudes. Results Many adolescents in our sample had viewed pornography in the past year (n =188, 41%), with pornography viewing frequency being higher among older adolescents (P =0.02), those who have had sex in the past year (P =0.001), and those who identified as White (P =0.01), LGB+ (P =0.05), and male (P =0.001). Adolescents who viewed pornography more frequently had more negative condom attitudes (r =-0.18, P Conclusions A substantial proportion of adolescents in our sample viewed pornography and those who view more frequently had more negative condom attitudes. Results indicate a need for experimental studies examining this relationship and interventions addressing pornography literacy among adolescents.

Women Reporting on Their Use of Pornography: A Qualitative Study Exploring Women's Perceived Precursors and Perceived Outcomes.

The aim of this study was to explore motivations women describe for using pornography. A qualitative online interview study was conducted with 30 women (Mean age 30.23, range 20-47; residing in the UK and in Greece; of varied sexual orientations and relationship status) about their pornography use, motivations for use, and preferences. Reflexive thematic analysis was used. Results were organized into four themes: Sexual Precursors, Non-sexual Precursors, Intended Outcomes, and Unintended Outcomes. The findings highlight that pornography use for women can have both positive and negative ramifications for women's sexual lives. Implications for clinical practice and education are discussed.

Pornography Use and the Acceptance of Gender Norm Violation in a School Context.

Although media effect studies have quite extensively investigated the association between pornography use and gendered attitudes, some questions remain. The present study aimed to address two of these questions by exploring how gendered attitudes and gender beliefs may be influenced by gender typicality and pornography use. First, the literature has not yet accounted for individual differences based on gender typicality. Second, the influence of pornography use on gender beliefs going beyond pornography's script application is understudied. This online cross-sectional study (N = 1,440, Mage = 23.86, SD = 4.79) contributes to the field by investigating the indirect association between pornography use and acceptance of gender norm violation through gendered attitudes and the moderating role of gender typicality. Acceptance of gender norm violation was measured via vignettes describing a school context in which a teacher and a student violated gender norms. Findings indicated that gendered attitudes negatively relate to the acceptance of gender norm violation. Moreover, compared to women, men's pornography use indirectly relates to lower acceptance rates through gendered attitudes. Additionally, for men, specific levels of gender typicality and atypicality form a strengthening and buffering role, respectively. This applies to the association between pornography use and gendered attitudes as well as to the indirect relationship of pornography use with acceptance of gender norm violation. These findings suggest that pornography use may also affect gender beliefs that are unrelated to the scripts present in pornography. Future studies should take into account the type of preferred pornography and unravel the specific impact of women's pornography use.

[Access to digital pornography by children and teenagers: when should you be alerted?] / Accès à la pornographie numérique par les enfants et adolescent-es : quand s'alerter ?

Pornography and, more broadly, the consumption of sexually explicit images are not new phenomena. However, the rise of new technologies has significantly facilitated access to this type of content, especially among young people. In what family context does the use of digital tools occur? What are the stakes of exposure in children and adolescents? What impacts on psychosexual development? What are the reasons for the difficulty in restricting this behaviour? Is there an addictive dimension? Health professionals and trusted adults have a role to play, both in preventing exposure to unsolicited and potentially shocking content, and in opening up a dialogue in the case of problematic situations for the child or adolescent.

La pornographie et, de manière plus générale, la consommation d'images à caractère sexuel ne sont pas des phénomènes nouveaux. Cependant, l'essor des nouvelles technologies a considérablement facilité l'accès à ce type de contenu, notamment chez les jeunes. Dans quel contexte familial s'inscrit l'utilisation des outils numériques ? Quels sont les enjeux d'une exposition chez les enfants et les adolescent-es ? Quels sont les impacts sur le développement psychosexuel ? Quelles sont les raisons de la difficulté à restreindre ce comportement ? Existe-t-il une dimension addictive ? Les professionnel-les de la santé et les adultes de référence ont un rôle à jouer à la fois pour prévenir l'exposition à des contenus non sollicités et potentiellement choquants, et pour ouvrir le dialogue en cas de situation problématique pour l'enfant ou l'adolescent-e.

Auditory Cues Alter the Magnitude and Valence of Subjective Sexual Arousal and Desire Induced by an Erotic Video.

Although women and men rate their subjective arousal similarly in response to "female-centric" erotic videos, women rate their subjective arousal lower than men in response to "male-centric" videos, which often end with the male's ejaculation. This study asked whether ratings of subjective sexual arousal and desire using the Sexual Arousal and Desire Inventory (SADI) would be altered if this ending was present or absent, and whether including or excluding the accompanying soundtrack would influence the magnitude and direction of the responses. A total of 119 cis-gendered heterosexual undergraduates (59 women and 60 men) viewed an 11-min sexually explicit heterosexual video that ended with a 15-s ejaculation scene. Two versions of the video were created, one with the ejaculatory ending (E+) and one without (E-). Participants were assigned randomly to view one of the two versions with (S+) or without (S-) the accompanying soundtrack, after which they completed the state version of the SADI. Women and men found both sequences without sound less arousing on the Evaluative, Motivational, and Physiological subscales of the SADI relative to the S+ sequences. However, on the Negative/Aversive subscale, women found the E + S- sequence more negative than did men, whereas this difference was not found with sound. Thus, women and men were sensitive to the auditory content of sexually explicit videos, and scenes of sexual intercourse ending with explicit ejaculation increased the Evaluative and Motivational properties of subjective sexual arousal and desire. However, this occurred in women only when the auditory cues signaled a clear and gratifying sexual interaction.

Problematic pornography use across countries, genders, and sexual orientations: Insights from the International Sex Survey and comparison of different assessment tools.

BACKGROUND AND AIMS: Problematic pornography use (PPU) is a common manifestation of the newly introduced Compulsive Sexual Behavior Disorder diagnosis in the 11th edition of the International Statistical Classification of Diseases and Related Health Problems. Although cultural, gender- and sexual orientation-related differences in sexual behaviors are well documented, there is a relative absence of data on PPU outside Western countries and among women as well as gender- and sexually-diverse individuals. We addressed these gaps by (a) validating the long and short versions of the Problematic Pornography Consumption Scale (PPCS and PPCS-6, respectively) and the Brief Pornography Screen (BPS) and (b) measuring PPU risk across diverse populations. METHODS: Using data from the pre-registered International Sex Survey [n = 82 243; mean age (Mage) = 32.4 years, standard deviation = 12.5], a study across 42 countries from five continents, we evaluated the psychometric properties (i.e. factor structure, measurement invariance, and reliability) of the PPCS, PPCS-6, and BPS and examined their associations with relevant correlates (e.g. treatment-seeking). We also compared PPU risk among diverse groups (e.g. three genders). RESULTS: The PPCS, PPCS-6, and BPS demonstrated excellent psychometric properties [for example, comparative fit index = 0.985, Tucker-Lewis Index = 0.981, root mean square error of approximation = 0.060 (90% confidence interval = 0.059-0.060)] in the confirmatory factor analysis, with all PPCS' inter-factor correlations positive and strong (rs = 0.72-0.96). A total of 3.2% of participants were at risk of experiencing PPU (PPU+) based on the PPCS, with significant country- and gender-based differences (e.g. men reported the highest levels of PPU). No sexual orientation-based differences were observed. Only 4-10% of individuals in the PPU+ group had ever sought treatment for PPU, while an additional 21-37% wanted to, but did not do so for specific reasons (e.g. unaffordability). CONCLUSIONS: This study validated three measures to assess the severity of problematic pornography use across languages, countries, genders, and sexual orientations in 26 languages: the Problematic Pornography Consumption Scale (PPCS, and PPCS-6, respectively), and the Brief Pornography Screen (BPS). The problematic pornography use risk is estimated to be 3.2-16.6% of the population of 42 countries, and varies among different groups (e.g. genders) and based on the measure used.

Pornography, sexual orientation and ambivalent sexism in young adults in Spain.

BACKGROUND: On line platforms offer access to an almost unlimited variety of pornographic material that shows high levels of sexism. Despite this fact, there are still few studies that assess the effect of pornography on sexism in young adults The aim of this study is to analyze the association of pornography consumption and sexual orientation with benevolent sexism (BS) and hostile sexism (HS) in young men and women. METHODS: We surveyed 2,346 people aged 18-35 years old. Multiple regression models were carried out for BS and HS. The independent variables: current pornography consumption and sexual orientation. Covariates: socio-demographic variables -age, sex, level of education and place of birth-. RESULTS: A) HS: Men who consumed pornography had higher median values of HS than those who did not [ß(95%CI):2.39(0.67;4.10)]. Homosexual/ bisexual men displayed lower values of HS than heterosexual men [ß(95%CI):-2.98(-4.52;-1.45)]. The increase in HS levels associated with pornography consumption was notably greater in homosexual and bisexual women relative to heterosexual women, where that pattern was not observed [ß(95%CI for interaction): 2.27(0.11; 4.43)]. B) BS: Mean values of BS were observed to be lower for both women [ß(95%CI):-2.16(-2.99;-1.32)] and men [ß(95%CI):-4.30(-5.75;-2.86)] who consumed pornography compared to those who did not. Homosexual/bisexual men recorded mean values of BS lower than heterosexual men [ß(95%CI):-3.10(-4.21;-1.99)]. CONCLUSIONS: Pornography consumption is related to sexism and differs according to sex and sexual orientation. As sexism is the substratum of inequality between men and women, it is urgent to launch affective-sexual education programs for young people that take into account the determinants of sexism.

Nonconsensual Sexting: Are the Moral Processes the Same If Boys or Girls Appear in the Forwarded Content?

Sexting is a form of intimate communication available in today's digital society consisting of exchanging erotic-sexual content online. However, doing it without the consent of the person appearing in the content is becoming a normalized form of cyberviolence among adolescents. To advance our understanding of this phenomenon, further research is needed on its facilitating factors, which may include those related to its potential moral dimension and online disinhibition. This study aims to analyze, according to gender and age, the relationship between nonconsensual forwarding of erotic-sexual content, differentiating between the type of content and the gender of the person appearing in it, moral disengagement, and toxic online disinhibition. A total of 1,611 adolescents (47.9 percent girls) aged 12-15 years (M = 13.4; SD = 1.0) participated in the study. Moral disengagement and toxic disinhibition have been shown to facilitate nonconsensual forwarding of erotic-sexual content, but their relevance varies depending on the type of content, and whether girls or boys appear in it. Facilitating factors for nonconsensual forwarding of content featuring boys include age, the diffusion of the consequences, and toxic online disinhibition. For girls, identifying with the male gender and cognitive restructuring were the main facilitators. These findings represent an original advance in the field of study by discriminating between the type of content forwarded and the gender of the person who appears in it. The differences found contribute toward explaining the processes that lead to making immoral decisions when sexting and help lay the foundations for designing psychoeducational programs in the future.

Revisiting the Role of Pornography Use in the Confluence Model Theory of Sexual Aggression.

This research tested Confluence Model reasoning that pornography use should be related to sexual aggression among men who are high but not low in the predisposing risk factors of hostile masculinity (HM) and impersonal sexuality (IS). This hypothesis was examined with three online surveys of young adult males, including an American Mechanical Turk sample (N1 = 1,528, Mage = 22.46 years); a national sample of Canadian students (N2 = 1,049, Mage = 20.89 years); and a national sample of Canadian non-students (N3 = 905, Mage = 21.66 years). As expected, synergistic interactions between HM and IS reliably predicted self-reported sexual aggression across samples. Results with respect to interactions with pornography use were more complex. The Confluence Model hypothesis was supported when pornography use was operationalized as the use of nine specific magazines but it was not supported when pornography use was operationalized with a contemporary inclusive approach that included use of internet materials. These discrepant findings are difficult to account for with Confluence Model theorizing and highlight the non-equivalence of pornography use measures in survey research.

Taking Another Look at the Pornography Problems Due to Moral Incongruence Model: Does Gender Play a Role?

The pornography problems due to moral incongruence (PPMI) model is a premier framework for understanding problematic pornography use (PPU). However, past studies have generally examined men or entered gender as a covariate in primary analyses. Such approaches mask between-gender differences. Additionally, dysregulation constructs are also thought to be relevant to PPU, yet it is unclear the degree to which they incrementally predict PPU beyond moral incongruence constructs in non-pathological populations. We addressed these gaps by gathering a large sample of college students (n = 295 men, n = 838 women). Analyses with pornography users (n = 251 men, n = 407 women) were consistent with the PPMI model, adjusted for pornography use frequency. Findings did not change when dysregulation constructs of impulsivity and emotional resilience were added to the model. No paths significantly differed between genders. Altogether, among college student pornography users, religiosity was strongly positively correlated with moral disapproval (ß = .65 men, ß = .62 women), moral disapproval was moderately positively correlated with PPU (ß = .41 men, ß = .29 women), religiosity was initially moderately positively correlated with PPU (r = .21 men, r = .22 women), but became non-significant in the full model (ß = - .21 men, ß = - .04 women), and indirect effects of religiosity to PPU through moral disapproval were significant (indirect ß = .27 men, ß = .18 women). None of the dysregulation constructs significantly predicted PPU. The full model accounted for 23-22% of the PPU variance in men and women, respectively. Implications, future directions, and limitations are discussed.

Understanding Perceived Problematic Pornography Use with the Differential Susceptibility to Media Effects Model.

Problematic pornography use and its adverse consequences are prevalent, but little is known about its psychosocial contributors. Drawing on the Differential Susceptibility to Media Effects Model (DSMM), this study explores whether and how perceived problematic Internet pornography use is associated with psychological factors from three domains: social (i.e., family adaptability), dispositional (i.e., self-acceptance), and development factors (i.e., impulse control difficulties). Analysis of an anonymous survey of 1,483 Chinese emerging adults showed that family adaptability and self-acceptance were negatively correlated with perceived problematic pornography use, whereas impulse control difficulties were positively correlated with perceived problematic pornography use. Self-acceptance mediated the association between family adaptability and perceived problematic pornography use. Impulse control difficulties moderated such mediation effect, in which the protective effect of family adaptability on self-acceptance and that of self-acceptance on perceived problematic pornography use were attenuated by impulse control difficulties. These findings advance understanding of the complex underlying psychosocial mechanisms of perceived problematic pornography use by providing evidence to the applicability of DSMM on such problematic use and clarifying the direct, indirect, and/or moderating role(s) of family adaptability, self-acceptance, and impulse control difficulties in those mechanisms. They also provide insights for targeted approaches in future intervention programs among emerging adults.

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.

Pornography and Sociosexual Attitudes and Behaviors in a Nationally Representative Survey: Potential Pandemic and Method Effects.

Due to the COVID-19 pandemic, The General Social Survey (GSS) switched from an in-person interview to a self-administered online survey for its most recent data collection. This modality switch makes it possible to compare sociosexual data gathered using the GSS's last in-person survey (2018) to its first-ever self-administered online survey (2021), an oft suggested format for reducing social desirability bias. This study compared sociosexual data collected in the 2018 GSS to the 2021 GSS, with a primary focus on pornography use. Results suggested that among men neither the direction nor the magnitude of the association between pornography use and more nontraditional sociosexual attitudes and behaviors are affected by whether surveys are conducted in-person or online; that among women the magnitude of the positive association between pornography use and certain nontraditional sexual behaviors could be attenuated by in-person interviews; a pandemic period increase in pornography use among both men and women; a pandemic period decrease in men's nonrelational sexual behavior; and that men's and women's reporting of certain nontraditional sexual attitudes may be reduced by in-person interviews. It is important to emphasize that alternative explanations for 2018-2021 change are possible. The goal of the present study was to promote interpretive dialogue rather than definitive answers.

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.

Fantasy Made Flesh - A Network Analysis of the Reciprocal Relationship between Sexual Fantasies, Pornography Usage, and Sexual Behavior.

Based on different theories in media research (3AM, catalyst model of violent crime, reinforcing spirals model), we further explore the relationship between pornography use, sexual fantasy, and behavior. We suggest that pornography use appears so persistent across time and culture because it is related to a human universal, the ability to fantasize. Consequently, pornography use seems to be an opportunity to acquire media-mediated sexual fantasies, and we believe that pornography use interacts with sexual fantasies and, to a much weaker extent, with sexual behavior. To assess our assumptions, we conducted a network analysis with a large and diverse sample of N = 1338 hetero- and bisexual participants from Germany. Analyses were done separately for men and women. Our network analysis clustered parts of the psychological processes around the interaction of sexual fantasies, pornography use, and behavior into communities of especially strong interacting items. We detected meaningful communities (orgasm-centered intercourse, BDSM) consisting of sexual fantasies and behavior, with some containing pornography. However, pornography use was not part of communities we perceive to account for mainstream/everyday sexuality. Instead, our results show that non-mainstream behavior (e.g., BDSM) is affected by pornography use. Our study highlights the interaction between sexual fantasies, sexual behavior, and (parts of) pornography use. It advocates for a more interactionist view of human sexuality and media use.

Victims of Technology-Assisted Child Sexual Abuse: A Scoping Review.

Over the past two decades, technology-assisted child sexual abuse (TA-CSA) has become the focus of attention in politics, legislation, society, as well as research. However, the majority of literature and studies focus primarily on the offenders. This scoping review therefore aims to illustrate how victims of TA-CSA are represented in studies as primary participants. The databases Embase, PsychInfo, PSYNDEX, Cochrane Library, and Web of Science as well as reference lists were searched. Studies needed to be published between 2007 and 2021 and obtain data directly from and about victims to be included in this review. A total of 570 articles were identified from which 20 studies met inclusion criteria. The analysis showed that data can be obtained via different samples like adult and minor victims or other data such as legal documents or sexualized images. The studies researched different types of TA-CSA including exposure to pornographic material, online grooming leading to both online and offline sexual abuse, sexting and sexualized images, and the visual depiction of sexually explicit content. Consequences due to the abuse were of an emotional and psychological nature, medical or physical or impacted relationships, and the social environment. Even though the impact of the abuse on the victims appeared to be similar between different types of TA-CSA, much remains unknown. In order to gain further and more detailed insight into victims of TA-CSA, a universally accepted definition of TA-CSA as well as its different types and their distinctions needs to be established.

The paradox of pornography - sexuality and problematic pornography use.

The experiences of sexual minority men who report self-perceived problematic pornography use is under theorised and not well understood despite controversial and conflicting research into the phenomena in heterosexual male populations. This study aimed to widen the conversation to consider the experience of sexuality in relation to self-perceived problematic pornography use, rather than contribute to literature that debates the definition and aetiology of problematic pornography use. Semi-structured online qualitative interviews were conducted with three sexual minority men who self-reported problematic pornography use. Interpretive phenomenological analysis was used to develop themes. Five themes pertinent to understanding the participants' experiences with problematic pornography use were developed: problematised sexuality, pornography as liberator, pornography as corrupter, reform, and relapse and restore. The themes highlight three men's relationship with their sexuality as a feature of their self-perceived problematic pornography use. The research suggests that idiographic experiences of self-perceived problematic pornography use are influenced and maintained by an incongruent and conflicting relationship between an individual's own experiences of sexuality and self-perceptions of pornography use. Limitations and future research recommendations are discussed.

Neuropsychological Functioning in Sexual Offenders With and Without Pedophilic Disorder.

This study sought to examine neuropsychological functioning in men with pedophilic disorder (PD), in order to assess whether findings from prior neuropsychological studies are replicated in a diverse sample including men with non-contact sexual offenses. It was hypothesized that when non-contact offenders are included in the study, a slowed processing speed will emerge as the only finding unique to men with PD. A comprehensive neuropsychological battery was administered to 58 men convicted of a sexual offense, 20 of whom were classified as having PD. The sample included men with contact sexual offenses (n = 33), non-contact sexual offenses (n = 5), and child sexual abuse material (CSAM) offenses (n = 20). Test performance was compared by PD status. Participants with PD performed significantly better on verbal memory and visual discrimination than those without PD. Men with PD made more errors on a set-shifting task but no significant differences were seen in domains of attention, intellectual functioning, visual learning and memory, visuospatial ability, or language ability. Effect sizes were generally small, although some medium effects were seen (visual discrimination and verbal learning and memory). Scores in both groups (with and without PD) were generally in the average range across tasks. Within the subgroup of CSAM offenders, minimal differences emerged between those with and without PD, although those with PD were slower on visuomotor set-shifting but made fewer errors (d = - 0.89). CSAM offenders with PD were in the high average range on many tasks of intellectual functioning; however, a potential trend was identified such that CSAM offenders without PD had lower scores on a task of verbal learning and memory, with medium effect sizes observed. As few differences in neuropsychological functioning emerged when comparing offenders with and without PD, differences demonstrated in prior research may be better attributed to contact offending status rather than sexual interest.

Withdrawal-like Symptoms in Problematic Pornography Use: A Scoping Review.

OBJECTIVES: There is still debate whether problematic pornography use (PPU) can be understood as an addictive disorder, and little is known about withdrawal-like symptoms in these patients. Therefore, our aim was to summarize the existing scientific literature about this topic in the format of a scoping review. METHODS: Potentially eligible references were retrieved from 6 databases (MEDLINE/PubMed, Web of Science, Embase, PsycINFO, LILACS, and SciELO) up to February 7, 2023. Studies were included if they reported original data about withdrawal-like symptoms in individuals with PPU. Studies investigating child pornography use, or in which it was not possible to extract data of interest were excluded. Data extracted from included studies and their quality assessment were described narratively. RESULTS: A total of 937 references were retrieved, and 14 studies were included (n = 31,009 participants). According to our results, cravings were intense in most cases and frequent reasons for relapse. The proportion of participants experiencing other withdrawal-like symptoms (mental, sexual, and physical symptoms) reached up to 72.2% in the cross-sectional studies with this information available. Severity of withdrawal symptoms was associated with severity of PPU and frequency of pornography use. In some studies, measures of withdrawal symptoms were considered central symptoms of PPU and were significantly higher in individuals considering treatment. Masturbation was reported to alleviate withdrawal-like symptoms in some cases. CONCLUSIONS: There is preliminary evidence for the existence of withdrawal-like symptoms in PPU. Future studies should investigate onset, characteristics, duration, and proportion of withdrawal-like symptoms in PPU with robust methodology, also investigating potential confounding variables.