On the current psychotherapeutic situation for persons with pornography use disorder in Germany

Markert, Charlotte and Storz, Florian and Golder, Sarah and Rechmann, Johanna and Rubel, Julian A. and Lalk, Christopher and Vogt, Rabea and Glombiewski, Julia A. and Braun, David and Pané-Farré, Christiane A. and Michael, Tanja and Mattheus, Hannah K. and Dominick, Nanne and Wölfling, Klaus and Lutz, Wolfgang and Schaffrath, Jana and Stangier, Ulrich and Kananian, Schahryar and Strüwing, Dirk and Klingelhöfer, Doerthe and Valbert, Frederik and Neumann, Anja and Walter, Bertram and Stark, Rudolf (2023) On the current psychotherapeutic situation for persons with pornography use disorder in Germany. Journal of Behavioral Addictions, 12 (2). pp. 421-434. ISSN 2062-5871

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Abstract

Background and aims: For the first time, the ICD-11 provides the diagnosis compulsive sexual behavior disorder (CSBD) that can be assigned for pornography use disorder (PUD). This study aimed to es- timate the prevalence of PUD and associated consequences in Germany, to identify the psychotherapy demand among likely PUD (lPUD) cases and the treatment supply in different psychotherapeutic settings, to survey psychotherapists’ level of expertise regarding PUD, and to identify predictors for psychotherapy demand. Methods: Four studies were conducted: 1. Online study in the general population (n 5 2070; m 5 48.9%, f 5 50.8%, d 5 0.2%), 2. Survey among practicing psychotherapists (n 5 983), 3. Survey of psychotherapists in psychotherapeutic outpatient clinics (n 5 185), 4. Interviews with psychotherapeutic inpatient clinics (n 5 28). Results: The estimated prevalence of lPUD in the online study was 4.7% and men were 6.3 times more often affected than women. Compared to individuals without PUD, individuals with lPUD more often indi- cated negative consequences in performance-related areas. Among lPUD cases, 51.2% of men and 64.3% of women were interested in a specialized PUD treatment. Psychotherapists reported 1.2%–2.9% of lPUD cases among their patients. 43.2%–61.5% of psychother- apists stated to be poorly informed about PUD. Only 7% of psy- chotherapeutic inpatient clinics provided specific treatments to patients with PUD. While, among other factors, negative conse- quences attributed to lPUD were predictive for psychotherapy demand, weekly pornography consumption, subjective well-being, and religious attachment were not. Discussion and conclusions: Although PUD occurs quite often in Germany, availability of mental health care services for PUD is poor. Specific PUD treat- ments are urgently needed.

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