Porn
Is porn addiction real?
Short answer
Not as an official diagnosis called “porn addiction,” but compulsive porn use is recognized. The DSM-5 does not include porn addiction, while the WHO's ICD-11 lists Compulsive Sexual Behaviour Disorder (6C72) as an impulse control disorder, and pornography use is one behavior it can involve. It requires a persistent failure to control sexual urges over an extended period (e.g., six months or more), causing marked distress or impairment. Whether it is truly an addiction is still debated.
Key takeaways
- “Porn addiction” is not a diagnosis in the DSM-5.
- ICD-11 includes Compulsive Sexual Behaviour Disorder (6C72) as an impulse control disorder; pornography use is one behavior it can involve.
- The diagnosis requires a persistent loss of control over an extended period (e.g., six months or more) with marked distress or impairment.
- A high sex drive, or distress that comes only from moral disapproval, does not meet the criteria on its own.
- Researchers still disagree about whether it is an addiction.
What is compulsive sexual behaviour disorder in ICD-11?
ICD-11 is the World Health Organization's international classification of diseases. It includes Compulsive Sexual Behaviour Disorder, code 6C72, in its impulse control disorders chapter. The disorder is a persistent pattern of failing to control intense, repetitive sexual impulses or urges. That leads to repetitive sexual behavior over an extended period (for example, six months or more) and causes marked distress or impairment in personal, family, social, educational, work or other important areas of life. Pornography use is named as one behavior that can be involved, alongside others such as masturbation and cybersex.
The diagnostic guidelines describe the pattern as showing up in one or more of these ways:
- Sexual behavior has become a central focus of life, to the point of neglecting health, personal care, or other interests and responsibilities.
- Numerous unsuccessful efforts to control or significantly reduce the behavior.
- Continuing despite adverse consequences, such as repeated relationship disruption, work consequences or harm to health.
- Continuing even when it brings little or no satisfaction.
What doesn't count as compulsive sexual behaviour disorder?
The guidelines were written to avoid treating ordinary sexuality as a disorder. A high sex drive is not enough on its own: people with high sexual interest who do not have impaired control and significant distress or impairment should not be diagnosed. Distress that comes entirely from moral judgments or disapproval about sexual urges or behavior does not meet the requirement either. Researchers also note that pornography use, even frequent use, is not always problematic.
Why isn't porn addiction in the DSM-5?
The American Psychiatric Association's DSM-5 does not include porn addiction. An attempt to add out-of-control sexual behavior to the DSM-5 as hypersexual disorder did not succeed.
ICD-11 took what its developers called a relatively conservative position. It placed the condition with impulse control disorders rather than with disorders due to substance use and addictive behaviors, because there was not yet definitive information on whether the same processes seen in substance use disorders, gambling and gaming are involved.
Is it an addiction or something else?
This is where researchers disagree. There is an active scientific discussion about whether compulsive sexual behavior is a behavioral addiction. Some prominent voices in the field argue it should be called and diagnosed as sexual addiction. The authors of a 2020 debate paper concluded there is not yet enough data to support that, noting that the field lacks consistent defining criteria and agreement on which symptoms count.
Another line of research looks at moral incongruence, meaning behavior that conflicts with a person's own beliefs. A 2019 review and meta-analysis by Grubbs and colleagues noted that the mental health community is divided on whether porn use can be addictive, even though many people feel their use is a problem. The authors proposed that, in many cases, feeling addicted to porn may be better explained by that conflict.
These explanations point toward different kinds of help, so if your sexual behavior is causing you distress, a careful assessment by a qualified professional is worthwhile. Treatment does appear to help: a 2022 systematic review found that treatment seems to improve symptoms, with the clearest evidence for cognitive behavioral therapy.
How common is compulsive sexual behavior?
Estimates depend on how the problem is defined. A 2018 paper describing the ICD-11 diagnosis noted that recent studies produced estimates of 1 to 3%, and that ICD-11's more restrictive requirements would be expected to produce lower rates.
In a nationally representative US survey of adults aged 18 to 50, 8.6% (10.3% of men and 7.0% of women) reported clinically relevant distress or impairment linked to difficulty controlling sexual feelings, urges and behaviors. That figure comes from a screening questionnaire cutoff, not clinical diagnoses.
How Vow can help
Vow does not diagnose anything. If you have decided you want to stop or cut back on porn, it anchors that goal to your own reason in your own words and tracks your streak, and a slip is logged without shame. Notifications are discreet, so sensitive habit names are not shown on your lock screen or watch face, and crisis resources by region are always free in the app.
Sources
Each source below was read when this answer was reviewed. Open a source to see the passages the answer relies on.
Journal of Behavioral Addictions (Antons et al., 2022) — Treatments and interventions for compulsive sexual behavior disorder with a focus on problematic pornography use: A preregistered systematic reviewpmc.ncbi.nlm.nih.gov
The attempt to integrate out-of-control sexual behavior as hypersexuality disorder into the DSM-5 (American Psychiatric Association, 2013) failed.
decided to add a new diagnosis in the impulse control disorder chapter (World Health Organization, 2020): “Compulsive sexual behavior disorder” (CSBD, ICD-11 Code: 6C72)
The problem must exist at least 6 months and cause marked distress or impairment in important areas of functioning.
pornography use is mentioned as one behavior besides others (e.g. sexual behavior with others, masturbation, cybersex, and telephone sex) that can become pathologic in CSBD
Distress that is entirely related to moral judgments and disapproval about sexual impulses, urges, or behaviors is not sufficient to meet this requirement
As pornography use (even high frequent use) is not always problematic
Receiving treatment seems to improve symptoms of CSBD and PPU. Especially, evidence for the efficacy of cognitive behavior therapy is present.
Open the sourceWorld Psychiatry (Kraus et al., 2018) — Compulsive sexual behaviour disorder in the ICD-11pmc.ncbi.nlm.nih.gov
It is characterized by a persistent pattern of failure to control intense, repetitive sexual impulses or urges, resulting in repetitive sexual behaviour over an extended period (e.g., six months or more)
that causes marked distress or impairment in personal, family, social, educational, occupational or other important areas of functioning
engaging in repetitive sexual activities has become a central focus of the person's life to the point of neglecting health and personal care or other interests, activities and responsibilities
the person has made numerous unsuccessful efforts to control or significantly reduce repetitive sexual behaviour
the person continues to engage in repetitive sexual behaviour despite adverse consequences (e.g., repeated relationship disruption, occupational consequences, negative impact on health)
the person continues to engage in repetitive sexual behaviour even when he/she derives little or no satisfaction from it
Individuals with high levels of sexual interest and behaviour … who do not exhibit impaired control over their sexual behaviour and significant distress or impairment in functioning should not be diagnosed with compulsive sexual behaviour disorder
For ICD‐11, a relatively conservative position has been recommended
compulsive sexual behaviour disorder is not included in the ICD‐11 grouping of disorders due to substance use and addictive behaviours, but rather in that of impulse control disorders
we do not yet have definitive information on whether the processes involved in the development and maintenance of the disorder are equivalent to those observed in substance use disorders, gambling and gaming
Currently, there is an active scientific discussion about whether compulsive sexual behaviour disorder can constitute the manifestation of a behavioural addiction
recent studies have produced somewhat lower estimates of 1 to 3%
The more restrictive diagnostic requirements proposed for ICD‐11 would be expected to produce lower prevalence rates.
Open the sourceJournal of Behavioral Addictions (Sassover & Weinstein, 2020) — Should compulsive sexual behavior (CSB) be considered as a behavioral addiction? A debate paper presenting the opposing viewpmc.ncbi.nlm.nih.gov
One of the prominent voices in this field considers CSBD as a behavioral addiction and proposes CSBD to be called and diagnosed as sexual addiction (SA).
We conclude that currently, there is not enough data supporting CSBD as a behavioral addiction.
the field mainly suffers from inconsistent defining criteria of CSBD and a consensus which symptoms should be included
Open the sourceArchives of Sexual Behavior (Grubbs, Perry, Wilt & Reid, 2019) — Pornography Problems Due to Moral Incongruence: An Integrative Model with a Systematic Review and Meta-Analysis (PubMed abstract)pubmed.ncbi.nlm.nih.gov
Although the mental health community at large is divided as to the addictive versus non-addictive nature of Internet pornography, substantial numbers of individuals report "feeling" as if their use of Internet pornography is problematic.
pornography-related problems-particularly feelings of addiction to pornography-may be, in many cases, better construed as functions of discrepancies-moral incongruence-between pornography-related beliefs and pornography-related behaviors
Open the sourceJAMA Network Open (Dickenson et al., 2018) — Prevalence of Distress Associated With Difficulty Controlling Sexual Urges, Feelings, and Behaviors in the United Statespmc.ncbi.nlm.nih.gov
8.6% of the nationally representative sample (7.0% of women and 10.3% of men) endorsed clinically relevant levels of distress and/or impairment associated with difficulty controlling sexual feelings, urges, and behaviors
Participants between the ages of 18 and 50 years were randomly sampled from all 50 US states in November 2016.
201 [8.6%] met the clinical screen cut point of a score of 35 or higher on the Compulsive Sexual Behavior Inventory
Open the sourceNational Institute of Mental Health — Help for Mental Illnessesnimh.nih.gov
Call or text 988 or start a chat online to connect with a trained crisis counselor. The Lifeline provides 24-hour, confidential support to anyone in suicidal crisis or emotional distress.
Open the sourceNHS — Help for suicidal thoughtsnhs.uk
NHS 111 Call 111 – 24 hours every day Information: Samaritans – for everyone Call 116 123
Open the source
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