Research Spotlight

Body Image, Depression, and Self-Perceived Pornography Addiction in Italian Gay and Bisexual Men: The Mediating Role of Relationship Satisfaction

Massimiliano Sommantico et al.

Mediterranean Journal of Clinical Psychology 9, no. 1 (2021): 1-19, doi:10.6092/2282-1619/mjcp-2758.

Key Takeaway:

Prior research has revealed that problematic pornography use has a negative impact on relationship satisfaction among heterosexual people. This study explored the psychological and social effects of problematic Internet pornography use on Italian gay and bisexual men, finding that gay and bisexual men reporting greater problematic pornography use were more likely to report dissatisfaction with their intimate relationships, higher dissatisfaction with their bodies, and were more likely to be depressed. Importantly, the researchers noted that depressed gay and bisexual men may be at risk for problematic pornography use due to lower levels of relationship satisfaction.

Study Highlights

Few studies have investigated the possible psychological and social effects of pornography consumption on gay and bisexual men. This study sought to fill that gap by examining gay and bisexual men’s self-perceived problematic pornography use (SPPPU). SPPPU is defined as “a self-identification addiction to pornography by individuals with dysfunctional online behaviors, characterized by uncontrolled, compulsive, and excessive use of pornographic online content” and is associated with psychological distress and relational difficulties.1

SPPPU was evaluated using responses to the Cyber Pornography Addiction Test, an 11-point self-report test which asks for responses to statements such as “I told myself to stop using online pornography, but I didn’t succeed,” “I get sexually aroused only when I watch online pornography,” and “I have continued watching porn sites despite some negative consequences.”2 Respondents rated their responses on a 5-point Likert type scale ranging from 1 (Never) to 5 (Always).

The subjects in this study were 158 Italian gay (65.8%) and bisexual (34.2%) men who were in a stable relationship lasting at least 6 months. Participants had been in a stable relationship for an average of 91.6 months, with 38% cohabiting, 22.2% in a civil union, and 15.2% in an open relationship. Data was collected through an Internet-based survey that assessed Internet pornography use, body image, and individual and relational wellbeing.


  • Relationship Satisfaction Strongly and Negatively Related to Body Image, Depression, and SPPPU: There was a strong negative correlation between the degree participants were satisfied with their relationships and the variables of body image, depression, and SPPPU. In other words, those with the most unsatisfying relationships were the most likely to report higher levels of negative body image, depression, and SPPPU.
  • Low Relationship Satisfaction, Negative Body Image, and Depression Predict SPPPU: Lower levels of relationship satisfaction, negative body image, and higher levels of depression were all correlated with higher levels of SPPPU in gay and bisexual men.
  • Strong Positive Relationship between SPPPU, Negative Body Image, and Depression: The results of this study also revealed a strong positive relationship between gay and bisexual men’s problematic pornography consumption and higher levels of body dissatisfaction and higher rates of depression. The finding of a “positive relationship” between these variables means that the variables move in tandem with each other. As body dissatisfaction and depression increase, so does SPPPU, and as body dissatisfaction and depression decrease, so does SPPPU. This finding is in line with previous research which has demonstrated that pornography use is highly correlated with both body dissatisfaction and depression.
  • Relationship Length Negatively Related to Body Dissatisfaction, Depression, and SPPPU: Participants in longer relationships were significantly less likely to report body dissatisfaction, depression, and SPPPU. Researchers hypothesized that long-lasting and satisfying couple relationships were “an important protective factor for individual wellbeing.”3
  • Religiosity Not Correlated with SPPPU: Also of note, there were no statistically significant differences in the outcomes of the study based on differing degrees of religiosity among the study’s participants.


In line with research on heterosexual individuals, this study showed that certain negative impacts associated with pornography use also extend to gay and bisexual men.

First, the results “strongly support the hypothesis of a negative correlation between relationship satisfaction and SPPPU in gay and bisexual men.”4 Poor relationship quality was strongly associated with higher SPPPU. Highlighting previous work by Peter and Valkenburg (2010),5 Sommantico et al. noted that problematic use of pornography may be a maladaptive way to “escape from an unsatisfying individual and relational life.”6

Second, the results found a strong positive association between gay men’s pornography consumption and unhappiness with their body image, as well as depression. The authors noted that this result corresponds with Social Comparison Theory7 framework because as gay and bisexual men view pornography of men with muscular (i.e., “mesomorphic”) builds, they may negatively compare themselves to the “ideal” bodies of men portrayed in gay male pornography. Similarly, using Objectification Theory,8 the authors suggested that gay and bisexual men who consume pornography may “self-objectify” resulting in increased dissatisfaction with their bodies. To self-objectify means that an individual places more value on how they look to others rather than on how they feel or what they can do.9

Additionally, this study reported a direct effect of depression on SPPPU, as well as an indirect effect of depression on SPPPU through relationship satisfaction. The authors stated, “Specifically, our results indicate that depressed gay and bisexual men may be at risk for SPPPU, due to lower levels of relationship satisfaction.”10

In summary, problematic Internet pornography use was found to play a pivotal, negative role in relationship satisfaction among gay and bisexual men, as well as their individual psychological wellbeing. High relationship satisfaction was related to a positive body image, low depression, and low problematic Internet pornography consumption. Conversely, gay and bisexual men reporting greater problematic pornography use were more likely to report dissatisfaction with their intimate relationships, higher dissatisfaction with their bodies, and were more likely to be depressed.

Before closing it is important to make connections with other, noteworthy research which has shown harms to relationships associated with pornography use. For instance, Sun et al. (2013) found that among heterosexual men and women, the more pornography a man watched, the more likely he was to deliberately conjure images of pornography during sex to maintain arousal, and to experience decreased enjoyment of intimate behaviors with a partner.11 In a separate study of 405 sexually active men and women who had viewed pornography, frequency of pornography consumption was directly related to a relative preference for pornographic rather than partnered sexual excitement. This preference, as well as devaluing sexual communication, was associated with less sexual satisfaction for both men and women.12

To review, taken together these studies found that increased pornography use generally—rather than pornography use within the confines of SPPPU—was associated with the following impacts including:

  • a necessity for the mental integration of pornography during partnered sex,
  • a preference for pornography-based rather than partner-based sexual activity,
  • a devaluing of sexual communication, and
  • the decreased enjoyment of sex with a partner.

These findings demonstrate important, adverse impacts of pornography use on relationship quality that were not explicitly explored in Sommantico et al. We suggest that these are four topic areas relating to the role of pornography use on relationship quality worthy of further research, especially among sexual minority groups.


1 Massimiliano Sommantico et al., “Body Image, Depression, and Self-Perceived Pornography Addiction in Italian Gay and Bisexual Men: The Mediating Role of Relationship Satisfaction,” Mediterranean Journal of Clinical Psychology 9, no. 1 (2021): 2doi:10.6092/2282-1619/mjcp-2758. 

2 Marco Cacioppo et al., “Cyber Pornography Addiction Test (CYPAT),” APA Psyc Tests (2018), doi:10.1037/t66951-000. 

3 Sommantico et al., ibid, 10. 

4 Ibid. 

5 Jochen Peter and Patti M. Valkenburg, “Processes Underlying the Effects of Adolescents’ Use of Sexually Explicit Internet Material: The Role of Perceived Realism,” Communication Research 37, no. 3 (2010): 375–399, doi:10.1177/0093650210362464. 

6 Sommantico et al., ibid, 10. 

7 Leon Festinger, “A Theory of Social Comparison Processes,” Human Relations 7, no. 2 (1954): 117–140, doi:10.1177/001872675400700202.

8 Barbara L. Fredickson and Tomi-Ann Roberts, “Objectification Theory: Toward Understanding Women’s Lived Experiences and Mental Health Risks,” Psychology of Women Quarterly 21 (1997): 173–206, doi:10.1111/j.1471-6402.1997.tb00108.x.

9 Self-objectification is the process of adopting “a third-person perspective on the self as opposed to a first-person perspective” such that individuals place greater value on how they look to others rather than on how they feel or what they can do. See: R.M. Calogero, “Objectification Theory, Self-Objectification, and Body Image,” Encyclopedia of Body Image and Human Appearance (2012): 574-80, doi:10.1016/b978-0-12-384925-0.00091-2.

10 Sommantico et al., ibid, 11.

11 Chyng Sun, Ana Bridges, Jennifer A. Johnson, and Matt Ezzell, “Pornography and the Male Sexual Script: An Analysis of Consumption and Sexual Relations,” Archives of Sexual Behavior 45, no. 4 (2014): 983–994doi:10.1007/s10508-014-0391-2.

12 Paul J. Wright et al., “Associative Pathways between Pornography Consumption and Reduced Sexual Satisfaction,” Sexual and Relationship Therapy (2017): 1-18, doi:10.1080/14681994.2017.1323076. 


Defend Human Dignity. Donate Now.

Defend Dignity.
Donate Now.