This cross-sectional survey (N=1,126 U.S. college students; 77% women, 23% men) examined the frequency and co-occurrence of problematic pornography use (PPU), compulsive sexual behaviors (CSBs), alcohol use problems, and depression across gender, using validated screening tools (BPS, CSBD-19, AUDIT, PHQ-9).
PPU was far more common in men (45.5%) than women (6.7%); CSBs affected 7.8% of men vs. 3.9% of women. Alcohol use problems showed moderate-to-strong associations with CSBs overall (OR categorized as 'strong'), while depression was uniquely and moderately associated with PPU only in women. Among women with PPU, 56.9% also had depression vs. 25.9% of men with PPU. Co-occurring alcohol use problems and depression were strongly associated with CSBs in women.
- Cross-sectional design prevents causal or directional conclusions. - Self-report measures only; no structured clinical diagnostic interviews, which may lead to over- or underreporting. - Non-cisgender individuals were excluded (n=17), limiting generalizability to gender-diverse populations; undergraduate psychology subject pools introduce selection bias.
Screen women presenting with PPU or CSBs for depression, and screen both men and women with CSBs for alcohol use problems. In college health settings, consider assessing for moral incongruence and religiosity in men with high PPU rates before pathologizing the behavior.
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