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SCIENCE

The intuitive mind is a sacred gift and the rational mind is a faithful servant.
We have created a society that honors the servant and has forgotten the gift."

​Albert Einstein
Aspects of Diversity: Identifying Symptoms of CSBD/PPU in a Romantic Relational System

Gretchen Blycker LMHC, LMT, CYT is a board-certified sex therapist and a sexual wellness educator at the University of Rhode Island. Her clinical work focusing on promoting sexual wellbeing, treating sexual trauma and compulsive sexual behaviors and addressing their relational impact informs her academic work and perspectives.

Background: 
Symptoms and consequences of Compulsive Sexual Behavior Disorder (CSBD) or Problematic Pornography Use (PPU) may first emerge in a relational context, therefore an increased understanding of interpersonal experiences and dynamics in a romantic relational system warrants further investigation. Addictions not only impact the person suffering with the disorder, but also significant others. However, when the addiction involves the integral nature of sexuality there are significantly different and unique consequences that sets this dynamic apart from being intimate with a person with any other addiction or compulsive behavior.

Method: This presentation includes a review of research focusing on pornography use and compulsive sexual behaviors and the effects on romantic relationships, including sexual and relationship satisfaction. Sociocultural influences which may contribute to the normalization of experiencing symptoms of CSBD/PPU in romantic relationships will be elucidated by research findings, as well as through clinical case examples.

Results: Impersonal approaches to sex, devaluation of intimate sex and communication, a gendered pleasure and orgasm gap, empathy reduction, power and control dynamics, expectations for a partner’s sexual compliance or avoidance of partner sex, and the blaming of the non-CSBD/PPU partner for sexual and relational problems are among the many symptoms identified in relational dynamics occurring with a partner with CSBD/PPU.  
​
Conclusions: More research is needed to explore the interaction effects between the addiction enabling phenomena of denial and dishonesty operating with the CSBD/PPU partner and relational dynamics. Future research assessing for CSBD/PPU may benefit by including collateral information regarding the relationship or partner’s experiences.  Interventions that are informed by CSBD, promote sexual health, integrate skillful interoceptive attunement and healthy emotional regulation, such as Compassion-Based Resilience Training, for sexual wellbeing are beneficial.

Click the video below to view this presentation.
Treatment needs for Women Impacted by a Partner’s Compulsive Sexual Behavior Disorder CSBD/PPU 

​
Gretchen Blycker LMHC, LMT, CYT is a board-certified sex therapist and a sexual wellness educator at the University of Rhode Island. Her clinical work focusing on promoting sexual wellbeing, treating sexual trauma and compulsive sexual behaviors and addressing their relational impact informs her academic work and perspectives.
​

Abstract
Background: Women in romantic relationship with a partner with CSBD or PPU are often affected in many ways before root causes of problems are identified or diagnosed. Women may experience challenges and unique harms, including trauma, due to the nature of an addiction or compulsivity operating in the sexual system of a romantic context where safety, trust, empathy, emotional intimacy, honoring of commitments, honesty, and sexual wellbeing are foundational to a healthy secure relationship. 
 
Method: A review of research focusing on the impact on women as well as a review of conceptual models for treatment for women with partners with CSBD/PPU will be presented along with clinical case examples. A holistic model will be utilized to compare the seven domains that comprise sexual wellbeing and how each domain may be impacted for women with partners with CSBD/PPU. 

Results: Women may be isolated without proper support and a partner’s sexual compulsivity, upwards comparison to pornography, preferring pornography to partnered sex, or focusing craving towards partnered sex and therefore expressing dissatisfaction or resentment of sexual frequency may all possibly interfere with a woman’s sexual self-esteem and feelings about her body, sexual autonomy and agency. Clinical recommendations for supporting women will be included.
​
Conclusions: Education about the traumatic impact on women is essential for clinicians to provide a trauma informed approach to treatment. More is needed in the research and clinical fields to advance understanding and knowledge to inform evidence-based treatment needed by women impacted by their partner’s CSBD/PPU.

Click the video below to view this presentation.
 

Picture
Click the video below to view Gretchen's presentation, 
“Cultivating Female Pleasure Through the
​Bliss Body With Subtle Body Practices” 
At the International Clitoris Summit, May 20, 2023.
Picture
Click Here to watch
presentation Above
"Promoting Sexual Health and
​Treating Problematic Sexual Behaviors:
​A Mindfulness-Based Approach
​in Clinical Practice
​​Dive into the research and explore over 100 references with hyperlinks to full articles and abstracts of peer-reviewed literature investigating the complexities of sexuality.

The library below is organized into six categories; wellbeing, mindfulness,
abuses of power, subtle body energy, sexual harm, and sexually explicit material.

​The topics studied include; sexting, body image, social media use, emotional intelligence, sexual self-esteem, mindfulness, yoga, sexual functioning, sexual abuse, trauma, intimate partner violence, healing, objectification culture, mating strategies, pornography, sexual scripts, body autonomy, and sexual wellbeing.
WELLBEING
  1. Bianchi D, Morelli M, Baiocco R, Chirumbolo A. 
    Sexting as the mirror on the wall: Body-esteem attribution, media models, and objectified-body consciousness. 
    J Adolesc. 2017;61:164-172.

  2. Dale LP, Shaikh SK, Fasciano LC, Watorek VD, Heilman KJ, Porges SW. 
    College females with maltreatment histories have atypical autonomic regulation and poor psychological well being. 
    Psychol Trauma. 2018;10(4):427-434.

  3. Fardouly J, Rapee RM. 
    The impact of no-makeup selfies on young women's body image. 
    Body Image. 2019;28:128-134.

  4. Fischer AH, Kret ME, Broekens J.
    Gender differences in emotion perception and self-reported emotional intelligence: A test of the emotion sensitivity hypothesis.
    PLoS One. 2018;13(1):e0190712.

  5. Gasso AM, Klettke B, Agustina JR, Montiel I.
    Sexting, Mental Health, and Victimization Among Adolescents: A Literature Review.
    Int J Environ Res Public Health. 2019;16(13).

  6. Gasso AM, Mueller-Johnson K, Montiel I.
    Sexting, Online Sexual Victimization, and Psychopathology Correlates by Sex: Depression, Anxiety, and Global Psychopathology.
    Int J Environ Res Public Health. 2020;17(3).


  7. Herzog S, D'Andrea W, DePierro J, Khedari V.
    When stress becomes the new normal: Alterations in attention and autonomic reactivity in repeated traumatization. J Trauma Dissociation.
    2018;19(3):362-381.
    ​
  8. Hogue JV, Mills JS. 
    The effects of active social media engagement with peers on body image in young women. 
    Body Image. 2019;28:1-5.

  9. Howard M, McMillen C, Nower L, Elze D, Edmond T, Bricout J. 
    Denial in addiction: toward an integrated stage and process model--qualitative findings. 
    J Psychoactive Drugs. 2002;34(4):371-382.

  10. Käll LF, Zeiler K. 
    Bodily Relational Autonomy. 
    Journal of Consciousness Studies. 2014;21:100-120.

  11. Le Cunff A-L. 
    Mindframing: A Proposed Framework for Personal Growth. 
    Educational Psychology & Cognition eJournal. 2019.

  12. Leavitt CE, Lefkowitz ES, Waterman EA. 
    The role of sexual mindfulness in sexual wellbeing, Relational wellbeing, and self-esteem. 
    J Sex Marital Ther. 2019;45(6):497-509.

  13. McClure MM, Parmenter M. 
    Childhood Trauma, Trait Anxiety, and Anxious Attachment as Predictors of Intimate Partner Violence in College Students. 
    J Interpers Violence. 2017:886260517721894.

  14. Peixoto MM, Amarelo-Pires I, Pimentel Biscaia MS, Machado PPP. 
    Sexual self-esteem, sexual functioning and sexual satisfaction in Portuguese heterosexual university students. Psychology & Sexuality. 
    2018;9(4):305-316.

  15. Pilgrim P. 
    Campus Climate on Hookup Culture Perceptions and Participation. 
    Citations Journal of Undergraduate Research. 2019;16.

  16. Pineles SL, Mostoufi SM, Ready CB, Street AE, Griffin MG, Resick PA. 
    Trauma reactivity, avoidant coping, and PTSD symptoms: a moderating relationship? 
    J Abnorm Psychol. 2011;120(1):240-246.

  17. Price C. 
    Body-oriented therapy in recovery from child sexual abuse: an efficacy study. 
    Altern Ther Health Med. 2005;11(5):46-57.

  18. Schweizer T, Renner F, Sun D, Kleim B, Holmes EA, Tuschen-Caffier B. 
    Psychophysiological reactivity, coping behaviour and intrusive memories upon multisensory Virtual Reality and Script-Driven Imagery analogue trauma: A randomised controlled crossover study. 
    J Anxiety Disord. 2018;59:42-52.

  19. Shannahoff-Khalsa D, Fernandes RY, Pereira CAB, et al. 
    Kundalini Yoga Meditation Versus the Relaxation Response Meditation for Treating Adults With Obsessive-Compulsive Disorder: A Randomized Clinical Trial. 
    Front Psychiatry. 2019;10:793.

  20. Silverstein RG, Brown A-CH, Roth HD, Britton WB. 
    Effects of Mindfulness Training on Body Awareness to Sexual Stimuli: Implications for Female Sexual Dysfunction. 
    Psychosomatic Medicine. 2011;73(9):817-825.

  21. Slavin MN, Kraus SW, Ecker A, et al. 
    Marijuana Use, Marijuana Expectancies, and Hypersexuality among College Students. 
    Sex Addict Compulsivity. 2017;24(4):248-256.

  22. Slavin MN, Scoglio AAJ, Blycker GR, Potenza MN, Kraus SW. 

  23. Child Sexual Abuse and Compulsive Sexual Behavior: A Systematic Literature Review. 
    Current Addiction Reports. 2020;7(1):76-88.

  24. Stapleton P, Luiz G, Chatwin H. 
    Generation Validation: The Role of Social Comparison in Use of Instagram Among Emerging Adults. 
    Cyberpsychol Behav Soc Netw. 2017;20(3):142-149.

  25. Sun C, Bridges A, Johnson JA, Ezzell MB. 
    Pornography and the Male Sexual Script: An Analysis of Consumption and Sexual Relations. 
    Arch Sex Behav. 2016;45(4):983-994.

  26. Tamplin NC, McLean SA, Paxton SJ. 
    Social media literacy protects against the negative impact of exposure to appearance ideal social media images in young adult women but not men. 
    Body Image. 2018;26:29-37.

  27. Torstveit L, Sutterlin S, Lugo RG. 
    Empathy, Guilt Proneness, and Gender: Relative Contributions to Prosocial Behaviour. 
    Eur J Psychol. 2016;12(2):260-270.

  28. Turban JL, Shirk SD, Potenza MN, Hoff RA, Kraus SW. 
    Posting Sexually Explicit Images or Videos of Oneself Online Is Associated With Impulsivity and Hypersexuality but Not Measures of Psychopathology in a Sample of US Veterans. 
    J Sex Med. 2020;17(1):163-167.

  29. Vogel EF, Bell NW. 
    The emotionally disturbed child as the family scapegoat. 
    Can J Psychiatr Nurs. 1969;10(3):5-14.

  30. Whiffen VE, Macintosh HB. 
    Mediators of the link between childhood sexual abuse and emotional distress: a critical review. Trauma Violence Abuse. 2005;6(1):24-39.

  31. Yoder KJ, Decety J. 
    The neuroscience of morality and social decision-making. 
    Psychology, Crime & Law. 2018;24(3):279-295.

  32. Zollman G, Rellini A, Desrocher D.
    The mediating effect of daily stress on the sexual arousal function of women with a history of childhood sexual abuse.
    J Sex Marital Ther. 2013;39(2):176-192.
MINDFULNESS
  1. Amihai I, Kozhevnikov M.
    Arousal vs. relaxation: a comparison of the neurophysiological and cognitive correlates of Vajrayana and Theravada meditative practices.
    PLoS One. 2014;9(7):e102990.


  2. Amihai I, Kozhevnikov M.
    The Influence of Buddhist Meditation Traditions on the Autonomic System and Attention.
    BioMed Research International. 2015;2015:731579.


  3. Bechara A, Naqvi N.
    Listening to your heart: interoceptive awareness as a gateway to feeling.

    Nature Neuroscience. 2004;7(2):102-103.

  4. Blycker GR, Potenza MN.
    A mindful model of sexual health: A review and implications of the model for the treatment of individuals with compulsive sexual behavior disorder.
    J Behav Addict. 2018;7(4):917-929.


  5. Boll S, Gamer M.
    Psychopathic traits affect the visual exploration of facial expressions.
    Biol Psychol. 2016;117:194-201.


  6. Critchley HD, Garfinkel SN.
    Interoception and emotion.
    Curr Opin Psychol. 2017;17:7-14.


  7. Gabriel MG, Curtiss J, Hofmann SG, Khalsa SBS.
    Kundalini Yoga for Generalized Anxiety Disorder: An Exploration of Treatment Efficacy and Possible Mechanisms.
    International Journal of Yoga Therapy. 2018;28(1):97-105.


  8. Garfinkel SN, Seth AK, Barrett AB, Suzuki K, Critchley HD.
    Knowing your own heart: distinguishing interoceptive accuracy from interoceptive awareness. Biol Psychol. 2015;104:65-74.


  9. Jung WM, Ryu Y, Lee YS, Wallraven C, Chae Y.
    Role of interoceptive accuracy in topographical changes in emotion-induced bodily sensations. PLoS One. 2017;12(9):e0183211.


  10. Kane MJ, Gross GM, Chun CA, et al.
    For Whom the Mind Wanders, and When, Varies Across Laboratory and Daily-Life Settings. Psychol Sci. 2017;28(9):1271-1289.


  11. Leavitt CE, Lefkowitz ES, Waterman EA.
    The role of sexual mindfulness in sexual wellbeing, Relational wellbeing, and self-esteem.
    J Sex Marital Ther. 2019;45(6):497-509.


  12. Lin CY, Potenza MN, Brostrom A, Blycker GR, Pakpour AH.
    Mindfulness-based cognitive therapy for sexuality (MBCT-S) improves sexual functioning and intimacy among older women with epilepsy: A multicenter randomized controlled trial.
    Seizure. 2019;73:64-74.


  13. Loizzo JJ.
    The subtle body: an interoceptive map of central nervous system function and meditative mind-brain-body integration.
    Ann N Y Acad Sci. 2016;1373(1):78-95.


  14. Novembre G, Zanon M, Morrison I, Ambron E.
    Bodily sensations in social scenarios: Where in the body?
    PLoS One. 2019;14(6):e0206270.


  15. Price C.
    Body-oriented therapy in recovery from child sexual abuse: an efficacy study.
    Altern Ther Health Med. 2005;11(5):46-57.


  16. Seth AK, Friston KJ.
    Active interoceptive inference and the emotional brain.
    Philos Trans R Soc Lond B Biol Sci. 2016;371(1708).


  17. Silverstein RG, Brown A-CH, Roth HD, Britton WB.
    Effects of Mindfulness Training on Body Awareness to Sexual Stimuli: Implications for Female Sexual Dysfunction.
    Psychosomatic Medicine. 2011;73(9):817-825.


  18. Smith GK, Mills C, Paxton A, Christoff K.
    Mind-wandering rates fluctuate across the day: evidence from an experience-sampling study.
    ​Cogn Res Princ Implic. 2018;3(1):54.
    ​​
ABUSEs OF POWER
  1. Anderson SK.
    An awakening to privilege, oppression, and discrimination: Sharon’s story.
    In: Anderson SK, Middleton VA, eds. Explorations in diversity: Examining the complexities of privilege, discrimination, and oppression. Oxford University Press; 2018:3-8.


  2. Birdsell B.
    Reevaluating Gag Orders and Rape Shield Laws in the Internet Age: How Can We Better Protect Victims?
    Seton Hall Legislative Journal. 2014;38(1).


  3. Chirwa ED, Sikweyiya Y, Addo-Lartey AA, et al.
    Prevalence and risk factors of physical or sexual intimate violence perpetration amongst men in four districts in the central region of Ghana: Baseline findings from a cluster randomised controlled trial. PLoS One. 2018;13(3):e0191663.


  4. Cormack D, Stanley J, Harris R.
    Multiple forms of discrimination and relationships with health and wellbeing: findings from national cross-sectional surveys in Aotearoa/New Zealand.
    Int J Equity Health. 2018;17(1):26.


  5. Costagliola M.
    Fires in history: the cathar heresy, the inquisition and brulology.
    Ann Burns Fire Disasters. 2015;28(3):230-234.


  6. Decety J, Yoder KJ.
    Empathy and motivation for justice: Cognitive empathy and concern, but not emotional empathy, predict sensitivity to injustice for others.
    Soc Neurosci. 2016;11(1):1-14.


  7. Eaton AA, Jacobs H, Ruvalcaba Y. 2017
    Nationwide Online Study of Nonconsensual Porn Victimization and Perpetration A Summary Report.
    Cyber Civil Rights Initiative, Inc.: Florida International University, Department of Psychology;2017.


  8. Farley M, Banks ME, Ackerman RJ, Golding JM.
    Screening for Traumatic Brain Injury in Prostituted Women. Dignity: A Journal on Sexual Exploitation and Violence.
    2018;3(2).


  9. Fritz N, Malic V, Paul B, Zhou Y.
    Worse Than Objects: The Depiction of Black Women and Men and Their Sexual Relationship in Pornography.
    Gender Issues. 2020.


  10. Gasso AM, Klettke B, Agustina JR, Montiel I.
    Sexting, Mental Health, and Victimization Among Adolescents: A Literature Review.
    Int J Environ Res Public Health. 2019;16(13).


  11. Gravelin CR, Biernat M, Bucher CE.
    Blaming the Victim of Acquaintance Rape: Individual, Situational, and Sociocultural Factors.

    Front Psychol. 2018;9:2422.


  12. Hoskin RA.
    "Femininity? It's the Aesthetic of Subordination": Examining Femmephobia, the Gender Binary, and Experiences of Oppression Among Sexual and Gender Minorities.
    Arch Sex Behav. 2020.


  13. Jewkes R, Fulu E, Tabassam Naved R, et al.
    Women's and men's reports of past-year prevalence of intimate partner violence and rape and women's risk factors for intimate partner violence: A multicountry cross-sectional study in Asia and the Pacific.
    PLoS Med. 2017;14(9):e1002381.


  14. Jewkes R, Sikweyiya Y, Morrell R, Dunkle K.
    Gender inequitable masculinity and sexual entitlement in rape perpetration South Africa: findings of a cross-sectional study.
    PLoS One. 2011;6(12):e29590-e29590.


  15. Kellie DJ, Blake KR, Brooks RC.
    What drives female objectification? An investigation of appearance-based interpersonal perceptions and the objectification of women.
    PLoS One. 2019;14(8):e0221388.


  16. Moradi B, Tebbe EA, Connelly KE, Lenzen AL, Flores MJ.
    Objectification of sexual minority women: Responses, consequences, and resistance.
    J Couns Psychol. 2019;66(5):519-533.


  17. Sikweyiya Y, Addo-Lartey AA, Alangea DO, et al.
    Patriarchy and gender-inequitable attitudes as drivers of intimate partner violence against women in the central region of Ghana.
    BMC Public Health. 2020;20(1):682.


  18. Slavin MN, Scoglio AAJ, Blycker GR, Potenza MN, Kraus SW.
    Child Sexual Abuse and Compulsive Sexual Behavior: A Systematic Literature Review. Current Addiction Reports. 2020;7(1):76-88.


  19. Stuewig J, Tangney JP, Heigel C, Harty L, McCloskey L.
    Shaming, Blaming, and Maiming: Functional Links Among the Moral Emotions, Externalization of Blame, and Aggression.
    J Res Pers. 2010;44(1):91-102.


  20. Tebbe EA, Moradi B, Connelly KE, Lenzen AL, Flores M.
    "I don't care about you as a person": Sexual minority women objectified.
    J Couns Psychol. 2018;65(1):1-16.


  21. Vogel EF, Bell NW.
    The emotionally disturbed child as the family scapegoat.
    Can J Psychiatr Nurs. 1969;10(3):5-14.


  22. Yoder KJ, Decety J.
    ​The neuroscience of morality and social decision-making.
    ​Psychology, Crime & Law. 2018;24(3):279-295.
SUBTLE BODY ENERGY ​
  1. ​Gabriel MG, Curtiss J, Hofmann SG, Khalsa SBS. 
    Kundalini Yoga for Generalized Anxiety Disorder: An Exploration of Treatment Efficacy and Possible Mechanisms. 
    International Journal of Yoga Therapy. 2018;28(1):97-105.
  2. Jindani F, Turner N, Khalsa SB. 
    A Yoga Intervention for Posttraumatic Stress: A Preliminary Randomized Control Trial. 
    Evid Based Complement Alternat Med. 2015;2015:351746.

  3. Loizzo JJ. 
    The subtle body: an interoceptive map of central nervous system function and meditative mind-brain-body integration. 
    Ann N Y Acad Sci. 2016;1373(1):78-95.

  4. Shannahoff-Khalsa D, Fernandes RY, Pereira CAB, et al. 
    Kundalini Yoga Meditation Versus the Relaxation Response Meditation for Treating Adults With Obsessive-Compulsive Disorder: A Randomized Clinical Trial. 
    Front Psychiatry. 2019;10:793.

  5. Taylor S. 
    Energy and Awakening: A Psycho-Sexual Interpretation of Kundalini Awakening. 
    The Journal of Transpersonal Psychology. 2015;47(2).

  6. Thursby GR. 
    The Power of Tantra: Religion, Sexuality and the Politics of South Asian Studies. 
    By Hugh B. Urban. The Journal of Hindu Studies. 2012;5(3):306-307.

  7. Venkatraman A, Nandy R, Rao SS, Mehta DH, Viswanathan A, Jayasundar R. 
    Tantra and Modern Neurosciences: Is there any Correlation? 
    Neurol India. 2019;67(5):1188-1193.
SEXUAL HARM
​
  1. Abrams D, Viki GT, Masser B, Bohner G.
    Perceptions of stranger and acquaintance rape: the role of benevolent and hostile sexism in victim blame and rape proclivity.
    J Pers Soc Psychol. 2003;84(1):111-125.


  2. Badour CL, Feldner MT.
    Trauma-related reactivity and regulation of emotion: associations with posttraumatic stress symptoms.
    J Behav Ther Exp Psychiatry. 2013;44(1):69-76.


  3. Belu CF, O’Sullivan LF.
    Once a Poacher Always a Poacher? Mate Poaching History and its Association with Relationship Quality.
    The Journal of Sex Research. 2020;57(4):508-521.


  4. Bridges AJ, Wosnitzer R, Scharrer E, Sun C, Liberman R.
    Aggression and sexual behavior in best-selling pornography videos: a content analysis update. Violence Against Women. 2010;16(10):1065-1085.


  5. Cantón-Cortés D, Cortés MR, Cantón J.
    Pathways from childhood sexual abuse to trait anxiety.
    Child Abuse Negl. 2019;97:104148.


  6. Carey KB, Durney SE, Shepardson RL, Carey MP.
    Incapacitated and forcible rape of college women: prevalence across the first year.
    J Adolesc Health. 2015;56(6):678-680.


  7. Carrotte ER, Davis AC, Lim MS.
    Sexual Behaviors and Violence in Pornography: Systematic Review and Narrative Synthesis of Video Content Analyses.
    J Med Internet Res. 2020;22(5):e16702.


  8. Chirwa ED, Sikweyiya Y, Addo-Lartey AA, et al.
    Prevalence and risk factors of physical or sexual intimate violence perpetration amongst men in four districts in the central region of Ghana: Baseline findings from a cluster randomised controlled trial.
    PLoS One. 2018;13(3):e0191663.


  9. Dale LP, Shaikh SK, Fasciano LC, Watorek VD, Heilman KJ, Porges SW.
    College females with maltreatment histories have atypical autonomic regulation and poor psychological wellbeing.
    Psychol Trauma. 2018;10(4):427-434.


  10. Dworkin ER, Menon SV, Bystrynski J, Allen NE.
    Sexual assault victimization and psychopathology: A review and meta-analysis.
    Clin Psychol Rev. 2017;56:65-81.


  11. Eaton AA, Jacobs H, Ruvalcaba Y.
    2017 Nationwide Online Study of Nonconsensual Porn Victimization and Perpetration A Summary Report.
    Cyber Civil Rights Initiative, Inc.: Florida International University, Department of Psychology;2017.


  12. Farley M, Banks ME, Ackerman RJ, Golding JM.
    Screening for Traumatic Brain Injury in Prostituted Women. Dignity: A Journal on Sexual Exploitation and Violence.
    2018;3(2).


  13. Gasso AM, Klettke B, Agustina JR, Montiel I.
    Sexting, Mental Health, and Victimization Among Adolescents: A Literature Review.
    Int J Environ Res Public Health. 2019;16(13).


  14. Gasso AM, Mueller-Johnson K, Montiel I.
    Sexting, Online Sexual Victimization, and Psychopathology Correlates by Sex: Depression, Anxiety, and Global Psychopathology.
    Int J Environ Res Public Health. 2020;17(3).


  15. Herbenick D, Bartelt E, Fu TJ, et al.
    Feeling Scared During Sex: Findings From a U.S. Probability Sample of Women and Men Ages 14 to 60.
    J Sex Marital Ther. 2019;45(5):424-439.


  16. Herzog S, D'Andrea W, DePierro J, Khedari V.
    When stress becomes the new normal: Alterations in attention and autonomic reactivity in repeated traumatization.
    J Trauma Dissociation. 2018;19(3):362-381.


  17. Jewkes R, Fulu E, Tabassam Naved R, et al.
    Women's and men's reports of past-year prevalence of intimate partner violence and rape and women's risk factors for intimate partner violence: A multicountry cross-sectional study in Asia and the Pacific.
    PLoS Med. 2017;14(9):e1002381.


  18. Jewkes R, Sikweyiya Y, Morrell R, Dunkle K.
    Gender inequitable masculinity and sexual entitlement in rape perpetration South Africa: findings of a cross-sectional study.
    PLoS One. 2011;6(12):e29590-e29590.


  19. McClure MM, Parmenter M.
    Childhood Trauma, Trait Anxiety, and Anxious Attachment as Predictors of Intimate Partner Violence in College Students.
    J Interpers Violence. 2017:886260517721894.


  20. Tebbe EA, Moradi B, Connelly KE, Lenzen AL, Flores M.
    "I don't care about you as a person": Sexual minority women objectified.
    J Couns Psychol. 2018;65(1):1-16.


  21. Whiffen VE, Macintosh HB.
    Mediators of the link between childhood sexual abuse and emotional distress: a critical review.
    Trauma Violence Abuse. 2005;6(1):24-39.


  22. 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;66(1):183-205.


  23. Zollman G, Rellini A, Desrocher D.
    The mediating effect of daily stress on the sexual arousal function of women with a history of childhood sexual abuse.
    ​J Sex Marital Ther. 2013;39(2):176-192.
SEXUALLY EXPLICIT MATERIAL
  1. Bothe B, Toth-Kiraly I, Potenza MN, Orosz G, Demetrovics Z. 
    High-Frequency Pornography Use May Not Always Be Problematic. 
    J Sex Med. 2020;17(4):793-811.

  2. Brand M, Blycker GR, Potenza MN. 
    When Pornography Bcomes a Problem: Clinical Insights. 
    In. Psychiatric Times.Vol 362019.

  3. Bridges AJ, Wosnitzer R, Scharrer E, Sun C, Liberman R. 
    Aggression and sexual behavior in best-selling pornography videos: a content analysis update.
    Violence Against Women. 2010;16(10):1065-1085.

  4. Carrotte ER, Davis AC, Lim MS. 
    Sexual Behaviors and Violence in Pornography: Systematic Review and Narrative Synthesis of Video Content Analyses. 
    J Med Internet Res. 2020;22(5):e16702.

  5. Fritz N, Malic V, Paul B, Zhou Y. 
    Worse Than Objects: The Depiction of Black Women and Men and Their Sexual Relationship in Pornography. 
    Gender Issues. 2020.

  6. Grubbs JB, Kraus SW, Perry SL.
    Self-reported addiction to pornography in a nationally representative sample: The roles of use habits, religiousness, and moral incongruence.
    J Behav Addict. 2019;8(1):88-93.

  7. Grubbs JB, Perry SL, Wilt JA, Reid RC. 
    Pornography Problems Due to Moral Incongruence: An Integrative Model with a Systematic Review and Meta-Analysis. 
    Arch Sex Behav. 2019;48(2):397-415.

  8. Johnson JA, Ezzell MB, Bridges AJ, Sun CF. 
    Pornography and Heterosexual Women's Intimate Experiences with a Partner. 
    J Womens Health (Larchmt). 2019;28(9):1254-1265.

  9. Mestre-Bach G, Blycker GR, Potenza MN.
    Pornography use in the setting of the COVID-19 pandemic. 
    J Behav Addict. 2020.

  10. Park BY, Wilson G, Berger J, et al. 
    Is Internet Pornography Causing Sexual Dysfunctions? A Review with Clinical Reports.
     
    Behav Sci (Basel). 2016;6(3).

  11. Perry SL, Schleifer C. 
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  12. Stewart DN, Szymanski DM. 
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    Sex Roles. 2012;67(5-6):257-271.

  13. Sun C, Bridges A, Johnson JA, Ezzell MB. 
    Pornography and the Male Sexual Script: An Analysis of Consumption and Sexual Relations. 
    Arch Sex Behav. 2016;45(4):983-994.

  14. 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;66(1):183-205.​​
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