One in Ten Swedish Teens Report Losing Control Over Pornography Use

A sweeping study of more than 3,000 Swedish high school students has found that roughly one in ten adolescents reports a distressing loss of control over their pornography use, a condition researchers call problematic pornography use, or PPU. The figure conceals a stark gender divide: nearly one in five boys reported such difficulties, compared with fewer than one in twenty-five girls. The findings, published in Archives of Sexual Behavior, offer one of the most detailed portraits yet of how compulsive patterns of sexual media consumption emerge during adolescence, a period that many adults treated for compulsive sexual behavior disorder identify as the starting point of their struggles.

Problematic pornography use is considered the most common clinical manifestation of compulsive sexual behavior disorder, a diagnosis formally included in the eleventh revision of the International Classification of Diseases. The disorder is defined not by how often someone watches pornography but by a persistent inability to control repetitive sexual urges and behaviors, coupled with personal distress. International surveys across 42 countries have estimated PPU prevalence among adults at between 3.2 and 16.6 percent, but adolescents have remained largely understudied, even though impaired control over consumption appears to predict future problematic use and many adult patients trace their difficulties back to their teenage years.

The new research drew on the fourth national Swedish study of adolescent sexuality and exposure to sexual assault and exploitation. Researchers from Karolinska Institutet, Marie Cederschiöld University and Linköping University selected a stratified, representative sample of 210 schools using the national education register, collecting data between December 2019 and March 2021, with a pandemic-related interruption that forced a shift from classroom surveys to a digital platform. The final analytical sample comprised 3,106 third-year senior high school students, 1,369 boys and 1,737 girls, with a median age of 18. Participants answered 112 main questions covering sociodemographics, sexuality, alcohol and drug use, abusive experiences, psychological well-being and internet use.

Crucially, the study defined PPU by self-perceived impaired control rather than frequency alone. Adolescents who rated either statement, that it was difficult to refrain from watching pornography or difficult to stop once started, at four or higher on a five-point agreement scale were classified as having PPU. This distinction matters clinically, because frequency of use by itself does not indicate pathology; a teenager who watches pornography often but feels fully in control differs fundamentally from one who watches rarely yet experiences the consumption as uncontrollable and distressing. In total, 324 participants, 257 boys and 67 girls, met the study’s threshold.

The behavioral profile of adolescents with PPU diverged sharply from their peers. Nearly half of the boys with PPU reported watching pornography more or less daily, compared with 16.1 percent of boys in the reference group, and both genders with PPU spent substantially longer per session. The content itself also differed: violent or coercive pornography was consumed by 37.3 percent of girls with PPU versus 11.8 percent of reference girls, and by 26.1 percent of boys with PPU versus 8.7 percent of reference boys. Lifetime use of sexual material involving children or animals was reported by roughly one in ten of the PPU groups, around three times the rate of their peers, a finding the authors interpret cautiously given that participants were themselves recently minors and the circumstances of exposure remain unclear.

Sexual experience followed strikingly different gendered pathways. Girls with PPU were more sexually experienced than reference girls, with 28.4 percent reporting more than six lifetime partners compared with 14.6 percent, and nearly 30 percent reporting a sexual debut before age 15, Sweden’s legal age of consent, versus 12.9 percent. Boys with PPU showed the opposite pattern: they were less likely to have had vaginal sex than reference boys, 51.4 versus 59.4 percent, suggesting a profile of social withdrawal in which online sexual activity substitutes for offline intimacy. Most alarmingly, 5.1 percent of boys with PPU reported exposing someone else to nonconsensual sexual acts, roughly four times the rate in the reference group, echoing adult research linking compulsive sexual behavior with coercive conduct.

Mental health and adversity emerged as central threads. Both boys and girls with PPU scored significantly higher on validated measures of emotion regulation difficulties and trauma symptoms, and reported more nonsuicidal self-injury. Nearly a quarter of girls with PPU, 23.9 percent, reported using sex as a form of self-injury, triple the reference rate. Girls with PPU also showed elevated risk behaviors: 44.8 percent reported high-risk alcohol consumption, defined by former national guidelines as four or more units on a single occasion at least monthly, and 35.8 percent reported lifetime drug use, roughly double the reference rates. Exposure to bullying, physical abuse and multiple forms of abuse was more common in both PPU groups, and girls with PPU reported more sexual abuse and grooming.

Multivariable logistic regression sharpened these patterns into distinct predictive profiles. For girls, the strongest independent predictors of PPU were being born outside Sweden, high-risk alcohol consumption and higher trauma symptom scores. The authors suggest that girls raised in environments with stricter sexual norms may experience moral incongruence, a conflict between personal disapproval of pornography and actual use, which is known to inflate self-perceived loss of control; notably, half of the girls with PPU reported only occasional use. For boys, the predictors were less sexual experience, more frequent sending of sexually explicit images, having exposed someone to nonconsensual acts, and higher trauma scores. Sociodemographic factors otherwise showed no significant associations, contrasting with studies of Israeli adolescents that linked compulsive sexual behavior to higher socioeconomic status.

The researchers emphasize that these adolescents appear to be using pornography as a coping strategy to regulate negative emotions, consistent with adult findings that compulsive sexual behavior frequently co-occurs with psychiatric comorbidity and emotion dysregulation. Although no direct association with formal psychiatric diagnoses emerged, possibly because participants were young and diagnoses take time to establish, the constellation of self-harm, trauma symptoms and substance use points to underlying vulnerability rather than simple excess. The authors argue that strengthening coping skills could benefit these youths, and that assessments should consider moral incongruence, risk behaviors and adverse childhood experiences rather than focusing narrowly on consumption itself.

The clinical implications are concrete. With PPU affecting one in ten adolescents, the authors urge professionals in schools, youth clinics and child health services to raise the topic in a balanced, destigmatizing way, particularly when other risk behaviors or emotional difficulties are present, while avoiding pathologizing normal sexual curiosity. The study’s cross-sectional design prevents conclusions about causality, and its two-item measure of PPU may not capture the construct’s full complexity, limitations the authors acknowledge alongside a possible pandemic influence on their sample. Still, the large, nationally representative school-based sample lends the findings considerable ecological validity, and the researchers call for longitudinal studies and culturally diverse replications to determine whether adolescent PPU, left unaddressed, hardens into the adult disorder that so many patients describe as having begun in their teenage years.

Subject of Research: Prevalence and correlates of self-perceived problematic pornography use among Swedish adolescents

Article Title: Problematic Pornography Use Among Swedish Adolescents: Characteristics and Clinical Implications

Article References: Piwowar, M., Jonsson, L. S., Bladh, M., Landberg, Å., Svedin, C. G., & Savard, J. (2026). Problematic Pornography Use Among Swedish Adolescents: Characteristics and Clinical Implications. Archives of Sexual Behavior. https://doi.org/10.1007/s10508-026-03544-9

Image Credits: AI Generated

DOI: 10.1007/s10508-026-03544-9

Keywords: problematic pornography use, adolescents, compulsive sexual behavior disorder, mental health, trauma symptoms, emotion regulation, gender differences, risk behaviors, sexual behavior, Sweden, self-injury, moral incongruence