Emotional Distress and Pornography Use: A Meta-Analytic Structural Equation Modeling Approach

Pornography use has been extensively examined in relation to psychological well-being. In particular, a growing body of empirical research has investigated its associations with emotional distress, including symptoms of depression, anxiety, and stress. Several quantitative studies have reported positive associations between emotional distress and problematic pornography use (PPU), suggesting that individuals reporting higher levels of depression, anxiety, or stress also tend to report higher levels of excessive and problematic engagement (e.g., Borgogna et al., 2018; Grubbs et al., 2019). However, the magnitude and consistency of these associations vary considerably across studies. One important source of inconsistency in the literature concerns how pornography use is operationalized. Traditionally, frequency of pornography use (FPU) has often been used as an indicator of potentially problematic engagement. Nevertheless, accumulating evidence indicates that frequency of use and problematic pornography use represent related but conceptually distinct constructs (Bőthe et al., 2020). Empirical studies have shown that individuals may engage in pornography use frequently without experiencing subjective distress or functional impairment, whereas others may report significant negative consequences and loss of control despite comparable or lower frequency of use (Bőthe et al., 2020; Grubbs et al., 2019). Consequently, emotional distress may show differential associations with pornography use depending on whether use is conceptualized in terms of FPU or problematic involvement (as measured by scales specifically designed to assess symptoms of excessive and problematic engagement for screening or diagnostic purposes). Research in this area includes both clinical (e.g., treatment-seeking individuals or participants recruited from clinical settings) and non-clinical adult samples drawn from the general population or student samples (Kor et al., 2014; Lewczuk et al., 2017). These aspects may influence nature and/or intensity of the association between emotional distress and PPU, expecting higher effect sizes among clinical populations. Studies may also vary in gender composition, age range, cultural context, and the instruments used to assess emotional distress and pornography use, including the use of different validated scales to measure problematic pornography consumption (e.g., Bőthe et al., 2018: Kor et al., 2014). Such heterogeneity complicates the interpretation of individual findings and limits the ability to draw generalizable conclusions from the existing literature. Although narrative reviews and integrative models have discussed the relationship between pornography use and psychological distress (e.g., Wéry & Billieux, 2017; Grubbs et al., 2019), no meta-analysis to date has systematically synthesized the quantitative evidence on emotional distress and pornography use while explicitly distinguishing between frequency of use and problematic pornography use across diverse samples, as well as accounting for potential moderators such as gender or type of sample (clinical vs. community). As a result, the overall strength of these associations and the extent to which they vary across different operationalizations of pornography use remain unclear. The primary aim of the present meta-analysis is to quantitatively synthesize the available empirical evidence on the association between emotional distress and pornography use. Specifically, this meta-analysis will estimate pooled effect sizes describing the associations between emotional distress and (a) frequency of pornography use and (b) problematic pornography use. In addition, between-study heterogeneity will be examined, and moderator analyses will be conducted to explore whether associations vary as a function of pornography use operationalization, type of emotional distress measure (e.g., depression, anxiety, stress), sample characteristics (clinical versus non-clinical samples), gender composition, and age. By providing a quantitative synthesis of the literature, this meta-analysis aims to clarify the consistency and variability of reported associations between emotional distress and pornography use, identify methodological sources of heterogeneity, and offer an integrative overview of the current state of evidence. As a secondary aim, beyond estimating pooled bivariate associations, the present study will apply Meta-Analytic Structural Equation Modeling (MASEM) to test a theoretically informed model in which emotional distress indicators (depression, anxiety, stress) are associated with pornography use outcomes, explicitly distinguishing between frequency of pornography use and problematic pornography use. This approach allows the simultaneous estimation of multiple relationships while accounting for the meta-analytic nature of the data and between-study heterogeneity.