The Role of Impaired Control in Screening Problematic Pornography Use: Evidence From Cross-Sectional and Longitudinal Studies in a Large Help-Seeking Male Sample

In help- or treatment-seeking people, there may be a portion of individuals with self-perceived addiction; however, how to distinguish these individuals from help-seeking patients with dysregulated pornography use remains unclear. The present study sought to examine the specific role of impaired control in identifying individuals with self-perceived problems when screening problematic pornography use (PPU) in a large help-seeking male sample (N = 8,845; M (age) = 25.82 years, SD = 7.83). Based on the results of latent profile analysis, three groups were identified in the help-seeking sample: Self-perceived PPU group (n = 2,089; 23.6%), impaired control group (n = 4,180; 47.3%), and PPU group (n = 2,576; 29.1%). The self-perceived PPU group was characterized by the highest moral incongruence, but not objectively dysregulated in pornography use. The other two groups met the criteria of impaired control, suggesting that, impaired control may distinguish between self-perceived PPU and dysregulated use in help-seeking men. Six months later, self-reported data were collected again from 972 of these help-seeking men. The longitudinal cross-lagged analysis showed that impaired control at baseline positively predicted PPU at the 6-month follow-up; simultaneously, the reverse association was also significant and positive. In sum, impaired control functioned as a criterion to differentiate between self-perceived PPU and dysregulated pornography use. Impaired control might be used as a robust and reliable predictor of PPU, but it may not be a sufficient criterion of PPU in itself. Public Health Significance Statement Impaired control is a reliable feature when screening for problematic pornography use (PPU). Impaired control is a robust predictor of PPU over time. Impaired control may distinguish between individuals with self-perceived PPU and dysregulated PPU in help-seeking samples.