Problematic Pornography Use Among Swedish Adolescents: Characteristics and Clinical Implications

Abstract Problematic pornography use (PPU) is the most common manifestation of compulsive sexual behavior disorder (CSBD). Many adults seeking help for CSBD report onset during adolescence, yet there is limited knowledge of PPU in adolescents and its predisposing factors. This study investigated the prevalence of self-perceived PPU among Swedish adolescents and explored associated factors as well as pornography use patterns. In this cross-sectional study, data were collected from a representative sample of 3106 Swedish third-year senior high school students. Information on sociodemographic background, pornography use, sexual behaviors, health, and experiences of abuse was collected. PPU was based on self-reported difficulties in refraining from or stopping pornography use. Gender-stratified descriptive statistics and logistic regression analyses were used to examine relationships between groups and variables. PPU was reported by 10.4% of respondents, with a higher prevalence among boys (18.8%) compared to girls (3.9%). It was associated with increased time spent on pornography and higher exposure to violent or other concerning sexual content. Compared to the reference group, adolescents with PPU exhibited higher rates of abusive experiences, mental health issues, risky behaviors, and nonsuicidal self-injury. Gender-specific patterns emerged. PPU is a significant issue among Swedish adolescents, particularly boys. Addressing concerns related to pornography use, underlying vulnerabilities and gender-specific factors is crucial to prevent the progression of PPU into adulthood and in treatment efforts.