Abstinence from compulsive sexual behavior and problematic pornography use: phenomenological experiences and short-term effects

Fernandez, D.P. ORCID: 0000-0001-7645-9959, 2022. Abstinence from compulsive sexual behavior and problematic pornography use: phenomenological experiences and short-term effects. PhD, Nottingham Trent University.

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The investigation of abstinence from compulsive sexual behavior (CSB) and problematic pornography use (PPU) is important for filling gaps in current knowledge about their assessment and intervention. These gaps include: (i) abstinence-based interventions for CSB and PPU being common yet little understood, and (ii) uncertainty about whether withdrawal-related symptomatology manifest when regular pornography users with varying levels of self-reported PPU attempt to abstain from pornography.

The first part of the present thesis comprised two systematic reviews that were conducted to review the state of the evidence in the following two areas: the theoretical conceptualization and psychometric assessment of PPU (Systematic Review 1) and short-term abstinence effects across multiple potential behavioral addictions (Systematic Review 2). Findings of Systematic Review 1 indicated a lack of consensus in the field about the theoretical conceptualization and operationalization of CSB and PPU and highlighted a need for further empirical research into less agreed-upon components of addiction (e.g., withdrawal). Findings of Systematic Review 2 showed that negative abstinence effects (potentially reflective of withdrawal-related symptoms) and/or positive abstinence effects (potentially reflective of benefits of abstinence as an intervention) manifested to varying extents across six potential behavioral addictions (exercise, gambling, gaming, mobile phone use, pornography use and social media use). Importantly, the review highlighted that no prospective study had examined the effects of short-term abstinence from pornography specifically on the manifestation of withdrawal-related symptoms.

The second part of the present thesis comprised three empirical studies that contributed to filling the aforementioned gaps in the literature by achieving two aims. First, qualitative analyses of phenomenological experiences of abstinence-based recovery were conducted on abstinence journals of members of a pornography 'rebooting' forum (Empirical Study 1; N = 104) and in-depth semi-structured interviews with members of a 12-step group for CSB (Empirical Study 2; N = 14). Descriptions and sense-making of abstinence-based recovery experiences across both communities revealed commonalities (e.g., the importance of lifestyle changes and social support from the group in achieving successful abstinence), but also notable dissimilarities (e.g., nuances in etiological conceptualization of the problematic behavior leading to differences in sense-making about the meaning of abstinence). Second, a randomized controlled design was used to examine whether there were any effects of a seven-day pornography abstinence period on withdrawal-related symptoms (and whether abstinence effects were moderated by self-reported PPU) in a sample of regular pornography users (Empirical Study 3; N = 176). Contrary to confirmatory hypotheses, no evidence of abstinence effects on withdrawal-related symptoms was found, and this was not dependent on level of PPU (but with the caveat that the sample was 64.2% female and had relatively low levels of PPU). However, because exploratory analyses found an abstinence effect on craving when PPU was high and past four-week frequency of pornography use (FPU) crossed the threshold of daily use, the possibility that withdrawal-related symptoms may manifest only at high levels of FPU and PPU needs to be investigated in future prospective studies. Overall, the present thesis provides novel insights into abstinence-based interventions for CSB and PPU and contributes to current theorizing about whether withdrawal-related symptomatology manifests in relation to PPU.

Item Type: Thesis
Creators: Fernandez, D.P.
Date: September 2022
Rights: This work is the intellectual property of the author. You may copy up to 5% of this work for private study, or personal, non‐commercial research. Any re‐use of the information contained within this document should be fully referenced, quoting the author, title, university, degree level and pagination. Queries or requests for any other use, or if a more substantial copy is required, should be directed in the owner(s) of the Intellectual Property Rights.
Divisions: Schools > School of Social Sciences
Record created by: Linda Sullivan
Date Added: 21 Jun 2023 08:44
Last Modified: 21 Jun 2023 08:44
URI: https://irep.ntu.ac.uk/id/eprint/49234

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