Pornography Use and Depressive Symptoms: Examining the Role of Moral Incongruence PDF

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Original Article Society and Mental Health XX(X) 1–19 Pornography Use and Ó American Sociological Association 2017 DOI: 10.1177/2156869317728373 Depressive Symptoms: http://smh.sagepub.com Examining the Role of Moral Incongruence Samuel L. Perry1 Abstract While studies have consistently observed an ...

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Pornography Use and Depressive Symptoms: Examining the Role of Moral Incongruence Samuel Perry

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Original Article

Pornography Use and Depressive Symptoms: Examining the Role of Moral Incongruence

Society and Mental Health XX(X) 1–19 Ó American Sociological Association 2017 DOI: 10.1177/2156869317728373 http://smh.sagepub.com

Samuel L. Perry1

Abstract While studies have consistently observed an association between pornography use and depressive symptoms, data limitations have precluded understanding the nature of this relationship. Drawing on data from a representative panel study of American adults and building on insights from stress process theory, this article demonstrates that the connection between pornography use and depressive symptoms hinges on the (1) (in)congruence between Americans’ moral beliefs about pornography and their viewing practices and (2) gender. Cross-sectional and longitudinal analyses reveal that American men (not women) who believe viewing pornography is always immoral but watch it anyway are more likely to experience depressive symptoms compared to others who do not report this incongruence. Results also suggest the connection between viewing pornography and depressive symptoms is bidirectional, contingent on men’s moral evaluation of its use. For male porn users who morally reject it, pornography use predicts depressive symptoms at low frequencies, likely stemming from cognitive stress or dissonance. For those who do not morally reject porn, however, only viewing it at the highest frequencies is associated with higher levels of depressive symptoms, which suggests reverse causation—depressed men likely view higher levels of pornography as a coping aid, especially when they do not view it as immoral.

Keywords pornography, depression, morality, gender, stress process

INTRODUCTION Pornography use has become increasingly pervasive in the United States over the past few decades, stemming largely from a combination of greater cultural acceptance and advances in Internet and smartphone technology (Carroll et al. 2008; Lykke and Cohen 2015; Price et al. 2016; Wright 2013; Wright, Bae, and Funk 2013). While estimates of pornography use often differ by the definitions used, available data affirm that Americans view pornography in larger numbers today than previous decades. In their analysis of aggregated General Social Survey (GSS) data, Price et al. (2016) show that the percentage of American men below age 45 who reported viewing an

X-rated movie in the previous year increased by roughly 20 percent between the 1973–1980 and 2008–2012 waves. The percentage of American women below age 45 who reported viewing pornography also increased roughly 5 to 10 percent during this time. As pornography use has become more prevalent, researchers have begun to explore its

1

University of Oklahoma, Norman, OK, USA

Corresponding Author: Samuel L. Perry, University of Oklahoma, 780 Van Fleet Oval, Kaufman Hall, 3rd Floor, Norman OK, 730192033, USA. Email: [email protected]

2 potential connection to indicators of psychological well-being, including compulsivity, distress, depression, and sexual dysfunction (for reviews, see Grubbs and Hook 2016; Short et al. 2012). Within this research, a consistent finding is that persons who view pornography more often are more likely to exhibit symptoms of depression (Cooper et al. 2001; Kafka 2000; Nelson, Padilla-Walker, and Carroll 2010; Owens et al. 2012; Peter and Valkenburg 2006, 2011; Poulsen, Busby, and Galovan 2013; Stein et al. 2001; Wolak, Mitchell, and Finkelhor 2007; Ybarra and Mitchell 2005). Several critical issues, however, remain unresolved regarding the nature of this relationship. The first is that causal direction and mechanisms remain undetermined. Some research, on the one hand, suggests that individuals suffering from depression or anxiety seek out pornography as a coping strategy (Cooper et al. 2001; Kafka 2000; Peter and Valkenburg 2006, 2011), while others propose that pornography use itself may be a contributing factor to forms of psychological distress (Baltazar et al. 2010; Nelson et al. 2010; Owens et al. 2012; Stein et al. 2001; Yoder, Virden, and Amin 2005). Second, and related to the directionality issue, is that virtually all studies linking depressive symptoms with pornography use are based on clinical samples, samples of adolescents, or convenience samples of undergraduates, each of which samples on either dependent variable (porn use or depression) for different reasons. No research to date has established whether a connection exists between pornography use and mental health among the general public and, equally as important, through what mechanisms. Resolving these issues is of pressing concern for mental health researchers. To the extent that pornography use is associated with poorer mental health among American adults, the rapid growth of pornography use among Americans could serve as either an indicator of depressive symptoms in the general population or a harbinger of mental health issues later on. One promising line of research has begun to explore the idea that the connection between pornography use and mental health hinges on how the porn viewer perceives or interprets that activity. Some preliminary research with convenience samples of undergraduates, for example, finds that persons who believe themselves to be “addicted” to pornography are more likely to report feelings of psychological distress, regardless of how often they actually view pornography (Grubbs, Stauner,

Society and Mental Health XX(X) et al. 2015; Grubbs, Volk, et al. 2015). Other studies in this vein find that undergraduates who are more religious are more likely to view themselves as addicted to pornography and more likely to report “spiritual struggles” as a result, even though they tend to view pornography less often than others (Grubbs et al. 2017; Grubbs, Exline, et al. 2015). While these researchers focus on the mechanism of labeling behavior as addictive, I propose that the more fundamental issue represented within these preliminary findings is that the connection between pornography use and poorer mental health are likely contingent on one’s (negative) moral evaluation of one’s own behavior. The current study extends the literature connecting pornography use to mental health by demonstrating how the link between pornography use and depressive symptoms in American adults hinges on the congruence between their moral beliefs about pornography and consumption practices. Drawing on data from a nationally representative panel study of American adults and building insights from stress process theory, I demonstrate that viewing pornography in and of itself has virtually no directional influence on the experience of depressive symptoms unless one is violating one’s own moral values by doing so. Absent of one’s moral rejection of pornography, depressive symptoms are more likely connected to pornography use in the opposite causal direction—depressed individuals likely consume more pornography as a coping strategy. I also show how this relationship is highly gendered. American men view pornography in far larger quantities than women and more often in isolation (Maddox, Rhoades, and Markman 2011; Regnerus, Gordon, and Price 2016), and these consumption patterns more strongly connect men’s pornography use and mental health, with causality going in either direction contingent on their moral views.

EMPIRICAL AND THEORETICAL BACKGROUND Pornography Use and Acceptance in the United States Determining who uses pornography and how often has grown increasingly difficult due to advances in media technology that ensure anonymity (Lykke and Cohen 2015), compounded by the fact that porn use is still stigmatized in many circles and

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Perry persons are often reluctant to admit viewing it (Perry and Hayward 2017; Regnerus 2007). A recent comparison of three different national data sets with different measures of pornography consumption (2008–2012 General Social Survey [GSS], 2012 New Family Structures Survey, and 2014 Relationships in America project) showed that between 55 percent and 70 percent of men and roughly 30 percent to 40 percent of women below age 40 report viewing pornography in the previous year (Regnerus et al. 2016). These estimates are comparable to those in the 2006 Portraits of American Life Study, which indicates that 67 percent of men and 33 percent of women below 40 report looking at “pornographic materials” in the past 12 months. Providing a better idea of viewing frequency, the 2014 Relationships in America survey, based on a probability sample of over 15,700 American adults, reveals that 46 percent of men and 16 percent of women under age 40 report intentionally viewing pornography in a given week (Perry and Hayward 2017; Regnerus et al. 2016). And while pornography use has increased over time for the adult population of men and women overall, this increase has been particularly strong among younger men and women compared to their older counterparts. Price et al. (2016) show that men below age 27 who report viewing porn increased by 16 percent from the 1973–1980 GSS waves to the 2000– 2008 waves compared to only 6 percent for men ages 45 to 53 during that same timeframe. So too, women below age 27 who view porn increased by 8 percent during that timeframe, while this percentage actually declined slightly for women 45 to 53 years old. Not surprisingly given consumption patterns, Americans’ attitudes regarding pornography’s dissemination and use have been growing more favorable over time (Carroll et al. 2008; Lykke and Cohen 2015; Price et al. 2016). Yet Americans’ acceptance of pornography has not grown as drastically as one might suppose given its greater accessibility or ubiquity in popular culture. Using aggregated GSS data from 1975 to 2012, Lykke and Cohen (2015) show that the percentage of American men and women who believe that the distribution of pornography should be illegal regardless of age has declined from about 35 percent of men in 1975 to 23 percent of men in 2012 and from about 50 percent of women to 43 percent of women during that same timeframe. Moreover, while one might expect that younger generations

of Americans would be more favorable toward pornography given their higher use patterns (Price et al. 2016; Regnerus et al. 2016), Price et al. (2016) found that men and women below age 27 were no less likely to believe porn distribution should be illegal in the 2000–2008 GSS waves compared to the 1973–1980 waves. This potentially presents a paradoxical situation, namely, that Americans (and younger Americans in particular) are increasingly more likely to view pornography compared to previous generations, and yet, these same Americans are not necessarily becoming more approving of pornography than previous cohorts, at least not to the point where their approval is keeping pace with growing use patterns. This suggests that an increasing number of Americans may find themselves in a situation where they oppose pornography in principle while also viewing it, creating a situation where their moral beliefs and behaviors are incongruent. The following section reviews the research on pornography use and mental health and considers this moral incongruence as a potential moderating factor.

Pornography Use and Mental Health Among the correlates often associated with pornography use—along with being younger, male, less religious, higher socioeconomic status, more politically liberal, and more sexually permissive (see Perry 2016, 2017; Peter and Valkenburg 2016; Wright 2013)—persons who use pornography more often are consistently found to exhibit symptoms of poorer mental health and symptoms of depression in particular. Notably, much of this finding may be due to the fact that studies are often drawing on clinical samples (Kafka 2000; Stein et al. 2001) or samples of individuals who have otherwise already conceived of their porn use as problematic (Cooper et al. 2001). Others are based on samples of adolescents who, due to common physical and social transitions in their life course, might already be disposed to experiencing bouts of emotional instability (Owens et al. 2012; Peter and Valkenburg 2006, 2011, 2016; Wolak et al. 2007). Nevertheless, while researchers have consistently identified an association between porn use and depressive symptoms in these samples, the nature of the relationship is not well understood. One line of research suggests that bouts of depression may influence individuals

4 to view pornography and masturbate as a way to relieve stress or cope with feelings. A psychiatrist, Kafka (2000) described how he was able to successfully treat men who compulsively view pornography by prescribing antidepressant medication, suggesting the depression contributed to frequent pornography use. Cooper et al. (2001), in a cross-sectional study of over 7,000 respondents, reported that persons who had previously experienced symptoms associated with depression and severe anxiety were more likely to view higher levels of pornography as a form of distraction and stress release. Other studies find that adolescents who score higher on indicators of depression are more likely to seek out porn (Wolak et al. 2007; Ybarra and Mitchell 2005). And in both cross-sectional and longitudinal surveys with Dutch adolescents and adults, Peter and Valkenburg (2006, 2011) reported that lower life satisfaction predicted more frequent use of online pornography later on. Another line of research, however, suggests that habitual pornography use may be a contributing factor to depression itself, possibly due to attendant self-isolation (Owens et al. 2012). Yoder et al.’s (2005) study of 400 Internet porn users found that higher porn viewing frequency predicted higher levels of isolation and loneliness. And in their longitudinal study of Dutch adolescents, van den Eijnden et al. (2008) found that viewing Internet pornography predicted later feelings of depression and loneliness through its connection to compulsive Internet use. And still other studies suggest that the relationship between depression and pornography is complex and bidirectional. In their psychiatric case study, Stein et al. (2001) described “Mr. A,” who was experiencing significant depression associated with habitual pornography use and masturbation. On the one hand, the psychiatrists observed that Mr. A would view pornography and masturbate during times of stress and loneliness as a way to seek relief. Notably, however, they also observed that Mr. A used pornography habitually even when his depression had been medically controlled and reduced. The patient also articulated distress at his lack of self-control and feared that his pornography use had become unmanageable, which led him to seek treatment. The doctors theorized the connection between the patient’s compulsive porn use and depression “does not simply involve one-directional causality but, rather, is likely to be complex” (Stein et al. 2001:1591). Other research

Society and Mental Health XX(X) has pointed to this ambiguous and likely bidirectional association between pornography use and depressive symptoms. In their study of 751 college students at a Christian university, for example, Baltazar et al. (2010) reported that 23 percent of men expressed that their pornography use increased when they were experiencing negative emotions, including anger, depression, stress, boredom, or loneliness. And yet, they also found that 26 percent of men and 12 percent of women indicated that their pornography use itself actually increased negative emotions like guilt, shame, and low self-esteem. Rather than viewing pornography use and mental health as directly related, recent research has considered the importance of how porn users interpret or understand their behavior, drawing largely on notions of cognitive dissonance—the psychological distress actors tend to feel when their stated values or beliefs do not align with their actions or experiences. Festinger’s (1957) original conceptualization of cognitive dissonance involved mental distress from failing to succeed in domains that one considers personally relevant and important. Employing this perspective, Mannheimer and Hill (2015) showed that conservative Protestants who failed to meet religious norms for faithful practice were more likely to experience psychological distress and depression. Going beyond the cognitive dissonance concept, stress process theory provides a more distinctively sociological framework through which to consider how a “failure” (in one’s own self-evaluation) could contribute to depressive symptoms (Bierman 2010; Schieman, Bierman, and Ellison 2013). Pearlin’s (1989) early work argued that socially constituted values (i.e., what is defined as good or bad) were influential in the process of stress formation because they defined how actors interpreted their behavior and experiences. Extending this idea, Bierman (2010) proposed the concept of “stress valuation” to argue that certain experiences may be particularly stressful and ultimately contribute to poorer mental health if they clash with actors’ inculcated moral values. Research that considers the moderating role of religion in the link between pornography use and psychological well-being lends itself to this view that the incongruence between moral values and behavior is at the heart of the relationship. Patterson and Price (2012) analyze aggregated GSS data and found that porn users who attended church more often reported lower life satisfaction than porn users who rarely attended church, suggesting that the lower life satisfaction was connected to

Perry violating the moral values of oneself and one’s faith community rather than porn use per se (see also Nelson et al. 2010; Short, Kasper, and Wetterneck 2015). Focusing more specifically on the issue of how one interprets pornography use, Grubbs and colleagues (Grubbs, Stauner, et al. 2015; Grubbs, Volk, et al. 2015) found in their nonrandom samples of undergrads and adults that those who considered themselves addicted to Internet pornography—who are also more likely to be religious persons (Grubbs, Exline, et al. 2015)—were more likely to experience psychological distress (symptoms for depression, anxiety, and stress). Importantly, this association remained regardless of how often someone viewed pornography, suggesting that the critical factor connecting pornography use to mental health and psychological well-being is how porn users interpret that behavior in light of their own moral values.

Hypotheses The current study is the first to directly examine how the connection between pornography use and depressive symptoms may be moderated by whether actors’ moral beliefs regarding pornography use are congruent with their viewing patterns. Based on previous research establishing a connection between pornography use and depressive symptoms, I first generally expect that: Hypothesis 1: On the whole, Americans who view pornography, either at all or in greater frequencies, will be more likely to report experiencing depressive symptoms. Conversely, there would be no reason to expect that Americans who oppose pornography morally would be more likely to experience depressive symptoms compared to those who are more accepting of it. In other words, there is nothing about the moral conviction against pornography per se that would be connected with depressive symptoms. Thus, I predict that: Hypoth...