ArticleJournal of behavioral addictions2022
Withdrawal and tolerance as related to compulsive sexual behavior disorder and problematic pornography use - Preregistered study based on a nationally representative sample in Poland.
Article in Journal of behavioral addictions, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
19 citing papers in PubMed, 2 syntheses or guidelines pooled it, 54 citations in OpenAlex.
- Psychotherapy for problematic pornography use: A comprehensive meta-analysis.Journal of behavioral addictions · 2025Pooled it
- Treatment Approaches for Problematic Pornography Use: A Systematic Review.Archives of sexual behavior · 2024Pooled it
- Reducing problematic pornography use with imaginal retraining-A randomized controlled trial.Journal of behavioral addictions · 2024Trial
- Crossing the Line: Factors Associated With Escalating Pornography Use.Journal of interpersonal violence · 2026Article
- Compulsive sexual behavior disorder (CSBD) and problematic pornography use (PPU): A comprehensive, interdisciplinary, and expert-informed narrative review with suggested future directions.Journal of behavioral addictions · 2026Review
- Sexual and Clinical Profile in Spanish-Speaking Individuals with Problematic Engagement in Online Sexual Activities: Comparison Between Subclinical and Clinical Groups.Archives of sexual behavior · 2026Article
- Problematic Pornography Use and Psychological Distress in the USA: A Nationally Representative Study.Archives of sexual behavior · 2026Article
- Global research status and trends of compulsive sexual behavior disorder: A comprehensive bibliometric analysis.Journal of behavioral addictions · 2025Review
- Prevalence of first- and second-wave digisexualities in Germany and their relation to Compulsive Sexual Behavior: Findings from a National Online Survey.Journal of behavioral addictions · 2025Article
- Profiles of problematic pornography use and religiosity-based moral incongruence using latent profile analysis: A two-sample study.Journal of behavioral addictions · 2025Article
- The Sacred, the Sinful, and the Shamed: The Association Between Compulsive Sexual Behavior, Moral Disapproval, and Sexual Shame Among Jewish Religious Adolescents.International journal of sexual health : official journal of the World Association for Sexual Health · 2025Article
- The Associations of Pornography Use and Body Image Among Heterosexual and Sexual Minority Men.Archives of sexual behavior · 2024Article
- The Associations Between Attachment Insecurity and Compulsive Sexual Behavior Disorder or Problematic Pornography Use: The Mediating Role of Emotion Regulation Difficulties.Archives of sexual behavior · 2024Article
- Assessment and treatment of compulsive sexual behavior disorder: a sexual medicine perspective.Sexual medicine reviews · 2024Review
- How much online pornography is too much? A comparison of two theoretically distinct assessment scales.Archives of public health = Archives belges de sante publique · 2024Article
- Investigating mood-modification, withdrawal, and sensitization in compulsive sexual behaviour.Frontiers in psychiatry · 2024Article
- Should problematic sexual behavior be viewed under the scope of addiction? A systematic review based on DSM-5 substance use disorder criteria.Addictive behaviors reports · 2023Review
- Compulsive sexual behavior disorder in 42 countries: Insights from the International Sex Survey and introduction of standardized assessment tools.Journal of behavioral addictions · 2023Article
- The Relation of Sexual Attitudes to Hypersexuality and Problematic Pornography Use.Archives of sexual behavior · 2023Article
Corrections and comments
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Authors and funding
6 authors at 5 institutions in 2 countries.
Funding
Abstract
Background: The addiction model of compulsive sexual behavior disorder (CSBD) and problematic pornography use (PPU) predicts the presence of withdrawal symptoms and increased tolerance for sexual stimuli in the disorder phenotype. However, clear empirical evidence supporting this claim has largely been lacking. Methods: In the preregistered, nationally representative survey (n = 1,541, 51.2% women, age: M = 42.99, SD = 14.38), we investigated the role of self-reported withdrawal symptoms and tolerance with respect to CSBD and PPU severity. Results: Both withdrawal and tolerance were significantly associated with the severities of CSBD (β = 0.34; P < 0.001 and β = 0.38; P < 0.001, respectively) and PPU (β = 0.24; P < 0.001 and β = 0.27; P < 0.001, respectively). Of the 21 withdrawal symptom types investigated, the most often reported symptoms were frequent sexual thoughts that were difficult to stop (for participants with CSBD: 65.2% and with PPU: 43.3%), increased overall arousal (37.9%; 29.2%), difficult to control level of sexual desire (57.6%; 31.0%), irritability (37.9%; 25.4%), frequent mood changes (33.3%; 22.6%), and sleep problems (36.4%; 24.5%). Conclusions: Changes related to mood and general arousal noted in the current study were similar to the cluster of symptoms in a withdrawal syndrome proposed for gambling disorder and internet gaming disorder in DSM-5. The study provides preliminary evidence on an understudied topic, and present findings can have significant implications for understanding the etiology and classification of CSBD and PPU. Simultaneously, drawing conclusions about clinical importance, diagnostic utility and detailed characteristics of withdrawal symptoms and tolerance as a part of CSBD and PPU, as well as other behavioral addictions, requires further research efforts.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.