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The Opponent Process Model of Problematic Pornography Use: Building a Foundation for Adaptive Digital Interventions

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Thesis(6.98 MB)

Date

2024

Authors

Supervisor

Donkin, Liesje
Pedersen, Mangor
Williams, Matt

Item type

Thesis

Degree name

Doctor of Philosophy

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Publisher

Auckland University of Technology

Abstract

Concerns are rising among mental health professionals and researchers about the effects of unrestricted pornography use, especially for those who experience moral incongruence related to pornography use. Mobile applications designed to address problematic pornography use (PPU) may provide a suitable alternative for those who would prefer not to discuss their pornography use with a therapist. However, there is a lack of literature examining the effectiveness of these applications. To evaluate the available options for these individuals, I began by conducting a content analysis of mobile apps in the iOS and Google Play stores, focusing on their purpose, features, and popularity. From the 170 apps analysed, the most common features were relapse tracking, tutorials and coaching, accountability partners, content blocking and monitoring, and reward systems for abstinence progress. Yet while each feature appears to provide a unique benefit for reducing pornography use, there is a lack of evidence in the literature for the effectiveness of any of these apps in managing PPU. A significant challenge in developing effective apps is the limited understanding of how, and over what timescales, pornography use may impact mental health. To address this gap, I proposed a novel modelling paradigm called behavioural posology, which quantifies the 'dose' of repeatable behaviours using four components: Potency, Amount, Frequency, and Duration. Using this paradigm, I simulated an opponent process model of pornography use, in which the behaviour triggers two opposing processes: a pleasurable a-process and a negative b-process. In this model, moral incongruence is a moderating factor that amplifies the b-process, leading to more rapid allostasis and greater harm to mental health. Using simulated data from a pharmacokinetic/pharmacodynamic model of pornography use, the model accurately predicted several features of behavioural addiction, such as hedonic allostasis, withdrawal, and apparent tolerance. To test the empirical accuracy of the opponent process model of pornography use, I conducted an Ecological Momentary Assessment (EMA) study to quantify the temporal dynamics produced by pornography use. EMA data was collected from 22 participants, who were divided into low and high moral incongruence groups. Results showed that pornography use and masturbation were followed by negative affective states that decayed in an approximately exponential fashion, as predicted by the opponent process model. Participants with high moral incongruence experienced increases in guilt, shame, loneliness, and difficulty thinking, along with decreases in mood and relationship connectedness, either before or after sexual episodes. Additionally, opponent process dynamics were observed in the mood of high moral incongruence participants, suggesting a potential mechanism that may explain the link between PPU and depressed mood for certain individuals. In conclusion, behavioural posology was developed as a theoretical framework for hypothesising and testing the temporal dynamics of addictive and compulsive behaviours such as pornography use. As such, this research provides new insights into the potential causal mechanisms behind PPU, which may help to guide the future creation of mobile applications for treating PPU that are adaptable to the individual’s momentary needs.

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http://hdl.handle.net/10292/19484

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Doctoral Theses