Accepted Manuscript

The Relationship between Frequent Pornography Consumption, Behaviors, and

Sexual Preoccupancy among Male Adolescents in Sweden

Meghan Donevan, Magdalena Mattebo

PII: S1877-5756(16)30101-X
DOI: http://dx.doi.org/10.1016/j.srhc.2017.03.002
Reference: SRHC 291

To appear in: Sexual & Reproductive Healthcare

Received Date: 6 September 2016

Revised Date: 31 January 2017
Accepted Date: 8 March 2017

Please cite this article as: M. Donevan, M. Mattebo, The Relationship between Frequent Pornography Consumption,
Behaviors, and Sexual Preoccupancy among Male Adolescents in Sweden, Sexual & Reproductive Healthcare
(2017), doi: http://dx.doi.org/10.1016/j.srhc.2017.03.002

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 The Relationship between Frequent Pornography Consumption, Behaviors, and Sexual
Preoccupancy among Male Adolescents in Sweden

Meghan Donevan1, Magdalena Mattebo 1,2

1
Uppsala University, Department of Women’s and Children’s Health Akademiska sjukhuset SE 751
85 Uppsala Sweden
2
Mälardalen University, School of Health, Care and Social welfare, Box 883, SE 721 23 Västerås
Sweden

Corresponding author:
Magdalena Mattebo
Ph.D.
E-mail. magdalena.mattebo@kbh.uu.se
Tel. +46 (0)73-673 13 75
Fax. +46 (0)21-173733

1
Introduction

Pornography has transformed young people’s sexual landscape. Compared to pornography

consumed prior to the Internet, online pornography is accessible, affordable, anonymous, and, by

and large, acceptable.1 Accessed on any kind of internet-enabled device, pornography has become a

primary source of sexual education for young people. 2 Research in Sweden reveals that nearly all

adolescent boys (96%) have viewed pornography by the time they reach 16, and the average age

they began to actively search for pornography is approximately 12 years old. 3,4 Similar trends have

also been found in other countries. 5-8

For several decades, researchers have attempted to disentangle the effects of pornography.

One area of research has looked at the relationship between exposure to pornography and risky

sexual behaviours, defined as sexual behaviours that pose an increased risk of a negative outcome

within a sexual interaction. 9 Such risks may include an increased chance of contracting sexually

transmitted infections (STIs), unintended pregnancies or the psychological and physical

consequences of sexual violence. Several studies involving adolescents reveal an association

between pornography consumption and risky sexual behaviours like engaging in vaginal intercourse

and oral sex at earlier ages ("sexual debut"), 4,10-13 anal sex,4,14,15 and sex with multiple partners. 13,16

Furthermore, a recent meta-analysis provides robust evidence that increased pornography

consumption is associated with verbal and physical sexual aggression, to the extent that

pornography’s contents appear to instil “attitudes conducive to sexual aggression.” 17 (p19)

If attitudinal and behavioural shifts appear to coincide with higher frequency of

pornography consumption, then speculations about pornography's addictive potential become all the

more concerning. Adolescents possess a natural sexual curiosity, so greater interest in sexuality

does not necessarily imply compulsive and addictive behaviour. Nevertheless, Peter and

Valkenburg18 show that exposure to pornography can lead to sexual preoccupancy, defined as a

2
“strong cognitive engagement in sexual issues, sometimes at the exclusion of other thoughts.” 15(p208)

The authors argue that pornography exposure can catapult adolescents’ interest in sex beyond their

natural sexual curiosity. In addition, neuroscientists have begun to map the effects of pornography

on a viewer’s brain.19-21 A recent thorough review by Love et al. 21 concludes that compulsive

internet pornography consumption should indeed become an official diagnosis in the addiction

framework, sharing similar basic mechanisms with substance addiction. Moreover, the overall

literature asserts that adolescents are “at a higher risk for developing problematic pornography use

if exposed to sexually explicit content during teenage development years.” 2(p114)

Theory

A particularly relevant theoretical framework for the present research is Wright’s 22,23

acquisition, activation, and application model (3AM) of mediated socialization. This model is based

on sexual scripting theory, which predicts that by consuming pornography, individuals acquire new

sexual scripts they were unaware of. 24 They are further encouraged to apply these scripts in real life,

since behaviours are portrayed as normal, acceptable, and rewarding. The model therefore suggests

that pornography becomes a template for how consumers should behave sexually, with consumers

using “[pornographic] sexual scripts to navigate real-world sexual experiences and guide sexual

expectations.”24(p4) Furthermore, it predicts that “on average, males who view more pornography

will … engage in different sexual behaviours than males who view less pornography.” 25(p7)

A content analysis of the 250 best-selling and most-rented pornography films in the US

offers an indication of the type of pornographic sexual scripts consumers are likely to adopt. 26 Of

the 304 scenes analysed, only one (0.3%) contained any discussion about pregnancy or STI risks

and less than 11% of the scenes showed explicit condom usage, even though 56% of the scenes

contained anal sex.23 Furthermore, physical aggression and verbal aggression were present in 88%

3
and 49% of the scenes respectively, while only 10% of the scenes contained any positive behaviour

such as compliments, caressing, and kissing. Given these content findings, the 3AM predicts that

frequent pornography users are more likely to engage in riskier sexual behaviours.

Hypothesis

The aim of this study was to investigate the relationship between frequent pornography

consumption, sexual behaviours, and sexual preoccupancy among adolescent 18-year-old Swedish

boys. Based on the above theoretical framework and in light of previous research, we hypothesized

that frequent users of pornography would report greater engagement in risky sexual behaviours and

show higher signals of sexual preoccupancy and compulsive pornography consumption compared

to average and infrequent users.

Methods

Population and sample

Data collection was completed among 18-year-old, third-year high school students in a medium

and large sized Swedish town in 2013. The total population of third-year students in both towns

was 946 students (510 girls and 436 boys). A power analysis was calculated based on previously

reported psychosomatic symptoms, as defined by the World Health Organization, among

adolescents in the county where data collection was performed. 27 This sample size was determined

to be sufficient to detect differences in psychosomatic symptoms between frequent/non-frequent

users of pornography with a p-value of 0.05 and a power of 80%. At the time of data collection, 24

senior high schools with 115 classes were eligible. The power analysis resulted in a sample of 53

randomly selected classes in 13 senior high schools. During data collection, 730 (77%) of all

available third-year students in the selected classes were available (359 girls and 371 boys). This
4
paper reports findings from the participating boys.

Instrument

The survey consisted of 48 multiple-choice questions related to demographic and lifestyle

characteristics, physical and psychological health, experiences of and perceptions about sex, and

usage of pornography. Participants were able to rate self-reported questions from a scale, and a “not

relevant to me” response was available when they had no experience with the topic. Nearly all

questions used have been asked in previous research within Sweden (Spearman 0.90 and Kappa

0.86).3,4 In this study, we report findings from experiences of and perceptions about sex and usage

of pornography (Table 1). A pilot test, where the items used in this study were test/retested, was

performed in 2011 in a similar sample (n = 35) in another town. Correlation tests using Cohen’s

kappa (nominal data) and Spearman’s rank order correlation test (ordinal data) were used, and an

acceptable degree of correlation was found between the two tests (mean values of 0.81 and 0.61,

respectively).3

Measures

Pornography consumption

We asked the participants to respond to 13 statements about pornography consumption. All

statements are specified in Table 2. Those who reported daily consumption were categorized as

frequent consumers, those who reported weekly consumption average users and those reporting

more seldom infrequent users.

Sexual experiences

5
 We asked participants to respond to 11 items related to sexual experiences.

Four items (Have you received oral sex? Have you given oral sex? Have you had vaginal

intercourse? Have you had anal sex?) had the following response alternatives: no, yes. These

questions were followed up by asking the age at first experience.

Three items (Have you had sex with someone on your first date, a so-called one-night stand? Have

you had sex with a friend? Have you had group sex?) had the following response alternatives: no;

once; yes, between two and five times; yes, between six and 10 times; yes, more than 10 times.

Perceptions of sexuality

One item (How often do you think about sex?) had the following response alternatives: Almost

never, Rather seldom, neither seldom or often, Rather often, Almost all the time/all the time. One

item (If you compare with peers, do you think you are more or less interested in sex) had the

following response alternatives: A lot less, A little less, Neither less nor more, A little more, A lot

more.

Procedure

The first step was to obtain permission from the Director of the Senior High School Department

of the County Council. Subsequently, each principal was informed about the nature of the study and

contacted for permission via email or a telephone call. Two schools were added to replace two

schools that declined participation. A letter explaining the aim of the study was sent to every

teacher, followed by telephone calls when necessary. When the second author of this paper and two

experienced research assistants visited each class, they provided a description of the survey and

emphasized that participation was strictly voluntary. Those that refrained from participating were

6
able to leave the classroom or stay and read through the survey. Consent was acquired by

emphasizing that students could decline participation. One respondent declined participation. The

survey was completed in the classroom with separated desks to maintain privacy when respondents

filled in the form. In total, the survey took 25–30 minutes to complete. A research assistant

collected the questionnaires in a sealed envelope. Cards for the local youth clinic were handed out

to ensure students had access to counselling if needed. Finally, the data were anonymized before

being accessed by the research team.

Ethics

The Regional Ethical Review Board in Uppsala, Sweden approved the study (Dnr 2010/369).

Statistical analysis

All statistical analyses were performed in IBM Statistical Packages of Social Sciences, SPSS

20. For statistical tests, a p-value level of 0.05 or less was deemed to be statistically significant.

Three sub-samples were constructed, based on the reported frequency of pornography use: frequent,

average, and infrequent users. Frequent users were defined as participants who watched

pornography one or more times per day. Average users watched pornography at least once a month

up to several times a week, but less than once per day. Infrequent users watched pornography less

than once a month. Outcome variables included measures for pornography consumption, sexual

experiences, and perceptions of sexuality. To determine differences between frequent, average, and

infrequent users, chi-square (χ²) and Fisher’s Exact test statistics were applied to contingency tables

for nominal outcome variables while interval outcome variables were tested using the one-way

analysis of variance test.

7
RESULTS

Results are reported in the following order: frequent users, average users, and infrequent users

of pornography.

Pornography consumption

Nearly all respondents (98%, n = 361) had watched pornography, although to different extents.

Eleven percent were found to be frequent users (n = 42), 69 percent average users (n = 256), and 20

percent infrequent users (n = 72). When they watched pornography, the majority took the initiative

to watch it (89%, n = 332) and watched it alone (90%, n = 336). Among frequent users, the most

common type of pornography consumed was hard core pornography (71%, n = 30) followed by

lesbian pornography (64%, n = 27), while soft core pornography was the most commonly selected

genre for average (73%, n = 186) and infrequent users (36%, n = 26). There was also a difference

between the groups in the proportion who watched hard core pornography (71%, n = 30; 48%, n =

122; 10%, n = 7; p < 0.001) and violent pornography (14%, n = 6; 9%, n = 26; 0%, n = 0; p =

0.011).

Sexual behaviours

The sexual behaviours reported by the respondents are shown in Table 3. Frequent users were

more likely to have participated in a wider range of sexual activities, such as giving oral sex (76%,

n = 31; 61%, n = 156; 49%, n = 34; p = 0.017) and receiving oral sex (76%, n = 32; 66%, n = 165;

53%, n = 37; p = 0.032). Table 4 shows that there was also a significant difference for whether or

not a participant had participated in anal sex or not (29%, n = 12; 20%, n = 50; 10%, n =7; p =

0.039). Frequent users were also more likely to have tried sexual acts seen in pornographic films

(50%, n = 20; 39%, n = 100; 17%, n = 17; p < 0.001). These acts included: oral sex (33%, n = 14;

8
21%, n = 53; 3%, n = 2; p < 0.001), vaginal intercourse (45%, n = 19; 30%, n = 77; 8%, n = 6; p <

0.001), and anal sex (17%, n = 7; 10%, n = 26; 0%, n = 0; p = 0.005). Results for sexual debut are

presented in Table 4. Mean age of first oral sex received (F(2, 228) = 3.99), p = 0.020) and mean

age at first vaginal sex (F(2, 250) = 7.59, p = 0.001) differed significantly between frequent,

average and infrequent users. Post hoc comparisons using the Tukey HSD test indicate that the

mean age of first oral sex received (M = -0.38, SD = 0.31) and the mean age at first vaginal

intercourse (M = -0.36, SD = 0.29) for frequent users were significantly different from average

users but not from infrequent users.

Indicators of sexual preoccupancy and compulsivity

Several responses may be associated with sexual preoccupancy and compulsive pornography

consumption. Referring to Table 5, frequent users considered themselves more interested in both

sex (19%, n = 8; 8%, n = 17; 1%, n = 1; p = 0.002) and pornography (19%, n = 8; 4%, n = 10; 0%,

n = 0; p < 0.001) compared to peers. Frequent users were more likely to think about sex almost all

the time (53%, n = 21; 50%, n = 123; 25%, n = 18; p = 0.001), and much more likely to have

fantasies about trying sexual activities seen in pornography several times a week (44%, n = 18; 9%,

n = 23; 6%, n = 3; p < 0.001). A higher proportion of frequent users who had watched hard

pornography, stated more pornography consumption than wanted compared with peers (Table 6).

Only one respondent of all (n=1, average user) stated experience from having watched violent

pornography and stating more pornography consumption than wanted. It was equally uncommon

among frequent and average users to have experience of watching violent pornography and state

thinking about sex all the time (60%, n=3; 42%, n=10; p=0.520). However, a higher proportion

frequent users stated experience from having watched violent pornography and stating fantasies

9
about trying sexual activities seen in pornography several times a week (n=3, 50%; 25%, n=6,

p=0.012). No infrequent user stated experience from having watched violent pornography.

DISCUSSION

Our findings show that frequent users more often report behaviours associated with sexual risk

taking including earlier age at sexual debut, anal sex, and having tried acts seen in pornography.

Sexual debut is “important because it affects the duration of exposure to STIs”, 9(p1207) and evidence

suggests that individuals who have sex at younger ages may have riskier behaviour over a lifetime. 9

Although anal sex is not necessarily a risky behaviour if adequate protection is utilized, the higher

instance of anal sex found among frequent users of pornography is concerning when considering

the prevalence of unprotected sex presented in pornography. Based on the 3AM, if frequent users

are more likely to test out sexual acts seen in pornography, it is not far-fetched to presume that the

risky manner in which they have seen the acts performed might also be internalized (acquired) and

applied (application) in real-life scenarios.

We also found that frequent users were more likely to consider themselves having a greater

interest in sex and pornography compared to their peers, fantasize trying acts seen in pornography

several times a week, think about sex almost all the time, and watch pornography more than they

wanted. These results offer compelling insights about sexual preoccupancy and compulsive

pornography consumption. The fact that frequent users on average consider themselves more

interested in sex and pornography compared to peers does not in itself indicate a problem. However,

in lieu of the 44 percent of frequent users having fantasies about trying sexual activities seen in

pornography several times a week and the 53 percent that think about sex almost all the time, these

findings together provide stronger evidence for sexual preoccupancy. It is difficult to determine the

direction of causality: are people consuming pornography because they were more interested in the

10
first place, or is it because they watch pornography that they end up thinking more about sex? Peter

and Valkenburg’s15 findings suggest that there could be a cyclical relationship: these individuals are

more interested in sex in the first place, but pornography triggers an even greater, potentially

problematic cognitive engagement in sex.

It is also noteworthy that a statistically significant relationship was found between fantasizing

about pornography several times a week and watching hard core pornography. Since verbal and

physical sexual aggression is so commonplace in pornography, what most adolescents considered

hard core pornography could likely be defined as violent pornography. 24 If this is the case, and in

light of the suggested cyclical nature of sexual preoccupancy in Peter and Valkenburg, 15 it may be

that rather than ‘purging’ individuals of their fantasies and inclinations of sexual aggression,

watching hard core pornography perpetuates them, thereby increasing the likelihood of manifested

sexual aggression.

With regards to compulsive pornography consumption, it is striking that one-third of frequent

users admitted they watch pornography more than they want to. As stated above, a growing body of

empirical research considers pornography potentially addictive. Since adolescents’ brains are still in

their development phase, young people may be especially vulnerable to problematic pornography

use. “Unlike adults, adolescents are believed to lack sufficient maturation and integrity in frontal

cortices necessary to exert cognitive control required to suppress sexual cravings, thoughts, and

behaviours elicited by pornographic content.”2(p114) This, combined with the notion that adolescents

process and retain images far better than written or spoken words, 2 means that the development of

relevant, effective sexual education becomes all the more crucial to counterbalance the messages in

the pornography ‘script’.

The classrooms were randomly selected so the results should be representative of the two towns

included. Results are however not necessarily representative of Sweden in general, or to other

11
countries. Future research could be conducted in areas with different demographics. The cross-

sectional nature of the data places a limit on the possible conclusions drawn from this study, since it

prevents any causal interpretations being drawn. For example, it is unclear whether pornography

usage results in earlier sexual debut, or if earlier sexual debut is associated with other confounding

variables related to social and behavioural factors. The body of literature would benefit from quasi-

experimental designs that deal with these confounding variables. Further, this study would benefit

from longitudinal measures, since this would enable an examination of how pornography

consumption affects individuals over time. Still, the strength of this study rests in its convergence

with theory and support from similar studies using alternative methodologies.

A further limitation in the present study was that pornography was not clearly defined. In other

words, the participants could define pornography as naked images of women/men or as images

depicting individuals engaging in sexual activities. Consequently, certain categories of participants

may have more likely embraced one definition over the other. However, asking the participants to

rate to what extent different genres of pornography were consumed provided the participants an

opportunity to reflect over the prevalent types of pornography.

Despite pornography acting as a first ‘sex educator’ for many young people, there is a general

lack of critical discussions about pornography, in part due to inconclusive research on

pornography’s effects. However, research among adolescents appears substantially less ambiguous

than research on adults, with this study among a plethora of others indicating that frequent

pornography consumption is associated with negative outcomes. When it comes to prevention and

ways forward, the 3AM maps out the importance of pre-existing scripts: the more incompatible a

consumer’s pre-existing scripts are to the pornography script, the less the pornography script will

dictate their future script upon exposure. 28 Accordingly, robust sexual education at relevant ages is

crucial, complemented by efforts to minimize children’s access to pornography. The model further

12
locates ‘audience criticality’ as a key moderator to the pornography script. 28 In this sense,

educational strategies such as media literacy would help to equip young people with the critical

thinking skills necessary to minimize the harms of pornography. Finally, since the results of the

present study are consistent with the argument that pornography has addictive properties,

appropriate support to young people struggling with problematic pornography consumption must be

made more readily available.

Results indicate that frequent users of pornography have sexual debuts at younger ages, engage

in a broader range of sexual encounters, and are more likely to struggle with sexual preoccupancy

and problematic pornography use. This study contributes to a growing body of research providing

evidence that pornography may have negative effects on adolescents.

Funding: This work was supported by The European Society of Contraception and Reproductive

Health [grant number 11065], Uppsala-Örebro Regional Research Council [grant number RFR

12712], and Uppsala University.

References

1. Carroll JS, Padilla-Walker LM, Nelson LJ, Olson CD, Barry CM, Madsen SD. Generation

XXX: pornography acceptance and its use among emerging adults. Journal of Adolescent

Research 2008; 23:6–30.

2. Owens EW, Behun RJ, Manning JC, Reid RC. The impact of Internet pornography on

adolescents: A review of the research. Sexual Addiction & Compulsivity 2012; 19:99–122.

13
3. Mattebo M, Tydén T, Häggström-Nordin E, Nilsson K, Larsson M. Pornography and sexual

experiences among high school students in Sweden. Journal of Developmental & Behavioural

Pediatrics 2014; 35:179–88.

4. Häggström-Nordin E, Hanson U, Tyden T. Associations between pornography consumption and

sexual practices among adolescents in Sweden. International Journal of STD & AIDS 2005;

16:102–7.

5. Ybarra ML, Mitchell KJ. Exposure to Internet pornography among children and adolescents: A

national survey. Cyberpsychology, Behaviour, and Social Networking 2005; 8:473–86.

6. Sabina C, Wolak J, Finkelhor D. The nature and dynamics of internet pornography exposure for

youth. Cyberpsychology, Behaviour, and Social Networking 2008; 11:691–3.

7. Flood M. Exposure to pornography among youth in Australia. Journal of Sociology 2007;

43:45–60.

8. Lo V, Wei R. Exposure to Internet pornography and Taiwanese adolescents’ sexual attitudes

and behaviour. Journal of Broadcasting and Electronic Media 2005; 49:221–37.

9. Slaymaker E, Walker N, Zaba B, Collumbien M. (2004) Unsafe sex. In: Ezzati M, Lopez AD,

Rodgers A, Murray CJL, eds. Comparative Quantification of Health Risks: Sexual and

reproductive health. Switzerland, Geneva: World Health Organization, pp. 1177–254.

10. Brown JD, L’Engle KL. X-Rated: Sexual attitudes and behaviours associated with U.S. early

adolescents’ exposure to sexually explicit media. Communication Research 2009; 36:129–51.

11. Kraus SW, Russell B. Early sexual experiences: The role of Internet access and sexually explicit

material. Cyberpsychology, Behaviour, and Social Networking 2008; 11:162–8.

12. Bulot C, Leurent B, Collier F. Pornography sexual behaviour and risk behaviour at university.

Sexologies 2015; 78-83.

14
13. Morgan EM. Associations between young adults’ use of sexually explicit materials and their

sexual preferences, behaviours, and satisfaction. J Sex Res 2011;46:520-30.

14. Braun-Courville DK, Rojas, M. Exposure to sexually explicit web sites and adolescent sexual

attitudes and behaviours. Journal of Adolescent Health 2009; 45:156–62.

15. Tyden T, Rogala C. Sexual behaviour among young men in Sweden and the impact of

pornography. International Journal of STD & AIDS 2004; 15:590–3.

16. Hald GM, Kuyper L, Adam PC, de Wit JB. Does viewing explain doing? Assessing the

association between sexually explicit materials use and sexual behaviours in a large sample of

Dutch adolescents and young adults. J Sex Med 2013; doi: 10.1111/jsm.12157

17. Wright PJ, Tokunaga RS, Kraus A. A meta-analysis of pornography consumption and actual

acts of sexual aggression in general population studies. Journal of Communication 2015; doi:

10.1111/jcom.12201.

18. Peter J, Valkenburg P. Adolescents’ exposure to sexually explicit internet material and sexual

preoccupancy: a three-wave panel study. Media Psychology 2008; 11:207–34.

19. Voon V, Mole T, Banca P, Porter L, Morris L, Mitchell S et al. Neural Correlates of Sexual Cue

Reactivity in Individuals with and without Compulsive Sexual Behaviours. PLoS ONE 2014;

9:e102419. doi: 10.1371/journal.pone.0102419.

20. Snagowski J, Wegmann E, Pekal J, Laier C, Brand M. Implicit associations in cybersex

addiction: Adaptation of an Implicit Association Test with pornographic pictures. Addictive

Behaviours 2015; 49;7-12.

21. Love T, Laier C, Brand M, Hatch L, Hajela R. Neuroscience of internet pornography addiction:

a review and update. Behavioural Sciences 2015; 5:388–433.

22. Wright PJ. Pornography and the sexual socialization of children: current knowledge and a

theoretical future. Journal of Children and Media 2014; 8:305–12.

15
23. Wright PJ. Mass media effects on youth sexual behaviour. Communication Yearbook 2011;

35:343–86.

24. Sun C, Bridges A, Johnason J, Ezzell M. Pornography and the male sexual script: an analysis of

consumption and sexual relations. Archives of Sexual Behaviour 2014; DOI 10.1007/s10508-

014-0391-2.

25. Wright PJ, Bae S. (in press, 2016) Pornography and male sexual socialization. In: Wong YJ,

Wester SR, eds. APA handbook of men and masculinities. Washington DC: American

Psychological Association.

26. Bridges A, Wosnitzer R, Scharrer E, Sun C, Liberman R. Aggression and sexual behaviour in

best-selling pornography videos: a content analysis update. Violence Against Women 2010;

16:1065–85.

27. Aslund C, Starrin B, Nilsson KW. Social capital in relation to depression, musculoskeletal pain,

and psychosomatic symptoms: a cross-sectional study of a large population-based cohort of

Swedish adolescents. BMC Public Health. 2010;10:715.

28. Currie C, Roberts C, Morgan A, et al. (2004) Young people’s health in context. Health

behaviour in school-aged children (HBSC) study: International report from the 2001/2002

survey health policy for children and adolescents, No. 4. Copenhagen, Denmark: WHO Europe.

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TABLE 1. QUESTIONNAIRE DESCRIPTION

Area Instruments Type of Response Type of data

and items questions alternatives and scales
used in
previous
studies

Pornography Haggstrom- Experiences Yes–No Nominal data

experiences Nordin et al. of consuming Age when first Ordinal data
13 items (2005) pornography consuming Rating scale
pornography
Likert scales
Genres of
pornography

Sexual Haggstrom- Experience of Yes–No Nominal data

experiences Nordin et al. sex, age- Likert scales Ordinal data
11 items (2005) related Age Rating scale
questions

Perception of Study specific Attitudes Likert scales Ordinal data

sexuality towards Nominal data
2 items sexuality

17
TABLE 2. STATEMENTS REGARDING USE OF PORNOGRAPHY

Items Response alternatives

Have you ever watched pornography No/Yes

How often do you watch I don´t watch pornography, More seldom than once
pornography? a year, A few times every year, A few times every
month, Every week, Every day, Several times every
day.

If you watch pornography, with whom Alone, Boyfriend/Girlfriend, Male friends, Female
do you do it? friends, Gender mixed group of friends, I don´t
watch pornography.

Who takes the initiative to watch Myself, Boyfriend/Girlfriend, Male friends, Female
pornography? friends, Gender mixed group of friends, I don´t
watch pornography.

Do you fantasize about performing I don’t watch pornography, No, Yes, seldom, Yes,
sexual acts you have seen in sometime every month, Yes, sometime every week,
pornography? Yes, a few times every week, Yes, several times
every day.

Oral sex, Vaginal intercourse, Anal sex, Group sex,

If yes, give example of what you Other.
fantasize about.

Have you ever tried to perform sexual I don’t watch pornography, No, Sometimes, Often
acts seen in pornography?

If yes, give example of what you have Oral sex, Vaginal intercourse, Anal sex, Group sex,
tried. Other

I watch pornography Much more than I want to, As much as I want to, A
lot less than I want to, I don’t watch pornography

What kind of pornography do you Softcore pornography, Hard pornography, Violent

watch most often? Number one being pornography, Bondage/Sado Maschosism (BDSM),
the most common, number two second Gay pornography, Lesbian pornography, Other, I
most common and so on. don’t watch pornography

18
To what extent do you think Very much, Rather much, Neither much nor little,
pornography affect your sexual Rather little, Very little/Not at all, I don’t watch
behaviour? pornography

To what extent do you think Very much, rather a lot, Neither much nor little,
pornography affect your sexual Rather little, Very little/Not at all, I don’t watch
behaviour? pornography

If you compare with same sex peers, A lot less, A little less, Neither more nor less, A
do you think you are more or less little more, A lot more.
interested in pornography?

19
TABLE 3. SEXUAL BEHAVIOURS AMONG 18-YEAR-OLD MALE ADOLESCENTS

Items Total Frequent Average Infrequent p-

users users users value*

n = 370 n = 42 n = 256 n = 72
(%) (%) (%) (%)

Oral sex, given 221 (61) 31 (76) 156 (61) 34 (49) 0.017

Oral sex, received 234 (65) 32 (76) 165 (66) 37 (53) 0.032

Vaginal sex 255 (71) 31 (76) 181 (73) 43 (61) 0.124

Anal sex 70 (19) 12 (29) 51 (20) 7 (10) 0.039

Sex with friends 270 (73) 31 (74) 185 (73) 54 (76) 0.934

One-night stand 153 (42) 23 (32) 107 (42) 23 (55) 0.064

Group sex 23 (6) 6 (14) 14 (6) 3 (4) 0.071

Tried sexual acts 129 (37) 20 (50) 100 (39) 9 (17) 0.002
seen in
pornographic films
*Chi-square and Fisher exact tests, significance level: p < 0.05.

20
TABLE 4. MEAN AGE AT SEXUAL DEBUT AMONG 18-YEAR-OLD MALE ADOLESCENTS

Items Total Frequent Average Infrequent p-value*

users users users

Mean age at first 15.53 14.93 15.69 15.32 0.052

oral sex given

Mean age at first 15.34 14.69 15.52 15.14 0.020

oral sex received

Mean age at first 15.42 14.50 15.61 15.25 0.001

vaginal sex

Mean age at first 16.51 16.18 16.62 16.29 0.646

anal sex

ANOVA test, significance level: p < 0.05.

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TABLE 5. INDICATORS OF SEXUAL PREOCCUPANCY AND COMPULSIVE PORNOGRAPHY USE
AMONG 18-YEAR-OLD MALE ADOLESCENTS

Items Total Frequent Average Infrequent p-value*

users Users users
n = 72 (%)
n = 370 n = 42 n = 256
(%) (%) (%)

More interested in sex 26 (7) 8 (19) 17 (8) 1 (1) 0.002

compared to peers

More interested in 18 (5) 8 (19) 10 (4) 0 (0) <0.001

pornography compared to
peers

Fantasies about trying 44 (13) 18 (44) 23 (9) 3 (6) <0.001

sexual activities seen in
pornography several times a
week

Think about sex almost all 162 (45) 21 (53) 123 (50) 18 (25) 0.001
the time

Watch pornography more 22 (6) 11 (27) 9 (4) 2 (3) <0.001

than want to

Pornography affects sexual

behaviour
- Own 28 (8) 4 (10) 23 (9) 1 (1) 0.063

- Others 77 (21) 11 (27) 51 (20) 15 (21) 0.651

*Chi-square and Fisher exact tests, significance level: p < 0.05.

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TABLE 6. INDICATORS OF SEXUAL PREOCCUPANCY AND COMPULSIVITY

Items Total Frequent Average Infrequent p-value*

users Users users
n=159 n=30 n=122 n=7
(%) (%) (%) (%)

Hard core pornography

consumers

- Watch
pornography more 15 (9) 9 (30) 5 (4) 1 (14) <0.001
than wanted

Hard core pornography

consumers

- Thinking
about sex most of 91 (58) 19 (66) 69 (58) 3 (43) 0.512
the time

Hard core pornography

consumers

- Fantasies 31 (20) 15 (50) 16 (13) 0 (0) <0.001

several times every
week

*Chi-square and Fisher exact tests, significance level: p < 0.05.

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Highlights

Frequent users watched hard core pornography and violent pornography to a higher extent

Frequent users were more likely to have engaged in a wider range of sexual activities

Frequent users fantasised about trying sexual activities seen in hard core pornography

Frequent users showed signs of sexual preoccupancy and problematic pornography use

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